For a Fleeting Moment, It Looked Like Genuine Leadership on Health Care Might Be Possible

Senator Lamar Alexander says he is giving up on a bipartisan effort to stabilize the health insurance marketplaces. However, not because a sound stabilization package was impossible. It is not because the Affordable Care Act is not working. It is because the effort does not serve the interests of the president and Republican leadership in Congress to make the ACA stronger. They promised to repeal the ACA, so that is what they are determined to do, regardless of how many of their constituents lose their health care. That is not just “disappointing,” as Sen. Alexander said. It’s disgusting.

The effort to provide increased stability to the marketplaces was the right approach. The ACA is not broken – it has extended quality health care to more than 15 million people who were previously uninsured. But the uncertainty created by the failure of the president and Congress to commit to paying the insurance companies what they were owed under the ACA – the cost of reducing out of pocket costs for low income people and a fund to provide back-up to insurance companies that experience unexpectedly high costs when they insure people who have been living without health care – those failures have caused volatility in the marketplaces. Rather than trying to sabotage the marketplaces, Congress should have gotten behind the bipartisan effort of Alexander and Democratic Senator Murray (Wash.) to address causes of any volatility in the marketplaces.

The decision by Republican leadership to squelch the stabilization effort speaks volumes about leadership’s priorities – and they do not include the health of the American people. According to Politico, House Speaker Paul Ryan told Senate leaders yesterday that the House would not support an ACA market stabilization bill and that all work should focus on repealing the ACA. Alexander called Ryan’s comments “disappointing.” He added, “A week ago, I think [a bi-partisan stabilization bill] was possible,” until the new repeal push “obviously makes a bipartisan consensus more difficult.” Later in the story a Democratic aide said, “It’s crystal clear that Republicans are trying to shut down those negotiations in order to close off the better, more bipartisan path that moderate Republicans could take.”

The bill that Republican leadership is trying to ram through the Senate, the “Graham Cassidy” bill, is even more dangerous than the previous repeal bills that were rejected in July. We do not even know the full magnitude of the harm it will cause because the CBO has not had time to score it – and will not be able to project how many individuals will lose health care in time for the vote the Republican leadership needs to have before September 30. We do know that it will eliminate health insurance for more than the 22 million people who would have lost coverage under the previous failed attempts to repeal the ACA and cut funding for Medicaid, and it will reduce the care available to those lucky enough to remain insured. Medicaid provides health care to more than 70 million people. Without Medicaid, low-income individuals and families, people getting by on limited incomes and hovering near poverty will be left with no options except for emergency rooms. At a time of historic economic inequality, the Graham-Cassidy bill callously proposes tossing people off Medicaid and into dire poverty. Sens. Graham and Cassidy are not visionaries. They are proposing a law that would take us back as a nation. It is a regressive measure for the sake of creating massive savings to help fund tax benefits for the nation’s super wealthy.

Polling shows that majorities do not want Congress to take away their health care, but they do want bipartisan action to strengthen the ACA. Similar polling, moreover, shows large swaths of people from coast to coast do not want Medicaid cuts. Throughout the previous battles over repeal efforts, tens of thousands of people with disabilities or pre-existing conditions, the LGBTQ community, and many others provided some of the most compelling testimonials, protests and resistance to destroying the ACA and Medicaid. They were joined by crowds flooding town halls demanding that their representatives not take away their health care.

The decision to block the bipartisan effort to ensure the success of the ACA says much about the values of the Republican leadership. The hundreds of millions of individuals and families who not only have a right to health care, but also without that care cannot enjoy, let alone participate in democracy are not valued as much as a partisan “victory.” Let us hope there are enough senators who will not be swayed by these values, but instead will be moved to protect the health care of all.

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