by Michael A. Cohen · March 7, 2017
Since the 1930s, the Republican Party has been largely seen as a party focused on the interests of big business and the wealthy at the expense of working-class Americans. While Republicans have occasionally been able to neutralize that image by playing on the racial fears of white working-class voters or portraying Democrats as out-of-touch elitists, it’s a stereotype that’s long stuck.
However, with the release of the GOP’s long-awaited Obamacare replacement bill, the party has confirmed that their political image and the political reality are one and the same.
If you wanted to offer, in stark relief, evidence of the modern GOP’s misguided priorities, a health care bill that cuts Medicaid insurance for poor Americans and provides a tax cut for wealthy Americans is it. That is exactly what House Republicans have done this week.
Under the GOP proposal, the Medicaid expansion part of Obamacare, which has enabled millions of poor people to gain insurance coverage, would be repealed in 2020 and replaced with block grants. Those already in Medicaid would continue to receive benefits; those who aren’t would be out of luck. But even for those still in the program, the shift to block grants would mean that benefits would be slashed.
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The replacement bill eliminates many of the tax measures in Obamacare, which would amount to a nearly $350 billion tax cut over 10 years, the benefits of which would go to Americans who make more than $200,000. There is even a provision in the bill that encourages health insurance companies to pay their CEOs more money.
Understanding the new plan to replace Obamacare
The legislation would also shift Obamacare subsidies away from an income-based system to one that is age-based. In addition, it would limit the size of subsidies that are available to working-class Americans. These moves benefit healthier and wealthier Americans and disadvantage sicker, older, and poorer Americans.
The GOP would keep a few provisions that people like about Obamacare: allowing young people to stay on their parents’ insurance until they turn 26 and maintaining bans on denial of coverage for preexisting conditions. But it would also get rid of the one provision that people dislike the most about Obamacare — the individual mandate, which requires people to buy coverage or pay a fine. Scrapping the mandate would likely create a death spiral in which healthy people would drop coverage (they don’t have to worry about paying a fine) and insurance companies either raise premiums or flee an individual market that will consist largely of sick people.
The bill would also end the requirement that health plans provide benefits like mental health care services and maternity care. And it would end all funding for Planned Parenthood and would force families to place their youngest child in indentured servitude if they cannot pay their health care bills.
OK, I’m making up the last part, but considering the other elements in this bill I wouldn’t be surprised if such a provision was left on the legislative cutting room floor.
Indeed, perhaps the most striking reaction to the draft legislation is the criticism from those conservatives who seem to believe a bill that will likely take away health care coverage for millions of Americans is too generous.
Even more amazingly, Republicans, who for years falsely accused Democrats of ramming Obamacare through in the dead of night, will spend just two days debating the bill and won’t even get a scoring of the legislation from the Congressional Budget Office.
This dog-and-pony show really has nothing to do with making American health care better or even fulfilling President Trump’s pledge to create a “tremendous” health care system. If that was the intention, Republicans would be looking for ways to increase health care subsidies, pushing for further Medicaid expansion, or forcing insurers to offer more individual plans in order to create more competition in Obamacare exchanges. Instead, this is a not very transparent effort to destroy a bill that the GOP has spent 7 years railing against. They want to kill Obamacare, and drafting even this lemon of a replacement plan has been seen as the only political vehicle for doing that. If there is any silver lining in its release, it is that the chances of the bill getting through a party-line vote in the House and the narrowly-controlled GOP Senate are slim.
But the real takeaway from this bill is that it is deeply reflective of a mindset and attitude among modern conservatives that government should do less, not more, to help those in greatest need. It’s reflective of a longstanding view that the role of government is to benefit the wealthiest in our society, at the expense of the most vulnerable. Paying for tax cuts for the rich by slashing benefits to the poor has long been a talking point out of the mouths of Democrats. With this obscenity of a bill, Republicans prove that this particular political spin is spot-on.