UPDATE: We’re thinking of a word that starts with “cluster” and rhymes with “duck.” There’s no better way to encapsulate the just-released newest version of a House Republican Obamacare repeal plan.
Another major twist in the intra-GOP battle over repealing the Affordable Care Act, a.k.a. Obamacare, a long-sought objective of the Republican Party now imperiled as swing-state GOP lawmakers blanch at the human costs of keeping their promise. Today, four GOP U.S. Senators including Sen. Cory Gardner of Colorado signed a letter to Senate Majority Leader Mitch McConnell, objecting to inadequate protections for the Medicaid expansion population under the House’s repeal plan:
Today, U.S. Senators Rob Portman (R-OH), Shelley Moore Capito (R-WV), Cory Gardner (R-CO) and Lisa Murkowski (R-AK) sent a letter to Senate Majority Leader Mitch McConnell (R-KY) outlining concerns that the February 10th draft health care plan from the House does not adequately protect individuals and families in Medicaid expansion programs or provide necessary flexibility for states….
While we support efforts to repeal and replace the Affordable Care Act and make structural reforms to the Medicaid program, we are concerned that the February 10th draft proposal from the House of Representatives does not provide stability and certainty for individuals and families in Medicaid expansion programs or the necessary flexibility for states.
We are concerned that any poorly implemented or poorly timed change in the current funding structure in Medicaid could result in a reduction in access to life-saving health care services. The Medicaid population includes a wide range of beneficiaries, many of which cycle on and off Medicaid due to frequent changes in income, family situations, and living environments. The Department of Health and Human Services reports that nearly one-third of individuals covered under the Medicaid expansion have a mental health or substance use disorder. As the largest payer of mental health and substance use services in the United States, it is critical that any health care replacement provide states with a stable transition period and the opportunity to gradually phase-in their populations to any new Medicaid financing structure.
So, there are a few things to unpack here. First of all and most obviously, these Senators’ objections could create a serious impediment to the repeal of the Affordable Care Act. There is no safe margin in the U.S. Senate for Republican defection, and these four could spell the difference between success and failure for anything that comes out of the House.
Given Gardner’s intense campaigning against the Affordable Care Act, both as a Congressman and as a U.S. Senate candidate in 2014, signing this letter could be considered a huge blow to the repeal effort. A big reason for that is Gardner has already voted in favor of an Obamacare repeal plan that killed the Medicaid expansion he claims he wants to protect. The Hill reported in December 2015:
The measure guts the law by repealing authority for the federal government to run healthcare exchanges, and scrapping subsidies to help people afford plans bought through those exchanges. It zeros out the penalties on individuals who do not buy insurance and employers who do not offer health insurance…
“This bill is a substantial improvement over the original House bill, and I’m grateful to Senate conservatives and Senate leadership for joining me in making it so,” Cruz said in a statement after the vote.
It repeals the expansion of Medicaid adopted by 30 states as well as many of the law’s tax increases, which the House bill left in place. [Pols emphasis]
You see, as a “message bill” with no real chance of becoming law, Gardner was delighted to vote to kill the Medicaid expansion! Today, with any such vote having a good chance of resulting in actual policy changes, it’s a much dicier proposition.
And suddenly, Gardner has lost the nerve to carry out what was once a proud promise.
Does Gardner’s shift away from a hard line on Medicaid expansion vindicate the “paid protesters” he has dissed at every opportunity? Without a doubt it does–how else is Gardner supposed to explain this evolution away? But will Gardner see any relief from the drama, now that he has come out in favor of protecting Medicaid expansion patients? We don’t think so. Gardner’s previous strident (and frequently misleading) claims about the Affordable Care Act have left him him in a serious credibility hole with the law’s backers, as does his continued lip service to “repeal and replace”–even as the list of “repeal” items gets shorter. Meanwhile, conservatives demanding repeal without regard for consequences see Gardner selling them out.
The most likely explanation, of course, is that Gardner’s newfound objections to repealing the Medicaid expansion are just meaningless theater–staged for appearances, in order to confound opponents and to pretend to be responsive. But we can’t ignore the growing evidence of fear: of what it’s going to mean if the promise to “repeal Obamacare” is actually kept.