Nel's New Day

March 25, 2017

Health Care Won—At Least for Now

Eighteen days ago, House Speaker Paul Ryan (R-WI) talked to reporters about the newly introduced health plan written behind closed doors, probably by aides:

 “We will have 218 votes. This is the beginning of the legislative process. We’ll have 218 when this thing comes to the floor. I can guarantee you that.”

Yesterday, just seven years and one day after the Affordable Care Act was passed, the GOP plan, distorted during the past few days by providing even fewer services than the original, died. House Republicans had entered over 50 bills to kill the ACA, many of them passing after the GOP gained a majority in the chamber, but Ryan was positive that the GOP takeover of both Congress and the executive branch would guarantee his success. Yet the Party of No is helpless in the face of Yes. Their work involved no stakeholders, and Dictator Donald Trump (DDT) followed his usual pattern of bullying threats instead of actually selling the bill.

Massive loud protests against the repeal of the health plan, steadily growing in popularity, pushed more moderate representatives to vote against the bill for fear of retaliation in their own district from people who would lose coverage. The Koch brothers’ promised to defend anyone voting no when they ran for re-election after DDT said that no voters would lose the next election. By the end of the debacle, only 17 percent of voters supported Ryan’s plan.

DDT blinked and lost the game of chicken. He canceled the vote rather than suffer the embarrassment of losing, but it’s obvious that he lost. With no experience or clout to lead his party, DDT lobbied 120 congressional members, “left everything on the field” in negotiations, and lost. In his ghost-written book The Art of the Deal, DDT claimed, “You have to be very rough and very tough with most contractors or they’ll take the shirt right off you’re back.” He repeats that the negotiator needs “to be willing to walk away or, more precisely, convince the people you’re negotiating with that you are.” DDT didn’t realize that legislators aren’t contractors. Sen. Rand Paul (R-KY) did a training session for the House Freedom Caucus on DDT’s book, complete with poster.

During his campaign, DDT managed to con voters into believing that he knows “the art of the deal,” that he can be the closer. Ezra Klein explains why DDT as president is a loser:

“Trump is not a guy who makes particularly good deals so much as a guy who makes a lot of deals — many of which lash his name and reputation to garbage products…. He licenses his brand and lets others worry about the details of the products. Trump’s partners often end up going out of business and his customers often end up disappointed, but Trump makes some money, and he gets his name out there, and it’s all good.”

DDT wasn’t alone in the Trumpcare con; he had company from Ryan, who Paul Krugman called “The Flimflam Man.” Ryan lied when he said that Trumpcare would lower premiums, end the “death spiral,” and increase choice. Premiums would have skyrocketed unless people chose junk insurance plans with no coverage, and the extra 24 million people without insurance, along with people who couldn’t afford full coverage, would cause a death spiral. Ryan proposed a tax plan for the rich under the name of health care and failed.

The bill began with a high “age tax”—raising premiums and expenses for older, working adults—and added the “mommy tax” that greatly added expenditures for maternity coverage while diminishing its availability. Asked about people living in a state that doesn’t require maternity coverage in insurance, OMB Director Mick Mulvaney said, “Then you can figure out a way to change the state that you live in.” He clarified his statement by saying he didn’t mean move out of the state but to change the law. Republicans also ridiculed other insurance benefits for over half the nation’s population. For example, Alice Ollstein tweeted about her Kansas senator:

“I asked Sen. Roberts if he supports scrapping Essential Health Benefits. “I wouldn’t want to lose my mammograms,” he snarked.”

Ollstein survived breast cancer discovered during a mammogram for preventative care. These are the people–no estrogen and largely white–who met to decide what services should be cut for women.

[A bit of humor….]

Trumpcare was so bad that Ryan’s only solution in getting it passed was speed. The cruel additions to woo ultra-conservatives by eliminating Essential Health Benefits was added only the day before Ryan hoped to call a vote. Among the items as unnecessary health care are maternity and newborn care, emergency room services, hospitalization, prescription drugs, mental illness care, laboratory services and pediatric services.

DDT’s “skill” is to always blame someone else. Finger-pointing shifted so fast that digits blurred. DDT with DDT’s his chief of staff Reince Priebus and Ryan, accusing them of faulty content and bad timing. Secretary of Health and Human Services Tom Price also got blamed because he was put in the job to pass Trumpcare—although DDT assigned that job to Mulvaney. DDT claimed he wanted to start with tax reform that would have been “far less controversial.” (We’ll see!) Ryan was a popular scapegoat on the Fox network. The Wall Street Journal blamed the House Freedom Caucus for their “insisting on the impossible over the achievable,” and DDT took after this group too, telling them that he would tell their constituents that they were voting in favor of Planned Parenthood.

Despite 34 no votes from Republican representatives, DDT ultimately settled on the Democrats publicly when he whined that not one of them voted for Trumpcare, despite his failure to ask them for support. DDT and the GOP will continue to exaggerate any problems of the ACA, and the media will most likely focus on problems rather than the successes because a train-wreck films better than a satisfied person.  The GOP may also try to sabotage efforts to improve the ACA.

DDT is failing in office for the same reason that he succeeded in his campaign—weak party leadership. In a little over a day, he took a bill that no one likes and made it worse while alienating more members of his own party. In addition, he may have broken the law in his last-ditch try to save it. Tweets asking DDT supporters to call their representatives to save Trumpcare were sent by White House social media director Dan Scavino Jr, the official @POTUS account, and DDT’s personal account. The use of federal dollars, including paid White House Staff, in directly lobbying Congress to support or oppose a bill is against federal law. Press Secretary Sean Spicer used the Nixonian approach toward law by saying that the law is “not applicable to the president.” Scott Amey, general counsel at the Project on Government Oversight, disagrees because of the direct appeal to contact representatives in support of Trumpcare.

Hillary Clinton had a grand time tweeting the victories of people who need and like the “Obamacare” that DDT has daily excoriated in his daily message. Watching her is a reminder of how close the United State was to having a president who could “keep America great.”

DDT, Ryan, and the far-right Republicans aren’t the only losers with the downfall of Trumpcare. The wealthy won’t get their billions in tax cuts, and Wall Street won’t get the wealthy’s extra money. Insurance companies are also the losers, outside keeping funding for Medicaid. Big corporations would rejoice over getting rid of consumer protection rules that would have allowed them to vastly increase sales, marketing, and IRS deductions while selling junk insurance that wouldn’t have those “essential benefits”—like hospitalization.

One winner is DDT because Trumpcare would have lost over 1.2 million jobs—some people say as many as two million—that would have hurt his desire to be seen as the “jobs president.” GOP senators are winners because they don’t have to cast any votes on health care, at least in the immediate future. And constituents of Rep. Greg Walden, leader of the committee trying to destroy health care, are winners. In his rural district comprising two-thirds of Oregon, Trumpcare would have taken health insurance from 64,300 of his 684,200 constituents, almost ten percent of the people he represents. The remaining residents would have had far less access to the rural hospitals that need ACA money to stay open.

The next step is for Democrats to fight DDT’s “tax reform” shifting millions to himself and his wealthy friends. Meanwhile Democrats can introduce bills for improving ACA. The GOP won’t vote for them, but people will see that it can be fixed—and maybe vote blue in the next election.

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