Healthcare, again.

People ought to know when they’ve been conquered.

That was a line from the film, “Gladiator” but it applies in equal measure to the Graham-Cassidy bill, the latest abomination to masquerade as healthcare “reform” trotted out by the GOP, which hopes to finally, somehow, live up to seven years of campaign promises to repeal Obamacare and somehow replace it with something or other.

When the last couple of attempts went down in flames, I thought that I would finally be done on the topic, especially since we now know that there are no counties in the country where Obamacare plans are unavailable and since the insurance market seems to have stabilized, although you’ll easily find people ready to declare that the sky is falling.  But importantly, insurance execs aren’t among them.

This latest fiasco is perhaps the worst of the bunch, but for the idea of a repeal with no replacement.  True to form, Republicans have no ideological drive to actually ensure that coverage stays in place for most of those who have gained it through the ACA’s Medicaid expansion or who can now afford policies on the exchanges that will cover pre-existing conditions.   Instead, what has been produced is an ideological document which is a grab-bag of unworkable ideas crammed together by people with no apparent understanding of the health insurance industry.

Graham-Cassidy, make no mistake, is cruel – plain and simple.  It’s been sloppily drafted by people who don’t grasp the industry they’re trying to reshape, and it’s been sold, without exception, on the back of a bunch of flat out lies.

Graham-Cassidy eliminates the individual mandate that brings younger and healthier people into the risk pool, and allows insurers to cover preexisting conditions and offer ACA’s essential benefits.  It replaces direct aid to individuals with block grants to states, under a formula that sharply reduces funding relative to current law, and especially penalizes states that have done a good job of reducing the number of uninsured. And it effectively eliminates protection for Americans with pre-existing conditions, by allowing states to get rid of that provision upon a showing that it’ll reduce costs.  Well, duh, of course it will, which is why people with pre-existing conditions would be screwed by this law.  Graham and Cassidy both insist this isn’t so, but that’d be news to anyone who actually read the thing.  The AMA, the insurance industry and Blue Cross/Blue Shield have all warned that millions will lose coverage.  And all 50 state Medicaid directors oppose it, characterizing it as a huge transfer of financial risk to the states, who will be left with dwindling funds to deal with the sick and uninsured.

Republicans are trying to ram the bill through before the Congressional Budget Office has time to analyze it, which more or less shows you everything you need to know about the bill’s ability to withstand scrutiny.  But C.B.O. has analyzed other bills containing some of Graham-Cassidy’s provisions, and those prior analyses confirm that it would cause more than 30 million people to lose coverage.  It’s polling at 24% approval.  It’s literally opposed by three quarters of the country.  But they are trying to do it anyway.

Most states would experience a serious cut in federal aid to deal with their sick and poor citizens’ healthcare, and every state would face huge cuts after 2027.  The bill is just another attempt at eliminating Medicaid.

So we’re looking at an incompetently drafted bill that would hurt millions of people, whose sponsors are trying to sell it with transparently false claims. How is it that this bill might nonetheless pass the Senate?

Because Republicans desperately want to destroy President Barack Obama’s legacy in any way possible, no matter how many American lives they ruin in the process.

Because most Republican lawmakers don’t know or care about how their policies effect the healthcare and insurance industries.   They are trying to keep a promise to undo what Obama did, on that basis alone, even though in 8 years they never tried to understand why Obamacare works the way it does or considered how to come up with something different which wasn’t utterly vicious and mean.

And that, in a nutshell, is why Graham-Cassidy is a suitable metaphor for the Republican party of today.  It doesn’t know anything, tries to do it anyway, and doesn’t care how many people it hurts in the process.

When it likely fails next week – and hopefully it will – let’s all hope that Lindsey Graham just goes back to masturbating over the idea of bombs falling on Iran.  It’s what he does best, and as he’s proved with this bill, it might be all he’s good for.