If the Affordable Care Act is the failure that Republicans Mitch McConnell and Donald Trump insist, then getting Congress to repeal and replace it wouldn’t be so difficult.
In reality, the law, signed by Barack Obama in 2010, is not a failure, quite the opposite. It has brought security to millions of Americans for whom sickness previously meant bankruptcy or premature death. It has brought greater financial certainty to the hospitals and clinics that care for them.
Like any complex law, the ACA has problems; those problems could readily be fixed by Republicans and Democrats working together.
Senate Majority Leader McConnell must realize that his decision to exclude the Senate’s women, Democrats and most Republicans from drafting a replacement was a mistake.
Now McConnell, who has vowed for years to repeal the ACA “root and branch,” has no choice but to work with Democrats, who will not, and should not, support the plans offered so far by Republicans. The GOP plans would leave an additional 22 million to 32 million Americans without health insurance.
Kentucky’s Sen. Rand Paul and his far-right allies may idealize the notion of health care free of government, but we’re far beyond that, and it would be a nightmare in any case. Government has long regulated insurance markets. Government support is critical to medical care for the elderly, disabled and impoverished and to the clinics and hospitals that care for them and train physicians.
The ACA is a market-based system that protects the insured from having to pay to care for people who lack health insurance because they chose to go without or can’t afford it. Repealing the ACA and its Medicaid expansion would shift the costs of the uninsured back onto other consumers, which, in turn, would raise costs for private employers and government programs like Medicare and Medicaid.
Repeal won’t reduce the overall cost of health care or improve its quality. And cost and quality are the overriding weaknesses of health care in this country.
Cost and quality are what Congress and President Trump should be tackling. Instead, they’re wallowing in politics and the toxic mire that McConnell helped create by rallying Republicans against anything that had President Obama’s name on it. The obstruction part was easy. The policy and governing parts seem to be eluding McConnell and his party, even though they control the White House, Congress and most state houses.
McConnell assigned a small group of male GOP lawmakers to write the Senate bill in secret, a move that could only generate more suspicion than support. That bill and a proposed revision collapsed because several Republicans, including McConnell’s fellow Kentuckian Paul, said they would refuse to move it. Republicans hold 52 of the 100 Senate seats, leaving little room for internal dissent.
McConnell’s Plan C, repeal without replacement, collapsed within hours. It would throw the insurance market into chaos, a move that three Republican women said they could not support.
Polls show that Americans favor Obama’s health-care law over anything the Republicans have offered. McConnell should enlist Democrats and Republicans in shoring up the ACA and moving on to address health-care costs and quality. It would be politically smart and, even better, the right thing to do.