Ernest Dumas explains this week how easy it would be to fix the Affordable Care
It would require the kind of bipartisanship that gave the country Medicare and Medicaid. Senate Republican Leader Mitch McConnell is not known for aisle-crossing.
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By Ernest Dumas
Majority Leader Mitch McConnell threatened his 51 disciples in the Senate and his party with the gravest injury imaginable. If they don’t pass his unpopular bill to “repeal and replace” Obamacare in the next few weeks, he may make them sit down with Democratic senators and work out a health-care law that would be acceptable to nearly all Americans.
He wouldn’t dare! Does he not remember what has accrued from bipartisanship in the
OK, it is probably an empty threat. McConnell, after all, is the father of partisan gridlock. It was he who ordered a bank of Republican senators in 2009 to cease working on the Affordable Care Act with Democrats on the Senate Finance Committee or face reprisals by the GOP caucus. He was so wary this spring that a Democrat might give a piece of advice or get a peep about what the bill did that he did not let even some of the 13 Republican men he said would write the Obama
But the Senate bill he produced has now assumed the status of the most unpopular piece of legislation in modern times. Republican governors have quailed at the impact it would have on their states—22 million losing their insurance, huge budget problems for state governments that Republican governors and legislators would have to deal with, far higher premiums and out-of-pocket costs for sicker, older and poorer people.
Even Arkansas’s John Boozman, a more faithful disciple McConnell has never met, is withholding support. Sen. Tom Cotton, who is supposed to be one of the authors, is silent, obviously hoping the bill never comes to a vote.
Arkansas would be devastated more than any state, except possibly Kentucky. If the Senate bill becomes law, some 367,000 more Arkansans will be uninsured by 2022, when the Medicaid provisions really kick in. The state government would lose $1.5 billion in federal health-care funding in 2022—a huge hole in the budget that would have to be made up with tax increases or abandoned medical services for some subset of the population—children, the elderly frail, the disabled, children’s colonies?
It’s a pointless exercise, but what might “amend and improve” look like if McConnell worked across party lines? First, you’d have to agree that it would be called a Republican reform—”
So what could Dems and Repubs do together? With a couple of words, they could fix the clumsy language in the Affordable Care Act that House Republicans used in a court challenge of the government’s cost-sharing of deductibles and copays of low-income policyholders. They got a ruling from a judge appointed by President George W. Bush that the payments had to stop. It is on appeal, ultimately to the Supreme Court where Trump has inserted a judge who will rule against Obamacare on any point of law. It has unsettled the markets and insurance companies don’t know whether to get out altogether or raise their premiums sharply in anticipation.
They could fix the “family glitch,” the inept wording in the law that often keeps family members in employer programs from being eligible for premium subsidies.
Charles Gaba, who runs a health-care blog, proposed 20 changes in Obamacare, including expanding Medicaid in the last 19 states, each
Kerr-Mills (our man Wilbur D. Mills) was the original Medicare and Medicaid, enacted in 1960. It was a total flop with fewer than 1 percent of the elderly and poor gaining coverage after five years. After a landslide victory in 1964, Lyndon Johnson asked Mills and Republican leaders to fix it and after a few