Trejos: Affordable Health Care Act is a clumsy, regressive failure

Jose Trejos, Columnist

After an embarrassing failure to pass the American Health Care Act the first time around, House Republicans managed to pass it last week with a four-vote margin. On some level, the AHCA as it stands is fairly insignificant, since Senate Republicans have been blatant about their plans to rewrite it almost from scratch before passing it. However, this bill deserves study as the culmination of what is wrong with the current Republican Party.

The AHCA is a bad policy that is both clumsy and regressive. Oftentimes, liberals accuse Republicans of pursuing policies that distribute money to the wealthy, but these policies are usually pursued to incentivize desirable economic behaviors. For example, low capital gains taxes are very regressive, but are generally agreed to increased economic growth. However, the AHCA breaks from this principle by transferring Obamacare’s insurance subsidies for low-income Americans to the general population based on age. This proposal only makes sense in a party that wants regressive policy per se, as the wealthy do not actually need an incentive to buy insurance.

Other vulnerable populations also would fare terribly under the AHCA. The bill would shift those with preexisting conditions into high-risk pools, which could lower premiums and make the market function better if handled correctly. However, the AHCA proposes ridiculously underfunded high-risk pools, giving merit to the Democratic talking point that the bill may get people killed. Some of the incentives the law provides also make no sense, such as imposing a 30 percent cost penalty for buying insurance on those who lapse on their coverage, which will meaninglessly incentivize the uninsured to stay uninsured. It is no wonder only 17 percent of Americans support the AHCA when it is the embodiment of every criticism Democrats levy against Republican policy.

The reason why this bill is such a disaster is mostly due to a failure to handle politics rather than policy. Republicans have promising ideas to reform health care, such as subsidized high-risk pools, insurance plans across state lines, expanded health savings accounts, increased availability of catastrophic health insurance, and tort and regulatory reform. However, effective versions of these plans would violate the Byrd Rule, which gives AHCA immunity from a Democratic filibuster if all of its clauses are strictly budgetary. In essence, the reason the AHCA is a mess is because Republicans couldn’t figure out a way to pass it properly and instead tried to create a complex health care system with only one legislative tool.

With solid control of three branches of government, it shouldn’t have been that difficult to force a reasonable bill through the Democrats. If the Republicans had introduced a better bill, the Democratic Party would have been trapped eternally filibustering a popular replacement even after losing an election over it. The government shutdown in 2013 may be an extreme example, but it shows that these tactics are a political disaster, which makes it surprising that Republicans were so cowed by such a threat.

The reason Republicans cannot pass anything is ultimately because the so-called “dealmaker” who leads them has failed to stand up to Democrats or even his own party. In the debate over the federal budget last week, Republicans were so afraid of being blamed for a shutdown that they conceded to almost every demand from the Democrats. After the House Freedom Caucus blocked the first version of the AHCA — which moderates only begrudgingly supported — President Donald Trump timidly granted most of their conflicting demands, which could only lead to an incoherent bill. What scares him the most seems to be his supporters, who eagerly voted for his imaginary health care plan that would finally repeal Obamacare while instituting both cheap and universal coverage. Every week, his failure to replace Obamacare despite controlling every branch of government will sink in deeper, causing him to order rushed and shoddy bills that he hopes will pass quickly just so he can sign something.

It’s interesting to me how Trump somehow has the reputation of an irrational and stubborn negotiator who insists on getting everything he wants. In reality, he has so far managed to give Democrats completely free victories in the budget and in health care, because he is scared of a serious confrontation and doesn’t know how to lead a party. Legislatively, Republicans are in a stronger position than arguably any party since the New Deal. If Trump continues to bow down to the Democrats and even factions of his own party, his supporters will grow less and less willing to forgive him.

Jose Trejos is a Weinberg sophomore. He can be contacted at [email protected]. If you would like to respond publicly to this column, send a Letter to the Editor to [email protected]. The views expressed in this piece do not necessarily reflect the views of all staff members of The Daily Northwestern.