I don’t understand why it helps to have the Secretary of Health & Human Services go on television and lie through his teeth while making promises that his bill can never keep. It might be more sensible if the lies could pass the laugh test, but they don’t even come close to doing that. What he says is the exact opposite of the truth in every respect:
No one will be adversely affected by the Republicans’ new health care bill once it’s enacted and more people would be covered, according to Health and Human Services Secretary Tom Price.
“I firmly believe that nobody will be worse off financially in the process that we’re going through,” Price insisted when pressed by NBC’s Chuck Todd during Sunday’s “Meet The Press.” “They’ll have choices that they can select the kind of coverage that they want for themselves and for their family, not the government forces them to buy.”
It’s hard to even devise a theory under which anything Price is saying could come true, but it seems to be premised on the idea that if you abandon all standards for what a health insurance plan must cover, it will be possible to sell really cheap plans even to 60 year olds. So, the reason a 60 year old won’t be negatively impacted by the changes in the health care law isn’t because he’ll pay less for the same coverage or because he’ll get a bigger subsidy than a younger person regardless of need. He’ll be better off because he can buy some really inexpensive plan that doesn’t cover anything.
An analysis from the Kaiser Family Foundation also found that the bill would broadly offer less help to Americans living in rural areas, as well as older people and those on lower incomes. According to Kaiser estimates, a 60-year-old making $30,000 a year would receive a $4,000 tax credit under the AHCA — nearly $8,000 less than what he or she would receive under Obamacare.
Price claimed that analysis is “looking at it in a silo.”
“If you look at it in the way that the market will allow, then, for individuals to have choices, who knows what that 60-year-old wants?” he asked.
What’s lost in that delusional rhetoric is the possibility that you’ll be worse off financially because your health care coverage doesn’t come close to covering your health care costs. Maybe it will have gigantic deductibles or it will have an annual or lifetime cap on how much it will pay. These are the ways that insurance companies offered “affordable” plans in the past, and they were rip-offs that left people broke, homeless and dead.
It’s not just that Secretary Price is saying that no one will be worse of financially. He’s arguing that more people will have health insurance. But the experts expect that somewhere around 15 million people will lose their coverage.
The bill’s cost is still unclear, and the Congressional Budget Office has yet to declare a price estimate. But external organizations have weighed in, including the Brookings Institution, which estimated that “at least 15 million people will lose coverage under the American Health Care Act (AHCA) by the end of the ten-year scoring window.”
Price rejected that assertion.
“I’ll tell you that the plan that we’ve laid out here will not leave that number of individuals uncovered. In fact I believe, again, that we’ll have more individuals covered,” he said.
This is the rough equivalent of responding to a question about rat poison killing humans by responding that you don’t believe that’s true and that, in fact, you think people who ingest rat poison will live longer and healthier lives than those who don’t.
What’s even more infuriating is that the way Price is framing his argument is inconsistent with the rhetoric that so many other Republicans are using, including the White House press secretary Sean Spicer. Price is saying that it doesn’t matter what kind of care you get, or even if you get care, as long as your premiums are cheaper. And here’s what Spicer said last week, which was a widely used talking point among supporters of Chumpcare.
Spicer: How many people are going be covered — that's not the question that should be asked
What kind of care they get is what matters
— Mark Murray (@mmurraypolitics) March 8, 2017
When I saw that tweet, I called it, “The most Republican answer to anything, ever.” I said that because you can’t get care if you’re not covered without going broke, becoming homeless and dying. You can’t talk about the quality of care people get if they are unable to get any care at all.
As I’ve said, Spicer’s talking point is the exact opposite of Price’s argument that a 60 year old man who makes $30,000 a year, and will see his subsidy go from $12,000 to $4,000 a year, will still somehow be unaffected financially because he’ll be able to buy a shit plan that doesn’t cover anything.
So, out of one side of their mouth they say that it doesn’t matter what kind of care (if any) you get under their plan as long as you have a health care plan.
And, out of the other side of their mouth they say that it doesn’t matter how many millions of people lose their health coverage and long as the quality of care that is provided is improved.
It’s not hard to suss this out. Their plan works for the person who doesn’t need health insurance because they can afford to pay for even catastrophic care by dipping into their stock portfolios. It doesn’t work for anyone else. Either people are priced out of having coverage at all, or they’re priced into buying rip-off plans that abandon them when they actually go to use them.
