Okay, Rob Portman, Time to Get Off the Fence

senate-health-care-bill-aca-repeal-replaceThe latest version of the Senate version of the GOP health care bill has been unveiled. Sen. Rob Portman remains a key swing vote; he also continues to hedge his bets:

“I opposed the last draft of the Senate health proposal because I had concerns about the measure’s Medicaid policies, especially those that impact drug treatment for those suffering from addiction,” he said in the statement. “I’ve also consistently said that the Affordable Care Act isn’t working for many Ohio families and small businesses whose premiums and deductibles have skyrocketed, and choices have disappeared as health insurance plans have left Ohio.”

In this post, some key points of the latest proposal are reviewed.

$45 Billion Isn’t Enough…

One of the key differences in the latest version of the GOP bill is that the fund for opioid addiction care has been increased from $2 billion to $45 billion. This change is a direct appeal to Rob Portman, who asked for this amount in earlier negotiations.

However, experts have found that this fund is insufficient, particularly when coupled with the Medicaid cuts that remain in the bill. The problem is that this money would treat only opiod addiction and potentially leave resultant and associated health issues unaddressed. As Dr. Corey Waller, from American Society of Addiction Medicine, notes, “You can’t treat any medical condition in isolation. It just seems illogical at every level.”

Hopefully Rob Portman will not take this bait: he’s spoken out forcefully, and in a bipartisan way, on the opioid issue, and has said he wants to help and protect these Ohioans. This concession from GOP leadership is not enough.

Some taxes on the wealthy are retained but…

In a move that seems like another concession to moderates, or at least some attempt to fight back against the charges of the reverse-Robin Hood philosophy of the GOP healthcare plan, some of the ACA taxes on the wealthy are retained. But, as Paul Krugman explains in the New York Times, this is “largely a scam” because of a new provision for health savings accounts. Only people who can afford to save money–which excludes many million Americans who live paycheck to paycheck–can really make use of these savings accounts. Once again, they benefit primarily the affluent becoming, essentially, a tax shelter, which functions as another type of tax cut.

Also, even though these taxes are retained, they are NOT put towards healthcare for the poor, sick, old, children, or any other vulnerable population by supporting Medicaid: all of the drastic Medicaid cuts, and the negative consequences that come with them, remain.

Pre-exisiting conditions!!

The worst part of this new bill is the Cruz amendment, the brainchild of least popular Senator, Ted Cruz. This ill-conceived amendment would allow insurance companies to offer cheaper plans that are not compliant with ACA Essential Health Benefit (EHB) guidelines. The EHB guidelines ensure that all insurance plans include coverage for a set of key elements, including things like pregnancy, mental health care, prescription drugs.

By exempting insurers from these guidelines for some of the plans they offer in a given market, we will return to the bad old days when people paid for plans only to find out later, when they really needed them, that they did not include coverage for the services they suddenly were relying on.

But more importantly, it will also make premiums skyrocket for people with pre-existing conditions. Think about it: people who are sick will be the ones to have to buy the one policy in their market that includes Essential Health Benefits. The healthy will overwhelmingly choose the cheaper, skimpier plans. That will create a pool of sick people in plans that have more benefits. Without the offset of healthy people in this pool too, premium prices will increase. A lot. Even an insurance advocacy group thinks this is a bad idea!


Republicans don’t have anything good to say about the ACA, but in reality, it was starting to stabilize before Republican sabotage. Republican leadership needs to stop using bipartisan as a dirty word and start working with Democrats to fix the existing law. Moderates like Rob Portman should be leading the way in this effort.

It is admirable that Portman will not commit to this plan without a CBO score and thorough reading of the bill, but hopefully he also will not fall for a $45 billion bribe that doesn’t mitigate the worst effects of this health care plan.

How to get in touch with Rob Portman

In Person

Sen. Portman has an office in Toledo, and every Tuesday at noon, constituents visit his staffers there. This is a good way to convey your opinions about these important healthcare topics.


Email Rob Portman here.

Schedule a meeting with Rob Portman here

Call or mail

Washington, D.C. Office

448 Russell Senate Office Building
Washington, DC 20510
Phone: 202-224-3353

Toledo Office

420 Madison Avenue
Room 1210
Toledo, OH 43604
Phone: 419-259-3895

Toll Free

Toll-Free: 1-800-205-6446 (OHIO)