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Monday, March 25, 2019

Senate Republicans Aren’t Just Aiming To Destroy Obamacare And Medicaid; They Want To Provide A Death Blow To Any Future Health Care Reform

Senate Republicans Aren’t Just Aiming To Destroy Obamacare And Medicaid; They Want To Provide A Death Blow To Any Future Health Care Reform

Reprinted with permission from AlterNet.

The Senate Republicans’ latest anti-Obamacare bill has bigger goals than destroying the Affordable Care Act and dismantling Medicaid. This bill aims to blow up the very foundation upon which a national health care system could be built—even if it roils private insurance markets via massive premium hikes for 2018.

This overarching goal—to destroy the health care system’s structural underpinnings that could be used to create a national health care system—was made clear in the opening boasts of the Senate bill’s co-sponsor, Sen. Lindsey Graham, R-SC, when he introduced the bill on the same day Sen. Bernie Sanders, I-VT, introduced a Medicare for All bill.

“If you want a single-payer health care system, this is your worst nightmare,” Graham boasted on September 13, referring to his own bill. “Hell no to Berniecare!” If that wasn’t clear enough, Graham doubled down on Tuesday, when in an appearance with Vice President Mick Pence, Graham said, “federalism versus socialism, you pick.” Then on Wednesday, a Pence aide told reporters the vice president was leaving a U.N. Security Council meeting on peacekeeper reforms “to speak with leader McConnell on continuing momentum behind Graham-Cassidy.”

The legislation introduced by Graham and his co-sponsors is the GOP’s last hope to take action before the new federal fiscal year begins October 1. It has run into opposition from within GOP ranks—at least six Republican governors don’t want to see millions of federal dollars diverted from state-run Medicaid programs, which expanded coverage of lower-income people under the ACA. On top of that, virtually every medical association opposes the bill because they know the chaos it would bring, starting with double-digit insurance premium hikes and leading to an estimated 32 million people losing coverage over the next decade. It also deregulates minimum coverage requirements, meaning the private insurance industry would lessen what’s covered.

The bill’s parade of horribles doesn’t end there. It would cut an estimated $4 trillion in federal funds to states for Medicaid over the next two decades, which typically is a fifth of state budgets, and turn the federal subsidy into block grants with no strings attached—meaning the grants could be used for anything else, like roads or corporate subsidies. And it would pull tens of billions of dollars out of blue states that expanded their Medicaid programs under Obamacare (California loses $78 billion, New York $45 billion) and redistribute it to red states that refused to expand their Medicaid programs (Texas gets $35 billion, Georgia $10 billion), according to an analysis by Avalere Health LLC.

As expected, the political response has been a mounting firestorm that is on track to equal the intensity of the opposition last summer to earlier Obamacare repeal bills. The stakes became apparent Tuesday, when Senate Majority Leader Mitch McConnell suspended that body’s consideration of a bipartisan effort to ward off private insurance premium increases in 2018. In short, McConnell single-handedly sabotaged the bipartisan effort by Senate Health Education Labor and Pensions Committee chairman and co-chair, senators Lamar Alexander, R-TN, and Patti Murray, D-WA, in one fell swoop.

“I am disappointed the Republican leaders decided to freeze this bipartisan approach and are trying to jam through a partisan Trumpcare, but I am confident we can reach a deal if we keep working together,” Murray said in a statement after McConnell knee-capped her.

The Senate Republican bill has so many potentially harmful effects it is easy to lose sight of the bigger picture and the GOP’s game plan. McConnell, Graham, Pence and the others lining up behind this ruthless legislation don’t just want to kill Obamacare. Graham, to his credit, laid out the stakes very candidly when he said “hell no” to Berniecare and portrayed the choice as “federalism versus socialism.”

