Trump’s Butchering of Obamacare

New Orleans  For all the pluses and minuses of any debate on the Boy Scouts, they taught me one life lesson that I wish President Trump had also learned: don’t play with knives! Looking at the way he is trying to mindlessly hack away and butcher the Affordable Care Act, there is little doubt that this is a guy without a clue or a care about the damage that cutting can do.

In the last week unable to bend Congress to his whim or will, he’s signed one executive order after another in an attempt to gut coverage for millions. Recently one order will allow low-balling, bottom of the barrel policies without the Obamacare minimum standards to be sold. Now he’s also signing one that would cutback on support for lower income participants on subsidies and payments to insurance companies through cost sharing participation. Earlier, he drove a hole through the requirement that coverage for contraception be included if institutions offer the flimsiest objection. He has also effectively defunded outreach and navigation for people enrolling with the next open window only weeks away.

Admittedly, the President could care less about the consequences of these decisions. None of them will hurt anyone he knows or likely has ever known his entire privileged life. Seven million people, including many in red states like Mississippi and Alabama that are part of his hardcore support, will be hurt badly by these orders. Working with his political advisers, rather than any voices from public health sectors, he has probably made two calculations on the impact. First, that many of these people in the red states who are going to be hurt are lower income African-Americans and Latinos, who are less and less likely to ever cast a vote for him any day in the future. Hey, that’s the whole point of voter suppression programs by the Republicans anyway. Secondly, he probably sees – correctly – no prospect of a competitive alternative emerging to him in the Republican primary, given the knee jerk opposition there has been to Obamacare for years anyway. He’s sitting in the White House, essentially saying, “What me worry?

Reports indicate that there is some rumbling among Republican officeholders in Congress who might actually have to pay a price for Trump’s butchering of the Act. Trump, as always, takes no responsibility for his own actions, claiming he is hoping some of his hacking will force the Democrats to beg him to negotiate on the Affordable Care Act. As long as he insists on bargaining in bad faith where the only open door is repeal-and-replace, that’s not going to happen. The Democrats are clear all this pain and suffering is now on his shoes, so I’m not holding my breath.

One way or another he has once again forced the Act into the middle of every mess coming forward on the calendar. The lesson on playing with knives is that you can seriously hurt yourself. This may be a lesson Trump is going to have to be forced to finally learn, if we have folks willing to school him both at home and at the Capitol.

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The Zombie Apocalypse of Republican Health Care Proposals

Newark  I don’t really watch these “living dead” zombie shows, but I’m starting to get the picture by following the various Republican proposals to “repeal and replace” the Obama Affordable Care Act. Here’s my question though? In the movies and television shows are each generation of zombies more disgusting and worse than the ones that came before them?

Certainly that is the case with the so-called Graham-Cassidy bill to take one more shot at this for the right wing before they would have to obtain more than a simple majority of Senators to push these horrors onto the American people. September 30th is the “expire by date” on the Republicans ability to make mischief with 50 votes, rather than having to go bipartisan with a super-majority.

Let’s look at this version of the healthcare apocalypse though.

A spokesperson for Kaiser Healthcare said it was almost impossible to imagine a bill so bad that it hurt even more people and that had less support from anyone.

Blue Cross/ Blue Shield, AARP, and other insurers, who have been largely silent in earlier versions of the bill, have all mobilized to oppose this version because they argue it will wreck havoc with insurance markets by destroying a national system and making it a state by state battleground.

Thirty-six states will immediately get less money from the Graham-Cassidy bill, if it succeeds. The pain will be especially pronounced in some of the blue states like New York, California, and Oregon, and generally in those states that expanded Medicaid for their citizens, but even the fourteen states that might see themselves as “winners,” have to understand it’s only temporary. By the 2020s part of the impact of this bill is not the simple devolution of healthcare responsibilities and the money that pays for them from the federales to the states, but a cutting of Medicaid dollars period, which will create a huge hole in state budgets everywhere and reduce many red states in the South to the healthcare delivery standards of third-world nations.

Economists argue that even the sponsors of the bill don’t seem to have a clear idea what’s in the language. For example, Cassidy and Graham have claimed it continues to protect those with preexisting conditions, but reading the bill it’s just not in there.

There is no cost estimate on the bill from the nonpartisan Congressional Budget Office nor is there a score on how many will lose coverage under this bill. The best estimate is that 30 million will be pushed off of insurance.

So, why are we worrying that this zombie may end up ruling our world, rather than having a stake driven through its heart? God knows, but it seems to be just a case of politics divorced from the impact of health and harm to the public. The Republicans are so desperate to fulfill an absurd promise that they willing to pretend a mangy dog is Lassie on the way to save you.

If there’s something you can do, do it now, before this zombie stalks the land and leaves million dead or dying.

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