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AdLib On March - 9 - 2017

To our fellow Americans who support Trump…what’s up?!  Been a pretty intense past two years not to mention the last two months since Trump was inaugurated. We may have been strongly opposed to each other all this time but we now have something we can come together on.

One issue where we seem to be on the same page is health care. Just like you, we want health insurance in America to be less expensive, more competitive and have lower deductibles. We are together on wanting the cost of health care and prescription drugs to go down. I think many of us are in sync in wanting seniors and those with serious health conditions who don’t have a lot of money to be able to have insurance and be covered for their preexisting conditions. Personally, I don’t care if Obama’s or Trump’s name is on the plan as long as it works.

I think most if not all of us would be 100% behind what Trump has claimed he would provide with regards to health care:

DONALD TRUMP: “We’re going to have insurance for everybody. There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us…[Americans] can expect to have great health care. It will be in a much simplified form. Much less expensive and much better.

I am an anti-Trump Progressive but I would fully support what Trump expressed he would do in a repeal and replace of Obamacare.

So for a brief, fragile moment, when most of America would be together on backing this Trump view, the only question that matters is, does the House healthcare support or oppose what Trump has promised and is he still standing behind his promise?

Both sides attack each other’s media sources as being untrustworthy so let’s all put them aside for now. Let’s just read and think for ourselves. Here is the actual bill:

[pdf-embedder url=”http://planetpov.com/wp-content/uploads/2017/03/AHCA.pdf”]

Instead of allowing someone else to tell us what it says, we can and should read it ourselves so together, we know with absolute certainty what the facts are. So here are the answers we need to find in it to confirm either way if it delivers what Donald Trump has promised us:

DONALD TRUMP: “We’re going to have insurance for everyone. There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.”

On Page 4, under “Subtitle B – Medicaid Program Enhancement” is the beginning of the section that legislates the end of the Medicaid expansion in 2020. Fox News, even in an article that’s critical of the ACA, claims 11.1 million Americans received healthcare from the Medicaid expansion. So we should be able to stipulate that at least 11 million Americans who could not afford healthcare before the ACA’s Medicaid expansion, have it now because of it.

There are also around 28 million Americans who still have no healthcare, mainly because they can’t afford it.

On Page 26, under “Sec 1903a. Per Capita-Based Cap On Payments For Medical Assistance”, Medicaid payments are reduced and the federal government will pay a smaller and smaller portion of state expenses in each year.

On Page 51, under “Section 2204 Allocations”, the amounts for federal funding is listed for the years 2018-2026 and shows “15,000,000,000” for 2018 and 2019 then “10,000,000,000” for 2020 and beyond. This is a massive reduction in Medicaid allocations to states, slashing it down to 2/3 of what was being paid. So in a scenario where people can no longer join through the Medicaid expansion but many will join regular Medicaid over the years and medical costs increase by double digits each year, there will be less money to provide more people with Medicaid. Governors and states will have to choose between preventing people from enrolling, dropping people off of Medicaid, offering much less in benefits and/or requiring greater amounts of money from the poor to participate in Medicaid.

On Page 61, states are required to go from providing zero co-financing of Medicaid (which under the ACA would have adjusted to 10% in 2020 and from then on), to paying 50% co-financing in 2024 (after the percentage goes up 10% a year from 10% in 2020). The financial burden this will impose on states will be enormous and exert powerful pressure to remove more and more people from Medicaid. States will not only have to make up for the $5 billion in costs that’s been shifted to them but as more people join Medicaid and inflation jacks up the cost of healthcare well past that amount, states will find themselves in desperate need.

On Page 91 are the details on what tax credits Americans will receive instead of subsidies in the current ACA system, addressed by their age and reduced by their income. Here is a graphic from the NY Times that makes it easy to sum up the impact on Americans (click on it to see it full size). Find your age, income and state to see how you will be affected:

Impact of Trumpcare - NY Times

What is clear from this graphic is that the less money one has, the worse their situation will be under this new plan. Considering that most people who didn’t have health insurance until the ACA was implemented and those who still don’t today are less-affluent or poor, it is easy to recognize that many of the 11 million who were not be able to afford health care before the ACA and those who are unable to afford it today, would be more likely to be uninsured for the foreseeable future.

