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Give us time to run the numbers on the giant tax cut disguised as health care bill

  • Author: Dermot Cole
    | Opinion
  • Updated: June 22, 2017
  • Published June 22, 2017

Sen. Lisa Murkowski says she needs time to run the numbers on the health care bill that Senate Republican senators are so proud of they had to keep it in the lockbox until Thursday morning, hoping to get it passed next week.

"I will be working closely with the state over the next several days to analyze the text and crunch the numbers," she said in a Faceook posting Thursday.

If she is serious, Murkowski will try to get Sen. Dan Sullivan and another Republican senator to force Senate leaders to provide more time.

With the 52-48 split in the Senate, that's all it would take to create something better than the stealth health care plan.

It's not much to ask, though it would collide with the GOP goal to get the bill passed before people start paying attention.

No one believes that "several days" is enough to sort out the policy choices buried in this giant tax cut disguised as a health care bill.

The measure would continue the basic structure of Obamacare — the Affordable Care Act — but it would be stingier for the middle class and would lead to reduced coverage and higher costs.

It would weaken Medicaid and deprive coverage to the poor, while providing a tax cut to the wealthiest people in the country, most of the benefit going to the top 1 percent.

The title of the bill, "Better Care Reconciliation Act," may be as close as it comes to delivering on President Trump's promise of better care for everybody at lower cost.

He didn't say anything about higher premiums, higher deductibles and reduced coverage.

The Senate plan would begin to phase out the Medicaid expansion in four years, which contradicts Murkowski's statement to the Legislature in February. There are about 34,000 Alaskans now receiving that coverage.

"So as long as this Legislature wants to keep the expansion, Alaska should have that option — so I will not vote to repeal it," Murkowski said Feb. 22.

Sullivan has declined to take a position in public on overturning Medicaid expansion, probably meaning he will support its elimination.

There are two ways the Senate bill hits Alaska harder than other states, the Center on Budget and Policy Priorities said in an early analysis Thursday.

First, an across-the-board cut in tax credits would be more costly here, given that premiums are higher. Second, the bill would end subsidies for individuals making about $53,000 a year.

"Older Alaskans at this income level would lose more than $20,000 in tax credits, compared to far lower amounts in other states," the center said. The bill would also end the so-called "cost sharing" subsidies for lower-income people that particularly benefit Alaska Natives.

Both the House and Senate bills would allow insurance companies to charge older people who aren't yet eligible for Medicare up to five times as much as younger people. Obamacare limits the difference to three times as much.

This was one of the provisions that angered Rep. Don Young, 84, when he talked about his opposition to the House bill, arguing that it would take 3 1/2 years to write a good bill.

"I happen to be a senior citizen. That disturbed me greatly, as far as premiums go, raising it five times over the young person," he said, speaking to the Chugiak-Eagle River Chamber of Commerce on April 19.

It didn't disturb him greatly nearly three weeks later when Young voted for the bill, which included the fivefold plan. Young said other people would fix the problems in the bill and it would not become law.

Continuing the steamroller schedule employed by the House, the Senate is planning no hearings and no review by experts.

The hurry-up-and-do-something frenzy guarantees that policy will take a back seat to politics.

Murkowski said she was unhappy with the secrecy. Several other Republican senators made similar comments, but failed to use their influence to derail Sen. Mitch McConnell's drive for a final vote next week.

In a statement Wednesday about health care, Sullivan said the Senate leaders "could have been more open," he doesn't like one-size-fits-all plans from Washington and that he won't support a bill that makes things worse for Alaskans.

This is as revealing as his decision to adopt "repeal and repair" as a guiding principle instead of "repeal and replace."

The Senate bill would mean deeper cuts to Medicaid in the future, reducing health care for poor people long after the current crop of senators have to stand for re-election or have moved onto other pursuits.

The Republican Party spent years complaining about Obamacare in the simplest terms and never prepared a credible alternative to address the complex details.

It's a sick joke to claim now that there is no time to lose because Republicans have been making promises for seven years and have to pass something.

There are far-reaching consequences with this bill, which cannot possibly be examined, understood or defended in the next several days.

Murkowski and Sullivan, before they get into the pluses and minuses of the bill, should do something about the senseless deadline of acting on this by next week.

Columnist Dermot Cole can be reached at dermot@alaskadispatch.com. 

The views expressed here are the writer's and are not necessarily endorsed by Alaska Dispatch News, which welcomes a broad range of viewpoints. To submit a piece for consideration, email commentary@alaskadispatch.com. Send submissions shorter than 200 words to letters@alaskadispatch.com or click here to submit via any web browser.

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