Trumpcare, Ryancare, Trashcare: While the GOP celebrates its found money, the poor will get sicker and die

With the AHCA, the Republicans have put a price tag on the lives of America’s working class: $300 billion

Trumpcare, Ryancare, Trashcare: While the GOP celebrates its found money, the poor will get sicker and die
(Credit: AP/Susan Walsh)

Trumpcare, Ryancare, Trashcare — whatever you want to call it, the American Health Care Act is nothing more than a cheap stab at Barack Obama, a petty attempt on the part of grudge-holding Republicans, including President Donald Trump, to try to diminish Obama’s legacy. They can try, but that will be impossible — Trump’s follow-up act has been so bad so far that he’s making George W. Bush look practically Lincoln-esque. But let’s set legacies and agendas aside for now and focus on health care.

“We have come up with a solution that’s really, really, I think, very good,” Donald Trump has said. “It’s an unbelievably complex subject. Nobody knew that health care could be so complicated.”

I’m not a president or a billionaire. I could never afford the kind of routine checkups that Trump has access to from award-winning physicians with platinum stethoscopes and solid gold scalpels — or even a state-of-the-art Viking fridge stocked with spare teenage hearts and kidneys, all plump and ready to be inserted when Trump’s conk out. He’ll probably live to be 360 years old as a result. Most of us don’t have that experience, and the president, just like the congresspeople and senators who are aimlessly playing with the lives of their constituents by threatening to kill Obamacare, is taken care of. They have amazing health care coverage that we, the taxpayers, fund. Strangely, that never makes it into the conversation.

Is Obamacare perfect? Absolutely not. But it has already saved the lives of millions of people. People who would have never voted for Obama are calling him a hero, even as some die-hard right-wingers praise the Affordable Care Act for saving their loved ones, not realizing that it’s the same as Obamacare.

Trump loves his catchphrase, “Make America great again.” Obviously he doesn’t understand that “great” is a process that we must constantly work toward. Greatness is edited, nurtured and achieved after recognizing what works and what doesn’t. Scrapping Obamacare and replacing it with a trash plan that will leave millions of people who were born without the luxury of being Trump-level rich uninsured is not making anything great. It’s evil. According to the CBO analysis, the AHCA would “reduce federal deficits by $337 billion over the coming decade and increase the number of people who are uninsured by 24 million in 2026 relative to current law.” And every Republican is running to the cable news networks, bragging about saving $300 billion. What does that mean to the person the Wall Street Journal described, a 62-year-old person who makes $18,000 a year who will now face premiums of up to $20,000?

Imagine a sickly elderly woman running home from work to her family to share with pride that the government just saved $300 billion. There is nothing more important than that to the government, even if it means that you’re broke, your granddaughter is pregnant because she couldn’t get birth control, and your grandson overdosed and died because he couldn’t be treated for his prescription drug addiction, which he developed to self-medicate his depression over the factory jobs that Trump promised never coming. We should all celebrate because the government saved $300 billion? That’s $300 billion that regular people will never touch.

People will not be treated for their illnesses. Many will suffer, and some will die. But at least the GOP beat Obama!

D. Watkins is an Editor at Large for Salon. He is also a professor at the University of Baltimore and founder of the BMORE Writers Project. Watkins is the author of the New York Times best-sellers “The Beast Side: Living  (and Dying) While Black in America” and “The Cook Up: A Crack Rock Memoir.”

Trump’s Medicaid assault: Now he’s gutting a social program he promised to protect

The White House plans to slash Medicaid funding and kick people off the program — that’s not how Trump campaigned

Trump's Medicaid assault: Now he's gutting a social program he promised to protect
(Credit: AP Photo/Pablo Martinez Monsivais)

For a long time now, Donald Trump has broadcast to the world that he is different from other Republicans when it comes to the social safety net. While most Republican candidates in the 2016 presidential race hugged the party orthodoxy that called for cuts to and restructuring of social programs, Trump positioned himself as a champion of entitlements.

