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The Casual Evil of Trumpcare

May 5, 2017

ACAdemo at capitol

Yesterday afternoon I went to an impromptu demonstration at the US Capitol as the House of Representatives was voting on a bill to repeal the Affordable Care Act and replace it with…what should we call it? Trumpcare? Ryancare? Wedon’tfuckingcare?

The demonstrators chanted “Shame! Shame!” as congressmen emerged from the Capitol, which was basically what I feel about this sordid affair–shame to be living in a country where the dominant political party has no shame at all. Where the apprentice despot in the White House and his Republican enablers in Congress rejoice at the prospect of making daily life more precarious and expensive for millions of their most vulnerable countrymen. Blessed are the rich, for they shall receive tax cuts.

There is simply no credible rationale for the bill that just barely passed the House. It was cobbled together and brought to a vote in great haste for no reason other than to sooth the sting and humiliation of previous failures. Both Trump and Ryan just needed a legislative win and didn’t care what the impact of their bill would be. Indeed, the members who voted for it had not read the bill and didn’t really know what it contained. It had not been vetted in committee hearings or debated on the floor. Nor did they have any idea what it would cost or what the fiscal impact would be, because the Congressional Budget Office had no time to “score” it on those grounds. They didn’t care. It just needed to pass, because…you know…Obama.

One thing we do know is that the bill is a major tax cut for wealthy people. Those hurt the most will be the old, the poor, and the sick. For an initial analysis of the impact, click here. Two aspects really stand out as cynical and cruel. One is drastic cutbacks in funding for Medicaid, which provides insurance for low-income people. The other is that it eliminates the pre-existing conditions coverage requirement under the ACA, allowing states to opt out, which some certainly will.  The list of conditions that states could decide not to cover is truly amazing. Most people would be affected by them at some point in their lives.

The CBO report will probably be out next week before the Senate takes up the bill. But it is virtually certain that this version will cover even fewer people than the previous one, which was estimated to eliminate coverage for some 24 million Americans currently covered under the ACA. For some Republicans, especially those in the Freedom Caucus, this is a feature, not a bug. Their position is essentially that if you can’t afford health insurance, then tough shit.

What Trump actually thinks about all of this is anyone’s guess. The only thing that’s clear is that he wants to destroy anything associated with Obama, regardless of the consequences for actual Americans. Both he and the Republicans who voted for this abomination are claiming that this bill will cover more people at lower cost, which clearly is false, and they seem to believe that they can get the American people to swallow this lie. What matters to him is the “win”, not who gets mangled in the process.

The battle isn’t over yet, and the bill faces serious difficulties in the Senate, but it is entirely possible that party discipline will prevail there as well. The only way to defeat this is massive public opposition and pressure on Republican congressmen and senators from their home districts. They are on recess now. Let them hear from you!



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