Hardly any Republican in the Senate has had the courage, other than Rand Paul of Kentucky, to stand up to the insurance companies and explain how Obamacare and any bill that preserves the subsidies is a permanent bailout for health insurance giants despite very strong profits for the major players in that industry since Obamacare became law. And again, these Republicans on the sidelines or supporting the subsidies, are supposedly from the party that stands for the free market and less government.
Another profile in cowardice.
On the other hand, the alternative health coverage plans that leave the subsidies in place and call for reversing the even more costly and immoral massive expansion of Medicaid run afoul of so-called "moderate Republicans." They're mostly from states that have embraced the increased federal funding Obamacare at least temporarily offered them to cover those added Medicaid recipients. And Democrats and the news media have also effectively used scare tactics to make a case that reforming or simply returning Medicaid to its pre-2010 parameters will cause chaos and death.
Precious few of them have bothered to question where the federal government is going to get the money to continue paying for all those new Medicaid recipients as their numbers continue to swell. More than 74 million Americans are on Medicaid now compared to 49 million just seven years ago. And even fewer of them have pointed out that massively expanding the number of people on Medicaid has crowded out the truly poor recipients who have a hard enough time finding doctors and other health care providers to treat them. A good case can be made that the Medicaid expansion that senators like Susan Collins, Ron Johnson, and Shelly Moore Capito are so unwilling to vote to undo isn't compassionate at all. But no one in elected office seems to be making that case right now.
More profiles in cowardice.
So where does that leave us? The term of the moment is "skinny bill." That's the measure that will leave the subsidies and the Medicaid expansion in place and just eliminate Obamacare's individual mandate penalty, the employer mandate penalty, and the medical device tax. NBC News reports that's where the Senate leadership has moved the goal posts to now. That makes the most sense politically, and even I have argued that at least stripping out Medicaid changes from an initial reform bill makes sense from a strategic point of view. The problem is, there's no solid evidence that even that "skinny bill" could pass right now.
In his impassioned speech on the Senate floor just after the vote Tuesday, Senator John McCain said he can't vote for any replacement bill as it stands now anyway. And this from a man showing the only courage of any kind in the Senate by shaking off his grave cancer diagnosis to return to Washington Tuesday.
We can't forget that the American people really don't care about political strategy, they want the health coverage price explosion fixed. Tuesday, the Senate just barely voted to even consider any plans to give the people what they want. That's not only a profile in cowardice, it's occupational indecency. And it's a terrible omen not only for the chances of meaningful health coverage reform, it's a bad sign that the legislative branch is capable of handling much of anything at all.
Commentary by Jake Novak, CNBC.com senior columnist. Follow him on Twitter @jakejakeny.
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