“I was the first & only potential GOP candidate to state there will be no cuts to Social Security, Medicare & Medicaid,” Trump tweeted a couple of months before entering the 2016 race. “The Republicans who want to cut [Social Security] & Medicaid are wrong,” he tweeted in 2015. After joining the race, Trump was similarly outspoken in his defense of government protections for the poor and the sick.

Throughout the 2016 campaign, Trump defended the idea of using government resources to provide low-income people with health care, insisting that he didn’t want to see anyone “dying in the middle of the street.” When asked how he would go about providing that assistance, Trump pointed to Medicaid. “We have to go and help them through the Medicaid system,” Trump said in September, when asked how he would provide coverage to people who can’t afford private insurance. “A lot of people said, ‘Oh, gee, that’s not the thing to say.’ I said, ‘Well you know what? If I can’t say that, I’m not running for office.’”

The casual observer might walk away from all these statements believing that Trump supports Medicaid and has no intention to do any damage to the program. But at the same time that Trump was campaigning as a Medicaid supporter, he was also pushing to fund the program through block grants, which would slash its finances and force people off the rolls. As president, Trump has continued this war on Medicaid.

Much of the violence that Trump plans to inflict on Medicaid will come through the American Health Care Act, the troubled health care reform bill that Republicans have offered as their “replacement” for the Affordable Care Act. The bill, which Trump and his administration strongly support, calls for a halt to the ACA’s expansion of Medicaid in 2020, and it would place per capita restrictions on the amount of federal funding that states can receive for their Medicaid programs.

All told, per the Congressional Budget Office, the AHCA amounts to a Medicaid funding reduction of $880 billion over the next decade. That’s a massive cut, and it would undoubtedly result in millions of low-income Americans either having their benefits slashed or being kicked off of Medicaid altogether. The budget office found that 24 million people would lose their health coverage under the AHCA by 2026, and those losses “would stem in large part from changes in Medicaid enrollment.”

Trump and his administration want to accelerate this process and worsen it. As noted above, the AHCA currently calls for an end to Obamacare’s Medicaid expansion in 2020. But the White House, in its eagerness to win conservative support for the legislation, is apparently planning to pressure Republicans in Congress to move up that date to the beginning of 2018.

This week brought still more bad news on the Medicaid front. As The Wall Street Journal reported on Wednesday, the Trump administration has communicated to governors that it “will work with states that want to alter their Medicaid programs by imposing work requirements, premiums, emergency-room copayments and other changes.” Imposing work requirements on Medicaid eligibility is an excellent way to cut people off from health coverage without doing much of anything to boost employment.

The notion that Medicaid recipients are just sponging off the government is wildly specious. According to the Kaiser Family Foundation, 63 percent of Medicaid recipients are in families with at least one full-time worker, and an additional 14 percent are in families involved with part-time work. The Center on Budget and Policy Priorities noted that Medicaid, rather than discouraging work, can actually help low-income people find jobs: “Research indicates that comprehensive Medicaid coverage can support work and help beneficiaries take advantage of promising job opportunities without worrying about losing their coverage.”

Imposing a work requirement as a barrier to eligibility, as the Trump administration wants to facilitate, makes it far more likely that unemployed people will lose access to health coverage. If those people become sick and can’t seek treatment, they’ll be less likely to find work. Providing “vulnerable populations with needed care can improve their health, help stabilize their housing or other circumstances, and ultimately improve their ability to work,” the center added.

President Trump, however, is hell-bent on hollowing out the social insurance program’s funding and making it harder for low-income people to have access to health coverage. That’s a terrible policy and a broken promise, one that runs directly contrary to how Trump sold himself to the American public.

The Republican House of Horrors Offers a Terrifying Health Care Vision

Republicans have exploited the repeal-and-replace meme with paybacks to some of their wealthiest friends.

NATIONAL HARBOR, MD – MARCH 6, 2014: Congressman Paul Ryan (R-WI) speaks at the Conservative Political Action Conference (CPAC).
Photo Credit: Christopher Halloran / Shutterstock.com

Halloween arrived early this year featuring the Republican house of horrors seeking to fulfill their long lust to repeal the Affordable Care Act.

