The past two weeks have been a revelation into how the Capitol GOP thinks. After seven long years of complaining how President Obama and the Democratic majority rushed through the Affordable Care Act (it took over 10 months and a version of Romneycare stolen from Massachusetts), the GOP decided to push their American Health Care Act through in less than two weeks. And they tried to keep it secret as long as they could even including hiding the draft in a locked room in the basement of the Capitol and only letting one representative at a time read it and no copies allowed!

And then presenting a half-assed (and that is being generous) plan that provided nearly no health insurance at all coupled with serious tax breaks for the rich. For a variety of reasons, major portions of the house wasn’t buying it. And their constituents back home, through a number of grass roots movements in opposition, harassed them at town halls and overwhelmed their offices with emails and phone calls.

And then just like that, without much notice, they made major changes to the AHCA in order to win support from the Freedom Caucus (Tea Party). Changes that made the bill far more onerous and put their moderate compatriots in a dither. They were going to have even more problems selling this new plan back home than the original version.

And then the president stepped in and essentially threatened Republican opponents of the bill…saying he would get them in 2018 if they voted against the bill (and I don’t think he even understood either version of the bill much less the existing ACA). For probably the first time, President Trump hit the wall and realized that the Republicans in the house felt more responsibility to their constituents than they do for the White House (i.e. they want to get re-elected). Which brings up the other part of the pressure brought to bear by the president. He kept exclaiming that the GOP would have a hard time in 2018 if they didn’t repeal and replace NOW! But even the opportunists in the house realized it would be harder to explain why people lost health care coverage than explain why the repeal failed.

Which brings up the next question…and I am not sure this entire episode answers this question or not. Is the GOP resistance to Obamacare because they continue to oppose the Obama agenda or are they truly against the government providing health insurance to all Americans? (Senator Graham was quoted as saying he didn’t think health care was a right but instead a responsibility [?])

But the fact they were ready to jettison what the president had termed the best plan so quickly is troubling. And how they were willing to bring the first bill forward without vetting from the Congressional Budget Office is appalling. Particularly in light of how nervous everyone got when the preliminary numbers came out last Monday. And how the follow up numbers got worse later in the week. And how they were going to vote on version 2 without any CBO numbers and with absolutely no idea what version 2 was going to cost.

But what is really scary is the wreckless abandon found in version 2 that was supposed to go to the vote on Friday. In an attempt to reduce premiums to a minimum, the bill would push to the states, the decision on what coverage a health insurance policy would provide. In essence, the states would decide which of the 10 essential benefits would be included in policies sold within the respective states. This would reduce the portability of coverage across state lines (in theory). But incredibly, if enacted along with the ability to sell insurance across state lines, removes the right of states to actually control the types of insurance offered in their state and the actual insurers authorized to do business in their state. Isn’t that in direct opposition to the GOP’s long held tenet of state’s right? I mean, really?

But just so we are all aware of what I am talking about, here are the 10 essential benefits:

Every health plan must cover the following services:

Ambulatory patient services (outpatient care you get without being admitted to a hospital)
Emergency services
Hospitalization (like surgery and overnight stays)
Pregnancy, maternity, and newborn care (both before and after birth)
Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
Prescription drugs
Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
Laboratory services
Preventive and wellness services and chronic disease management
Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)

Now let me ask you, do you really have health insurance if any of these items are left out of your policy? At what point is the cost of the monthly premium truly throwing away money of you went to the ER to find out you have NO coverage there? Most of us who have employer provided coverage take these benefits for granted. At what point do we finally get fed up and demand health care as a right and Medicare for all?

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