Will Their Dogged Opposition To Health Care Catch Up With Republicans In 2018?

Earlier today we looked at the need for Democratic candidates to talk with voters more about the issues voters are most concerned with and less about what a walking freak show Trump is. Trump and Putin-Gate may be lots of fun to watch and discuss with friends and colleagues but Americans are going to decide whether or not to vote in the 2018 midterms based, at least in part, whether or not Democrats are offering sound, realistic alternatives to the issues they themselves are most concerned about. And there's nothing that trumps healthcare policy and the way Paul Ryan, Tom Price, Mike Pence and the Republican Party have botched that up.

In his column in Sunday's L.A. Times Michael Hilzik got into the reasons why the entire healthcare industry is panicking that Trump is about to blow up Obamacare. It's no coincidence that the photo The Times led with was of Trump and Ryan. "Action being contemplated by Trump," wrote Hilzik, "could lead to millions of Americans suddenly moving 'to the ranks of the uninsured,' a coalition of healthcare groups wrote in a letter to Senate Republican and Democratic leaders. 'This threatens not just their own health and financial stability, but also the economic stability of their communities.'... The industry leaders and states are reacting to signs that Trump is a thin reed to rely on to preserve health coverage for millions. 'The President has increasingly made clear that he views decisions about providing access to health insurance...as little more than political bargaining chips,' the states say in the motion to the appeals court." The healthcare industry and attorneys general from 15 states and the District of Columbia are taking the Regime to court.

The issue before the court is a dangerous one for the Affordable Care Act and some 10 million Americans who depend on its individual exchanges for their health coverage. At the center of the case are the act’s cost-sharing reductions-- subsidies covering deductibles and co-pays for individual buyers with income less than 250% of the federal poverty line.

The subsidies this year come to $7 billion, to be paid to insurers covering 7 million customers. The subsidies are authorized under the healthcare act, but House Republicans filed a lawsuit in 2014 asserting that because the money hadn’t been specifically appropriated, paying the money is illegal. They won the first round in U.S. District Court last year, but the judge stayed her ruling pending an appeals court decision.

Ending the cost-sharing reductions would destroy the individual insurance market in many states, where insurers have the legal right to cancel policies immediately if the CSRs aren’t paid.

That’s where matters stand. Since his inauguration, Trump has dithered over whether to pay out the subsidies and continue fighting for them in court. On occasion, he’s threatened to kill the payments as a bargaining chip to force Democrats to negotiate an Obamacare repeal.

On Tuesday, according to Politico, Trump told aides he wants to end the subsidies. And as my colleague Noam Levey reported Thursday, at a recent meeting, Trump’s new Medicaid and Medicare chief, Seema Verna, offered a bargain to stunned industry officials: The administration would fund the cost-sharing reductions if insurers supported House Republicans’ hugely unpopular bill to repeal the Affordable Care Act.

These alarming signals prompted the flurry of letters and pleas filed Friday by insurers and state officials. The industry letter was signed by America’s Health Insurance Plans, the insurance industry lobbying group; the American Academy of Family Physicians; the American Benefits Council; the American Hospital Assn.; the American Medical Assn.; the Blue Cross Blue Shield Assn., the Federation of American Hospitals and the U.S. Chamber of Commerce.

They called uncertainty about cost-sharing reductions “the single most destabilizing factor causing double-digit premium increases for 2018.” Insurers must file preliminary rate requests in many states by June 21, which means they’re pondering right now whether to participate in the market next year.

The consequences of a blowup are dire, they warned. Not only will millions lose their coverage, but doctors, hospitals and employers will face higher healthcare costs. Taxpayers will pay billions in extra costs, they wrote, because higher premiums will mean higher tax subsidies for eligible buyers. And for more than 2 million Americans in the individual market who earn too much to receive subsidies, higher premiums could make coverage unaffordable.

The organizations place the responsibility squarely on the lawmakers: “At this point, only Congressional action can help consumers.” That’s because the CSR issue would be rendered moot by a simple fix of a few lines enacted by Congress, authorizing the payments.

Oncologist Jason Westin, the Democrat mostly likely to face Houston anti-health care Republican John Culberson in 2018, was interviewed by The Atlantic recently. He told them that "This is personal for me. All of my patients have pre-existing conditions and I can’t do anything in my current role to fight back for them. I’ve had a lot of patients who have problems with insurance. They’re doing well in clinical trials of life-saving drugs, but their access is now threatened. This isn’t a political football. This is going to hurt real people."

The Atlantic continues that Westin "is perplexed by the Republican physicians who have voted for the AHCA. 'The Hippocratic oath I took said: First, do no harm,' he says. 'How could someone else who took that same oath look at the same bill and support it? I don't know... [TX-7] is a highly educated area, with a major medical center. It’s ripe for someone with a background in science and medicine to speak on political issues with authority.'"

Anyone who has followed this for any length of time knows that it's the Republican Party-- as a matter of dogma-- that opposes government efforts to define health care as part of what society in general (through government) owes the citizens. Conservatives have fought a dogged battle against Social Security, against Medicare, against Medicaid and, most recently, against the Affordable Care Act. This is horrific and it speaks for itself in terms of what the GOP as a party has been doing in their war against working families: