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.
How concerned are congressional Republican leaders about dragging their health care bill across the finish line? Enough to start adding last-minute sweeteners intended to buy off specific on-the-fence members. The New York Times reported overnight:
Not surprisingly, New York Gov. Andrew Cuomo (D) isn't pleased, saying in a statement last night, "The more we learn about the repeal and replacement for the Affordable Care Act, the sicker New York gets." The Democratic governor is reportedly rushing to D.C. today to meet with the state's congressional delegation, explaining to them that this one new provision -- which some have labeled the "Buffalo Bribe," or the "Buffalo Buyout" -- would create a multi-billion-dollar hole in New York's state budget.So why add it? Because many upstate Republicans believe New York's existing Medicaid policy adds a significant tax burden in their area. GOP leaders on Capitol Hill inserted language into the American Health Care Act last night that's likely to make Reps. Chris Collins (R-N.Y.), Claudia Tierney (R-N.Y.), Elise Stefanik (R-N.Y.), John Faso (R-N.Y.), and John Katko (R-N.Y.) happy -- or at least happier -- and given how narrow the margins are likely to be on Thursday, every vote counts.But let's also take a moment to pause and appreciate just how breathtaking the hypocrisy is.When the Affordable Care Act was coming together, proponents were trying to lock down support from then-Sen. Ben Nelson (D) of Nebraska, one of Congress' most conservative Democrats. Party leaders agreed to a special Medicaid reimbursement policy that would specifically benefit Nelson's constituents.Republicans quickly labeled this the "Cornhusker Kickback," and the media used this as striking evidence of legislation that was being crafted in an ugly, almost corrupt fashion. (The "Cornhusker Kickback" provision was ultimately scrapped, and Nelson voted for the ACA without it, but Republicans continued to insist that the measure was included in the final law.)And yet, here we are, watching an eerily similar dynamic play out with Republicans who condemned the way in which "Obamacare" came together in 2009 and 2010. Instead of Democratic congressional leaders trying to buy off the support of a Nebraska Dem, it's GOP congressional leaders trying to buy off the support of New York Republicans.As we discussed several weeks ago, I can appreciate the fact that calling out politicians for hypocrisy is almost too easy, but once in a while, the dynamic is so strong, and so jarring, even the most jaded and cynical of political observers have to pause and take note.Republicans complained about Democrats jamming the ACA through Congress quickly, and now that's exactly what GOP leaders are doing. Republicans complained about Democrats writing their health care bill behind closed doors, and now that's exactly what GOP leaders are doing.Republicans said the ACA was written without bipartisan input, which isn't true, and which hasn't stopped them from writing their alternative plan without even trying to solicit bipartisan input. Republicans said deductibles are too high under the ACA, which led them to write a bill in which deductibles will be even higher.Republicans said it was an outrageous abuse to pass elements of the ACA through the budget reconciliation process, and yet here we are, watching them try to push their own reform bill through the budget reconciliation process. Republicans attacked "Obamacare" for not reaching universal coverage, and now they're embracing a plan that would make the uninsured rate worse, not better.And Republicans said it was ridiculous to include carveout provisions to target specific members, which is exactly what they did last night.New York's Jon Chait had a piece in early January, highlighting the irony: "[T]he claims that conservatives have falsely made about passing Obamacare provide a true description of the Republican plan to undo it."There are all sorts of reasons to balk at the GOP health care plan. Save a little space on the list for the breathtaking hypocrisy on display.