There’s something awfully familiar and not very pleasant about the way this new GOP health care bill seems to be progressing through the House at the moment. Actually, it’s a whole bunch of things, but the latest is what clearly appears to be a negotiating tactic designed to buy off the votes of all of the upstate New York Republican members. It’s an exclusive deal being offered only to a portion of one of the 50 states, and while it may sound sweet to the voters up here (since I happen to live in the aforementioned area), this really doesn’t seem like a very good way to do business. (New York Times)

House Republican leaders, trying to lock down the votes of wavering upstate New York Republicans, inserted a last-minute special provision in their health care bill that would shift Medicaid costs from New York’s counties to its state government.

The move — one of a number of late changes designed to gain more votes — would affect New York State only. It could save county governments outside of New York City $2.3 billion a year. But it could shift costs to state taxpayers or deny New York that same total in matching federal aid if the state continues to require those counties to contribute to the cost of Medicaid. Upstate New York Republicans, backed by local government officials, pressed for the measure over the angry opposition of New York’s Democratic governor, Andrew M. Cuomo.

There was a time after the massacre of 2008 when the GOP only held three seats in New York. We slowly clawed our way back and are currently up to nine. Most of them are found in the somewhat more conservative upstate region to the north and west of the Big Apple. But while the representatives of these districts can generally be considered “more conservative,” that’s a relative term. This is still New York, so our Republicans tend to come from a background that doesn’t swing quite as far to the right as some of their southern and Midwestern colleagues. I only offer that observation as prologue for what’s to follow.

Yes, the idea of this deal being cut is driving the current governor insane, and that’s always good for some amusement on my part. But is this really any way to do business? You’ll recall that when Obamacare was first passed there was lots of this sort of deal making going on, along with all manner of backroom meetings resulting in a gigantic bill which Nancy Pelosi famously said we would need to pass before we could find out what was in it. Is any of this sounding familiar?

They’re talking about holding a vote on the AHCA as early as Thursday. I still haven’t fully digested everything that’s in there and I get paid to read about this stuff for a living. Too much of it just sounds like a trimmed down version of Obamacare and the proposed cost-saving measures strike me as rather dubious. All in all, this is beginning to look far too much like a panicky effort to just make sure that we do something while producing an end product which only differs significantly from its predecessor by not having Obama’s name on it.

Not to sound like a broken record here, but the one thing that virtually every Republican on the Hill agreed on was that Obamacare was bad. And one of the chief reasons that it was bad was that it wrapped up too many things into one overly complicated package. If the GOP was going to be true to its word, wouldn’t it have been better to simply repeal the entire Obamacare structure and then tackle the admittedly serious issues surrounding healthcare in America one piece at a time? You could introduce cross state competition to keep premiums down. Money could be allocated in the form of either tax credits or direct payments to reduce premium costs for the poorest citizens. And if we really wanted to be ambitious we could tackle the question of why healthcare (not health insurance) costs so much in the first place.

Each of those agenda items could be handled and debated in a separate package where everyone could have their say and vote on them. What we’re doing now just sounds suspiciously like a rebranded version of what the Democrats did eight years ago. I really don’t think any of us signed on for that.