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Health Insurance Sausage

It is often said that passing bills in Congress is like making sausage. You don’t really want to see it being done. And the way the Republicans are trying to strong-arm their repeal of Obamacare is a prime example.

The current focus is on the MacArthur amendment, which would allow states to opt out of key provisions of the ACA, including the provisions that force insurance companies to cover pre-existing conditions, and cover things like maternity care or mental health services. That would essentially sabotage Obamacare in those states.

But the MacArthur amendment included a curious (and well hidden) exemption for members of Congress and their staff. That’s right, the MacArthur amendment would not apply to our Congress critters, who would continue to reap the benefits of Obamacare, while the rest of us could suffer.

However, when the media found and reported this exemption, there was a public outcry. So Congressman Tom MacArthur (R-NJ), the author of the MacArthur amendment, promised to remove the exemption.

As a side note, MacArthur even issued a statement claiming that the exemption was originally put in at the request of the Senate Budget Committee in order to comply with their rules. But the Senate Budget Committee responded that his claim was untrue.

Furthermore, the exemption for Congress critters is still in the amendment, which means that it is still in the repeal bill.

I just want to point out that the Republicans are still trying to fast-track the repeal bill. They want it to be voted on today without posting the text of the bill, and (certainly) without the CBO doing an analysis of the ramification of the repeal. And indeed, in the arm-twisting that is going on to get enough Republicans to vote for the repeal, the text of the repeal bill keeps changing in order to get to yes. The latest change to the bill is providing $1.6 billion per year to fund the high-risk pools that people with pre-existing conditions will be forced to use, but experts have estimated that an $20 to $30 billion is needed. However that change was enough to get Fred Upton (R-MI) to change his vote to yes.

MacArthur now claims that the removal of the exemption will be contained in separate legislation. That’s right, they are going to leave the exemption for Congress in the repeal bill, but introduce a separate bill to remove it, to be voted on after Congress votes on the repeal bill. Of course, they didn’t explain why this was necessary. Why would you leave something in the bill if you are just going to remove it (assuming that they really will get around to removing it, and as we already pointed out, they have already lied about the purpose of this exemption).

Does anyone else get the feeling that we are being bamboozled? As Electoral Vote put it, “Nothing says ‘we believe in our bill’ like not wanting to have anything to do with it.”

UPDATE: If you are interested in the meat of the sausage, here’s a good summary. The Washington Post’s fact checker is skeptical of promises that people with pre-existing conditions will not be hurt by the bill. And even if this bill doesn’t pass, it is already damaging health insurance in this country by introducing uncertainty. The American Medical Association, AARP, and hospital associations are all against the repeal bill. Plus if the bill passes, it will weaken Medicare. And speaking of hypocrisy, in 2009 Paul Ryan said “I don’t think we should pass bills that we haven’t read and don’t know what they cost.” And yet, that is exactly what he is doing now.



  1. Michael wrote:

    As if all that’s not bad enough, even the Wall St. Journal is saying that it gets worse. If states obtain waivers from the pre-existing condition requirement or the ban on lifetime out-of-pocket limits, that applies to all insurers, not just the policies through the exchanges. So if you get your insurance through your private employer, you might also be losing these benefits.

    Not only that, but states are actually encouraged to opt out. From what I have seen, they have to opt out in order to get their share of the $8B for high-risk pools.

    Thursday, May 4, 2017 at 8:14 am | Permalink
  2. Iron Knee wrote:

    Well, the repeal of the ACA passed the house. Now on to the Senate. Sad.

    Thursday, May 4, 2017 at 12:25 pm | Permalink
  3. ebdoug wrote:

    Latest news is that the Senate is going to ignore what the house did. They are going to write their own bill.

    Thursday, May 4, 2017 at 3:49 pm | Permalink
  4. Wildwood wrote:

    Ebdoug, dumb and dumber?

    Thursday, May 4, 2017 at 6:46 pm | Permalink