Saturday, May 6, 2017

Winners and losers in the GOP health bill

The Associated Press reported on the passage of the House Health Care Bill, saying that:  "A defeat would have been politically devastating for President Trump and Speaker Paul Ryan. . . . Passage was a product of heavy lobbying by the White House and Republicans leaders, plus late revisions that nailed down the final supporters needed."

But voters have increasingly come to like Obama's Affordable Care Act, so that Republicans' persistence in their mantra of "Repeal" has lost much of its conservative luster -- and it's likely to become a political liability to the party in 2018.  Nancy Peolos warned them:  "You vote for this bill, you'll have walked the plank from moderate to radical. . .  You will glow in the dark on this one."

But Ryan and Trump had to have their win -- at any cost.   They kept revising the bill to make it more acceptable to Freedom Caucus members, hoping that they would hold on to enough moderates to squeak out a win.   Let the Senate worry about how to deal with it later.

Here are some of the major features, as described by the Associated Press:
   It eliminates the mandate to buy insurance and the penalties on those who don't.  It also erases the tax on the wealthy in Obamacare.   It makes huge cuts in the Medicaid program, and it transforms subsidies into tax credits.

Children can stay on parents' insurance until 26, and it pretends to retain protection for people with pre-existing conditions.   But that's a bit of a farce.  It allows states to set up high risk group policies that will receive some subsidies;  but the amount appropriated is totally inadequate, which will cause premiums to rise by tens of thousands of dollars.    One estimate puts premiums for someone with metastatic cancer at $145,000 a year.  It allows insurance companies to charge higher premiums on older people by up to 5 times as much, where Obamacare held it to 3 times.

A major problem in the rushed passage was that the CBO has not yet scored the bill, so no one really knows how many would lose insurance.  Most people think it will be even more than the 24 million the CBO calculated in their first version.

Republicans emphasize that their plan frees people from the mandate to buy insurance;  but it provides the "opportunity" for all to get it.   I guess when you've trained your voters, as they have, to listen to slogans and not ask questions, then you can hope they won't realize that "opportunity" and "free choice" mean nothing when you can't possibly afford what is made available for your free choice.

Sally Kliff, of Vox News, summarizes:  If this passes, the winners will be the young, the healthy, and those with high incomes.   The losers will be older, sicker, and low income people, who need it most.

In the political balance of the House, the Freedom Caucus won out over the Tuesday Group (moderate Republicans), because it was their interests that were accommodated and their votes that put it over in the win column.

First, this bill will not pass the Senate and become law.   I'd guess there's about a 50/50 chance that something will be passed that they can claim as success, and that it will not be as bad as this one is.    If that does happen, I believe the Republicans will pay at the polls in 2018, perhaps even losing control of the House.  If they can't agree on anything, however, there's no doubt they will lose 'bigly' at the polls in 2018.


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