The Republican health deform, drafted by House Speaker Paul Ryan with Trump’s blessing, would drain $1.2 trillion from federal health programs over the next decade. Most of the money comes from programs helping the working poor who need financial assistance to get health care. The money would go back to the rich who were taxed to provide many of those benefits.
Some $880 billion comes out of Medicaid, the federal program that provides comprehensive insurance that provides people with income up to 133% of the poverty line, or $27,159 a year for a family of three. Trumpcare also turns Medicaid into a block grant in which states are turned loose to use the remaining money with reduced federal oversight. So much for Trump’s repeated promises during the campaign that he would protect Medicaid (as well as Medicare and Social Security — watch out seniors: They’re coming for you next).
Other “savings” from the Trumpcare health bill come from the subsidies for people with relatively low incomes buying health insurance on their own, who for the past three years have been eligible for tax credits that discount premiums. The Republicans would shift assistance from the people with lower incomes to people based on their age, but it also lets insurance companies dramatically increase premiums on older Americans. It also repeals tax credits for small businesses that provide insurance for workers.
For example, Nancy Altman of Social Security Works noted, a 64-year-old who earns $26,500 now pays $1,700 annually for health insurance. Trumpcare would force the senior to pay $14,600 for the same coverage. “That is more than half of her income! And that is just the cost of the annual premium. It doesn’t include the cost of medication, co-pays, deductibles, or non-covered items like glasses. That doesn’t leave a whole lot left over for housing and food,” Altman said.
The Republican bill also would let insurance companies dramatically hike premiums for people with “pre-existing conditions,” including everything from mental health problems to cancer. Republicans point out that people with chronic health problems would not face those premium hikes unless they let their current coverage lapse, but Jonathan Cohn noted at HuffingtonPost.com, with the changes in tax credits, lapses in coverage would become much more common. Republicans promised a safety net, in the form of high-risk pools, even though they have been tried before, never proved adequate, and under the AHCA would have inadequate funding.
The Congressional Budget Office, after reviewing an earlier version of Trumpcare, predicted that it would cause 24 million Americans to lose their coverage. Ryan rushed the vote on Trumpcare 1.1 before the CBO could analyze the amended version, so Republicans didn’t know the fiscal impact before they voted on it.
The savings mainly go to cut taxes on America’s wealthiest people. For individuals earning more than $200,000 or couples earning more than $250,000, it eliminates a 0.9% increase in the Medicare payroll tax and a 3.8% tax on investment income. The Center on Budget and Policy Priorities estimated that the wealthiest 400 households in America would get an average of $7 million in tax breaks.
As the public backlash grew to the apparent gutting of healthcare protections, Republicans resorted to lying about Trumpcare’s potential effects at the Sunday morning political talk shows May 7, Zack Ford noted at ThinkProgress.org.
House Speaker Paul Ryan on ABC This Week called any concern that the bill was passed without a final CBO score a “bogus attack from the left,” insisting that the final amendment “was only three pages long.”
But those three pages were significant enough to sway the Freedom Caucus to change their votes from their previous opposition to what they termed “Obamacare Lite.” Ryan claimed it didn’t matter that Trumpcare passed without a new assessment. (Some reporters recalled that Ryan loudly attacked Democrats in 2010 for passing Obamacare without a final CBO score.)
Ryan also insisted, “under this bill, no matter what, you cannot be denied coverage if you have a preexisting condition.” In reality, the latest version of Trumpcare has even weaker preexisting condition protections than the version that the CBO scored.
The new version allows states to opt out of Obamacare’s prohibition against insurers charging people with preexisting conditions higher rates, and to shuffle these people into “high-risk pools.” In the past, high-risk pools often offered skimpy coverage at exorbitant rates — if coverage was available at all. Ryan ignored this concern, insisting people will be fine so long as they have continuous coverage.
On Fox News, White House Chief of Staff Reince Priebus was spreading the same misinformation about pre-existing conditions. Like Ryan, Priebus downplayed the number of people who would be impacted, pointing out it wouldn’t affect pre-existing conditions for employer-based insurance, Medicare, Medicaid, or anyone with continuous coverage. “Let’s assume that there are some people who might not have continuous coverage,” Priebus said, before host Chris Wallace interrupted to highlight that it’s not just “some people,” but in fact millions of people.
Priebus insisted that the $8 billion for high-risk pools will help keep down costs for people with preexisting conditions, but the Center for American Progress found that $8 billion over 10 years will only subsidize 76,000 more people. In reality, the bill would need about $200 billion in subsidies for the risk pools, meaning $8 billion is just a drop in the bucket and the high-risk pools are likely to be overburdened and underfunded as they were before.
In interviews on both NBC’s Meet The Press and CNN’s State of the Union, Health and Human Services Secretary Tom Price defended the way Trumpcare cuts $880 billion from Medicaid. This cut was one of the primary reasons the CBO concluded that 24 million people would lose their coverage by next year. Price tried to downplay the cut by suggesting it was somehow not a cut, adding that he believes it will correct the problem of many doctors not accepting Medicaid. On CNN, Jake Tapper countered that the primary reason some doctors don’t accept Medicaid is because it doesn’t reimburse them enough, asking Price how less money will help reimburse doctors more.
When a constituent at a town hall May 5 in Lewiston, Idaho, told Rep. Raul Labrador (R), “You are mandating people on Medicaid accept dying,” Labrador replied,“No one wants anybody to die. That line is so indefensible. Nobody dies because they don’t have access to health care,” he continued, drawing loud jeers from the audience.
Why do they lie about what the health deform does? Because solid majorities of the American people oppose the changes (55% told Gallup Congress should not repeal the ACA and 87% in a March CNN poll opposed lifting the requirement that insurers cover people with pre-existing conditions).
The bill goes on to the Senate, where Senate Majority Leader Mitch McConnell hopes to pass the health deform as part of budget reconciliation, which only requires a simple majority and cannot be filibustered. But the rules require that the bill’s provisions be limited to tax and spending changes.
Republicans cannot afford to lose more than two senators from their side, if they try to railroad the bill through budget reconciliation. Contact your senators (the Capitol switchboard at 202-224-3121 will put you through) and let them know that voting to repeal the ACA will be hazardous to their continued public service. — JMC
From The Progressive Populist, June 1, 2017
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