As the House goes racing to a vote to repeal and replace the Affordable Care Act (aka Obamacare) with Ryan Care or Trump Care or whatever it will be called, I noticed that those Republican members of the House with issues recently met with the President. Ostensibly, he assured them that the problems they pointed out would be “taken care of” down the road. While some changes have been made, his breezy assurances must have evoked memories from anyone who has ever bought something unfinished with a verbal assurance that it will eventually be completed and that it will all work out just fine eventually. Now sometimes it does. However, who among us would advise paying in full for something still undone? Yet from the world of New York real estate we have a President who is so used to assuring nervous buyers that all will be well, convincing a group of Republican Congressmen to trust him on this “really complicated Healthcare stuff” was, no doubt like shooting fish in a barrel.
My sense is that Republican leadership is desperately looking for a way out of having dissed Obamacare for seven years and having only the old saw of block grants to replace Medicaid and increase competition while keeping the most popular parts of the ACA in place. The increase in costs for anyone over 50 is a problem and, fundamentally, if you keep the pre-existing condition language and the ability for families to keep their kids on their policies up to age 26, the deal just doesn’t work. Remember, originally Obama was not an advocate of the mandate, but after gaining an understanding of the trade-offs, he put it in. And, of course, when the Congressional Budget Office, run by a Republican appointee, pointed out the new version would create 24 million fewer people with insurance over the next 10 years, the creator of Ryan Care, the Speaker said it was a flawed analysis because he didn’t believe that Obamacare would be around in 10 years. A curious response at best.
What makes this even more depressing is that there is no pretense of any cooperation from either side of the aisle. I think that by now the fact that 20 million Americans have their insurance at stake might cause the Democrats to offer some constructive change to the Republicans in order to try and fix the ACA problems. That would allow the updated plan to pass with some Democratic votes, get through the Senate and actually help people. I know this is really a fantasy of my mind but somehow we have to break this logjam of political destruction. Clearly, having a President who brings mendacity to a new level is not helpful. Republican leaders of Congress could decide to see if there is a bridge across the aisle rather than a ride in a hot air balloon that is obviously going to burst.