One thing that has intentionally been avoided in the rapid pushing of this plan is any independent analysis to calculate how many Americans could lose their healthcare because of it or how the healthcare system and economy could be impacted. Republicans in Congress are doing the very thing they accused Democrats of doing with the ACA, they are trying to force this bill down everyone’s throat in a matter of weeks, without any Senate hearings and only a few days of incomplete, expedited House hearings.

Whatever one’s opinion on the ACA, we all remember the Tea Party protests and rallies over many months against approving the ACA, the election of Scott Brown in Massachusetts causing greater delays and difficulty in passing it, numerous Senate and House hearings and even the live, televised public session between President Obama and Congress debating the ACA.

Republicans in Congress have instead rushed their hearings and votes before allowing a report from the Congressional Budget Office to be provided, as is provided on all bills that have an economic impact. Healthcare spending represents approximately 18% of the U.S. economy, it is grossly irresponsible to blindly pass a bill that could greatly impact that much of our economy with no analysis on whether such changes could do great damage or not.

And any reasonable person on either side of the fence should expect that those voting in Congress and the Americans people should know what the cost and effect of such a huge change in our daily lives, our economy and our future is likely to be.

Many conservative Republicans have expressed the same concerns as many Democrats, that the cost of this could explode the deficit while causing the cost of health insurance to skyrocket. Deductibles could jump and a surge in uninsured could boost up the cost of premiums insured Americans pay (if the uninsured once again use emergency rooms for standard care and incur huge bills for emergency care that they can’t pay, the costs are put on the backs of those who are insured through increasing their premiums).

One would naturally have to ask that if Trump and Republicans in Congress thought this plan would actually accomplish his stated goals, reducing the expense, improving insurance and getting every American insured, why aren’t they anxious to have the CBO score the bill and display this positive outcome to Americans and reticent Congresspeople.

Instead, Republicans in Congress and Trump have been pre-dissing any report the CEO delivers, which would only make sense if they thought this plan isn’t going to score well with the CBO. They have no other analysis to provide to the country and are badmouthing the only respected, non-partisan entity that could be providing it.

Would you agree to buy a car from a seller who won’t tell you the price or let you take it to your mechanic to see if it’s in working condition? If he just wants you to agree to buy it first then he’ll tell you how much you owe him and you’ll have to find out afterwards if the car even worked or fell apart a week later?

As the bill and the chart show above, most of the Americans with lower incomes who voted for Trump, trusting him to deliver what he promised, should at least be curious if not concerned, because it appears likely that they will be hurt the most.

Trump voters, this is your healthcare, your economy and possibly your job on the line. Medicaid is also what provides for the elderly to be taken into nursing homes so with Medicaid at stake, this is also about your parents and/or elderly relatives being able to live in and be cared for in a nursing facility or not.

This is about your being able to purchase and afford healthcare with reasonable deductibles and blocks insurance companies from refusing to cover costs. This is about preventing you from losing everything if you have a medical emergency in the family.

So don’t take it from me, from Fox News or pundits, read the bill yourself and require that an impartial analysis is done before further congressional “deliberations” (how can you deliberate the impact of something before you have any analysis of its impact?) take place.

This is truly a matter of life and death so consider the lives and health of your family, this isn’t something to rush into place without understanding the consequences. Once that’s all on the table, if you support it then so be it. However, if like many of us on the Dem side, Donald Trump’s promise of providing less-expensive, better health care for everyone is a promise that you believe needs to be kept, I would hope that you look into the details of this plan on your own and consider whether it will really help you or really hurt you if it passes.

Written by AdLib

My motto is, "It is better to have blogged and lost hours of your day, than never to have blogged at all."

20 Responses so far.

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  1. AdLib says:

    Here is a Washington Post article out today that really illustrates in WV for example, how many poor people are truly dependent on Medicaid and so poorly educated and poorly informed that they voted for Trump and support the repeal of the ACA with no awareness that they and their families will lose their healthcare if Trump and Repubs in Congress do what these ignorant people empowered them to do.