I don’t think this should even be a contentious point. They don’t really argue otherwise. They try to throw sand in people’s eyes by saying a little of this and a little of that, but their argument is still fairly straightforward. They want to make health insurance affordable by making it legal to offer plans that won’t have to pay out when you need them. And, insofar as that won’t work, they think it’s more important that health care quality is good for the rich guy with a stock portfolio than that millions and millions of people will be left vulnerable and unable to access health care of any quality.
If anything, I’m sugarcoating this, since their plan would basically cut off addiction treatment in the midst of a nationwide opioid epidemic, would drastically undercut women’s access to preventative care, and have other lethal repercussions that really amount to murder by policy.
But I don’t want to get too far down in the weeds here. Secretary Price is saying no one will be negatively impacted financially by losing health insurance, losing subsidies to buy health insurance, or by being screwed over by their cheapo insurance plans that won’t come close to fully covering their health care costs.
If those lies actually work well enough to get Chumpcare enacted into law, the day of reckoning will come the next day and every day after, like Groundhog Day, without end.
A Republican who values his job would be nuts to say what Price is saying. It’s incredibly short-sighted to make promises that will seem like the cruelest of jokes once they are tested against reality.
Based on videos of the town halls, and attempts to meet with congresscritters who avoided town halls, ppl are not falling for the lies.
We may be able to defeat this reckless campaign to put our health care system in a much worse place than it was before 2009. But it’s going to be an unpleasant political tightrope.
are any Rs opposing it?
Rob Portman, Shelley Moore Capito, Cory Gardner, and Lisa Murkowski have all expressed opposition to date. Susan Collins called the house bill DOA in the senate. That doesn’t mean they’ll hold the line though.
Rand Paul, Ted Cruz, and Mike Lee have all pledged to oppose it because it just isn’t evil enough but they’d probably jump on board if their votes mattered.
it is a masterpiece of awfulness. saw some good cartoons on twitter feeds – will take look for those too
Yes, from both the right and the left.
Current bottom lines: the GOP Freedom Caucus in the House has enough votes to prevent Ryan’s Bill from passing unless it is made even more radical and cruel, and they’ve announced their intent to do so. But if Ryan accepts their amendments in order to ensure House passage, then there is no way they can get 50 votes in the Senate for the Bill. It doesn’t appear that there are 50 votes in the Senate for Ryan’s Bill even if it is left unamended, because more than three GOP Senators have announced their opposition to the current Bill.
Ryan’s Bill is crafted in the way it is because the Republicans believe the Senate parliamentarian would allow it to pass thru reconciliation (majority vote). They appear to think if this limited ACA replacement can pass, then Democrats will be forced to the table to negotiate the ACA replacement policies which will require 60 votes.
There are also GOP Governors who have voiced opposition (Kasich comes most immediately to mind). Of those GOP Governors, the bulk represent states that benefited from Medicaid Expansion, and the loss of Federal $ would hurt state budgets. I seriously doubt their opposition to “TrumpCare”/”RyanCare” is particularly altruistic – either they’re facing re-election, if term limited want to make sure their party’s replacement has a relatively easy go of it come election day, or still have aspirations to higher office. Heck my governor has promised his constituents that they could have both tax cuts and maintain social services at their current somewhat substandard levels largely because of Medicaid Expansion. The moment that goes bye-bye, he reneges on many of those promises, and once that happens, his re-election prospects start to dim (right now, he’d be a shoe-in).
Governor Baker of Massachusetts was CEO of Harvard Pilgrim Health care for ten years, is a truly moderate Republican (vastly popular in the blue Bay State), and is on record defending much of the ACA thusly as of mid-January:
http://www.masslive.com/politics/index.ssf/2017/01/baker_defends_parts_of_obamaca.html
I can’t find on a quick search any statements by Baker on Ryan’s bill as a whole, although the governor has pledged that the state will offset any decrease in funding to Planned Parenthood.
Of course, Baker is so far off the mainstream of current Republicanism that he probably has little influence over the wrecking crew in Washington.
Don’t count on Republicans to do our work for us. Already Eric Erickson has done a lovely pirouette and is now supporting it. We need to be screaming about what a tragic and cruel joke this is. AT EVERY FUCKING OPPORTUNITY! Then maybe we’ll stop it and, if Republicans ram it through anyway, there will be no way to claim Democrats were in any way a part of it.
One of the main problems that Ryan and McConnell have here is that there is almost zero support for Ryan’s Bill from the institutions the GOP cares about. All the conservative think tanks are opposed to the Bill, along with the AMA and the American Hospital Association. Even the health insurers have not come on in a big way. Nor has Big Pharma.
There’s this flaw in the modern conservative movement that Josh Marshall has described well; he’s even coined a name for it:
the Hate and Nonsense Debt.
From the original column:
“…Take Trump’s plan to deport 11 million people living in the US illegally or build the planned Trump Taj MaWall. As John Kasich has futilely tried to explain in debate after debate, whatever the rights and wrongs of it, this is simply never going to happen…in the real world net immigration across the US-Mexico border has actually gone into reverse in recent years. More are leaving than coming. But in the Republican/Fox news world, hordes of feral Mexicans are still streaming across the Southern border – them and a layering of ISIS death squads who fly from Ankara to Belize and then walk to the Arizona border.
But this is just the hate and nonsense debt coming due from 2013. You can either let the status quo go on or you can devise a way to regularize at least the majority of people who are here illegally. There’s no other option. Unless you just want to say ‘No Amnesty’ and pretend the problem will go away with ‘self-deportation’ or some other such nonsense. And that of course is precisely what Republican congressional leaders did. All Trump did was say openly, clearly, more coherently what Republicans were already saying themselves, while also saying out of the sides of their mouths that somehow they’d get to the mass deportation later.
The truth is virtually Trump’s entire campaign is built on stuff just like this, whether it’s about mass deportation, race, the persecution of Christians, Obamacare, the coming debt crisis and a million other things…What about Obamacare? Can Marco “Establishment” Rubio really get traction attacking Trump for having no specific plan to replace Obamacare when Republicans have spent the last five years repeatedly voting to repeal Obamacare without ever specifying a plan to replace it with? On each of these fronts, the slow accumulation of nonsense and paranoia – ‘debt’ to use our metaphor – built into a massive trap door under the notional GOP leadership with a lever that a canny huckster like Trump could come in and pull pretty much whenever. This is the downside of building party identity around a package of calculated nonsense and comically unrealizable goals.”
Remember that Ryan dismissed the AARP criticism because it’s “a special interest group.”
You’ve got to love the sheer audacity of that.
No, he did NOT say that. Oh, Lord, I missed that moment from the Very Serious Policy Wonk of Seriosity.
Well, if you don’t push back on people who trash your own CBO, I guess you’re craven enough to do anything.
the cell phone comment is a keeper – must go look for it, if anyone doesn’t know the reference
Yes, Secretary Price’s lies are so bad. The President himself is going to put his lie-riffic shoulder into the con job soon. This political movement is interested in seeing people suffer and die, as long as it’s the right people who deserve to suffer and die. It never ends up working out that cleanly in real life, but Real Americans may have to learn that hard lesson for themselves.
If this radical movement is allowed to maintain power for a while, they may succeed in doing away with EMTALA, the Federal law which requires acute care Emergency Departments to provide care to everybody regardless of their insurance/financial status. Or, perhaps the catastrophic loss of funding that safety net hospitals would suffer if the Republicans achieve what they want to achieve in the ACA replacement law will allow this movement to bring about that outcome because most of the safety net ED’s will become financially unsustainable and will close.
In the end, modern Presidential elections become binary choices. None of this could be surprising to anyone who heard from the candidates during the campaign, or to anyone who has seen the modern GOP’s behavior. It was vital to keep this reckless political movement out of power, but the American people collectively decided to play with fire.
Yes, I’ve heard this touted as a way to dramatically cut hospital costs, but I don’t have a link.
“Let them eat cake” has been replaced by “let them die at home”.
Oh, it would dramatically cut hospital costs. It would also cause Americans to die at home, at their friends’ homes, in the streets, in the waiting rooms of Emergency Departments and right outside the Emergency Departments after security guards escort acutely ill Americans off the hospital’s private property.
Trump’s America.
It will probably put a lot of rural hospitals in dire financial straits. Another example of how Trump will preside over the harming of the very people whom he promised to help.
Yes, both people and hospitals from small towns would be devastated. The marketplace already has them in a precarious position, and this Bill would cause many more to close.
This crew and the people who support them do not believe in facts. They don’t care to seek accurate, nonpartisan measurements of policy outcomes. Many of them will be made to suffer by Trump, Ryan and McConnell and will blame the browns and the blacks when they get hurt. It’s a difficult problem to solve.
