The moment of truth for health care

I’ve got friends with diabetes and rheumatoid arthritis who will die because states will feel pressure not to accept federal subsidies for waiving cost protections for people with preexisting conditions. In other words, states will get rewarded for not covering citizens. I’m certain the bill to “repeal and replace” the Affordable Act will stumble when it gets to the Senate, but November 2016 taught me the peril of complacency. Paul Ryan doesn’t believe in reducing budget deficits — caring about deficits is a Trojan horse for tax cuts for the rich. Republicans don’t care about the sick — if you’re sick, blame the decisions you’ve made in your life. This is what they mean by “personal responsibility.”

States have tried high risk pools; indeed, the Affordable Care Act experimented with them a few years ago.

Meanwhile, Iowa insurance providers, nervous, dither:

Anthem chief executive Joseph Swedish said in a earnings call last week that his company, which has 1.1 million members in the exchanges, is weighing many factors when considering where to sell plans in 2018. Swedish added that if there isn’t a commitment to funding the federal payments that reduce out-of-pocket costs, called cost-sharing reductions, his company would consider exiting marketplaces, curtailing its participation and raising rates.

Currently, Medica participates statewide in Iowa’s marketplaces and has 12,645 members through the Affordable Care Act exchanges, making it the third-largest insurer in the state’s exchanges.

But passing something that assuages House Republican’s think tank electorate, takes precedence, even at the expense of the Senate. House Republicans have a message for senators who think they can mitigate the bill’s effects: “They better not change it one iota,” Freedom Caucus member Rep. David Brat (R-VA) threatened Tuesday. “If they change it, you’re not going to have 218 [votes].”

Conservatism is a shuck.

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