Nel's New Day

June 22, 2017

Senate Trumpcare: ‘Mean and Meaner’

After weeks of secrecy, the Senate version of Trumpcare is out, and police dragged protesters from the hall outside from Majority Leader Mitch McConnell’s (R-KY) door. Many of them were disabled in wheelchairs and on respirators. Over 40 people were attacked and arrested, and photographs showed blood on the floor of the hall. Photographs and video here. These protesters aren’t alone: Trumpcare has only a 17 percent approval rate in the country and no majority in any of the 50 states.

 SAUL LOEB/AFP/Getty Images)

GOP senators said that their bill would not be as cruel as the House bill passed last month, but it is more “mean,” to use a word from Dictator Donald Trump (DDT). Republicans said that they had to pass a repeal of “Obamacare” to keep their promise, but it leaves most of the Affordable Care Act (ACA) bones while taking away the flesh. Four senators have criticized Trumpcare because it doesn’t do enough damage to most of the people in the United States.

The sole purpose of the bill was to take money out of health care for women, the poor and low income, the elderly, the sick, and any health person who becomes injured in order to give massive tax cuts to the wealthy, the health care companies, and the pharmaceutical corporations. People with incomes over $200,000 are the ones who benefit. The rich get over $600 billion while people on Medicaid lose over $800 billion. Forty percent of the tax cuts go to the top one percent: multi-billionaire Warren Buffet said that his tax bill would drop about $680,000 with the bill, a 17 percent reduction on his taxes. The top 20 percent will gain 64 percent of the cuts. No date is listed for the giveaway to the wealthy, but it’s retroactive to last December.

The pharmaceutical industry would gain $28 billion from Trumpcare to add to its massive profits, $83 billion last year alone. These companies are also among the biggest offshore tax dodgers; Pfizer, Johnson & Johnson, and Merck are three of the top ten U.S. corporations avoiding U.S. taxes.

In essence, Trumpcare is only an income-distribution plan.

The bill will meet the requirement of lowering the deficit by a few billion because people will no longer have the benefits of the ACA. Like the House bill, the senate Trumpcare will take insurance from tens of millions of people, remove guarantees for pre-existing conditions, and force massive increases in premiums and deductibles.

Bill highlights:

  • No ACA mandates.
  • Elimination of taxes for wealthy and corporations.
  • Disappearance of Medicaid expansion throughout the next few years. In eight states—Arkansas, Illinois, Indiana, Michigan, Montana, New Hampshire, New Mexico, Washington—phasing out Medicaid automatically ends any expansion and cuts off currently enrolled people.
  • Limits on Medicaid spending with per capita caps or block grants for states, allocating a specific amount of money no matter what the actual costs of care are. Caps are tied to general rate of inflation, meaning a smaller percentage of the actual cost of care each year. States can also use this funding for purposes other than health care.
  • Waivers allowing states to sell insurance without the Ten Essential Benefits that include hospitalization, emergency care, mental health, lab tests, maternity and pediatric care, etc. People can pay lower premiums to get minimum health care from insurance, leaving them with much higher medical costs. Low- and middle-income Americans will spend significantly more for less coverage.
  • Elimination of tax credits by 2020.
  • Repeal of ACA’s cost-sharing subsidies by 2019. Until then subsidies are reduced to 350 percent of the poverty line from 400 percent, providing help to fewer people. People would have to spend as much as 16.2 percent of their income on premiums instead of no more than 9.5 percent.
  • Reduction of covered medical costs to 58 percent, down from the ACA 75 percent.
  • Shift to Medicaid spending growth to general inflation rate, much lower than medical costs inflation.
  • Work requirement for Medicaid recipients except elderly, pregnant women, and people with disability.
  • Elimination of Medicaid payments to Planned Parenthood.
  • Limitations on insurance for abortions, making it almost impossible to purchase.

Most of the 13 senators on the committee who supposedly wrote the 142 pages of Trumpcare were not aware of its contents during the process. [These 13 white men average over 60 years of age and more than $1 million in assets.] One member, Sen. Mike Lee (UT), said on Tuesday that he had not seen the bill that is “apparently being written by a small handful of staffers for members of the Republican leadership in the Senate.” Trumpcare must get a vote by the end of next week, according to McConnell. He will allow no testimony from experts and no input from the public. The debate will be limited to ten hours.

