By now you know the GOP House finally came up with a bill to replace Obamacare, and everyone freaked out over it. Then the Senate came up with its own version, and now everyone is freaking out about that
I’m hesitant to even post anything about it because Holy Cats, no one wants to have a rational conversation about healthcare in America. No one is interested in facts. I know this because even the fact-checkers are taking a beating from people on both sides for trying to put the AHCA and the BRCA in perspective. No one wants perspective – if yr not describing either bill as either the biggest most evil disaster ever or the end to the national nightmare known as Obamacare, FAKE NEWS!
Also, I’m not an expert on healthcare, and I generally don’t like to comment on things I don’t know that much about. But I do know a little about Congress and bills (thank you, Schoolhouse Rock), and I know a bit more about political grandstanding. So I do have a few thoughts on those.
1. Both the AHCA and BCRA are pretty clear evidence that the GOP has basically lost its collective shit over Obamacare to the point that they don’t really care what they replace it with, so long as it’s replaced. Secret drafts, fast votes, no CBO vetting – “There’s yr stupid bill, now vote! Don’t read it, YR WASTING TIME!”
I’m exaggerating, of course. But not by much. And it speaks volumes when yr party leadership is so eager to pass a bill that they don’t even care that they literally have no idea if it will work as promised or even improve the healthcare situation.
2. However, the more I think about it, the more this approach makes sense – especially now that we know the details of the BCRA/AHCA bills and their projected impact
. It doesn’t matter if they’ll improve the healthcare system because they’re not designed to improve the healthcare system or make it affordable – they're designed to dump Obamacare, slash Medicaid, cut taxes
on the wealthy and leave as much as possible to the free market. Any possible benefit to healthcare costs is incidental.
That’s not too surprising to me, because the GOP never really wanted federal healthcare reform in the first place, unless by “reform” you meant “dumping Medicaid altogether”. It wasn’t until Obama made healthcare a major issue in his 2008 campaign that they sort of felt compelled to come up with a serious alternative plan. Meanwhile, the GOP has always wanted to ditch Medicaid and other federal entitlement programs for strictly ideological reasons (welfare state, givers and takers, austerity, etc). The only reason they haven’t gutted it already – not even in the 90s when they took control of Congress and in the early 2000s when they controlled all of Congress AND the White House – is because entitlement programs are so entrenched that voters get very angry when you try to take them away. Repubs always talked a big game but in the end, no one had the political nerve to touch Medicaid.
3. The fact that they’re doing it now suggests that either the political tide has turned in their favor, or Mitch McConnell and Paul Ryan think
it has, whether because of Trump or gerrymandering or they spend too much time watching Fox News or whatever. There’s the small matter that the BCRA/AHCA bills are massively unpopular in the polls – and the CBO score won’t fix that – but, you know, fake news? Or it’s not Obamacare and that’s really the important thing, right?
Or maybe McConnell knows full well that he’s taking a major political risk with BCRA but has decided, the hell with it, this is the best chance we’re going to get and it will not get this good again. It might also be that he intentionally put the worst, most extreme bill possible out there to make the subsequent compromise look like a good deal.
Or maybe it really is mass psychosis fuelled by insane visceral and irrational hatred of all things Obama, encouraged by Trump’s apparent mission to literally undo and erase every single thing that Obama ever did in office – especially his signature accomplishment.
Honestly, I don’t know what McConnell and Ryan are thinking. But I can say with certainty that the GOP would not be writing these cockamamie bills if they believed there was any serious risk of losing power.
4. One thing I’m pretty sure they are NOT thinking is, “Ha ha ha, this bill will kill millions of poor people!” Many critics on the Left would have me believe otherwise. Sorry, no. I’m sure that’s easy to believe when you’ve already bought the meme that the GOP are literally one-dimensional evil Nazis. But I don’t think it’s true.
That doesn’t mean the bills won’t result in people losing insurance they currently have and potentially dying as a result of being unable to afford either healthcare or insurance. But it doesn’t mean the GOP intentionally wrote the bills to specifically ensure that poor people will die – which is clearly what those memes are meant to imply. Like I said, the bills aren’t really about healthcare at all. GOP legislators have their eyes on the prize of ditching Obamacare and implementing ideological austerity measures (tax and entitlement cuts) in its place. That’s it.
The worst you can say is they don’t care about negative impacts like people losing healthcare and dying. And even then, they’ll just trot out the old “personal responsibility” meme (which sounds more noble than “every crumb for himself”). Or, if yr a Fox News contributor
, you can deploy the old “c’mon, we all die someday” line (in which case let's just close all the hospitals, because why bother getting well when yr just gonna die eventually?).
That said, it’s kind of funny to see Repubs complain about liberals talking up that angle when the GOP and the Tea Party ran so hard with the “death panels” meme back when Obamacare was being crafted.
5. Anyway, we’ll see where this goes. The Senate vote has been delayed – undoubtedly to give McConnell some breathing room to put his vote-whipping skills to good use. And we may see some amendments to the current draft, although it’s possible they could make the bills even worse (like Mitch’s recent addition that if you don't buy the insurance you can no longer afford thanks to this bill, we get to penalize you for that).
But as far as I can tell, the BCRA and the AHCA are two sides of a terrible and stupid coin that create more problems than they solve.
6. But again, I don’t know much about healthcare, so I could be wrong.
7. In the interest of fairness (which no one cares about, but hey, whose blog is this?), here’s an interesting interview
with conservative health care expert Avik Roy who is very much in love with the BCRA and explains why it’s a good idea. Basically, it comes down to whether the healthcare markets work the way pro-ACA people think or the pro-BCRA people think.
I’m not saying he’s right or wrong (and I do think he’s wrong on things like dismissing the polls) – and many of his fellow conservative wonks don't agree with him
(mostly because they think it's just another version of Obamacare and not the full-on repeal they wanted) – but it’s a far better-worded defense of BCRA than any of the Senators or Fox News creatures actively pushing it.
It’s certainly better than the one I usually hear, which is usually “Obamacare is a disaster!”, followed by the explanation that the “disaster” is that it personally inconveniences them in some way – which is kind of the same as saying, “I don’t care how many people it helps – it’s not helping me, so I say we dump it entirely!”, which kind of makes them sound dickish.
I’m just saying.
Call the doctor,
This is dF