Never mind the bullying tweets that unnerve allied nations and reverberate through financial markets.
Put aside for moment the disturbing confirmation hearings that have revealed not only ethical conflicts of nominees, but people who either don’t understand the issues handled by the agency they will lead or have expressed open hostility toward the fundamental mission of the jobs they have been nominated to fill.
And for a moment try not to think about even the fact that every part of the U.S. intelligence infrastructure believes a foreign government interfered with the 2016 election to help one candidate win.
All those things are jaw-dropping enough and deserve a lot more attention than they are getting.
But then consider that the new president and the Republican majorities in Congress are rushing to take health care away from 30 million people by repealing the Affordable Care Act without any announced plan to replace it, only vague promises by the new president that everybody will be covered, a statement that others in power immediately tried to walk away from.
Repealing the ACA isn’t just a political act. It is an assault that threatens people’s lives and the financial security of millions of families. The Congressional Budget Office reported this week that partial repeal of the law would mean 18 million people would lose health coverage in the first year and 32 million eventually.
It would also result in dramatically higher insurance premiums and an end to the wildly popular and important provisions in the ACA, the prohibition on insurance companies denying coverage to people with preexisting conditions, the end of lifetime caps on benefits, the ability for children to remain on their parents policies until they are 26, and the free physicals and other preventative care that have saved lives.
People with cancer or diabetes or a heart condition or cerebral palsy will now have virtually no chance to find decent insurance and some may wind up in a high-risk pool, a proposal recently touted by House Speaker Paul Ryan, where premiums and deductibles are high and exclusions and waiting lists are common.
Republicans have responded by saying that the CBO study didn’t consider any replacement for the ACA even though they haven’t offered one.
But the CBO analysis was not based on hypotheticals. It was based on legislation passed by Congress in 2015 that was vetoed by President Obama. The Republicans have already tried to take health care away from 32 million people.
But now they are in control in Washington and they are trying again.
Millions of people in North Carolina should be very nervous. The Kaiser Family Foundation estimates that 27 percent of the state’s non-elderly population has pre-existing conditions that could lead to a decline in insurance coverage if the ACA is repealed
That comes to 1.65 million people.
A study by the Urban Institute finds that at least a million people in the state would lose coverage almost immediately under ACA repeal.
Another popular proposal among Republicans is Health Savings Accounts, which according to a study by the Government Accounting Office is more of a tax shelter for the wealthy than a meaningful health plan. Kiplinger once called HSAs just another tax deferred way for the wealthy to save for retirement.
And of course it’s hard to imagine working people putting enough aside every week to pay for cancer treatment for their child or even managing to pay for chronic health conditions like hypertension.
Allowing companies to sell coverage across state lines, another common GOP talking point, isn’t going to cause insurance companies to rush to cover people with pre-existing conditions either.
There’s a reason that Republican leaders have not presented a comprehensive alternative to the ACA in the seven years since the law has been in effect. They can’t come up with one.
No one can seriously argue that the woefully inadequate piecemeal approach the Republicans have floated so far to take the place of the ACA wouldn’t leave millions of people without coverage, many of them in Republican states that have expanded Medicaid under the law.
Repealing the ACA, or Obamacare, was easy to promise to do on the campaign trail. It is proving much more difficult to accomplish when lawmakers are now realizing how many families will be devastated by their decision and their lack of a meaningful replacement for the law.
That’s not surprising, that lawmakers are stammering when confronted by stories of people whose lives were literally saved by the ACA and data that shows that millions of families will suffer if Congress follows through on its ideological promise to repeal it.
What’s more shocking is that most of them remain committed to ending the ACA anyway, in the face of the suffering it will cause and with no idea of what can possibly replace it.
That’s the scariest thing happening in Washington these days. Never mind the tweets. Real lives are hanging in the balance here.
Chris Fitzsimon is founder and executive director of N.C. Policy Watch.