A lot of words have been used to describe the American Health Care Act (AHCA). Headlines across the country, screaming: “Dismal”, “Disaster”, “Failure”, and “Deadly.” President Trump himself called the AHCA a “mean” bill. So -- unless they haven’t picked up a paper or gone online recently -- you have to wonder why moderate Senate Republicans are falling in line with the far right as they continue to push a bill so roundly objected.
Governor John Kasich and Senator Rob Portman of Ohio were originally opposed to the AHCA due to its attacks on Medicaid. Their initial stance against the AHCA made sense: nearly one million Ohioans received health insurance for the first time through the state’s Medicaid expansions. That’s why Kasich championed Medicaid expansions for Ohio, even appearing on national television promising to oppose any Republican effort to roll them back -- and why Portman voiced a similar stance.
Now, after secret discussions with Mitch McConnell and other extremists, Kasich, Portman and a host of other “moderates” have done a complete 180, declaring that that they will support the AHCA’s passage through the Senate. Let’s be clear: supporting the AHCA means supporting the elimination of Medicaid as a federal entitlement program and ripping federal funding from Medicaid expansions. In other words, it goes against everything Kasich and Portman claimed to stand for.
Usually, I would argue that health care is a fundamental human right for all — and that caring for the most vulnerable among us is a moral obligation. But, in an attempt to appeal to our fiscally-focused Republican friends, here's an argument that might appeal to moderates like our friends from Ohio: expanding access to health care reduces deficits, increases worker productivity, and creates thousands of jobs that boost state tax revenues.
The Affordable Care Act (ACA) is on track to reduce the total deficit by $109 billion by 2022, with an additional reduction of 0.5 percent of GDP each year. That would lead to a total deficit reduction of nearly $1.6 trillion by 2032. This budget reduction will increase capital accumulation, reduce our dependency on foreign governments, and strengthen the country’s economy.
If we’re looking to maximize worker productivity -- another essential pillar in the structure of our economy -- ensuring that people have legitimate access to health care is a good place to start. People with health insurance can access the care that allows them to return to the workforce quickly after illness, and therefore continue contributing to the economy. Medicaid also allows workers to be proactive about their health by providing free screenings for things like health disease and diabetes, meaning sickness is caught early. This way, Americans don’t have to stay at home when they could be functioning as active, contributing members of society.
Even more compelling, the ACA directly benefits the economy by creating thousands of jobs, which improves state tax revenues. It also bolsters the budgets of states who chose to accept the Medicaid expansions. In 2016, Kasich and Portman’s home state of Ohio saved $428 million through the Medicaid expansions!
Instead, a new report from the Commonwealth Fund and George Washington University researchers found that the AHCA would slash total jobs by about a million, total state gross domestic products by $93 billion, and total business output by $148 billion by 2026. Bottom line, there’s another term we can use to describe this bill: fiscally irresponsible.
But beyond the concrete economic advantage of protecting the ACA is a humanitarian urgency. Health care is not and should not be made into a partisan issue-- it’s a fundamental human right. Our friends from Ohio seem to know this: in their effort to keep the state’s Medicaid expansion, Kasich and Portman’s originally argued that we have a responsibility to protect “the most vulnerable among us.”
Yet in the era of Trumpism – victory at all costs, with benefits only for the wealthy – Republicans seem content to fall in line as the White House pillages the lifesaving health care of 23 million Americans.
With not a single state supporting it, the AHCA is the most unpopular piece of legislation proposed and passed by Congress in over 50 years. The AHCA wouldn’t have passed the House of Representatives if it wasn’t for four moderate Republicans who lost sight of the road ahead. They seemed to forget that at the end of that road is an election. And the only job that will be at stake this time is their own.
At the end of the day, if you don’t invest in your market, you won’t have a market. When gearing up to vote on the AHCA, moderate Senate Republicans should remember that the 60 percent of Americans who agree that the government should provide health coverage to its citizens will also be voting soon. And chances are, they won’t elect someone who was bullied into bad economic decisions by greedy billionaires in the White House.
The coming weeks will be a major political test for moderate Senate Republicans. For the sake of millions of American lives, I hope they pass.