Monday, March 20, 2017

Blind fury: F-rating for wreckage from Trumpcare

The Fujita scale is the "F" by which weather people rate tornadoes.

F-1: a carport down. F-5: whole city blocks reduced to grout.

We now lean on such comparisons in assessing the shades of disaster that would emanate from Trumpcare, especially compared with what Donald Trump claimed would happen.

Trump the campaigner said his plan would provide "insurance for everyone."

The Congressional Budget Office says that with this plan he would be off by only 24 million or so.

"I'm going to take care of everybody," said Trump regarding health coverage. "I don't care if it costs me votes or not."

No biggie here – only the difference between sunshine, lollipops and rainbows, and, oh, an F5 hellhound ripping whole houses off their foundations.

At this point we are way past assuming this president will say only what he knows to be true. But you would think the people he hires -- you know, his experts -- would.

And yet there was Gary Cohn, Trump's chief economist, telling Fox News, "If you're on Medicaid, you're going to stay on Medicaid."

That is only true if this monster of a policy shift can be blunted in the Senate. This seems increasingly likely.

A key reason is that some Republicans in states that expanded Medicaid under the Affordable Care Act won't consent to telling hundreds of thousands of their constituents to take a flying leap.

The same goes for senators in states that have considerable success with their health exchanges and where the ACA is working as designed.

Over the weekend, Trump was negotiating with the hardest of the hard in his party in making it more difficult for Medicaid recipients to receive the care they need.

Twenty-four million? Forty-eight million? Is matters not to the merciless. What the tea party wing wants is to wind the clock back to before a Congress and a president did something that actually helped working Americans of meager means.

Paul Ryan has spoken to the hearts of the heartless (always massaging that base) in explaining that the "fatal conceit" of the ACA is that it requires the healthy (and wealthy) to help insure the less healthy.

Yes, and that's what health insurance does in every case. The only difference is that, before ACA, insurers could refuse to cover the least healthy.

Another "fatal conceit" is that ACA requires all to participate – not like, say, insurance to get a home loan, insurance to own and operate a car, flood insurance in a flood plain, liability insurance to start a business. Yes, mandatory insurance.

Oh, by the way, some of that very same "conceit" is built into Ryan's plan, as insurers would be empowered to stick people with higher rates if they let coverage lapse.

Effectively there's no difference between that and the tax penalties for those opting out of ACA, except that the money goes to insurers and not to helping pay to cover people who need it. 

Here's something else that this ruthless storm force would extract: Damage to Medicare.

Take it away, AARP:

"Trumpcare raids Medicare to the tune of $275 billion and gives drug companies a $25 billion tax break – part of a $465 billion tax handout to the wealthy and health-care companies."

Medicare is one of those things Trump said he'd not touch, along with Social Security.

Of course, as with all those health-insured Americans he would blow off, we can expect the hardest of the hard in Congress to press for the diminishing of Social Security and Medicare benefits before their reign is through.

Forces of moderation must win in the Senate on Trumpcare. Then alarmed voters must work on ending the GOP reign in Congress in 2018.

Longtime newspaperman John Young lives in Colorado. Email: jyoungcolumn@gmail.com.

No comments: