EDITORIAL: Republicans unveil their prescription for American health care

March 08--After more than six years of lambasting the Affordable Care Act, Republican lawmakers on Tuesday unveiled their own health acre reform package, labeled the American Health Care Act.

Now, we'll find out whether theirs is a better idea.

That the ACA, or Obamacare, was in trouble was evident long before President Trump's upset win over Hillary Clinton last fall. Insurers have abandoned the program that, while it expanded care millions of the poorest Americans, proved to be a burden for millions of middle-class Americans who didn't qualify for subsidies. They were saddled with high premiums and high deductibles, and found the promises that they could keep their old plan and their doctor if they wanted were specious. In our own region, those who had to go to the ACA for coverage found it was expensive and that choice of insurance providers was nonexistent.

What we felt went wrong with the ACA -- and may also prove to be the case with what may come to be known as Trumpcare -- was a failure to incorporate input from the "other" side. Republicans were shut out of the process. This time around, unfortunately, the same has happened to the Democrats.

The problem is the poor health of our national political system. Hard lines have been in place for some time now, and they have only been reinforced. While the discussion about a wall between the United States and Mexico has been polarizing, the wall that has been constructed -- gleefully, it seems, by those who built it -- between liberals and conservatives has been paralyzing.

The sad thing is we likely are living in an America where this is the normal operating procedure in Washington, D.C., and downstream as well. There is no room for compromise, only criticism.

By all accounts we have seen, the development of the AHCA has been a closed process. Republicans apparently believed that Democrats would spin any details they got in an attempt to gain traction against it, and they were right to have that concern. Democrats now seem most concerned with obstructing those they have long condemned as obstructionists.

From the early accounts of the ACHA, it keeps some popular aspects of the ACA. Children will continue to be able to stay on their parents' policies through age 26, and coverage is maintained for those with pre-existing conditions. The tax penalty is done away with, replaced with a new "stick" that allows insurers to charge higher prices to those who allow their coverage to lapse. It also gives tax refunds to those who buy insurance policies -- an income cap has been included to keep wealthy taxpayers from getting the refunds -- and restructures Medicaid payments to states to a set amount annually.

Whether it's better than the ACA, as Republicans contend, or worse, as Democrats argue, will be debated for some time. Reports say that it doesn't have full support within the GOP, particularly with lawmakers from states that expanded Medicaid under the ACA.

What we'd like to see is a meeting of the minds as the process moves forward. The condition of the ACA is terminal with the GOP in charge of the White House and Congress. In a better political climate, Republicans and Democrats would sit down in a spirit of doing what's best for the American people as a whole, discuss various aspects openly, make their cases and work out a health care reform package that incorporates the best ideas from all sides. Creating a plan that makes coverage affordable, expands choice and that doesn't drive poor Americans helped by the ACA back to emergency rooms for primary care is a difficult prescription to write.

We expect, however, that the Republicans alone will move this reform package to the president's desk. While there's been a flurry of activity so far this year, health care is different. It has a direct, intimate impact on every American's life. Republicans have an opportunity to implement a plan that is truly better, and they had better avail themselves of it. The dissatisfaction that many voters had with the ACA was one of the deciding factors that propelled the GOP to power last fall. Just as the Democrats owned the ACA, the Republicans will own the AHCA.

The experiences voters have with this plan once it's implemented will determine what the GOP experiences in coming elections.

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