Saturday, June 24, 2017

Senate health bill: Rich get richer, poor get sicker, and children take it in the chops

Here are some items from New Yorker writer John Cassidy’s email yesterday (Saturday, June 24) morning, all concerning the unhealthy “Better Care” bill making its way through the Senate (that is, being rammed through by Mitch McConnell).

The first thing to understand (IMnotsoHO) is that the whole motivation behind the repeal bills in the House and Senate is to effect a reverse robin-hood transfer of wealth - away from those needing Medicaid and to those least needy, wealthiest families in America. Follow the money! As Molly Ivins once noted, “You Got to Dance With Them What Brung You.”

Shifting Dollars from Poor to Rich Is a Key Part of the Senate Health Bill — The New York Times
For some reason, much of the media coverage of the House bill focussed almost exclusively on the measures affecting the individual insurance market, which are certainly important but affect fewer people than the changes to Medicaid would. Thankfully, the coverage of the Senate bill is already more balanced, with virtually every major publication pointing out that the legislation is an exercise in reverse redistribution. “The bill’s largest benefits go to the wealthiest Americans, who have the most comfortable health care arrangements, and its biggest losses fall to poorer Americans who rely on government support,” the Times reporter Margot Sanger-Katz wrote in a front-page piece on Friday.

Just when you thought the GOPlins could not be meaner …

It Really Is Meaner — Slate
In terms of the human effect of these changes, the cuts to Medicaid are undoubtedly the most consequential part of the bill. According to the Congressional Budget Office, the House bill would reduce enrollment in Medicaid by about fourteen million over ten years. The C.B.O. has yet to score the Senate bill, but the expectation is that the numbers will be similar. Unless the states stepped in to fill the funding gap, many of those affected would be children from low-income families, who are covered by the Children’s Health Insurance Plan (chip), which is Medicaid’s sibling. Over the long term, the Senate bill would restrict federal spending on Medicaid and chip even more than the House bill. From 2025 onward, spending would be tied to the rise in the overall Consumer Price Index, which for decades has risen a lot more slowly than the cost of medical goods and services. “Over time, this approach could easily drain hundreds of billions more from Medicaid,” Slate’s Jordan Weissmann noted in a clear explainer, “leaving the program a shadow of its former self as its budget fails to keep up with ever-climbing costs.”

As Forrest Gump once said: Shit Happens. What are the chances of this shit happening?

Will the Senate Pass Its Health Care Bill? — FiveThirtyEight
How the politics of all this will play out remains to be seen. With the Republicans having fifty-two votes in the Senate, McConnell can afford to lose just two votes. (On a fifty-fifty vote, Vice-President Mike Pence could be the tiebreaker.) This means that McConnell needs to win over at least two of the four conservative naysayers—Ted Cruz, of Texas; Ron Johnson, of Wisconsin; Mike Lee, of Utah; and Rand Paul, of Kentucky—who don’t think the bill goes far enough in dismantling Obamacare. The Majority Leader also has to worry about potential dissidents from the less extreme wing of the Party. On Friday, Dean Heller, the Nevada senator who faces a tough reëlection fight next year, said publicly that he wouldn’t vote for the bill in its current form. Other moderate Republicans—including Shelley Moore Capito, of West Virginia; Susan Collins, of Maine; Lisa Murkowski, of Alaska; and Ron Portman, of Ohio—have also registered concerns about particular aspects of the bill. Many Washington insiders, who tend to be a cynical lot, believe that enough of these Republicans will ultimately support the bill to insure its passage, even if McConnell has to delay the vote a bit. But, as FiveThirtyEight’s Nate Silver pointed out on Friday, there are a lot of different variables in play, including the fact that the House bill and President Trump, who is backing the bill, have such low approval ratings.

You will observe, without surprise but with dismay nevertheless, that our two AZ senators seem to be sitting this one out. Email, fax, phone, all of these now! Tell our two boys to get off their behinds and vote against the senate version of the House’s AHCA (American Horrible Care Act).

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