What A Trumpcare Nightmare: Just About Everyone With Health Care Is Going To Pay More, Get Less And Face Chaos
Reprinted with permission from Alternet.
The buzz hadn’t even worn off the Republican fratboys chugging beers to celebrate the House’s passage of its latest Obamacare repeal before the political hangover started surfacing.
While this motley crew was drinking Bud Light before trekking to the White House to bask in President Trump’s winner’s circle, the Washington Post’s editorial page—no bastion of liberalism—trashed this flock as venal lying political hacks.
House Republicans “betrayed” Americans by promising they would “maintain access to health insurance for people with preexisting medical conditions, and then on Thursday press[ed] a bill through the House that would eliminate those guarantees,” the Post said. “What a joke,” they continued, as a once-respected Republican “objects to the loss of protection, and then pretends that a paltry $8 billion over five years will fix the problem.” Paul Ryan’s leadership? “What hypocrisy,” they said, for a vote made “before the Congressional Budget Office can tell lawmakers what it will cost or how many people will lose access to health care as it takes effect.”
The list of deplorables that can aptly be applied to the House Republicans’ effort to destroy Obamacare and give a half-trillion-dollar tax cut to the rich, the health insurance industry and drug makers in one fell swoop is long and deserved. But for millions and millions of Americans who might be on the receiving end of this nightmare—where just about everyone with health insurance is going to pay more, get less and face chaos where it need not exist—there is a slightly hopeful sign.
The Senate, where, as has been the case 60-something times since 2010 when Obamacare was first passed, now takes up repeal legislation. Those in the know say there’s no chance it will emerge as passed by the House, if it emerges at all. Only seven Republican senators tweeted reactions in the first two hours after it passed the House by a party-line 217-213 vote, including 20 GOP defections. Sometimes silence speaks louder than gloating and beer guzzling.
Senate Republican Leader Mitch McConnell just said, “Job well done.” Senate Finance Committee Chairman Orrin Hatch’s statement ended, “We must manage expectations and remain focused on the art of the doable as we move forward.” As soon as he put a link to his remarks on Twitter, he was slammed.
“This is what you’re proud of?” wrote ConcernedCitizen. “If you have #cancer, like I do, this is a death sentence,” said Victoria Brownsworth. “If you are so proud of this legislation, hold a town hall and defend it,” added Nick Pinnau. “So, where’s the replacement? You’re angering your constituents,” said Jinoru.
What Have House Republicans Wrought?
You get the idea. The House’s bill may be a legislative shipwreck headed for the Senate’s shoals, but the Washington Post’s editorial writers said this Republican crew was messing with fundamentals of the U.S. economy and sending signals that unscrupulous players in the insurance and pharmaceutical industries had little to fear from unduly profiting from the pain and suffering of sick Americans.
“Carelessly, the bill would threaten the integrity of even employer-based health-care plans in every state,” they wrote. “Tragically, the repeal-and-replace effort is causing so much uncertainty that, even if this bill dies in the Senate, it may unravel the existing health-care system.”
How can that be? Republicans made no effort to fix the institutional barriers that caused problems with Obamacare—such as letting rural states to form interstate compacts to create larger pools that would attract more private insurers. Instead, they pursued a scorched-earth plan to deregulate the insurance industry despite protests from every medical and patient advocacy group in America that such a move would lead to higher costs and less coverage. They didn’t stop there.
They went further and used the repeal legislation to take more than $800 billion away from state-administered Medicaid programs over the next decade, which serve millions of children and provide nursing home care for the elderly—not simply offering the poor a health care safety net. They also repealed the law’s income tax surcharges on the wealthy that funded the law’s subsidies while additionally giving tax breaks to insurers and drug makers.
As the Post noted, the Congressional Budget Office did not “score” the bill, or provide a non-partisan analysis of its costs and impacts. But many advocacy groups and Democrats did on the House floor Thursday. Their prior bill, which Ryan pulled before a vote in March, would leave 24 million people without the coverage they now have. The latest bill goes further and says states can seek waivers—the technical process it lays out—to allow insurers to reject selling policies to people with pre-existing conditions. Democrat after Democrat said there were more than 100 million Americans in this category. It’s anyone who’s had a sickness worse than a common cold and everyone over age 50.
Before the House began its series of votes, members of Congress and the public were discovering other fine print in the hastily drafted legislation that included even more brazen cuts and giveaways to corporate America than they knew.
The biggest example, first reported in the Wall Street Journal, allows insurers to lessen the benefits covered in policies provided by employers to employees. These are not people covered under the Affordable Care Act, or Obamacare, at all, but who benefitted from the ACA’s minimum coverage provisions.
