The 13 Senators who drafted a bill to replace Obamacare are all Republican, male, white, over age 40, and prosperous. California, Florida and New York, which together account for one-fourth of our population, were not in the room but there were two Senators from number fifty Wyoming.
Discussing diverse opinions is one way to identify and avoid unintended consequences of new legislation. Do Republicans think that women, middle class, minorities, young, poor, and other Americans left out of the process have no ideas worthy of consideration?
They did their work in secret meetings without input by experts in health policy or economics, out of the sight of the public and the press. The result is a political bill to satisfy Republican ideology with little regard for facts or alternatives.
Previously, Republicans in the House of Representatives passed a similar bill that was designed behind closed doors without serious public hearings, expert testimony or debate. They proceeded despite a Congressional Budget Office projection that it would cause 23 million Americans to become uninsured. The CBO’s estimate of spending reductions from the bill amount to $43 per month saved for each person who loses health benefits – not a good deal!
There’s no doubt that Obamacare has serious problems in the individual and small employer exchanges. Republicans try to mislead us into believing that those troubles mean that the law is failing. It isn’t. Because of Obamacare 20 million more Americans are now insured and the rate of growth in total health care spending is lower than it was before Obamacare. It is a successful law that needs improvements.
Bluntly, Republican lawmakers don’t believe that all Americans should receive basic health care regardless of their ability to pay and they’re willing to let other Americans die for that ideology. Republican leadership intends to pass their bill before Americans understand that it will cause more people to lose health benefits, more healthcare related family bankruptcies and more individuals suffering death or disability.
Rushing ill-considered bills through a legislature to satisfy an ideology is not limited to the congress. North Carolina Republicans imagined an “emergency” when Charlotte passed a civil rights ordinance allowing transgender citizens to use restroom facilities consistent with their gender identity (and, in most cases, consistent with their physical appearance). Rather than holding hearings and carefully considering what (if any) legislation was needed, they packed the infamous HB-2 with unrelated and controversial provisions then passed it as “emergency” legislation. If standard legislative processes had been followed, a more appropriate response (or no response) to Charlotte’s ordinance might have been made. HB-2 has been mostly repealed, but the damage to the state’s reputation remains and some economic losses will never be recovered.
Similarly, North Carolina Republicans gerrymandered the state’s congressional and legislative districts through secret processes. They hired attorneys who hired consultants to design legislative districts that would give massive election advantages to Republicans. Because the work was done through attorneys, they were able to claim attorney-client privilege as justification for refusing to let the public and the press see exactly how they instructed the consultants. The US Supreme Court ruled that the result of their work was racial discrimination. It again seems obvious that an open process with public hearings could have produced a better outcome.
If Republicans were practicing medicine rather than legislating, their negligence would be called malpractice. They circumvented the rules and procedures that assure thoughtful deliberation before laws are passed. That violates American values, undermines trust in government and exposes us all to the negative consequences of ill-considered laws.
Senate Republicans plan to debate, amend and pass a healthcare bill back to the House of Representatives in 10 days, with no public hearings and no expert testimony. As an example of the unanticipated consequences of doing that, unemployed Republican rural voters in the coal mining areas of the Kentucky mountains will probably lose their Medicaid benefits and see closure of clinics opened to serve them under Obamacare. Health care has added more jobs than mining lost in the Kentucky mountains. Similar outcomes are inevitable in other places. The damage to the credibility of our legislative processes is severe. Worst of all, Americans will die as a result of Republican legislative malpractice.