With wall-to-wall cable news coverage of the Senate health-care bill, many in Washington, D.C., have become obsessed with process: Who’s up, who’s down, who can be brought on board, for what price? This focus on the horse-race obscures what actually matters to people in Maine, and across the country: Will a health reform bill lower costs, increase quality and provide coverage for more Americans than the system we have today?

Fortunately, Maine’s two senators, an independent and a Republican, have kept their eye on the ball — demanding a focus on substance over process and an objective assessment of any reform ideas that emerge from closed doors in the Capitol.

With that lens, the latest version of the Senate health bill is easy to understand: Rather than lowering cost and improving quality, most Americans would pay more for less, and rather than expanding coverage, 22 million more Americans would join the ranks of the uninsured.

What would this mean in Maine? An estimated 117,900 Mainers would lose coverage and tens of thousands more would see their coverage get worse or more expensive, whether they get health insurance through the Maine health insurance marketplace, MaineCare or even their employer.

• First, the bill would raise premiums, deductibles or both for most of the roughly 70,000 Mainers getting coverage through the marketplace. The impact would be especially harsh in states like Maine, where there are higher-than-average health insurance premiums, large rural populations and large numbers of residents in their 50s and early 60s.

For example, a 60-year-old in Washington County with income of $40,000 would see her premium increase by $1,300 and her deductible more than double to about $6,300. Or she’d have to pay over $5,000 more to keep the coverage she has now. These cost increases would be particularly burdensome to self-employed and small business owners in Maine who access coverage through the exchange.

On top of that, people with pre-existing conditions might no longer be able to get coverage at any price. The Senate bill would let states waive requirements that insurance companies cover services like maternity care, mental health care, substance-use treatment, and prescription drugs — services that were often excluded from coverage before the Affordable Care Act.

Is there any doubt what the LePage administration would have done with this provision, had it been in effect over the last few years?

• Second, the bill would weaken vital protections for the 600,000 Mainers who get health care through their employers. Today, because of the ACA, insurance companies cannot impose lifetime limits on care. Under the Senate bill, that could change.

Anyone who has experienced a serious illness knows how quickly the hospital bills stack up, and how devastating it could be for an insurance company to impose a lifetime cap and force you to pay every dollar at your most vulnerable moments in life. Today, every American is protected from this devastating anxiety. It should not be allowed to return again.

• Third, the bill would dismantle MaineCare, the state’s Medicaid program. In congressional debates, Medicaid is often treated as an abstraction. Here, it is anything but. Forty-seven percent of Maine children rely on MaineCare to see a doctor and get the care they need to stay healthy. And 72,000 people with disabilities across the state access care that helps them live independently. Maine seniors utilize MaineCare at nearly twice the national average rate for Medicaid.

The Senate bill would not only prevent Maine from ever getting the benefit of expanding MaineCare, it would also erode the program in place today by capping Medicaid reimbursements at a rate well below the growth rate health cost. As Sen. Susan Collins recently told NBC’s “Meet the Press Daily,” that would “ship billions of dollars of costs to our state governments, to those who have insurance, and to health-care providers such as rural hospitals, which would be faced with a great deal of uncompensated care.”

When fully implemented, the bill could shift millions in costs to Maine, forcing Augusta to decide how to ration care — cutting vital opioid addiction treatments, eliminating nursing home care, denying services to half of Maine’s children. Partly as a result of its Medicaid cuts, the Senate bill is projected to more than double Maine’s uninsured rate for kids.

Not surprisingly, when you take all of these pieces together, the Senate approach is unpopular — supported by only 12 percent of Americans in a recent poll. As a result, Mitch McConnell is spending this week looking at “tweaks” to the bill. But if we keep our eye on the goal — lower costs, higher quality, greater coverage — this bill cannot effectively be tweaked.

Any version that uses the Senate bill as its starting point will set us backward on all of those measures. Adding some additional opioid funding while dismantling Medicaid’s safety net and consumer protections for people needing mental health and substance abuse treatment is, as Republican Ohio Gov. John Kasich recently described, like “spitting in the ocean.”

Reducing the cut to a self-employed Mainer’s tax credit is cold comfort — like a boss excitedly exclaiming, “I was going to cut your pay by 50 percent, but good news — we’ve decided to give you a 30 percent pay cut instead.” As Sen. Collins recently put it, “the bill needs a lot more than tweaking or tinkering around the edges. It needs a major overhaul.”

That overhaul can occur only if Congress abandons the rushed, secretive and partisan process that led to the development of the Senate bill and adopts a different approach. The good news is that there is ample opportunity to find bipartisan solutions to improve the health care status quo. Maine’s senators are well positioned to lead this effort, but it will happen only if they and others in the Senate reject the tweaking-the-Titanic strategy and focus on moving forward.

Brian Deese of Portland is a former acting director of the Office of Management and Budget and senior adviser to President Barack Obama.

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