Monday, June 26, 2017

The Anti-Medicaid Bomb in the Republican "Health Care" Bill


Tom Toles/Washington Post (source)

by Gaius Publius

Just one more note on the Senate "health care" bill, to add to the information you're already reading. Via Robert Reich, the bill's real aim is the destruction of Medicaid (see explanation below), one of the three great social programs passed by FDR and his fervent New Deal acolyte, LBJ.

There's a trick with the Medicaid death trap though — most of the destruction is timed to occur after the CBO's 10-year analysis window, which means it's not going to show up when the CBO scores the bill.

Will Americans be fooled? Who knows? Will Republicans think Americans will be fooled? Likely.

Here's Reich on that (h/t Naked Capitalism; source; emphasis mine):
The Secret Republican Plan to Unravel Medicaid

Bad enough that the Republican Senate bill would repeal much of the Affordable Care Act.

Even worse, it unravels the Medicaid Act of 1965 – which, even before Obamacare, provided health insurance to millions of poor households and elderly.

It’s done with a sleight-of-hand intended to elude not only the public but also the Congressional Budget Office.

Here’s how the Senate Republican bill does it. The bill sets a per-person cap on Medicaid spending in each state. That cap looks innocent enough because it rises every year with inflation.

But there’s a catch. Starting 8 years from now, in 2025, the Senate bill switches its measure of inflation – from how rapidly medical costs are rising, to how rapidly overall costs in the economy are rising.

Yet medical costs are rising faster than overall costs. They’ll almost surely continue to do so – as America’s elderly population grows, and as new medical devices, technologies, and drugs prolong life.

Which means that after 2025, Medicaid will cover less and less of the costs of health care for the poor and elderly.

Over time, that gap becomes huge. The nonpartisan Urban Institute estimates that just between 2025 and 2035, about $467 billion less will be spent on Medicaid than would be spent than if Medicaid funding were to keep up with the expected rise in medical costs.

So millions of Americans will lose the Medicaid coverage they would have received under the 1965 Medicaid act. Over the long term, Medicaid will unravel.
Note that date — after 2025. That means that the bulk of the damage will occur outside the 10-year window of the Congressional Budget Office's typical analysis.

Reich again:
Does anyone now know this time bomb is buried in this bill?

It doesn’t seem so. McConnell won’t even hold hearings on it.

Next week the Congressional Budget Office will publish its analysis of the bill. CBO reports on major bills like this are widely disseminated in the media. The CBO’s belated conclusion that the House’s bill to repeal and replace the Affordable Care Act would cause 23 million Americans to lose their health care prompted even Donald Trump to call it “mean, mean, mean.”

But because the CBO’s estimates of the consequences of bills are typically limited to 10 years (in this case, 2018 to 2028), the CBO’s analysis of the Senate Republican bill will dramatically underestimate how many people will be knocked off Medicaid over the long term.

Which is exactly what Mitch McConnell has planned. This way, the public won’t be tipped off to the Medicaid unraveling hidden inside the bill.
The long-term goal? To entirely delete the New Deal from U.S. social policy. This is step one:
For years, Republicans have been looking for ways to undermine America’s three core social insurance programs – Medicaid, Medicare, and Social Security. The three constitute the major legacies of the Democrats, of Franklin D. Roosevelt and Lyndon Johnson. All continue to be immensely popular.

Now, McConnell and his Senate Republican colleagues think they’ve found a way to unravel Medicaid without anyone noticing.

Don’t be fooled. Spread the word.
The wicked plan might just work.

The Neoliberal Republican End Game

Have you ever wondered what will happen in this country if right-wing neoliberalism ("free market economics" in its most aggressive form) ever succeeds absolutely?

Imagine repealing... a single two- to four-year span. Would the country not tip into chaos of the most unimaginable sort at that point?

And would Paul Ryan care? There's a word for behavior like this, and it applies perfectly.

I personally think Republicans like Paul Ryan would sacrifice any Republican chance of holding office for a generation if they could accomplish that transformation. Once destroyed, the New Deal government, as degraded as it has become, would never ever be rebuilt, even in the lifetime of the last person born tomorrow, were she to live to the age of ninety, and even if the Democrats achieved the kind of Congress and mandate Obama enjoyed in 2009.

The New Deal would fall to the floor of the historical past, never to rise in this country again.

And every Republican who helped pull off this coup, if they could do it, would be so richly rewarded by the Kochs of the world, they'd never need to work for a living again. They could float to their graves on Thank You money, enjoying government-paid health care right till their final breath.

Will they succeed? Who knows? But they're giving it their very best shot, and they have the votes in the Senate if they can get the Susan Collins of the world ("I vote Republican, but only when it matters" ) to cast them.

Will Democrats succeed in blocking them? They had better be giving it their very best effort. The next "designated Democratic villain" to step out of line — looking at you, Manchin and Heitkamp, McCaskill and Coons — might just be signing the death warrant for the entire rest of the Party as she does it.


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At 11:09 AM, Anonymous Anonymous said...

The Republicans WILL get away with this.

Due to a television-addicted spouse, I get to hear all the major media "news" programs and how they cover things. They sugar-coat just about everything that the Republicans (and Trump, for the record) do, and find ways to present it in the least-damaging light if they can't find a meme to present it as the best thing since wealthy white men running the government.

Recently, many liberal YouTube sites were blocked from collecting on their viewership. That people began using Patreon and other means to support the effort seems to have ended the attempt to eliminate anti-corporatist news reporting.