Bernie Sanders’ bill is most accurately described as an “aspiration,” as the New Yorker put it, in that it creates a national single-payer system by expanding Medicare, the federal health program for those 65 and over. Sanders doesn’t say how it’s to be paid for, nor does the bill address how that transition would be phased in beyond lowering Medicare’s eligibility age over a four-year period. But 62 percent of the public support national health care, according to a nationwide poll by the Associated Press. That means Sanders is winning the war of ideas, even if he isn’t offering the implementation details.

In contrast, Graham’s bill attacks the governing structures and foundation of a national health care system like a malignant cancer. The Republicans don’t care a whit about being aspirational. They are ruthless and remorseless, and focused on dismantling the building blocks for a nationwide system: the federal funding of Obamacare and Medicaid, and the government’s most prominent means of delivery, state-run Medicaid and subsized Obamacare. As NBC Capitol Hill Reporter Lee Anne Caldwell tweeted about Graham’s fellow South Carolina sentor, “SenTimScott#: (the bill) stops us from having conversation in the future about Medicare for All” bc $ (because money) and decisions go to states.”

This is not the first time powerful Republicans have used Medicaid as a deliberate fissure to undermine Obamacare’s potential.

You may remember 2012’s U.S. Supreme Court decision written by Chief Justice John Roberts that preserved Obamacare. He ruled the law’s tax penalties (for not having coverage) were legal, but did so by saying the feds could not force states to expand Medicaid—even if the feds initially were paying for that expansion. In short, Roberts validated the parts of Obamacare that was corporate welfare for private insurers (Obamacare subsidies), but fractured a nationwide public program, Medicaid expansion. Taken together, Roberts ensured that the private sector would flourish while impeding any government program that could build toward a national system.

What’s happened since then is the American public—as evidenced by the AP poll and a handful of Republican governors who have expanded Medicaid and see its benefits to their citizens—increasingly are realizing that government-managed health care is viable and preferable to the current mostly privatized system. (The GOP governors are from Ohio, Nevada, Massachusetts, Vermont, Maryland and New Hampshire.) In other words, the Supreme Court’s 2012 Obamacare ruling slowed, but didn’t reverse, the progression toward nationalized health care, as seen in polls and successful Medicaid expansions.

The target of the Senate bill is not just Obamacare. That’s the political opening for a larger and deeper attack on the structures that are the basis for national health system—perhaps like what’s in Sanders’ bill. By dismantling Medicaid, ending federal subsidies for Obamacare policy holders, ending minimum insurance coverage standards, cutting trillions in health care funding, and shifting billions from blue to red states, Republicans are knowingly destroying the near-term possibility for socialized health care—to use Graham’s words, “federalism versus socialism.”

The Supreme Court slowed the march toward a national system when it made Medicaid expansion optional. Now, the Republicans running the Senate and White House are aiming at the systemic underpinnings of implementing national health care solutions.

They might not succeed in the long run. But if they’re successful passing legislation next week, when the bill comes to the Senate floor, America’s health care system would be set back years—with multitudes of people needlessly suffering from a triumph of right-wing extremists.

Steven Rosenfeld covers national political issues for AlterNet, including America’s democracy and voting rights. He is the author of several books on elections and the co-author of Who Controls Our Schools: How Billionaire-Sponsored Privatization Is Destroying Democracy and the Charter School Industry (AlterNet eBook, 2016).


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25 responses to “Senate Republicans Aren’t Just Aiming To Destroy Obamacare And Medicaid; They Want To Provide A Death Blow To Any Future Health Care Reform”

  1. Da FrogMeister says:

    I think it is time to get rid of these empty shells of humanity. They sit there deciding that healthcare for them is good and should be subsidized, but providing AFFORDABLE health care for the other 315 million residents of America is bad. Another thing that has not been too widely discussed is that this bill also allows employers to discontinue employer sponsored insurance. So, all you smug people who have insurance through your work, need to be aware of the fact that your employer could kill it at any time, and there’s nothing you can do about it. Veterans will also be impacted, as the VA will lose a considerable amount of funding, meaning that care will have to be rationed. So, if you think that this is outrageous, call, write, tweet, text or visit your senator and tell them to vote no. Let them know that if this passes, then you will be working to put them in the unemployment line.

