THEY JUST DON’T CARE ABOUT SUBSTANCE AND POLICY…. Whenever I write about my concerns that Republican lawmakers don’t seem to know anything about public policy, I invariably get emails pushing back. Just because GOP leaders take a different approach, doesn’t mean they’re dumb, I’m told. They must know substantive details, I’m reminded. After all, they’re experienced politicians responsible for shaping U.S. policy at the federal level.
I can appreciate why the premise seems implausible, but consider a classic example from the Atlanta Journal-Constitution‘s Jay Bookman.
This week, Bookman and other AJC editors and columnists participated in an 80-minute interview with Senate Minority Leader Mitch McConnell (R-Ky.) and Sen. Saxby Chambliss (R-Ga.). Both agreed that they had serious objections to the Affordable Care Act, but said they intended to keep some provisions of the new law, including protections for those with pre-existing conditions. The individual mandate, however, would have to go, the conservative senators said.
Readers of this blog probably already recognize the problem here. If those with pre-existing conditions will be protected, the mandate is necessary to keep costs from spiraling and to prevent the “free rider” problem.
Bookman understands this. The senators don’t.
If you somehow tell companies they can no longer deny coverage of pre-existing conditions, you need to provide them another way to eliminate free riders. Under the new law, individual mandates are that tool. As long as everyone is required to have coverage, nobody can game the system and there’s no longer any justification to deny coverage based on pre-existing conditions.
So if the GOP plan is going to ensure that pre-existing conditions are covered, as Chambliss and McConnell suggested, how would they do it without individual mandates? What mechanism would they use?
Chambliss and McConnell had no answer. Literally.
After Chambliss fumbled an initial response, McConnell broke in with a long and familiar condemnation of the Democratic plan, including its failure to include tort reform. After a few minutes, I interrupted and brought him back to the question: OK, but how are the Republicans going to cover pre-existing conditions?
“The premiums are going up either way,” he said.
OK, I responded, a little stunned. That doesn’t explain how the Republicans intend to cover pre-existing conditions.
“The premiums are going up either way,” he repeated.
That was that. We moved on, and I still don’t have my answer.
Let’s be clear about this. After over a year of debate about health care policy, two leading Senate Republicans, including the Senate Minority Leader, can’t speak intelligently about the basics. Bookman didn’t throw a curve ball at them, quizzing them on some obscure provision — this was an easy one for anyone with a basic understanding of what policymakers have been discussing since early last year.
They want protections for those with pre-existing conditions, and want to eliminate the mandate, but asked how that could work, these experienced senators have no idea how to even begin answering the question.
They have their talking points, but if anyone dares to scratch the surface, even a little, they’re completely lost.
Anyone who thinks Republican lawmakers are well-informed, thoughtful public officials, with a working knowledge of public policy, simply isn’t paying attention.