Republicans in Congress have a new version of their plan to repeal Obamacare, which they are spinning as the “Better Care Act.” But who will get this legislation’s better care? Hint: People not like you or me.

Share story

In poker there’s a term called a “tell.” It’s when a player exaggerates some mannerism or body language, giving away that the hand is the opposite of what it seems.

Poker is far more sophisticated than politics. Because in politics they don’t even try to hide their tells. Sometimes they write them straight into the titles of the bills.

Example: The “Better Care Reconciliation Act,” the Senate Republicans’ answer to remaking the nation’s health insurance. If you think this act will in any way result in better care, then I have a neighborhood card game I’d like to invite you to.

Republicans are taking us all for chumps, and they say so right in the name.

We already know that 20 million-plus people will lose health coverage under the Republican replacement for Obamacare. That was the independent estimate made when the House approved its health-care bill in May, and the Senate bill is similar in design.

Millions of people losing coverage cannot possibly equal better care. Cheaper care, maybe — though even that’s dubious because people with no insurance often just end up in emergency rooms, the priciest place of all for basic medical services.

It probably shouldn’t have the word “care” in it at all.

Consider the plight of community-health centers. Established 50 years ago, these low-cost, nonprofit clinic chains serve as the first line of medicine to the poor and people with limited insurance.

We have 28 of them in Washington state. In return for federal aid, they follow a simple mandate: Nobody can be turned away, regardless of ability to pay. Last year they served 971,000 patients here. (In Seattle, the clinics are SeaMar in South Park, and Country Doctor in the Central Area.)

Eighty percent of their patients are either on Medicaid — the federal health program for the poor — or have no coverage at all.

So … what is the Better Care Act plan for these clinics? It slashes Medicaid, their primary funding source, even as the requirement that they must continue to treat all is retained. And it offers no plan to continue a $3.6 billion annual support fund for the clinics created under Obamacare.

It’s trying to get something for nothing.

“We’re very alarmed by the bill,” said Shirley Prasad, director of policy for the Community Health Network of Washington, which oversees 19 of the centers. “It’s at the point where you read it and you say, ‘how would we continue to do business?’ ”

Obamacare had its own tell, as it turns out. Its real name is the “Patient Protection and Affordable Care Act.” It has been one of the more successful health reforms in U.S. history in that it provided medical coverage to about 20 million people who didn’t have it before, and saved both lives and bank accounts of patients with pre-existing conditions. But overall it failed with the “affordable” part.

That was the most unbelievable promise when it passed — that it somehow would save everyone money on their health insurance.

It remains to be seen whether the Better Care Act will do any better at reducing the price of premiums. But what’s definitely cruel is that by repealing the Medicaid expansion for the working poor, it goes hardest after the one part of Obamacare that worked the best. That’s where the money is — nearly a trillion dollars, much of which will be converted into tax cuts solely for the wealthy.

“I have to start off by, I guess, congratulating all the millionaires on the incredible gift they are about to get,” said Dr. Ben Danielson, senior medical director at another low-income clinic, Odessa Brown Children’s Clinic in Seattle, at a news conference Friday.

“I always wondered what you get for the person who has everything, and now I know; it’s cutting benefits to young children, poor families, the infirm, the elderly.”

Now that’s how you call the Better Care Act’s bluff. Following the good doctor’s lead, I humbly submit a two-word title amendment to name it what it really is. Call it the Better Care for Millionaires Act.