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Sunday, October 22, 2017

House Republicans are now busily working to repeal the Affordable Care Act in secret.

Even when the GOP plan is done and made public, the secrecy will continue. The potential impact will still be hidden from the public, as it’s likely to not have any score from the Congressional Budget Office before the House votes on it. This means members of the House will not have any real idea of how many people they’re voting to uninsure, how much this plan will increase the deficit, and just how big a giveaway it will be to the rich.

Why is Paul Ryan is hiding his plan?

He knows that Republicans cannot afford an honest debate about the GOP’s repeal plans, especially their true intentions for Medicaid and Medicare.

Several reports suggest an early draft of the House GOP’s bill was scored by the CBO and — and then pulled before it could become public because the numbers were atrocious, uninsuring nearly all of the Americans who gained coverage thanks to the ACA, and driving up costs for most Americans, especially those closest to retirement who are most likely to have a pre-existing condition.

Topher Spiro and Harry Stein of the Center for American Progress analyzed the House GOP’s outline and found the results weren’t exactly something they’d want to shout about.

“The repeal bill will transfer money from low-income and middle-class Americans to millionaires,” the conclusion states. “Because the math dictates massive cuts to Medicaid and much lower tax credits, millions of people will lose their coverage or have their coverage downgraded.”

Why wouldn’t they want to hide that?

And there’s more. For instance, the argument that Bill Gates needs a $7 million annual tax break while police officers and nurses need to pay higher taxes is a particularly tough sell for a “populist.”

But the real dirty secret that the GOP will likely refuse ever to admit is that its plan to eliminate the ACA is also a stealth plan to gut one of the most popular things the government has ever done that didn’t involve killing Osama bin Laden — Medicaid — while laying the ground work to gut another — Medicare.

Nobody — at least nobody in the Republican Party — seems to understand that Americans love their public health insurance  better than Donald Trump.

During the GOP primary Trump insisted that Mike Huckabee “copied” his promise of “no cuts to Social Security, Medicare & Medicaid.” He went on to make contradictory promises about health reform, always promising “something terrific” to replace Obamacare, even while veering towards Paul Ryan’s brutal plans on Medicaid, which are huge cuts disguised blandly as “block grants.”

Republicans feel very safe talking about repealing Obamacare, which has only recently become popular. But they don’t want to admit that they’re planning to uninsure people who qualified for public health insurance even before the ACA took effect.

Republicans can’t simply admit this because they know that once Americans get health insurance with government help, they tend to like it. They really, really like it.

Certainly that is true of Medicare. Some 75 percent of those on the government’s single-payer program for retirees said it worked well for most seniors in a 2015 Kaiser Health Tracking Poll. It’s true for Medicaid. About 9 out of 10 beneficiaries told Morning Consult that they were satisfied with the coverage and benefits last year. And it’s even true of the Affordable Care Act: A recent poll from the Commonwealth Fund found “82 percent of Medicaid and [ACA] marketplace enrollees say they are ‘very satisfied’ or ‘somewhat satisfied'” with the plan,” Vox reports.

In a nation where Congress struggles to get 20 percent approval, both parties languish below 40 percent, and the president crests at 40 percent only on a good day, there is a pretty amazing consensus that Americans like health care when it’s provided by the public. In fact, they like it even better than they like insurance they buy themselves, or get from their employer, which is still quite popular and also subsidized by taxpayers. (Yes, we spend around three-times more subsidizing employer-provided health insurance than we do on the ACA.)

The ACA added more than 10 million Americans to the Medicaid rolls through expansion and better outreach. To block grant Medicaid, even under the “more friendly” plans being negotiated by GOP governors, would threaten coverage and tens of millions more.

Why would they want to hide this? Well, only 12 percent of Americans support cutting Medicaid.

And then there is Medicare, once a sacred cow in American politics, until the GOP embraced Paul Ryan’s fantasy of turning the program’s guarantee into a “premium support” system that massively shifts the costs of coverage to seniors.

The ACA has strengthened Medicare while adding free preventive care for all seniors. Straight-up repeal would likely increase Medicare spending by $800 billion over the next decade while eliminating that new benefit.

Yep, Ryan’s dream is to make repeal his Trojan horse for finishing off the Medicare guarantee. Purposely weakening the program will provide him with more momentum to gut Medicare through the bones, the way ACA repeal is gutting Medicaid.

Have no doubt: Even without projecting nefarious future intentions, repealing the ACA as Paul Ryan wants to do it will break Trump’s promise not to cut Medicaid or Medicare. And it will be a nightmare for the millions of poor Medicare beneficiaries who depend on Medicaid for support, including nursing home coverage.

Ryan thinks he can get away with this because the GOP — with the help of its donors outspending ACA defenders 6-to-1 — has gotten away with accusing the ACA of harming Medicare, when it did the opposite, and denying millions of the hardest-working Americans any Medicaid expansion.

But you don’t need a fact checker to tell you that you’ve lost your insurance or been kicked out of a nursing home. The math will eventually catch up with the GOP.

The Kaiser Health tracking poll recently found that 74 percent of Trump backers aren’t worried about repeal causing them to lose coverage, yet the same survey found that Medicaid is at least somewhat important to 44 percent of Republican families. Eventually they may have to figure this out the hardest way possible — through tragic experience.

The GOP is proposing to repeal the ACA but has no intention of replacing it. Instead Republicans are using this opportunity to do what they’ve always dreamed of doing — ending Medicaid and Medicare as we know them.

 

 

 

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