While there are legitimate criticisms of the ACA—notably the 28 million still uninsured and its failure to limit escalating out-of-pocket costs—the coverage gains made through the ACA, through Medicaid expansion and the crackdown on insurance abuses, are largely eviscerated by the GOP plan.

Instead we have a plan that again fetishizes a market-based health care fundamentalism that saw the U.S. plummet in a wide array of health care barometers, including infant mortality and life expectancy rates and people skipping needed care due to cost compared to the rest of the developed world, especially before the ACA.

With the hodgepodge plan hurriedly released Monday night, the House majority attempts to straddle growing public support for a government role in establishing health security for the American people and approval of the Tea Party crowd that views any fingerprints of public protection as akin to Satanism.

The bill fails on both counts, while also betraying promises made by candidate Donald Trump that “we’re going to have health care for everybody” that is “far less expensive and far better.”

The principal effect of the new bill will be the loss of existing health coverage for tens of millions of people, without any restraints on health care industry pricing practices that add up to massive health insecurity for the American people.

Pretending to retain popular components of the ACA, the bill offers refundable tax credits to replace the ACA subsidies to buy private insurance, temporary continuation of the ACA Medicaid expansion, and requiring insurers to sell insurance to people with pre-existing conditions. But it’s like fools gold, each component sabotaged by the not-so-fine print.

Some lowlights:

  • Medicaid expansion, the mechanism of most of the ACA expanded coverage, is temporarily retained, but open ended federal funding would be ultimately replaced by a cap on federal payments that would encourage financially strapped states to slash eligibility of those covered and sharply cut covered services.
  • Refundable tax credits would provide less financial support than the current ACA subsidies, and by most initial analyses provide far less help for low and moderate-income people.
  • A 30 percent premium penalty surcharge on people who allow their “continuous coverage” requirement to lapse completely undermines the false promise that the bill retains the ban on insurers denying coverage for people with pre-existing health conditions. Even through the ACA health exchanges, insurers routinely change plan designs yearly in ways to increase out of pocket costs and limit patient choice through narrower networks. The surcharge will increase insurer incentives to engage in these practices.
  • Cuts in minimum covered health benefits, services now required by the ACA. Those would expire in 2020.
  • Elimination of funding for Planned Parenthood is a significant attack on women’s overall health care. Planned Parenthood clinics provide a wide array of needed health services.
  • Reduced funding for public health. Elimination of the ACA’s Prevention and Public Health Fund will disproportionately harm low-income people and patients with chronic illnesses like diabetes and heart disease that will worsen the health of communities and facilitate the spread of infectious diseases. As reported today by Vox, affected programs include the federal vaccines program, and programs to reduce heart disease and hospital acquired infections.

The architects of the new bill have exploited the repeal and replace meme with paybacks to some of their wealthiest friends and donors.

The draft bill includes a roll back of most corporate and high income taxes used to pay for the ACA, and, “as Rep. Keith Ellison has noted, a tax cut for wealthy people’s investment income and tax deduction for health care CEOs making more than $500,000 a year.”

If you follow the rhetoric of the repeal-and-replace crowd, they pay a lot of lip service to restoring “freedom” and “liberty.” But their approach to health care restricts freedom in the most personal aspect of our lives: health care.

Freedom to choose junk insurance has nothing to do with getting the care we need. In fact, it is the false choice of a faux freedom. This bill lets insurance shape what procedures doctors do, what drugs we take, and even which doctors we can see.

Nurses know there is only one real fix for our broken, dysfunctional, profit-focused health care system—an improved Medicare-for-all system, much as the rest of the developed world assures health care for its people.

NNU’s California affiliate, the California Nurses Association, is sponsoring a bill in California that could become the national model as an alternative to both the ACA and the fraudulently named GOP American Health Care Act.

http://www.alternet.org/economy/aca-replacement-terrifying?akid=15277.265072.oPECsp&rd=1&src=newsletter1073557&t=8