TrumpCare 3.0-- The Senate Version Is Even Worse!

Everyone thought the Senate would get their hands on the really radical, really destructive-- and really hated-- House Republican “healthcare” bill, TrumpCare, crafted by Paul Ryan and Tom Price and bastardized by Freedom Caucus chairman Mark Meadows and rogue Tuesday Group opportunist Tom MacArthur, and turn it into something more palatable and more mainstream. Why did anyone think that-- with people like Mitch McConnell, John Cornyn and Ted Cruz driving the show? Instead, if the Washington Post’s leaked report of what the Senate Republicans have come up with is to be believed, the Senate version is even worse than the House version. Not better, worse!

If this Frankenstein’s monster of a bill passes, say goodbye to Planned Parenthood and say goodbye to Medicaid-- and say goodbye to healthcare for millions and millions of American families who have coverage now.

The bill largely mirrors the House measure that narrowly passed last month but with some significant changes aimed at pleasing moderates. While the House legislation tied federal insurance subsidies to age, the Senate bill would link them to income, as the ACA does. The Senate proposal cuts off Medicaid expansion more gradually than the House bill, but would enact deeper long-term cuts to the health-care program for low-income Americans. It also removes language restricting federally subsidized health plans from covering abortions, which may have run afoul of complex budget rules.

Senate Majority Leader Mitch McConnell (R-KY) intends to present the draft to wary GOP senators at a meeting Thursday morning. McConnell has vowed to hold a vote before senators go home for the July 4 recess, but he is still seeking the 50 votes necessary to pass the major legislation under arcane budget rules. A handful of senators, from conservatives to moderates, are by no means persuaded that they can vote for the emerging measure.

Aides stress that the GOP plan is likely to undergo more changes to garner the 50 votes Republicans need to pass it. Moderate senators are concerned about cutting off coverage too quickly for those who gained it under the ACA, also known as Obamacare, while conservatives don’t want to leave big parts of the ACA in place.

As a nod to conservatives, the Senate bill would give states more leeway in opting out of the ACA’s insurance regulations through expanding the use of so-called “1332” waivers already embedded within the law, according to the draft proposal. States could use the waivers to make federal subsidies available even off the marketplaces-- but they couldn’t go so far as to lift ACA protections for patients with preexisting conditions.

…[M]oderates are likely to be turned off by how the bill cuts Medicaid more deeply than the House version. But the biggest cuts wouldn’t take effect for seven years, a time frame that could be more politically palatable for members like Sens. Rob Portman (R-OH) and Shelley Moore Capito (R-WV).

Under the Senate draft, federal Medicaid spending would remain as is for three years. Then in 2021 it would be transformed from an open-ended entitlement to a system based on per capita enrollment. Starting in 2025, the measure would tie federal spending on the program to an even slower growth index, which in turn could prompt states to reduce the size of their Medicaid programs.

In a move that is likely to please conservatives, the draft also proposes repealing all of the ACA taxes except for its so-called “Cadillac tax” on high-cost health plans in language similar to the House version. Senators had previously toyed with the idea of keeping some of the ACA’s taxes.

Andy Kim, a national security expert who worked in the Obama White House and is now running for the south Jersey congressional seat held by Tom MacArthur, one of the TrumpCare architects, told me this morning that "Senate Republicans are taking the baton from Tom MacArthur and the House by secretly working in back room deals that prevent the American people from knowing the impact on their health care and their lives. The people deserve better." David Gill, an emergency care physician in Illinois, is running for the seat held by Ryan rubber stamp Rodney Davis. He’s on the same page as Kim. "My opponent in the upcoming 2018 election, Rodney Davis, played a pivotal role in the development of TrumpCare, serving as an assistant to the whip in the U.S. House to help garner support for its passage, and also frequently appearing as an apologist for the bill on TV news programs. Accordingly, Mr. Davis bears full responsibility for the overwhelming pain and suffering that will be wrought upon tens of millions of Americans by the passage of TrumpCare. As an advocate of single-payer as a member of Physicians for a National Health Program for the past 25 years, I am essentially the antithesis of Mr. Davis: I recognize the many benefits in guaranteeing all necessary coverage to all Americans, and I look forward to leading the charge towards single payer once I get to Washington. It is said that it is darkest before the dawn, and I have little doubt that passage of this atrocious Republican healthcare bill will serve to ultimately open the door wide to single-payer; Americans will be looking for a solution to their healthcare woes, and the time will finally be ripe for the type of single-payer program that should have been instituted decades ago."

And Randy Bryce, the newest Blue America endorsee, is clear how he feels about the Senate “healthcare” bill that leaked as well. “What is it going to take,” he asked, “to get people who are supposed to ‘represent’ us to actually listen to us? How can anyone claim to make decisions on our behalf when they pull garbage like this? America has always been about taking care of each other-- not taking away from each other! I’ve had enough of us working harder but having less to show for it. Not even the people who are supposed to vote on this bill know what is in it. That’s no way to ‘represent.’ Please— call your electeds-- ALL of them-- and demand that they do the right thing. Make it crystal clear that you vote. Then keep your promise and vote. Don’t forget to take your neighbors-- this is for them too. We still have some power-- use it before it’s gone.”


UPDATE

Matt Coffay is up against the godfather-- or co-godfather (with Ryan and Price)-- of TrumpCare, Freedom Caucus chairman Mark Meadows, one of the most dangerous extremists in Congress. Matt, a former Bernie organizer in western North Carolina offers voters in NC-11 a really clear choice for themselves and their families. "My opponent, Mark Meadows, negotiated the worst components of the House version of this bill. He's responsible for the loopholes that will allow insurance companies to price people out of care because of pre-existing conditions. It's largely because of his insistence that 23 million people will lose health coverage. As if that weren't enough, he's reportedly been in talks with the Senate to ‘negotiate’ their version of the bill, and is now calling for a cancellation of August recess so that he and the Freedom Caucus can ram the AHCA back through the House (or through committee) rather than returning to his district to hold a town hall. When I'm in the House, one of my first acts as a member of Congress will be to co-sponsor HR 676, the Medicare for All bill introduced by Rep. Conyers. Every person in this country deserves health care, and I won't stand idly by while the people of Western North Carolina-- and people all across this country-- are forced to suffer so that a handful of billionaires can get a tax break."

Ted Lieu (D-CA), who has been taking a leading role in the House on issues where a backbone is required, eviscerated McConnell’s miserable excuse for healthcare legislation. "Born from the most cynical kind of politics and raised in total secrecy, the Senate Republican version of Obamacare repeal offers very little in terms of health or care for hardworking American families. The Senate version tinkers with the margins of the heartless House GOP version of repeal but make no mistake, this new legislation still would deny health security to millions of Americans, while unconscionably making even deeper long-term cuts to Medicaid-- all in the name of giving those most fortunate Americans a gargantuan tax cut that they don't need and many don't want. The Senate Republican plan is not bold leadership with 'heart,' it's a cowardly and complete abrogation of the solemn responsibility to guarantee health security for each and every American."