Republicans cant seem to figure out if their health care plan will lead to the same number of people with health insurance as have it today, or more people, or less people, or if it doesnt matter.
The rhetoric coming out of the White House and Capitol Hill is all over the place, and theres no mystery about why.
The GOP is hell-bent on repealing the Affordable Care Act, the 2010 health care reform law that extended health coverage to 20 million people who didnt have it before and drove down the national uninsured rate to a historic low.
Eliminating that law means eliminating the federal funding that made those coverage gains possible through tax credits for low- and middle-income people, and expanded Medicaid access to people living near poverty.
The bill would rescind the Medicaid expansion and reduce future funding for other Medicaid beneficiaries which mainly consists of children, pregnant women, people with disabilities and elderly nursing home patients. It also would replace the Affordable Care Acts tax credits with financial assistance based on age, not income, that would have less value to poorer families than whats available now.
We dont believe that individuals will lose coverage at all. Health and Human Services Secretary Tom Price
And Republicans do want to get rid of all those things because they also want to repeal the $600 billion in taxes on wealthy people and health care corporations that help pay for them, and because they philosophically dont think the federal government should be helping people with their medical costs.
But coming right out and saying you want more uninsured people would make you look monstrous. You also cant say you want to maintain the Affordable Care Acts coverage, because then youre a big government RINO whos soft on Obamacare.
Theyre even going so far as promising that it wont, which seems highly suspect given that they arent planning to spend the money it would take to prevent it.
Heres Health and Human Services Secretary Tom Price making this likely impossible promise Friday morning on MSNBC.
We dont believe that individuals will lose coverage at all, Price said. We want nobody to lose coverage or lose access to coverage that currently has that, and we want to increase the number of individuals that have access to coverage.
Earlier Friday, Ryan appeared on conservative radio host Hugh Hewitts program and delivered a different message, seemingly acknowledging that his plan cant cover as many people as Obamacare, while attempting to argue that the Affordable Care Acts coverage expansion somehow doesnt count.
We always know youre never going to win a coverage beauty contest when its free market versus government mandates. If the government says thou shall buy our health insurance, the government estimates are going to say people will comply and it will happen. And when you replace that with were going to have a free market, and you buy what you want to buy, theyre going to say not nearly as many people are going to do that. Thats just going to happen. And so youll have those coverage estimates. We assume thats going to happen. Thats not our goal. Our goal is not to show a pretty piece of paper that says were mandating great things for Americans. Our goal is to get a vibrant health care system thats patient-centered, that brings down costs, that increases choices, that has a marketplace so that we lower the costs and increase, and therefore increase the access to affordable care. Thats our goal, and its not to win some coverage beauty contest.
And on Wednesday, White House Office of Management and Budget Director Mick Mulvaney went on MSNBC to deliver yet a different message.
Were looking at it in a different way, Mulvaney said when asked about coverage numbers. Insurance is not really the end goal here.
Part of whats going on is a preemptive strike against the official scorekeepers of legislation on Capitol Hill, the nonpartisan Congressional Budget Office. White House press secretary Sean Spicer, Price and a number of GOP lawmakers have begun a campaign to discredit the agency in advance of its analysis of the House health care bill.
We always know youre never going to win a coverage beauty contest when its free market versus government mandates. House Speaker Paul Ryan (R-Wis.)
The most obvious reason they would do that is they anticipate the CBO is going to deliver them bad news and tell the country that the legislation will result in millions of people becoming uninsured. Brookings Institution scholars predict the Congressional Budget Office will project losses at least 15 million people, and the ratings agency Standard and Poors estimates the bill will cause up to 10 million people to lose coverage.
Ryan said this has been weighing on his mind. Ive spoken to our members about that. Were going to talk to our members constantly about this, because were not going to get into a bidding war with the left about how much we can mandate or put entitlements out there for people, he said on Hewitts show.
Republicans also began to preview another strategy to blunt the effects of an unfavorable Congressional Budget Office score: Alternative math.
Price countered questions about the CBO and the Brookings Institution estimate by saying the Office of Management and Budget which is part of Trumps White House and outside groups would make their own assessments.
To wit, Ryans office distributed an email to reporters Friday carrying the subject line, Former CBO Director: The American Health Care Act Is A Good Start.
Within was the content of a Washington Post op-ed penned by Douglas Holtz-Eakin, who held that job from 2003 to 2005 and now is president of the conservative American Action Forum. Holtz-Eakin cited a preliminary analysis of the GOP health care bill projecting more enrollment in private insurance than under the Affordable Care Act.