In 2010, after a Democratic-controlled Congress passed and President Obama signed the Affordable Care Act, Republicans denounced what came to be known as Obamacare with critiques that were often borne out. Rep. Darrell Issa, R-Calif., for one, has long had on his website a statement ripping the law because it was “passed on a partisan vote with the rationale that we would have to pass it to find out what was in it. Now that the bill is law, the American people are finding out that what’s in it is completely contrary to what they were promised.”
Sure enough, by 2017, the GOP could claim vindication on several fronts. The ACA didn’t allow people to keep their doctors. It didn’t drive down premium costs. It gave incentives for people to game the system by buying coverage after they got sick. Dissatisfaction with the law helped propel Republicans to years of gains across much of the nation.
Yet now that the Republicans control Congress, they haven’t learned from this history at all. With Issa providing one of the final votes to put the bill over the top, House Republicans on Thursday passed the American Health Care Act — a complex bill to repeal and replace much of the ACA — on a partisan 217-213 vote. Astonishingly, they did so without knowing what was in the bill and with promises about its effects that are likely to prove untrue.
No analysis was done by the nonpartisan Congressional Budget Office before the vote so that lawmakers — and the public — would know its effects on U.S. health care. This allowed House Speaker Paul Ryan and others to frame it as a humane, less expensive reform measure that represents a huge improvement on Obamacare. As if.
Yes, it would save a great deal of money. But it doesn’t take a CBO analysis to see that as with the previous version of the bill that died without a vote, it is much more a cold-hearted spending cut than reform — and there is nothing humane about provisions that would lead to many millions of people losing access to health care. The bill would end subsidized insurance for poor and middle-income families in favor of much less generous tax credits. Its 10-year, $880 billion reduction in Medicare funding would roll back the expansion of Medicare in many states and end or limit the coverage used by many poor people, seniors and disabled children. It would allow states to seek waivers allowing them to deny coverage to people with pre-existing conditions.
The political dynamics driving the vote are clear — a Wall Street Journal editorial labeled it a “do-or-die moment for the GOP Congress” to placate the party’s base. If Republican senators have even a slightly different view, perhaps a better bill will emerge in a more open process. For now, one doesn’t have to be a fan of the Affordable Care Act or a Democrat to conclude that what happened Thursday did not represent progress toward a better America.