Jamelle Bouie: Political Malfeasance

http://www.slate.com/articles/news_and_politics/politics/2017/05/passing_trumpcare_2_0_will_be_an_unmitigated_disaster_for_the_gop.html

Political Malfeasance
Passing Trumpcare 2.0 will be an unmitigated disaster for the GOP.
By Jamelle Bouie

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After seven years of promising to repeal and replace the ACA, Republicans are certainly desperate to pass something. So desperate that they are now sprinting for the finish line as quickly as possible, forgoing customary analysis from the Congressional Budget Office to avoid controversy or second thoughts from hesitant members. These amendments—which it seems would likely worsen coverage for many—don’t change the fact that the AHCA is a political and policy disaster waiting to happen—a disaster that could undo the Republican majority in dramatic fashion.

To start, there’s the fact that the Upton amendment doesn’t do much to fix the basic problem of the AHCA and its treatment of Americans with pre-existing conditions. As my colleague Jordan Weissmann notes, that $8 billion would likely not be enough to make up for the current shortfall needed to fund the pools adequately. Indeed, it’s not even clear that this money will be used for high-risk pools. According to one report, the $8 billion is there to pay the law’s insurance penalty for consumers who were priced out of the health market on account of pre-existing conditions and thus couldn’t maintain coverage. It’s less a subsidy to individuals and more a giveaway to insurers, who could charge high penalties knowing the government will recoup the cost, to say nothing of their newfound freedom to sell junk plans. What’s more, Weissmann points out, the Upton amendment may encourage consumers to wait to buy insurance until they are sick (again, the government will pick up the penalty), destabilizing health care markets.

All of this is on top of the fact that the basic structure of the AHCA hasn't changed. It still cuts Medicaid, still defund subsidies for health insurance, and still presumably ends health insurance for more than 24 million people over the next 10 years (we can’t say for certain because, again, the Republicans still don’t have a CBO score). And all of this is in service of massive tax cuts for the wealthiest Americans, the overriding priority of Ryan and much of the House Republican caucus.

The original AHCA failed because it was an unworkable and unpopular policy, opposed by huge majorities of the public. Ryan’s boosterism aside, this new AHCA is still unworkable and, in all likelihood, still unpopular—the original bill was polling at 17 percent. Although these changes may have made the bill more palatable to conservatives, there’s no reason to expect them to move the numbers to anywhere near majority support. And that unpopularity matters: Following its introduction in March, the AHCA sparked a steep and sustained decline in Trump’s standing, which damaged the Republican Party writ large and may have contributed to the surprise strength of Democratic congressional candidates in Kansas and Georgia. House Republicans can continue their push for a bill, but they have to know that they risk genuine political disaster, to say nothing of the human costs of their bill.