Dr David Cutler: Won't Be Easy for Senate Republicans to Create a Healthcare Bill

Senate Republicans are faced with a tall task to create a healthcare bill that repeals the Affordable Care Act because they've made conflicting promises. According to David. M. Cutler, PhD, of Harvard University, Senate Republicans have set themselves up for a situation where they can't meet all of their promises.

Transcript

I think there are a couple of paths. One path is that the Senate may not pass anything, and this is probably my best guess because the Republicans have really made 2 conflicting promises. So the first promise they made was to the right wing of the Republican Party, where they said, “We will repeal the Affordable Care Act and along with doing that, we will get rid of the taxes on high-income people that were used to pay for medical care. So we’re going to repeal it and we’re going to cut the taxes to cut the money.” And then for middle-income Americans, they said, “Don’t worry, you’re going to get more care, better care, cheaper care.” But you’ve taken away the money, so more care, better care, cheaper care means you’re going to put in more money, but they’ve taken away a bunch of the money.

So they have now made completely conflicting promises: on the one hand you won’t have to pay in, on the other hand, you’re going to get better. There is no way to reconcile those without some magic happening somewhere. And so what you’re seeing is they’re trying to go around and figure, “Well, you know let’s cut Medicaid, but oh let’s do that in a way that doesn’t have people become uninsured; let’s cut the subsidies, but oh we can’t do that without people deciding not to take it up."

So I don’t think they can meet those promises—they can’t, as a matter of arithmetic, meet those promises. And so what they do then is really up in the air. Do they say, “You know what, we’re going to go to the right wing and say this is what you’ve wanted, screw middle America, we’re going to do what you want.” In which case, they’ll pass something with 20% support. Or are they going to say, “You know what, we couldn’t do this, so therefore we’re just not going to do anything.”

I’m not a great prognosticator, but I don’t think it’s going to be easy for them to come up with something.