Chicago Sun-Times

Senate GOP health billwould be largest transfer of wealth to rich

- BY ROBERT REICH Robert Reich was Secretary of Labor under President Bill Clinton.

The Senate’s bill to repeal the Affordable Care Act is not a health care bill. It’s a tax cut for the wealthiest Americans, paid for by a dramatic reduction in healthcare funding for approximat­ely 23 million poor, disabled and working middle class Americans.

America’s wealthiest taxpayers ( earning more than $ 200,000 a year, $ 250,000 for couples) would get a tax cut totaling $ 346 billion over 10 years, representi­ng what they save from no longer financing healthcare for lower- income Americans.

That’s not all. The billwould save an additional $ 400 billion on Medicaid, which Sen. Mitch McConnell, Speaker Paul Ryan and President Donald Trump are intent on shrinking to cut evenmore taxes for the wealthy and big corporatio­ns.

If enacted, itwould be the largest single transfer of wealth to the rich from the middle class and poor in American history.

This disgrace is being proposed at a time when the nation’s rich own a higher percentage of the nation’s wealth and receive the highest percentage of America’s income since the era of the Robber Barons of the late nineteenth century.

Almost all of the transfer is hidden inside a bill that’s supposed to be a kinder and gentler version of its House counterpar­t, which Trump called “mean, mean, mean.”

Look closely and it’s even meaner.

The Senate bill appears to retain the Affordable Care Act’s subsidies for poorer Americans. But starting in 2020, the subsidies would no longer be available formany of the working poor who now receive them, nor for anyone who’s not eligible for Medicaid.

Another illusion: The bill seems to keep the Affordable Care Act’s Medicaid expansion. But the expansion is phased out, starting in 2021.

The core of the bill— where its biggest savings come from — is a huge reduction in Medicaid, America’s health care program for the poor, elderly and disabled.

This, too, is disguised. States would receive an amount of money per Medicaid recipient that appears to grow as healthcare costs rise.

But starting in 2025, the payments would be based on how fast costs rise in the economy as a whole.

Yet medical costs are rising faster than overall costs. They’ll almost surely continue to do so— as America’s elderly population grows, and as new medical devices, technologi­es and drugs prolong life.

Which means that after 2025, Medicaid coverage will shrink.

The non-partisan Urban Institute estimates that between 2025 and 2035, about $ 467 billion less will be spent on Medicaid than if Medicaid funding were to keep up with the expected rise in medical costs. The states would have to make up the difference, but many won’t want to or be able to.

One final major deception: Proponents of the bill say it would continue to protect people with preexistin­g conditions. But the bill allows states to reduce insurance coverage for everyone, including people with preexistin­g conditions.

So insurance companies could technicall­y “cover” people with preexistin­g conditions for the cost of, say, their visits to a doctor, but not hospitaliz­ation, drugs or anything else they need.

The Senate bill only seems like a kinder, gentler version of the House repeal of the Affordable Care Act, but over time it would be even crueler.

Will the American public find out? Not if McConnell can help it.

He shut out major hospitals, physician groups, consumer advocates and organizati­ons representi­ng millions of patients with serious illnesses.

McConnell thinks he’s found a quiet way not only to repeal the Affordable Care Act but also to unravel Medicaid and funnel the savings to the rich.

For years, Republican­s have been looking forways to undermine America’s three core social insurance programs— Medicaid, Medicare and Social Security. The three constitute the major legacy of Democrats Franklin D. Roosevelt and Lyndon Johnson. All continue to be immensely popular.

Barack Obama’s Affordable Care Act is almost part of that legacy. It’s not on quite as solid a footing as the others because it’s still new, and some wrinkles need to be ironed out. But most Americans support it.

Now McConnell believes he can begin to undo the legacy, starting with the Affordable Care Act and, gradually, Medicaid.

But he knows he has to do it in secret if he’s to be successful.

If this shameful bill is enacted, McConnell and Trump — aswell as every Republican senator who signs on— will bear the burden of hundreds of thousands of deaths that could have been avoided, were they not so determined to make rich Americans even richer.

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