Cooper: Sampling health care biscuit dough

Sen. Rand Paul, R-Ky., speaks to reporters at the United States Capitol on Thursday after Republicans released their long-awaited health care bill.
Sen. Rand Paul, R-Ky., speaks to reporters at the United States Capitol on Thursday after Republicans released their long-awaited health care bill.

Determining the fitness of the Senate Republicans' version of a new health care bill is somewhat like sampling the dough of a biscuit not yet baked. Its consistency and taste are nothing like what will come out of the oven.

Of course, that hasn't stopped Democrats, who wrote in secret the bill the Republicans are trying to replace, from criticizing it, or organizations that profit from the current law, the American Medical Association, the American Hospital Association and the American Association of Retired People among them, from verbally shredding it.

We've said before we prefer a health care bill crafted in a bipartisan effort, but that didn't happen when Democrats wrote the now crumbling Affordable Care Act (ACA) and is not happening now with the Republican House and Senate versions of the replacement bill.

If the current bill passes the Senate, and that is far from a lock, it still must be combined with the House version of a bill that passed last month. What the end product will look like is anybody's guess.

If the combined and conferenced bill is unable to pass both houses of Congress, President Trump should let the ACA die of its own accord. That would - or should - force Democrats to come to the table to pass a bill that is satisfactory to both parties.

Pie-in-the-sky thinking? Perhaps.

While anything - anything! - written or said about the Republican plan today is only speculation because of what must happen before such a bill passes Congress, what is bankable is what is happening with the ACA.

In Tennessee, for instance, two-thirds of the state's 95 counties will have only one insurance provider offering individual health insurance plans under the ACA's health exchange markets in 2018.

BlueCross BlueShield of Tennessee, which had withdrawn from the state's three biggest markets to limit its losses, agreed to offer plans in Knoxville so that every county would have at least one carrier.

Even at that, premiums will continue to rise in the state and across the country as they have for every year of the plan, according to an acturial consulting firm.

Nationwide, individual plans on the exchange markets are expected to rise between 28 and 40 percent, Oliver Wyman Actuarial Consulting reports.

Meanwhile, Democrats have pulled out the words "mean" and "meanness" - from Trump's description of the House bill - to describe the Republicans' not-yet-in-stone new plan, but, in truth, "mean" is what former President Obama's lies about Americans' premiums decreasing with the advent of the ACA were and what its expected premium cost hikes have to be because of the overall price of the health care program.

It's also "mean" to force people to pay for insurance they don't want or pay a fine, "mean" to force companies to pay for insurance instead of be able to grow and "mean" to force insurance companies to offer plans with coverages clients don't want.

All that aside, is there anything in the Republican Senate health care biscuit dough worth waiting for? Sen. Lamar Alexander, R-Tenn., without giving his full-throated endorsement to the entire measure, says there is.

For one, he says, there is no change to the ACA's protection for people with pre-existing conditions. Long before the ACA, this was a Republican idea and is also one Trump had vowed to keep. He also says the bill makes no change in Medicare benefits and reasonably increases Medicaid funding - TennCare in our state - at the rate of inflation.

Alexander says the bill also offers health care coverage to 162,000 Tennesseans who make less than $12,000 a year but under the current law get no help in buying insurance. Among other things, he says, it provides more money for hospitals that serve low-income state residents who don't have insurance, repeals the medical device tax on one of our state's largest exports, provides new funding for opioid abuse (rampant in the state) and provides new Medicaid funding to double the number of days for mental health inpatient treatment.

Those to date who have criticized the suggested Senate plan fall into two categories. Either they're Republicans who believe the Senate plan doesn't go far enough in eliminating every jot and tittle of the ACA, or they're Democrats and supporters of the ACA who don't want even one aspect of the previous plan changed unless it makes the plan more generous and more of a burden for the government.

How delightful it would be if the millions of reasonable Americans between the two extremes got their heads together and came up with a workable plan that took more onus off the government and put more responsibility on the person whose health care is in question.

Is that too much to ask?

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