    West Virginia’s McDowell County has high rates of chronic diseases and the shortest life expectancy in the nation. It’s also a place that voted overwhelmingly for Donald Trump, who promised to repeal the Affordable Care Act that helped many residents get health coverage.

    https://www.washingtonpost.com/graphics/national/west-virginia-tug-river-obamacare/

  2. Kalima says:

    Trump supporters in the heartland fear being left behind by GOP health plan

    Republican proposal would upend a healthcare system in Indiana that covers many low-income people – in a program that Mike Pence put in place

    https://www.theguardian.com/us-news/2017/mar/12/republican-healthcare-trump-pence-medicaid-indiana

    • AdLib says:

      Kalima, the real question is if this will be a domino effect and the legit fear some lower income people have will spread widely to both scare Repubs out of repeal and take them out of power in 2018 and 2020.

      Reality is on our side, just a matter of reality or at least legit fear breaking through the propaganda enveloping their minds.

      • Kalima says:

        The irony is that trump ran a campaign on fear, hate and conspiracy that continues into his WH, and now his supporters are faced with a “real” threat not from “the other” but created by the fool they voted for.

        Be careful what you wish for, it seems to be coming true and you are on the receiving end.

        • AdLib says:

          Kalima, iroonic but maybe also the M.O. for Repubs, the old Lee Atwater/Karl Rove scheme of attacking your opponent for your own weakness. People needed to be afraid of the threat Trump posed so he campaigned on how people should be afraid of the threat Hillary posed.

          In the end, Trump still is the threat people shoould fear and it would be ironic and just desserts if Trump is undermined by the fear he whipped up in people that’s turned against him.

  3. Nirek says:

    AdLib, you make a great point. However with the trumpist voters and their ignorance and their “leaders” in congress, I fear they will not read.

    http://www.msn.com/en-us/news/politics/the-poor-%e2%80%98just-don%e2%80%99t-want-health-care%e2%80%99-republican-congressman-faces-backlash-over-comments/ar-AAo4yzX?ocid=spartanntp

    And then you have idiots like this in our government.
    http://www.msn.com/en-us/news/politics/%E2%80%98is-that-not-correct%E2%80%99-male-gop-lawmaker-asks-why-men-should-pay-for-prenatal-coverage/ar-AAo5g2W?li=BBmkt5R&ocid=spartanntp

    Ad, these guys are in the majority in congress and the senate. It scares me to think that people who think like they do are in their positions of power.

    It would be great if people were to read and understand the republican Bill, but Most don’t. They listen to Fox snooze and rush limpblah bla bla.

    All that said, your piece is excellent and if people would read it they would NOT support the republican Bill.

    • AdLib says:

      Nirek, for a majority of Trump supporters, you’re probably right. There is nothing we can do to get them to stop supporting the guy who wants to destroy their lives. It’s like trying to de-program cult members.

      But we do know that there is a segment of Trump voters who switched to him after Bernie lost the nom or they just wanted to try someone who was an outsider to give it a shot. There are definitely an amount of non-dedicated Trump voters out there, they’re the silent minority we rarely hear about, we always see the loud, hostile types or the passive authoritarian types but like Dem voters, there is a variety of types of people that voted for Trump.

      So I’m with you on not chasing after the racists and authoritarians but if we don’t stereotype and generalize all Trump voters as having the same identity, we may be able to connect with those who could move away from him (and back to supporting their own and the nation’s best interests).

  4. Fuzzy Dunlop says:

    Two major hurdles, in my opinion. Reading, and thinking for one’s self. The majority of present day Trump supporters don’t do either. It’s a nice piece of advice, but I’m afraid it’s a lost cause.

    Am I being too negative? Not after all I’ve seen and heard over the last year and longer.

    A+ for effort though, Ad.

    • AdLib says:

      FD, I can’t say if you’re being negative or realistic. It’s just hard for me to imagine that there isn’t something that could sneak through their force fields and get them to at least examine the facts for themselves. Perhaps their love and concern for their families could outweigh the practice of rejecting any warnings about Trump outright.

