Paul Krugman: A Bill So Bad It’s Awesome

Why did Republicans propose a “sick joke of a health plan”?:

A Bill So Bad It’s Awesome, by Paul Krugman, NY Times: It has long been obvious to anyone following health policy that Republicans would never devise a workable replacement for Obamacare. But the bill unveiled this week is worse than even the cynics expected…

Given the rhetoric Republicans have used over the past seven years to attack health reform, you might have expected them to do away with the whole structure of the Affordable Care Act — deregulate, de-subsidize and let the magic of the free market do its thing. This would have been devastating for the 20 million Americans who gained coverage thanks to the act, but at least it would have been ideologically consistent.

But Republican leaders weren’t willing to bite that bullet. What they came up with instead was a dog’s breakfast that conservatives are, with some justice, calling Obamacare 2.0. But a better designation would be Obamacare 0.5, because it’s a half-baked plan that accepts the logic and broad outline of the Affordable Care Act while catastrophically weakening key provisions. If enacted, the bill would almost surely lead to a death spiral of soaring premiums and collapsing coverage. …

How could House Republicans … have produced such a monstrosity? Two reasons.

First, the G.O.P.’s policy-making and policy analysis capacity has been downgraded to the point of worthlessness. There are real conservative policy experts, but the party doesn’t want them, perhaps because their very competence makes them ideologically unreliable… Basically, facts and serious analysis are the modern right’s enemies; policy is left to hacks who can’t get even the simplest things right.

Second, Republicans seem to have been undone by their reverse-Robin-Hood urges. You can’t make something like Obamacare work without giving lower-income families enough support that insurance becomes affordable. But the modern G.O.P. always wants to comfort the comfortable and afflict the afflicted; so the bill ends up throwing away the taxes on the rich that help pay for subsidies, and redirects the subsidies themselves away from those who need them to those who don’t.

Given the sick joke of a health plan, you might ask what happened to all those proclamations that Obamacare was a terrible, no good system that Republicans would immediately replace with something far better — not to mention Donald Trump’s promises of “insurance for everybody” and “great health care.”

But the answer, of course, is that they were all lying, all along — and they still are. On this, at least, Republican unity remains impressively intact.