When the House of Representatives recently passed a $1 trillion tax cut disguised as a health care bill, one Republican in Washington spoke up against what he saw as the real motivation behind the bill. “I think it’s to set up tax reform,” Republican Louisiana Sen. Bill Cassidy said in remarks to the American Hospital Association, “and all the money used for coverage is instead going to be used to pay down the bill for tax reform.”
Cassidy’s resistance to using health care reform as a front to slash taxes for the wealthy is not a popular position in his own party. But he is absolutely right about the true intentions behind this proposal: Republicans are jamming through a massive tax giveaway under utterly false pretenses. With the process now moving behind closed doors in the Senate, and Washington increasingly consumed with investigating the troubling links between the President and Russia, it is critical that Democrats expose and defeat this cynical ploy.
Soon after his emotional monologue about his son’s heart condition went viral, Jimmy Kimmel hosted Cassidy on his show to talk about the health care debate. Wouldn’t it be easier, Kimmel asked, to achieve the goal of covering more people and making health care more affordable if Congress simply did away with trying to pass a tax cut for millionaires at the same time?
Cassidy agreed with Kimmel. “Tell the American people to call their senators,” he urged.
We must take him up on that. As the Senate begins considering — in secret, at the moment — what to preserve and what to eliminate from the House bill, we should deliver a loud and clear message to Washington: leave those wasteful tax cuts on the cutting room floor.
The truth is, the Republican health care plan achieves very little when it comes it to actual health care. The bill does not, as President Trump promised, increase the number of insured Americans. It does the opposite: 23 million more Americans would lack insurance, according to the Congressional Budget Office’s newest estimate released earlier this week.
The bill does, however, provide — by one independent estimate from the Tax Policy Center — the richest Americans with an average tax cut of $37,000. Health insurance companies would receive a $145 billion tax cut. Investors would see taxes on their capital gains slashed by $158 billion.
These giveaways are a feature, not a bug, of the House health care plan as intended by its authors. In the rollicking negotiations that led up to the House bill’s passage, many provisions underwent major changes, but the tax cuts remained intact throughout.
These tax cuts also actively thwart the objectives of making coverage more accessible and affordable.
They would come at the expense of programs that deliver health care to some of the country’s most vulnerable populations. The CBO estimates that Medicaid alone would lose $880 billion, or 25% of its funding. Enrollees in the program — which covers women, children, the elderly and disabled — could face new, arbitrary caps on coverage. Far from empowering states, these structural changes to Medicaid would shift an impossible burden to governors, hospitals and others on the front lines in local communities. Inevitably, many of those most in need — in places like my home city of South Bend, Indiana, and around the country — would almost certainly be forced to go without care.
There would be other less-discussed impacts from these Medicaid cuts as well. Over the years, those of us in local government have come to know the critical role Medicaid plays in helping school districts meet the needs of children with disabilities. Medicaid provides around $4 billion annually in reimbursements for schools to make investments like hiring health professionals, such as speech pathologists and physical therapists, who serve special needs students. This aid would be in jeopardy under the House plan.
On top of all this, President Trump’s budget takes these senseless cuts a giant step further by proposing even deeper reductions — this time, to children’s health insurance and Social Security disability benefits — for the sake of funding even more extravagant tax cuts.
Protecting these programs should be a bipartisan priority. During his campaign, Trump repeatedly promised to leave Medicaid and Social Security alone. Red and blue states alike have successfully expanded their Medicaid enrollments since passage of the Affordable Care Act. That includes my state of Indiana, where then-Gov. Mike Pence’s decision to accept a form of expansion has made 400,000 residents eligible for Medicaid.
A few Republicans in the Senate — like Rob Portman of Ohio and Lisa Murkowski of Alaska — have promised to oppose the House bill’s proposed Medicaid cuts. But safeguarding Medicaid expansion is likely going to be impossible if Republicans continue to insist on giving millionaires a tax cut as part of the deal. To make the legislation’s math work, you can likely afford only one or the other.
There are literally millions of lives at stake when it comes to the issue of health care. Congress should be ashamed of itself if it treats this as just another opportunity to provide a tax windfall for the fortunate few.
