Will Ryan Postpone The TrumpCare Vote Again Today?

Would it change your negative feelings towards Trump voters-- not the racists, the others-- if you understood the "sea of despair" their lives have become? That's how the Washington Post described their state of mind yesterday, based largely on a new report from the Brookings Institution, Mortality and Morbidity in the 21st Century. The researchers found that "deaths of despair"-- deaths from suicide, from drug overdose, from alcohol-related liver diseases-- are on the upswing among non-Hispanic whites, the American working class. They make the point that it isn't just an Appalachian problem or a rural problem, but something that is happening across the U.S. Mortality rates are going up everywhere in the country, New York, New Jersey and California being the only exceptions. In the video above, Princeton Professor Anne Case explained that "The people who are really getting hammered are people with less education."

While midlife mortality rates continue to fall among all education classes in most of the rich world, middle-aged non-Hispanic whites in the U.S. with a high school diploma or less have experienced increasing midlife mortality since the late 1990s... [M]ortality rates of whites with no more than a high school degree, which were around 30 percent lower than mortality rates of blacks in 1999, grew to be 30 percent higher than blacks by 2015.

Case and her colleague, Professor Angus Deaton suggest that the increases in deaths of despair are accompanied by a measurable deterioration in economic and social wellbeing, which has become more pronounced for each successive birth cohort. Marriage rates and labor force participation rates fall between successive birth cohorts, while reports of physical pain, and poor health and mental health rise. They documented an accumulation of pain, distress, and social dysfunction in the lives of working class whites that took hold as the blue-collar economic heyday of the early 1970s ended, and continued through the 2008 financial crisis and the subsequent slow recovery.

Unable to round up enough votes to pass it, Ryan and McCarthy pulled the TrumpCare vote off the congressional schedule for yesterday and claim there'll be a vote today-- a vote on a bill that, if ever signed into law, will exacerbate every single thing that Case and Deaton are talking about. Of course, when you demonize science and scientists... you become immune to hearing their warnings. As Matt Taibbi emphasized in his new Rolling Stone piece this week, Trump The Destroyer, "One of the brilliant innovations of the Trump phenomenon has been the turning of expertise into a class issue. Formerly, scientists were political liabilities only insofar as their work clashed with the teachings of TV Bible-thumpers. Now, any person who in any way disputes popular misconceptions-- that balancing a budget is just like balancing a checkbook, that two snowfalls in a week prove global warming isn't real, that handguns would have saved Jews from the Holocaust or little kids from the Sandy Hook massacre-- is part of an elitist conspiracy to deny the selfhood of the Google-educated American. The Republicans understand this axiom: No politician in the Trump era is going to dive in a foxhole to save scientific research. Scientists, like reporters, Muslims and the French, are out." Oh, and by the way, Trump announced that if Ryan can't pull this off today, he's moving on to his own priorities and that Ryan will be on his own with this mess. No one ever thought Trump had much of an attention span for anything that doesn't include enriching himself.

Late last night, Glenn Thrush and Maggie Haberman reported for the NY Times that Trump, who they wrote has appeared "impatient and jittery" all week "has told four people close to him that he regrets going along with" Ryan's anti-healthcare jihad right out of the box, although that doesn't line up with the million and one statements Trump made on the campaign trail promising to repeal Obamacare on his first day in office. "Trump," they reported "was slow to recognize the high stakes of the fight, or the implications of losing." He wants to win so badly that he doesn't seem to care how bad of a betrayal to his voters TrumpCare has become-- scrapping mandatory essential benefits like outpatient visits, mental health services (such as opioid addiction, which he specifically campaigned on) and maternity care.

Yesterday, Ryan's SuperPAC, the Congressional Leadership Fund, was instructed to put a scare into Republicans opposing Ryan's TrumpCare bill by pulling financial support from David Young's 2018 reelection efforts-- in an Iowa swing district Obama won both times and Trump won 48.5% to 45.0%. That's hard ball. I bet Ryan wasn't excited yesterday to get a letter from the new CBO director he appointed, Keith Hall, with the latest estimates on the latest version of TrumpCare, after the changes that Ryan and his cronies made to the bill to make it more attractive to far right extremists who generally just oppose government activities in health care. The new estimates incorporate the manager's amendments from Wednesday night when Pete Sessions kept the Rules Committee up all night coming up with something ever more horrible than the first version. "As a result of those amendments," he wrote, "this estimate shows smaller savings over the next 10 years than the estimate that CBO issued on March 13 for the reconciliation recommendations of the House Committee on Ways and Means and the House Committee on Energy and Commerce." That's $186 billion over the 10 year period. But that isn't the worst of it:

CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under the legislation than under current law. The increase in the number of uninsured people relative to the number under current law would reach 21 million in 2020 and 24 million in 2026. In 2026, an estimated 52 million people under age 65 would be uninsured, compared with 28 million who would lack insurance that year under current law.

