Cutting to the chase

D.C. Republicans are pushing back on the idea that the Senate's now-delayed bill to reform health care — the so-called "Better Care Reconciliation Act" — is imposing "cuts" on Medicaid.

The White House says that Republicans are being victimized by a broken budgeting system that unfairly casts their fiscal restraint as callous cutting.

“Generally speaking, we spend more every single year on Medicaid,” Mick Mulvaney, the White House budget director, said in an interview this month. “We are not gutting or filleting or kicking people off those programs. We are trying to slow the rate of growth of government.”

Give Republicans the benefit of the doubt for a moment. Accept that Mulvaney and Congressional Republicans aren't the devils in suits that they're caricatured as in left-of-center discussions. Look at it from the standpoint of genuine concern about the growth of government spending, particularly over what seems to be the explosive growth of federal health-care spending.

Okay. Now take a fresh look at the Congressional Budget Office's conclusion that the Senate's bill would force 22 million people to relinquish their health insurance by 2026.

Does the nobility of Republicans' cost-cutting motives change the CBO's findings?

Of course not.

Mulvaney and Congressional Republicans can claim they're not kicking people off vital federal programs, but if they fail to fund the programs to the extent necessary, kicking people off vital federal programs is precisely what Mulvaney and company will have done.

Now, are health-care costs spiraling out of control? That's the impression I have. So I'm more than sympathetic to the urge to do something to get those costs under control.

But Congressional Republicans and the administration seem to be trying to take the easy way out by simply saying, "No more than X dollars will be spent — how X is divided is up to somebody else".

That's not good enough. If the movers of this misbegotten legislation (from both houses) genuinely want to keep ordinary people from feeling pain, they will have to do real work to understand why costs are spiraling out of control, and take on those root causes.

Anything short of that major effort will put the lie to the claim that those elected officials aren't "gutting or fllleting or kicking people off those programs".

Republicans, the ball's in your court. Tackle the hard problems underlying our health-care cost crisis. Show the rest of us you're not silent-movie villains foreclosing on widows and orphans — because that's the image you're cultivating with your slapdash legislative efforts so far.