Thursday, June 22, 2017

What the Republicans’ Senate Health-Care Bill Means for America

The Senate republican health care bill goes into effect over several years, some things not fully going into effect until 2021. (Tax cuts for the rich go into effect immediately.) Surely I'm not the only one who sees that this puts these changes not only after the next mid-term elections, but after the next presidential election. So many people will blame the people who are in office then. Since the party of the president usually loses seats in the next mid-year election, this would result in many people blaming them for the actions of the republicans. Same if the Democrats win in 2020. And the people who are oblivious to the way republicans blocked President Obama's efforts to help the economy will be oblivious to the clever scheming of Congressional republicans on this issue.

By John Cassidy, Benjamin Wallace-Wells, and Adam Davidson

On Thursday, Senate Republicans unveiled their bill to replace the Affordable Care Act. Below, New Yorker writers offer some initial reactions to the news.

The Senate bill is really three separate proposals. In the private-insurance market, it amounts to what Larry Levitt, a health-care expert at the Kaiser Family Foundation, calls “Obamacare-lite.” As for Medicaid—the federal program that provides health services to roughly seventy-five million Americans, most of whom are poor or elderly or are children—the bill involves much bigger, and more harmful, changes. Finally, the legislation would deliver a hefty tax cut to some of the wealthiest households in the country.


The Affordable Care Act’s biggest achievement came through its expansion of Medicaid and its sibling, the Children’s Health Insurance Plan. By raising the income-eligibility threshold for households and allowing states to cover low-income adults who don’t have children, some thirteen million people have been added to the Medicaid rolls since January, 2014. But the Senate bill would reverse this extension, over three years, starting in 2021. Additionally, it would drastically change the future financing of Medicaid, placing a cap on federal subsidies per person and putting strict limits on the subsidies’ future growth. (The funding formula is actually less generous than the one in the House legislation.) Like the House bill, these changes would cause millions of Americans to lose their health coverage. It would also generate hundreds of billions of dollars of cost savings over the next ten years. We’ll see some precise projections in the coming days, after the Congressional Budget Office releases its analysis of the bill. For some reason, the Republicans’ desire to slash Medicaid has received less coverage than their proposals for the private-insurance market have. This should be at the center of the political debate.


According to a recent analysis by the nonpartisan Tax Policy Center, the top 0.1 per cent of earners—i.e., households that make at least 3.9 million dollars a year—would receive a tax cut of more than two hundred thousand dollars. And, unlike other aspects of the bill, this one would go into effect immediately.


This bill does openly what killing the Labor Reform Act did with considerable more subtlety: it takes hundreds of billions of dollars from the poorest and most vulnerable and gives it to the richest. It is, by any rational metric, the opposite of what our country needs at this moment. And savvy, self-protective Republican lawmakers feel no need to offer an explanation. This is not a health-care bill; it is a wealth grab by the wealthy. Political-opinion polls show that most Americans know that. Do Republicans care?—Adam Davidson

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