(Bloomberg View) — The Republicans are trying to assemble a health care bill the way some people play Words With Friends. “Is ‘raitch’ a word? How about ‘taitch’? Okay, let’s try my ‘z’ in that slot.…” House Republicans are trying anything to see whether they can actually secure the 216 votes needed to clear the House and move a bill to the Senate, where it will be someone else’s problem at least for a while.
As in Words With Friends, however, the activity quickly loses any connection with hard-won knowledge and keen analysis. You lose sight of the goal, and start just trying to jam in anything the system will accept.
The current plan is apparently not to get rid of “essential health benefits,” (a big talking point for the conservative part of the coalition), but instead to use waivers that would give states broad latitude to pare them back, if they wanted to. (Very sick people, whose insurance bills might spike under this scenario, are to be taken care of via “high-risk pools,” a remedy which liberals say is inadequate, because premiums in those pools can be quite high if they’re underfunded.)
This is no way to build a health care plan. To be fair, it is certainly the approach encouraged by the legislative system. Obamacare had plenty of its own silly deals that could be justified only on the unlovely grounds that they were necessary to secure votes for the program. And the public option, for which the left lobbied hard, was left out to get moderates on board.
However, there is a difference, which is that those things were not core to Obamacare’s design; they were peripheral issues, usually small ones. (No, the public option was not core, and would not have prevented the problems that beset the Obamacare exchanges.) Republicans are now ripping apart a program that was designed to work as a (barely) coherent whole, and trying to reassemble some of the pieces, pasting them together with other bits that various coalition members find aesthetically pleasing. The result will be … well, about the same as you’d get if you tried to do this to the engine of your car.