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Black Betrays Constituents, Profession with Health Care Vote

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Leonard Assante

Writer's block hits virtually everyone who puts finger to keyboard at some point. This usually happens when the writer can't think of anything to write about. But mine is different. I have too much to write about. Let me explain. This paper only gives me so many column inches and this week they are supposed to be devoted to the health care bill Congressman Diane Black voted for a few weeks ago. The deeper I dug into the bill, its implications and the motivations for its passage, the more hurtful and downright mean-spirited I find this legislation to be. There is simply so much wrong with it, I didn't know where to begin. In summary, I think it is a betrayal of Diane Black's constituents, her former profession, and the many that could die if it became law.

Betray is a harsh word, but I think it fits. Here's why. First, according to a recent Quinnipiac University national poll, only 21 percent of Americans approve of the bill.

Next, it is likely millions of people will lose insurance under the plan Black voted for. An earlier version of the bill was estimated to cost up to 24 million people their insurance, while the new bill has yet to be scored by the non-partisan Congressional Budget Office. That score is expected this week, and that figure is not likely to change much. According to a recent study in the journal Health Affairs, the current ACA law has dramatically improved numerous measures of health outcomes, most particularly in states which allowed Medicaid expansion. (Our GOP legislature has refused to allow such expansion in Tennessee.) It is simple; people with insurance are healthier and less likely to die. Congress should want that.

Next, Diane Black often points to her former career as a nurse, showing that she is sympathetic to the needs of patients and well-aware of the "failures" of the ACA. Interestingly the American Nurses Association strongly opposes the repeal of the ACA and the replacement bill supported by Diane Black. To quote their letter to Congress: "In its current form, the bill changes Medicaid to a per capita cap funding model, eliminates the Prevention and Public Health Fund, restricts millions of women from access to critical health services, and repeals income based subsidies that millions of people rely on. These changes in no way will improve care for the American people." Congressman Black usually fails to mention that the ACA "failures" she refers to are often due to the lack of Medicaid expansion in republican-controlled states. The increase in enrollees and federal funding such expansion would provide would help the marketplace.

And what about our children? Diane Black offers us strong "pro-life" rhetoric, but her enthusiasm seems to wane after life exists the womb. According to an article in The Atlantic, children "constitute the single largest eligibility group in the Medicaid program and would be affected by changes to its funding structure the most. And the AHCA certainly aims to change that funding structure: Its rollback of the Obamacare Medicaid expansion and its changes to Medicaid financing would slash the program even below pre-Obamacare levels, to the tune of a cumulative $880 billion reduction between 2017 and 2026." That does not sound pro-life to me. Older Americans are similarly hurt by the bill, as they will be paying much more for insurance in many cases.

Finally, one of the most hideous aspects of this bill is the "high risk pool" feature. This is the part that allows people like Diane Black to claim the bill protects people with pre-existing conditions, but in reality gives states plenty of leeway to ask for "waivers" and very little money to support the pools. According to the Kaiser Family Foundation, pre-ACA high risks pools operated by many states had rates 50%-100% higher than the average market.

This bill has the potential to throw millions of people off health insurance, offers tax breaks to big companies and the rich financed by cutting Medicaid, gives those with pre-existing conditions a possible death sentence depending on what state they live in, and is opposed by every single health profession association I could find. It was hastily written, not scored by the Congressional Budget Office, and has a dismal 21% approval rating. It was created not to solve problems or fix the imperfect Affordable Care Act, but rather to score political points. If it somehow becomes law, and even one American dies from its consequences, then all those that voted for it, especially those who were nurses, will deserve getting booted from office.

Leonard Assante is the Democratic Executive Committeeman for the 18th Senate District and a resident of Gallatin.

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