Wednesday's Opinion Intro

Wednesday, May 3, 2017

David Leonhardt
Op-Ed Columnist

Why is the Republican Party having a Groundhog Day experience on health care, with its House leaders continuing to push for a bill only to go through the same cycle of having their own members rebel?

Because top Republicans still aren’t willing to grapple with reality.

They have spent years pretending that it’s easy to fix the health care system and lying about both Obamacare and their own proposals. They’re still doing it.

I found it particularly sad to watch Paul Ryan, the speaker of the House, stoop to offering the same kind of obvious untruths as President Trump regularly does. On Tuesday, Ryan insisted — with no factual basis — that the new bill would protect the sick. “Politicians always stretched truth & cherry-picked facts,” the economist David Rothschild tweeted yesterday. “But very concerning that career politician, Speaker of House, just flat out lies.”

This past weekend, President Trump gave an unintentionally revealing interview to CBS’s John Dickerson that I recommend reading if you didn’t already watch. In it, Trump displays no grasp of the mechanics of health policy and instead repeats a series of nice-sounding promises, most of which are simply false:

“The health care bill is going to help my supporters.”

“Pre-existing conditions are in the bill.”

“We’re going to have lower premiums.”

“This bill is much different than it was a little while ago.”

Evidently — and unfortunately — you can win elections by making up your own facts about health care, among other things. But it’s hard to pass a bill based on fiction. And it will be even harder to pass the bill through the Senate, if it somehow makes it through the House.

Health policy, like most of life, involves trade-offs — between helping the sick and the healthy, the young and the old, the rich and the poor, and even between benefiting doctors and patients. Just about every politician tends to downplay these trade-offs, but Trump, Ryan and some of their colleagues go further and conjure fairy tales involving easy fixes and no hard choices.

So far, at least, enough members of Congress have refused to play along to prevent the bill from passing. Here’s hoping reality continues to prevail.

Thursday, May 4, 2017

David Leonhardt
Op-Ed Columnist

Earlier this week, the pollster Matt McDermott posed a question: Why are Democrats working so hard to prevent House Republicans from passing their health care bill?

“It’s an extreme bill that’s probably dead in Senate. And puts vulnerable GOPers on the record for vote that’ll cost them House next year,” McDermott predicted. Democrats were opposing it anyway, because they believed it was wrong — “a truly awful bill that will truly hurt everyday Americans,” he wrote.

He added: “In this health care debate, Democrats are doing something few in politics ever do: staking a moral position regardless of the politics.”

On Wednesday, House Republicans finally seemed to find a path to passing the bill. But it’s an amazingly cynical path. They flipped the votes by adding a fig leaf, of an extra $8 billion over five years to help cover sick people. The amount is not nearly enough to prevent the bill from doing terrible damage, as reporting by Reed Abelson and Margot Sanger-Katz shows.

The bill, at its core, is still what it has always been: It’s a large cut in health benefits for the sick, the old, the middle class and the poor, as an academic study published today — which I cover in a new column — shows. The savings from these cuts is then funneled into tax cuts for the rich.

That’s why the bill continues to be opposed by conservative, moderate and liberal health care experts, as well as groups representing doctors, nurses, hospitals, the elderly, the disabled and people with cancer, diabetes and multiple sclerosis. Oh, and that’s a partial list.

No wonder Republicans are hastily rushing through the bill. “There have been no hearings, no studies, no Congressional Budget Office analysis; not even the text of a bill circulated the day before Thursday’s vote,” Jonathan Chait’s latest piece for New York magazine points out. No major bill has ever passed Congress in this fashion.

My colleague Ross Douthat put it this way: “Say what you will about European right-populists, but they wouldn’t be dumb enough to vote for this health care bill.”

In the end, the principled Republican resistance to the bill in the House appears to have been smaller than the desire to let President Trump and Paul Ryan claim a political victory. House Republicans seem to be betting that the progressive resistance to Trump has exhausted itself, as Ezra Klein noted.