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Tuesday, June 13, 2017

The Daily Combover - June 13, 2017

On May 4th, the House GOP voted to cripple the nation's healthcare. As I wrote back in May, a quick look inside the bill reveals the following:
  • 80% of people who are on the Healthcare Exchange receive subsidies. Those are now gone.
  • Instead it provides tax credits of up to $4,000, increasing with age and decreasing with income above $75,000 per individual or $150,000 per family. Those with the most to gain: married couples in their 60's nearing retirement and earning a six-figure salary. Almost all of the people in that category are white Republican voters. 
  • An additional $85 billion tax cut for for the elderly. Details are left to the Senate.
  • Repeal of individual AND employer mandates. This takes the repeal one step further. Now companies will face no repercussions for stripping healthcare benefits from their employees.
  • Instead of facing tax penalties for no coverage, the AHCA empowers insurance companies to charge a 30% markup for people whose coverage lapses. This makes insurance even less affordable for those that lose coverage. So if you lose coverage due to unaffordability, you will never receive healthcare again.
  • States may request waivers of minimal healthcare coverages so they can offer sub-minimal insurance plans.  Plans that will make the ObamaCare Bronze packages look like they're made of pure Palladium.
  • Finally, they've authorized $123 billion for what they call a "stability fund" to smooth the transition over the next 8 years for high-risk individuals, those seeking preventative care, mental health benefits, and maternity care. Read that to mean none of those coverages will be available after 2026.
  • Remove restrictions on statistical discrimination: meaning insurers can now start charging certain groups a disparate price.
  • Shift burden of Medicaid funding to the states and end federal funding of Medicaid expansion. This alone will affect at least 14.4 million people.
  • It also encourages states to promote a Work-for-Medicaid program similar to the 1990s Welfare Reforms.
  • Guess What? It also cuts Medicaid for school children specifically in Special Ed programs.
  • Restricts Upstate NY and Long Island counties from paying for state Medicaid bills for New York City residents. This was probably a late insertion to obtain 1-4 votes from NY Republican Congressmen.
  • Restore support for federal payments to hospitals that treat the uninsured. This is a major payday for "not-for-profit" hospitals.
  • Increases the cap on annual Health Savings Account (HSA) contributions -- something that are primarily utilized by wealthy white families as a tax shelter.  Further proof this is only for the wealthy: It bans individuals from using money obtained through tax credits to be placed in HSAs. CNN reports that this was due to a fear of said money being used for abortions.
  • Removes the cap on Flexible Spending Accounts (FSA).  Coupled with the recent changes that allow FSA funds to be used beyond the year of accrual, this serves as yet another tax shelter for the wealthy.
  • Eliminates the ObamaCare funding taxes that were placed on: the top 1% income earners (3.8% on investment income and 0.9% Medicare surcharge on individuals earning over $200,000); medical devices (2.3% excise tax); tanning services (10% sales tax); and repeals restrictions on tax breaks for insurance companies who pay out more than $500,000 in compensation to their executives. Now insurance companies can reduce their earnings by paying executives millions of dollars in benefits and options. This ultimately saves them billions of dollars in taxes annually.
  • It reduces the threshold for deducting medical expenses to 5.8% of total income. Again helping the wealthy.
  • It defunds the CDC Prevention and Public Health Fund.
  • Finally, it defunds Planned Parenthood, instead providing $422 million to community health centers.
That's a heck of a lot of bad in one bill.  But that was finally enough harm to the American people coupled with a big enough tax cut for the top 1% to draw 217 GOP Congressmen together to pass it.  Afterwards, Trump invited them all to the Rose Garden for a celebration:
And they celebrated like old white men do, by cracking open cases of Bud Light. Because nothing says you're going to fuck over America like drinking beer from a company that used to be headquartered in Middle America but then decided to fuck over thousands of local workers and go off-shore.

“As much as we’ve come up with a really incredible health care plan, this has brought the Republican party together.
We’re going to get this finished.” -- Trump on May 4, 2017
Can you feel the GOP unity?

I closed my original piece with: "Stay tuned for Episode 4: A New (Senate) Hope." And now a month later, here we are with all hope resting with the Senate.

To kick things off, Trump held a meeting with 15 key Republican Senators to try to push them to move forward with the AHCA. Of course since we are talking about the Fontange Fuhrer, the Trump Train derailed rather quickly:
Mean? ... Mean? Yes, mean.
In a rebuke of the House bill, congressional sources told the AP that Trump said to 15 GOP Senators over lunch on Tuesday that he wants their legislation to be “more generous.” The AHCA would cut Medicaid funding, increase health care costs for older Americans and people with preexisting conditions. The CBO concluded the bill would leave 23 million more Americans uninsured by 2026.
 So much for party unity.
Trump also referred to Obamacare as a “disaster” during the meeting, which was attended by a diverse set of Republican senators including Orrin Hatch, Rob Portman and Ted Cruz, according to CNN.
The president’s characterization of the AHCA may seem strange, given the Rose Garden victory lap he held for the law when it passed the House in May — where he lauded House leadership for putting together an “unbelievable” bill.
According to the AP’s sources, “the president did not say what aspects of the bill he was characterizing” when he called the legislation “mean.”
Who knows what prompted this. Maybe it was the AMA coming out strongly against the bill just hours before the meeting?

Let's check in with Paul Ryan's office for a GOP House response:
AshLee Strong, a spokeswoman for House Speaker Paul Ryan, said "congressional Republicans, with President Trump’s support, are working to repeal and replace this terrible Obamacare law that is harming Americans." 
Regardless of the trigger, it's pretty clear Trump is trying to salvage something, anything really, so he can save face. And the GOP continues to play ostrich and pretend like everything is normal.

Help! Paul Ryan's head is stuck again!
I don't have any faith in the GOP Senate to improve the ACA, but I do have faith that the Democrats will not allow a bad bill to come to the floor for a vote.

Catch you on the flip side.

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