Anyone who knows a Conservative has heard the phrase “we have to pass the bill to find out what’s in it.” It’s a phrase often taken out of context to suggest that the ACA was built to fail. But in truth, such large-scale changes to an institution that accounts for nearly 20 percent of all American spending aren’t easy to design beforehand. And as the act was rolled out it had a number of measures that allowed various officials to adjust progress or even to make one-time decisions that would change how the final product looked.
For many who oppose the bill, this was exactly what was wrong with the ACA. Such a large bureaucratic behemoth is bound to be inefficient they imagine and stories about how the thing seemed to take on a life of its own after it was passed only exacerbated that fear.
But now, as the Senate released a preliminary bill to begin repealing and replacing the health care law they’re using the same sort of language. Except instead of retooling and accepting feedback McConnell’s plan seems to be not to make any decisions until after Congress passes the bill.
McConnell admits that he has no idea how the bill will be paid for or how it’ll even get through the House. Worse yet, it’s not even clear whether or not budget reconciliation – a rule that allows budgetary matters to pass with fewer votes – can even be used. Congress has a long history of abusing budget reconciliation to force policy through. But usually, the policy at least has something like an impact on the budget. McConnell’s plan doesn’t spell out funding at all, and many experts say it will wind up costing us more money than it could ever save.
So far the bill has no apparent direction. It’s not even clear what sort of system will be erected once it’s in place or if people who had coverage under the ACA will continue to be covered. But what is clear is that after spending the better part of a decade complaining that Obamacare was an unmoored monster they’ve set out to create one themselves upon ascending to power.
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