The GOP’s Millionaire Tax Cutting–Planned Parenthood Defunding–Medicare Gutting Health Plan
A lot of names have been bandied about for the proposed Republican replacement for the Affordable Care Act – TrumpCare (but I’m sure Trump knows nothing about it), RyanCare (but Speaker of the House Paul Ryan (R-WI) doesn’t care about anyone), and WealthCare (accurate), but I’m going with RepubliCare as this bill provides a true reflection of the belief system of the GOP.
In RepubliCare (officially the “American Health Care Act”), the Republicans do not even attempt to solve the complicated challenges of a national health care policy. The bill is an amalgamation of 10 years of Paul Ryan’s letters to Santa. Tax cuts for the very wealthy, punishments for the poor, restrictions on women’s health, and more money for health care executives – Paul was a very good boy this year.
I’ll do my best to summarize the lowlights of this plan, which the Brookings Institute estimates will cause 15 million people to lose their insurance. I’ll answer your most urgent question though first. Yes, the bill addresses the greatest health care challenge of our day – getting lottery winners off of Medicare. 10% of the bill’s pages are dedicated to this scourge (seriously).
Here we go:
Tax Cuts for the Wealthy
Provides estimated $600 billion in tax cuts over the next 10 years – Sounds great, right? Well, before you get too excited, check your pay stub to see if you one of the 400 highest earners in the country. Here’s the breakdown of the tax break benefits as estimated by the Center on Budget and Policy Priorities:
- If you earn < $200k: you get nothing and like it!
- $200k – $500k: $510 tax break
- $500k – $1 million: $4,700 tax break
- >$1 million: $54,130 tax break
- Top 400 earners: $7 million tax break
Restrictions on Women’s Health
Makes Planned Parenthood ineligible to receive Medicare reimbursement – Trump allegedly offered Planned Parenthood that it could keep its access to federal reimbursements if it stopped offering abortions (which by the way, federal funds are already not allowed to be used for abortions – this act threatens to take funding for all of the much needed medical care Planned Parenthood provides). PP declined to give into Trump’s threat.
Forces insurance companies to not cover abortions – Under RepubliCare, Federal subsidies could not be used to purchase a health insurance plan that covers abortion. Therefore there would likely not be any insurance plans that cover abortion.
Punishments for Poor People
Allows insurance companies to increase premiums as punishment – The plan would eliminate the mandate that you buy insurance. However, if you have a gap in coverage for more than 63 days, because say, you’re poor or you lost your job, the insurance companies can charge you 30% more for your premium for a year. So instead of paying a penalty to the government for not having insurance, you now pay the insurance companies. Yeah!
Eliminates Medicare expansion – A primary reason so many more people were covered by the ACA was the expansion of Medicare to the nation’s poorest. The expansion was paid for by the aforementioned taxes on the rich. Since the GOP can’t wait to give that money back to the rich people, we need to take the Medicare away from the poor.
Replaces insurance subsidies with tax credits – Under the ACA, health insurance subsidies were tied to your premium and your income. So if premiums went up (or your income went down), your subsidies went up. Under the GOP plan, you would get a flat tax credit. When premiums go up, good luck.
Punishments for Everyone
Rates should skyrocket – The GOP plan would eliminate the individual mandate to buy insurance, which would cause a big adverse selection problem. Without the mandate and its associated tax penalty, young, healthy people may decide en masse not to buy insurance. However, when they leave, only the sick will remain. With only the sick in the insurance pool, premiums will shoot up.
Eliminates requirement that Medicaid cover mental-health and addiction services – Good news though is Trump signed a bill to make it easier for the mentally ill to get guns.
Increases allowed premiums for older customers – Under the ACA, insurers can only charge older customers 3x as much as younger ones. The GOP proposes to increase that to 5x. The AARP estimated that the elimination of subsidies combined with this allowed increase, would mean a 64 year-old earning $15,000/year could see annual premiums up to $8,400 under RepubliCare.
Breaks for Big Business
Reinstates tax breaks for health care company executive pay – The ACA capped the amount of executive compensation that health care companies could deduct on their taxes. The GOP plan recognizes this tragedy and would eliminate the cap and take away $400 million in revenue for the country.
Eliminates requirement that businesses with over 49 employees provide insurance – Since we cling to the odd concept that people access health plans through their employer, the ACA required employers to offer health plans. A logical solution to an illogical problem. RepubliCare does away with this requirement, leaving many to see what, if anything, they can find and afford on the open market.
Paul Ryan is trying to pass the bill at breakneck speed, hoping to get Trump’s signature on it by mid-April. Ryan spent the past 7 years complaining that President Obama jammed the ACA down Republican throats with a . . . 14-month approval process. The bill has already passed two committees. The alleged fiscally conservative party voted on the bill without even waiting for the Congressional Budget Office to provide a cost and coverage estimate.
The good news is that Paul Ryan’s incompetence may be the one thing that unites this country. Democrats, the AARP, the American Medical Association, and the American Hospital Association are unified against it since they think the bill is terrible. Conservative congressional Republicans and conservative think tanks are speaking out against it because they think it’s too generous. Apparently, they would like more people to go bankrupt and/or die to give more tax cuts to rich people. Regardless, this version of the bill will likely not make its way to Trump’s desk (I hope).
Quotes from This Week’s GOP Health Care Plan
Paul Ryan on being evil
Fox News host Tucker Carlson: It’s kind of a hard sell to say, ‘Yeah, we’re going to repeal Obamacare, but we’re going to send more money to the people who have already gotten the richest over these last 10 years.’
Ryan: I’m not that concerned about it, because we said we were going to repeal all the Obamacare taxes and this is one of the Obamacare taxes.
Paul Ryan showing he doesn’t understand what insurance is
Ryan: The whole idea of Obamacare is…the people who are healthy pay for the…sick.
Jason Chaffetz (R-UT) proving that he’s a worse person than Paul Ryan and has no idea how much medical care costs
Chaffetz: Americans have choices, and they’ve got to make a choice. And so maybe rather than getting that new iPhone that they just love and want to go spend hundreds of dollars on that, maybe they should invest in their own healthcare.
Representative Ron DeSantis (R-FL) explains what the uninsured should do if they get cancer
DeSantis: If people really need [cancer treatment], they show up to the emergency room. They do get care, it just gets passed on to other folks.
CNN host Erin Burnett: But she had $1 million in cancer treatments. You’re not going to get that by showing up in an emergency room.
Representative John Shimkus (R-IL) lets Representative Mike Doyle (D-PA) know what he finds truly objectionable in Obamacare and human reproduction
Doyle: What mandate in the Obamacare bill does [Shimkus] take issue with?
Shimkus: What about men having to purchase prenatal care? Is that not correct? And should they?
Representative Dr.(!) Roger Marshall (R-KS) enlightens us as to what Jesus would do (spoiler alert: Jesus would apparently take away health care from the poor since they don’t appreciate it)
Marshall: Just like Jesus said, ‘The poor will always be with us.’ There is a group of people that just don’t want health care and aren’t going to take care of themselves . . . a group of people that even with unlimited access to health care are only going to use the emergency room when their arm is chopped off.
On MSNBC later, Reverend William Barber had a reply to Marshall’s interpretation of scripture: Jesus, if He did anything, provided free health care.