THE BURNED OVER DISTRICT

That may be so in the Health Industry as the Republican forced passage of Trumpcare 2.0 "The Rotteed Zombie Bill" has managed to unite hospitals, doctors and health insurers in their condemnation of one of the worst pieces of shit ever to get through a house of Congress.

It is a rare unifying moment. Hospitals, doctors, health insurers and some consumer groups, with few exceptions, are speaking with one voice and urging significant changes to the Republican health care legislation that passed the House on Thursday.

The bill’s impact is wide-ranging, potentially affecting not only the millions who could lose coverage through deep cuts in Medicaid or no longer be able to afford to buy coverage in the state marketplaces. With states allowed to seek waivers from providing certain benefits, employers big and small could scale back what they pay for each year or reimpose lifetime limits on coverage. In particular, small businesses, some of which were strongly opposed to the Affordable Care Act, could be free to drop coverage with no penalty.

The prospect of millions of people unable to afford coverage led to an outcry from the health care industry as well as consumer groups. They found an uncommon ally in some insurers, who rely heavily on Medicaid and Medicare as mainstays of their business and hope the Senate will be more receptive to their concerns.

“The American Health Care Act needs important improvements to better protect low- and moderate-income families who rely on Medicaid or buy their own coverage,” Marilyn B. Tavenner, the chief executive of America’s Health Insurance Plans, the industry’s trade group, said in a strongly worded statement.

Others were even more direct about the effects the bill would have, not only on patients but also on the industry. “To me, this is not a reform,” said Michael J. Dowling, the chief executive of Northwell Health, a large health system in New York. “This is just a debacle.”

Hospitals that serve low-income patients “will just be drowning completely when this happens,” Mr. Dowling said, noting that more people would become uninsured at the same time that government payments to cover their costs were reduced.

In contrast to hospital and doctor groups, insurers had largely remained silent about their reservations, perhaps in the hopes of bartering their low profile in exchange for assurances that billions of dollars in subsidies for low-income coverage would continue. The White House and Congress have gone back and forth about their willingness to pay for the subsidies, prompting anxiety among some companies. Several, including Anthem, have threatened to sharply raise their prices or leave markets altogether without the funding.

But a few, including Blue Shield of California, came out in opposition to the bill before the vote. “We feel compelled to oppose it,” said Paul Markovich, the company’s chief executive. “It raises the specter that the sickest and neediest among us will be disproportionately hit in losing access.

”But the overriding concern — for insurers, many workers and officials throughout the health care systems in many states — is the broad reductions proposed for Medicaid. Even for insurers that have largely abandoned the individual market, like UnitedHealth Group and Aetna, a substantial portion of their business is providing coverage under Medicaid. The same is true for many local nonprofit plans, said Ceci Connolly, the chief executive of the Alliance of Community Health Plans.

True their unity may be only due to the vision of the loss of millions of now paying customers, but their taking the right course and that is important. When enough people get outraged we can start removing Republicans.