The Republican Health Care Bill Is Carefully Crafted to Solve a Specific Problem

In my post this morning about the Republican health care bill, I was going to make a snarky comment about its weakness being driven partly by the Republican desire to avoid anything like the “2,700 page” ACA, which they’ve been griping about for years. But I desisted. There’s no need to get sarcastic when there are plenty of substantive criticisms to make. But then we get this:

These guys never give up. But just for the record, it takes a lot of pages to set up a healthcare system. It takes one sentence to repeal it. That’s why the Republican bill is so short.

And as long as we’re on the subject, Ezra Klein says this today:

The GOP health bill doesn’t know what problem it’s trying to solve

Ezra makes a bunch of good points, and his piece is worth reading. But I disagree with him. There’s no way to say this without sounding hopelessly partisan, so I’ll just say it: Republicans knew exactly what problem they were trying to solve. Their preference has always been to repeal Obamacare and do nothing in its place, but they don’t have the votes to overcome a Democratic filibuster, so they can’t do that. They also realize that the optics of baldly ripping away health coverage from 20 million people would be mildly troublesome.

So their goal was simple: do what they could to destroy Obamacare and take away as much health coverage as they could, without making it look like they weren’t offering a replacement. The result is a plan that offers the trappings of health care—subsidies, pre-existing conditions, etc.—but which is all but useless to the people who actually need it. It’s too stingy for poor people, and mostly unnecessary for middle-class folks who already get health insurance from their employers. It will cost very little because virtually nobody will use it.

The part they apparently didn’t realize is that keeping the pre-existing conditions clause—which is both popular and impossible to repeal—while tearing down the rest of Obamacare is likely to destroy the individual insurance market. At least, I assume they didn’t realize that, since this would be bad news even by Republican standards. I don’t know what, if anything, they plan to do about that. Maybe nothing. Maybe they’re just counting on their repeal bill failing in the Senate, so nothing bad will happen and they can get back to complaining about Obamacare.