Thursday, May 25, 2017

Republicans' budget hides a brutal moral vision with lies layered on more lies

Budget decisions
How much can I take from the poor
and transfer to the rich?

I know - the budget is Trump’s. But the Congress was set to dispose even before the President proposed.

In the New Republic, Brian Beutler asks Will Republican Lies Catch Up to Them Before or After They Ruin People’s Lives? Beutler starts by providing a guide to Republican euphemisms. Snippets follow.

The political durability of conservative economic doctrine owes a great deal to euphemisms. As the main exponents of that doctrine, Republicans seek to distribute income from the poor to the wealthy by gutting social programs and returning the savings to high-income earners through tax cuts. Euphemisms obscure the brutality of that underlying moral vision. The affluent, in the language of the right, are “job creators,” the poor are “dependents,” the central goal (reducing top marginal tax rates) is a “simplification,” the programs losing funding are being “reformed” or “saved,” and the purpose of this reordering, stripped of ideological valence, is “growth.”

Trump distinguished himself from his Republican primary rivals by repeatedly promising not to cut any of the three largest social spending programs: Medicare, Medicaid, and Social Security. Trump’s first presidential budget breaks that promise quietly with respect to Social Security (by proposing to cut the program’s disability benefit) and outlandishly with respect to Medicaid (which it would essentially halve).

… CNBC’s John Harwood pinned down Trump’s budget director, Mick Mulvaney, on the Medicaid question.

at briefing today, Mulvaney told me Trump promise not to touch Medicaid had been overridden by Trump promise to repeal/replace Obamacare https://t.co/WSafn6ighT
— John Harwood (@JohnJHarwood) May 23, 2017

Quaint supply-side spin can’t resolve this contradiction. When Mulvaney said one Trump promise would override another, what he meant was Trump made two incompatible promises and will honor the one that does more harm to the poor and sick. But Mulvaney was not simply covering for the fact that Trump lied. He layered a lie of his own on top of Trump’s.

It was clear during the campaign that Trump’s promise to repeal Obamacare and replace it with “something terrific” was in tension with his promise not to cut Medicaid, because the Affordable Care Act included an expansion of Medicaid that many states, including GOP-led ones, have adopted. If Trump and Republicans were proposing now to simply phase out that expansion, Mulvaney’s claim that one promise had “overridden” another would match the facts. But Trump’s proposed Medicaid cuts, which assume both the enactment of AHCA and further cuts to Medicaid, go hundreds of billions of dollars beyond phasing out Obamacare’s Medicaid expansion.

Even if Trump had not taken over the Republican Party, conservative shibboleths would be practically useless for the purposes of resolving the party’s contradictory promises to repeal the ACA without throwing millions off of their health insurance, and to leave people with pre-existing conditions vulnerable to discrimination by insurance companies. Republicans were only able to pass the AHCA in the House by deceiving themselves and their voters–in the face of widespread, cross-ideological criticism–about what the impact of the legislation would be. They cast votes on the bill, and then used it as the basis of Trump’s foundational governing blueprint, before the Congressional Budget Office could analyze its impacts on coverage and cost, and settle the dispute.

When that analysis finally lands on Wednesday [apparently this Wednesday - May 24th - judging from the reporting by MSNBC over the noon hour], it will give form and scope to the lies Republicans told the public about what the bill would do—just as the CBO’s report on a previous, failed version of the AHCA did when it determined that the bill would cause 14 million people to lose their insurance immediately and leave 24 million uninsured over 10 years.

But Ryan’s Raiders passed the AHCA atrocity anyway. Now …

Assuming Republicans continue to pursue their agenda as the evidence of their deceptions grows, the question will be whether reality asserts itself before they can enact the AHCA and other priorities, or they beat reality to the punch and deal with the consequences later when the truth catches up to people.

UPDATE: CBO confirms negative effects of Trumpcare

Here are snippets from the NY Times alert, G.O.P. Health Bill Would Leave 23 Million More Uninsured in a Decade.

Here’s a number for you. $5,173 and change. That’s how much each of the 23 million uninsured would be contributing to deficit reduction. That’s the value Republicans place on a human life. Then there’s the issue of the sick and the poor not being able to afford insurance. Having a baby? Pay more. Need mental health services? Pay more. All that so that the young and healthy can skip insurance.

WASHINGTON — A bill to dismantle the Affordable Care Act that narrowly passed the House this month would leave 14 million more people uninsured next year than under President Barack Obama’s health law — and 23 million more in 2026, the Congressional Budget Office said Wednesday. Some of the nation’s sickest would pay much more for health care.

Under the House bill, the number of uninsured would be slightly lower, but deficits would be somewhat higher, than the budget office estimated before Republican leaders made a series of changes to win enough votes for passage. Beneath the headline-grabbing numbers, those legislative tweaks would bring huge changes to the American health care system.

In many states, insurance costs could soar for consumers who are sick or have pre-existing conditions, while premiums would fall for the healthy, the new estimate concludes.

The forecast by the nonpartisan Congressional Budget Office, Capitol Hill’s official scorekeeper, is another potential blow to efforts to undo Mr. Obama’s signature domestic achievement. Republican senators have said they will make substantial changes to the measure passed by the House, but even Senator Mitch McConnell of Kentucky, the majority leader, sounds uncertain about his chances of finding a majority to repeal and replace the health law.

In states that obtain waivers from certain health insurance mandates, “premiums would vary significantly according to health status and the types of benefits provided, and less healthy people would face extremely high premiums,” the budget office said.

In addition, it said, “out-of-pocket spending on maternity care and mental health and substance abuse services could increase by thousands of dollars.”

Republicans in Congress generally focus more on reducing health costs than on expanding coverage. Their proposals will inevitably cover fewer people than the Affordable Care Act, they say, because they will not compel people to buy insurance.

But critics zeroed in on a bifurcated health care system that the bill could create: Those who are sick, at risk of getting sick or nearing retirement would pay more, while those who are young and healthy would pay less. In states that obtain waivers from rules mandating essential health coverage at uniform rates, the legislation could put insurance economically out of reach for some sick consumers.

“Unless you’re a healthy millionaire, Trumpcare is a nightmare,” said Senator Chuck Schumer of New York, the minority leader. “This report ought to be the final nail in the coffin of the Republican effort to sabotage our health care system.”

The new report tends to validate criticism of the House Republican bill by AARP and other advocates for older Americans. “For older people with lower income, net premiums” — after tax credits — “would be much larger than under current law, on average,” the budget office said. As an example, it said, for a typical 64-year-old with an annual income of $26,500, the net premium in 2026 would average about $16,000 a year, compared with $1,700 under the Affordable Care Act.

four horsemen
The GOP health care plan

The bill would reduce projected spending on Medicaid, the program for low-income people, by $834 billion over 10 years, and 14 million fewer people would be covered by Medicaid in 2026 — a reduction of about 17 percent from the enrollment expected under current law, the budget office said.

In a separate report, the congressional Joint Committee on Taxation said Wednesday that the House bill would cut taxes for high-income people by $230 billion over 10 years. The bill would repeal provisions of the Affordable Care Act that increased the payroll tax rate for many high-income taxpayers and imposed a surtax on their net investment income.

That’s not so bad. Remember that “The House bill would reduce federal budget deficits by $119 billion over a decade …”. So the net effect on tax breaks for the rich would only cost us $110 billion.

The GOPlins have gone on record waging a war against the poor, sick, elderly, and pregnant.

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