Sunday, March 11, 2018

Policy that mattered while you weren't watching (healthcare edition)

Remember all of the health insurance sabotage?

Yeah, I know, that means you have to tear yourself away from the President getting sued by a porn star about the hush money he paid her, the fact that we don't know if there will be talks with North Korea, the fact that the President just started a trade war because he can, Mueller's ongoing investigation and...

Damn, it's hard to keep up.

Anyway, if you recall, first Trump decided to cut off the cost-sharing subsidies.  Health insurance companies that get expensive customers are supposed to have money allocated to them to even out the costs and balance out the risks, but the ACA was sloppily written, and there was an error in which the money wasn't properly appropriated.  Obama made the payments anyway, but congressional Republicans weren't about to fix the error, and Trump decided it would be more fun to sabotage the markets and try to crash the companies that get expensive customer bases, 'cuz, you know, Trump is all about following the letter of the law.  Then, the tax bill repealed the individual mandate, which required healthy people to buy insurance, making it possible for health insurance companies to turn a profit even though they are required to insure the sick people.

So, if you run an insurance company, you are required by law to insure the sick people, the healthy people are no longer required to participate in the insurance markets, and the cost-sharing subsidies are cut off.  That's a lot of sabotage, and it was intended to crash the insurance markets so that the GOP could use the crash as a justification for a full repeal.  That was the reason.  Period.

Some Republicans didn't like the idea.  Example:  Susan Collins.  But she wasn't alone.

When Trump cut off the cost-sharing subsidies, Sen. Lamar Alexander (R-TN) started working with Sen. Patty Murray (D-WA) on a bill to restore them by, among other things, fixing the screw-up in the ACA that gave the president the power to do what Trump did.  The Alexander-Murray bill was never really going anywhere, though.

Then came the tax bill.  Once the individual mandate repeal was proposed for inclusion in the tax bill, that was it.  It was going to happen, as I wrote consistently.  That brings me to the ever-impressive idiocy of Sen. Susan Collins (R-ME).

Collins claimed to hate the idea of that much sabotage for the health insurance markets.  She said she would only vote for the tax bill-- which then included an individual mandate repeal-- if she got a promise of action on Alexander-Murray or something like it (she had her own proposals).  She voted yes, in exchange for that promise.

What did I write?  I wrote that she got conned.  See, for example, here.  Murkowski negotiated for something real, and got it, but Susan Collins got conned.  Alexander-Murray was never going anyway.

So... let's check in on Alexander-Murray.  How's that pulse?



There are a few negotiations going on between the House, Senate and White House on options for restoring the cost-sharing subsidies, and they are all collapsing completely right now.  If I had to bet, I'd bet that we don't even see a vote on any of this.  As predicted.

No comments:

Post a Comment