June 28, 2017, Update
It’s not over, people. I wish it was, but Mitch McConnell is not easily deterred. He wants to win and he and his leadership team will be seeing what they can do to bribe or threaten their GOP colleagues into supporting their bill over the course of the next several weeks; and once they have the votes, they’ll bring it to the floor quickly.
In other words, if you care about this issue, you need to keep pressuring your GOP Senators not to backtrack in the coming weeks.
June 25, 2017, Original Post
Last Thursday Mitch McConnell finally released the Senate GOP’s version of healthcare reform. Of course, it’s not really a healthcare reform bill at all. As the New York Times noted: “It is, plain and simple, a plan to cut taxes for the wealthy by destroying critical federal programs that help provide health care to tens of millions of people.”
The Senate GOP bill throws the old, the sick, and the poor under the bus – and a lot of kids as well! It will deprive millions of Americans of health insurance entirely and raise premiums for many others who are older and sicker. It will also reduce benefits and raise costs as well as deductibles for still millions of others.
Think you may be one of those who benefits substantially from the tax cuts? Think again! You’ll save a pittance if you make between $200,000 and $500,000 a year and somewhat more if you make more than $500,000.
But the biggest benefits accrue to those making more than $1 million annually, people like Donald Trump and his family.
Some, like cartoonist Drew Sheneman (more of whose work is featured here), have pointed out that the Senate GOP proposal is not all that different from the version passed by the GOP-controlled House of Representatives.
But the truth is that the Senate GOP bill is worse than its House counterpart in at least one critical respect. It will do far more damage to the Medicaid program over the long term; and that’s really the key to the shell game Senate Republicans are playing.
The Senate GOP proposal immediately gets rid of all the taxes the Affordable Care Act imposed on higher income Americans to help subsidize insurance for those less well off. But the benefit reductions will take place much more gradually; and they will hit the Medicaid program especially hard.
Why should I care you may wonder? I’m not on Medicaid. That may be true, but someone you know may very well be.
Nearly one in five Americans, 74 million people, are on Medicaid, including a third of the nation’s children. Medicaid pays for half of all births and covers almost two-thirds of nursing home residents, including many who are middle class and spent all their savings on care before becoming eligible.
You can learn more about Medicaid here.
Congressional Republicans, who originally supported the program, have turned against it. They think it costs too much even though the Federal government spends hundreds of billions less on it annually than it does on the defense budget.
That’s why, starting in 2021, they want to change Medicaid from a Federal-state financing partnership that expands with need to a block grant program that doesn’t.
Funding would be capped at a set amount per Medicaid recipient. Of still more importance, starting in 2025 the Senate bill will begin to cut Medicaid deeper than the House bill as the cap on Medicaid payments would grow at a much slower rate than the inflation rate for medical costs.
Why 2025 you may ask?
First, McConnell and his Republican colleagues are counting on you to forget who was responsible for wrecking the healthcare system by phasing in the benefit reductions more slowly.
But with regard to Medicare specifically, pushing the timeline for the full effect of benefit reductions out to 2025 and beyond also has the effect of concealing the full damage being done to Medicaid by the GOP.
Because of the way the Congressional Budget Office typically scores bills it may not pick up some of the most devastating damage the Senate GOP proposal does down the road as inflation starts eating away at the program
This is a point discussed in far more detail by Jared Bernstein in an article well worth reading.
Of course, it isn’t just those on Medicaid who are harmed by the Senate proposal. For those who get insurance through a healthcare exchange, the Senate bill provides smaller subsidies to pay for less generous health insurance plans that will also feature higher deductibles.
Both GOP bills also defund Planned Parenthood for one year (the idea being to permanently defund it in separate legislation less constrained by the rules the Senate is operating under to consider this proposal; rules that prevent Senate Democrats from filibustering the bill).
In the end, the Senate GOP proposal is a $800 billion plus transfer of wealth to the rich and powerful, one of the biggest redistributions of wealth from less well-off Americans to the rich.
In fairness, of course, the Affordable Care Act (Obamacare) paid for its expansion of health care coverage by increasing taxes on the wealthiest Americans. And why not? To whom much is given much is expected.
In the end, when push comes to shove, it all comes down to what kind of a person you are. If you’re someone who believes more Americans should have access to healthcare, this is very bad bill indeed. If you are among those much better off and don’t care what happens to others, this is the bill for you.
The bottom line is clear. Millions of Americans will lose insurance coverage over time if this bill or its House counterpart are enacted. Many others will pay a lot more for coverage worth much less and with higher out-of-pocket deductibles. States will be given more flexibility to scale back essential health services.
That’s why these GOP proposals are opposed by AARP and virtually all of the organizations representing health care professionals.
“There has never been a rollback of basic services to Americans like this ever in U.S. history,” said Bruce Siegel, president of America’s Essential Hospitals, a coalition of about 300 hospitals that treat a large share of low-income patients.
“Let’s not mince words. This bill will close hospitals. It will hammer rural hospitals, it will close nursing homes. It will lead to disabled children not getting services …. People will die.”
Will it pass? Don’t bet against Mitch McConnell. Yes, some GOP Senators are saying they cannot support the bill in its current form. Much of this is just an elaborate charade to allow certain GOP Senators to offer amendments they will then claim improved the bill and justified voting for it.
But if the bill passes the game is over. We will have taken a colossal step back in time and become a much more mean-spirited nation when it comes to taking care of our own.
Meanwhile, the defense budget to support unwinnable wars in Afghanistan and the Middle East will continue to rise; and still another tax cut to benefit the rich and powerful will be the next order of business for Donald Trump and congressional Republicans.
One bite at the tax cut apple isn’t enough for them; and if that means wrecking our healthcare system in the process and becoming a meaner nation, so be it.