The basics of Republican health legislation, which haven’t changed much in different iterations of Trumpcare, are easy to describe: Take health insurance away from tens of millions, make it much worse and far more expensive for millions more, and use the money thus saved to cut taxes on the wealthy.
.. Meanwhile, taxes that fall mainly on a tiny, wealthy minority would be reduced or eliminated. These cuts would be big in dollar terms, but because the rich are already so rich, the savings would make very little difference to their lives.
More than 40 percent of the Senate bill’s tax cuts would go to people with annual incomes over $1 million — but even these lucky few would see their after-tax income rise only by a barely noticeable 2 percent.
.. So it’s vast suffering — including, according to the best estimates, around 200,000 preventable deaths — imposed on many of our fellow citizens in order to give a handful of wealthy people what amounts to some extra pocket change.
.. I think there are two big drivers — actually, two big lies — behind Republican cruelty on health care and beyond.
First, the evils of the G.O.P. plan are the flip side of the virtues of Obamacare. Because Republicans spent almost the entire Obama administration railing against the imaginary horrors of the Affordable Care Act — death panels! — repealing Obamacare was bound to be their first priority.
.. Republicans, through their political opportunism and dishonesty, boxed themselves into a position that makes them seem cruel and immoral — because they are.
.. this story began with a politically convenient lie — the pretense, going all the way back to Ronald Reagan, that social safety net programs just reward lazy people who don’t want to work. And we all know which people in particular were supposed to be on the take.
.. What it does — punish the poor and working class, cut taxes on the rich — is what every major G.O.P. policy proposal does. The only difference is that this time it’s all out in the open.
.. remember this moment. For this is what modern Republicans do; this is who they are.
How the Republican Coward Caucus is about to sell out its own constituents — in secret
a repeal bill so monumental in its cruelty that they feel they have no choice but to draft it in secret, not let the public know what it does, hold not a single hearing or committee markup, slip it in a brown paper package to the Congressional Budget Office, then push it through to a vote before the July 4th recess before the inevitable backlash gets too loud.
“We aren’t stupid,” one GOP Senate aide told Caitlin Owens — they know what would happen if they made their bill public.
.. Today, we learned that in a break with longstanding precedent, “Senate officials are cracking down on media access, informing reporters on Tuesday that they will no longer be allowed to film or record audio of interviews in the Senate side hallways of the Capitol without special permission.” Everyone assumes that it’s so those senators can avoid having to appear on camera being asked uncomfortable questions about a bill that is as likely to be as popular as Ebola.
.. This is how a party acts when it is ashamed of what it is about to do to the American people. Yet all it would take to stop this abomination is for three Republicans to stand up to their party’s leaders and say, “No — I won’t do this to my constituents.” With only a 52-48 majority in the Senate, that would kill the bill. But right now, it’s looking as though this Coward Caucus is going to be unable to muster the necessary courage.
.. Take Shelley Moore Capito of West Virginia, a state where over 175,000 people have gotten insurance thanks to the Medicaid expansion... Last week The Hill reported that Capito now supports eliminating the expansion after all — just doing it over seven years instead of the three years that the House bill required...Or how about Ohio’s Rob Portman? In his state, 700,000 people gained insurance as a result of the Medicaid expansion... They’d pay for the slower elimination of the expansion by cutting money out of the existing program, so they could get rid of all of the ACA’s tax increases.. — over half of Medicaid dollars go to the elderly and disabled... That means that they aren’t just undoing the ACA; they’re making things substantially worse for tens of millions of America’s most vulnerable citizens than they were even before the ACA passed... And they’re hoping they can do all this before anyone realizes what they’re up to, making this an act of both unconscionable heartlessness and epic cowardice. Their efforts to hide what they’re doing show that they are still capable of feeling some measure of shame. But it might not be enough to stop them.
Trump to propose big cuts to safety-net in new budget, slashing Medicaid and opening door to other limits
Trump’s budget plan would follow through on a bill passed by House Republicans to cut more than $800 billion over 10 years.
.. The Congressional Budget Office has estimated that this could cut off Medicaid benefits for about 10 million people over the next decade.
