The newest hurdle for the American Health Care Act, which has yet to win over doctors, nurses, hospitals, health insurers, older people, Democrats and some Republican senators, is something called the "Jimmy Kimmel test." The bill fails that, too.
The shorthand arises from comedian Jimmy Kimmel's tearful monologue earlier this month about his newborn son's heart defect. Kimmel told his story and ended with a plea to Washington to ensure that people with pre-existing health problems be able to afford insurance.
Obamacare passes the test, because it requires insurers to accept all customers and not charge sick people more. The AHCA does not, because it would let states allow insurers to charge sky-high premiums to people who are already ill.
The bill, which passed the House just days after Kimmel's monologue, may yet get revised in the Senate. In the meantime, defenders of the AHCA are trying to have it both ways -- arguing against the very idea of the test while at the same time claiming their bill passes it.
At a health-care forum last week, for example, White House budget director Mick Mulvaney agreed that America should provide a safety net for those with natural conditions, "so that if you get cancer you don't end up broke." Then he added: "That doesn't mean we should take care of the person who sits at home, eats poorly and gets diabetes. Is that the same thing as Jimmy Kimmel's kid? I don't think that it is."
It's not a new argument, nor is Mulvaney the first to raise it. But it is not very persuasive. For one thing, it disregards the concept of insurance -- which holds that the healthy share in the cost of care for the sick in return for the security of knowing they'll be covered, too, when the time comes.
More important, the argument creates an artificial distinction between people who need medical care through no fault of their own and those who are somehow responsible for their condition. Yes, there are cases that can be considered acts of nature, such as a heart defect at birth. But most illnesses -- including diabetes, heart disease, and even lung cancer -- arise from the interaction between genetics and behavior.
Mulvaney and other defenders of the AHCA seem not to have worked through the implications of their argument. If they did, they might have inserted language into the bill to distinguish the undeserving sick from the deserving. Such a provision would be impossible to write, of course -- and difficult to enforce, not to mention cruel -- so the AHCA simply puts health insurance out of reach for all sick people if they let their coverage lapse for two months.
It may well be that Republicans decide their bill needn't pass the Jimmy Kimmel test -- maybe they think it's too expensive, or have other priorities. If that's the case, then they should say so. Otherwise, their arguments fail a basic test of integrity.
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