GOP Freshmen Discover Health Care Hell

Oh, the irony. The Politico interviewed several GOP representatives who opted out of their Congressional health care plans, and discovered they're all having second thoughts about that whole 'repeal and replace' thing. If it's not the cost of

Oh, the irony. The Politico interviewed several GOP representatives who opted out of their Congressional health care plans, and discovered they're all having second thoughts about that whole 'repeal and replace' thing. If it's not the cost of individual insurance that's getting them steamed, it's the pre-existing conditions.

But talk to some of the 16 freshman lawmakers who have declined their government health benefits, and you’ll hear a different side of the story — about tough out-of-pocket expenses, pre-existing conditions and support for health reforms that would help those who struggle with their coverage. As they venture into the free market for health insurance, these lawmakers — many of whom swept into office fueled by tea party anger over the health care law — are facing monthly premiums of $1,200 and fears of double-digit rate hikes.

The experience has caused some of them to think harder about the “replace” part of the “repeal and replace” mantra the GOP has adopted regarding the health care law.

“I have a niece who has pre-existing conditions, and I worry about her if she was ever to lose her job,” said Florida Rep. Richard Nugent, one of the freshman lawmakers who declined federal health insurance benefits.

Every single House Republican voted to repeal the health care law last month.

“I can simply, honestly say that this is going to impact my wife and I to a fairly serious degree, like it would any average American out there,” said first-time Rep. Joe Walsh of Illinois.

Walsh’s wife has a pre-existing condition and will need a procedure in the coming months, but because he declined federal benefits, they’re paying for it out of pocket. Meanwhile, Walsh is contributing to a health savings account to cover his expenses.

“It’s a cost we will feel, a cost I will have to pick up. I won’t turn down benefits because I have something to fall back on or because I’m independently wealthy,” he said.

Before I boo-hoo too hard for them, I remember they're being paid $174,000 per year to represent their constituents. But even at that level, $1,200/month is a solid chunk of change, and the limits to Health Savings Accounts won't cover surgery or even medications for some people.

As always, it's about the pre-existing conditions.

Nugent, a former sheriff, doesn’t receive federal employee benefits, choosing instead to purchase a Blue Cross Blue Shield plan for retired county employees, which he said costs about $1,200 a month for his family. Still, he said, his niece’s experience has contributed to his support for ending coverage bans on pre-existing conditions. “One of the key components with the ‘replace’ [bill] was to make sure we take care of people who have pre-existing conditions,” he said.

But don't be fooled by that. Republicans' best plan for people with pre-existing conditions is to shove them into high-risk pools where they can pay ten times what the base rate is for coverage. Wendell Potter says lobbyists and policy representatives from the Big 5 for-profit health insurers are meeting nearly weekly to form a strategy to weaken or eliminate the consumer protections in the Affordable Care Act. In other words, they're fine with the mandate, but the consumer protections have to go.

Think on that when you hear Republican lawmakers get on their oh-so-high horses about "market-based solutions". Their idea of market-based solutions is to bankrupt people who have the misfortune of getting sick while profiting on the healthy. They hate the medical loss ratio requirements, they hate the limits on rate spreads under the new law (3 times the base rate, maximum), and they hate not being able to cap costs.

There are flaws in the bill, and it's true that it doesn't drive down the cost of health CARE. This is because we have this whacked up system where health providers are for-profit, health risk pool providers (insurers) are for-profit, and they rely upon innovation to drive profit margins up, rather than health risks down.

Nevertheless, Republicans are discovering the truth: The status quo is unsustainable, unaffordable, and discriminatory. Now what will they do about that? And how will they appease their angry hordes of Tea Party members being stoked daily via email and fear campaigns?

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