Medicaid ‘blood money’
Even by Washington standards, this is a particularly dumb political moment. Earlier this month a political zealot went to a baseball practice with the intention of killing as many Republican congressmen as he could. As often happens after such horrible events, various politicians and media figures suggested that we should tone down the rhetoric and not paint everything in apocalyptic terms, casting Republicans or Democrats as villains with traitorous or evil intent in their hearts. Words have consequences, they sagely said into the TV cameras.
Two weeks later, many of the very same people are describing the Republicans as murderers for proposing changes to Medicaid. “Forget death panels,” Hillary Clinton tweeted. “If Republicans pass this bill, they’re the death party.” Sen. Elizabeth Warren said the tax cuts in the bill amount to “blood money.” These comments are restrained compared with those of some activists, like the left-wing filmmaker Josh Fox who proclaimed, “Mitch McConnell is a terrorist. [Donald Trump] is a terrorist. This bill terrorizes people and sentences poor people to death.”
I think the flawed Republican healthcare plan is very much open to criticism, from the left and the right, but this rhetoric is repugnant and dangerously stupid. Both the House and Senate versions would impose a per capita cap on Medicaid funding (or states can take a block grant), leaving it up to the states how best to administer the program. And they would reduce Medicaid spending by the federal government compared with current trends. The hope is that this pressure and flexibility would encourage states to impose efficiencies to the bloated, bureaucratic and budget-busting program (total Medicaid spending last year was $533 billion). It also has provisions for tax credits and other reforms for those who would be knocked off the Medicaid rolls, so they could obtain insurance on the private market.
Would people die? Despite a host of very specific numbers from people like Sen. Bernie Sanders, no one really knows. The data is at best mixed about whether Medicaid improves mortality rates or even health overall (though it’s clear some people, like pregnant women, do benefit). Still, it might be true that some people would die earlier than they would have if we kept the status quo.
This is not the damning concession it may appear to be. Politicians like to defend some law on the grounds that “if it saves just one life, it’s worth it.” But by that logic we should make the speed limit 5 MPH. That would surely save lives. Are you a murderer if you oppose such a move?
There’s no evidence Obamacare saved lives either. Some people lost health insurance because of it. Heck, life expectancy went down for the first time in decades after Obamacare went into effect. Is Obama a murderer? Of course not.
Put aside the hypocrisy and danger implicit in saying elected leaders are murderers if they dare pare back the welfare state. Taken literally, such rhetoric means that entitlement reform is impossible, because any attempt to get our fiscal house in order would require some people, somewhere, to lose some benefits.
Now, exonerating the Republicans from the charge of deliberate terrorism is faint praise, indeed. Even President Trump called the House version “mean” — despite celebrating its passage with an upscale kegger in the Rose Garden
The truth is that healthcare “reform” has been a story of bipartisan malpractice. Obamacare was lied into passage (“you can keep your doctor,” “you can keep your plan” etc.) on a strict party-line vote. The Republicans spent the better part of a decade vowing to tear it all down. When the dogs caught the car, they had no idea what to do next. They’ve halfheartedly opted to keep the structure in place but carve off a chunk of money to fund tax cuts (but not for the working-class people most harmed by their bill).
Trump’s irresponsible promise to leave entitlements alone has been memory-holed by Republicans because they want to claim they repealed Obamacare to give the president a “win.” The Democrats, likewise, are more concerned about keeping Obama’s healthcare “win” on the books for the sake of his legacy, than fixing Obamacare’s dysfunction. And if that requires calling Republicans murderers, so be it. It’s just words.