Which States Will Be The Most Severely Damaged By Trump's Broken Promise To Not Touch Medicaid?

Yesterday the DCCC targeted 10 Republicans whose seats appear vulnerable with new digital ads about their votes for TrumpCare. There were 217 Republicans who voted for it but the DCCC picked 10: Martha McSally (AZ), Jeff Denham (CA), David Valadao (CA), Carlos Curbelo (FL), Kevin Yoder (KS), Bruce Poliquin (ME), Jason Lewis (MN), Rodney Frelinghuysen (NJ), Claudia Tenney (NY) and John Faso (NY). Except for Frelinghuysen and the 3 freshmen (Faso, Tenney and Lewis), they're all failed targets from last year. Perhaps the DCCC should have thought a little more outside the box and gone after fresh meat-- TrumpCare supporters they've never targeted before like Dana Rohrabacher, Mimi Walters and Ed Royce in Orange County, CA, or Texans like Pete Sessions, Lamar Smith, John Culberson, and Kenny Marchant. And then there's a pair ripe for the pickin' in Illinois-- Pete Roskam and Rodney Davis, maybe Fred Upton and Dave Trott in Michigan or maybe even smug assholes who think they're immune from attack like Steve Russell (OK), Ted Poe (TX), Virginia Foxx (NC)... Raul Ryan (WI).

Save My Care also launched an ad campaign-- the "How Could You Do This To Us?" series-- but against 30 Republicans (like the one up top that slams Antelope Valley/Santa Clarita/Simi Valley Rep. Steve Knight). The other Republicans who Save My Care took aim at were Mark Amodei (NV), Don Bacon (NE), Dave Brat (VA), Carlos Curbelo (FL), Jeff Denham (CA), John Faso (NY), Darrell Issa (CA), Jason Lewis (MN), Brian Mast (FL), Martha McSally (AZ), Erik Paulsen (MN), Bruce Poliquin (ME), Pete Roskam (IL), Pete Sessions (TX), Elise Stefanik (NY), Scott Taylor (VA), David Valadao (CA), Tim Walberg (MI), Mimi Walters (CA), Don Young (AK), David Young (IA), and Lee Zeldin (NY), definitely a more interesting list and adventurous list.

There's a case to be made that all the New Jersey Republicans should be targeted. There are 5 in the state's 12 districts. Here's the list along with Trump's percentage in each district:

• NJ-02- Frank Biondo (50.6%)
• NJ-03- Tom MacArthur (51.4%)
• NJ-04- Chris Smith (55.8%)
• NJ-07- Leonard Lance (47.5%)
• NJ-11- Rodney Frelinghuysen (48.8%)

As Jonathan Salant reported for NJ.com, the Republican Obamacare repeal would hit N.J harder than any other state. That's heavy and it's because of the cuts to Medicaid, cuts he promised over and over again while campaigning would never come. Over half a million New Jersey citizens would be out of luck healthcare-wise as a result.

While New Jersey officials likely won't seek waivers to allow insurers to sell bare-boned insurance policies and jack up rates for those with pre-existing conditions, the House Republicans' health bill would hurt the state in many other ways.

"This waiver just made things worse but it was bad enough before the waiver," said Rep. Frank Pallone Jr. (D-6th Dist.), who led the fight against the Republican bill as the top Democrat on the House Energy and Commerce Committee.

Rep. Tom MacArthur (R-3rd Dist.), whose proposal on the state waivers led to approval of the Republican measure, said the Medicaid cuts are designed to force states to try hold down health care costs.

"What the Medicaid reforms really do is put pressure on the states to get costs under control," MacArthur said. "That's where the pressure is. It's not going to be on patients. I don't ultimately believe it will be on hospitals or doctors either. It's going to be on states."

...A study by the Urban Institute found that federal Medicaid funding to New Jersey on a per person basis would drop by 20.6 percent, more than any other state.

That could threaten the health cate of 1.8 million New Jersey seniors, people with disabilities and children, according to New Jersey Policy Perspective, a progressive research group.

"The point of the bill is to reduce federal funds," said Ray Castro, NJPP's director of health policy. "It's going to be less than what we need."

New Jersey would be hit hard because the GOP bill caps Medicaid spending for the poor, elderly and disabled, ending an entitlement in which expenditures funded by the federal and state governments fluctuated depending on how many residents qualified for the program.

The cap would cost New Jersey $30 billion in federal funds over 10 years, causing the state to lose tens of thousands of jobs, according to NJPP.

In addition, states like New Jersey that expanded Medicaid no longer would get extra federal funding for new recipients after 2019.

The state also would lose the extra funding for an individual who temporarily got off Medicaid and then came back onto the program. That happens often as someone lands a temporary job for a month or two and then needs assistance again, Castro said.

New Jersey is projected to have 553,000 adults with coverage due to the Medicaid expansion in 2019, according to the Urban Institute.

The state would have to increase its Medicaid spending by 35.6 percent to make up the GOP cuts, the study said.

But Trump and House Republicans also want to eliminate the federal deduction for state and local taxes, which would make it harder for New Jersey to raise its levies to ease the pain on its lowest-income residents.

"The state's going to lose all of this money," Pallone said. "How are they going to cover this medical population that's left?"

In all, the Republican health care bill would cut Medicaid by almost $840 billion over 10 years, with most of that money going to cut taxes for corporations and wealthy Americans.

Meanwhile, the lower subsidies would raise the cost of health insurance for many buying coverage on the exchanges set up under the Affordable Care Act. A 60-year-old living in Monmouth County and making $20,000 a year would see premiums rise to $9,660 from $960, according to the Kaiser Family Foundation.

"You cut out the funding," Pallone said. "Republicans said repeal and replace. There can't be an effective replacement because there's no money."

New Jersey voters are in a position to teach the GOP a valuable lesson in 2018: five targets. The dozen state hit hardest by Trump's broken Medicaid promise:

• New Jersey (-20.6%)
• Colorado (-20.1%)
• Washington (-19.9%)
• Oregon (-16.4%)
• North Dakota (-15.9%)
• Hawaii (-15.7%)
• New Mexico (-15.2%)
• New Hampshire (-15.1%)
• Delaware (-15.0%)
• Illinois (-14.9%)
• Rhode Island (-14.8%)
• Nevada (-14.6%)

There is no state with such a plausible target-rich field as New Jersey's, although Mike Coffman and Scott Tipton should be pursued in Colorado; Jaime Herrera Beutler, McMorris Rodgers and Dave Reichert from Washington would send a chilling message to GOP royalists; Illinois' Peter Roskam, Rodney Davis, and Randy Hultgren could be defeated with devastating effect; and Mark Amodei in Nevada, who switched votes from NO to Yes at the last minute, should be made to pay for that with his career.