Zirpoli: Republicans now carry burden of health care

It was a strange sight. President Donald Trump and Republican House members were celebrating with cheers and self-congratulations after the passage of a bill that, if approved by the Senate, would remove health care insurance from millions of their constituents, and deny millions more elderly and disabled Americans from future Medicaid and Medicare assistance.

So what exactly were they celebrating?


Paul Kane, writing for The Washington Post, thinks they were not so much celebrating the passage of a poor health care bill, but a badly needed legislative victory that Trump was lacking during his first 100 days in office. According to Kane, "few lawmakers truly liked" the bill they voted for. In fact, they hoped that the Senate would soften the blow to millions of their constituents who would be negatively affected by their vote. But they needed a victory and this was the best they could do.

Peter Suderman, features editor at Reason magazine, writes in The New York Times that the answer to why Republicans would pass such a terrible health care bill "makes more sense when you realize that isn't what they were doing at all. They were passing a tax cut." Indeed, the House bill included over $800 billion in tax cuts to the top 20 percent of wealthy Americans that the Affordable Care Act used to subsidize health care for the poor.

So Trump and his friends in Congress got their "victory" and their tax cut vote. And, of course, they got their vote to repeal Obamacare (again). They also got this thing in American politics called responsibility.

For the past seven years, since the passage of The Affordable Care Act, responsibility for American health care has hung around the necks of former President Barack Obama and Democrats. That burden now belongs to President Trump and Republicans.


"This is a repeal and replace of Obamacare. Make no mistake about it," said Trump. To be sure, the American people will "make no mistake about" who is responsible for their future premiums and deductibles, what is covered and what is not in their new insurance plans, and their future access to affordable health care.

"As far as I'm concerned, your premiums are going to come down," stated Trump after the House passed their bill. Of course, since the Congressional Budget Office had not yet scored the new health care bill, no one knows what will happen to premiums. However, an earlier version of the House bill scored by the CBO found that 24 million Americans will lose their health insurance, and that many Americans, especially older Americans, would pay higher premiums.

Nothing actually changed after the House vote and will not change until if and when the Senate approves their bill. They will not, however. Instead, the Senate will develop their own bill and they have assembled 13 men to do it. Yes, I said 13 men. Make that 13 white men. Evidently, according to Senate Republicans, women have nothing to contribute to the health care debate, and this is evident by the House plan that doesn't mandate coverage for child birth or newborn care.

Regardless of what these 13 men in the Senate decide, Obamacare is dead. Republicans have so effectively disabled the Affordable Care Act over the last seven years that it now claims its own preexisting conditions of neglect and assault.

For seven years Republicans have clobbered Democrats about Obamacare, especially around elections. But now Republicans are giving away their clobbering tool. Trump has declared it dead. Goodbye, Obamacare. Hello, Trumpcare.

The clobbering tool has been passed to the Democrats and they will try to employ it during the 2018 midterm elections. Republicans may soon learn that Americans don't like it when politicians mess around with their health care, especially when they make it worse or more expensive. Republicans will now be responsible for rising insurance premiums and deductibles. They will be responsible and held accountable for everyone who loses their coverage in the future. Interestingly, according to a Kaiser Family Foundation study, the top 11 states with the largest proportion (30 to 36 percent) of people with preexisting conditions are all red states that went for Trump in the presidential election.

When these voters and others have problems with health care insurance, they may be reminded of the time when Obamacare covered 24 million more Americans, and millions more Americans, especially the elderly and disabled, received supplemental assistance from Medicaid and Medicare. Americans may remember that Obamacare protected them from discrimination due to preexisting conditions. They may also remember that under Obamacare pregnant mothers and their newborns were guaranteed coverage. They may remember that Obamacare also mandated that insurance plans cover hospitalization, blood tests, and prescription drugs—some of the services not required by the Republican plan.

With power comes responsibility, and responsibility yields many burdens.

Tom Zirpoli writes from Westminster. He is the coordinator of the human services management graduate program at McDaniel College. His column appears Wednesdays. Email him at