There is bound to be a sigh of relief when the U.S. Senate completely rewrites the new health care bill passed by the U.S. House.
One of the biggest sighs will come from U.S. Rep. Kevin Yoder of Kansas. Yoder, who represents mostly Johnson and Wyandotte counties, voted for the legislation but now is getting stiff blowback from constituents like he has rarely seen during his four terms in Congress or during his stint in the Kansas Legislature.
In a phone conversation last week, Yoder attempted to convince me that the reason for the uproar is Democrats’ distortion of the American Health Care Act. Yoder claims the bill does not hurt people with pre-existing conditions by either making them ineligible for health insurance or by raising premiums by astronomical numbers.
One thing we know for certain: The perception held by much of the public that the new plan is punitive to those who have serious health conditions has stuck. And like the Republicans’ claims that Obamacare included death panels, some repeated claims stick, no matter how much they are vigorously denied.
Without a doubt the AHCA does penalize some with pre-existing conditions, but not as much as we have been led to believe. For the overwhelming majority of those with health insurance, including the 93 percent who are covered by their employers or a government plan, there will be no noticeable change. Suffice it to say that there are still millions of people at all income levels with pre-existing conditions who will pay more, perhaps much more. And they could end up in state-run high-risk pools, which are hell. We know that because there were high-risk pools before Obamacare in certain states, and the outcomes were punitive.
The real black eye in the bill that Yoder did not want to dwell on does not make the news as much. Conservative Republicans hate entitlement programs, particularly those serving the poor. They have openly expressed their views. They wish Medicaid never existed, and they would like to get rid of it altogether.
Medicaid is not a welfare program. The overwhelming majority of adults on Medicaid work. They just don’t make enough money to pay for private medical care. Those low-income Americans who are unable to get on Medicaid end up in expensive emergency rooms or ignoring their illnesses.
Conservatives know they cannot repeal Medicaid. The general public would not accept that. So, in the AHCA, conservative Republicans have taken a meat ax to the program. They have frozen any expansion. They are replacing federal funding of Medicaid with block grants to the states. There are other clever ways the AHCA seeks to obliterate Medicaid as much as possible. The result will be that tens of millions of low-income Americans insured by Medicaid will become uninsured.
When I told Yoder that was a serious concern of mine and that low-income, working Americans deserve decent health care assistance provided by the government, he said we had a philosophical difference. Yes, we certainly do.
Low-income Americans do not vote in big numbers, and when they do, they don’t often vote for Republicans. For that reason, the Republicans in the U.S. Senate may not make major changes to the Medicaid bloodbath the House passed.
The rest of the AHCA is filled with questionable changes, such as the elimination of mandates, which will dramatically lower the enrollment of healthy young Americans. It also would eliminate taxes on the super-rich that were helping to fund health care for those with lower incomes.
The U.S. Senate is more moderate than the House, where hard-right conservatives forced their agenda. Senate Republicans outnumber Democrats by only a few votes. The Senate will rewrite the final bill, extracting the most controversial parts. That means the consequences of Yoder’s yes vote will be mitigated because many of the controversial portions he voted for may not come to pass.