By contrast, the entire population of Great Britain is less than 65 million people. And again, unlike Obamacare, it's an entitlement program that requires no payments or financial commitments from its recipients. Even though it can often be very hard to find good and reliable care on Medicaid alone, it's clearly very popular considering this Medicaid expansion hasn't had any trouble finding more than 35 million new takers in under 10 years.
These massive numbers should make it clear why Medicaid is the key stumbling block in the Obamacare replacement or reform effort. It's not just because rolling back Medicaid would be responsible for the bulk of people losing coverage, it's because even a bare-bones entitlement like Medicaid is so hard to take away once the public gets it.
Now that the GOP senators know where this problem is coming from, it's time for them to throw in the towel for now on Medicaid, leave it for later, and get back to fixing the actual private insurance market.
That means getting back to so many of the insurance market reforms Republicans have said they've supported for years like allowing companies to sell insurance over state lines, allowing all kinds of bare-boned "major medical" plans to be sold everywhere, and expanding tax-free health spending accounts. These are the kinds of reforms that will truly bend the cost curve in health coverage and stop the insanity of using so many subsidies and regulations to help big insurance companies inflate prices.
The Medicaid expansion was not something President Obama or the Democrats talked a lot about when they were trying to sell Obamacare to the public in 2009 and 2010. Most of what we heard was about helping working people afford private coverage and, "if you like your plan, you can keep your plan."
This almost doubling of the number of people getting onto Medicaid was basically never discussed or publicly debated. Now, the Republicans are finding that rolling back this Medicaid expansion won't be possible under the same fog. It's obvious now that they shouldn't even try.
Conservatives and fiscal hawks know the Medicaid issue is not something that should be put aside for too long. That near-75 million Americans on the plan are a major cost balloon that could burst very soon. But after what's happened this week, they must also now know that it's a problem that cannot be politically addressed concurrently with private health insurance. Doing something about cutting back the Medicaid rolls and all the spending that comes with it, can wait at least until the Republicans can put together a reasonable alternative beyond White House Counselor Kellyanne Conway's advice that Medicaid recipients get a job. That will skew all the savings the CBO is projecting for the GOP bill right now, but saving money isn't the issue that's holding up the votes, it's these Medicaid orphans that are too hot to handle.
Delaying the votes on this GOP bill by a week, or even a month won't be enough to get the magic number of Republicans to vote for and pass the measure. The reason is Medicaid. So with time running out, it's time for McConnell to make like a surgeon and cut out the Medicaid part of this bill and focus on private coverage reforms only. That will perform the medical miracle of making things not only politically easier for the GOP, but actually achieving something that will do some good for the rest of the country too.
Commentary by Jake Novak, CNBC.com senior columnist. Follow him on Twitter @jakejakeny.
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