“Many people who obtain health insurance through their employers—about half of the country—could be at risk of losing protections that limit out-of-pocket costs for catastrophic illnesses, due to a little-noticed provision of the House Republican health-care bill to be considered Thursday, health-policy experts say,” the WSJ report began. “Insurers in states that obtain the waivers could be freed from a regulation mandating that they cover 10 particular types of health services, among them maternity care, prescription drugs, mental health treatment and hospitalization.”
This was not the only surprising analysis that’s appeared in the past 24 hours. A New York Times report noted how the bill will take billions away from K-12 public schools that’s now used for special education, where specialists are hired to help children with developmental disabilities.
“The new law would cut Medicaid by $880 billion, or 25 percent, over 10 years and impose a ‘per-capita cap’ on funding for certain groups of people, such as children and the elderly—a dramatic change that would convert Medicaid from an entitlement designed to cover any costs incurred to a more limited program,” the Times reported. “School districts receive about $4 billion in Medicaid reimbursements annually.”
An economic analysis by Americans for Tax Fairness and Healthcare for America Now, both progressive coalitions, broke down how the Obamacare repeal bill was a massive giveaway to the wealthy, insurers and the drug industry at the expense of people who are now covered or would see premiums skyrocket. House Minority Leader Nancy Pelosi said the GOP’s legislation was a tax cut masquerading as health care reform, which their numbers confirmed.
“The GOP plan will deprive 24 million Americans of healthcare coverage and drive up the cost of coverage for millions more, especially older people and people in rural America,” their summary said. “At the same time, it will create tax breaks worth about $600 billion that will mostly go to health insurance companies, prescription drug manufacturers and the wealthy.”
Their analysis gave this breakdown. The House GOP’s “winners” are:
• Tax cuts: Gives $600 billion in tax breaks, mostly to the rich and corporations;
• Millionaires: Get a $50,000 tax break each year from repeal of the ACA’s taxes on the rich. A total of $275 billion in tax cuts goes mostly to the richest 2%;
• 400 Richest Families: Each gets a tax cut of $7 million a year, on average;
• Insurance Companies: Get $145 billion in tax breaks over 10 years;
• Drug Companies: Get $25 billion in tax breaks over 10 years;
• Richest 2%: Get a $117 billion tax cut by eliminating a small Medicare tax on couples with incomes above $250,000 a year.
The “losers” are:
• Health Care Cuts: Takes health care away from 24 million Americans;
• Low-Income Americans: Loss of $275 billion in revenue from wealthy tax cuts plays a big role in 14 million low-income kids and seniors losing Medicaid coverage;
• Workers: 7 million will lose health care coverage from their employer;
• Older Americans: Health insurance companies could increase premiums by up to $13,000 for older Americans;
• Patients: No protections from huge drug price increases by pharmaceutical companies;
• Medicare beneficiaries: Loss of $117 billion in revenue from wealthy tax cut shortens Medicare’s ability to pay full benefits by three years.
Republican Extremism Is Now Mainstream
It is breathtaking that this level of extremism is now the political mainstream in the Republican-controlled House. No Democrats voted for the bill. Twenty GOP members voted no. Republicans, in speech after speech, ignored their bill’s real life consequences but offered vague platitudes of limiting government, expanding freedom and letting people decide what’s best for them—as if average Americans have any clout in negotiating with health insurance corporations.
“Today this House has an opportunity to do more than fulfill a promise,” Ryan said, making the GOP’s closing argument. “We have the opportunity to show we have the resolve to tacking the big challenges in this country before they tackle us. To stop the drift of arrogant big-government policies in our lives and begin a new era of reform based on liberty and self-determination. Giving people choices.”
Pelosi slammed the moderate Republicans who were about to vote yes.
“Our members and colleagues who have the mantle of being a moderate, if you vote for this bill, you have walked the plank from moderate to radical,” she said. “And you’re walking the plank for what—a bill that will not be accepted by the United States Senate? Why are you doing this? Do you believe in what is in this bill? You said they’ll fix it in the Senate. But you have every provision of this bill tattooed on your forehead. You will glow in the dark on this one.”
The bill’s passage is perfectly emblematic of the direction that Trump and the extremist Republican mainstream is taking America. The Washington Post said it was pathetic that such irresponsible legislation is being called a major victory.
“This process began with Republicans seeking to solve a problem that exists only in their imagination, the supposed catastrophic failure of Obamacare,” their editorial page said. “Their solution has involved half-baked legislative language and magical thinking at every step. It is beyond sad that this is what passes for a ‘win’ for President Trump and the Republican majority in Congress.”
But John Lewis, the Civil Rights Era icon and Democratic Georgia congressman, had a more earthy and somber take. He tweeted, “Never have I seen legislative action that reveals such clear disdain for the human dignity of the most vulnerable among us.”
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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