I have referred to the Republican effort to repeal the Affordable Care Act as the “Make America Sick Again” bill. The numbers from the Congressional Budget Office make that an apt description. According to the CBO, 24 million more Americans could be uninsured by 2026 under the House Republican bill than under Obamacare.
I do give Republicans points for consistency: They have always been clear that they see the very existence of Medicare and Medicaid as signs of weakness, and, as well, they resolutely pursue spending and tax policies that exacerbate the gap between rich and poor.
But three numbers in the Republican American Health Care Act tell us all we need to understand about Republican efforts to undermine low- and middle-income Americans.
First, when the CBO says the Affordable Care Act repeal will reduce the deficit by $337 billion over the 2017-2026 period, this is accomplished largely by kicking people off Medicaid. Under the Republican bill, there will be a 2020 freeze on Medicaid expansion and the federal government will reduce funding from 100% to just 90% leaving the states to fill the gap — a gap that will then be a political football, with Republicans who now control two-thirds of state legislatures doing everything possible to make Medicaid eligibility harder.
It’s also worth noting that the Medicaid costs per person figure will be computed at the 2016 pricing, which, even under the 100% federal contribution, is too low because of rising health care costs.
Second, the CBO’s noting of the reductions of revenues (generated under the ACA) doesn’t underscore why: The Republican replacement bill offers a huge tax cut, essentially a transfer of wealth, for the top 1%. Principally, that tax cut comes by eliminating the 3.8% tax on investment income and the 0.9% hike on the Medicare tax for the highest earners. This will also result in bringing the insolvency of Medicare closer, a critical reason the AARP opposes the bill.
Lastly, the Affordable Care Act is not perfect. In my view, the only solution is a single-payer “Medicare for all” system, which the ACA didn’t advance toward. But, the ACA did reduce the uninsured numbers from roughly 47 million down to 28 million. The CBO says those numbers will increase: “In 2026, an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law.” Essentially, the Republican bill will almost double the number of people who would have been uninsured in 2026 if the ACA stayed in place. That’s just immoral.
Vladimir Putin, a popular topic of conversation here, has taken advantage of a system that concentrates wealth and power in the hands of a few Russian oligarchs; Republicans appear to be doing the same thing through health care “reform” and tax cuts.