  2. dbtheonly says:

    Block grants to the States means 51 different requirements, 51 different standards, makes even private health insurance a questionable proposition on a national level. Makes multi-State insurance dubious.

    BUT: Washington Post announces McCain will vote No on Cassidy-Graham. So, Lord Willing, none of this matters. That’s Paul & McCain announced as Nos, with Collins out and Murkowski bribed.

    • Da FrogMeister says:

      Block grants means that states like Wisconsin can use the funds to repair their roads instead of providing insurance coverage to the poor and working poor.

      • dbtheonly says:

        Repair roads. Hah!

        Build the new football stadium!

        • Da FrogMeister says:

          Yeah, Walker just stuck us with the tab for the new Bucks stadium, we’re still paying for Miller stadium, so why not screw us completely for a complete remodel of Lambeau stadium.

          • dbtheonly says:

            Ours spent the money on a helicopter for the State Police to ferry the Governor around.

            And should we mention the FoxxCon deal? Emphasis on the “Con” part.

          • Da FrogMeister says:

            Yeah, another thorn in the sides of the people of Wisconsin.

          • dbtheonly says:

            More like hand in the wallet.

            But elections are coming.

          • Oh, isn’t that nice of your governor to purchase a helicopter to have himself ferried around. I suppose his concern is that he quickly and efficiently move about to stiff the state.
            What a world we live in, eh?

            Hope you are well.

          • dbtheonly says:

            Thank you Aaron,

            Funerals for elderly relatives are draining. Family illnesses have made money tight, but manageable. Everyone recovering. Your prayers, both past and future, are appreciated.

            It was the old Governor who splurged on the helicopter as part of the block grants for Law Enforcement.

            Generally just soured me on the whole concept of block grants. I get the idea, but you’re asking 51 different jurisdictions to act wisely. And you’re giving them money which is “use it or lose it”. Of course you’re not going to get the money well spent every time.

  3. Dapper Dan says:

    I’ve come to the conclusion that several republicans in their efforts to undo good programs like the Affordable Care Act and rollback other good initiatives pushed forward in the past by Democrats the GOP imo has become the Neanderthal Party. They tend to live in the past and refuse to acknowledge science. Welcome to the age of the Flintstones

  4. In the aftermath of Dylann Roof killing church-goers in South Carolina and events surrounding the killings of blacks males by police officers, Senator Lindsay Graham showed a viscosity of mental awareness rivaling that of molasses. And during his tenure in office as a politician the same torpid thinking process has been in effect.
    The latest example of lack of thinking creatively and “out of the box” is this DOA attempt to wreak havoc on citizens of South Carolina and the rest of the country. But Lindsay is not alone in being a slow thinker with the mental agility of a stegosaurus—the entire GOP conglomerate suffer the same inability to sidestep the healthcare issue which was doomed from the moment the GOP formally announced it would work to reject affordable healthcare for all.

    The GOP’s stupidity may be thwarted once again by way of serendipity(and Divine Intervention), thus saving the constituents of South Carolina from their attempts to commit suicide, by way of electing a Senator who promised indirectly that he would inflict on them a slow and agonizing death, via a campaign promise of no health care or extremely expensive care.

    Is it the ghosts of slavery and white nationalism which drive so many constituents in South Carolina to wish to jump over the edge of a cliff like lemmings??

  5. TZToronto says:

    I’ve noticed a new talking point being tossed out by GOP health care [sic] spokespeople: Socialism. We haven’t heard much about socialism re: health care in the last couple of years, but here it is! They don’t actually explain why Obamacare is socialism (yeah, socialism for insurance companies), but it sure sounds bad. (Then there’s that endless, evidence-poor ranting of how Obamacare is imploding, in spite of the fact that millions of people who couldn’t get health insurance in years past now have it.) Of course, most of the Trumpian universe has no idea what socialism is, only that it sounds bad and is probably kind of like communism (no longer practiced in Russia [sic] now that Putin is Trump’s best buddy). The fact that most of the happiest countries in the world really are socialistic and have health care for all with medical outcomes far better than America’s means nothing when the GOPTP yells “Socialism!!”

