Nel's New Day

March 14, 2017

Trumpcare: The GOP Killer Plan

The Congressional Budget Office has come out with the numbers for Trumpcare (excuse me, The American Health Care Act), and here’s the good news. The deficit could be lowered by $33.7 billion a year. Of course, that accomplishment come from moving costs to the state as well as taking people off Medicaid and government subsidies. For example, Oregon will have to pay 35 percent of health costs instead of the 95 percent that the federal government now covers.

The bad news for Trumpcare by the numbers:

  • 54 million individuals uninsured in ten years, double projections for ACA, according to a leaked White House analysis.
  • 24 million fewer people with coverage by next year.
  • 14 million more uninsured people in one year.
  • 14 million fewer people with Medicaid coverage in 10 years.
  • 7 million fewer people with employer-sponsored coverage in 10 years.
  • 2 million fewer people not buying health insurance each year.
  • 15-20 percent higher premiums in the first year than with ACA.
  • $880 billion cut from Medicaid over 10 years.
  • 15 percent of low income people without services to help women avert pregnancy because of defunding Planned Parenthood that results in thousands of more births. (Savings of $178 million for no care for these women would be offset by increase in Medicaid that pays for 45 percent of all U.S. births.)

Older Americans pay “substantially” more. At the same time, Trumpcare also takes away from the Medicare fund, causing it to become insolvent three or four years earlier than formerly projected unless positive action is taken.

Health insurance companies are encouraged to pay CEOs more because Trumpcare removes the ACA limit on corporate tax deductions for compensation. Under ACA, health insurance companies could deduct only $500,000 of the pay for each top executive making deductions for the companies only 27 percent instead of 96 percent. This limitation has been enough to buy dental insurance under the ACA for 262,000 people or pay the silver plan deductibles for 28,000. The 10 biggest insurance companies paid their top 57 executives a total of $300 in 2013. The provision to give them back the 96 percent was buried in six lines on p. 67, and even Tom Price, Secretary of Health and Human Services, seemed unaware of it until reporters inquired.

Republicans, claiming to be the part of smaller government, also have a provision in Trumpcare that employees without genetic testing as part of their workplace wellness programs can face large penalties in premiums. Existing federal laws don’t have this power because genetic privacy is protected. For example, the Kaiser Family Foundation could charge an additional $5,443 in annual premiums employer-sponsored family health coverage.

An oddity in Trumpcare is its obsession with lottery players, mentioned 11 times, the same number as Medicaid. Six of the 67 pages in the replacement plan focus on lottery winnings. Anyone getting at least $80,000 from the lottery or lotto would be kicked off Medicaid. To give you an idea of the savings, Michigan’s plan, withholding part of lotto winnings over $1,000 and not $80,000—saved $2 million.

Republicans have spent lots of time and energy criticizing the mandate that everyone purchase insurance. Trumpcare’s new system allows insurance companies to charge a 30-percent penalty after a break in purchasing coverage. It’s still a penalty: the only difference is that the money goes to insurance companies and not to the government. It also threatens destabilization of the individual insurance market.

Geographically, Trumpcare is disastrous for DDT supporters. The plan’s elimination of 0.9 percent for additional Medicare tax on wages and 3.8 percent surtax on investment income are only people in the top income stratum. John McCormick’s independent analysis of House Speaker Paul Ryan’s (R-WI) plan for Bloomberg states:

“Counties that backed him would get less than a third of the relief that would go to counties where Hillary Clinton won. The two individual tax cuts contained in the Republican plan to replace Obamacare apply only to high-earning workers and investors, roughly those with incomes of at least $200,000 for individuals and $250,000 for married couples. Taxpayers in counties that backed Trump would see an annual windfall of about $6.6 billion, (an) analysis of Internal Revenue Service data shows. In counties that backed Clinton, it’d be about $21.9 billion.”

