Republicans must protect vulnerable patients: Michael Steele

Following the withdrawal of the Affordable Health Care Act by Speaker Paul Ryan last month, much has been written about the poor strategic decision by President Trump and the GOP to tackle health care as their first major legislative effort. But, the reality of healthcare remains for many Americans: As a country, we spend an average of $10,000 per person per year on health care, and that growth will continue at a faster rate than our overall economy over the next decade. Health care is an issue that demands immediate attention from our national leaders.

Yet as the White House and congressional leaders regroup after the failure of the AHCA, reports indicate that they are currently working on a health care deal with members of the House Freedom Caucus that would severely weaken politically popular and policy savvy protections for America’s most vulnerable patients.

The proposal could enable states to request a waiver to opt out of a number of different provisions of the Affordable Care Act/Obamacare, including one called the “community rating,” which requires insurance companies to charge the same price for patients the same age, regardless of their status of health. This is the coverage for preexisting conditions that has proven so popular on both the political left and right.

The enormity of the consequences are clear. The Kaiser Family Foundation estimates that 27% of adult Americans under the age of 65 have pre-existing conditions and would not qualify for insurance under pre-Obamacare rules.

No one denies that Obamacare has serious issues (well, almost no one). Small businesses in particular have been crippled by the rising premiums that have come as a consequence of the law, and patient choice has been harmed as health care providers have consolidated and insurers have fled from smaller markets. Politically, Republicans have railed against the law for years, and owe it to the voters who voted our party into power in the House, Senate and the presidency to follow up on the promise for a fix.

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However, that fix should not include doing away with provisions that protect the most vulnerable patients and are, as a result, popular among wide swaths of Americans. According to a Politico poll last month, 71% of voters believed the Republican replacement legislation “should include prohibiting insurance companies from denying coverage to patients with pre-existing conditions.”

According to Margot Sanger-Katz’ excellent analysis, “Technically, the deal would still prevent insurers from denying coverage to people with a history of illness. But without community rating, health plans would be free to charge those patients as much as they wanted. … Only cancer patients with extraordinary financial resources and little interest in the fine print would sign up.”

As Republican lawmakers meet in the coming weeks to debate and legislate, they should remember the lessons of last month’s legislative debacle as well embrace a renewed understanding of the responsibility they have to their constituents. They should also act in a politically savvy way that supports holding their majorities in the Congress and the White House.

Consequently, unnecessarily catering to any one faction within the Caucus or the Party in shaping such consequential legislation as health care is not in the best interests of Trump or Ryan.

Not only is this political suicide for a President with historically low approval ratings, but this is a blow to our nation’s most vulnerable. Time after time, both Trump and Ryan promised to protect and not discriminate against ill patients as they pledged to repeal and replace Obamacare.

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Health care cannot be overhauled through quick legislative fixes that hinge on easily reversible waivers for states. This will create a system of constant disruption for patients as their plans will continue to change for the worse.

Rather, congressional leaders should give themselves time to carefully craft and debate legislation to undo the challenges Obamacare has sprung on our health care system.

Likewise, Rep. Charlie Dent, R-Penn., and the Tuesday Group Republicans should understand they too have leverage in this fight and should continue to stick to their principled argument, "bringing down costs and improving health outcomes." More important, they know that abandoning susceptible patients is not only bad policy, but bad politics that will surely haunt the party in next year’s elections.

Michael Steele is the former chair of the Republican National Committee and former lieutenant governor of Maryland. Follow him on Twitter at @MichaelSteele.

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