Rep. Bill Cassidy

Rep. Bill Cassidy

We were fortunate growing up in the south. The president is a community organizer. You wonder if he ever worked with a poor person ... Insurance people they will tell you that they will go to a company and an employer will pay for everything, and there are some people who will not sign up. Turns out, those are my patients. They’re illiterate. I’m not saying that to be mean. I say that in compassion. They cannot read. The idea they’re going to go on the internet and work through a 16-page document to put in their data and sign up does not reflect on understanding of who is having the hardest time in our economy. [...] [My plan] I think actually reflects the reality of who the uninsured are, relatively less sophisticated, less comfortable with forms, less educated. Those are the folks that—not all—there’s a guy who goes to my church who’s uninsured, who’s middle-class but couldn’t get it because he has Type I diabetes. So it’s not all, but it is the folks who I think are going to have the hardest time reaching.

Rep. Bill Cassidy has a plan to replace Obamacare. The Louisiana Republican, currently vying to be Sen. Mary Landrieu's challenger in November, wants to replace the full health care coverage of the exchanges with catastrophic insurance, Health Savings Accounts, and pharmacy policies that cover all low-income people. Because a program with no choices, he feels, is what the "less sophisticated" people who are currently uninsured will be able to understand. Yes, less sophisticated. But allow him to explain. His plan "wouldn't be bells and whistles. It wouldn't have all these benefits that we have to pay so much for. But it would take care of you if you got in a car wreck." And that's what these people need:This is an interestingly Republican kind of compassion. Let's give illiterate unsophisticated people coverage ... but with a quality level matching their level of understanding. Maybe coverage quality could actually be matched to people's performance on reading comprehension tests. If anything, this is an argument for single-payer health care—removing the choices and complicated sign-up process, just giving everyone a certain level of coverage. Except that Cassidy's arguing that poor people should get a specific, crappy level of coverage. Which, yes, might offer you some help in the event of a car wreck, but would likely also leave you with a whole bunch of debt.

A non-Republican confronted with people whose literacy was inadequate to understanding their health care options—and I mean, really, few among us actually understand insurance jargon, as Sy Mukherjee points out—might call for simpler documentation or better support walking people through their interactions with their insurance companies. But Cassidy's is the classically Republican answer: Let's just make coverage worse. For poor people, anyway.