The refund of this tax to the wealthy is what keeps the deficit reduction only $33.7 million when the massive cuts to benefits, including Medicaid, should come to much more. Getting rid of ACA’s taxes and annual fees would reduce revenues to the federal government by $592 billion over ten years. Just one person in the top 0.01 percent, for example, will get an extra $197,000 if the bill passes, and people in the top one percent will each get $33,000.

How Trumpers—and people at the same income level—will suffer from Trumpcare: A 64-year-old person with an annual income of $26,500 pays $1,700 a year in annual insurance premiums. Trumpcare will change that annual premium to $14,600 for equivalent insurance. The math makes it an increase of $12,900.

Ryan has made two strategic problems. He tried to push the bill through the House in three weeks; the ACA took over 16 months to pass after four months of groundwork. He also failed to involve any stakeholders. To pass ACA, Democrats developed support by convening health-care groups, largely the same groups that now strongly oppose Trumpcare. In retaliation, Dictator Donald Trump (DDT) is trying to minimize opposition from the American Association of Retired Persons (AARP) as just another flawed interest group. Their 37 million members comprise over one-third of the U.S. population over 50 years of age and are likely to be DDT voters. Bush’s 2005 struggle to privatize Social Security failed after AARP’s opposition.

http://www.msnbc.com/rachel-maddow-show/why-the-white-house-isnt-sharing-health-care-numbers-its-own?cid=eml_mra_20170314   The White House has its own analysis of Trumpcare. A leaked report from Office of Management and Budget (OMB) shows numbers are even grimmer than those from CBO with 26 million people losing coverage within the next decade instead of CBO’s 24 million. Although the White House called that report wrong, it hasn’t released anything in its place. GOP-confirmed OMB Director Mick Mulvaney, in charge of the health care legislation instead of the Secretary of Health, called the CBO estimates “just absurd” and said that “I don’t believe facts are correct.” DDT may have moved Price because Mulvaney, a founding member of the far-right House Freedom Caucus and former South Carolina U.S. representative, is more conservative than either Ryan or Price.

Congress may also take both health insurance and pensions from retired coal miners. After 22,600 miners retired, the company in charge of their health care gave it to another company that declared bankruptcy and was relieved of responsibility for retiree health care. Both companies finally agreed to pay into a special fund for retiree health care benefits, but one of them stopped contributing. In addition, UMWA’s multi-employer pension plan, serving more than 90,000 retirees and their widows, became severely underfunded. The Miners Protection Act (MPA) uses federal funds to pay for threatened health benefits and strength the pension plan, but Senate Majority Leader Mitch McConnell (R-KY) blocked its inclusion for his own constituents in an omnibus budget bill. The four-month extension of health benefits is due to expire on May 1, 2017 if Congress doesn’t act on the bill. Democrats wrote DDT for support in January, but he didn’t respond.

Yesterday Sen. Bernie Sanders (I-VT) talked to some of these miners during a panel discussion in West Virginia. One of them thanked Sanders for his support regarding the bill and said to applause:

“I never dreamt that I’d get to thank you personally for the bill that you are co-sponsoring. I’m one of those miners that will lose his health care at the end of April if they don’t pass that law. I think it’s kind of ironic that a senator from the northeast takes care of my benefits better than someone like Mitch McConnell.”

Sanders told the crowd:

“The Republican bill, it should not be seen as a health care bill, because throwing millions of people off of health care [is not] health care legislation. What it should be seen as is a huge tax break for the wealthiest people in this country.”

Two months ago, DDT promised “insurance for everybody.” He and other Republicans claim insurance access to all—probably the same way that everyone has access to buy a Mercedes-Benz but don’t have the money. Price claimed that Trumpcare would “cover more individuals at a lower cost.” The only way that they can be right is for people to be consigned to crappy insurance plans that may not even cover hospital costs, just as they were before the ACA. To show how obvious DDT is about killing ACA, he sent out an email asking people to “share your Obamacare disaster story.” They have no interest in any success stories or needs from “hard-working Americans like you,” but people have been sending them anyway.

The clearest description of Trumpcare has been provided by comedian John Oliver..

 

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