The GOP's Healthcare Woes Continue

Most Americans have had some gripe or another with the Affordable Care Act, colloquially known as Obamacare. Liberals criticized the fact that it still kept privatized health insurers making profits and was far from universal health care. Conservatives criticized the top-down mandates on businesses and the additional regulatory burdens on the healthcare industry.  Everyone criticized the higher health insurance premiums for the middle class. 

But then Republican nominee Donald Trump became president and vowed to repeal and replace Obamacare. Suddenly, a red-hot battle ensued. Liberals began supporting the controversial healthcare law and an ultra-conservative GOP replacement bill, the American Health Care Act (AHCA), died on the vine due to Republican infighting. But, as Donald Trump and Speaker of the House Paul Ryan (R-WI) vowed, the GOP alternative to Obamacare is back…and it ain’t pretty.

A month ago, the AHCA failed to gain traction because it alienated both liberal Republicans, who saw its gutting of Medicaid as cruel and draconian, and ardent conservatives, who saw it as too regulatory and liberal-friendly. Apparently, Trump and co. have decided to “fix” the problem by removing the liberal leanings and sticking to staunch conservatism. Specifically, the AHCA redux changes three prominent Obamacare provisions that were included in the failed bill last month: The “essential health benefits” provision, the “community rating” provision, and the “age rating” provision. 

The “essential benefits” provision of Obamacare required health insurance companies to provide comprehensive care in all plans. Conservatives have long criticized this as raising prices on consumers who do not need coverage for things like maternity care or physical therapy, and the GOP is looking to excise this provision in order to allow insurers to offer less comprehensive plans that have lower premiums. The “age rating” provision limits premium hikes on the elderly, but has the unpleasant effect of doing so on the young, which has also brought about lots of complaints.

But it is the “community rating” provision that brings about a potential huge thorn for Republicans looking to pass AHCA part deux: The GOP bill-writers have added an amendment to exclude themselves (members of Congress) and their staffs from the removal of this provision, which would allow health insurers to charge higher premiums for those with pre-existing conditions. Basically, those who are writing AHCA 2.0 are making sure that their own premiums don’t go up.

This news has likely not gone viral because of the mainstream media’s laser-focus on President Trump, especially as he reaches his traditional 100-day “performance review,” and the continual hijinks of North Korea. There is also the widespread misconception that members of Congress do not use Obamacare and receive, instead, some sort of luxury health insurance. In reality, members of Congress and their staffs have to purchase Obamacare plans on health insurance exchanges, just like many of their own constituents. 

Most people hearing about Republican legislators attempting to insulate themselves from their own healthcare bill would likely be shocked to discover that those lawmakers relied on Obamacare in the first place!

Frankly, news that the GOP is trying to protect its own congressmen from AHCA 2.0 should be an eye-opener for the general public. House Republicans have argued that exempting Congress from AHCA 2.0’s changes, including the removal of the “community rating” provision, is necessary due to “arcane” Senate budget rules that would require 60 votes in the Senate, rather than a simple majority of 51, to pass the bill. However, a source on the Senate Budget Committee has denied that the committee urged House Republicans to craft the exemptions.

While House Republicans may honestly be including the exemptions only to make their healthcare bill easier to pass, it definitely rankles the public. Currently, the AHCA’s new incarnation is winning little love from conservatives, with even right-leaning pundits mocking its language  Republican leadership has responded swiftly and is looking to remove the exemption, but the damage may have already been done. Even moderate Republicans trashed the bill as the “height of hypocrisy.”

Although the conservative Republican Freedom Caucus now supports the latest version of the AHCA, moderate Republicans and Republicans in swing states may be wary due to the negative publicity surrounding the Congress exemption. Combined with this negative publicity is the fact that Democrats are making unexpectedly strong inroads ahead of special elections in traditionally Republican districts. This spring, Donald Trump named a handful of GOP Representatives, and U.S. Senator Jeff Sessions (R-AL), to his cabinet, forcing special elections to be held in those districts. 

Normally, those “safe districts” would be a lock for the GOP, but Democratic challengers have won higher-than-anticipated margins in both Kansas and Georgia. While the Republicans won their usual House seat in Kansas, a runoff will occur in Georgia that could lead to a Democratic upset. Charges of Republican hypocrisy on healthcare give Dems more ammo to use in these special elections to shift increasingly-narrow margins in their favor. Flipping a few thousand Georgia voters could mean a Democrat going to Washington rather than a Republican, signaling a grim midterm season for the GOP.

Republicans in Congress need to step up their legislative game and avoid making painful errors that could hobble them in upcoming special elections and in 2018. 

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