It does the opposite of what they say.
The American Health Care Act, passed today by the US House of Representatives, is a law that fundamentally does the reverse of what its proponents are promising.
Having run a campaign during which he promised to cover everyone, protect Medicaid from cuts, and replace Affordable Care Act plans with “terrific” coverage, Donald Trump is now behind a bill that cuts Medicaid, covers fewer people, and allows states to replace ACA plans with stingier coverage. Having promised repeatedly to protect patients with preexisting health conditions from insurance market price discrimination, Paul Ryan is pushing a plan that removes existing protections and replaces them with hand-wavy and inadequately funded high-risk pools. Having leveraged public discontent with high deductibles and rising premiums, Republicans are pushing a bill that will leave most patients with higher out-of-pocket costs for equivalent plans and bring back skimpy plans with even higher deductibles.
That’s all happening because the GOP is committed to rolling back the taxes that pay for the Affordable Care Act, delivering a financial windfall to high-income families even though Treasury Secretary Steve Mnuchin swore at his confirmation hearings that the Trump administration would not pursue tax cuts for the rich.
.. When Ryan initially rolled out the American Health Care Act, he accompanied it with a Frequently Asked Questions page that offered a firm statement of moral purpose regarding the treatment of patients with preexisting conditions:
That statement is now gone from the House leadership’s website. In search of additional Freedom Caucus votes, Ryan abandoned that commitment and signed on to the MacArthur Amendment that will, in fact, allow insurers to charge higher premiums to sick people.
.. “I’m not going to cut Social Security like every other Republican and I’m not going to cut Medicare or Medicaid,” Trump told the conservative Daily Signal way back in May 2015. “Every other Republican is going to cut, and even if they wouldn’t, they don’t know what to do because they don’t know where the money is. I do.”
.. That fall, his promises got even bigger. “I am going to take care of everybody,” he told 60 Minutes. “I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now.”
.. The bill his party is now pushing will cover fewer people, charge higher premiums, raise copayments, and raise deductibles.
The reason is that the AHCA takes a ton of money out of the health care system in order to provide a $600 billion tax cut,
.. While running for president, for example, Barack Obama promised that his health plan would lead to lower premiums for average families. When pressed, his policy team would gladly clarify that what he meant was premiums would increase at a lower-than-expected rate. That was a reasonable promise, but not nearly so politically appealing as the much grander promise the candidate made in his speeches. And the policy of misleading people worked well enough until he was actually in office, signed a major health care bill, and then people discovered that their premiums were not, in fact, going down.
Trump’s Tax Proposal Is Just a Symptom of the Disease
No wonder this administration can’t get anything done. It specializes in wishful thinking.
This conveys the impression that the administration cares a lot about cutting taxes for very wealthy people and corporations, and considers the other elements of the plan to be filler, to be sketched in brief if at all.
.. Tell hundreds of thousands of government employees that they need to make a more business-friendly environment, and you’ll rapidly discover the terrifyingly myriad ways in which such a directive can be interpreted by individual minds. No, what you actually have to do is create rules to follow, all of them spelled out in mind-numbing minutiae.
Detail makes enemies.
Let’s revisit the personal deduction eliminations, for example. Going to get rid of the deduction for people with high medical expenses? Enjoy the frantic phone calls from patient groups. How about educational savings accounts? Are they going away? Stand by for the firestorm of indignation from middle-class parents. If the Trump administration actually tries to enact its plans, one by one, many of its ideas, so pleasing in vague summation, will become flesh, encounter political resistance, and die an early and gruesome death.
Living in the Trump Zone
The reason I use scare quotes here is that the single-page document the White House circulated this week bore no resemblance to what people normally mean when they talk about a tax plan. True, a few tax rates were mentioned — but nothing was said about the income thresholds at which these rates apply.
.. Meanwhile, the document said something about eliminating tax breaks, but didn’t say which. For example, would the tax exemption for 401(k) retirement accounts be preserved?
.. So if you were looking for a document that you could use to estimate, even roughly, how much a given individual would end up paying, sorry.
.. Trump is like a temperamental child, bored by details and easily frustrated when things don’t go his way; being an effective staffer seems to involve finding ways to make him feel good and take his mind off news that he feels makes him look bad.
This Isn’t Tax Policy; It’s a Trump-Led Heist
This isn’t about “jobs,” as the White House claims. If it were, it might cut employment taxes, which genuinely do discourage hiring. Rather, it’s about huge payouts to the wealthiest Americans — and deficits be damned!
.. If Republicans embrace this “plan” after all their hand-wringing about deficits and debt, we should build a Grand Monument to Hypocrisy in their honor.
Trump’s tax “plan” is a betrayal of his voters. He talks of helping ordinary Americans even as he enriches tycoons like himself.
.. fewer than 10 percent of low-income households with children would get anything at all
.. families earning between $10,000 and $30,000 a year would receive an average child care benefit of just $10.
.. In fairness, Trump’s proposal does include some sensible elements. Raising the standard deduction is smart and would simplify everything, reducing cheating and the need for record-keeping because millions of filers would no longer itemize deductions.