On CNBC’s Shark Tank — a program that happily mixes capitalism, reality television, and entrepreneurial tears — business owners are often asked about their “secret sauce,” the thing that makes them different from competing products or services. Sometimes it’s a patented advantage, or a special skill or drive possessed by the owner. And if they don’t have it, the Sharks won’t open their wallets.
The Republicans’ plan to repeal and replace Obamacare has its own special sauce, and it’s not the boring name (nobody’s going to call it the American Health Care Act, just like nobody calls Obamacare the Affordable Care Act). But it’s something that will allow them to declare it a success, no matter how badly it fails.
The secret sauce is plausible deniability.
More specifically, it’s the changes to Medicaid that doles out block grants to states and wishes them godspeed on their mission to take care of the poor who rely on it. That way, when they fall short of preserving coverage for Obamacare recipients to the tune of millions of uninsured, you can’t really blame Republicans. Blame your state, who somehow can’t make do with a reduced package of assistance. Who could have known?
It’s also the new entitlement (but don’t call it that) which offers tax credits to individuals to buy health insurance. That way, it’s on them to buy the coverage they need. And when premiums rise much faster over the years than the tax credit increases, well, that’s not the GOP’s fault, is it?
And when the only thing people can afford are bare-bones catastrophic policies, they’ll cheer individual empowerment! Never mind that preventative care will no longer be mandated for policies. Preventative care, by the way, is by far the cheapest form of care and provides the very best outcomes. And it’ll be missing for many people trying to find a policy they can afford.
Remember when your grandmother told you that an ounce of prevention was worth a pound of cure? Not on Capitol Hill. Offer up a few ounces of cure, ditch the prevention and claim people are technically “covered.” And if they didn’t pick a policy that helps keep them healthy, it’s not the GOP’s fault. Personal responsibility, right?
The Obamacare replacement does offer some fantastic benefits — for politicians. They can wash their hands of the Medicaid-dependent poor, they can expand “choice” by allowing flimsy policies to dominate the market when nobody can afford real care, and they can cut future budgets by playing with the block grants and tax credits each year. Insurance companies can offer more profitable policies, politicians can claim people are covered by something, and politicians can run on repealing Obamacare.
And if the end result is millions without care, millions more with no preventative care and the cost of policies increasing annually to make the credits less and less valuable…well, don’t blame the GOP. How could they know this would happen?
Well, they could have asked the Congressional Budget Office. Then they’d have known. But who wants to do that when the news will likely be bad? We’re still waiting for a CBO score.
If the Sharks heard this plan and saw that the best protections are going to the politicians instead of the consumers, they’d be out faster than Gen. Flynn’s new resume on LinkedIn. Sadly, nobody expects the House, Senate or President to show similar wisdom.