Tag Archives: Congressional Budget Office

Trumpcare – National Nightmare in the Making

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I do not pretend to be an expert in the art/science of health care programs. I have been fortunate enough to not have to deal with the Affordable Care Act (“ACA”) personally and remain somewhat unschooled in all of its details.

But I know this much. The Republican “repeal and replace” plan, as thus far revealed, has been evaluated by the non-partisan Congressional Budget Office (“CBO”) as depriving 14 million people of health insurance in Year One, 21 million in 2020 and 24 million in 2026, compared to the number insured under the ACA. https://www.cbo.gov/publication/52486.

If you’ve been following the news, you now know that the Republican managers of this fiasco do not have the votes in the House of Representatives, assertedly the legislators “closest to the people,” to pass the American Health Care Act (“AHCA”) being promoted by Speaker Paul Ryan. There are two main sources of opposition, one a group of extreme-right ultra-conservatives who contend that the AHCA leaves too much of the ACA in place and demand more cutting of benefits. The other group is labeled “moderate Republicans,” a term that I don’t pretend to understand but they apparently think the AHCA goes too far.

Faced with apparent deadlock between those groups, the AHCA bill managers are trying, with the help of Not-My-President Trump, to negotiate with the ultra-conservatives. If such an arrangement is struck without the ultras completely caving in, which is unlikely, this approach necessarily means that the legislation will be worse than the AHCA in its present form and thus likely to deprive even more Americans of health insurance.

Note, however, that we will not know for sure by the time the bill passes. The Republicans managers are in such a rush to get this gruel passed and on to the Senate that, if some deal is struck, they may vote as early as tomorrow or Monday. This in turn means it is assured that CBO evaluation of the amended legislation will not be available to the House when it votes on what then would presumably be a “done deal” and passed.

Of course, there is the Senate and another procedural morass and fight over the governing procedures, but everyone should be clear that if the present course continues, the U.S. House of Representatives will vote on one of the most consequential pieces of legislation affecting the welfare of tens of millions without the benefit of the one neutral source of cost-benefit evaluation.

If this analysis is correct, there are no words to adequately describe the outrage being perpetrated against the American people by their elected representatives. Everyone who votes for this legislation should be turned out of office in 2018.

Update: Speaker Ryan Doesn’t Know, Doesn’t Care

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Last night I posted a piece that argued the Republicans were blindly adhering to a political philosophy at the expense of depriving some of America’s most vulnerable people of their health insurance now provided through the Affordable Care Act (Obamacare). I woke today to learn that the Republican Speaker of the House, when asked yesterday how many people may lose coverage under the Republican plan, responded with “I can’t answer that question. It’s up to people…. People are going to do what they want to do with their lives because we believe in individual freedom in this country.” http://wapo.st/2nwDKOA See that and other similar quotes from key Republicans, some of whom apparently believe in magic and argue that the Republican replacement legislation, ridiculously call the American Health Care Act, will result in more people being covered than under Obamacare and for lower costs, just like Trump promised during the campaign and subsequently.

Ryan’s “I don’t know and it doesn’t matter as long as people have freedom to choose” comment confirms my earlier point that the replacement legislation is about a point of political philosophy and its proponents could care less who is hurt.

We will know shortly, as the Congressional Budget Office is due to release its analysis of the Republican bill today or tomorrow. Of course, anticipating the worst, the Republicans are ready. They say “you can’t believe what those people say; they’re wrong all the time; health care is very complicated.” No doubt Trump would agree, having already intoned that “nobody knew” how complicated it was. Ryan is saying, in effect, “take some medicine; it’s good for you because you get to choose it and, trust us, it will cost less, though we can’t say what it will actually do for you. But at least you were free; no one forced you to take it and that’s what’s most important.”

We are in a scenario now where sitting on the sidelines will result in fundamental changes in the American way of life. It is very hard to see who will benefit. Trump promised to help coal miners, steelworkers and automobile workers but there is no evidence so far that he has any concept of how to deliver on those promises. I urge all who believe what I am saying to look closely at the websites for PeoplePower.org, MoveOn.org and ACLU.org to see ways you can take action, lawfully and peacefully, to resist the Republican plan to move America backward.

Speed Kills – The Republican Rush to Eviscerate the Affordable Care Act

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Republicans in Congress are rushing to “repeal and replace” the Affordable Care Act, known as Obamacare. No hearings have been held to receive public inputs. Why not? The Republican managers have now declared that the Congressional Budget Office “scoring” of the replacement bill is unnecessary because the CBO always “gets it wrong so who cares what it says?” That is a total reversal of previous positions taken by Republicans when objecting to federal spending under Democratic administrations. Why?

Republicans claim to care about the welfare of the people and of the country as a whole but after seven years of complaining about the ACA, they now are desperate to prevent public input into the legislation they cobbled together. Why is it always party before country with these people? Why the secrecy and the resistance to thorough and thoughtful analysis and examination of the elements of their alternative? What are they afraid of? Do they not hear the cries across the country from even their political base that =the replacement for the ACA is going to deprive millions of people of their health insurance in exchange for what …  a tax credit? If the replacement bill is so good for everyone and consistent with Trump’s campaign promises, as he routinely claims, why are Republicans afraid to give the legislation full exposure to expert analysis?

It’s not that the Republican bill is completely without redeeming elements. Trump’s desire to allow create a single national marketplace for competition among insurance companies may be sound or at least worth an in-depth examination. If so, why not let that and other elements of the legislation be fully examined on the public record? Is there a gift to the insurance companies hiding in the complex economics of this legislation?

The almost certain answer to all these questions is that the Republicans want this legislation at all costs, regardless of the very high probability, if not certainty, that it will destroy so much of the health care on which many millions rely. Taken as a whole, which is what the Republicans are insisting on, the “replace” legislation is an outrageous attack against many of our most vulnerable citizens while conferring a huge tax break for the very well off. The Republicans claim it’s all about giving people more choice and avoiding government mandates. In other words, the real-world impacts don’t matter as long as the Republican philosophy of “individual choice” is the centerpiece of the new system.

Trump promised his supporters a cheaper health insurance system that would cover all the same people as the ACA, with more choices and at lower costs. This turns out to be just another lie. In fact, the Republican alternative will not cover millions who were covered under the ACA, it will not provide meaningful choices for millions whose new Republican-approved choice will only be “no insurance” and the costs will ultimately be infinite for those with no insurance and thus no access to essential health care services.

Along the way, the Republican alternative will defund Planned Parenthood. Republicans hate PP primarily because they believe it pays for abortions. So they want to take a financial meat ax to it … again in the name of Republican philosophy. Curiously, to put it mildly, it seems not to have occurred to the congressional Republicans that their core philosophy of avoiding government intervention in the lives of Americans is being used to justify telling women what they can and can’t do with their bodies, while Republican-dominated science-denying legislatures around the country obsess over which bathrooms transgender individuals use.

It is a fair conclusion that the Republican approach to health insurance is going to result in denial of critical health care to large numbers of Americans and deaths will result … deaths that could have been avoided. Yes, the Republicans are moving very fast to get rid of Obamacare and in the process are signing death warrants for many vulnerable Americans.