March 23, 2017

As the clock ticks on Republicans' opportunity to raise a collective middle finger to Barack Obama's signature legislative achievement, Republicans are closing in on a deal with Donald Trump which will do exactly the opposite of what he promised.

As Chris Hayes observed:

That's right, welcome to your new subprime health insurance market, where you can pay massive premiums for no coverage whatsoever, while your tax dollars go to subsidize the markets and create new speculation opportunities for billionaire investors.

Jonathan Chait enumerates the ten essential benefits which the amendment will eliminate:

The proposal is to eliminate ten essential benefits that, according to the Affordable Care Act, must be offered as part of any insurance plan. Those benefits are:

  • Outpatient care without a hospital admission, known as ambulatory patient services
  • Emergency services
  • Hospitalization
  • Pregnancy, maternity, and newborn care
  • Mental health and substance use disorder services, including counseling and psychotherapy
  • Prescription drugs
  • Rehabilitative and habilitative services and devices, which help people with injuries and disabilities to recover
  • Laboratory services
  • Preventive care, wellness services, and chronic disease management
  • Pediatric services, including oral and vision care for children

In other words, all potential benefits of health insurance, like covering hospitalization and prescription drugs, gone in favor of some sort of ridiculous a la carte system where men don't have to pay for maternity benefits but women would have to pay for men's boner pills if they wanted prescription drug coverage. Apparently men don't have anything to do with pregnancy, either.

This is Paul Ryan's nirvana right here, and apparently it's enough to get the Freedom Caucus on board.

But it's going to make things very, very difficult for Donald Trump, who promised all of those voters who believed in him that he would magically make health insurance more affordable without taking their benefits away. Those people in West Virginia who voted for him because they believed him when he said he'd help them with the opioid addiction issues, the ones who heard him say he wouldn't take their Medicaid coverage away, will now be confronted with their new reality, where they can't actually get affordable coverage for what they need.

And just look at the petty, cruel things they're eliminating. Glasses for kids. Dental services for kids. And so very much more.

Because it is so very cruel, there are a handful of moderate Republicans who cannot support the bill and keep their seats in 2018. It is now time for everyone to call their Representatives and let them know that anyone who votes for this travesty will have to contend in 2018, no matter whether they're Paul Ryan or Charlie Dent.

This is the Republican Party right here, intent on making sure children can't get glasses and people with injuries can't get rehabilitative devices. They need to pay for this, and pay dearly.


Matt Yglesias:

As Slate’s Jordan Weissmann explains, the issue is that millions of Americans will be given essentially free money in the form of tax credits they can use to buy health insurance. The free money won’t be enough to buy good health insurance, but without the Essential Health Benefits in place there will be no requirement that insurance companies offer good insurance. You can just craft a cheap, totally worthless plan, spend a ton on marketing it, and scoop up government money.

While plans sold this way might be totally useless as health insurance, they don’t need to be entirely worthless. You could market them with some throw-ins that are likely to appeal to a relatively young and healthy population — a free copy of the latest Zelda game or coupons for some yoga classes — even while providing basically no value to someone with extensive health care needs.

Subprime seems to fit perfectly here.

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