A Dialogue on Health Care

In the Senate Health, Education, Labor and Pensions (HELP) committee, Republicans are now confronting healthcare. It’s going something like this:

SENATOR LAMAR ALEXANDER of TENNESSEE: Um…Patty? I didn’t want to tell you this, but we broke the television.
SENATOR PATTY MURRAY of WASHINGTON: What the unholy hell?!?? Are you kidding me??!?
LAMAR: Yeah, um, no. No, I’m not.
PATTY: What’s wrong with it?
LAMAR: Well, it’s smashed.
PATTY: Smashed?!?? Why the hell is it smashed?
LAMAR: See, remember when you told us to be sure to pay the cable bill?
PATTY: Yeah.
LAMAR: We didn’t do it.
PATTY: Figures. So?
LAMAR: We couldn’t watch the ball game.
PATTY: Right.
LAMAR: So, Mitch and Paul and everyone threw bricks at it.
PATTY: You idiots!!
LAMAR: Well, we want to fix it.
PATTY: Yeah, you better.
LAMAR: But we need your help.
PATTY: MY help? Why do you need MY help?
LAMAR: See, we also figured we owed you an apology.
PATTY: Damn straight y’all owe me an apology!
LAMAR: But I can’t get the guys to help pay for a new set unless I promise they won’t have to admit they did anything wrong.
PATTY: You’re kidding, right?
LAMAR: So, what I need is for you to tell them they didn’t do anything wrong.
PATTY: Why would I make a foolish concession like that?
LAMAR: Because otherwise, the television is going to stay smashed.

This is what’s happening in the committee:

In exchange for funding Obamacare’s subsidies to insurers that cover care of low-income people with severe health needs, Republicans are demanding that some of the ACA’s protections and mandates be waived—and have suggested rolling back the requirement that every insurance plan cover essential health benefits like maternity care and mental health treatment.

Now that the Republicans realize they’re stuck with the Affordable Care Act, they realize they can’t just leave it broken. But Republicans also feel like they have to get some kind of concession from the Democrats or they won’t agree to fix it.

Without a concession or a win they can point to, GOP aides and lawmakers have said, it would be hard to get their caucus on board with funding the cost-sharing reduction subsidies or taking other steps to prop up Obamacare’s marketplaces.

“To get a Republican president and a Republican House and a Republican Senate just to vote for more money won’t happen in the next two or three weeks unless there’s some restructuring,” Alexander said.

So, they come to Patty Murray, the ranking member on the committee, and they ask her to help them eliminate maternity coverage and coverage for people with mental health or addiction problems. They tell her that if she doesn’t give them these concessions, they can’t fix what’s wrong with the health care bill. But of course, the things that are wrong with Obamacare are a result of Republican sabotage. They threw a brick at the individual mandate. They threw a brick at Medicaid expansion. They threw a brick at cost-sharing subsidies. They threw a brick at transitional financing. They threw a brick at the public relations enrollment drive. They threw a brick at health care “in person assisters.” They threw a brick at the premium tax credit.

They did everything they could think of to keep enrollment low, premiums high, and the markets unprofitable.

Ironically, they still didn’t manage to destroy the law. It doesn’t need to be replaced, but it does need some repairs.

The only concession the Republicans will get is that they don’t have to say they did anything wrong. All they have to do is patch the thing up and pay the damn cable bill.

And if they can’t do that, hopefully the voters will fix things next November.

Martin Longman

Martin Longman is the web editor for the Washington Monthly and the main blogger at Booman Tribune.