    • Charles Winter says:

      The Trumpian universe has no more idea of what socialism is than they do of what a fact is.

      • TZToronto says:

        You are so correct. All they know about socialism is that it is the devil’s tool. It’s hard to imagine (1) what sort of education these people received and (2) how disinterested they were in what they were being taught. For them, personal opinion is fact and needs no empirical support; for them, any objective evidence that conflicts with their opinions is not worth understanding.

  6. Charles Winter says:

    Let’s add a friendly amendment to Graham-Cassidy: Eliminate the Congressional health care plan. These people can certainly afford to buy insurance on the private market, and they surely don’t want to give the impression that they’re being better treated than the people who voted for them.

  7. says:

    Senate Republicans Aren’t Just Aiming To Destroy Obamacare And Medicaid; They Want To Provide A Death Blow To Any Future Health Care Reform / the worse and saddest part about this is the gang of pinheads =GOP and DUM 45 rather let the people that put them all in office suffer as thy give the greedy bastard’s 1 & 2% rich the money that will save heal and protect the people of the country . hey GREEDY BASTARDS RICH with out all the people you wouldn’t be the GREEDY BASTARD RICH in the first place . so as you take your greedy dirty money that will end the lives of the ones that got you to where you are at today

  8. Beethoven says:

    With the loss of Sen. McCain’s vote, it looks as if this bill won’t get passed. But the Republicans in Congress are not going to give up. The real foundation of the problem is that certain billionaires who have been giving right-wing Republicans large campaign contributions have threatened to cut off their campaign support, or switch it to a primary challenger, if the Republicans in Congress don’t make good on their promise to dismantle ObamaCare and use the federal savings to give those billionaires the huge tax cut they are demanding. So the Republicans are caught between a rock and a hard place: do they give their billionaire supporters what they are demanding, and risk losing the next election because their voters are fed up; or do they give their voters what the voters want, and risk losing their campaign dollars and possibly a primary election. They are gambling that the public won’t realize that their bill has screwed up health care to the point that only wealthy people can afford it.

    If this bill passes, we can expect the following: premiums for medical insurance will rise very quickly, as fewer and fewer people are able to afford the premiums, so the insurance companies will have to charge each customer more to make up for the loss of customers. Many hospitals, especially those in rural areas, will be closing; they are required by a law passed during the Reagan administration (with Reagan’s support) that requires them to treat anyone who shows up needing treatment, regardless of whether that person has insurance or the means to pay the bill. As a result, the hospitals will have to provide services to more people (the ones who would have gone to a physician rather than an ER if they had been able to pay the doctor), yet they will have much less income to cover their expenses, because they won’t have Medicare and Medicaid covering a large part of their budget. Many nursing homes will be closing, for the same reason: they rely on Medicare and Medicaid to cover the costs of a vast majority of their patients and when they lose that source of income, they won’t be able to remain in business. What will happen to those patients; will they be dumped on the streets? If they have family, their family will be expected to take up the slack, which will mean many people having to quit their jobs to stay home and care for an elderly, very sick, family member with high medical bills. Many people will put off getting medical care for problems they can live with, until those problems get much worse and have to be taken care of at much greater expense to simply keep alive.

    Most of the other advanced, industrialized countries of the world have implemented systems of national health care that enable all their citizens to get good health care at little or no cost to the individuals because the health care is paid for with taxes, and what they pay for their better health care is less than we pay in America. In America, too many of our voters have such an aversion to paying taxes that they would rather pay thousands of dollars in higher health bills for mediocre care than to pay hundreds of dollars in taxes to guarantee adequate health care for all citizens.

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