They don't know how much it would increase the federal deficit. They don't know how many millions of Americans would lose their health coverage. Yet U.S. House Republicans on Thursday rammed through their latest effort to repeal and replace the Affordable Care Act, leaving the devastating consequences to be sorted out later. Then they celebrated with President Donald Trump, but it is a hollow and hopefully temporary victory.
The first thing Tampa Bay voters should know is that these Republicans foolishly voted for this legislation that could cost millions of Floridians their health coverage: Reps. Gus Bilirakis of Palm Harbor, Dennis Ross of Lakeland, Vern Buchanan of Sarasota and Dan Webster of Clermont. Never mind that Bilirakis heard from hundreds of constituents at town hall meetings in Pinellas and Pasco counties who urged him not to repeal the Affordable Care Act. Never mind that Webster held out until he was given vague assurances by Trump and congressional leaders that somehow Medicaid patients in Florida's nursing homes would be protected even though analysts estimate more than 50,000 would lose coverage. If anything remotely like this legislation becomes law, voters should hold them accountable next year for making health coverage less available and more expensive for millions of Floridians.
What would it take for Republican U.S. House members from Tampa Bay to stand up for their constituents like Rep. Ileana Ros-Lehtinen, R-Miami: "If enacted, the older and poorer South Floridians will be worse off and find it more difficult to obtain quality health care. My constituents should not have to take a step backward in their ability to obtain treatment for any illness, and thus I will vote NO.''
Second, do not believe the assertions by Trump and House Speaker Paul Ryan that the Republican legislation protects people with pre-existing conditions who are guaranteed coverage now. The Affordable Care Act requires insurers to charge the same price for coverage regardless of pre-existing conditions, and the Republican legislation does not do that. Instead, it allows states to waive that rule for people with lapses in coverage, which often happens when they change jobs or move. And instead of having access to affordable, private coverage, people with pre-existing conditions could be forced to seek coverage in state-run high-risk pools, which would be far more expensive and provide fewer benefits.
Third, it's a safe bet Gov. Rick Scott and the Florida Legislature would leap at the chance to reduce required benefits in all coverage and to have the state opt out of "community rating,'' which the Affordable Care Act relies upon to ban insurers from charging people with pre-existing conditions higher premiums. Florida allowed those higher charges before the Affordable Care Act, and this governor and this Legislature would do it again in a misguided effort to keep premiums lower for everyone else. The state would re-establish a high-risk pool for those with pre-existing conditions who otherwise couldn't find or afford coverage, and last-minute changes to the Republicans' repeal bill added $8 billion to help make that work. Critics say it would take billions more in federal money to make the high-risk pools reasonably affordable, and such high-risk pools traditionally have failed to work because they concentrate risk and are so expensive.
This is a Pyrrhic victory for the president and for House Republicans who should get an earful when they get home this weekend. If there is a silver lining, it is that the Senate will set this mess aside and try to create something more palatable that does not take health coverage away from millions of Americans.