How House Republicans Defend AHCA Vote By Luke Perry
House Republicans who voted for The American Healthcare Act (AHCA) immediately began defending the bill in the wake of scoring by the nonpartisan Congressional Budget Office (CBO). This included our home direct at The Utica College Center of Public Affairs and Election Research, NY-22. This morning Representative Claudia Tenney wrote an op-ed for Utica’s local paper, the Observer Dispatch, entitled “Time for facts on the American Healthcare Care Act.”
Tenney is a freshman Congresswoman who faced a tough primary to replace Richard Hanna (R) and won the general by defeating a self funded, third party, right-leaning challenger, in addition to a well funded Democrat. While in office, Tenney has sought to navigate ongoing tensions between moderate Republicans in the district, who supported Hanna, and Tea-Party and/or Trump Republicans, where Tenney receives most of her support. Meanwhile, Democrats have enthusiastically criticized her personally (for not holding town hall meetings) and in terms of policy, including her support of Trump's refugee ban and repealing Obamacare.
Congresswoman Tenney’s op-ed begins by emphasizing the fragility of Obamacare and her perception that people are losing access to affordable, high quality healthcare. This is a valid concern, but it’s unclear how that will be improved under AHCA. If AHCA becomes law the CBO estimated 23 million people will lose insurance, about the same number who gained insurance under Obamacare, and premiums for the elderly and poor will increase 850 percent.
Tenney focused on four points in defending her vote. AHCA will: 1) relieve Medicaid related tax burdens on upstate counties; 2) repeal the individual mandate; 3) allow young adults to stay on their parent’s plan until the age of 26; and 4) help vulnerable populations defray insurance costs.
The first point touches on a perpetual debate in New York over taxes and services, particularly between upstate and downstate, while the second has been a national point of contention for the GOP, even though the individual mandate was designed by Republicans and advocated by the GOP during the 1990s. Both arguments are typical for a Republican House member is an upstate district like NY-22.
The last two points were more unusual. Tenney neglected to mention that point three was something established through Obamacare, so the Congresswoman neither repealed, nor replaced it. The final point cited several spending provisions in AHCA, which sound like a lot of money in raw terms, and it is, but as a whole, constitutes a significant decrease in support and services for the elderly, children, disabled, and the chronically ill. Such provisions enable Congresswoman Tenney to write that she fought “to protect the most vulnerable,” but by removing the context, she creates the false impression that the bill helps these people more than it hurts them.
What Congresswoman Tenney didn’t discuss was almost as interesting as what she did. For instance, Ms. Tenney didn’t mention that the bill would save $119 billion. Decreasing federal spending is typically embraced positively by the GOP. There may be two reasons for this.
First, saving money by having 23 million people lose insurance coverage is not widely considered sound policy. Second, Republicans wanted to pass healthcare reform first so the money saved could be applied to tax cuts. That is a difficult sell politically when people losing insurance coverage are moderate to low income, and the people who benefit most from tax cuts (because they pay the most) are the most affluent.
Two questions emerge looking ahead. Will healthcare reform pass the Senate? Senator Majority Leader McConnell has outplayed Democrats many times in recent years, but McConnell doesn’t think so, so probably not. Why did the House pass the bill then? Donald Trump wanted to claim credit for a legislative accomplishment (recall the odd celebratory ceremony outside the White House pictured above) and held out hope for the off chance the Senate would come around. It still may, but Speaker Ryan deliberately pushed for a vote prior to the CBO score knowing it would be difficult for his members to defend. McConnell doesn’t have that option.
Today's op-ed by Congresswoman Tenney provides a valuable window into how House Republicans will react to the CBO fallout. One thing is certain, healthcare reform remains a challenge for the GOP as they attempt to keep their campaign promises in a way voters approve of.
Luke Perry (@PolSciLukePerry) is Professor of Government at Utica College. His column Sound Off! critiques various aspects of American politics.