Opinions

Young backs health care bill that harms Alaska more than any other state

Rep. Don Young voted for a one-size-fits-all health care bill last week that would harm Alaska more than any other state.

The bill contains much smaller tax credits than the Affordable Care Act, known as Obamacare, and makes no geographic allowance for high-cost states like Alaska.

The increase in Alaska would be $12,599 for average out-of-pocket health care costs in the individual health care market, an analyst at the Center on Budget and Policy Priorities said.

"Alaska policymakers would likely see waiving protections for people with pre-existing conditions as their only option to stabilize Alaska's market, even though it would put coverage even further out of reach for Alaskans who have the most serious health needs, who could face premium surcharges of tens of thousands of dollars," wrote senior fellow Aviva Aron-Dine of the research institute.

But don't worry, says the Congressman for All Alaska: The version of the bill approved by the House will not become law, and he has been assured that the problems will be corrected.

In the words of President Trump, "Nobody knew that health care could be so complicated."

[How Don Young went from no to yes on the House health care bill]

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Last week Young, 83, who has already said he is running for re-election in 2018, declared that "inaction's not an option" and he voted for the bill, which passed 217-213, with two votes to spare.

But back on March 24, Young said inaction was the best option because the bill would have harmed Alaska. He said he would have voted against it had the measure not been placed on hold.

Young declared a "victory for Alaska and a victory for me" after the House did not put the measure to a vote in March.

Young stopped just short of declaring another victory last week, though he contradicted most of what he said in March and the major problems with the bill remain.

In March, the bill was headed for defeat, because of opposition from the Freedom Caucus, when Young revealed his opposition.

"When I first saw this so-called — I don't want to call it Trumpcare — to be passed and repeal Obamacare, I said we're not repealing Obamacare. The premiums will be just as high, which are killing my Alaska workers," Young said March 24 in a video released by his office, answering questions from one of his staff members.

"We have a lot of Medicaid people in fact damaged through this legislation and those that have signed up for the exchanges, they would be of course in limbo. And I told them, let's fix this up, especially for an area like Alaska, this large isolated and costs are the highest in the nation. They were writing a bill, very frankly, one size fits all," he said.

He said the way to serve Alaskans would be to spend the next three and a half years writing a good bill, working in a bipartisan fashion. It was a sensible position to take.

He criticized Republicans for not consulting people in the medical field and said House Speaker Paul Ryan "wasn't able to deliver what I think was necessary for the state of Alaska, the size of Alaska, the high cost of Alaska."

"Much as I hate Obamacare, I will not support legislation that doesn't improve for the constituents which I serve. That's my main goal to do so," Young said.

"I'm a so-called 'loose cannon,' " Young told reporters in March.

But last week the cannon went off  in the opposite direction. No longer was he demanding a bipartisan bill, a three-year review, consultation with experts or an examination of how it would impact Alaska.

"This bill we passed today will not become law. It'll be changed as time goes by. But unless we move it, or move a vehicle, nothing's going to happen, and that's not good," Young said in an interview after the vote.

"I got a commitment from the speaker to take care of the disproportionate cost — we and Illinois are really hurt the worst, but we think we can take care of that," Young said.

Nothing I have seen says that Illinois is second to Alaska. Rural states where costs are highest would be among the hardest hit across the country.

In Anchorage, a 40-year-old earning $50,000 who now pays $5,100 for insurance would pay $9,780 under the House plan. A 60-year-old in Anchorage earning $50,000 who now pays $5,100 for Obamacare insurance would pay $32,470 under the House plan, according to the Kaiser Family Foundation.

A 60-year-old earning $40,000 who pays $3,530 under Obamacare would pay $32,470 under the House health care plan. For a person in that situation, the Obamacare tax credit is $23,620, compared to $4,000 under the House plan, the Kaiser Family Foundation predicts.

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These enormous changes would increase instability and make it more likely that to preserve some insurance, state leaders under the House plan would be tempted to lessen the requirements for essential coverage and limit pre-existing condition coverage, which would make insurance less effective and less expensive.

In some ways, the situation seems similar to how congressional Republicans behaved during the Obama administration while repeatedly voting to repeal the law without preparing a substitute.

They didn't bother with difficult details, spending more time on catchy titles, such as the Restoring Americans' Healthcare Freedom Reconciliation Act.

Young told the Chugiak-Eagle River Chamber of Commerce last month that it was always an "easy vote" with President Obama in the White House, knowing the bills would never pass.

"We were unprepared. I don't deny that," Young said, adding that the "work had not been done" to draft a good bill.

In that appearance, Young said he was deeply disturbed by the GOP plan to charge older people up to five times as much as younger people. Obamacare limits the difference to three times the cost for younger people. But the factor of five remains in the bill Young supported.

Before taking final action and celebrating at the White House with Trump, House Republicans did not bother to hold hearings, listen to opponents or ask experts about weaknesses in their plan.

They couldn't even wait a few days to receive updated figures from the Congressional Budget Office on how many millions of people would lose health insurance.

The earlier version would have reduced Medicaid spending by more than $800 billion over a decade and caused 24 million people to lose health care coverage, according to the CBO estimate.

I would have some confidence in Young's ideas about how to create a better health care bill if the problems had been addressed before he voted for it. That would have been a real victory.

Now the bill is in the Senate, where Republican leader Mitch McConnell has excluded Sen. Lisa Murkowski from the group of 13 men drafting a Senate alternative.

Columnist Dermot Cole can be reached at dermot@alaskadispatch.com. 

The views expressed here are the writer's and are not necessarily endorsed by Alaska Dispatch News, which welcomes a broad range of viewpoints. To submit a piece for consideration, email commentary@alaskadispatch.com. Send submissions shorter than 200 words to letters@alaskadispatch.com or click here to submit via any web browser.

Dermot Cole

Former ADN columnist Dermot Cole is a longtime reporter, editor and author.

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