BLOOD MONEY
Trumpcare secret out: Grab aid from working class, give to rich
WASHINGTON — Senate Republicans finally released their secretive bill to repeal Obamacare on Thursday after weeks of backroom negotiations — and it was immediately slammed as “heartless” by Democrats and too soft by hard-line conservatives.
“It’s time to act, because Obamacare is a direct attack on the middle class and Americans deserve better than the failing status quo,” Senate Majority Leader Mitch McConnell (R-Ky.) said on the Senate floor shortly after the bill’s release.
President Trump tweeted he was “very supportive” of the bill, but indicated more work still had to be done.
“Look forward to making it really special!” he wrote.
Dozens of protesters gathered outside McConnell’s personal office in the Senate, and Capitol police arrested them, bodily dragging many away, including some in wheelchairs.
On Facebook, former President Barack Obama said at the heart of the bill was “fundamental meanness.”
“The Senate bill, unveiled today, is not a health care bill. It’s a massive transfer of wealth from middle-class and poor families to the richest people in America,” Obama wrote.
The bill is in many ways similar to the bill the House passed that would leave millions more people without health coverage in the next decade. It gets rid of many of Obamacare’s taxes on the wealthy, defunds Planned Parenthood, ends subsidies for low-income Americans to buy health insurance after 2019 and makes deep cuts to Medicaid while phasing out states’ Medicaid expansion.
The subsidies for low-income Americans are replaced by tax credits that will benefit wealthier people more. And while the Senate bill offers more money to subsidize older Americans than the House version did, both allow insurance companies to charge older Americans as much as five times more than younger ones, a shift from the limit of three times as much contained in Obamacare.
Just hours after the bill was released, a powerful quartet of conservatives said they couldn’t back the legislation in its current form — a large enough number to sink the bill if they can’t be won over.
“Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor,” Sens. Rand Paul (Ky.), Ted Cruz (Tex.), Mike Lee (Utah) and Ron Johnson (Wis.) said in a joint statement. “There are provisions in this draft that represent an improvement to our current health care system but it does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs.”
While that statement reads as more of a negotiating ploy than hard opposition, it will be tough for McConnell to win over those four while trying to convince nervous moderates to support the final product.
And it didn’t sound like some moderates are much happier than their hardline colleagues.
The bill only allows a threeyear phaseout of state’s Medicaid expansion starting in 2020. That’s longer than what the House proposed but is a potentially major sticking point for moderate senators and those from states that expanded the program and covered millions more people.
Lawmakers from those states, such as Sens. Rob Portman of Ohio and Dean Heller of Nevada, had pushed for a seven-year
phaseout. Heller said in a statement that he had “serious concerns” about the bill’s provisions to fundamentally restructure Medicaid and end its expansion.
Republican senators were mostly tight-lipped as they exited a Thursday morning meeting where they were briefed on the bill.
“We’ve got a lot to look at” was all Sen. Lisa Murkowski (R-Alaska) would say, the key swing vote remaining pursed-lipped as she waited for elevator doors to close on a scrum of reporters.
“I want to read it first,” Sen. Jeff Flake (R-Ariz.) said as he hustled onto the Senate floor.
Sen. Bill Cassidy (R-La.), a doctor who has been sharply critical of the House bill, said he wanted to see the text itself. But he said that there were good things in the bill.
“There’s a lot of effort to lower premiums immediately,” he told reporters. He said the three-year Medicaid expansion phase-out was “better” than the House bill's abrupt cutoff, and made positive noises about the way the Senate’s version of the legislation structured the tax credits to better support older and poorer Americans.
Sen. Susan Collins (R-Maine) is another key moderate vote. Her staff said she “has a number of concerns and will be particularly interested in examining the forthcoming (Congressional Budget Office) analysis on the impact on insurance coverage, the effect on insurance premiums, and the changes in the Medicaid program.”
The budget office announced it hopes to release a full analysis of the bill sometime early next week, a moment that could prove crucial for moderates’ support.
Republicans can only afford to lose two of their own and still pass the bill. McConnell is pushing for a vote on as soon as next Thursday ahead of the July 4 congressional recess.
The 142-page bill provides a short-term stabilization fund for state-level individual marketplaces through 2021 to help incentivize insurance companies to stay in the markets and offer more choice to consumers, and repeals the individual and employer mandates to buy health insurance.
It doesn’t include the House bill’s allowance for insurance companies to charge people more if they’ve let insurance lapse, an incentive for healthy people to stay insured. And unlike the House bill, it doesn’t include provisions to allow states to waive protections for people with preexisting conditions.
On top of the provisions to end states’ Medicaid expansion, it includes additional huge changes to Medicaid’s overall program aimed at slowing the growth rate of the program more dramatically in future years, which could lead to major cuts in what states can offer their citizens.
Though Trump praised the House bill last month in a Rose Garden ceremony, he reportedly called the House measure “mean” last week, and urged the Senate to show more “heart.”
Democrats said the Senate version is meaner.
Senate Minority Leader Chuck Schumer (D-N.Y.) described the House bill as a “wolf in sheep’s clothing,” and said the Senate version “has even sharper teeth than the House bill.”
Sen. Bernie Sanders, a Vermont independent, called it “by far the most harmful piece of legislation I’ve seen in my lifetime.”