EDITORIAL: Replace GOP’s Obamacare replacement | Editorial

March 17--It could be good news for America -- and for Florida in particular -- if Republican leaders genuinely understand their Obamacare replacement must itself be replaced. But there's this caveat: It's only good news if any revised plan they craft reverses the original plan's heartless attempt to deny health care to as many as 24 million Americans over the next decade -- with 14 million losing coverage in the first year.

The caveat is essential because Republicans in the far-right Freedom Caucus are pushing to make the bill more heartless, not less. They insist the original version's fundamental flaw is that it does not cut health care spending enough.

The Congressional Budget Office projects it would lop $337 billion off the nation's deficit over the next decade by slashing Medicaid and subsidies that Obamacare provides so lower income people can afford health insurance.

The push to cut even more puts House Speaker Paul Ryan, Senate Majority Leader Mitch McConnell and President Donald Trump in a bind. A significant number of Republicans -- including Rep. Ileana Ros-Lehtinen of Miami -- say the original bill cuts off too many people and they won't vote for it.

Republican opposition might make it impossible for Ryan to get the bill he championed through the House, and the Senate is an even harder sell.

If bipartisan deal-making still were possible, Republicans could go around their Freedom Caucus and work with Democrats to fix Obamacare. Granted, the GOP promised to repeal Obamacare. But negative reaction to the GOP plan is proving that the more important promise, frequently repeated by President Trump, is to provide coverage to all. And not just coverage, but better coverage.

Beware a GOP strategy that seeks to sway reluctant Republicans like Ros-Lehtinen -- or, at least, to provide them with plausible political cover -- by providing smoke-and-mirror numbers to conceal the high toll of lost coverage. It is encouraging that a version of that strategy already failed, when Trump and others went on a disinformation offensive trying to discredit the CBO's projection that 24 million would lose insurance coverage.

We understand that the CBO's numbers, like any prediction, can be challenged. And we welcome ideas to reduce the cost of health care. But challenges must be based on credible assumptions and cost-reduction must not be based primarily on depriving millions of coverage and, therefore, depriving them of medical care.

There are some winners in the GOP plan -- and not just the wealthy who get big tax cuts out of the deal. Younger people in urban areas would pay lower premiums, eventually. But every credible analysis of the original GOP plan says it would be very hard on older Americans and low-income people. It is nearly inexplicable why Republicans -- and Trump in particular -- would back a plan that seems almost designed to punish the voters who gave Trump his victory.

In the starkest example, the CBO calculated the impact on a 64-year-old with an income of $26,500. Under Obamacare, he or she would pay $1,700 in annual premiums. Under the GOP plan, the cost would explode to $14,600 -- more than half of that person's total income.

One of the most cynical GOP assumptions is that if such a person drops coverage, they have chosen to voluntarily give up health insurance.

This issue is tremendously important to Florida. As originally presented, the GOP's American Health Care Act would have hit older and low-income people especially hard. That means it would have hit this state particularly hard. Consider just a few of the consequences reported last week by The Miami Herald:

Most of the 1.74 million Floridians covered by Obamacare exchanges would be unable to afford coverage under the GOP plan. An estimated 4.3 million children, pregnant women, low-income and disabled people would suffer reduced access to care. And hospitals treating Medicaid patients would have to reduce services to the poor as well as seek to recoup more of the cost from insured patients.

Do Republican leaders have the governing skill to produce a compromise that protects people who have coverage now, creates a system that covers even more, finds sensible savings and can pass Congress? If they possess such skill, their first attempt utterly failed to show it.

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