I do not pretend to be an expert in the art/science of health care programs. I have been fortunate enough to not have to deal with the Affordable Care Act (“ACA”) personally and remain somewhat unschooled in all of its details.
But I know this much. The Republican “repeal and replace” plan, as thus far revealed, has been evaluated by the non-partisan Congressional Budget Office (“CBO”) as depriving 14 million people of health insurance in Year One, 21 million in 2020 and 24 million in 2026, compared to the number insured under the ACA. https://www.cbo.gov/publication/52486.
If you’ve been following the news, you now know that the Republican managers of this fiasco do not have the votes in the House of Representatives, assertedly the legislators “closest to the people,” to pass the American Health Care Act (“AHCA”) being promoted by Speaker Paul Ryan. There are two main sources of opposition, one a group of extreme-right ultra-conservatives who contend that the AHCA leaves too much of the ACA in place and demand more cutting of benefits. The other group is labeled “moderate Republicans,” a term that I don’t pretend to understand but they apparently think the AHCA goes too far.
Faced with apparent deadlock between those groups, the AHCA bill managers are trying, with the help of Not-My-President Trump, to negotiate with the ultra-conservatives. If such an arrangement is struck without the ultras completely caving in, which is unlikely, this approach necessarily means that the legislation will be worse than the AHCA in its present form and thus likely to deprive even more Americans of health insurance.
Note, however, that we will not know for sure by the time the bill passes. The Republicans managers are in such a rush to get this gruel passed and on to the Senate that, if some deal is struck, they may vote as early as tomorrow or Monday. This in turn means it is assured that CBO evaluation of the amended legislation will not be available to the House when it votes on what then would presumably be a “done deal” and passed.
Of course, there is the Senate and another procedural morass and fight over the governing procedures, but everyone should be clear that if the present course continues, the U.S. House of Representatives will vote on one of the most consequential pieces of legislation affecting the welfare of tens of millions without the benefit of the one neutral source of cost-benefit evaluation.
If this analysis is correct, there are no words to adequately describe the outrage being perpetrated against the American people by their elected representatives. Everyone who votes for this legislation should be turned out of office in 2018.