To the surprise of few Democrats, Cassidy has now gone on to co-sponsor with Lindsey Graham (R-SC) the Cassidy-Graham bill, which by all accounts is the harshest Republican repeal effort yet, resulting in 32 million fewer being uninsured and flagrantly failing the “Kimmel test.” Kimmel fought back, and has become a powerful advocate for patients who would be imperiled by this legislation.
But the truth is, the Republicans have never believed in the Kimmel test.
If Republicans supported the Kimmel test, House Republicans wouldn’t have voted for legislation that decimates Medicaid when 1 in 5 Americans receive their health coverage through Medicaid or CHIP. If Republicans supported the Kimmel test, they wouldn’t be considering letting CHIP expire in their latest heartlessness toward poor children. If Republicans cared about the Kimmel test, they wouldn’t be manufacturing and disseminating lies about the Obamacare markets – on which many families rely – to help render markets unstable and score a political point with the base while patients face higher premiums amid market uncertainty. And if Republicans supported the Kimmel test, they would demand a CBO score and thorough hearings to evaluate the impact of this legislation, rather than endangering millions because of a stubborn adherence to an arbitrary deadline after which they will be forced to work with Democrats when reorganizing a sixth of the American economy.
I am hardly an unbiased party in these debates. I was born with a kidney disorder that resulted in chronic kidney infections from early childhood until my late teens. In my teens, I was diagnosed with anemia severe enough to require iron infusions, though the cause was then unknown. At 22, I was hospitalized for severe hypocalcemia and other electrolyte imbalances and at 24 was formally given the diagnosis of a very rare parathyroid disorder that had already rendered me osteopeneic. At 25 (and 27), I was raped and while the physical wounds healed within a few days, I fell into a deep depression requiring extensive treatment for depression and PTSD. Soon thereafter, I was diagnosed with a rare GI disorder that accounted for my chronic symptoms, as well as a less rare autoimmune condition that accounted for my iron deficiency and B-12 anemias. I was in and out of the emergency room the last couple of years, primarily due to electrolyte imbalances. And in my current (hopefully very short-term) state of unemployment, I am for the first time reliant on Medicaid, thanks to Connecticut's Medicaid expansion through the ACA.
Suffice it to say, absent employer-provided insurance and the preservation of Obamacare and the associated Medicaid expansion, I’m screwed or dead. I never felt that more potently than as I watched President Trump's inauguration from my hospital room at New York Presbyterian Hospital at Columbia, fearful about the fate of my health care.
We have cynically – and I think rather dangerously – become accustomed to politicians lying to us. By all accounts, it’s our president’s main talent. And to be sure, politicians are no strangers to reliance on “cheap talk,” and so has been the case for decades.
But health care is different. While there is persistent health inequality, in many cases, disease does not discriminate between Democrats and Republicans, between the rich and the poor. The expansion of health coverage should not be a Democrat versus Republican issue, but rather a human issue to which we should all be committed.
Health care is also different in that it’s harder to fool patients than it is to fool voters on a number of other issues.
People can unfortunately be goaded into thinking that voter fraud is an issue about which we should be concerned, despite voter suppression being the issue with which vastly more Americans struggle. People can be manipulated into thinking that immigrants are taking their jobs more than automation and outsourcing are. But people cannot be manipulated into thinking that they can pay for both groceries and a doctor’s visit when their health coverage is taken away and they’ve got fifty dollars left in their checking account. And no politicians’ framing will erase the bankruptcy someone might face pursuing expensive cancer treatment under the Graham-Cassidy bill.
Those who care more about tax cuts for the wealthy than about a child with cancer or heart problems not hitting a lifetime limit by the age of 15 shouldn’t be in the business of drafting and voting on health care legislation. Those who embrace the new “choice” between bankruptcy and untreated illness shouldn’t be in politics, let alone have the audacity to call themselves “pro-life.” Believing in the “Kimmel test” isn’t about partisanship, it’s about demonstrating a conscience and basic human decency. It’s as simple as that.
And those up for reelection in 2018 and 2020 would do well to remember that while Americans may not properly attribute credit for some policies like the Medicaid expansion that accompanied Obamacare in many states, you can be sure that we will know it was Republicans who took their health care away.