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Republicans Behaving Badly on Health Care

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Republicans in Congress who voted for the Tax Cuts and Jobs Act may have rushed through an underdeveloped, sloppy bill. They may be guilty of hypocrisy for increasing federal budget deficits after campaigning against them (although in my view their actions have been consistent, and I don’t really care much about hypocrisy anyway). Economists almost universally don’t believe that these tax cuts will have the economic effects that the bill’s supporters claim will happen.

But I’m quite confident that Paul Ryan and most Republicans in the House and Senate sincerely believe they are improving the nation by passing this bill. I’m an outsider, so on-the-ground reporters might have insights I don’t have from my distance, but I think the bottom line here comes down to a party that agrees on almost nothing but the positive effects of cutting taxes, especially on the wealthy.

The same, however, cannot be said about the provision in this tax bill to eliminate the Obamacare individual health insurance mandate. In that case — and in all the other ways that Congress and the Donald Trump administration have tried to depress participation in the Affordable Care Act individual markets — they are actively trying to make the nation worse, in hopes that some good will come of it eventually.

(Related: 4 Good Things in a Bad Tax Bill)

I know that because that’s what Republicans say they are doing. Bloomberg’s Stephen Dennis quotes Senate Minority Whip John Cornyn saying as much: “Arguably, doing away with the individual mandate makes the Affordable Care Act unworkable.”

(Related: 3 Things to Know About the Fiduciary Rule’s Little Brother)

Of course, Republicans have been saying for some time that Obamacare was in a death spiral, with fewer healthy customers buying insurance, thus producing higher premiums, thus pushing more people out of the market, thus raising premiums even more, and so on. Trump jumped to the end of that line, declaring over and over again that Obamacare was already dead. While the exchanges certainly have growing pains and other problems, none of this has actually been true — so much so that despite everything, enrollments this year were not catastrophic at all.

Republicans had pledged for years that they would repeal and replace the Affordable Care Act. They wouldn’t strand millions without health care. But they are now doing just that: repealing a key piece of the legislation in an attempt to collapse the individual market. Perhaps that will eventually yield new legislation after all. In the meantime, however, people without employer-linked insurance who don’t qualify for Medicaid or Medicare may wind up just out of luck.

Now, as it happens, it’s also extremely unlikely to work. Like it or not, people strongly tend to hold incumbents responsible for government actions, and justified or not — and now, it certainly will be — voters will tend to hold Republicans responsible for whatever happens with health care. However, that doesn’t change the political ethics involved.

I often call some Republicans radicals. This kind of thing is exactly why. Indeed, “radical” is a mild term for those who attempt to make things worse for citizens in hopes of benefiting from it in the longer run. It’s a terrible way for elected representatives in a democracy to behave. It’s bad enough when a sizable section of the House Republican conference attempts it. But this time it’s a consensus position within the party. It’s an embarrassment to the once-good name of the Republican Party, and they deserve to suffer for it.

— For more columns from Bloomberg View, visit