Killing Obamacare without a plan threatens real Americans

By E.J. Dionne

Wednesday, Jan. 11, 2017 | 2 a.m.

Let’s try to get this straight. Donald Trump campaigned as the champion of lower-paid working people who deserve better than they have. Republicans have spent the Obama presidency complaining about high deficits and promising to cut them.

And whenever liberals put forward major reforms, conservatives say, No, no, you can’t make radical changes on the basis of narrow partisan majorities. Let’s take it slow and be very careful. They love to cite Thomas Jefferson’s dictum, “Great innovations should not be forced on slender majorities.”

In moving with reckless speed to repeal the Affordable Care Act, Republicans are violating every one of these supposed principles. That’s because the principle that really matters to them is the one they try to shroud behind happy talk about efficiency and compassion: They want to spend a whole lot less money helping Americans get health coverage.

This needs to be made very clear as their throw-people-over-the-side juggernaut rolls forward. Any vote to repeal Obamacare before there is a comprehensive alternative on the table that all can study, understand and debate is a vote to deprive many of their health insurance. It is a vote to make the lives of millions of Americans demonstrably worse.

And a bunch of politicians who regularly accuse their progressive opponents of being “out of touch” with the “real America” need to be exposed for what they are: a comfortable, affluent and privileged coterie that does not need to spend a single second worrying about whether their kids can see a doctor or whether they will get the care they need if a health disaster strikes.

So let’s see what Republican senators from states whose constituents particularly benefited from Obamacare decide to do.

That means you, Sen. Pat Toomey. The Urban Institute studied the impact of the partial repeal of the ACA through the budget reconciliation process — precisely what Republicans are proposing to do. By 2019, the study found, this would increase the number of uninsured in Pennsylvania by 956,000 over what it would be if we simply kept the law.

That also means you, Sens. Lamar Alexander and Bob Corker. In Tennessee, 526,000 more people would be uninsured. (Corker, it should be said, acknowledged that “repeal and replacement should take place simultaneously.”) Senate Majority Leader Mitch McConnell is threatening to hike the uninsured figure in Kentucky by 200 percent, or 486,000 people.

In Arizona, Sens. John McCain and Jeff Flake, the number without coverage would rise by 709,000. In West Virginia, Sen. Shelley Moore Capito, the ranks of the uninsured would go up by 208 percent, more than twice the national average, from 88,000 if the ACA were left in place to 272,000.

These are real Americans, and they all live in states carried by Trump.

Now Republicans will dispute data of this sort and claim that their “replacement” of Obamacare will take care of these folks. It will be, Trump has said, “something terrific.” OK, if it’s so terrific, let’s see it and discuss it before we threaten the insurance coverage of so many of our fellow citizens.

But they don’t want to do this because they have no plan to replace it with, only fragments of partial solutions and a lot of empty words. Their un-Jeffersonian haste is part of a cover-up, a con game in which voters are told to give up something concrete in exchange for — well, we’ll tell you later, maybe.

Oh, yes, and as for the deficit, the very bill McConnell is putting forward would swell it to $1 trillion — that’s with a “tr” — by the end of the decade. This is quite an achievement. In one vote, the Republican Congress would deprive millions of lower-income Americans of their health care while saddling the next generation with a whole new debt load. At least Sen. Rand Paul, R-Ky., has been willing to do some elementary math on the matter of deficits. He’s one of four Republican Senators, including Corker, who have questioned the party’s current path.

If Democrats don’t see the fight against this truly monstrous way of legislating as both a moral battle and a political gift, they should just pack up and find themselves another country.

But what the nation needs most right now are Republicans willing to face up to how devious and manipulative this process is and how damaging their votes could be to some of their most faithful supporters. These GOP loyalists believed them when they promised to replace Obamacare. Show them the “terrific” replacement first.

E.J. Dionne is a columnist for The Washington Post.