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It'll be terrific, believe me


After a few weeks of frenzied secrecy and a deep commitment to ass-covering, Senate Republicans are expected to finally reveal their plan to repeal the Affordable Care Act today. So all you complainers had better shut up about the process being rushed and the bill being written behind closed doors, because they may wait a whole week before voting on the abomination that not even most Republican senators have seen.

Despite a lot of Republican reassurances that the Senate would remove some of the most horrible parts of the House's American Health Care Act (AHCA), the Senate bill is expected to look pretty much like the House bill, except even meaner: The Senate's rollback of Medicaid expansion will cut the program even more deeply than the House version, although that bigly cut would be phased in more slowly in hopes that people would forget who did it. Isn't magical thinking wonderful? As in the House version, federal Medicaid payments to states would be switched to a block grant based on the state's population, which would require states to cut back on how many people receive Medicaid services. Bummer about losing your nursing home care, Gramma.

For people buying individual insurance plans on the state exchanges, the Senate would still replace premium subsidies with tax credits that would cover less of the cost of coverage; unlike the House plan, the credits would be keyed to income instead of age, which might make them slightly less cruel than the House version.

Subsidies are currently available to Americans earning between 100 percent and 400 percent of the federal poverty level. Starting in 2020, that threshold would be lowered to 350 percent under the Senate bill — but anyone below that line could get the subsidies if they’re not eligible for Medicaid.

That provision, said Larry Levitt, senior vice president for special initiatives at the Henry J. Kaiser Family Foundation, would be “a real benefit to poor people in states that don’t expand Medicaid.”

That last provision actually counts as a genuinely good idea, and in a sane government, it would be applied to how the ACA works without throwing the whole law out.

To keep "pro-life" Republicans happy, the bill will eliminate Medicaid funding for health services at Planned Parenthood, even though federal funding of abortions is already illegal. The all-male Senate team that drafted the bill simply doesn't want women to get birth control, cancer screenings, or checkups at Planned Parenthood either, because what if, in the middle of getting their blood pressure checked, ladies might decide to get pregnant and then have an abortion? Happens all the time.

Like the House version, the Senate bill is expected to allow states to opt out of requiring insurers to cover essential health benefits, so people could once again purchase "junk insurance" that has low premiums, but wouldn't cover unnecessary luxuries like emergency room visits, major diseases, preventive care, or hospital stays. But boy, would it be inexpensive!

It's not clear whether -- or how much -- the Senate bill would allow states to also opt out of protections for people with preexisting conditions; Politico reports it would not allow states to get waivers like the House version does:

Keeping the Obamacare requirements would mark a victory for GOP moderates but prompt pushback from conservatives, who want the waiver to be broader and allow more exclusions.

And of course, like the House plan, the Senate will eliminate virtually all taxes in the ACA so rich people can have at least a $600 billion tax cut, which will eventually make everyone prosper thanks to all the economic growth resulting from increased yacht sales.

While the details of exactly how many tens of millions of Americans will be left without health insurance are still unclear, Republicans were at least kind enough to share their work with health insurance industry lobbyists Wednesday, because it's very important to reassure those whose input matters. While the staffers didn't show the lobbyists the text of the bill, they did at least let the industry know the Senate plan promises to fund subsidies for enrollees in the individual health exchange for two years -- coincidentally, just long enough to get the 2018 elections out of the way. That's actually more than Donald Trump has committed to recently. Insurers' uncertainty about whether the government would actually pay for the subsidies -- required by law under Obamacare -- has been one of the main reasons some companies have pulled out of the individual market or raised premiums.

Senate Majority leader Mitch McConnell hopes to ram the bill -- whatever it looks like -- through the Senate, without any hearings or public input, by next Friday, because if you're going to fuck over a sixth of the economy, you may as well fuck it over quickly.

At a campaign rally in Iowa last night, Donald Trump promised -- sort of -- that the Senate bill would have more "heart" than the House's: “I can’t guarantee anything, but I hope we’re going to surprise you with a really good plan,” he said. We're still waiting for Donald Trump Jr. to jump on Twitter to say this proves his daddy couldn't have obstructed justice by telling James Comey he hoped Comey would drop the investigation into Mike Flynn, because after all, no way was Trump ordering the Senate to surprise America with a good plan.

Trump also accused Democrats of obstructionism since they refuse to help Republicans leave millions of Americans with worse, more expensive healthcare, the selfish jerks. Needless to say, this is from the off-teleprompter portion of his speech:

“If we went and got the single greatest health care plan in the history of the world, we would not get one Democrat vote, because they’re obstructionists,” Trump claimed. “If we came to you and said, ‘Here’s your plan, you’re going to have the greatest plan in history, and you’re going to pay nothing,’ they’d vote against it, folks.”

Since this thing is clearly not the greatest healthcare plan in the history of the world, we're OK with Dems not joining in the fun. Now, if Senate R's actually do offer the greatest plan in history that wouldn't require people to pay anything, that would sound a hell of a lot like single-payer, universal coverage, so Yr Wonkette will go out on a limb and urge Democrats to get behind it just as soon as Republicans bring it to the floor.

Yr Wonkette is supported by reader donations. Please click the "Donate" clicky and we'll give you a free liver transplant! (Offer void where we can't pay for a liver transplant.)

[WaPo / Politico / The Hill / LAT / HuffPo]

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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