Saunders: Health care bill’s key to cutting costs just a gimmick

The version passed by House Republicans on Thursday is different. Under the new version, states will be able to apply for waivers from the Obamacare pre-existing conditions mandates. To qualify, states would have to set up pools for high-risk individuals.

There’s one problem with this so-called remedy. It’s a gimmick that throws the hot potato where few hands are eager to claim it. How many governors want to incur the wrath of their voters by announcing that they want to get rid of a benefit that Kimmel and Trump himself in 2016 framed as American as apple pie?

Asked how many states were likely to apply for pre-existing conditions waivers, House Majority Whip Kevin McCarthy answered, “It could be a lot. It could be none.” White House Deputy Press Secretary Sarah Sanders referred a reporter to the Department of Health and Human Services, which would not respond on the record. Be it noted, governors and state lawmakers are not clamoring for the opportunity to do what House Republicans would not do themselves.

Forget governors. “There isn’t a single insurance executive I know of who wants to get rid of pre-x,” said health-care policy guru Robert Laszewski, using the lingo.

So why did House Republicans go after a reform that even insurance executives don’t want?

Promises they can’t keep

A large chunk of the premium increases that hit the market with Obamacare are due to pre-existing conditions. In 2014, the Affordable Care Act caused individual premiums to increase 40 percent, said Laszewski, with about 30 percent due to pre-existing conditions.

Since then, premium increases have been in the double digits because Obamacare policies are so unappealing that healthy people aren’t buying, while sick people are clinging to their plans. In the industry, this is known as a death spiral. And it is the reason why insurers are running headlong from the individual market.

As Trump said of Obamacare during a Rose Garden celebration of the House passing the bill: “It’s dead. It’s essentially dead. If we don’t pay lots of ransom money over to the insurance companies, it would die immediately.”

Still, Trump seems poised to make the same mistake President Obama made before him — making huge promises on which he should have known his plan would not deliver. Obama promised, “No matter what you’ve heard, if you like your doctor or health care plan, you can keep it.” Trump says: “Yes, premiums will be coming down. Yes, deductibles will be coming down. But very importantly, it’s a great plan.”

But if the key to cutting costs is a stunt — asking state politicians to do to their neighbors what D.C. Republicans will not do from afar — better not to hold your breath.