The Shame of the House Health-Care Vote

(Bloomberg View) -- The dereliction of duty is breathtaking. In pushing the American Health Care Act through the House of Representatives, Speaker Paul Ryan and his Republican conference have voted to remake almost one-fifth of the U.S. economy. They did so without public hearings, without input from outside experts, without analysis by the Congressional Budget Office and without, finally, much compunction or consideration of the tens of millions of Americans it will harm.

“I don't think we should pass bills that we haven't read and don't know what they cost,” Ryan said in the summer of 2009, referring (unfairly) to Obamacare. This kind of hypocrisy might be overlooked if the new bill had any merit. It doesn't.

If anything, it's more damaging than the original bill Republicans tabled in March. The CBO said that legislation would have taken away health insurance from some 24 million Americans. The new bill could push the number higher. 

It would allow states to get waivers from some of the protections that the Affordable Care Act provides -- most important, the rule that says insurers cannot charge higher premiums to people with pre-existing health problems. In such states, people who let their insurance lapse for a couple of months could be charged unaffordable premiums.

An amendment added on the eve of the vote is meant to soften this blow by giving states a little more money to set up “high-risk pools” for the victims. But high-risk pools -- which separate sick people from the general population and charge them higher premiums -- can't work without adequate funding. And this legislation offers hundreds of billions of dollars less than what would be needed.

Details aside, the bill would undermine health-insurance markets by increasing uncertainty for insurers who are trying to determine what plans to sell -- if any at all -- in the months ahead.

Why did Ryan, who rose to prominence on the wings of wonkery, force this bill through the House with only passing review? Not because it would improve anyone's welfare. One of the main attractions of the bill for Republicans is that it would cut taxes for the well-to-do. Another is that it would help Republicans escape a political dilemma of their own design: Having dissembled about Obamacare for years, the party was forced to propose its alternative. Because Republicans didn't actually have one, they had to fake it.

Ryan has achieved his goal -- passing this tainted buck to the Senate. The Senate should treat the legislation with the respect it deserves.

--Editors: Frank Wilkinson, Mary Duenwald, Michael Newman

To contact the senior editor responsible for Bloomberg View's editorials: David Shipley at davidshipley@bloomberg.net.

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