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Friday, May 05, 2017


Abundance of malice

by Tom Sullivan

The Philadelphia Inquirer's Will Bunch calls yesterday's American Health Care Act (AHCA) vote in the U.S. House "a Thursday afternoon that will live in infamy." The New Yorker's John Cassidy calls it Paul Ryan's "health-care suicide pact," "a moral travesty, a betrayal of millions of vulnerable Americans." As if that mattered to House Republicans.

House Republicans voted to repeal the increasingly popular Affordable Care Act because the nickname they gave it celebrates a black Democratic president. They didn't pass the AHCA because it was the right (or adult) thing to do. They didn't pass the AHCA because it would help their constituents. (It won't, and they never offered a cogent argument for how it would.) They passed it because they had the power, and because the naif in the White House wanted something, anything legislative to hold up for the "fake news" cameras besides another executive order:

Trump did not want to talk about the merits of the legislation — he didn’t care much about those specifics, senior officials said. What mattered to him was how a failed vote would hobble his presidency and the ability to get other legislation through Congress.

He wanted a win.
The ACHA is his first grader's finger painting for mom to fix to the refrigerator door with an alphabet magnet. The president himself has no idea how healthcare works, as he proved again in remarks yesterday to Australian Prime Minister Malcolm Turnbull. It didn't much matter what is in the bill. It didn't much matter that Republicans were celebrating one stage of the process to be tackled next by the Senate. The celebration was the win.

For the moment, forget process. Forget the AHCA's unknown cost or details. Paul Waldman lists the grim details and pulls no punches:

I won’t mince words. The health-care bill that the House of Representatives passed this afternoon, in an incredibly narrow 217-to-213 vote, is not just wrong, or misguided, or problematic or foolish. It is an abomination. If there has been a piece of legislation in our lifetimes that boiled over with as much malice and indifference to human suffering, I can’t recall what it might have been. And every member of the House who voted for it must be held accountable.
Robert Schlesinger of U.S. News and World Report writes:
But this is the unalterable bottom line: Under the Affordable Care Act, people with pre-existing conditions have iron-clad protections; 217 House Republicans just voted to create a path for insurers to circumvent these safeguards and charge them more. That this path may be narrow and convoluted is really beside the point.


The Washington Post's Greg Sargent reports that the CBO is expected to deliver its new assessment next week or the week after. Two-hundred and seventeen Republicans, then, have just strapped this bomb around their necks and it could go off in a matter of weeks – and they'll have to explain that to their constituents. We're talking about one-sixth of the economy and these bozos couldn't be bothered to so much as hold a hearing, let alone wait for a nonpartisan score of it. This isn't a political party; it's a political suicide cult.

There is more than loss of protections for those with pre-existing conditions in what Cassidy considers "one of the most regressive pieces of legislation in living memory":
On top of all this is another huge issue, which I’ve pointed to before. The bill passed on Thursday includes a substantial tax cut for the rich, financed by big cuts in Medicaid, the federal program that provides health care to the poor and indigent. Obamacare expanded Medicaid and chip, the children’s version of the program, and, to pay for these and other provisions, the law imposed a tax of 3.8 per cent on the investment incomes of wealthy households and a 0.9-per-cent surtax on their ordinary incomes. That money has helped sixteen million struggling Americans, many of them kids, obtain health coverage since the start of 2014.

The House bill eliminates the Obamacare taxes, reverses the Medicaid expansion, and converts the financing of the program from a per-capita subsidy to a block-grant system. What impact would this have? Since the treatment of Medicaid in the bill that passed is basically unchanged from the original version, we can rely on the C.B.O.’s analysis, which showed that, over ten years, spending on Medicaid would be reduced by almost nine hundred billion dollars. Of the roughly twenty-four million people the C.B.O. estimated would lose their health coverage under the original version of the bill, fourteen million were Medicaid recipients.
Trump and the Republican congress pledged to repeal and replace Obamacare. Yesterday they took a big step towards that goal. They might have warned supporters beforehand that what they planned to replace it with would be worse than what they had before. Don't tell Donald Trump. He still thinks TrumpCare is terrific. Just like his university.