We begin today’s roundup with The New York Times and its editorial on the Senate Republican health care bill, which is nothing more than a massive tax cut for the wealthy at the expense of the nation’s most vulnerable:
It would be a big mistake to call the legislation Senate Republicans released on Thursday a health care bill. It is, plain and simple, a plan to cut taxes for the wealthy by destroying critical federal programs that help provide health care to tens of millions of people. [...]
If passed in its current form, the Senate bill would greatly weaken Medicaid, the federal-state program that provides insurance to nearly 69 million people, more than any other government or private program. It would do this by gradually but inexorably shifting more of the financial burden of Medicaid to states, in effect, forcing them to cover fewer people and to provide fewer services. Over all, the Senate would reduce federal spending by about $1 trillion over 10 years and use almost that much to cut taxes for rich families and health care companies.
It includes a range of mostly unwise and ungenerous changes to the nation’s health-care system, but it might, if enacted, end up as mostly a massive, unpaid-for tax cut for wealthy people and industries with pull on Capitol Hill. [...]
The cynicism of this exercise is evident in its staging. The bill would kill a variety of taxes right away, but the subsidy and Medicaid cuts would not phase in until after the 2018 midterm election. It would be left to future Congresses to allow severe cuts to the safety net or major expansion of the federal debt, or a combination of the two. Instead of forcing this choice between Americans’ physical health and the nation’s fiscal health, senators should end this repeal-and-replace disaster now.
It’s hard to overstate how radical these changes to Medicaid are, both practically and politically. Although gutting Medicaid has long been a pipe dream for Paul Ryan, it’s not something most Republicans campaigned on. In fact, Trump promised while campaigning that he would not cut Medicaid if elected. The GOP has no mandate for so deeply altering the 52-year-old program, and it’s not something the party has tried to justify to the public. Instead, Republicans pretend it’s not happening. “Medicaid is not being cut from our perspective,” South Carolina Senator Tim Scott told reporters as he left a meeting on Thursday morning.
The bill also allows states to opt out of the ACA's "essential health benefits" requirement, meaning insurers would once again be free to offer cheap plans that cover very little. Ending the EHB requirement could be a backdoor way of gutting the protection people with pre-existing conditions now enjoy — if insurers can offer you bare-bones plans, then the guarantee that you'll be covered for your pre-existing conditions will cease to mean very much. It also allows states to seek waivers for the ACA's outlawing of annual and lifetime limits on coverage, which threatens the security of everyone who has an employer-provided plan. The bill allows insurers to charge more to older people, and bars women on Medicaid from getting care at Planned Parenthood for one year.
The Senate’s Better Care Reconciliation Act would eventually make deeper cuts to the Medicaid program for the poor. In California, Medi-Cal covers nearly 14 million, including half of the state’s children and two-thirds of seniors in nursing homes.
Newsday also calls out the bill for being a massive tax cut:
Trump has wavered in his reaction to the bills. He held a huge party to celebrate the House’s passage of the AHCA in May, but recently called it “mean, mean, mean.”
Trump’s problem is that these bills are a tax cut for the wealthy masquerading as a health care reform. According to the rules the Senate must use to pass the bill with a bare majority, the health care part will have to be “mean” to poor people for Trump to afford the huge tax gift he wants to give to rich people. To pass the bill in the Senate with 51 votes rather than the usual 60-vote requirement, it must reduce the deficit. But the 3.8 percent tax cut to the wealthy that these bills create would explode the deficit.
These tax cuts wouldn’t help the economy, because they would mostly go to people who don’t need to spend the extra money. But the health care spending cuts to offset the tax cuts would devastate the economy, particularly in New York, costing patients their coverage, health care workers their jobs, and nursing homes and medical facilities significant revenue. Even worse, a New York-specific amendment would take away an extra $2.3 billion in annual Medicaid money from the state.
Meanwhile, Jeva Lange at The Week highlights Trump’s promises that the bill breaks.
In closing, Eugene Robinson calls it what it is — a massive theft from the poor:
[A]bout 20 percent of Medicaid spending goes to provide nursing home care, including for middle-class seniors whose savings have been exhausted — a situation almost any of us might confront. Roughly two-thirds of those in nursing homes have their care paid by Medicaid.
Why would Republicans want to slash this vital program so severely? You will hear a lot of self-righteous huffing and puffing about the need for entitlement reform, but the GOP’s intention is not to use the savings to pay down the national debt. Instead, slashing Medicaid spending creates fiscal headroom for what is euphemistically being called “tax reform” — a soon-to-come package of huge tax cuts favoring the wealthy.