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The latest shame

SoVaNow.com / July 27, 2017
Monday night I went to check the latest headlines on Politico’s website and spotted this stinker: “McConnell warns wavering Republicans on big Obamacare vote.” You might think that after so many hapless attempts to ram ever more odious Trumpcare bills through Congress, Mitch McConnell and Paul Ryan and the gang would get a clue and give up, but apparently not: “The GOP repeal bid sees a flicker of hope after being left for dead,” the Politico story blared underneath the main headline. In other words, Zombie Trumpcare continues to stalk the land.

I’ll try not to bore you with an overabundance of detail as to why the Republican health care bills (which collectively comprise what is known as Trumpcare) are so putrid. Here’s a quick rundown of things to keep in mind:

» Various versions of Trumpcare, House and Senate, would subtract $1 trillion from the healthcare system over the next decade and redistribute that money to America’s richest people (many of them GOP donors) in the form of tax cuts. Sorry to break the news, but you cannot slice up medical care by $1 trillion and not leave an ugly mark on the nation’s health and well-being. Obamacare famously relied on $700 billion in Medicare savings (none of which affected the program’s guaranteed benefits) to fund the new law — but whereas that money was redirected back into the health care system, Trumpcare is a straight-up, $1 trillion pound of flesh ripped from the body to feed to the sharks. It’s more wealth for the wealthy, bloody chum for everyone else.

» As for how that $1 trillion in Trumpcare “savings” would be achieved: Republicans are proposing to cut Medicaid by about $800 billion, with the rest of the money mostly taken from Obamacare cost-sharing subsidies to help people afford health insurance. If you think one of the biggest problems with Obamacare is the high cost of premiums, watch out: you ain’t seen nothing yet.

» This is especially true if you’re getting up there in years: Whereas Obamacare bars insurance companies from charging more than three times what younger, healthier customers pay for the same policies, Trumpcare bills let insurers charge up to five times more. If enacted, this provision is going to present an especially nasty surprise to people in their forties, fifties and sixties (that is, before they reach the age of Medicare eligibility).

How nasty? According to a Commonwealth Fund analysis, everyone over 47 will pay higher premiums under Trumpcare. That’s you, me and the middle-aged person behind the tree. Is it conceivable that a few people in their fifties, for some obscure reason, might fare better under Trumpcare? I suppose so, although it seems unlikely. Either way, you can expect our Adolescent-in-Chief to whine about “fake news” reporting on the Republican bill. But take this to the bank, Trump voters: If you’re old enough to still read newspapers and you obtain health insurance outside of the workplace, the day will come when you’ll wish it was only “fake news” when Republicans voted to do away with Obamacare and replace it with this turkey of a bill.

Let’s look at the state of play here in Mecklenburg County, courtesy of an excellent interactive map provided by the Kaiser Family Foundation (kff.org). If you’re 60 years old, and earn more than 351 percent of the federal poverty level ($43,875 a year), you can look forward to paying around $12,000 a year for a Trumpcare plan that’s comparable to what you would receive under Obamacare. (The Obamacare premiums run around $5,000 annually). In some markets yearly premiums for this cohort will rise to nearly $18,000. No wonder everyone who examines the Republican legislation arrives at the same conclusion: rather than pay such exorbitant sums to keep their health insurance, people will simply exit the marketplace and go without. Taking that risk at age 50 or 60, voluntarily or not, will not work out well for a lot of folks.

» Folks with private insurance plans get hammered. What about people who are insured through Medicaid? And who are these people, anyway? A quick list of Medicaid beneficiaries includes the following: children enrolled in Virginia’s FAMIS program; senior citizens who reside in nursing homes; disabled persons of all ages; expectant mothers and women with newborn babies; and poor people. (This latter group represents a very small segment of Virginia’s Medicaid population due to the shameful refusal by General Assembly Republicans to expand the state’s program under the Affordable Care Act. States that are far more conservative than Virginia — Arizona, Louisiana and Kentucky come immediately to mind — have expanded Medicaid to cover the working poor with highly beneficial results.) It’s uncertain how each Medicaid constituent group will be impacted by Trumpcare, but what we do know is that much less money will be available in the future to take care of their needs, if this abomination of a bill passes. Someday we may find ourselves confronting truly awful choices on who gets to go on Medicaid: desperately ill children or destitute seniors with nowhere else to turn. Because Congressional Republicans also want to turn control of Medicaid over to the states, as a bonus we may even end up with hacks like Frank Ruff serving as the program’s gatekeepers. Oh the horror.

This stuff just scratches the surface. Depending on the final form the bill takes, there’s a real chance Trumpcare could decimate the market for private health insurance in the U.S. entirely. There’s also a significant risk that its provisions will spill over into the world of employer-provided health insurance, undermining that system in ways we can only guess at for the moment. You would think enough Republicans would shudder at the possibilities to say, “Let’s slow this Trumpcare business down and think through what we’re doing.” Alas, if you believe this, you might well be wrong.

On Tuesday, the Republican-controlled Senate voted 51-50 (with Vice President Pence casting the tiebreaker vote) to open debate on Obamacare repeal bills that are floating around, although the two versions that have come up for votes so far, late Tuesday night and Wednesday, went down to resounding defeats. There are 52 Republicans in the Senate; only two (Maine Senator Susan Collins annd Alaska’s Lisa Murkowski) have shown the guts and gumption to stand up to this Trumpcare nonsense. Few if any Republicans seem to believe that they’re actually doing right by the American people, but cowardice levels are so high that no one (aside from the aforementioned female Senators) will cop to the fact that seven years of Obamacare-bashing by the GOP has been a scam of epic proportions.

And what about the White House major domo who has privately described the Congressional health care legislation as “mean”? Because our president is an infantile moron, he spends his time preening in front of a captive audience of Boy Scouts rather than trying to fulfill his promise to make health care great for everyone. Trump gave a speech Monday in West Virginia to the Boy Scout Jamboree that embarrassed the entire Boy Scouts of America organization by mere association. If this latest outrage — just the latest of many — leaves you in a helpless-feeling state, resist that thought, and fight back instead.

Your first chance comes in November when Virginia Democrats and Republicans will vie for the Governor’s Mansion and control of state government. True, there’s not a direct line connecting the Obamacare debate in Washington with the battle for Richmond, but if blunt-force messaging is the only way to convey dissatisfaction, then blunt force is what one must use. With their actions in Washington, Republicans have surrendered any claim to honor and decency. It’s time to let the party know that there is a cost to be paid for such shameful behavior.





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