Memoirs of the Addams Administration 26.

In May 2017 the House of Representatives passed the American Health Care Act (AHCA) in an attempt to “repeal and replace” the Affordable Care Act (ACA).   Senate majority leader Mitch McConnell assigned a small group of senators to quickly re-write this legislation to deal with its flaws.  In late June 2017 they revealed their handiwork to the public.  The Senate bill sought to introduce market-based solutions to health care.  In place of the ACA’s supposed individual “mandate”[1] to buy health care insurance, the Senate bill created a “lockout”[2] intended to keep people from only buying insurance when they are sick, then dropping out when they get better.  In place of the current open-ended government spending on Medicaid, the Senate bill would cap the amount of money that the federal government would pay.  The Senate bill reduced the average premium by about 20 percent, raised the average deductible by 70 percent, allowed insurance companies to offer a wider variety of plans in place of the expansively defined set of benefits required by the ACA, and raised the permissible differential between premiums for sick people and healthy people.   It also replaced direct subsidies paid to insurance companies with smaller individual tax credits.  The ACA’s expansion of the Medicaid eligible population to include the “working poor” would be rolled back by 2024.  The Congressional Budget Office (CBO) reported that the Senate bill would cut $722 billion out of federal health-care spending over a decade and that 37 million fewer people would have health insurance by 2026.[3]

McConnell found that he could not muster enough Republicans to vote for the bill.  Some of the dissidents wanted an even more radical repeal of the ACA, while others opposed the size of the cuts to Medicaid.   McConnell “postponed” a vote on the bill until later in the summer—or maybe ‘till the cows come home.

Otherwise, little is going on in government.  Most of the real news sprang from the Supreme Court.  The Court allowed a limited version of the administration’s initial travel ban on possible terrorists to go into effect until the Court can hear full arguments in October.  It also found that a Missouri law barring public funds to a church school violated the free exercise of religion.  The Court agreed to hear cases on the constitutionality of partisan gerrymandering and religious-based refusal to serve gay people.[4]  The dismantling of the “legacy” of President Obama continued.  The Environmental Protection Agency proposed repeal of a 2015 rule that claimed for the federal government the right to regulate water quality in the tributaries and wetlands surrounding major bodies of water like the Chesapeake Bay.[5]

Even so, people filled up the early summer with nonsense.  President Trump admitted that he had no tapes of his conversations with James Comey.  CNN admitted that it had published an unsubstantiated story about President Trump’s alleged Russian contacts.    Some Democrats bit at House minority leader Nancy Pelosi after the series of disappointing losses in Congressional special elections.[6]  Others urged staying the course that has brought the Democrats so much success of late.

[1] Many younger people just ignore the mandate.  That’s why the insurance companies haven’t been able to get a sustainable mix of poor, but healthy younger people to subsidize the health costs of wealthier, but sick, older people.  Massive losses have led insurers to pull out of a rising number of state insurance market places.

[2] Anyone who went without insurance for 63 days would not be eligible to buy insurance for six months.

[3] “Republicans divided over Senate health-care bill,” The Week, 7/14 July 2017, p. 4.

[4] “Supreme Court revives Trump’s travel ban”; “The U.S. at a glance…”; “Gerrymandering: A GOP advantage?” The Week, 7/14 July 2017, pp. 5, 7, 16.

[5] “Boring but important,” The Week, 7/14 July 2017, p. 6.

[6] The Week, 7/14 July 2017, pp. 6, 7, 17.

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