      Maybe the possibility of the disaster that could strike them and the ones they care about, as healthcare is yanked out of their reach, would be enough for them too at least inquire a bit into the facts on their own.

      All we can do is lay out the impartial facts and maybe do so in good faith. There will be many who won’t care but these things can start with a few cracks that spread and eventually shatter the wall.

      We can at least try, it at least has a better chance to accomplish something than venting anger at them.

      • Fuzzy Dunlop says:

        I have to answer by saying that I have no sympathy for Trump voters. They knew all about his sexual predatory behavior, his lies, his bigotry and his excessive wealth, at the expense of others.

        OK, that being said, I suppose there are some who just couldn’t bring themselves to vote for Hillary, and held out hope that Trump was capable of changing for the better. I think these are the people who might actually read the new bill and finally wake the hell up. I am, to put it mildly, skeptical.

        As far as their family members suffering because of this bill, it would then already be too late to do anything about it. Most of these people need to be virtually hit over the head with a baseball bat, before they will even think about seeing reality.

        This old adage applies to Trump supporters remarkably well…”There are none so blind, as those who won’t see.”

        • AdLib says:

          FD, I’m looking at this now in a very simple, pragmatic way. The most important thing to me is that Trump and the GOP are stopped from severely damaging this country.

          I’ve vented quite a bit at my upset and frustration over Trump’s election and those who voted for him but that seems ancillary right now to accomplishing what’s imperative.

          Yes, there will be a core of Trump voters who are unmovable…unless Trump succeeds in tearing away their health insurance from them and destroying their lives but as we agree, that’s too late.

          As we know, Trump used and uses fear to motivate many voters to support him, I’m just wondering if we can’t use fear against him. If people become fearful enough of losing healthcare, as they will under this AHCA, perhaps that fear will “trump” the fears Trump exploits?

          And we know that insulting his voters sure won’t open them up to considering the real threat coming their way so maybe just bringing the tone doown to reasonable and presenting Repub issues in their own words could get a toe hold with Trump voters who aren’t 100% convicted about him.

          There are some of the more moderate voters already flirting with buyer’s remorse, those may be the ones who could recognize what’s really going on as long as they don’t feel it’s being shoved on them.

          My preference would be that Repubs would be as ready to criticize and oppose those in their own party who aren’t looking out for them the same way many of us are with Dems. But this is the way things are and I’d propose that keeping our eye on the ball means aiming our energies at stopping the bad things Trump is pushing and trading resentment of his voters for an open hand.

          • Fuzzy Dunlop says:

            I agree that insults don’t accomplish anything, but neither does capitulation. These people are irridimable, in my opinion.

            I will not reach out to them in any way, shape or form. They make up the very same 20-25% of American voters that feel as anti-liberal as I am anti-stupid.

            Good luck in your crusade. I mean that sincerely.

            What you are attempting, no matter how noble (which it is), is to somehow normalize these traitors to everything this country stands for, and I can’t help but think of all those who gave their lives and limbs to prevent such a state of our union.
            I believe in bending, but not breaking. There is no bending to these miscreants.

  5. filo says:

    I fully understand your point AdLib but I never ever believed one word tRump ever said. He is a world class bullshit artist with a Narcissistic Personality Disorder who will say anything to get what he wants.

    • AdLib says:

      Hey filo, good to see you!

      You see Trump for who he is but he is, as you say, a world class bullshit artist and he’s conned a lot of people in his life. How do we get those he’s conned to recognize it?

      That’s the challenge, whether we can do that and thus stop Trump in his tracks or if the realization will only come after his voters are so harmed by him that they come to that conclusion after the damage has been done.

      I’m hoping the former.

      • filo says:

        Hi Ad!

        The only way his voters will recognize they have been conned is if they themselves get hurt and hurt bad. They are in blinders mode now.

  6. kesmarn says:

    AdLib, this is such an important message. And the tone of your article is so respectful and rational as well. It’s such a relief to see an author addressing Trump voters as human beings.

