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Tuesday, August 20, 2019  Spokane, Washington  Est. May 19, 1883
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Opinion >  Editorial

AHCA ‘victory’ was nothing to celebrate

The process to pass the American Health Care Act in the House was irresponsibly rushed and overtly political. We don’t ever recall representatives partying at the White House for a bill that had yet to be scored.

White House chief of staff Reince Priebus compared Thursday’s vote to a punt into the end zone. Who celebrates a touchback? Changing sports, President Donald Trump told Senate Majority Leader Mitch McConnell that the ball was in his court now.

This will not be a slam dunk, nor should it be. The president promised to protect Medicaid. This bill severely undermines it.

The massive cuts to Medicaid alone would have a negative ripple effect in every community. The progress on mental health care would be lost. Instead of early treatment – made possible by expanded coverage – needy people would be neglected.

Spokane County leaders have collaborated on criminal justice reforms to lower costs and to steer people into needed care. That work is predicated on the availability of treatment for people diverted from incarceration. The medical community has reported progress in caring for previously uninsured people early on to stave off suffering and to lower health care costs.

All of this momentum would be lost.

The Congressional Budget Office says 24 million Americans would lose coverage by 2026 under the original AHCA bill. About 14 million of them because of Medicaid cuts. That should’ve been the end of it. Instead, Republicans recovered their own fumble, quick-kicked and called it a victory.

The Affordable Care Act has its problems. Health care costs are still high. Some markets are lacking insurers. But the AHCA would trade those headaches for even bigger ones.

One of the hang-ups in the health care debate is the notion that we can take a snapshot of Americans and go from there. Covered at work? All set. Young and healthy? You deserve to pay less for insurance. Five percent of the population accounts for half of health care costs? Isolate them and give everyone else a break.

But the picture is constantly changing. People go from healthy to sick and back. The middle-aged man with a chronic condition was once young and healthy. Back then, he subsidized sicker people. Now he’s getting subsidized.

This reality is somehow lost in the debate over what to do with the individual market. If the pool of people who don’t have coverage through work is segregated by specific characteristics, then a lot of people who are currently sick or old are going to get hammered. And those who do buy cheap policies will discover they got what they paid for when they get seriously ill.

Then medical-related bankruptcies will surge, as will insurance premiums and health care inflation when the cost of taking care of the uninsured and underinsured is passed along. We’ve been down this road.

Now it’s up to the Senate to be the deliberative body. Early reports say it will start from scratch and take it slow. Democrats might even be consulted.

So put the champagne on hold. This contest isn’t close to over.

Edited to reflect that Trump called McConnell rather than tweeted.

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