Mr. Trump signaled last week that one of the reasons he has reprioritized health care is that he was relying on savings from the health bill to bolster the tax plan.
.. If the health plan is signed, “we get hundreds of millions of dollars in savings that goes into the taxes,”
- .. an additional 3.8% tax on high-income households’ investment income,
- an extra 0.9% tax on top earners’ wages and
- various taxes related to health-care, such as medical devices.
.. repealing those taxes and offsetting the effect on budget deficits by cutting Medicaid, the health program for the poor.
.. lower projected federal revenue by about $1 trillion over a decade.
.. Republicans on Capitol Hill worry that they may not be able to adopt a 2018 budget resolution because of intraparty disagreements on spending.
Paul Ryan Failed Because His Bill Was a Dumpster Fire
It was bad policy, not poor tactics or negotiating skills, that doomed the GOP’s efforts to repeal and replace Obamacare.
he and his allies crafted a poorly constructed and radical bill that would sharply cut support to low-income Americans and those with serious health conditions, while enacting big tax cuts for the wealthy.
.. Speaker Ryan’s crafting of AHCA was a slapdash enterprise.
.. even leading health-care experts were confused by the changes. As Timothy Jost noted at Health Affairs: “This comprehensive a repeal of the ACA would have far-ranging consequences for our health care system that can scarcely be described, much less understood, in the hours that remain before a vote.”
.. wondered whether the game plan was just for the House to pass something—anything—and then let the Senate do the real work.
.. So why did Republicans fail? In a word: insincerity.
.. they might have refined another conservative model, such as Avik Roy’s modifications to ACA exchanges, to turn ACA’s exchanges in a more conservative direction.
.. Secure in the knowledge that they would face President Obama’s veto, Republicans rammed through a succession of extreme repeal-and-replace bills that resembled AHCA’s original draft. These bills excited the Republican base, but would have horrified most other Americans if they ever found sufficient reason to look.
.. Congressional Republicans suffered what George W. Bush might call a “catastrophic success” with Donald Trump’s unexpected victory.
.. leaving people in plans where the “deductibles are so high that it’s really not worth much to them.”
.. He vowed to replace the “failing,” “horrific” Obamacare with “something terrific.”
.. Republican plans are designed around higher deductibles and narrower benefits, not to mention more limited Medicaid.
.. smaller financial subsidies for people with chronic health conditions. That was the clear intention, but Ryan refused to admit it.
.. Many in the GOP, above all President Trump, seemed strangely uninterested in the policy details.
.. To the extent Republicans did have an animating passion, it was to puncture President Obama’s legacy—and to avoid looking foolish by failing to honor their “repeal and replace” rhetoric.
.. For all their endless warnings about how Obama’s signature health law was hurting American families, driving up costs and putting us on the path toward socialism, it turns out they didn’t care enough to put in the work.
Will Donald Trump Cave on Social Security?
Sam Johnson, the chairman of the House Social Security subcommittee, introduced a billthat would slash Social Security benefits for all but the very poorest beneficiaries. To name just two of the bill’s benefit cuts, it would raise the retirement age to 69 and reduce the annual cost-of-living adjustment, while asking nothing in the way of higher taxes to bolster the program; on the contrary, it would cut taxes that high earners now pay on a portion of their benefits.
.. most current retirees rely on Social Security for more than half of their income, and future retirees are expected to rely even more on the program.
Recently, he put forth a proposal to reform the budget process by imposing automatic spending cuts on most federal programs if the national debt exceeds specified levels in a given year. If Congress passed Mr. Trump’s proposed tax cut, for example, the ensuing rise in debt would trigger automatic spending cuts that would slash Social Security by $1.7 trillion over 10 years, according to an analysis by the Center for American Progress, a liberal think tank. This works out to a cut of $168 a month on the average monthly benefit of $1,240. If other Trump priorities were enacted, including tax credits for private real estate development and increases in military spending, the program cuts would be even deeper.