Slower action, hearings needed on Obamacare

The recent secrecy around health care reform in Washington, D.C., is a national disgrace. Republican leaders controlling the U.S. Senate were wrong to keep details of their Obamacare replacement plan secret and to fast track it to passage by July 4 — all without public hearings.

This is as wrong as policy making can get. But it is no wonder. The GOP proposal released Thursday would retain some of the Affordable Care Act’s income-based subsidies, which is a small improvement on the draconian plan that passed in the House. But it heartlessly risks throwing millions of Americans off the coverage rolls over the next decade.

Early reports say the Senate plan reverses the Medicaid expansion after 2020, reduces eligibility, caps payments to states based on the number of low-income people enrolled, and is certain to reduce the number of Americans who receive tax credits to help pay for private plans they buy through exchanges. A minority of Americans — those who aren’t covered by employers, who are ineligible for Medicaid or Medicaid and who still need insurance — ever buys it on the individual market.

The proposal also lets insurers jack up premiums for older consumers that are five times higher than for young consumers, up from the three-fold cap in the ACA.

More than 600,000 Washingtonians gained coverage since 2013 through the expansion of Medicaid and sale of subsidized insurance plans sold through a state run exchange. Despite a destabilizing of individual markets nationally, Washington’s market has grown overall.

By keeping his party’s changes secret, Senate Majority Leader Mitch McConnell, R-Kentucky, managed to avoid a total meltdown in his caucus as he tried to craft a bill that gets a bare majority of votes. Unfortunately he’s hell bent on delivering a campaign promise and also wants to confer a multi-billion dollar tax break on the nation’s wealthiest.

Any real reform proposal must improve coverage, reduce or hold down premium costs and expand the number of Americans insured. Failing that is an invitation to a single-payer system.

For legislation this huge and vital, there should be an independent analysis of the bill’s impacts followed by public hearings in the Senate. Two independent analyses of the House-passed ACA-replacement plan found it would throw at least 20 million Americans off health care over a decade — in addition to the millions still not covered by the ACA.

Hospitals, doctors and pretty much every medical advocacy group in our state is opposed to the House approach.

GOP leaders assailed Obamacare on grounds it didn’t get enough public exposure before its adoption by slim margins in 2010. They need to take their own advice.

Sunlight is a disinfectant for government and the bad ideas it can breed. The Senate needs to slow down its policy railroad and shine a bright cleansing light on its proposal.

This story was originally published June 22, 2017 at 9:01 PM with the headline "Slower action, hearings needed on Obamacare."