A contortionist is one who bends the body in strange and unnatural ways. While Sen. Lisa Murkowski is not bending her body, she is bending her stance on health care in strange and unnatural ways.
First, she shows tremendous strength of character in being one of a few Republican senators to protect health care for 62,000 Alaskans and 23 million Americans by rejecting the House passed version of repealing the Affordable Care Act, also known as Obamacare. I, like many Alaskans, applauded her standing by her convictions while being heavily pressured by the Trump Administration. Now, in an Anchorage Daily News op-ed (Nov. 21), she supports undoing one of the three core pillars of Obamacare, the individual mandate to buy health insurance. She defends her action by calling on her libertarian beliefs that support the freedom to choose.
Back when the ACA was first being drafted 30 distinguished conservative economists conservative wrote to Congress explaining why the individual mandate (also expressed as the health insurance tax penalty) was essential for building an affordable health care system. They explained that "the mandate expresses a basic obligation of citizenship as well as an economic reality. Without the mandate, some people will choose to gamble or to free-ride, undermining the fairness and financial stability of the health insurance system." In other words the individual mandate is the corollary to the fundamental principle of fairness; it's about paying whatever you can in to the system so that when you need medical attention, you will have contributed. It's about personal responsibility. It's about contributing, not just receiving. It did not arise out of a desire to limit freedom but out of fairness and the necessity to not turn away the uninsured at the emergency room.
Even conservative Mitt Romney gets that the individual mandate is driven by economic fairness and underpins affordable health care. When signing Massachusetts' equivalent of the individual mandate he noted, "Some of my libertarian friends balk at what looks like an individual mandate. But remember, someone has to pay for the health care. Either the individual pays or the taxpayers pay. A free ride on the government is not libertarian." Surely, Sen. Murkowski can recognize that unless you want emergency rooms to turn away the uninsured that health care is not a personal choice, it is a collective investment.
In standing up against repealing the ACA, Sen. Murkowski often cited how Alaskans pay the highest price for premiums in the country. How does Sen. Murkowski square this concern square with the finding by Congressional Budget Office, the nonpartisan budget scoring agency, that eliminating the individual mandate would raise health insurance premiums for all Americans by about 10 percent in most years over the next decade? Now, in a moment of misguided libertarian principles she apparently supports an effort that will increase premiums for Alaskans?
Sen. Murkowski's biggest contortion on her health care stance, comes at the end of her op-ed when she proclaims her support for the bipartisan legislation introduced by Sen. Lamar Alexander and Sen. Patty Murray. She says, "I strongly support enacting the bipartisan compromise Alexander/Murray into law as fast as possible to stabilize our markets, provide more control to states and more choices to individuals." Guess what? This health care compromise legislation maintains the individual mandate to purchase health insurance.
After eliminating the individual mandate was added in the tax reform bill, Sen. Murray issued a press release claiming that Senate Republicans are "sneaking devastating health care changes into a partisan bill at the last minute; completely counter to the bipartisan spirit in which we worked on our stabilization bill." So now Sen. Murkowski is suddenly OK with undoing the very bipartisan effort she supports?
My head is spinning as I try to follow all her efforts to have it multiple ways. Being a champion for those who would lose health insurance, a strong voice for Alaskans facing high premiums, an advocate for "regular order" of Senate proceedings, and a stalwart for bipartisan solutions — absolutely none of this squares with her support for repealing the health insurance mandate.
Since the budget bill that contains the open-ANWR provision is now attached to the tax reform bill, could it be that she is willing to completely contort her values for the sake of opening up ANWR to oil and gas drilling? If so, imploding health care and a bipartisan effort to stabilize costs is a high price to pay for development that given the low price of oil and the world's move toward a low-carbon economy is speculative at best.
Kate Troll is the author of "The Great Unconformity: Reflections on Hope in an Imperiled World." She has more than 22 years of experience in Alaska fisheries, coastal management and energy policy. She lives in Douglas.
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