Republican senators claim that their bill stops denial of insurance for people with pre-existing conditions. In reality, premiums will be too high for people to afford. An analysis of the bill shows that older people could see their premiums increase by more than 700 percent.

Women will suffer from Trumpcare with lack of birth control to maternity coverage. Medicaid now pays for half of all births in the United States, including two-thirds of unplanned births. Women in the U.S. have some of the worst maternal health and mortality outcomes in the industrialized world, and life expectancy for women is going down.  Trumpcare allows the nation to return to the days when only 11 states required maternity coverage on individual and small-group markets. At that time, 88 percent of individual plans failed to provide maternity coverage.

Another highly vulnerable population is disabled and elderly people living in nursing homes who depend on Medicaid. With federal spending reduced by 25 percent, states will be able to cover millions of fewer people. Medicaid also pays for opioid treatment in the current epidemic. Trumpcare allocates $2 billion in 2018 for treatment and recovery services but nothing beyond. Sens. Rob Portman (R-OH) and Shelley Moore Capito (R-WV) have requested $45 billion over the next ten years, and experts say that $19 billion a year is needed for the addiction crisis that results in hepatitis C, HIV, and bacterial endocarditis.

Rural people will be hard hit with Trumpcare. Their hospitals are partly keep afloat by Medicaid funds because hospitals are required to care for people whether they have insurance or not. At least 79 rural hospitals have closed since 2010, and another 700 are at risk. Trumpcare wants to remove $834 billion in Medicaid, and DDT takes another $610 billion cuts with his budget. The loss of hospitals means not only less health care but also fewer jobs and lowered property values.

Republicans complained about the secrecy of passing the Affordable Care Act when the ACA had over 100 hearings and involved hundreds of interested parties during more than a full year. Both the House and the senate bills for Trumpcare were more secret than the Russian hacking. Democrats always clearly stated the purpose for the law, but Trumpcare supporters can’t even come up with a logical reason for the bill. They just repeat that they want to repeal “Obamacare.”

Hopefully, senators will have to face constituents during the summer recess. Twenty GOP senators represent 14 states that accepted Medicaid expansion. Over 30 percent of people in Sens. John Kennedy’s Louisiana, John Boozman and Tom Cotton’s Arkansas, and Mitch McConnell and Rand Paul’s Kentucky are Medicaid beneficiaries. More than one-fifth of those living in eight of the other states with Republicans senators are enrolled in Medicaid.

In explaining the House Trumpcare bill, used as a pattern for the senate bill, Rep. Mo Brooks (R-AL) said:

“It will allow insurance companies to require people who have higher health care costs to contribute more to the insurance pool that helps offset all these costs, thereby reducing the cost to those people who lead good lives, they’re healthy, they’ve done the things to keep their bodies healthy. And right now, those are the people who have done things the right way that are seeing their costs skyrocketing.”

Using Brooks’ statement as a guideline, he should tell Rep. Steve Scalise (R-SC) after he was received at least three surgeries from the recent shooting in Alexandria (VA) that he should have done a better job keeping his body healthy. Scalise now has at least one pre-existing condition—and probably many more—from the shooting. Fortunately, however, the people losing health care are paying for his health insurance.

The Republicans have trapped themselves. They can’t pass a repeal of the ACA if it needs 60 votes in the senate so they put it into a reconciliation process that requires only 50 votes. They can’t pass a reconciliation measure if it doesn’t have the budgetary savings as the House bill so they cut hundreds of billions of dollars that have helped people. They can’t “add some money to it,” as DDT suggested. So they end up with another bill that, added to the House bill, is “mean and meaner,” as Sen. Jeff Merkley (D-OR) said. [Right: Sen. Chuck Schumer (D-NY) speaking on the floor of the senate.]

The 142-page bill is available on line.

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1 Comment »

  1. Oh, no. I just saw this. These photos and videos reflect the cursed unhealth plan.

    Like

    Comment by Lee Lynch — June 23, 2017 @ 12:10 AM | Reply


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