Sunday, July 16, 2017

Kill (the Trumpcare) Bill, Part I: And the Magic Number Is...?

I'm curious.

Just how many people have to lose their health insurance before the Republicans in Congress shout, "Eureka! We have done it?"

Obviously 22 million people is too many. But what happens if the Congressional Budget Office comes back this week and says that the new, not-really-improved Trumpcare bill will only result in 19 million or 15 million or 11 million people losing their health insurance? Is that number small enough for the GOP to claim success in their quest to not-really-repeal-but-just-do-something-so-the-base-thinks-that-Obamacare-is-dead?

It speaks volumes about the state of the right wing in this country that they will sacrifice so many Americans in the name of...what? Fiscal prudence, as if saving some money off the deficit will make up for the ruined lives? The promise to repeal the ACA even though the GOP STILL hasn't quite thought through the ramification of their actions? The misguided, indeed immoral, view that many conservatives have of the poor as undeserving couch potatoes who have no innate responsibility and are addicted to government programs? Never mind that millions of the people who will lose insurance voted for the president (shudder) and/or live in states where the opioid epidemic is raging through both city and farm. Cutting Medicaid would be a disaster for those people.

And if you think it's just the poor who will lose, then please think again. If you plan on growing old, then you need to read all of the articles by Ron Lieber about how the Medicaid debate will affect you later in life. Medicaid is not just for those we generally think of when we think of the poor. It also pays for elderly people who, oddly enough, don't believe they will suffer from dementia, or contract a debilitating illness, or fall and break their hip or just plain run out of money because they didn't save quite enough through a retirement plan.

Add this to the fact that Medicaid also covers millions of children who will lose their coverage if this Senate bill passes. And even without the Trumpcare cuts, the president's budget proposal would reduce health insurance coverage for CHIP. These are children that we see in our public schools who need far more support than just learning how to read. They come to school without the guarantee that if something happens to them, they'll be covered. Further cuts to school lunch and nutrition programs will complete this cruel turn the GOP thinks will help the country.

The Republican dream of turning Medicaid into a state grant program is also seriously and fatally misguided. States will likely use the money to shore up finances in other programs since, unlike the federal government, they must balance their budgets. And the GOP plan forces states to make choices that they should not have to make concerning who gets aid and who doesn't. Medicaid was created to cover all people who qualified for it. Changing that will produce winners and losers, which of course means those who live and those who don't.

In the end, the Senate and House plans will create lower cost health insurance pl;ans, but what people will get for their money will cost them far more when they actually need care. Sky-high deductibles will negate the low premiums as people will be forced to pay full price until their deductible kicks in. And allowing insurance companies to sell policies that don't include maternity care, mental health insurance or drug treatment coverage will make the cost of those options go up for those that do need it.

As business savvy as the Republican Party, and the president, think they are, they still haven't learned that insurance is all about spreading the risk so that those who don't make many claims pay for those who do, which evens out the cost. Having an a la carte health care system is a recipe for higher costs and lower outcomes as those who can pay will, and those who can't, won't get care.

The GOP seems oblivious to this, but they do have a number. This week we'll learn what that is.

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