Higher deductibles? Check. Millions more uninsured? Check. Unaffordable plans that offer skimpy coverage? Check. Skyrocketing out-of-pocket costs? Check. The Congressional Budget Office confirmed that the Senate’s version of the House’s “mean” bill (to use Trump’s own description) is still a policy and political nightmare. We begin today’s roundup of the reaction to the CBO score with Michael Tomasky at Newsweek:
The bill is a policy monstrosity. A health-care monstrosity. It will dramatically increase the number of uninsured, by 22 million over 10 years, as you’ve heard. But it will also increase premiums for most people, at least at first. [...]
All the cable networks on Monday night led with the 22 million uninsured, because it’s the biggest number and because it’s the “out-year” projection, which is what these reports always emphasize. But politically, the far more important number is 15 million. The CBO projects that the Senate bill would create 15 million more uninsured in 2018. That’s next year. An election year.
That is to say that 68 percent of those expected to lose their coverage are going to lose it in the bill’s first year. The Republicans are gonna throw 15 million Americans off the insurance rolls in an election year? That’s a lot of people. Divided by 435, it’s around 34,000 people per congressional district, but of course the distribution won’t be even, and there will be many districts—toss-up districts—where 60,000 or 80,000 people will stand to lose their coverage. And states where half a million will lose coverage. How’d you like to be a Republican incumbent House member or senator defending that next fall?
John Cassidy at The New Yorker highlights the toll the bill will take on the working poor:
Whatever Trump and the Republicans might say, these figures make it very clear that the working poor would be huge losers under the bill. One of the progressive innovations of the A.C.A.’s expansion of Medicaid was that it allowed working families who subsisted just above the poverty line to get access to health care. According to the Kaiser Family Foundation, about sixty per cent of the people who enrolled in the program were employed. Under the Senate bill (and the House bill), many of these workers, some of whom could be earning as little as fifteen thousand dollars a year, would no longer be eligible for Medicaid in a few years, and they would have to take their chances in the open market.
For them and anybody else who buys individual insurance, the outlook would be grim. The C.B.O. analysis said that premiums in the private market would rise by about twenty per cent next year, on average, because of the elimination of the individual mandate. After that, price premiums would start to fall relative to the current law, but so would the quality of insurance plans. Plans would offer fewer health services, and deductibles would rise even further. All this would happen by design.
Here’s Eugene Robinson’s take:
Republicans have no great political options here, so maybe they should just do what is right: stop sabotaging Obamacare and start working with Democrats to make it better.
The Washington Post editorial board reacts:
Republicans pre-spun the CBO score by arguing that Congress’s official scorekeepers could not be trusted. Health and Human Services Secretary Tom Price said Sunday that the CBO does “a relatively poor job on what the coverage consequences of a health plan are.” Projections are hard, but neither Mr. Price nor anyone else has produced any that are more credible. In fact, the CBO’s record on forecasting the effects of Obamacare is respectable. And its analysts would have to be fantastically wrong for either of the Republican health-care bills to look good.
Jonathan Chait takes on the Republican salesmanship on the bill, which centers around simply lying about it:
In the health-care case, what they have come up with is a simple, blunt-force denial that their plan to reduce health-care spending is anything of the sort. Fanning out on the media. Republican officials have spread word that nobody would lose any benefits at all. “We would not have individuals lose coverage,” says Health and Human Services Director Tom Price. “No one loses coverage,” echoes Republican senator Pat Toomey. “These are not cuts to Medicaid,” insists Kellyanne Conway. Even for those of us inured to the effects of right-wing propaganda, it is bizarre to watch a party attempt to carry out a major welfare-state rollback while fervently insisting the welfare state will not be rolled back a single inch.
Conservative Jennifer Rubin:
Make no mistake: This bill is about cutting Medicaid and giving tax cuts to the rich, with health care for everyone else an afterthought.
David S. Cohen at Rolling Stone calls out Republicans for their “pro-life” hypocrisy:
...then there's that 26,500 figure – the conservative estimate of the number of Americans who would die every year under an Obamacare repeal plan like the one currently before the Senate. (Other studies put the number even higher.) We know this because of research conducted in the mid-2000s in Massachusetts, which was the first state to enact a program designed to insure everyone. After the program was fully implemented, researchers determined that for every 830 people who gained health insurance, there was one less death per year.
In other contexts, the Republican Party likes to talk about being the party of life. In particular, Senate Majority Leader Mitch McConnell has a perfect record from National Right to Life, having voted with the group on every abortion-related bill it has tracked during his tenure.
If McConnell and his Republican colleagues really cared about life – if being "pro-life" were anything but a slogan meant to restrict women's rights – then they would not be pushing this legislation.
Meanwhile, Catherine Rampell at The Washington Post goes through all the ways the Senate bill undermines the Republican arguments made about health care over the years:
Principle No. 3: Give consumers more choices.
Forget making sure plans offer an adequate number of “choices” of doctors. This bill would lock millions of people out of the “choice” of Medicaid.
It would make individual market premiums, even after including subsidies, prohibitively expensive, effectively locking millions out of the “choice” of individual insurance, too.
In fact, for some unlucky people, subsidized individual plans would disappear entirely. That’s because the Senate bill says that people offered any employer coverage would become ineligible for subsidized insurance on the exchanges — even if they can’t actually afford the plan their employer offers.
Paul Waldman at The Week:
Put it all together, and it adds up to quite a feat: Republicans took the thing that makes Americans maddest about the current state of health insurance, and plan to make it much, much worse. That is, if they can pass their bill before enough people realize what's happening and rise up against it.
In short, Senator Schatz from Hawaii probably summed it up best: