The U.S. Senate, once labeled the world’s “greatest deliberative body,” has failed to create a satisfactory alternative to the Affordable Care Act — in part because of a lack of deliberation.
Senate Majority Leader Mitch McConnell said Tuesday that his partisan, behind-the-scenes effort to “repeal and immediately replace” the ACA, aka Obamacare, “will not be successful.”
Health care is, indeed, complicated and McConnell overestimated his ability to gain enough votes from members of his party. That includes conservatives unconcerned that the bill would have resulted in some 20 million Americans losing or forgoing health care insurance, and moderates concerned about the impacts of caps on spending for Medicaid, the federal-state program for low-income children, working adults and senior citizens.
Plus, some Republican senators recognized that, despite its shortcomings, the ACA benefits people in their states. Shelley Moore Capito of West Virginia was one of three GOP senators — along with Susan Collins of Maine and Lisa Murkowski of Alaska — who vocally declared their opposition Tuesday to repeal without replacement.
“I did not come to Washington to hurt people,” Capito said in a statement. “I cannot vote to repeal Obamacare without a replacement plan that addresses my concerns and the needs of West Virginians.”
Trump, who said he’d lead Congress to “immediately” repeal the ACA and replace it with “something terrific,” responded Tuesday to the impasse in the Senate. In lieu of repeal, Trump stated that he favored letting “Obamacare die.”
Easy for the president to say: He has his health care coverage; if the ACA dies, millions of Americans will lose their insurance.
Trump claimed that failure of the ACA will lead Democrats to negotiate with the Republican leadership. Despite the president’s insistence that neither he nor Republicans in Congress will “own” the failure of Obamacare, they will be blamed, once Americans begin to lose their coverage, for failing to either improve the ACA or replace it with something better.
Stabilize-and-improve should be the immediate goal.
If leaders of Congress — including those in the House of Representatives, which passed a partisan bill worse than the Senate’s — need help conducting bipartisan discussions, they should consult with a group of 11 governors who oppose repeal without replacement and offer guiding principles for legislation.
The group includes one independent, five Democrats and five Republicans — the most vocal of whom on this topic is John Kasich, who served in Congress before being elected governor of Ohio.
Kasich and others have opposed “unsustainable reductions to Medicaid,” as proposed, but called for long-term reform of the program — including the ability of states to control rising drug costs. They have urged adequate funding for the ACA’s income-based tax credits for the purchase of insurance sold on the private market. They have advocated maintaining minimum levels of insurance and coverage of pre-existing conditions.
Those standards form the basis of a principled compromise through deliberation — if leaders of Congress in both parties have the fortitude to let it occur, and if the Trump administration resists the temptation to hasten the ACA’s demise through negligence.
This editorial was originally published in the Sarasota Herald Tribune, a sister newspaper of the Daily News within GateHouse Media.