GOP leaders question why a new healthcare act should protect vulnerable people

At one point during this week’s marathon 27-hour House Energy and Commerce Committee debate over the GOP healthcare bill, a Democratic congressman asked a Republican colleague which Obamacare mandates he took issue with. The Democrat, Rep. Mike Doyle from Pennsylvania, said he didn’t think it could possibly be assurances of coverage for pre-existing conditions, caps on benefits, or coverage for children up to age 26 — all policies that are generally very popular with Americans.

“What about men having to purchase prenatal care?” Republican Rep. John Shimkus answered. Doyle, apparently taken aback, was left sputtering for several seconds as murmurs rippled through the chamber.

Shimkus’s comment appeared to display ignorance of how insurance coverage works — individual insurance plans are not offered à la carte — and also appeared to reaffirm statements made by other GOP lawmakers, who say that a major problem with Obamacare is the fact that it forces young people to buy and pay a certain amount for insurance so that older, sicker people, who still pay more, don’t have to pay quite as much more.

“The fatal conceit of Obamacare is that we’re just going to make everybody buy our health insurance at the federal-government level,” Speaker of the House Paul Ryan said in a press conference Thursday. “Young and healthy people are going to go into the market and pay for the older, sicker people. So the young, healthy person is going to be made to buy healthcare, and they’re going to pay for the person, you know, who gets breast cancer in her 40s or who gets heart disease in his 50s.”

Currently insurance companies are allowed to charge older or sick people only up to three times as much as young or healthy people. Under Ryan’s proposal, insurance companies would be able to charge older people as much as five times more than the young, which the politically powerful American Association of Retired Persons has called an “age tax.”

Ryan’s comments followed those of House Oversight Committee Chairman Jason Chaffetz, who suggested on Tuesday that disadvantaged people would be able to pay for health care if they didn’t buy iPhones.

“Americans have choices, and they’ve got to make a choice,” Chaffetz said. “So rather than getting that new iPhone that they just love and want to go spend hundreds of dollars on, maybe they should invest in their own healthcare.”

Chaffetz later walked back his comments in response to intense criticism.

And Rep. Roger Marshall, a member of the GOP Doctors Caucus, said in remarks made earlier this month and published last week that poor people shouldn’t be a consideration in the GOP plan because they don’t want coverage enough.

“Just like Jesus said, ‘The poor will always be with us,’” Marshall, an obstetrician from Kansas, said in an interview with Stat News. “There is a group of people that just don’t want health care and aren’t going to take care of themselves…. The Medicaid population, which is [on] a free credit card, as a group, do probably the least preventive medicine and taking care of themselves and eating healthy and exercising. And I’m not judging, I’m just saying socially that’s where they are.”