Despite what you may have heard about the so-called devastating CBO report on the Trump/Ryan answer to Obamacare, the report is actually quite encouraging.
What I mean is, the report is so bad, so incredibly and incriminatingly bad, that no one in his right mind could still think this bill would ever become law. How much more encouragement could you ask for?
The CBO report reveals many things, but, for our purposes, we’ll go with the two most revealing and most damning.
First, we go to the numbers. In 10 years, the CBO report projects that 24 million fewer people would be insured under Trumpcare. You’ve no doubt seen that number, but stop and consider what 24 million actually means. Those are living, breathing (for now, anyway) people. Many of them are voters. Most of them are low-income voters. Many of them are Trump voters. Most of them are among the most financially vulnerable American voters.
And here’s an even more startling number: The bill that would completely wipe out the insurance-coverage gains made by Obamacare would also mean 14 million more people without insurance in the first year. Yes, in the very first year.
These numbers reveal, of course, the lie in everything Donald Trump has ever said about Trumpcare. He said the plan would be “terrific.” He said “everybody” would be covered. He said (actually, Tom Price, Trump’s health secretary, said it) that no one should lose coverage under Trumpcare, a prediction that seems to be off by around 24 million. Trump said he wouldn’t mess with Medicaid, which, it turns out, would be cut by an astonishing $880 billion.
In other words, the bill was revealed to be both monstrously cruel and, surprise, politically untenable. Who thought up this thing?
Oh yeah. We know who thought it up. Which brings us to the second big reveal. Paul Ryan, who takes ownership of the bill, insists that he loves the CBO report. The speaker said he found it “encouraging.” He insisted that it “exceeded” his expectations. He said that of course the report would show huge increases in the uninsured because “government is not going to force people to buy something they don’t want to buy.”
Paul Ryan is at least being honest when he says he loves a bill that cuts Medicaid by a quarter. He loves a bill that reduces the deficit over the next decade by $300 billion, and especially because the rest of the $880 billion saved on Medicaid goes to tax cuts for the rich. He doesn’t seem at all fazed by this unalternative fact that you’ll see again and again and again: When we reach the 10-year mark under this plan, a 64-year-old who makes a $26,500 salary would pay nearly $13,000 more in annual premiums. You can do the math here. Anyone can do the math. Even Donald Trump can do the math.
The rich benefit from this plan. The poor and near-poor do not. The young and healthy benefit from this plan. The older and sicker do not. It is, as several pundits have noted, a giant wealth-redistribution plan, with the redistributing going in exactly the wrong direction and on an unprecedented scale.
What the report makes clear — and what Ryan doesn’t even bother to deny — is Paul Ryan’s Ayn Randian view of freedom. Yes, Americans would have the freedom to keep their own doctors. They just wouldn’t have the money with which to pay them.
So, what happens now?
I’m imagining that Cory Gardner must be much relieved by this report. He had warned that he couldn’t support a bill that jeopardizes those 400,000 Coloradans getting their coverage from the expansion of Medicaid. Well, if that’s the case, he definitely can’t support this bill. Nor could he possibly support a bill that weighs so heavily on white working-class voters — you know, the Republican base. There’s a reason it took seven years to find a bill to adequately replace Obamacare that also meets Republican standards. Because there is no such bill that does both things.
Gardner is off the hook. And if Gardner is off the hook, so are a bunch of other Republicans who were already wary of the bill. Six GOP senators, including Gardner, had criticized the bill before the CBO report. Add 24 million uninsured, and voting for the bill becomes a political suicide mission. Do not expect Gardner to volunteer.
The big question, though, is what Trump does. If he sticks with the bill and it loses — possibly even in the House — then you’ve got that winning-so-much-you’ll-be-tired-of-winning issue. If he sticks with the bill and it loses, it also breaks one of Trump’s primary campaign promises, which was to repeal and replace Obamacare. He is already underwater with his promise that Mexico would pay for the border wall, and it’s not even certain that his big beautiful wall will ever be built.
Now Trump did say — and many of us are still chuckling — that no one had any idea that health care reform could be so complicated. It was nearly as absurd as Trump’s claim that Obama was wiretapping him, but, absurd as it was, the health care claim might give the president a way out.
All it would take is for Trump to throw Ryan under the bus. Trump, who as of this writing has said nothing about the CBO report, could say that he was shocked by its findings, that Ryan assured him that the bill would do everything that Trump had promised instead of, well, none of the things he had promised.
Trump could say that Ryan betrayed him. It might even be true. And here’s the bonus: If Trump throws the plan over, he could actually take credit for the millions of Americans who wouldn’t be betrayed.
Illustration by DonkeyHotey