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The political effect of Thursday’s U.S. House vote on health policy – Trumpcare, as we hear – may be enormous, even in Idaho.

Both Idaho representatives, Raul Labrador and Mike Simpson, voted in favor of the Republican bill.

Writing about the raw ammunition this gives Democrats, the liberal site Daily Kos cobbled a quick generic attack ad: “Rep. X voted for tax cuts for millionaires and billionaires while gutting health care for everyone else. Twenty-four million people thrown off Medicaid. Protections for people with pre-existing conditions destroyed. A bill so bad, Republicans wouldn’t even let Americans see it before they voted.”

Actually, the 24 million refers to to the total number who would lose insurance, Medicaid or otherwise, based on earlier versions of the legislation. (Disclosure: I may be one of the 24 or so million.) But that number may rise when the Congressional Budget Office and other organizations have time to carefully review the bill. Not in a very long time has a chamber of Congress voted for such a large bill without any solid research on what its cost or effects will be, and even without any hearings. It was jammed together in rapid-fire closed-door meetings, and even most House members were left in the dark on specifics.

The followup to 20 million people losing health insurance as a result of this legislation, recent academic studies estimated, is that somewhere between 24,000 and 44,000 Americans would die annually as a result. (A side rhetorical question: When Al-Qaeda attacked us in 2001 and killed more than 3,000 Americans, we accurately labeled them terrorists; if members of Congress vote to pass a bill they have been told will cost more than 20,000 Americans their lives, every year, what should we call them? We may get that debate in the months ahead.) It also may weaken health insurance provided by employers, so if you’re insured through your job, don’t think you have no skin in this.

The effect in Idaho would be large. The new bill may destroy many state health insurance exchanges, which more than 100,000 Idahoans rely on for health care. As a starter.

True, the bill as written is unlikely to get far in the Senate. But House members, even if they were acting with that in mind, voted on the bill as written. It’s on their records, and they’re stuck with it.

But surely that doesn’t have anything to do with Idaho? Idaho is, as they say, ruby red. Labrador and Simpson win in landslides every other years. Does it matter what they do?

Don’t be so certain: People could be hurt, frightened, or both, by what may come next. Politics evolves, even in Idaho. The Senate will not act on it swiftly. (Actual hearings are likely there.) The legislation, at least some of the Senate options, will likely not wear well as people figure out their increased risk.

Don’t be surprised if the unruly town hall Labrador held a couple of weeks ago becomes a portent of larger things to come.

Now, a followup note on last week’s column about Raul Labrador’s political future.

It included a passing reference to Senator Jim Risch, who is up for election in 2020, for what would be a third term. Owing maybe in part to considerations of age, there’s been some chatter (including in Republican circles) that Risch may not run again.

That drew a quick phone call from Risch personally. He was unequivocal: Any such contention was wrong; he and his backers already are at work raising money and organizing (even this early in the cycle); he plans and expects to be on the ballot seeking another term.

I heard nothing evasive or cautionary; he made his intentions as clear as he could short of a formal campaign announcement (which would not come until much further along in the cycle).

Noted. Another factor for Labrador to consider, presumably, in evaluating his future.

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Idaho Idaho column Stapilus