Here at the Plum Line, we write a lot about the mechanics of politics — the processes of governing, the interplay of political forces, the back-and-forth between citizens and lawmakers, and so on. We do that because it’s interesting and because it winds up affecting all our lives. But there are moments when you have to set aside the mechanics and focus intently on the substance of what government does — or in this case, what government is trying to do.Here are some of the things Waldman says this bill does:
I won’t mince words. The health-care bill that the House of Representatives passed this afternoon, in an incredibly narrow 217-to-213 vote, is not just wrong, or misguided, or problematic or foolish. It is an abomination. If there has been a piece of legislation in our lifetimes that boiled over with as much malice and indifference to human suffering, I can’t recall what it might have been. And every member of the House who voted for it must be held accountable.
Takes health insurance away from at least 24 million Americans; that was the number the CBO estimated for a previous version of the bill, and the number for this one is probably higher.Waldman concludes:
Revokes the Affordable Care Act’s expansion of Medicaid, which provided no-cost health coverage to millions of low-income Americans.
Turns Medicaid into a block grant, enabling states to kick otherwise-eligible people off their coverage and cut benefits if they so choose.
Slashes Medicaid overall by $880 billion over 10 years.
Removes the subsidies that the ACA provided to help middle-income people afford health insurance, replacing them with far more meager tax credits pegged not to people’s income but to their age. Poorer people would get less than they do now, while richer people would get more; even Bill Gates would get a tax credit.
Allows insurers to charge dramatically higher premiums to older patients.
Allows insurers to impose yearly and lifetime caps on coverage, which were outlawed by the ACA. This also, it was revealed today, may threaten the coverage of the majority of non-elderly Americans who get insurance through their employers.
Allows states to seek waivers from the ACA’s requirement that insurance plans include essential benefits for things such as emergency services, hospitalization, mental health care, preventive care, maternity care, and substance abuse treatment.
Provides hundreds of billions of dollars in tax cuts for families making over $250,000 a year.
Produces higher deductibles for patients.
Allows states to try to waive the ACA’s requirement that insurers must charge people the same rates regardless of their medical history. This effectively eviscerates the ban on denials for preexisting conditions, since insurers could charge you exorbitant premiums if you have a preexisting condition, effectively denying you coverage.
Shunts those with preexisting conditions into high-risk pools, which are absolutely the worst way to cover those patients; experience with them on the state level proves that they wind up underfunded, charge enormous premiums, provide inadequate benefits and can’t cover the population they’re meant for. Multiple analyses have shown that the money the bill provides for high-risk pools is laughably inadequate, which will inevitably leave huge numbers of the most vulnerable Americans without the ability to get insurance.
Brings back medical underwriting, meaning that just like in the bad old days, when you apply for insurance you’ll have to document every condition or ailment you’ve ever had.
Perhaps this bill will never become law, and its harm may be averted. But that would not mitigate the moral responsibility of those who supported it. Members of Congress vote on a lot of inconsequential bills and bills that have a small impact on limited areas of American life. But this is one of the most critical moments in recent American political history. The Republican health-care bill is an act of monstrous cruelty. It should stain those who supported it to the end of their days.Click here for the editorial on the subject from The New York Times. (" Neither Mr. Trump nor Mr. Ryan seemed bothered by this overwhelming criticism of their Trumpcare bill, the American Health Care Act. They seemed concerned only about appeasing the House Freedom Caucus, the far-right flank of their party.") Click here for John Nichols at The Nation, an article entitled "History Will Remember These 217 House Republicans for Their Inhumanity - What Paul Ryan and his minions just voted for is immoral." (" Republicans now must be identified for what they are: charlatans who would lie to Americans with cancer and heart conditions about the health care they cannot live without.") Click here for Ryan Cooper at The Week, an article entitled "Paul Ryan's American carnage." ("he American Health Care Act is an absolute moral abomination."