There’s enough of the persuadables to win elections if we can defeat and overcome voter suppression, gerrymandering and propaganda on the right and left. But our work is made much more difficult by these and other factors.
All too painfully aware of that. I may live in a decent sized city, but I don’t have to drive to far to go where there are nothing but dirt roads, and I spent a decade in an isolated small town before that. Those small hospitals are lifelines. Without those, a survivable heart attack or stroke, or a survivable snakebite become a death sentence. The GOP response seems to be be “meh, who cares.” That’s an awful way to view the world. I know I am preaching to the proverbial choir, but health care is a human right, rather than a privilege for a chosen few.
Trump hates the same people they do, and that’s good enough for them.
.
important: no, “the American people collectively” did not “decide[] to play with fire”.
A Reality-Denying minority coalition of the evil greedy with the ideologically dogmatic with the religiously extreme with the self-defeatingly ignorant with the deplorably bigoted — geographically concentrated in the precisely wrong places so as to thwart the [small-d]emocratic will of the majority via the undemocratic Electoral College — “decided to play with fire”.
There, FTFY.
Yabbut, you have to add into that toxic brew all the supposedly saner Americans who didn’t bother to vote for Clinton, either out of (propagandized, quite often) distaste, or because they thought she had it in the bag and couldn’t be bothered, or because BothSidesDoIt cynicism made them believe they were upholding some higher moral standard by not voting or voting third party or writing in some protest figurehead. They may not have intended to bring down the avalanche upon us, but without their help it likely wouldn’t have happened. Put the mad, the bad, and the abstainers together and you have, alas, a majority of Americans.
I almost wrote something about feeling pretty sure my list of coalition members was leaving some out.
When turnout is persistently <60% of eligible voters, this gets close to automatic:
I.e., you don’t have to add that many to 40+% to get to majority.
Over and over again, it bears repeating: Trump made huge promises about health care and lied shamelessly. The GOP doesn’t seem to have a coherent message about how to repeal/”replace” ACA and hence it is no surprise that neither Price nor Ryan nor much of anyone else on that side of the aisle can stay on point. There is no “on point” to begin with aside from tax breaks for the rich. If the town halls are an indicator, constituents are aware that they’re being sold a bill of goods. Our best hope now is that enough Republicans get cold feet when it comes to voting on whatever monstrosity Ryan has hatched. Lives are at stake.
Great post, Booman.
One thing I’ve been wondering about is “does this bill remove the ACA insurance company profit cap?” I would think a Republican bill would.
Here’s some answers which provide some response to the focus of your question:
http://www.cnbc.com/2017/03/07/health-insurers-billion-dollar-windfall-gop-obamacare-replacement.htm
l
http://healthaffairs.org/blog/2017/03/07/examining-the-house-republican-aca-repeal-and-replace-legis
lation/
The last summary is pretty superb overall; it creates some comprehensive understandings for the layman.
Fun fact: doctors prescribe rat poison all the time, and it does extend lives. It’s called warfarin and it keeps blood from clotting. In controlled doses, this helps keep blood from clotting around artificial heart valves and the like. In less controlled doses, it is used to induce hemorrhage in rats.
It’s all about privatization and tax cuts for the wealthy.
And if the GOP gets their way with this bill and thereby succeeds at murdering you . . . you won’t be financially worse off!
You’ll be dead.
So wrt that subgroup that they actually succeed at killing off, he’s right!
But, yeah, for all except those many lucky-duckies they manage to exterminate and the 1%, his lies are transparent for all the reasons you spell out.
I’ve said it before, it seems political malpractice that Dems are not making their core message, relentlessly shouted from the rooftops and in every single media appearance, “PEOPLE WILL DIE!!! UNNECESSARILY!!!” when they otherwise wouldn’t if GOPers get their “MURDEROUS” (yes, that’s how we should be framing what they propose!) way on this. To the point that if Dems/liberals let slip or ignored all other concerns, that would not seem to me a bad thing right now. Not that there aren’t at least some Dems capable of multi-tasking. It’s the recipients of this messaging who aren’t so capable, who need to hear this non-stop, johnny-one-note style.
Alas that it will likely take this prediction coming to fruition to get through to many of those who most need to understand what will come with GOP success here . . . or at least get it through to those not already among the dead-by-then subgroup, but who “merely” end up sicker and/or financially worse off (e.g., bankrupt).
I wish Democrats were willing to speak truth to power. WE SO NEED THAT!
“Big Lie.”
It’s got a history of success.