Wednesday, December 7, 2016

The coming health insurance scam: Staring into the abyss

Paul Krugman picks the Republican’s looming “debacle” as just one example in The Art of the Scam.

… it’s already clear that bait-and-switch — big but empty promises, completely lacking in detail — will be central to Republican strategy on one key issue: the future of health coverage for millions of Americans.

The background: Back in 2010 President Obama and the short-lived Democratic majority in Congress passed the Affordable Care Act with zero G.O.P. support. Ever since, Republicans have promised to repeal the law as soon as they had a chance, replacing it with something much better. Strange to say, however, they have never described what their replacement would look like.

And I don’t mean that they haven’t spelled out all the details. Almost seven years after Obamacare was enacted, Republicans haven’t offered even the broad outline of a health reform plan. Why not?

Actually, there’s no mystery here. While many Americans say they disapprove of Obamacare, large majorities approve of the things the Affordable Care Act does, notably ensuring that people with pre-existing medical conditions can still buy insurance. And there’s no way to achieve these things without either a major expansion of government health programs — hardly a Republican priority — or something very much like the law Democrats passed.

Worse yet, from the Republican point of view, Obamacare has worked. It’s not perfect, by a long shot, but the number of uninsured Americans has plummeted to its lowest level in history. And Americans newly insured thanks to Obamacare are highly satisfied with their coverage.

So what can the G.O.P. offer as an alternative? We know what Republicans want: a free-for-all in which insurance companies can discriminate as they like, with minimal regulation and drastic cuts in government aid. Going there would, however, cause millions of Americans — many of them people who voted for Trump, believing that their recent gains were safe — to lose coverage. The political blowback would be terrible.

Yet failing to repeal Obamacare would also bring heavy political costs. So the emerging Republican health care strategy, according to news reports, is “repeal and delay” — vote to kill Obamacare, but with the effective date pushed back until after the 2018 midterm elections. By then, G.O.P. leaders promise, they’ll have come up with the replacement they haven’t been able to devise over the past seven years.

There will, of course, be no replacement. And there’s likely to be chaos in health care markets well before Obamacare’s official expiration date, as insurance companies exit markets they know will soon collapse. But the political thinking seems to be that they can find a way to blame Democrats for the debacle.

Lest you think that the Republican dementers won’t do that, consider Charles Blow’s observation about Trump’s Agents of Idiocracy.

… there are disturbing signs about how a Trump administration will conduct itself, from the early diplomatic blunders that signal a worrisome break in the continuity of protocol, to his team nursing vendettas and continuing to dangle the threat of jail in front of his opponents. Last week Conway appeared to waffle on whether Trump or a federal agency during his term might still pursue prosecution of Clinton; the Trump lackey Corey Lewandowski forthrightly said of the executive editor of The New York Times: “He should be in jail.”

And to add insult to injury, Trump surrogate Scottie Nell Hughes uttered this jaw-dropping line last week on The Diane Rehm Show:

“One thing that has been interesting this entire campaign season to watch is that people that say facts are facts; they’re not really facts. Everybody has a way, it’s kind of like looking at ratings or looking at a glass of half-full water. Everybody has a way of interpreting them to be the truth or not true.” She continued: “There’s no such thing, unfortunately, anymore of facts.” Folks, Dimwit-ism is a disease easily spread and denigrators of the absolutism of truth are its vectors.

Blow concludes: “We are not in an ordinary postelection period of national unity and rapprochement. We are facing the potential abrogation of fundamental American ideals. We stand at the precipice, staring into an abyss that grows darker by the day.”

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