Ross Douthat had an opinion piece in the New York Times this week titled “Why Republicans Can’t Do Health Care” in which he argues that the recent Ryancare proposal is disliked by everyone on the right because the right “as an organism does not know what it believes in anymore.”
It’s likely something different going on. Republicans know what they believe. They believe in power and rule by the wealthy. They’ve thrown every other past belief they’ve pretended to have overboard and there’s not much left beneath the surface (from "personal responsibility” to “family values” to “free trade” etc, etc). In order to rig the game for their powerful and wealthy donors though, they have to get elected. They have to pretend to believe in something.
Healthcare presents a dilemma: If they repeal it, they kick 20 million people off insurance. If they make changes to it, they own it. If they do nothing, as the party in control of all three branches of government, they own it. The real problem they’re facing right now is that none of the options the wealthy and corporate special interests want look very good—and they’re going to own them.
People lose health care and Republicans own it
The American Medical Association, the biggest group of doctors in the U.S., called the Ryan proposal “critically flawed."
In their letter to the House, they wrote:
More than 20 million Americans currently have health care coverage due to the Affordable Care Act (ACA) and among the AMA’s highest priorities for on-going health system reform efforts is to ensure that these individuals maintain that coverage. While we agree that there are problems with the ACA that must be addressed, we cannot support the AHCA as drafted because of the expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations.
The Congressional Budget Office estimates that the number of uninsured would increase by 18 million in the first year after enactment of the bill.
The larger problem is that there isn’t a Republican plan in existence that ensures people maintain coverage. The full repeal many want would kick 20 million people off health insurance.
Please don’t tell me that you care about “life” after taking away insurance from so many people.
Costs go up and Republicans own it
The CBO estimates that premiums will be roughly 20 to 25percent higher after the bill passes. This comes from getting rid of the penalty for not having insurance. This would reduce the number of people with insurance (especially young people) and since costs are higher for those who are older, the average cost of insurance will go up.
This could be much higher for seniors. In an interview with NPR, Jonathan Gruber, the MIT economist who helped design the ACA, said:
By one analysis, by the year 2020, those age 50 to 64 on average will pay $10,000 more a year for health insurance as a result of this law, this proposal.
The AARP and its 48 million members are against the GOP plan. They estimate that a 64-year-old would pay $8,400 more per year than they do now.
Sean Spicer tried to argue there’s less paper in the changes than there was in the original bill.
It’s okay if you pay more—so long as there’s less paper? How long can just slapping the title of “American” on the bill hide this?
People find out that there’s a massive tax cut for the rich in the bill—and Republicans own it
Wealthy Americans would no longer pay two major taxes under the Ryancare bill.
The first is a 0.9 percent tax on taxpayers earning more than $200,000 in wages ($250,000 for married couples). These households must also pay a surcharge of 3.8 percent on income from several types of investments.
These tax cuts for the rich would reduce revenue by $346 billion over the next 10 years, according to the Congressional Budget Office.
If you do nothing and people lose insurance, as the party in power, Republicans own it
It was easy to do nothing when President Obama was in office because Republicans had someone in a position of power to blame. Now, they have control of government.
Republicans have the power to make changes to the ACA laws to prevent the issues they keep bringing up: insurers leaving the market, issues with the risk management programs, etc. Republicans have the power to change things for the better. The problem, however, is that by and large, they don’t want to change things for the better. This is why they’re not even looking at solutions that would address some of the issues with the ACA.
If they can’t get something passed to fix the problems that they themselves keep bringing up, they own it. They’re already talking about blaming Democrats if they can’t get something passed. It’s going to be hard to blame Democrats, however, when you control the House, the Senate, and the Presidency.
Call to action
How is the White House pushing this then? They’re not selling it to the public. Instead, they’re threatening Republican politicians. Trump warned House Republicans that there could be a “bloodbath” in 2018 if they don’t do something about health care.
Trump doesn’t understand anything about health care. But he does understand politicians and that what they care most about is re-election.
We should be using this to our advantage. We should be reminding Republicans that they’re going to own this going forward. Yes, they will surely try to blame it on Obama somehow. But blaming Obama is going to be much harder once a Republican Congress and Republican president pass legislation.
None of my conservative friends want to own health care. It’s almost as if they’re so used to raging about what Obama did that they don’t realize they are the government now. Here’s one of our former local Republican pols after I told him that Republicans are about to own healthcare:
I don’t think he realizes that if the ACA fails, Republicans are the ones who will have let it fail. Republicans own it because they have the power to fix it.
Our president is threatening Congress with tough election fights if they don’t pass this bill that no one on the planet seems to support. Call your Congress member and remind him or her that they now own health care and that we expect them to make changes for the better.
David Akadjian is the author of The Little Book of Revolution: A Distributive Strategy for Democracy (now available as an ebook).