This was done before. Back in the late Nixon years, the underground press was starved out of existence by pressure being applied to the sponsors of publications such as The Seed to stop ad buys. There was no reason for the simplistic current-day corporatist mind to believe that it couldn't work again.

It doesn't appear (for now) to have worked, which means after a trip to the woodshed for failing, those corporatists assigned to the project to eliminate an oppositional news and commentary network will now have to work out another way for corporatist propaganda to be the only source of "information" available to the proletariat. This is where Net Neutrality comes in, for I expect it to be destroyed to aid this effort to keep power in the hands of those who now wield it.

When the last of these governmental supports is gone -after at least one re-election for each of the corporatist tools who put this travesty into law- even if the effort to eliminate the oppositional news and commentary network were to some how fail, the vast majority of the morons who constantly vote against their own self-interests will believe what they are told to believe.

The Retribution Will Not Be Televised.

At 12:37 PM, Anonymous Anonymous said...

Just when you think the bar couldn't be any lower they come up with: "Kill Grandma and Grandpa." If anyone has been waiting for things to get bad enough to stand up, this is it.

At 2:31 PM, Anonymous Anonymous said...

Yeah. Saw that. Saw Reich's piece.

The CBO *COULD* notice it. But prolly not. I'm sure mcturtle knows what he's doing.

Thank you Clintons and obamas for assisting in the ratfucking that we've already endured, only to let us be killed in 8+ years, also thanks to you greedy corrupt motherfuckers.

Remember the words of JFK. Remember (or learn for the first time, if you're under 50 -- schools suck) your French, Chinese, Russian history. When people get hungry, sick, miserable, desperate enough... look the fuck out you plutocrats and oligarchy. Your heads (kochs, Clintons, obamas, DWS, Immelt, billionaires and CEOs), also, will end up displayed on pikes for the masses to throw feces at and piss on.

I hope I live long enough to see it.

At 2:33 PM, Anonymous Anonymous said...

forgot Pelosi, hoyer, reid, scummer, ryan, mcturtle, manchin... hundreds of others too.

At 10:52 PM, Anonymous Anonymous said...

Just noted that Susan Collins recognizes the secret plan to kill Medicaid in 22 years.

Long before Medicaid is killed, it'll be strangled and millions will die. but whatever. That's their goal.

Stephanopolous didn't note the Medicaid sunset... fucking fake journalist (kudos to the entire network who couldn't be bothered to read the fucking thing) but Collins did.

Even with that epiphany, Collins wasn't a no until after the CBO gave their estimate of how many (22m, which means more like 40m).

OK. With the exception of MacArthur, who wanted a dozen nukes to win the Korean war, and Goldwater who declared, generally, that nuclear war would be just fine to defeat the soviets... name any time in our past when the prez and congress were negotiating just how many citizens it would be ok to kill... in order to give billionaires huge tax cuts, no less.

I'm at a loss here. Has ANY civilized nation ever held such a debate???
Are we now the most barbaric society since the Nazis? Or are we already more barbaric?

At 1:08 AM, Anonymous Anonymous said...

To Anon @ 10:52 PM

Re " ... name any time in our past when the prez and congress were negotiating just how many citizens it would be ok to kill... in order to give billionaires huge tax cuts, no less."

Most recently since the austerity "debate" commenced (and any other time is has occurred ... under whatever disguise), i.e. throughout the Obumma administration.

John Puma

At 3:38 AM, Anonymous Anonymous said...

Re GP quote: " ... even if the Democrats achieved the kind of Congress and mandate Obama enjoyed in 2009."

As if that majority/mandate was in any way realized?!?

Then, not only the opportunity but the duty was to strengthen SocSec/Medicare/Medicaid against the attacks against them that had clearly been waged against them for previous decades.

The pathetic ObummaCare was simply his contribution to continue down the slippery slope already heavily greased by the GOP.

John Puma

At 6:58 AM, Anonymous Anonymous said...

JP, I feel you on the obamanation austerity and offers of further cuts. But I view that as a debate on how many (more) and how much to further impoverish the powerless rather than how many and how fast to kill them. Granted, making poor people poorer would result in deaths. But not the wholesale killing that denying them health care would cause. At least not right away.

But I also view current times as being since 1980. The long and gradual luge ride to the bottom started then. That's when a president actually ran on mathematical stupidity, hate of fellow citizens, diminution of others and was able to beat someone trying incremental altruism.

Like climate change, the change has been slow enough that our extraordinarily slow populace (enough to keep things rolling with every election, anyway) never noticed or were fully engaged in it.

Like climate change, it also seems too late to reverse it. Too many sub-sentient fucktards, too many Nazis, too much momentum and nobody to stand in the way.

At 3:50 PM, Anonymous Anonymous said...

To Anon @ 6:58 AM

Convince me that Obumma-Care ultimately provided for health care insurance for all the estimated 47 million Americans without it at the time of its passage.

As I understand, it only ever intended to cover about half, the oft-quoted 23 million who will lose their coverage over 10 years after passage of His Hairness-Care.

So the other ~24 million ignored by Obumma, and his insurance corp VP-written bill, were not going to die in the manner you describe?

John Puma

At 5:40 AM, Anonymous Anonymous said...

JP, you are correct. But realize that most of the 24m never-to-be insured are of the young and healthy variety. The great dodge of obamneycare is it tended to pull in those who actually need to consume health care, thus being much less PROFITABLE to the insurance cartels.

When the margins got small enough, as per design, and/or when it amused insurance cartels to try to get republicans elected, they fled "markets" so white racist douchebuckets could use the word "death spiral" to scare potted plants who vote.


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