It’s official. The CBO projects that the Senate version of Trumpcare would not be quite as mean as the House version. Instead of 23 million people losing their health care coverage by 2026, the Senate number goes all the way down to … 22 million.
We can start there and, really, if we have even a little of what Donald Trump daringly calls “heart,” we can stop there.
There’s only one question to consider: Under what circumstance is America better, much less great, by removing health care coverage for 22 million people? For all its problems, the great triumph of Obamacare is that the uninsured rate in the country has plummeted. If the Senate plan passes, the number of uninsured Americans is projected to grow from 27 million to 49 million by 2026.
Is there anything left to say? I mean, we can debate all the other stuff, and, yes, there’s much to debate. We can talk about Mitch McConnell’s cynical plan to rush the bill through the Senate. But once you get to the 22 million, it’s hard to consider anything else.
Still, for the record, we’ll note the cruel Medicaid cuts, which would reduce projected spending by $780 billion. Yes, that’s three-quarters of a trillion dollars. Also the huge tax cut for the rich. The removal of lifetime caps. The essential health benefits that states can waive. The coming of even higher deductibles, which Republicans keep saying needed to be addressed and yet which would soar, under the GOP’s silver plan, to $6,000. The crushing premium hikes, particularly for those nearing Medicare age. A 64-year-old making $56,800 would pay — get this — $20,500. And then there’s the bizarre six-month waiting period to renew coverage — the plan that would replace the hated mandate. Under the bill, if you have no coverage and get disagnosed with, say, cancer in June, the doctor will see you in December, if you’re not already dead.
But we shouldn’t have to go there. If we know just this, that 22 million who have coverage now won’t be covered over the next 10 years and that, even worse, 15 million people who have insurance now won’t be covered in a year, we don’t need to know anything else.
What Republicans are trying to do here is to take a buzzsaw to the safety net. And not just that. But to give the savings to the wealthy, who don’t need the money or the saw. We have to remember to mention the tax cut, because Trump and the GOP never mention the nearly $1 trillion in cuts. You don’t have to wonder why. It’s the unspoken rationale for the bill, joined with the always-spoken rationale that whatever else this bill is, it’s not Obamacare.
Predictably, the Republican reaction to the report has been that you can’t trust the CBO estimates. But here’s how you know not to take the critics seriously: The Trump administration and Senate leaders never offer their own numbers to counter the CBO projections.
There’s a reason for that. What if they said 15 million people would lose their insurance? What if they said 10 million?There’s no good number here. Once upon a time, Trump said everyone would be covered. That, I believe, is one of the lies mentioned in The New York Times‘ full page of lies told by Trump since taking office.
But this is not just on him. You saw Mike Pence saying that the Senate bill was based on personal responsibility. He didn’t say which people needed to be more responsible, so we’re left to guess. You saw the many Republicans going on cable news to say that Medicaid would be untouched by the bill even as the CBO would reveal that touching is the least of it. And now, some Republicans are actually said to be wavering.
There’s the right wing contingent saying that too much of Obamacare is being left in place. They’re right about that, at least in one sense. The shell remains, even as the law is being gutted. And then there are the moderates who will admit this bill is a disaster while expressing their “concern.” If there are four or five votes in opposition, as some are saying, then the bill dies. Republicans, with their 52-48 edge in the Senate, can afford to lose only two, but don’t count McConnell or the bill out yet.
So now in Colorado we must ask, what will Cory Gardner do? As we know, Gardner co-authored a letter to McConnell saying he was worried that the rate of Medicaid cuts would potentially cost participants “access to life-saving health care services.” Since he is the one who put it in life-and-death terms, we shouldn’t feel any compunction about going there. Experts tell us that of the millions who would lose coverage, many would die sooner than if they were insured.
And yet, Gardner told The Denver Post that the CBO score hadn’t changed his position — at last check he was “reviewing” — but that he was heartened by recent talks he has had with insurance company CEOs about stabilizing markets. He might have mentioned he was also seen recently reviewing with the Koch brothers.
But while he’s reviewing, he might want to check some other sources. He could consult the American Medical Association, which said emphatically that the bill would do America much harm. Or he could check the CBO report which says that with higher premiums and sky-high deductibles that “few low-income people would purchase any plan” at all. He might review, too, what this bill means for the working poor — a majority of those who gained insurance through expanded Medicaid are employed, according to the Kaiser Family Foundation — who might have a stronger visceral sense of the bill’s impact than the CEOs.
In a recent column, I asked whether Gardner was willing to risk his political career by voting for a wildly unpopular plan in a state that has benefited greatly from Medicaid expansion and strongly favors many other aspects of Obamacare. But after the CBO report, which suggests that more than politics are at stake here, I think I should pose the question differently.
Is Gardner really ready to vote for a plan that not only risks his political career but also risks, for the sake of a needless tax cut, the futures of 22 million real live human beings?
Photo by Pictures of Money, via Flickr: Creative Commons