Obamacare Architects ‘Sad, ‘ ‘Irritated’ And ‘Determined’ As Repeal Looms

3 months, 17 days ago

Disturbing. Tragic. Inordinately troubling. Disconcerting. Sad.

Those are just some of the words original designers of the Affordable Care Act used in interviews with The Huffington Post to describe the effort by President Donald Trump and congressional Republicans to speed through a bill to repeal major parts of the law and replace it with a more meager define of health reforms.

Its easy to ensure why key figures behind the biggest expansion of the social safety net in decades would be aghast at whats happening now. On Thursday seven years to the day since President Barack Obama signed the Affordable Care Act into law the House is tentatively scheduled to advance its repeal measure.

More people are going to get hurt under the Republican version than under the ACA. They may not like the ACA, but we could certainly work on it and improve it, said former Sen. Max Baucus( D-Mont .), who chaired the Finance Committee during the period the Affordable Care Act passed Congress.The legislation that emerged from the commission in September 2009 formed the backbone of the eventual law.

But theyre going to dislike the Republican version, Baucus continued, because its going to give much more benefits to the wealthy at the expense of others, and a lot of people are going to get hurt along the way.

If House Speaker Paul Ryan( R-Wis .) and the White House succeed in this gambit a far away from certain prospect, given major schisms among Republican lawmakers about the bill the consequences would be significant.

A law that extended coverage to 20 million previously uninsured people and reduced the national share of Americans without health coverage to its lowest-ever percentage would be throttled. Almost$ 1 trillion in money currently financing health benefits for low- and middle-income households would be diverted for tax cuts on the wealthy and health companies.

In the process, if the Affordable Care Act does not remain in place, 24 million more people would lack health coverage a decade from now, according to a Congressional Budget Office review of the legislation approved by three House committees this month.

We Americans have to ask ourselves: Are we in this together or are we not? Former Sen. Max Baucus( D-Mont .)

Older Americans, especially those with less income, would exit the health insurance marketplace because they wouldnt be able to afford policies, the CBO projected. Nations would lose $880 billion in Medicaid funding, forcing cutbacks to that program.House leaders have made changes to the bill since that analysis, but do not have a new CBO rating yet.

Were in a very tough spot, and its sad. It really is very sad. But what do we do about it? People who care about all this have to simply maintain presenting the facts, Baucus said.

And the Democratic Partys decades-long mission to strengthen the social safety net, dating back to President Franklin Roosevelts New Deal, would suffer a major setback.

It actually comes down to an attitude. We Americans have to ask ourselves: Are we in this together or are we not? asked Baucus, who served six terms in the Senate before becoming Obamas ambassador to China from 2014 until Trumps inauguration.

The Republican bill answers that question by saying , no, were not in this together, that insurance is genuinely available for those who can afford it and is not really as available for those who cant afford it. The sort of underlying basis of the ACA was: Were in this together, were all Americans, Baucus said.

Kathleen Sebelius, who served as Obamas secretary of health and human services from 2009 to 2014, is worried about the people shes encountered who would be worse off under the House Republican bill.

I is certainly troubled to my soul and very disturbed about what is going to happen to the people I meet on a still-regular basis who tell me about their family situation, about their narratives, about their worries that whether its themselves or their children or their parents who finally have some health security, who ultimately have a sense that they can count on affordable health coverage now this is going to be swept away, Sebelius said.

I find it extraordinarily troubling that individuals are rushing to take away people health care, to shift expenses onto people who are in difficult medical situations, Sebelius said. Its hard to see who the beneficiaries are.

Chip Somodevilla/ Getty Images
Then-Senate Finance Committee Chairman Max Baucus( D-Mont .) receives then-Health and Human Services Secretary-designate Kathleen Sebelius in his Capitol hill offices on March 12, 2009.

Beyond the human cost, those who spent all of 2009 and one-quarter of 2010 writing the Affordable Care Act in Congress consider a deep irony in GOP leaders rushto pass their repeal and replace bill within three months of Trump taking office.

We spent more day “re going through” the particulars of any bill in all of my years here, said Rep. Sandy Levin( D-Mich .), whos serving his 18 th term in the House. Levin chaired the Style and Means Committee during the final months of the Affordable Care Act debate in 2010.

When Baucus and other key lawmakers wrote their legislation, they held dozens of hearings and spent many days marking up and amending the bill in committee. By contrast, two House committees approved the Republican bill without a Congressional Budget Office analysis of its impact.

I is certainly troubled to my soul. Former Health and Human Services Secretary Kathleen Sebelius

It attains me very irritated, and its sad, because we were open, we Democrats were, Baucus said. Accusations that Democrats rushed their billbylawmakers who are now doing just that are adding insult to injury, he said.

The Finance Committee approved its version of the Affordable Care Act after eight days of debate, some of which stretched into the night. The Senate Health, Education, Labor and Pensions Committee spent even longer on the bill in June and July 2009.

The Finance Committee action came after Baucus with the Obama White Houses support spent months courting Republican senators, including Chuck Grassley( Iowa ), Mike Enzi( Wyo .) and Olympia Snowe( Maine ). In the end, all he got was Snowes vote in committee, before she resisted it on the floor two months later.

As we were starting to put it together, regrettably, it became partisan. You merely feel it falling away at the very end, Baucus said. Republican assured an important political opportunity to try to demonize Obama, demonize the Democrats and all vote against it. And theyve been demonizing the ACA every since.

Even the lengthy committee work in 2009 understates the cornerstone Democrats laid in Congress before Obama took office. For two years, we worked on this. Worked very hard. Had all kinds of groups and subgroups. It was all nonpartisan. We all worked together, Baucus said.

In 2007 and 2008, Baucus convened 14 hearings on health reform, plus eight more in 2009. Eight days after Obama won the 2008 presidential election, Baucus released a 98-page white paperlaying out options for health care legislation. Before the election was even over, Sen. Edward Kennedy( D-Mass .), dying from a brain tumor, and his staff convened meetings with a wide array of interest groups that would be affected by health care reform.

The contrast with todays proceedings is stark. At present, the Senate isnt even scheming committee action on the House bill and will take it immediately to the floor if it passes the lower chamber.

There is this sort of beat-the-clock mentality of We have to fulfill campaign promises at any cost[ that is] is very, very troubling in an area where there are real life and death consequences, Sebelius said.

Levin is the last person who chaired a committee that passed a version of the Affordable Care Act whos still in Congress, so hes watching all this firsthand. He still serves on the Ways and Means Committee and participated in its markup of the Republican health bill that ran until 4:30 a.m.

Levin shares Baucus frustration about the alternative history told by Republicans opposed to the Affordable Care Act. As a sitting is part of Congress, however, he is absolutely determined to use his position to push back, directly and in concert with voters and allied interests. Were in combat trim, he said.

What we need to do is to battle them here, but to combine resources, to coordinate, to coordinate, Levin said. What we need is just a massive outpouring. The people, I guess, will speak and we need to help them speak out, to provide more and more opportunities and to organize.

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