Congressional Budget Office Scores House Health Bill with an “F”

Oakland    The Congressional Budget Office finished its nonpartisan, objective evaluation of the costs and impacts of their recently passed bill to replace the Affordable Care Act, and channeling Gertrude Stein found that there was “no there, there,” at least if any of us were looking for health insurance, especially when we have health problems.

Begin with the fact that they estimate that 23 million Americans will lose health insurance. I say “begin,” because there is no way to get an accurate view on how high that number could rise. The Republican bill, as written, gives states the ability to ask for waivers from an anti-healthcare Department of Human Services, which would rubber stamp the ability of states to eviscerate care for the individuals with preexisting conditions, women’s health needs, and allow skinnier and skinnier requirements from the plans, thereby eliminating the minimum health provisions of Obamacare for everyone on the program. Analysts report that the CBO usually consults with states in making its estimates, so the 23 million may include some, but this number would likely swell in the red states with “red” now not referring to the color of a map on election night, but instead standing for the blood draining out of these states’ dying people.

Furthermore in the CBO score, they reject the argument that Republicans have made that such miserly benefits will bring happy days with lower premiums and therefore more participation. The CBO flatly argues that the Republican House plan will end up with higher prices, especially because of the Medicaid cuts, and will collapse insurance markets because of the reduction of subsidies. Young people will get cheaper insurance though that will only be good news in the flower of youth, because if, and when, faced with any healthcare needs, young people will be as screwed as everyone else.

The CBO also totally dismissed the Republicans’ argument that “risk pools” would cover take care of Americans with preexisting conditions. If you read between the lines the CBO believes they will pretty much die as soon as they run out of money, and it won’t take long. The “risk pools” are inadequately funded in their view, and they have never worked. The dustbin of history is calling, but the House Republicans are determined to sell the scam. At least they are if they can keep their tempers when asked to defend their votes in favor of this trash, which wasn’t the case for the Montana Republican Congressional candidate facing a tough contest, who decided to body slam a British reporter for the nerve of asking him about his vote.

Some Senate Republicans might notice that one of the groups being slammed the hardest is older people. The New York Times analysis noted that “The cost of insurance for a 64-year-old earning about $27,000 would increase to more than $13,000, from $1,700 under the Affordable Care Act, even for states that pared back insurance rules.” Bad news, these folks actually vote and even with diminishing basic math skills, all of them will figure out that their bill would be almost half of their income.

There are some winners though, but in the Republican plan that’s the folks with the fatter wallets, especially if they are neither old nor poor. The Times reports, that “The bill makes big cuts to taxes on payroll and investment income for those earning more than $200,000, and provides more subsidies to buy insurance for people earning between about $50,000 and $150,000.”

There is no irony here, though their could be. Fewer subsidies for the poor, but more for wealthier families? How can anyone rationalize that? There’s a clue to their thinking though. Perhaps they are channeling HUD Secretary Ben Carson, and want us all to believe that health insurance is like poverty, “just a state of mind.”

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Healthcare Lives Another Day, but Does Trump Have a Way to Win?

New Orleans   The Trump Tower has now been reduced to rubble. Ryan’s House is a shambles. Obamacare is now with us “for the foreseeable future,” according to the Speaker.

Right now the Affordable Care Act is better than nothing, but it could be nothing better.

The best news of the Trumpcare debacle and the inability of all of the concessions and arm twisting producing nothing is that it may have taught the President to write off the so-called Freedom Caucus, committee of no way. After having given away the store of all of the essential guarantees of the ACA, even the inclusion of children on parents’ policies until 26, which reportedly even the President understood was past the pale, the no-birds were still flying and demanding more, more and more. They had already pulled the bill so far right that what remains of moderates in the House of Representatives were forced to run from the bill and declare they would vote no. One lesson we can hope that Trump has learned is that these folks don’t negotiate in good faith, and it is worth walking away from their demands and their skinny 30 odd votes in their secret caucus, if you have a job that you want done.

Given the obstinence of the Republicans to countenance any fixes over the last seven years – and, yes, many are needed, as we have argued continually, especially capping deductibles – there might be an opportunity to get something good done if the President, the moderate Republicans, and the Democrats in the House and the Senate finally looked at “repair,” rather than “repeal and replace.” The polling on this recent abomination of a bill, thankfully pulled off the calendar, had indicated only 17% support and 56% opposition with 26% undecided. The Republican effort was failing most miserably among the so-called Trump base where as conservative Wall Street Journal columnist Peggy Noonan wrote that it was 26% “underwater” among non-college educated whites and an amazing 46% “underwater” in the 50 to 64 year old age group where people are more likely to forget to take their pills that day than they are to forget to vote. Trump couldn’t threatened to punish Congressman by mobilizing his base because they were in the bathroom losing lunch at the prospect that they would lose the healthcare they had gained under the Affordable Care Act.

If Trump wants to govern and we want to live through these next couple years, the President needs to stop all of this alt-right baloney and crazy flirting with the far right wing, and get closer to the where real deals are made. Even his former Breitbart Rasputin Stephen Bannon was reportedly disgusted with the concessions and bargaining posture of the far right, and that’s saying a mouthful.

I can remember presidents in Peru getting so low in popularity that they were hardly making it to two-digits. Trump is on his way there and the slope is no longer slippery, but fully greased unless he figures out a way to put the brakes on. Experts estimate that any new Congress only has about 200 days to get anything done for good or evil until mid-term elections suck the votes out of the room. For Trump and his gang 60 of those days are already gone, and we’ll all be counting on the death watch now.

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