GOP health care, from the gang that has no clue how to govern

House Republicans have finally unveiled their vision for health care — eight years in the making! the suspense was killing us! — and all you really need to know is that policy scholar Donald Trump thinks it’s “wonderful.” Which means, of course, that the GOP’s replacement plan for Obamacare is a steaming pile of stink.

Seriously, everyone hates RyanCare. The left hates it because it’ll force millions of people to lose their health coverage (S&P Global Ratings, a business outlet, puts the figure at six to ten million). The right hates it (“Obamacare-lite!”) because it keeps some popular Obamacare features, and creates some new subsidies without any idea how to pay for them. Center-right Senate Republicans hate it, too. They hate the provision that slashes Medicaid; 31 states, including many run by Republicans, use that money to provide Obamacare to low-income people. The American Medical Association hates it too, because it would ensure that millions who are currently covered would “become uninsured.”

Even Avika Roy, a prominent conservative critic of Obamacare, is appalled by the various provisions that favor the affluent (hey, it’s a Republican plan; of course the provisions favor the affluent). Roy says that Ryan Care is a political disaster: “Expanding subsidies for high earners, and cutting health coverage off from the working poor – it sounds like a left-wing caricature of mustache-twirling, top-hatted Republican fat cats.”

Are any of us really surprised about this?

As I’ve repeatedly noted, during the years when Republicans assailed Obamacare as a “train wreck,” throwing rocks is easy but governing is hard. And these lawmakers, who were in the wilderness for so long, have no clue how to govern. They’re hostage to the conservative base, which has long pined for the death of Obamacare, but now they’re also tasked with serving the broader citizenry – which has broadly benefited from Obamacare.

Killing off people’s health coverage, with no rational plan to replace that coverage, is a surefire way to drive those voters to the polls in the ’18 midterms. The recent Republican town halls have already foreshadowed that ire. And how does Trump square his tweeted rave about RyanCare (“wonderful”) with his campaign promise of “insurance for everybody”? That pledge was just another Don con.

And the Republicans are in such a rush to get this thing through the House! Paul Ryan wants it done in a month. Their haste is hilarious, because I well recall their complaints that Obamacare was “rammed through” the chamber — “rammed through” after a solid year of hearings. But why the haste? Because they want to act before the nonpartisan Congressional Budget Office weighs in. Because they fear that the CBO will describe RyanCare as a red-ink mess that will deepen the deficit. Because they fear that if the CBO does so, that momentum for RyanCare will grind to a halt.

How disgraceful is it that Republicans would seek to kill and overhaul a hugely consequential law without first having all the necessary information about its cost and impact? How disgraceful is it that they’d proceed in haste without first knowing how many people will be adversely affected — and what the impact will be on economic inequality, since the RyanCare provisions actually favor the affluent (by killing the taxes they pay for Obamacare) at the expense of the needy (who benefit from that tax money)?

I’ll let Jennifer Rubin answer that. She’s a Republican-leaning columnist and longtime Obama critic. Here’s what she said yesterday: “The notion that House Republicans would vote to end legislation on which tens of millions of people depend for health-care coverage, without knowing critical facts about their bill, arguably is the most irresponsible display of governance in my lifetime.”

By the way, many of the people who depend on Obamacare happen to be aging Rustbelt folks of modest means. In other words, Trump voters. As the Kaiser Foundation points out, having crunched the RyanCare provisions, “In almost every single county in Iowa, Michigan and Ohio, a 60-year-old with $30,000 in income would pay more for coverage.” But rest assured, Trump didn’t read RyanCare’s fine print before he pronounced it “wonderful,” before he decreed that “we’re going to have a tremendous success.” He’s too busy watching cable news to read anything.

Turns out — big surprise! — that Trump had no plan of his own to replace Obamacare. Some leader he is. And if you truly want to see a “train wreck,” watch what happens on Capitol Hill when RyanCare jumps the tracks.

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