Why do U.S. congressional tinkerers keep thinking that taking health-care coverage away from millions of Americans is a way to improve health care?
The latest self-contradictory “solution” is a bill being proposed by Senators Bill Cassidy of Louisiana and Lindsey Graham of South Carolina. That culinary duo has cooked up a plan that is no better – and in many ways worse – than the two other so-called health-improvement plans that suffered humiliating defeats in Congress and that something less than 15 percent of Americans approved.
Here’s the gist of the Graham-Cassidy plan (scheme is more like it):
Starting in 2020, it would end ObamaCare premium subsidies and the federal funding that covers the expansion of Medicaid in 31 states. The states would then get block grants that would help people pay for their health care based on state plans.
However, the cold reality is the bill would decrease federal investments in health care by $400 billion during the next decade, according to the Center on Budget and Policy Priorities. The federal infusion of block-grant funds would cease in 2027 unless renewed.
We’ve heard this “solution” before – giving the states more flexibility to come up with more at-home, efficient workable plans. Sounds good, at first. Trouble is, all too often there’s nothing to stop state plans from allowing the same old inequities from rearing their ugly heads again: higher premiums for those with pre-existing conditions, loss of benefits for mental-health services and for maternity care, junk coverage plans and not enough block-grant funding used to help low-to-middle-income residents.
The bill would, of course, repeal the Affordable Care Act and its individual mandate, causing spikes in premium rates that would make the current increases downright miniscule by comparison.
In other words, without the ironclad provisions now in the Affordable Care Act, plans state by state would come unraveled, creating the same mess that existed pre-ACA – that is, millions of people not having coverage. Even states that mean well would lose a grip on the random chaos that would result.
Part of the plan calls for a sly and sneaky shell game to direct more federal funding to “red” states and away from more-populated “blue” states – the very ones that have implemented ACA provisions, such as expansion of Medicaid, unlike most “red” states that balked at the ACA from the get-go.
The Congressional Budget Office has not weighed in yet on the Cassidy-Graham plan, but you can be sure the CBO will not give it a glowing report card.
The good news is an increasing number of legislators in both parties are at least considering patching up the ACA and making it more workable until a more comprehensive solution can – possibly – be crafted via congressional compromise – a compromise that would result in affordable coverage for more people, not fewer, a compromise that would bring decent coverage for all Americans.
Dare we hope such a compromise – such a miracle – can be achieved in a Congress too often paralyzed by stubborn deadlock and obstructionism?
Well, let’s keep hoping. In the meantime, the tinkerers so intent on repealing ObamaCare should either come up with a good replacement, or they should quit lying and quit trying.
