If you want to gain an understanding of why it's so difficult for many people to trust Republicans on healthcare, look no further than the cynical decision of Rep. Fred Upton, R-Mich., to abandon his long-standing support for repealing Obamacare.
For years, when nothing Upton proposed had any chance of becoming law, he helped lead the campaign to fully repeal Obamacare as chairman of the House Energy and Commerce Committee. In fact, even as I write, his website reads, "I support full repeal and replacement of the Affordable Care Act (Obamacare)."
But now that a Republican is in the White House instead of President Obama, and that what he votes on actually does have a chance of becoming law, he has decided that he cannot support even partial repeal of Obamacare. As my colleague Kimberly Leonard reports, Upton told a local Michigan radio station, "I've supported the practice of not allowing pre-existing illnesses to be discriminated against from the very get-go. This amendment torpedos that and I told leadership I cannot support this bill with this latest provision in it."
To be clear, the latest proposed amendment to the legislation would still require insurers to cover those with pre-existing conditions, but allows states to opt out of the requirements that all insurance policies cover certain categories of benefits and the mandate that says insurers cannot charge more based on health status. (Critics say that's effectively the same, but that particular debate is not the focus of this post.) What is undeniable is that Upton not only called for full repeal of Obamacare with the passive knowledge that these regulations were a core part of the law, but his committee put out a report that specifically attacked these regulations for driving up premiums.
In May 2013, months before the implementation of Obamacare, Upton released a statement titled, "Upton Supports Full Repeal of Obamacare as Rate Hikes Loom." The purpose of the statement was to highlight a new report issued by his committee outlining why premiums were expected to skyrocket once Obamacare became law.
The report, which has Upton's name emblazoned at the top of it, reads: "As the documents provided by the insurers indicate, the primary reason costs will increase is that the PPACA [i.e. Obamacare] requires insurers to provide increased services and benefits while, at the same time, it limits their ability to charge consumers based on age or health status. The minimum coverage requirements will increase premiums for those who had previously purchased less robust coverage, while 'the infusion of less healthy individuals into the risk pool' will compound premium increases."
The two provisions being referenced here (known in the policy world as "essential health benefits" and "community rating") are precisely the same two provisions that House conservatives have been fighting to be made optional to states. So in other words, Upton is opposing the bill on grounds that it allows states the option of waiving two regulations that Upton previously wanted to repeal entirely for the whole country because he thought they drove up premiums.
It's hard to escape the conclusion that Upton cynically played conservatives and that he was never serious about wanting to repeal the law in the first place. Because, after all, how serious could he have been about fully repealing Obamacare if giving states the option of partially repealing it is now too much for him?