The fight to defend Medicaid, Medicare and the Affordable Care Act is fully engaged. Contacting members of Congress and letting them know how important progressive health care taxes, program funding and regulatory enforcements are for everyone is an effective way to alter the actions of Congress. The political activity and voter organizing done by the regressive movement worked to prevent President Obama and Congress from achieving more for Americans with middle and lower incomes. We can and must do what we can to succeed in blocking the regressive agenda of President Trump and Congressional Republicans.
“Republican Health Proposal Would Redirect Money From Poor to Rich
Margot Sanger-Katz @sangerkatz
FEB. 16, 2017
Republicans in Congress have been saying for months that they are working on a plan to repeal and replace Obamacare in the Trump era. Now we have the outline of that plan, and it looks as if it would redirect federal support away from poorer Americans and toward people who are wealthier.
A white paper drafted by House leadership and the staff of the House and Senate committees that oversee health policy details a structure that could replace large sections of the Affordable Care Act. Crucially, the proposal largely contains provisions that could be passed through a special budget process that requires only 50 Senate votes, and fulfills President Trump’s promise that the repeal and replacement of the law would take place “simultaneously.”…
…Obamacare, as the A.C.A. is known, extended health coverage to 20 million Americans through two main mechanisms. It expanded Medicaid coverage to Americans below or just above the poverty line in states that participated, and it offered income-based tax credits for middle-income people to buy their own insurance. Obamacare was a redistributive law, transferring money from rich to poor.
The Republican plan would alter both of those programs, changing the winners and losers. It would substantially cut funding for states in providing free insurance to low-income adults through Medicaid. And it would change how tax credits are distributed by giving all Americans not covered through work a flat credit by age, regardless of income.
That means that the biggest financial benefits would go to older Americans, like, say, Secretary of State Rex Tillerson. If he didn’t have a job in the Trump cabinet and access to government coverage, a 64-year-old multimillionaire like him would get the same amount of financial assistance as someone his age, living in poverty, and he would get substantially more money than a poor, young person…
…the current system is set up to ensure that low and middle-income Americans can afford the cost of their premiums. The Republican plan would not do that, and would result in many more low-income people losing out on coverage if they couldn’t find the money to pay the gap between their fixed tax credit and the cost of a health plan…
…The plan includes additional features that redistribute resources from the poor to the rich. It would allow Americans to sock more money away for health spending in special tax-free health savings accounts. The benefits of such accounts fall largely to higher income-people who pay more in taxes, and a recent analysis of current health savings accounts found that they are held disproportionately by families with high earnings. (The white paper is silent on two Obamacare taxes that target wealthier Americans, but other Republican plans have proposed eliminating them. It does eliminate a number of taxes on the health care industry.)…
…There’s still a lot subject to change, of course. Congressional leadership has said the bill, once completed, will proceed through committee hearings and amendments. And the politics of passing such legislation, even with Republican control of both houses of Congress, will be a challenge. But this proposal, with the imprint of every major committee working on health care, seems likely to set the terms of the discussion.
I wrote a few weeks ago about how all health policy decisions involve trade-offs, and it will be hard for President Trump to honor his promise of coverage that is “far less expensive and far better” than Obamacare. This plan is a good illustration of those challenges. It’s a simpler, potentially cheaper plan than Obamacare. But it’s far less generous to the poor, and unlikely to provide the health insurance for “everybody” that President Trump envisions.”
What happens now is up to each one of us. There is a great opportunity to defend our health care programs from the depredations of the President and the current Congressional majorities. Significant differences between the health policy preferences within the GOP caucuses in the House and Senate are creating real difficulties for the majority leaders and their Congressional committees. Let’s work together to meet the urgency of this moment.
There are things that can be done. I have a spouse who weekly calls our Senators’ and our Congressional Representative’s offices. Staff have been polite and noted her remarks. That may not necessarily change the way they vote, but it does remind them that they do have constituents – perhaps a significant number – who could be directly harmed by a repeal of the ACA.
If us lefties can defend Obamacare through the Trump interregnum the future is bright for progressive reform. If not, devil take the hindmost.
You must not have gotten the memo……the ACA is a neoliberal sellout to the insurance companies. It’s not worth defending.
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One does what they can do.
Well, apparently they have finally come up with a preliminary sketch of an outline of a plan for a replacement.
About now they must be getting desperate. Too much time is passing. Look for them to jump the gun and, in the House, vote to kill it without a replacement, or a mirage of a replacement.
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If you had asked me a couple months ago, I would have been convinced that the ACA was toast. Not so sure any more. The more time passes and the more these cretins have to listen to angry constituents, the less of an appetite they’ll have to pull the trigger. Only gets more difficult with time. If I were betting now, I’d say its odds of ACA’s survival (more or less) are about that of a coin flip. Could be wrong.
