Star Tribune

Distributed by Tribune Content Agency, LLC.

U.S. Sen. Mitch McConnell kicked off Tuesday’s debate on the Republican health reform plan by promising “We can do better than Obamacare.” It’s only fair that consumers and patients in Minnesota and elsewhere hold the Senate majority leader from Kentucky — and his party — to his word as debate barrels forward in Congress over plans to repeal the Affordable Care Act.

Will the GOP plan lower monthly premiums for health insurance? Will it lower deductibles that force policyholders to shell out thousands of dollars before coverage kicks in? Will the plan ensure affordable coverage for those with serious medical conditions, expand the number of plans to choose from, and strengthen Medicaid for kids, the elderly and the disabled?

This is what it means to do “better than Obamacare,” and there shouldn’t be any dispute about that. Health reform ought to serve consumers, not political needs. On Tuesday, Republicans selfishly cast aside this responsibility with a vote that breathed new life into their party’s secretive, shapeshifting reforms.

Calls to improve the legislation do not change this ugly truth: GOP reforms do the opposite of McConnell’s promise. Whether it’s a pared-down “skinny repeal” or a full replacement, the main planks of the party plans remain in play — deep cuts to Medicaid, reckless regulatory rollbacks or reduced aid to pay premiums — despite damning evidence that these “solutions” are anything but.

Multiple analyses from the Congressional Budget Office have concluded that GOP reforms will generally increase premiums (especially for older people), hike deductibles, result in fewer insurers selling individual plans and pull at least $772 billion out of Medicaid by 2026. Reducing health care spending by $1 trillion over 10 years has consequences. Adding back piecemeal sums of money, such as $45 billion for opioid addiction, cannot make up for that.

It’s pure fantasy that the free market will make these painful impacts disappear. Insurers have already cited uncertainty created by the GOP reform roller coaster for steep rate hikes in 2018. A recent Senate push to remove a waiting period for those who go without coverage will further destabilize the marketplace. Insurance doesn’t work when people game the system by waiting until they are sick to buy coverage. Failing to penalize this will scare off more insurers from offering plans in the individual market.

Tuesday’s vote does not guarantee the GOP plan’s passage. A final bill likely will have to clear both congressional chambers. Minnesota’s three Republican House members — Erik Paulsen, Tom Emmer and Jason Lewis — already voted “yes” on the original House health bill despite objections from constituents and state officials worried about deep federal funding cuts to health services. Another “yes” vote would deepen the trio’s ownership of the real harm the GOP reforms would cause.