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:AHCA
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:
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.