Brian Howey: Health care reform and a lack of bipartisanship
Friday, March 17, 2017 2:35 PM
MUNCIE – President Trump sits in the White House today because, in part, Democrats ceded rural Indiana and rural America. The Hoosier State is barely functioning in a two-party system.
President Trump talks with U.S. Rep. Jim Banks and the Republican Study Group at the White House on Friday.
I asked Indiana Democratic Chairman John Zody for a list of county chairs elected on March 3. According to a party spread sheet, Daviess, Gibson, Martin and Henry counties listed no chair. Mine down a bit further and you see Donald Trump won Daviess County with 79.6 percent of the vote, 71.6 percent in Gibson, 69.2 percent in Henry and 76.9 percent in Martin.
This is all relevant because during the 2016 presidential campaign, candidate Trump vowed repeatedly and vociferously to repeal and replace Obamacare. In January, Trump promised “terrific” coverage “for everybody.” The new Health and Human Services Sec. Tom Price vowed that “nobody will be worse off financially” with the plan proposed by House Speaker Paul Ryan and is being pushed by Vice President Mike Pence.
A Congressional Budget Office scoring of RyanCare this past week reveals an $880 billion cut for Medicaid, prompting 14 million of those, including many of the 420,000 Hoosiers enrolled in the successful Healthy Indiana Plan 2.0, will likely lose coverage. There will be a $300 billion tax cut for wealthy Americans.
But, according to the Kaiser Family Foundation, the replacement of Obamacare subsidies for poor and middle income folks with RyanCare tax credits isn’t going to be such a great deal. The Kaiser analysis reveals: Under the ACA in 2020, we project that a typical 40-year-old making $20,000 per year would be eligible for $4,143 in premium tax credits, while under the American Health Care Act, this person would be eligible $3,000. A 40-year-old would face a 59 percent loss.
How much would Hoosier residents in the four counties that Indiana Democratic Party has essentially abandoned lose in health care Obamacare subsidies to the RyanCare tax credits on the Kaiser interactive map? In Daviess it would be 557 percent (yes, 557 percent), in Gibson 61 percent, in Martin 115 percent and in Henry 73 percent. Essentially, these Hoosiers are voting against their own economic interests.
A White House analysis that RyanCare coverage losses would include 17 million for Medicaid, six million in the individual market and three million in employer-based plans. A total of 54 million individuals would be uninsured in 2026 under the GOP plan.
Republican Gov. Eric Holcomb told the Fort Wayne Journal Gazette on Monday, "I want to make sure that we are compassionate and we cover the Hoosiers that we are right now. I completely believe we have to fix the Affordable Care Act, and the repeal was the right first step, but the devil's always in the details." Holcomb says HIP 2.0 is working. "I have not seen a more successful program. I don't want to overreact ... but I do think that HIP 2.0 is part of that answer in how our nation can address the issue of health care."
With the Tea Party oriented Freedom Caucus pushing RyanCare to the brink of an embarrassing defeat, Pence and others pushed the idea of actually accelerating cuts to Medicaid from 2020 to 2018. Essentially, Pence is calling for the evisceration of HIP 2.0, his most successful policy achievement as Indiana governor.
U.S. Rep. Luke Messer was attempting to help Ryan and Pence line up votes for House passage, even though they know the bill will be dead on arrival in the Senate, where moderate Republicans don’t want to gut Medicaid. Messer told Politico, "My perception is that changing that date would lose at least as many votes as it would gain.”
Republicans flirt with political disaster if they can’t deliver credible reform or take away coverage from millions of Americans. A Fox News Poll shows that 54 percent oppose the GOP plan and 34 percent favor. And this: 50 percent have a favorable opinion of Obamacare. That's unchanged from January, and up from 38 percent from March 2015.
Another Republican, U.S. Sen. Lindsey Graham of South Carolina, observed, “Here’s what I would tell the president: If you can't get a better deal and . . . you can't get the Republican party on board, stop, take a time-out, let it collapse. Then turn to the Democrats and say this was the system you created. It has collapsed, now help me replace it. That’s what I would do."
What is absolutely stunning is that instead of spending the last seven years evolving Obamacare, Republicans dug in, criticized, cast 50 votes for repeal, and then when given the chance to replace/repeal, are exposed as vapid and divided.
Graham may be on to something here. This type of social engineering that impacts hundreds of millions of Americans and one-sixth of the economy requires bipartisan work. We need the kind of artful deal making that President Reagan and Democratic Speaker Tip O’Neill were so good at when they saved Social Security in 1983 and forged tax reform in 1986, both with bipartisan support.
We. Need. True. Leadership.
The columnist is publisher of Howey Politics Indiana at www.howeypolitics.com. Find him on Facebook and Twitter @hwypol.