There's something a little weird about watching President Trump and House Republicans celebrate the vote to repeal and replace the ACA: there really is still the Senate vote to go, which isn't actually a done deal, and this bill wasn't rated by the CBO and is pretty likely a dud when it comes to lowering premiums for all but the young and healthy, and will likely result in un-insuring about 24 million folks, and raising premiums for some older and sicker people, and making it all but impossible for many people with pre-existing conditions to get insured. They can pop cheap beer and have a Rose Garden chuckle over handing a Republican president a little victory--but it's kind of grim.
Now, I don't doubt that Senate Majority Leader Mitch McConnell might just take Trump up on one of his tweets and do away with the 60 vote legislative barrier, just as he did for confirming Neil Gorsuch to the SCOTUS, and get this mangy dog of a health care bill pushed through the Senate with a bare majority. Why is it that I don't doubt that?
Because they can. Not because it's great legislation or better for their constituents. But because they probably promised X number of donors and can count on y number of voters to forget about this issue before their election comes up.
And they can also count on people not realizing that the ACA really did get more people covered, and for less money than it might have taken. I've never been certain that policy coverage in the media did the best job of explaining how the ACA worked-and plenty of the language against the ACA led me to suspect that many Republicans don't really get how insurance works, or what a pool is and how costs are distributed in a larger pool of healthier-trending people.
What will especially suck, if the current AHCA passes, is that pre-existing conditions will create a kind of second-class citizen for health purposes. Things like pregnancy, C-Section, domestic violence, rape, heavy periods, acne, could cause higher premiums or coverage denials for many people (quite a lot of them female-bodied). This doesn't sit well with me--it seems prejudicial. Things like asthma, allergies, high blood pressure, can affect certain (ethnic/racial) groups and certain regions more decidedly--which also seems prejudicial.
It bothers me that this might be viewed as a "win" for Donald Trump--can you believe he's even president, and this gets passed in the kind of Tea-party GOP House? Should Paul Ryan be smiling because he won one, and won't get a challenger to his Speakership anytime real soon--or does this vote for an unpopular change in health care law bode poorly for him come 2018?
We'll just have to see. But it sticks in my craw that so many of the "pre-existing conditions" that will drop women from coverage under the "grab'em by the pussy" POTUS' watchful eyes, stem from their victimization--DV, sexual assault, even certain reproductive health care treatment. Does he even see us as people--not the sum of our confusing lady business? Who knows--to me he is always a groper.