The New Republic has a thoughtful piece examining the potential consequences of the GOP's healthcare repeal bill on someone who becomes the victim of a shooting, requires extensive care, and thank goodness, survives that attack, as Republican Congressman Steve Scalise hopefully will.
Naturally, Republicans and Democrats alike have shied away from politicizing last week's shooting of one of their own (though a pro-Karen Handel Super PAC saw it as fair game in the GA-06 race). But the short-term and long-term impacts of the GOP's healthcare repeal bill on someone in Scalise's situation are worthy of examination, which is exactly what Brian Beutler endeavored to do.
Uninsurance is not a widespread problem for people who work on Capitol Hill, which means Scalise will likely be spared the second-most horrifying consequence of his injuries: the financial cost.
Through no fault of his own, Scalise has just incurred hundreds of thousands, if not millions of dollars in medical expenses. And while he may ultimately be responsible for a tiny, tiny, tiny fraction of these costs, he and his Republican colleagues in Congress are, as he convalesces, attempting to expose millions of Americans to the kind of financial ruin he has so far avoided.
The elephant in the room since the shooting in Alexandria has been the tension between elected Republicans’ reflexive expectation that one of their colleagues receive outstanding care at essentially no monetary cost to him, and what they believe millions of other Americans should expect if they meet a similarly unlucky fate.
Beutler asked Scalise's office for redacted copies of his insurance records following the shooting so as to make "his total medical costs and his out-of-pocket costs a matter of public record." As one might imagine, his office was not responsive to the inquiry.
The Senate and House repeal bills differ slightly, but the results are similar: tens of millions of Americans will be pushed off health insurance and/or not be able to get insured for certain pre-existing conditions. Given the rate at which Americans experience gun violence, at least some of the people who lose their insurance will become the victims of a shooting, or perhaps experience some other health calamity—like being diagnosed with cancer—that they have absolutely no control over.
In either case, the total cost of care includes both the initial surgeries and treatments as well as the ongoing care, such as physical therapy, which in insurance terms will become a “pre-existing condition." And that's where the GOP's change to the healthcare market, should their bill succeed, could actually have long-term consequences for Scalise and the millions upon millions of Americans who would subsequently be labeled "defective" by insurers. Beutler continues:
The House and Senate Trumpcare bills gut protections for people with pre-existing conditions in different ways: the former by allowing insurers to price gouge sick people; the latter by allowing insurers to exclude the treatments sick people need from covered benefit schedules, creating adverse selection. Both would destabilize insurance markets for people with pre-existing conditions in at least some states. The Senate bill does not exempt members of Congress, and House Republicans have gone on record with the promise that Trumpcare will apply to them, too.
We don’t know if Scalise’s recovery will take years, or if he will need chronic care when he gets through rehabilitation. Hopefully the answer to both questions is no. But it’s dreadfully easy to imagine that if a Republican health care bill becomes law, Scalise will ultimately be uninsurable under its terms, leaving him exposed to the long-term costs of his injuries, and to the costs of other ailments that might befall him between now and when he becomes eligible for Medicare.
It is painfully obvious that Republicans would like to pretend that the issues raised by the Alexandria shooting and by their health care repeal efforts don’t overlap at all. It is just as obvious that the health and financial security of people they don’t know, or who aren’t independently wealthy, isn’t of concern to them as public officials. But a recurring theme of conservative politics in America is the discovery of empathy when consequences of right-wing policies hit home. The best thing that could possibly come of Scalise’s shooting wouldn’t be some fleeting moment of political unity. It would be pulling Republicans back from the brink of trading American lives for tax cuts.