Trumpcare 2.0 needs coverage for its preexisting suckiness

The New York Times is reporting that Fred Upton (R – Michigan), the former chairman of one of the House committees that drafted legislation to repeal and replace large parts of the Affordable Care Act came out against a new version of the Trump Administration/Paul Ryan bill on Tuesday, arguing that the revised bill “torpedoes” protections for people with preexisting conditions.

Paul Ryan, for his part, was still out there insisting that the legislation would protect the sick, but the fact of the matter is that the series of negotiations meant to placate the hard-right House Freedom Caucus resulted in a bill which allows states to entirely opt out of the ACA’s mandatory coverage of preexisting conditions as well as its list of required benefits.

Although the revisions bought the support of Freedom Caucus members, they’re  kryptonite to moderates.  If you look a the gubernatorial map, as well as the number of states that have refused the ACA’s Medicaid expansion on partisan ideological grounds, it’s pretty clear that a huge amount of people with preexisting conditions would be left out in the cold, or shuffled off to extremely costly “high risk pools” most of them wouldn’t be able to afford.  And the AHCA as currently written wouldn’t provide nearly adequate funding to help defray those costs so as to allow coverage to remain affordable to people who are already sick.  The upshot:  You would have a lot of “choice”:  You could choose to purchase a plan that covers nothing but doesn’t cost much if you’re healthy, and you’d have a choice between burial or cremation if you aren’t.

The reality is that everybody knows that this bill would never get past the Senate, where moderate Republicans would kill it because it’s so hard on their constituents.  It was hoped, particularly by the House Freedom Caucus yahoos that they could at least pass the thing out of the House so that they could go back to their districts and claim they did their best in advance of 2018 midterms, where they’re all up for re-election.

Upton’s defection was a big blow to that plan.  He is an influential Republican voice on health care, and his declaration of opposition comes as Republican leaders are getting blasted by medical groups, advocacy groups, attack ads and even Jimmy Kimmel, who went viral with a rant against the bill that suggested his newborn son would have died if the House bill was the law.

The problem with all of this chicanery is that the House GOP has locked out experts from providing any input on the bill, with the result that the final product is a monstrosity crafted by people who want to replace the ACA for purely political reasons, which lacks public approval, will drive up costs, will eliminate coverage and kick 24 million people off their insurance plans, because the party insisted on relying on people who don’t understand the dynamics of health insurance at all.

It doesn’t help that the party is led by a president who hasn’t apparently read the bill, doesn’t understand it, and frankly doesn’t care to.  All he wants is to sign a replacement bill and check off a box that says he replaced the ACA.  It breaks every promise he made on the campaign trail, hurts families, and achieves nothing positive that anyone has been able to articulate, other than the possibility of purchasing cheap but useless coverage – and you have to be charitable to call that a positive in the first place.

Things were a lot easier for these folks when they were an opposition party.  The GOP is so fractured that they are simply unable to lead.  They share no governing principles other than the love of money and unrestricted capitalism, are utterly divorced from any moral considerations, and are unconcerned with the public interest, preferring the affections of their large insurance and pharma industry donors.  Never has such a political majority been so squandered on useless lawmakers without the ability to leverage it for the benefit of the nation.