The fight to defend Medicaid, Medicare and the Affordable Care Act is fully engaged. Contacting members of Congress and letting them know how important progressive health care taxes, program funding and regulatory enforcements are for everyone is an effective way to alter the actions of Congress. The political activity and voter organizing done by the regressive movement worked to prevent President Obama and Congress from achieving more for Americans with middle and lower incomes. We can and must do what we can to succeed in blocking the regressive agenda of President Trump and Congressional Republicans.
“Republican Health Proposal Would Redirect Money From Poor to Rich
Margot Sanger-Katz @sangerkatz
FEB. 16, 2017
Republicans in Congress have been saying for months that they are working on a plan to repeal and replace Obamacare in the Trump era. Now we have the outline of that plan, and it looks as if it would redirect federal support away from poorer Americans and toward people who are wealthier.
A white paper drafted by House leadership and the staff of the House and Senate committees that oversee health policy details a structure that could replace large sections of the Affordable Care Act. Crucially, the proposal largely contains provisions that could be passed through a special budget process that requires only 50 Senate votes, and fulfills President Trump’s promise that the repeal and replacement of the law would take place “simultaneously.”…
…Obamacare, as the A.C.A. is known, extended health coverage to 20 million Americans through two main mechanisms. It expanded Medicaid coverage to Americans below or just above the poverty line in states that participated, and it offered income-based tax credits for middle-income people to buy their own insurance. Obamacare was a redistributive law, transferring money from rich to poor.
The Republican plan would alter both of those programs, changing the winners and losers. It would substantially cut funding for states in providing free insurance to low-income adults through Medicaid. And it would change how tax credits are distributed by giving all Americans not covered through work a flat credit by age, regardless of income.
That means that the biggest financial benefits would go to older Americans, like, say, Secretary of State Rex Tillerson. If he didn’t have a job in the Trump cabinet and access to government coverage, a 64-year-old multimillionaire like him would get the same amount of financial assistance as someone his age, living in poverty, and he would get substantially more money than a poor, young person…
…the current system is set up to ensure that low and middle-income Americans can afford the cost of their premiums. The Republican plan would not do that, and would result in many more low-income people losing out on coverage if they couldn’t find the money to pay the gap between their fixed tax credit and the cost of a health plan…
…The plan includes additional features that redistribute resources from the poor to the rich. It would allow Americans to sock more money away for health spending in special tax-free health savings accounts. The benefits of such accounts fall largely to higher income-people who pay more in taxes, and a recent analysis of current health savings accounts found that they are held disproportionately by families with high earnings. (The white paper is silent on two Obamacare taxes that target wealthier Americans, but other Republican plans have proposed eliminating them. It does eliminate a number of taxes on the health care industry.)…
…There’s still a lot subject to change, of course. Congressional leadership has said the bill, once completed, will proceed through committee hearings and amendments. And the politics of passing such legislation, even with Republican control of both houses of Congress, will be a challenge. But this proposal, with the imprint of every major committee working on health care, seems likely to set the terms of the discussion.
I wrote a few weeks ago about how all health policy decisions involve trade-offs, and it will be hard for President Trump to honor his promise of coverage that is “far less expensive and far better” than Obamacare. This plan is a good illustration of those challenges. It’s a simpler, potentially cheaper plan than Obamacare. But it’s far less generous to the poor, and unlikely to provide the health insurance for “everybody” that President Trump envisions.”
What happens now is up to each one of us. There is a great opportunity to defend our health care programs from the depredations of the President and the current Congressional majorities. Significant differences between the health policy preferences within the GOP caucuses in the House and Senate are creating real difficulties for the majority leaders and their Congressional committees. Let’s work together to meet the urgency of this moment.
