Conservatives React To TrumpCare, Call For ... Wait, Single Payer?

Same clusterfuck time, same clusterfuck channel

Now that the Congressional Budget Office has released its analysis of the effects of the Republican plan to kill the Affordable Care Act and replace it with a cardboard standee of a doctor, the Republican consensus is in: After repealing the ACA, they need to kill the CBO, too. Or at the very least, Republicans simply don't believe the CBO's estimate that repealing the ACA will cause 24 million people to lose health insurance by 2026, although they're pretty sure the same report's estimate of deficit reduction is perfectly accurate. Let's start right at the top, from Tom Price, the secretary of Dismantling Health and Human Services, who said it was a load of hooey:

“We disagree strenuously with the report that was put out,” Health and Human Services Secretary Tom Price told reporters after leaving a Cabinet meeting with Trump at the White House. “It's just not believable is what we would suggest.”

Why is it not believable? Obviously, because the CBO only scored the actual bills the House has actually approved, not the magical changes to come later, like selling insurance across state lines (which, depending on state insurance regulations, will give more people "access" to cheap plans that don't really cover much of anything) and limiting malpractice awards, which will free incompetent doctors to offer care at a lower cost. Hi, Dr. Nick!

Even before the CBO report was released, administration officials were trying to undercut its credibility; we're particularly pig-bitin' mad at Mick Mulvaney, Trump's director of the Office of Management and Budget, who took to the Sunday Shows to half-truth the CBO's report on the ACA:

If the C.B.O. was right about Obamacare to begin with, there’d be eight million more people on Obamacare today than there actually are [...] Sometimes we ask them to do stuff they’re not capable of doing.

Ever the nit-pickers, the New York Times points out what a clever lie that is:

The number of people who have signed up for insurance through the health law’s exchanges is lower than expected, in part because employers did not drop coverage to the extent that had been anticipated. In addition, the Supreme Court ruled that states could not be compelled to expand Medicaid — and many Republican-led states did not.

So yeah, fewer people got Obamacare because employers kept insuring them -- a tragedy! -- and because Republican governors refused to accept Medicaid expansion. Shame on the CBO for not recognizing what craven bastards Republicans could be. Still, Mulvaney makes a good point -- it's possible the CBO once again hasn't counted on all the ways Republicans might decide to screw people over even more. At least this time around, as we noted earlier today, the CBO anticipates a lot of employers may decide to keep insuring their workers because they don't trust the new GOP law will be at all stable.

Paul Ryan decided to go Full Pollyanna, stressing all the wonderful news in the report and not mentioning any of the trivial details like people losing coverage and skyrocketing costs for older policyholders:

"This report confirms that the American Health Care Act will lower premiums and improve access to quality, affordable care. CBO also finds that this legislation will provide massive tax relief, dramatically reduce the deficit, and make the most fundamental entitlement reform in more than a generation," Ryan said in a statement. "These are things we are achieving in just the first of a three-pronged approach. It's important to note that this report does not take into consideration additional steps Congress and the Trump administration are taking that will further lower costs and increase choices."

Funny, we can't seem to stop embedding this video lately:

And it's true -- for some, premiums will come down, because the new law will get rid of a lot of the ACA's requirements that policies actually cover health services people need. So lots of people will once again be able to buy really shitty insurance that will fail them when it comes to actually being ... what's the word... health insurance. The cost of real insurance, of course, will go into the up-up-up.

Speaking of Paul Ryan, let's have a hand for MSNBC's Lawrence O'Donnell, that good Catholic liberal from Boston, who gave Ryan holy hell Monday for being an especially crappy Catholic. Noting that Ryan wouldn't dream of forgoing health insurance for his own family, O'Donnell ripped Ryan for being perfectly willing to take it away from other families when he should be defending those who are most vulnerable:

That is what Paul Ryan's religion teaches him. But he does not accept that interpretation of Catholicism, no matter how many members of the Catholic clergy believe that. When Paul Ryan looks at the federal budget, he sees the devil, and he wants to destroy it, he wants to hack away at it. He always has and he always will; he wants to cut that budget, and nothing makes him prouder than cutting money from the federal budget that goes to programs that Republicans don't like, including the tiny amounts of money that go to funding the arts, and the large amounts of money that go to supporting health care for poor people. The thing he is proudest of in this legislation is what it does to what his religion would call "the least of our brethren."

Happily, displeasure over what the AHCA will do to low-income folks isn't just limited to MSNBC hosts. South Dakota Sen. John Thune (R-Yes Really!) says he's planning an amendment to increase the refundable tax credit for those in lower income brackets, which is better than nothing. Barely. Republicans Lamar Alexander and Roy Blunt say they'd support such an amendment; that's a significant step away from the House plan, which bases the credits only on age.

“I do think there are things we can do to tailor the tax credit in a way that it makes more attractive to people and more helpful to people on the lower end and with a phaseout that is a little less steep than what the House has,” Thune told reporters Tuesday [...]

It is unclear how much the tax credits would be increased by.

Hey, guys, here's an idea: how about tax credits indexed to income that actually subsidize a significant portion of premiums for people in the lowest income brackets, then taper off for folks with higher incomes? You could copy that over from Obamacare. While you're at it, you could expand Medicaid and prevent insurance companies from gouging older policyholders. And instead of that stupid 30% premium increase for those who let their insurance lapse for two months, how about some kind of individual and employer mandates to make sure younger, healthier people are in the risk pool, to keep premiums lower for everyone? You could copy a lot of good cost-saving, coverage-increasing measures over from the ACA, but call it something like the "Very Affordable Care Act That Republicans Thought Of Themselves."

Or heck, you could simplify the whole thing and make Medicare available to all Americans.

Strangely, that's almost what the free-market loons at NewsMax endorsed in response to the CBO report; Newsmax editor (and real life close Trump pal) Christopher Ruddy has decided that since states regulate insurance companies, then private insurance isn't REALLY a market-based system, so for all Americans who can't afford insurance he wants Medicaid (not Medicare) for all, at least until the free market finds a way to make cheap, full-coverage insurance available to everyone. It is actually an insane piece of writing that insists on single-payer coverage as a stopgap until the market figures out how to make insurance much cheaper. We actually sort of support that, if only because no truly free market approach to healthcare exists anywhere or is able to provide universal coverage. So if Ruddy wants single payer until Free Market Jesus comes, we're willing to take the single-payer part and wait right along with him.

We might snicker at him quietly, though.

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Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.


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