Who will lose coverage under Trumpcare?

 

Here are nine people who will lose their coverage under Trumpcare and one who won’t:

1. a diabetic
2. a cancer survivor
3. an asthmatic
4. someone with allergies
5. a heart disease patient
6. an HIV/AIDS patient
7. someone with chronic lung disease
8. someone with Cystic Fibrosis
9. someone with Multiple Sclerosis
10. any member of Congress

List by:
Dr Cathleen Greenberg
Oregon Health & Science University
Residency Family Medicine
Yale University School of Medicine

Donald Trump literally knows nothing: The moronic fiction of his “really, really good” health care plan is now obvious

Trump’s idiotic pronouncements on health care can’t conceal that he has no plan and doesn’t understand the details

Donald Trump literally knows nothing: The moronic fiction of his "really, really good" health care plan is now obvious
(Credit: Getty/Saul Loeb/Eduardo Munoz Alvarez/Photo montage by Salon)

President Donald Trump’s ridiculous plan to repeal and replace the Affordable Care Act would be slightly less disgusting if we were confident that he knew what the hell he was talking about. Throughout the past two years, though, it’s impossible to point to a single instance in which anyone, including Trump’s staff and supporters, could say that he totally nailed the nuances of the issue. Not once — ever.

Sure, he’s regularly claimed that the ACA is collapsing, contrary to the recent scoring by the Congressional Budget Office. He’s also mentioned that the ACA is a disaster. Same situation. He’s mentioned that under his replacement plan, everyone will have coverage that he or she loves and will save a lot of money in the process.

Oh, and he said something about keeping the ACA’s language about pre-existing conditions and “children living with their parents.” He noted the latter on a small, seldom-watched show called “60 Minutes,” despite the fact that there’s nothing in the law about covering kids who live with their parents. Yeah, it’s one of the top two most popular aspects of the ACA, and he couldn’t accurately describe it:   The law allows adult children to stay on their parents’ insurance until age 26 — regardless of where they live.

Perhaps Trump’s ignorance about the law is allowed to slide because his supporters know even less about the ACA than he does. Though it’s not just when Trump talks about the ACA that he sounds like an eighth-grader bluffing his way through an essay exam. That describes everything he says about health care in general. The president who chose health care reform as his big legislative goal in his first 100 days doesn’t know anything about how health care works.

As part of his effort to resurrect a major legislative crash and burn, what’s been nicknamed “Trumpcare,” the president fielded a question last week about the status of his negotiations with the House Freedom Caucus, the far-right hotheads largely identified with members of the Tea Party.

During a joint press conference with the president of Italy, Trump said, “The plan gets better and better and better, and it’s gotten really, really good. And a lot of people are liking it a lot. We have a good chance of getting it soon; I’d like to say next week, but it will be — I believe we will get it, and whether it’s next week or shortly thereafter.”

Words have no meaning for Trump.

“It’s gotten really, really good” isn’t the language of a man who’s familiar with the details. In fact, he can’t say anything specific about anything related to health care, for two reasons. First, he just doesn’t know. Generally, the ongoing rule about Donald Trump is that he knows nothing. Second, the details of Trumpcare, at least in terms of what’s being discussed partly in secret, totally undermine his promises for universal, affordable coverage. Discussing those details out loud would expose the game. Oh and incidentally, “gotten really, really good” might sound familiar because it’s the same awkward phrase Will Ferrell once used in a George W. Bush parody video back in 2004 (check the YouTube clip at 40 seconds in). In other words, at least until recently, describing how things have “gotten really, really good” was merely a joke at the expense of stupid people. Now the actual president talks like that. Hashtag Make America Great Again.

Nevertheless, if Trump were to actually tell us what’s in the latest version of Trumpcare, he might have to acknowledge that there’s no legislative text; there’s no actual bill yet. Nothing exists on paper. He’d also have to acknowledge that this new iteration won’t be more affordable and indeed that many more people will be kicked off their insurance policies under the new “really, really good” version of Trumpcare than would have lost insurance under the now-defunct American Health Care Act.

Donald Trump literally knows nothing: The moronic fiction of his “really, really good” health care plan is now obvious.

The Washington Post’s Eugene Robinson called Trumpcare 2.0 “comically bad.” But that language understates the awfulness of what’s being debated. Robinson reported last week that proponents of this new version are claiming it would protect essential health benefits (covering things like “hospitalization, maternity and emergency care” according to Robinson) and protect people with pre-existing conditions.

But here’s the catch. States will be able to opt out of covering essential health benefits. We can assume most red states will opt out, not unlike the way they opted out of the Medicaid expansion, for no other reason than they hate Obama. Smart. (By the way, the new version preserves the slow phaseout of the Medicaid expansion.) States can also opt out of the pre-existing conditions language as long as they create “high risk pools.” Of course this is totally unacceptable because Trumpcare 2.0 doesn’t prevent insurers from charging dramatically higher premiums for people with pre-existing conditions — basically rebuilding the pre-ACA system of gouging and usury against people who need health care the most.

Making matters worse, especially in the near term, it appears as though Trump is planning to use subsidy payments to customers with existing ACA marketplace policies as potential ransom in the forthcoming battle over a potential government shutdown. To put it another way, if the Democrats don’t agree to support appropriations to build Trump’s ridiculous border wall, Trump will withhold subsidies for literally millions of ACA customers. That means Trump haters in blue states and, yes, Trump fanboys in red states, too. Everyone living below 400 percent of the federal poverty level will lose their subsidies unless the Democrats vote for Trump’s pointless wall, which (not insignificant) was supposed to be financed by Mexico.

If both sides fail to agree, the government will be shut down as of Saturday. So Trump is basically saying, “Yeah, I promised Mexico will pay for the wall. But now that I’m reneging on a major platform plank like the weasel I am, I’m going to hold the lives of millions for ransom.” Yes, this is the bargaining position of the chief executive who pledged in his inaugural address to be the people’s president. America first, etc.

Really, really gotten good? You decide.

Again, we have no choice but to wonder whether Trump has even the slightest idea what’s at stake. Does he know how many of his red-blooded MAGA-hat wearing loyalists will lose their subsidies in this ludicrous cash grab for the border wall? Do his loyalists know? I doubt it. Does he even understand how and why the ACA subsidies are distributed? Does he realize how obvious it is that he’s entirely clueless about what will happen in a government shutdown or that his health care plan will lead to far worse outcomes than the current situation — even if the ACA marketplaces collapse, as he has predicted?

Does he know that the marketplaces are only a part of a more comprehensive pair of Obamacare-related bills containing critically important consumer protections, which are supported by majorities of Americans? No way. He knows none of it. It’s worth repeating this maxim because the more we internalize it, the more we embrace the horror, the better: Trump knows nothing.

 

Bob Cesca is a regular contributor to Salon.com. He’s also the host of “The Bob Cesca Show” podcast, and a weekly guest on both the “Stephanie Miller Show” and “Tell Me Everything with John Fugelsang.” Follow him on Facebook and Twitter.

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.