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Home » Editor's Note » AHCA and the Moral Conundrum of Lies

AHCA and the Moral Conundrum of Lies

Here’s something that sounds reasonable but isn’t. The requirement for insurance companies to cover people with pre-existing conditions has been dropped by the House of Representatives:

In place of that mandate, the bill encourages people to maintain coverage by prohibiting insurance companies from cutting them off or charging more for pre-existing conditions as long as their insurance doesn’t lapse. If coverage is interrupted for more than 63 days, however, insurers can charge people a 30 percent penalty over their premium for one year. 

http://www.npr.org/sections/health-shots/2017/05/04/526887531/heres-whats-in-the-house-approved-health-care-bill

That sounds fair, but it isn’t. In practice, it’s a bait and switch. Anecdotes aren’t data but we don’t have a CBO report so they will have to do (post yours in the comments below or on Twitter at #AHCAantidote). 

Here’s mine. I was injured while teaching special ed over 10 years ago. Much to my disappointment, I ultimately had to switch careers due to my doctor’s assessment that the combination of a nerve injury in my neck and the normal stress of teaching would be untenable. I left my job before my workers compensation case closed, and before I was allowed to retrain.

While on disability, I couldn’t make COBRA payments and let my coverage lapse. I applied for an individual plan from the same insurer and was rejected. Four reasons were given, and though I’ve probably (hopefully!) shredded that document, I do remember that my work injury was not included. One factor was my allergies and another was a cervical condition that affects millions of women. I remember thinking at the time, “Basically, the issue is I’m female and I sneeze.”

That sounds ridiculous, and it is. The argument for the AHCA proposal is that it lets the market work with less government interference and allows individuals more freedom. But freedom is just another word for “plenty dough to burn.” If you’re not rich, that doesn’t help much. So why does this provision even exist?

For the same reason the AHCA exists. To hide the fact that Republicans have no reasonable alternative to the ACA. Repealing and replacing the ACA with a better, more functional plan that serves the good of the country and meets key  party principles is complicated. Republicans want to solve it in the space of one baseball season so they can campaign on that victory. Unfortunately, they have neither the data prowess nor the decades of experience that guides the MLB. 

Perhaps Trump and his team of congressional leaders should consult with the Rickett family about the complicated business of building a team that -could- win the World Series. The Cubs didn’t start that process in January 2016, they had more than a few empty files on the table when they announced their goals and deployed their strategies, and they didn’t dare pop the champagne publicly before the last out of the last game of the series. Even then, their best laid plans nearly went awry due to a persistent opponent and factors like weather.

Millions of people voted like they did because they believed the frequent refrain of Republicans who claimed the Affordable Care Act could be repealed and replaced with some other plan that would be more affordable and more caring. Instead, the replacement plan resembles a mountain lodge advertised as completely redesigned when in fact, it’s been stripped to the bones and all that’s left is a portable toilet and free wifi, at least until the wind knocks the power out.

Now, the best that tens of millions of people like me who have pre-existing conditions country can hope is that either the CBO report is fatal, as happened with the first draft of the AHCA, or the bill dies in the Senate. What kind of hope is a hope that depends upon the death of something 217 elected representatives cast their precious votes? 

That hope is built on an avalanche of lies that started with the very first repeal vote in the House. That vote, and every repeal vote that followed, was easy because it had no consequences. Like most little white lies, it led to bigger lies, culminating in Trump’s impossible promise that his replacement for the ACA would be bigger, better, and cheaper. Also, it would cover everybody.

The AHCA does not meet that standard. It does give states more control, but they already have so much room to innovate that Maine’s invisible high risk pool is touted by at least one Republican leader as a great success. Perhaps that means the ACHA is not a full “repeal and replace” but yet another snow job.

The ACA is far from perfect document that meets the highest ideals of our country. Lies were told to get it passed, and unfortunate moral comprises were made during implementation. But it did do much of what it hoped to accomplish, and efforts were made to improve it.

The only thing the ACHA truly accomplishes is another avalanche of lies. And not everyone survives an avalanche.

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