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Tuesday, March 21, 2017

Trumpcare will be a disaster, but GOP doesn't care



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We begin today’s roundup with The New York Times and its assessment of the Congressional Budget Office’s scoring of the Trumpcare:
So much for President Trump’s pledge of “insurance for everybody.”
The Congressional Budget Office said on Monday that next year 14 million fewer Americans will have insurance if the Affordable Care Act, or Obamacare, is repealed and replaced on the terms the president is seeking. That tally would rise to 21 million in 2020 and 24 million in 2026. By then, the total number of uninsured Americans would reach 52 million.
And for what? To give a gigantic tax cut to wealthy Americans.
According to the C.B.O. the loss of health care coverage under the Republican plan stems largely from gutting Medicaid for low-income Americans, even though Mr. Trump has said he would not cut Medicaid. Coverage would also be lost in part because insurance would become unaffordable for millions as subsidies are withdrawn, despite Mr. Trump’s claim that coverage would become “much less expensive and much better.”
Margaret Hartmann:
Just after the Congressional Budget Office said it estimates that under the Republican health care bill 14 million Americans will lose their health insurance next year, and 24 million will lose their coverage by the end of the decade, the White House said it disagrees “strenuously” with that analysis.
“We believe that our plan will cover more individuals at a lower cost and give them the choices that they want for the coverage that they want for themselves and for their families, not that the government forces them to buy,” Health and Human Services Secretary Tom Price explained on Monday.
Hours later, the White House’s internal analysis of the American Health Care Act leaked. It confirms that the Trump administration disagrees with the CBO’s findings – but not because AHCA will “cover more individuals.” The executive branch estimates that 26 million people would lose coverage within the next decade, far more than the CBO’s estimate of 24 million. 
Jeff Guo at The Washington Post explains that Trump-supporting areas of the country will be the hardest hit:

Grant County, Nebraska is one of the most pro-Trump places in America. In this rural community of about 700, the President won over 93 percent of the vote in the last election. But Grant County is also a place that has benefited hugely from the Affordable Care Act. In 2016, the law provided more than a quarter of its residents with tax credits to help them purchase health insurance.
Now, under the Republican plan to repeal and replace Obamacare, many Grant County residents would suffer steep cuts to the tax credits they've come to rely on. It's a nationwide pattern: Some of the harshest consequences of the GOP's health bill would fall on rural Republican strongholds — precisely the voters who helped elect Trump.
Glenn Kessler gives budget director Mick Mulvaney four Pinnochios for this wildly false claim:

“It’s there. Anybody can read it. Folks watching on television now can go online and read what the bill is. They can watch the committee hearings. Those are things that were dramatically missing in Obamacare.”
— White House budget director Mick Mulvaney, interview on CNN’s “State of the Union,” March 12, 2017 [...] 
We [had with Obamacare] about 20 hearings, many aired on C-SPAN. That’s 18 more than the current replacement bill. On top of that, the bills were available to read for many days (though, frankly, legislative language is rather dense for most laypeople). So Mulvaney’s comments are clearly wrong. [...]
We’re not sure what Mulvaney has been smoking, except his own propaganda. The process that led to the Affordable Care Act was lengthy and complex, but involved numerous hearings and ample time for public comment and input. Any suggestion to the contrary is ridiculous.
Erin Gloria Ryan assesses the plan’s effect on women:

“What’s going to happen to the 2.4 million women who are folks that are accessing their health care through Planned Parenthood clinics?” Taylor says. “Planned Parenthood is the entry point or access points to health care particularly for low-income women. This is not just about Planned Parenthood as a provider. This is about taking services and health care away from people who really need it.”
Taylor is skeptical that the GOP’s proposed ACA replacement is even fiscally conservative. “In the long term, it does nothing to help women be more economically secure,” she says. “We’re just pushing people further down into the hole of poverty. And that’s unacceptable.”
Damon Linker at The Week analyzes the Republican disarray over the bill:

It would be one thing if Trump recognized how awful the GOP's plan will be for the very people he was elected to help and vowed to fight it. He could turn his ire on Ryan and the factions of the House GOP that support his plans or who think they don't go far enough in gutting ObamaCare. At least these voters would feel like their champion was going to the mat for them. They might even reasonably hope that the president would lead a charge to reform the GOP even further, by supporting "workers party" candidates to challenge Ryan and his ideological allies in the 2018 midterm elections. Such a shrewd, genuinely populist Trump might even come out in favor of a single-payer reform of the health-care system to provide security to American workers (as opposed to the greater health-care "choice" that very few outside of the House GOP's Freedom Caucus seem to be clamoring for).
But instead, Trump is pushing to pass Ryan's bill. That means he will own it — and if it passes and inflicts immense pain on these already angry voters? Then they will likely turn on the law and on Trump for supporting it.
And we close today’s roundup with Jonathan Chait’s take:

This proposal, the centerpiece of the new all-Republican government’s legislative agenda, is an expression of its shared philosophy. Donald Trump has altered the Republican stance on trade and immigration, not to mention self-enrichment by the First Family and the routine propagation of conspiracy theories by the chief executive. But he has hewed closely to the party’s conviction that the central problem in American life is a government that redistributes too much from the privileged to the underprivileged.
It remains to be seen whether enough Republicans have the courage of their convictions to follow through on this plan. Depriving millions of Americans access to medical care would impose pain more directly and widely than any legislative act in modern U.S. history.

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