I agree.
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The Medicare Expansion is looking pretty good. The Exchanges are still in danger even without statutory law change because the uncertainty is pushing insurers to quit – although the system may be bailed out by the enormous advantages an insurer can get from a monopolized markets. In addition to monopoly pricing, they get high bargaining power with providers, and they can manipulate their pricing to increase subsidies for consumers so the government ends up carrying most of the monopoly pricing for people getting substantial subsidies. Weirdly Humana, which just quit, wasn’t doing that in a number of markets where they had monopolies.
One small but important correction: the ACA expanded Medicaid insurance eligibility, not Medicare eligibility. The ACA did improve some coverage levels for those with Medicare insurance, particularly in coverage for medication prescriptions.
Over 10 million Americans have gained Medicaid as a result of the ACA-enabled expansions in about 30 States. Many more millions woul have gained Medicaid if Chief Justice Roberts had not declared the ACA’s essential mandatory Medicaid expansions unconstitutionally coercive, and if about 20 Stupid States had not remained obstinate in their opposition to health care for lower income citizens in their States, so obstinate that these States are refusing billions of dollars in Federal money to fund health care for their constituents.
GOP leaders in Congress are determined to eviscerate the entire Medicaid program, not just the program for expanded eligibility. I think they will have a hard time destroying Medicaid’s guarantees by turning it into a block grant program, but I don’t consider us out of the woods on that issue.
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but I don’t consider us out of the woods on that issue.
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Victory begats victory. Not unlike the republicans/libertarians roaming around here, the ones in congress are a bunch of pants pissing cowards. Win on the ACA, and their blood will turn to piss and their hearts will start pumping dog shit (like around here).
But if they on the ACA it will lead to all sorts of misery on Medicaid and Medicare, and wins there would lead them to their promise land…Social Security.
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I agree with this premise. The modern conservative movement and Republican Party have perpetuated their own myth. They claim to have monolithic public support from “good Americans”, and they use that myth to support their ruthless use of government power when they gain executive positions and sufficient majorities in legislative bodies. That myth is false, which makes their delusions of grandeur fragile as paper mache’. Once they begin losing the ability to dictate government outcomes, they can be routed.
The GOP’s takeover of Federal agencies is a big, big problem, but even that can be overcome. Those Agencies are going to leak a torrent of politically damaging information against Republicans. It’s not ideal, but it’s where we are. I’ll take almost any help we can get.
If the worst happens, and it may very well happen, it won’t matter if it’s a neocon, and neoliberal, a communist, or a capitalist stooge, it will be everybody on deck or we all go down.
It’s why I don’t wonder, like you seem to, on the motivations of the ones who want to convince us that some weapons are not useful or a waste of time. I know their motivations. Or like the article above..their motivations are irrelevant, if we end up in the same place.
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In a meeting of the House Freedom Caucus Monday night, they voted to oppose any ObamaCare repeal bill if it does not go as far as the repeal measure that passed in 2015. If the Freedom Caucus all withheld their votes for a bill the Speaker puts on the floor of the House, the bill would be a couple of dozen votes short of passage unless Ryan went out and got some votes from Democrats.
Later this week, the Chair of the Senate Committee responsible for moving the majority of the work which will need to be done to assemble the ACA replacement said the 2015 repeal bill will not get a vote in his committee, and Chairman Alexander has spoke most frequently and hopefully in support for broad policy principles which would be pretty bad, but more progressive than the 2015 bill.
They can’t pass an ACA replacement under these circumstances. Every day, week and month which ticks by without replacement legislation moving thru the committees and onto the House and Senate floors reduces the odds that they will get an Obamacare replacement signed into law before their rapidly diminishing political capital is gone.
They better be quick, because I think Trump is going to kill any and all political capital with his behavior. Although I don’t think they had much anyway.
That’s why I believe the House will vote on something, and it will die in the Senate.
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The HFC also opposss using tax credits of any kind — or at least a good chunk of their members do. Can’t extend health care with tax breaks, guys.
I know it feels like 7 years, but we are only four weeks in. The ACA didn’t pass the House until March of 2010.
Right now I feel like every day that goes by without a loss is a victory, though. 🙂
Wait until the deportations really get going
Then no day will feel like a victory.
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The Republican proposals, including the one you mention, usually favor the young over the old, although there are a lot and the whole scene is a hot mess. Right now subsidized old individuals get more of a subsidy than young ones, because they pay more. In addition, older individuals are more likely have insurance and need subsidies in the first place. The HHS rule allowing a greater old-young price difference helps the young and hurts the old as well.
The reverse Robin Hood take-from-the-poor-to-give-to-the-rich changes are very much the case and characterize almost everything in their entire panolpy of nutty proposals.