.. The White House also will call for giving states more flexibility to impose work requirements for people in different kinds of anti-poverty programs
.. Numerous social-welfare programs grew after the financial crisis, leading to complaints from many Republicans that more should be done to shift people out of these programs and back into the workforce. Shortly after he was sworn in, Trump said, “We want to get our people off welfare and back to work. . . . It’s out of control.”
.. In that budget, he sought a big increase in military and border spending combined with major cuts to housing, environmental protection, foreign aid, research and development.
.. The White House also is expected to propose changes to the Supplemental Nutrition Assistance Program, though precise details couldn’t be learned. SNAP is the modern version of food stamps, and it swelled following the financial crisis
.. As the economy has improved, enrollment in the program hasn’t changed as much as many had forecast.
.. An average of 44 million people received SNAP benefits in 2016, down from a peak of 47 million in 2013. Just 28 million people received the benefits in 2008.
.. SNAP already has a work requirement, which typically cuts benefits for most able-bodied adults who don’t have children. But states were given more flexibility during the recent economic downturn to extend the benefits for a longer period
.. the U.S. government spends between $680 billion and $800 billion a year on anti-poverty programs, and considering wholesale changes to many of these initiatives is worthwhile, given questions about the effectiveness of how the money is spent.
.. it could pave the way for states to pursue even stricter restrictions, such as drug tests, that courts have often rejected.
.. In March, the White House signaled that it wanted to eliminate money for a range of other programs that are funded each year by Congress. This included federal funding for Habitat for Humanity, subsidized school lunches and the U.S. Interagency Council on Homelessness
.. a change in the funding for Social Security’s Supplemental Security Income program, which provide cash benefits for the poor and disabled.
.. budget director, former South Carolina congressman Mick Mulvaney
.. A key element of the budget plan will be the assumption that huge tax cuts will result in an unprecedented level of economic growth.
.. these tax cuts would end up creating trillions of dollars in new revenue, something budget experts from both parties have disputed.
.. The tax cuts would particularly benefit the wealthiest Americans, as Trump has proposing cutting the estate tax, capital gains and business tax rates.
.. Robin-Hood-in-reverse
.. there has been a deficit in the United States every year since the end of the Clinton administration
.. “People think government is cheaper than it is because we’ve allowed ourselves to borrow money for a long period of time and not worry about paying it back.”
.. Its premise is that the creation of more wealth will help all Americans succeed, and the Trump administration believes that some anti-poverty programs have created a culture of dependency that prevents people from re-entering the workforce.
.. “I don’t think the Republicans on the Hill are going to feel a strong compulsion to follow the president,” Haskins said. “They are not afraid of him.”
.. the White House is expected to call for $200 billion for infrastructure projects and an additional $25 billion over 10 years for a new program designed by Ivanka Trump that would create six weeks of parental leave benefits.
Soak the Poor, Feed the Rich
Trumpcare will eliminate virtually all of the taxes that Obamacare introduced to expand health care coverage, including the Medicare surcharges that only apply to high earners: 0.9% on earned income and 3.9% on investment income. That in itself is a 16% cut in taxes on investments for a class of people who make lots of money from investments. Health savings accounts will increase the tax breaks available to high-income families. The “Cadillac tax,” which would have affected people with generous health plans, will be pushed back until 2025 (in a transparent bid to improve the bill’s scoring for reconciliation purposes), with the expectation that it will be repealed at some point in the future.
.. Because Trumpcare eliminates the individual mandate, more healthy people are likely to opt out of coverage. This will increase the average actuarial cost of people buying individual plans, which will push up premiums—a transfer from sick people to healthy people.
.. Trumpcare achieves the long-held conservative dream of converting Medicaid into a block grant program, which means that Republican state governments will be able to use the money in ways that are only tangentially related to providing health care for poor people. (Temporary Assistance for Needy Families block grant money, for example, is routinely used to support abstinence programs or premarital counseling services aimed at getting couples to marry.)
.. People will need the same amount of health care no matter what Congress does. If the government pays less for health care, poor people will have to pay more. If they can afford it, Trumpcare is effectively the same as a tax on the poor. If they can’t afford it, it’s even worse. This is as naked an example of class warfare as you’ll see today.