Blair Horner: U.S. Senate Makes Another Run At The ACA

Sep 25, 2017

If you promised to do something, but you found out that if you fulfilled your promise tens of millions of people would be hurt, and some may die, would you do it?

That’s the question facing the U.S. Senate Republicans right now.

For years, Republicans across the nation have pledged to “repeal and replace” the Affordable Care Act.  Their promise was a cynical one since they never developed a replacement. Instead, they pandered to their supporters with a promise that was empty.

But they did promise.

Now, Republicans control both Houses of the Congress and the White House.  For their supporters, it is time to deliver on that promise.

But since the pledge was never serious and merely intended to throw “red meat” to a partisan base, the Republican Congressional leadership never had to contemplate the consequences of their failure to develop a meaningful alternative to the Affordable Care Act.

When members of the House of Representatives voted to advance their “repeal and replace” plan, they did so without holding public hearings and without allowing the independent Congressional Budget Office time to analyze their replacement program.

They dramatically limited independent analysis for one reason – they knew that their plan would hurt tens of millions of Americans.  And when the Congressional Budget Office issued its review – after the Republican House members had approved it – the impact became clear: over 20 million Americans would lose their health care coverage.

And losing health care coverage can be devastating: if someone gets sick and has no coverage, they can become deathly ill; and if their family tries to pay for care, they could become bankrupt.

House Republicans knew this, but didn’t care.  A promise was a promise, no matter if it cost people their health, their income, or their lives.

On the Senate side, a similar plan was offered.  It too would have stripped away health insurance from tens of millions of Americans.  It too would have led to needless illnesses, financial ruin, and early deaths that would have resulted from its plan. 

But the Senate is a different place. The majority cannot easily steamroll their legislation through.  So the Republican leadership changed the rules to allow their so-called replacement to be considered – again with minimum public input – but the plan failed.  Republicans have a small majority in the Senate and a few members thought that a promise that would hurt millions of people was a bad promise to have made, and worse to fulfill.

Now the Senate Republican leadership is once again trying to advance a plan to strip health insurance away from millions.  This time, there is additional pressure – from wealthy campaign donors.  According to the New York Times, a wealthy Dallas businessman said he had formed a “loose-knit coalition of donors who warned senior Republicans — including Senator Mitch McConnell of Kentucky, the majority leader — that contributions would dry up if Congress did not overhaul the tax code and repeal the Affordable Care Act.”

Why would rich campaign contributors want to strip away benefits from lower income people?  We can only guess that it’s part of some ideology. But we should expect our public officials to stand up to those pressures.

Yet, weak-kneed Senators have advanced a new plan, one that not only takes away coverage from tens of millions of Americans, but is also considered unworkable by experts.  The plan is so flawed and cruel that Republican opposition from governors and a small group of U.S. Senators may doom it.

Why should Americans have to experience this spectacle?  How can a nation which currently spends far more than any nation on its health care, yet has mediocre health outcomes and millions of people still without health insurance – have as its top domestic debate plans to make things worse?  All because elected officials have not been interested in telling the truth.

“Repeal and replace” is a fraud.  It appears that all some donors, activists and the Congressional leadership want is repeal.  They don’t seem to care about who gets hurt. 

Blair Horner is executive director of the New York Public Interest Research Group.

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