    Granted, we all have our differences. I most definitely didn’t vote for Trump, nor did many folks who are regulars at the Planet. But I’d bet that we all know someone who did. And I think that it’s so important to stay in communication with those people. Which means resisting the impulse to say things like: “What in bloody hell were you thinking, you $#%@*# dimwit?” After all, the nation is already polarized enough, I think most of us would agree. We don’t really need to drive those wedges even deeper.

    As you said in this piece, lower income voters and/or the elderly have the most to lose from draconian cuts to Medicaid. Huge numbers of people in nursing homes are on Medicaid (it covers 50% of all long term care expenses). With the new GOP plan, when these people reach the “cap” limiting the amount that can be spent on their individual case — that’s it. They are on the street (unless a child or other family member takes that person in), elderly and ill. Period.

    This is why even GOP Governors are not happy about this “improvement.” And why the AMA has come out against it. Trump voters would do well to take your advice — have a look at what this bill might mean for them personally. If they have a handicapped child and/or a frail elderly member, they could be in real, serious, genuine trouble.

    • AdLib says:

      Thanks so much, Kes. I do think we’re into a new period that now transcends where we just were. Trump voters, whether they see it that way or not, are on the same side of the ACA issue that we are.

      They trusted Trump and he continues to con them, not even appreciating that they helped put him in the WH. He lies to them about all the jobs he isn’t actually creating, he’s using his office to allow the polluting of their water, to raise the price for their home loans and now, to take away their healthcare or make it much more expensive in order to give the wealthy tax cuts.

      My thought right now is that the best thing we can do on the issues that represent a threat to all of us, is to act that way. If we can just lay out the facts directly, from The House’s bill and not from any news source, maybe the threat they represent to Trump voters as well will eventually break through with them.

      As you mentioned, we know that the rural and blue collar voters that are loyal Trump supporters, are the ones who are going to get hurt the worst by this vicious AHCA. They will have to pay at least $7,000 more per year to maintain their healthcare or lose it, be bankrupted because they don’t have it and as you mentioned, watch as their elderly parents and relatives are kicked out of nursing homes.

      Despite our disappointment at the outcome of the election, are we so angry and stupid that we would have our own house burned down as long as Trump’s voters have theirs burned down too? Of course not.

      If you don’t want your own house burned down, it’s better if nobody’s house is on fire.

      I am afraid that many Trump supporters will have to be hammered by his policies and be put in terrible positions before they realize he’s been dishonest with them. They need to oppose him to protect themselves and their family and I don’t know that they see that or will see it until it’s too late for them.

      So how do we communicate across the divide with all the suspicion and charges of “fake news” nailed to anything critical of Trump? With the facts. And since most facts reported in the media are open to dispute, we need statements and legislation in writing by Republicans.

      The AHCA is a rare opportunity, I think, for the rest of Americans to connect with Americans who voted for Trump. The Repub pols have to put in specifics what their policies are when they write a bill so there is no “fake news” aspect here to disqualify the destruction they seek to the lives of tens of millions of Americans…including a great deal of Trump voters.

      I don’t expect any minds will change quickly, I think the first step is to create a spark of concern or curiosity in what is actually happening and what specifically their lives will be like if the AHCA passes.

      Have they considered that a handicapped family member or elderly relative could be left without care? Or that an accident or serious health event could bankrupt them if healthcare becomes unaffordable?

      I think Trump and Repub pols have successfully kept many Repub voters distracted, focused on disliking Obamacare instead of what kind of care they will be losing and end up with.

      It will be interesting to see what happens after the CBO report exposes how devastating the AHCA is, after Freedom Caucus and other conservative Repub Congresspeople refuse to support it and moderate Repubs and Repub Governors come out even stronger to argue for keeping the Medicaid expansion.

      When it’s coming from all sides including those in the GOP, maybe enough Trump voters will check it out for themselves and start to stand up against Trump and his policies that are directly destructive towards them.

      They will come to recognize it in any case, either the easy way or the hard way and for everyone’s sake, I’d rather it was the easy way.


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