Sohn: Trump/GOP care just another fiction

President Donald Trump speaks as House Republicans came to the White House to celebrate passing the American Health Care Act, in Washington, Thursday. The measure, which passed by a vote of 217 to 213, faces uncertainty in the Senate. (Stephen Crowley/The New York Times)
President Donald Trump speaks as House Republicans came to the White House to celebrate passing the American Health Care Act, in Washington, Thursday. The measure, which passed by a vote of 217 to 213, faces uncertainty in the Senate. (Stephen Crowley/The New York Times)

We've become accustomed to Trump lies.

But we winced with new heartache Thursday as President Donald Trunp declared victory in his push to repeal the Affordable Care Act and partied in the White House Rose Garden with Republican lawmakers after the House of Representatives finally squeaked out a narrow 217-to-213 approval of a new Trump/GOP health care plan that is expected to drop at least 24 million Americans off of their insurance and sky-rocket premiums for older Americans and those with pre-existing conditions.

Of course, those painful health care losses are not really the point. The point of the bill - aside from giving Republicans another chance to rebuke former President Barack Obama and the ACA's nickname Obamacare - is to provide enormous tax cuts for the richest Americans.

photo Protesters chant as Republican and Democratic House members walk down the steps of the Capitol in Washington on Thursday after the Republican health care bill passed in the House.

"Yes, premiums will be coming down; yes, deductibles will be coming down, but very importantly, it is a great plan," Trump crowed at his garden party - the kind of event usually reserved for signing bills into law.

But this controversial bill was dangerously close to failing in the House for a second time, and still faces an uncertain reception in the U.S. Senate. Even if it passes in the Senate (which it would do only with major revisions), it and the changes then would have to again clear the House, another unlikely scenario.

Beyond the brittle celebration, here's what the legislation would really do:

Premiums might come down for young, healthy people, and those who choose to go without insurance would no longer face a penalty. But premiums would skyrocket for middle-aged and older Americans - perhaps even those on employer-provided insurance - if the states where they live opt out (as the legislation, as written now, gives states the right to do) of no-caps coverage plans and "essential benefits" such as preventive care. Such opt-outs gut protections for people with pre-existing conditions.

(To swing the House GOP vote to approve the legislation, the bill was amended this week to provide $8 billion over five years to be used for so-called high-risk pools to help lower premiums for those with pre-existing conditions, but health policy experts say that number would have to be many times higher to actually have an impact.)

The bill could also affect Medicaid beneficiaries, and could mean cutbacks on coverage for mental health and drug addiction treatment.

State governments and hospitals stand to lose large. Obamacare made substantial cuts in how much Medicare pays hospitals, on the theory that they would make up the difference with more paying customers since more people were insured. Trump/GOP care does not restore any of the Medicare cuts.

Republicans have promised for seven years to repeal Obamacare, under which about 20 million Americans gained health insurance coverage. But the GOP has never really devised an alternative, and following Trump's election they ran headlong - when they didn't hide from citizen town halls - into constituents who say that the present law saved their lives or the lives of a family member.

But Tennessee Republicans in the House - including Rep. Chuck Fleischmann of Chattanooga and Rep. Scott DesJarlais of South Pittsburg - unanimously approved GOPcare.

In a statement, Fleischmann said "For far too long Obamacare has hurt American families by not keeping its promises of lowering costs, while increasing patient choice. That is why I voted in favor of the American Healthcare Act."

We'll see.

Democrat Rep. Jim Cooper of Nashville voted no.

"I proudly voted against Trumpcare," Cooper said. "This Republican bill is a national tragedy. Millions of Americans will lose health coverage and protections. Lives will be lost, and Congress will regret the vote. I pray the Senate will reject this reckless plan."

Tennessee Sen. Lamar Alexander, chairman of the Senate Health Committee, said in a statement, "The Senate will now finish work on our bill, but will take the time to get it right."

In other words, don't hold your breath.

In the meantime, the Affordable Care Act will remain in place.

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