McCain points way to better process

“It is time to move on,” said Senate Majority Leader Mitch McConnell.

So it is. With a one-vote margin provided by Sen. John McCain, an institutional warrior girding for his own battle against brain cancer, the Senate voted down the Republicans’ latest, and perhaps last, attempt to destroy the Affordable Care Act.

That the “skinny repeal” bill made it to the Senate floor early Friday morning, and came within a single vote of passage, is testament to the reckless cynicism that has defined this perverse quest to relieve tens of millions of Americans of their health insurance.

The bill would have eliminated the individual mandate to buy health insurance and suspended, for eight years, enforcement of the employer mandate requiring companies with 50 or more workers to provide employees with coverage. The effect on insurance markets would have been devastating. The proposal also would have eliminated funds for prevention and public health and made it easier for states to avoid federal requirements on insurance benefits. It took an obligatory swipe at Planned Parenthood, restricting Medicaid beneficiaries from being reimbursed for Planned Parenthood services for a year.

It was hard to find anyone who would defend this bill on the merits; Sen. Lindsey Graham called it “terrible policy” before voting for it. He and 48 other Republicans were simply willing to roll the dice in the hope something less awful emerged in conference negotiations with the House.

What McConnell and House Speaker Paul Ryan must “move on” from is a reflexive habit of misleading Americans about the complex realities and difficult trade-offs inherent in health care policy.

When they are ready to make an honest start, Republicans will find there are feasible ideas for solving the real problems with Obamacare. To start, Congress should permanently authorize the cost-sharing payments to insurers meant to keep deductibles low for needy families.

It should find alternatives for people living in “bare counties” where all insurers have left the marketplace. And it should shore up the health care marketplaces by either strengthening the individual mandate that penalizes the uninsured or through another mechanism, such as automatic enrollment.

If nothing else, maybe this sorry episode has taught Congress how not to enact legislation. Neither the House, which passed its own ramshackle repeal bill in May, nor the Senate held a single public hearing on replacing the Affordable Care Act. Experts, patient advocacy groups and professional organizations, who were virtually unanimous in their opposition, were blithely ignored. The goal clearly was not to fix problems with the American health care system or improve its outcomes, but to solve a political problem stemming from seven years of falsehoods about the law.

In a statement after the vote, McCain emphasized legitimate outcomes depend on a legitimate process. “We must now return to the correct way of legislating,” he said.

It’s a prescription Congress should heed.

— Bloomberg View