Donald Trump is right. The House health insurance bill is “mean, mean, mean,” as he put it last week. He correctly called the measure that would strip health insurance from 23 million Americans “a son of a bitch.”
The proposal is not at all what Donald Trump promised Americans. He said that under his administration, no one would lose coverage. He said everybody would be insured. And the insurance he provided would be a “lot less expensive.”
Senate Democrats spent every day this week pointing this out and demanding that Senate Republicans end their furtive, star-chamber scheming and expose their health insurance proposal to public scrutiny. That unveiling is supposed to happen today.
Republicans have kept their plan under wraps because, like the House measure, it is a son of a bitch. Among other serious problems, it would restore caps on coverage so that if a young couple’s baby is born with serious heart problems, as comedian Jimmy Kimmel’s was, they’d be bankrupted and future treatment for the infant jeopardized.
Donald Trump has warned Senate Republicans, though. Even if the GOP thinks it was fun to rebuff Democrats’ pleas for a public process, they really should pay attention to the President. He’s got veto power.
Republicans have spent the past six years condemning the Affordable Care Act (ACA), which passed in 2010 after Senate Democrats accepted 160 Republican amendments, held 110 bipartisan public hearings and conducted 25 consecutive days of public floor debate. Despite all of that, Republicans contend the ACA is the worst thing since Hitler.
That is what they assert about a law that increased the number of insured Americans by 20 million, prohibited discrimination against people with pre-existing conditions and eliminated the annual and lifetime caps that insurers used to cut off coverage for sick infants and people with cancer.
The entire cavalry of Republican candidates for the GOP nomination for President promised to repeal the ACA, but Donald Trump went further. He pledged to replace it with a big league better bill.
In May 2015, he announced on Twitter: “I’m not going to cut Social Security like every other Republican and I’m not going to cut Medicare or Medicaid.”
In September 2015, he said of his health insurance plans on CBS News’ 60 Minutes, "I am going to take care of everybody. I don't care if it costs me votes or not. Everybody's going to be taken care of much better than they're taken care of now.”
In another 60 Minutes interview, this one with Lesley Stahl last November, he said, “And it’ll be great health care for much less money. So it’ll be better health care, much better, for less money. Not a bad combination.”
In January, he told the Washington Post, “We’re going to have insurance for everybody.” He explained, “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.”
But then, the House Republicans betrayed him. The nonpartisan Congressional Budget Office said the measure they passed, called the American Health Care Act (AHCA), would cut more than $800 billion from Medicaid. It said people with pre-existing conditions and some older Americans would face “extremely high premiums.”
Extremely high is an understatement. Here is an example from the CBO report: A 64-year-old with a $26,500 income pays $1,700 for coverage under the Affordable Care Act (ACA), but would be forced to cough up more than half of his or her income – $16,000 – for insurance under the House Republican plan. Overall, premiums would increase 20 percent in the first year. And insurers could charge older people five times the rate they bill younger Americans.
House Republicans said states could permit insurers to squirm out of federal minimum coverage requirements, and in states where that occurred, the CBO said some consumers would be hit with thousands of dollars in increased costs for maternity care, mental health treatment and substance abuse services.
In the first year, the House GOP plan would rob insurance from 14 million Americans.
So much for covering everyone with “great health care at much less money.”
It’s true that President Trump held a party for House Republicans in the Rose Garden after they narrowly passed their bill. But it seems like he did not become aware until later just how horrific the measure is, how signing it into law would make him look like a rank politician, a swamp dweller who spouts promises he has no intention of keeping.
By last week when President Trump met with 15 Senate Republicans about their efforts to pass a health insurance bill, he no longer was reveling in the House measure. He called it “cold-hearted.” He asked the senators to be more “generous,” to put “additional money” into their version.
Senators told reporters that President Trump wanted them to pass a bill that is not viewed as an attack on low-income Americans and provides larger tax credits to enable people to buy insurance.
Now that sounds a little more like the Donald Trump who repeatedly promised his health insurance replacement bill would cover everyone at a lower cost. Still, those goals remain amorphous.
The House bill is stunningly unpopular, almost as detested as Congress itself. President Trump seems to grasp the enormity of that problem. But even his calling it a “son of a bitch” doesn’t seem to have been enough to persuade senators that he’s serious about getting legislation that achieves his promises to leave Medicaid intact, cover everyone and lower costs.
Republican senators deciding the fate of millions of Americans must hear from Donald Trump that passing a health insurance bill that doesn’t fulfill his campaign promises is, shall we say, a cancer on the Presidency.
A veto threat would get their attention.