...Compared with the previous version of the legislation, H.R. 1628, with the proposed amendments, would have similar effects on health insurance coverage: Estimates differ by no more than half a million people in any category in any year over the next decade. (Some differences may appear larger because of rounding.) For example, the decline in Medicaid coverage after 2020 would be smaller than in the previous estimate, mainly because of states’ responses to the faster growth in the per capita allotments for aged, blind, and disabled enrollees-- but other changes in Medicaid would offset some of those effects.

Pramila Jayapal took one look at the new CBO report and told her Seattle constituents that "the revised TrumpCare bill is worse than the original. In addition to stripping 24 million people of health care, raising costs for low and middle income families, and subjecting middle-aged Americans to an age tax, TrumpCare will now give a $1 trillion tax cut to the rich. Despite all this, Republicans are still ratcheting up this tax bill disguised as a health care plan and offering backroom deals to drum up support. The American people want nothing to do with TrumpCare. I hope the majority in Congress listens to them, and gives up on their ideological quest that would leave millions without health care. As much as Republicans talk about moral values, this bill makes a mockery of every one of those American ideals. Instead of getting more people health care, they just increased tax cuts for the rich by $400 billion."

When she said that "the American people want nothing to do with TrumpCare," she wasn't just speaking rhetorically. Just before the new CBO report came out, Quinnipiac released a new poll showing already very low support for TrumpCare plummeting further. Voters overwhelmingly disapprove 56% to 17%, with 26% undecided. Even support among Republicans is a very tepid 41%. Quinnipiac reported that "if their U.S. Senator or member of Congress votes to replace Obamacare with the Republican health care plan, 46 percent of voters say they will be less likely to vote for that person, while 19 percent say they will be more likely and 29 percent say this vote won't matter... 'Replacing Obamacare will come with a price for elected representatives who vote to scrap it, say many Americans, who clearly feel their health is in peril under the Republican alternative,' said Tim Malloy, assistant director of the Quinnipiac University Poll.

John Yarmuth (D-KY), ranking Democrat on the House Budget Committee, pointed out that the "CBO has reconfirmed tonight that the Republican plan will cause millions of Americans to lose their coverage and out-of-pocket costs to skyrocket, while subjecting middle-aged Americans to an age tax. They do all this to give $1 trillion in tax cuts to corporations and the wealthy, but they may not stop there. It is astounding and appalling that Republicans in Congress are negotiating with the health and well-being of American families. They have no moral compass."

It had been widely predicted that if Ryan moved the bill in an uglier direction-- which he very much did with the manager's amendments-- mainstream conservatives would bail... and they did, while Freedom Caucus extremists, who want repeal without replace, are still not on-board. In the last few days many swing state Republicans, sensing the betrayal, ran for the exits. Undecided congressmembers in districts where Democrats have the best chances of beating them are no longer undecided. Among the NO votes now are Charlie Dent (PA), Leonard Lance (NJ), who voted for the first version in committee, John Katko (NY), Dan Donovan (NY), David Young (IA), Chris Smith (NJ), Frank LoBiondo (NJ) and Jaime Herrera Beutler (WA). John Faso (NY) who bought into one of Ryan's promises a couple of days ago is wavering again.

"Sad," wrote Charles Pierce in Esquire referring specifically to Paul Ryan, "the zombie-eyed granny starver from the state of Wisconsin, [who] took one in the chops when a vote of his well-camouflaged tax-cut bill was postponed until Friday morning. This came after a frenzied 48 hours in which Ryan and the president were pulled around by the nose by the more lunatic members of their party who thought the dead-fish Ryan had sent to the House wasn't tough enough on poor people. Finally, rather than face the revolt of the wingnuts, Ryan and the Republican leadership pulled the vote, opting for a meeting of the Republican conference and a possible vote on Friday. This sent the House side of the Capitol into a positive whirlwind of rumor, speculation, and undeniable flopsweat."

Carol Shea-Porter represents a very swingy New Hampshire district. She won in a 3-way race 44.3%-42.9%-9.4%, while Trump beat Hillary 48.2% to 46.6%. In her report to her constituents-- 40,049 of whom would lose health care under the less terrible first TrumpCare proposal-- yesterday she put it like this: "“There are proposed last-minute changes to the bill that would make a cruel bill even meaner. Republicans now want to take away requirements that insurance plans cover essential services like hospitalization, pregnancy care, prescription drugs, and mental health and addiction treatment. These changes would make a terrible bill-- one that would kick 24 million Americans off their coverage-- even worse. The American people don’t want this bill, and neither does New Hampshire: we have a large volume of calls coming in to my office. House Republicans are ignoring their own hardworking constituents, who are pleading to keep their insurance. Health care organizations are attacking this bill. The only people who benefit are the wealthiest, who would get huge tax breaks. Republican leadership is rushing this unpopular, destructive bill to a vote this week because today is the 7-year anniversary of the Affordable Care Act. Clearly, this rushed process is about spite, scoring political points, and helping wealthy supporters, rather than about doing what’s best for the American people.” See that thermometer on the right? Tap it and help slow down Trump and help end Paul Ryan's tenure as Speaker.