When Republicans Tell the Truth About Their Health Care Bill

We’ve gotten used to hearing Republicans lie about their health care bill. Just this weekend, VP Pence said: “The Senate health-care bill strengthens and secures Medicaid for the neediest in our society.”

That sets up a question: Who do you believe, VP Pence or the CBO’s projection that the current bill would mean that 14 million Americans will lose their Medicaid coverage?

One way to answer that question is to take a look at what happens when Republicans actually tell the truth about their intentions with this bill. HHS Sec. Tom Price did that recently in this exchange with Jonathan Karl of ABC News.

KARL: There’s no doubt there’s significant problems with the current system. But if you look at the Republican plan to modify it and replace it, more than 10 medical groups are against it. Thirty-two cancer organizations oppose it. And on Thursday, in a rare joint statement by the biggest insurance companies in the country, called the Cruz Amendment unworkable in any form and warned it would lead to, quote, “widespread terminations of coverage.” So, Dr. Price, why this wall of opposition?

PRICE: It’s really perplexing, especially from the insurance companies, because all they have to do is dust off how they did business before Obamacare.

What Price is suggesting is that all insurance companies have to do is go back to the days when they denied coverage to those with pre-existing conditions. That goes against what Trump and most Republicans in Congress promised when they talked about their plans to repeal Obamacare. The ban on denying people coverage for pre-existing conditions is something they have repeatedly promised to keep. Tom Price just told the truth. The current bill reneges on that promise.

But Britt Hume went even further than that on Fox News.

The triumph of Obamacare is this coverage for pre-existing conditions, which basically defeats the whole idea of insurance. Which is, for example, in the automobile insurance market, if you could wait until you had a wreck and then buy insurance and have the repairs covered, that’s comparable to what we’re doing here. ..

The idea of insurance is that you purchase it to guard against risks and things that may occur in the future. It’s not that you purchase the coverage after you are already sick. Once that idea is gone, Obamacare essential remains.

In a way, Hume gets it: “Once that idea is gone [guaranteeing coverage to people with pre-existing conditions], Obamacare essential remains.” That is precisely why Republicans are having such a hard time coming up with an alternative. They promised to keep the regulation about coverage for those with pre-existing conditions, but can’t do that without keeping major portions of Obamacare in place.

What Hume doesn’t say is that Obamacare doesn’t simply guarantee coverage to those with pre-existing conditions. That is just one leg of the three-legged stool described by Charles Gaba. The other two are the individual mandate and tax subsidies. Republicans really want to get rid of the individual mandate. Notice that Hume didn’t even mention it though. That’s because the mandate is what keeps people from being able to wait until they get sick to purchase insurance. The third leg of the stool—tax subsidies—are there to help make the mandate affordable.

Conservatives like Cruz and Price want to eventually get rid of all three legs of that stool, while taking a shot at dismantling Medicaid in the process. Other Republicans tried to tamp down fears about going back to the pre-Obamacare status quo days by promising to keep the guarantee of coverage for people with pre-existing conditions and substituting the idea of “continuous coverage” for the mandate.

But by accepting Cruz’s amendment as part of the Senate bill, Republicans have started to take off the mask and reveal their true intentions. When they tell the truth about what they’re trying to do, it really is all about repealing the entirety of Obamacare, including the guarantee of coverage for people with pre-existing conditions.

Nancy LeTourneau

Nancy LeTourneau is a contributing writer for the Washington Monthly.