Republicans are most certainly about money. Money for the rich. Money for big business. They tell you that you will be better off as campaign rhetoric, but when legislation is passed, average Americans lose.
In this election cycle, there are two primary points of focus to the Republican Party: a strong military, and a better economic outlook for Americans. The better economic outlook was to be achieved through the replacement of the Affordable Care Act, smaller government, and lower taxes. Now that the American Health Care Act AKA Trumpcare and the Trump budget have been released, we can see that all of these campaign promises were disingenuous. The reality is that the very people who voted for Trump to change their desperate situation are going to see change that makes their situations even more desperate.
The Congressional Budget Office analysis of Trumpcare shows that fourteen million Americans will lose their healthcare coverage immediately, and that within 10 years twenty four million Americans will lose their health care. The standard Republican argument in this is that Trumpcare “increases choice. Current premiums are too high. Current plans are forcing people to pay for things they don’t want. People shouldn’t have to pay for the costs of other people’s coverage. Medicaid produces inferior care. In the end, Trumpcare is only phase 1 of the program. Phase 2 will produce more jobs so that people who lose Medicaid will be able to buy better insurance.” Examining these assertions one by one:
Trumpcare increases choice: This is an assertion without explanation. If you don’t have enough money to buy anything, what difference does it matter how much choice there is? While the Republican Party says there will be more providers, what difference does that make if you can’t afford it?
Trumpcare keeps people from paying high premiums that are high because riskier people are covered: This is the way insurance works. Insurance companies have spent billions on actuarial science to determine the risk group you are in, and to charge premiums that reflect that group. This is true for all types of insurance. The broader the definition of any group, the more the less risky are paying for those who are more risky. In auto insurance, your premiums are lower because the worst drivers have been separated into a high-risk pool. However, in your own pool, some are paying more to cover those who claim more. This is the nature of insurance. It is inescapable. This mechanism is how Republicans show that for younger Americans, premiums will end up dropping. It is because older Americans that require more care will be put into a separate pool, where the premiums will be allowed to rise. The young will do better, the old, infirm, those on fixed income will do much worse.
Trumpcare keeps people from buying coverage they don’t need: No one knows what coverage they don’t need. They are engaged in a cost versus risk evaluation where they can’t know the outcome. If people make choices, it is because they can’t afford the gold plan. Calling this a benefit of Trumpcare is calling a flaw a benefit.
Trumpcare says that because Medicaid doesn’t always provide good care, the program should be eliminated: This is throwing out the baby with the bath water. It is true that some doctors don’t accept Medicaid patients, and that this can lead to sub-optimal health care for some. But how would they fare without any insurance? Can this really be better than simply sub-optimal care?
Trumpcare says Medicaid can be cancelled because people will have jobs to buy better options: This is truly “and a miracle occurs”. There is no evidence that one million jobs will be produced, let alone the twenty four million jobs that would be required for all those losing insurance to pay for coverage. The companies in this country are under continual pressure to lower costs. That means automation and lower wages. How this miracle of jobs is going to occur is completely unexplained. Leaving all these people without a safety net, as you take away all their health care is totally irresponsible.
Trumpcare will give back 880 Billion dollars in tax cuts: Yes, to the top 2% earners. It will do so at the expense of poorer Americans, out of the 880 Billion dollars in reduced benefits. This is Robin Hood in reverse scheme, where the poor pay the rich.
Lower taxes will help out Americans: The current talk about lowering or eliminating taxes has centered around big business paying too much in tax, making them uncompetitive versus foreign firms, and the elimination of the alternative minimum tax. The administration quotes that American firms pay 35% tax, where as foreign companies pay much less, on the order of 21% or less. This ignores that 50% of American big businesses pay NO tax. This means that American business pays an average of 17.5%, but that it is unfairly spread amongst the businesses. The alternative minimum tax, which is currently targeted to be eliminated, is very poorly named. It is not used in place of your normal tax calculation. It is an additional tax in the case that your deductions are too much. This only affects the very well off. In the case of Donald Trump, of the roughly thirty million dollars in tax he paid in 2005, more than 90% was due to the alternative minimum tax. This cut is meant to help the wealthy.
Smaller government will decrease the deficit: It might, but the Trump budget is not small government. It is a shift of money from programs that benefit the poor, infirm, addicted, needy, and disaffected to the defense establishment, big business, and billionaire cronies of the president. A wonderful comment, that I heard on conservative media the other day, came from a small government advocate. She described both republicans and democrats as big government spenders. The difference, she said, is that democrats want to spend on people and negotiate problems in the world, and republicans want to buy guns and tell other nations what to do at the expense of people.
Trump is helping the people that elected him: This is clearly not the case. A look at his budget shows many programs that help rural areas, older Americans, veterans, and the sick will be cut. It is misdirection to say that his budget is only a suggestion to Congress. While true, it doesn’t change that Trump’s suggestion is to implement his plan, and that his plan hurts the Americans who are the most in need of help.
Republicans are saying also that the ACA is “imploding”. The Congressional Budget office describes the situation as “stabilizing”, and unlikely to implode. The Republican Party has been trying to destabilize and cripple the ACA. This was done to create the problems that need to be fixed as viable campaign issues. Here is a link to one article detailing this story (click here). Today, the Huffington published this story also (click here). The short story is: The Republican Party defunded compensation to insurance companies at the state level for “risk corridors”, which are high risk groups like the elderly. This shifted the costs directly onto the insurance companies, which then had to raise rates.
The hurtful consequences of Trumpcare and the Trump budget for Americans are very clear. The offset of a better economy through job creation is the wildest of wishful thinking, and won’t work for elderly Americans who have retired in any case. That either of these have been put forward as the administration’s answer to America’s problems is patently ridiculous. People should be angry that the White House and Congress think that we can be fooled by self-serving appeals to patriotism and fear. The Republican Party is out to make life better not for average Americans, but for the billionaires and big businesses that have bought it.