Are we about to be left in the lurch?

by Michael Bilodeau, Constituent of CA-04

Reading Congressman McClintock’s surprising silence on the AHCA

While Congressman McClintock has offered many off-target statements about his constituents lately, he has held back his opinion on the Republican’s American Health Care Act (AHCA). Just last week, the Congressman described his town hall meetings as important venues for “people to see the behavior and hear the views of the radical left.” Perhaps if he were more focused on listening at his recent town halls, Rep. McClintock would already know that his constituents are deeply concerned about Affordable Care Act [ACA] repeal and are waiting to hear from him.

To hear the frequently expressed anxiety, we needn’t look any further than the very first question asked at the Roseville town hall. When she was 22 years old, Amanda Barnes was the victim of a hit-and-run while crossing the street, an accident that left her paralyzed from the waist down. She asked, “What do you expect seniors and people with disabilities with low income to do if you take away our Medicare and Medicaid that we rely on to literally stay alive?”

McClintock’s response included the following, “Some people have done very well with [the ACA], other people have not... I will make you this promise: we don't want to leave anyone in the lurch, and we are going to do our very best to assure that the health system that replaces Obamacare is going to be better for the vast majority of Americans.” He has repeated these talking points many times in subsequent town halls. While his answer didn’t offer any specifics, we did get important promises that Republicans would do their “very best” to create a better system. How does the Republican AHCA plan measure up?

Politicians often neglect to mention the inherent trade-offs involved in making health care policy changes. They focus on winners in legislation they support, and losers in legislation they oppose. Sarah Kliff recently described this trap politicians commonly fall into, “Officials are pretending that health policy doesn’t have trade-offs, that they have finally written a plan that is great for everyone. They are wrong. Every health bill has people who do better because of its changes, and every bill has people who do worse.”

At the consumer level, the ACA benefitted the previously uninsured while hurting self-employed healthy people above the income threshold to qualify for tax credits. McClintock’s observation that “some have done very well...other people have not” is correct but meaningless - the same will be true of any health care plan.

The AHCA plan creates a clear set of winners across three spectrums- the healthy over the sick, the young over the old, and the wealthy over the poor. Since winners and losers cannot be avoided, the question to ask is: are these the right ones? I don’t think so.

  • Our health care system should advantage the sick over the healthy. Even those with a spotless health history can see that change in the blink of an eye. It's reasonable to ask the healthy to pay more into a system that will provide the best protection if they get injured or sick. Good health care will be the only way to move from the sick end of the spectrum back towards the healthy end.
  • Our health care system should advantage the old over the young. We all move in one direction on the age spectrum. Health care use and costs rise as we age. It's reasonable to ask the young to pay more into a system that will provide the best protection when they get old.

  • Economic status should not determine access to affordable health care. A plan that provides tax cuts for the wealthy instead of providing health care for low income individual and families will not live up to the promise of being “better for the vast majority of Americans.”

Finally, we should consider the process that is unfolding in the House. We know McClintock opposed using budget reconciliation as the process for ACA repeal due to the risk it might create an “even more dysfunctional system than we currently have.” Budget reconciliation remains the vehicle for the AHCA and a dysfunctional system remains its apparent destination. Further, the bill was developed in secret and was rushed through two committees a few days after release. These committees voted without the benefit of the Congressional Budget Office score released today, revealing that 24 million Americans would lose coverage under the AHCA.

So what does Tom think of the AHCA? Is it the Republican’s best effort and better system he promised us? He plainly stated the consequences of missing the target, reminding his colleagues that “we’ll be judged in the election less than two years away.” How will his previous positions hold up under pressures from Republican leadership and his constituents at home?

This Wednesday, the AHCA will reviewed by members of the House Budget Committee, including Congressman McClintock. When his silence breaks, we hope that his focus will be less about disparaging constituents and more about thoughtful policy analysis. We anxiously await hearing how seriously he takes the promise he made to us.