With Affordable Care Act subsidies poised to expire and tens of millions of American consumers facing painful spikes in their health care costs, Senate Republicans pitched a bill last week that made no effort to extend the existing enhanced tax credits. Rather, the plan from Sen. Bill Cassidy of Louisiana and Mike Crapo of Idaho tried to replace the subsidies with expanded health saving accounts.
It was an inadequate proposal that was easily defeated: When the plan reached the Senate floor, it needed 60 votes to advance. Facing bipartisan opposition, it received 51.
As for the GOP majority in the House, party leaders have spent months insisting that they’d present a plan of their own, and on Friday, they fulfilled this promise — sort of. As my MS NOW colleague Clarissa-Jan Lim reported:
The bill includes several measures that have broad support among Republicans, including reinstating cost-sharing reductions and allowing small businesses to buy health insurance as a group. But it notably would not extend enhanced ACA subsidies, which are set to expire in just a few weeks.
The expiration of those subsidies is expected to cause premiums to more than double on average for roughly 22 million Americans.
For those keeping score, this proposal, unveiled late Friday by House GOP leaders, is one of at least 10 different health care bills pushed by congressional Republicans in recent weeks, as the party struggles to coalesce around a unified approach.
At this point, it’s important to define some of the relevant terms here. Broadly speaking, there’s been talk in GOP circles for roughly 16 years about creating a comprehensive Republican alternative designed to replace the Affordable Care Act. Separately, GOP officials have also focused more recently on a plan to address the expiring ACA subsidies and looming spike in health care coverage premiums.
The legislation unveiled late last week by House Speaker Mike Johnson and his colleagues neither replaces the ACA nor resolves the more immediate crisis facing tens of millions of consumers.
So when you see references to the party’s “plan,” we’re talking about a narrow, half-hearted bill, filled with disparate and loosely connected conservative ideas, that Republican leaders believe might help address health care costs — while allowing existing insurance subsidies to evaporate as scheduled in the coming weeks.
Longtime readers know that I’ve been digging into proposals like these since the debate over Obamacare started in 2009. But in this instance, there are two reasons why this isn’t worth a deep dive. The first is that House GOP leaders aren’t even pretending to have completed a serious health care blueprint. They threw together a handful of items from partisan wish lists, which they intend to bring to the floor without holding a single policy hearing, without a Congressional Budget Office score, and without any meaningful substantive analyses of any kind. The point of this endeavor isn’t to solve a problem; it’s to offer political cover to House Republicans worried about their backsides. They want to be able to say, “See? We unveiled a plan,” and this helps them check a box in the most superficial way possible. The other reason not to dwell too much on the details is that the House GOP leadership’s bill will never become law. There’s some question as to whether it can even pass the lower chamber, but even if it does, its odds of success in the Senate are nonexistent. As for the White House, which Republicans in both chambers keep looking to for some semblance of leadership or direction, Donald Trump has practically checked out of the process. Asked Friday for his message to the tens of millions of Americans facing dramatically more expensive health care insurance, the president replied: “Don’t make it sound so bad.”
Steve Benen is a producer for "The Rachel Maddow Show," the editor of MaddowBlog and an MS NOW political contributor. He's also the bestselling author of "Ministry of Truth: Democracy, Reality, and the Republicans' War on the Recent Past."
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