Compromise can get truly affordable health care
Perhaps the art of politics — compromise — isn’t dead, after all. Good for U.S. Sens. Rob Portman, R-Ohio, and Shelley Moore Capito, R-West Virginia, for attempting to jump start it.
I recently suggested the Affordable Care Act, Obamacare, won’t be repealed and replaced unless members of Congress begin compromising. Ideological hardliners, liberal and conservative, need to be brought to their senses.
Attempts to make that happen occurred last week, with Capito and Portman leading the charge.
For weeks, the situation has been this: Most Democrats don’t want Obamacare repealed and replaced. Most Republicans want it scrapped — and for two very good reasons.
First, Obamacare is fiscally unsustainable. The cost of the Medicaid expansion alone is somewhere between $80 billion and $100 billion a year. Add billions more in subsidies to around 9 million people buying insurance on the marketplace. To that, add billions more to help prop up insurance companies losing money because of Obamacare provisions.
A second complaint is that millions of people who were supposed to be helped by the ACA have been hurt. Their premiums have gone up. Insurance companies are pulling out of entire states.
But because Republicans hold only a razor-thin majority in the Senate, all of them have to agree to a replacement plan. About half a dozen, including Capito and Portman, have said they can’t vote for a replacement that hurts constituents.
To date in the House of Representatives and the Senate, Republican proposals have, in essence, pulled back federal support for Medicaid expansion. The 16 million to 18 million people covered under it could be kept on the rolls — but only if their states covered much more of the cost than under Obamacare. That concerns GOP holdouts.
But last week, an amendment to one plan to replace Obamacare was offered by Portman.
In a speech on the Senate floor last Tuesday night, Portman explained the core of his idea, which was to ease the Medicaid transition.
“I’ve worked to put Medicaid expansion on a glide path,” Portman told fellow senators. Instead of reducing federal support in two years, as called for under a House plan, his amendment would have stretched the change out for six years. Under the first three, the Obamacare federal subsidy plan would be retained. The following three years would be a transition to lower federal support.
And — in a very important move — Portman would have given governors “new flexibility … to design innovative Medicaid programs that meet the needs of their states and their expansion population.”
Translation: States would have been given more authority to find ways to provide decent health insurance under Medicaid while reducing costs.
Finally, the bill included $45 billion over 10 years for substance abuse programs.
Portman’s bill was shot down by a resounding 57-43 vote in the Senate. Among those voting for the measure, however, was Capito.
She, Portman and a few other senators were criticized roundly by staunch conservatives and firm liberals. But what they are doing is attempting to get Obamacare repeal and replacement off dead center. The Portman bill was an attempt at the very kind of compromise needed to get a new, truly affordable care act in place.
And notice this: Though the amendment was defeated, 43 Republicans voted for it.
Find other compromises that can attract seven more senators and, with Vice President Mike Pence (hopefully) breaking the tie, the deed is done.
So let’s hope Capito, Portman and company don’t give up. They’re on the right track and, if they can withstand the slings and arrows of the ideologues, may be able to get something important done for all Americans.
Mike Myer is executive editor of The Intelligencer and Wheeling News Register.