Sun Sentinel Palm Beach Edition
Remind Rubio millions of lives at stake
Nothing in history compares to the catastrophe that the Republican Congress and president intend to inflict on Americans. Over more than a century, 32 nations, including all the industrialized democracies except ours, have enacted universal health insurance as a human right for their citizens. No government has ever attempted to stride backward by eliminating existing coverage for millions of people. Until now. Florida’s Marco Rubio and other Republican senators return to Washington this week under intense pressure from Majority Leader Mitch McConnell to accept a deal — any deal — that fulfills the party’s obsession with destroying the Affordable Care Act.
There’s a new wild card at play: President Donald Trump’s suggestion to simply repeal it and talk about replacing it later. The irresponsibility is staggering. In part, it’s meant to try to blackmail congressional Democrats into cooperating in the unmaking of their historic achievement with President Barack Obama seven years ago. McConnell would be a fool to try it, but you never know.
His party has been bent on vengeance ever since Obama signed the ACA into law with no Republican votes. The party made headlines and bushels of right-wing money with futile votes to repeal it. Now there is a president who is spoiling to share the disgrace of making 22 million more people uninsured. That’s the Congressional Budget Office estimate. The Urban Institute puts it even higher, at 24.7 million.
As we’ve said before, McConnell’s cynically misnamed “Better Care” bill is about more than just doing away with what people perceive as the most controversial part of Obamacare — the provision that those who can afford it must purchase insurance or pay a tax.
First of all, it is tax relief, $700 billion of it, targeted heavily to those who least need it. Higher-income Americans would get nearly $231 billion of that, insurance companies $144.7 billion and drug and medical equipment manufacturers $25.7 billion. The cuts even extend to a 10 percent levy on tanning beds. For the richest 1 percent, there’s an annual windfall of about $40,000. Others might net enough to dine out once in a while, but not after skimpier policies, lower subsidies and higher deductibles add to their out-of-pocket health costs.
Secondly, the bill also carries out the persistent Republican vendetta against Medicare and Medicaid, the great 1965 reform that preceded Obamacare. In that less polarized day, there were Republican votes for and Democratic votes against, but the bill passed with overwhelming majorities in both houses.
Medicaid is the health safety net for low-income and disabled people. It also helps many seniors secure beds in nursing homes. Of the 22 million people who would become uninsured almost immediately, 15 million are on Medicaid. In the long term, the bill’s per-capita Medicaid spending limits, deliberately set lower than the cost of inflation in health care, would likely force the states to exclude or reduce benefits to millions more, including people with mental or substance abuse problems.
McConnell’s plan also endangers every senior on Medicare and all those who expect to be.
The lost revenue would empty the Medicare Part A trust fund by 2026, two years sooner than anticipated, forcing the showdown between severe benefit cuts or higher taxes that Obama sought to postpone.
More people entering Medicare would be suffering from costly, chronic, untreated illnesses because the bill is harshest on those between 50 and 64. It allows insurance companies to charge older people up to five times more than younger ones in the individual and small-group markets. Plus, fewer would qualify for Obamacare subsidies, and there would be increased deductibles, higher cost-sharing and skimpier coverage.
Under Obamacare, the average unsubsidized annual premium for a 64-year-old on the popular Silver Plan is $15,300. Under McConnell’s plan, it would cost $20,500. The narrower Bronze Plan costs $12,700. It would rise to $16,000, and cover less.
According to the CBO, some 1.4 million of these older Americans would become uninsured by 2026, many because of unaffordability.
Florida’s Democratic senator, Bill Nelson, is fighting this atrocity. Rubio is a worry. Although the telegenic junior senator can talk a good game, he has been putty under pressure from McConnell and Trump. Here are some Florida facts it would behoove him to consider before joining in their dirty work.
1.5 million more Floridians would become uninsured, nearly one adult in four under the age of 65, according to the Urban Institute. That’s a 62 percent increase to 3.9 million altogether.
Florida would lose $8.2 billion in federal funds by 2022, an enormous blow to the economy.
Some 450,000 Floridians between 50 and 64 are insured in the Obamacare Marketplace, where they would face higher cost-sharing and deductibles.
Medicaid protects 1.8 million Florida children – 57 percent of those in rural areas and 44 percent in urban centers. That’s an increase of more than 522,000 since Obamacare was passed, even without Florida’s participation in the Medicaid expansion program. Much of that occurred in Broward County, where children’s enrollment increased from 131,510 to 179,750. The harsh spending caps in McConnell’s bill would erase much of that progress.
More than 350,000 Floridians receive behavioral health care, including treatment for substance abuse, under Medicaid. Because mental health for adults isn’t a benefit mandated by Congress — unlike nursing home coverage — it would likely be one of the first items Florida’s notoriously stingy Legislature would cut.
Rubio was nowhere to be seen during the July 4 recess, a time when members of Congress normally shake as many hands as they can find. Most other Republicans laid low. Only three said they would be in parades. Only three planned town halls, fewer than those senators who went to Afghanistan.
They can hide, but they can’t escape the telephone calls, emails and faxes that have been coming and should keep coming to them. Rubio needs to know that the bill is too flawed, in dozens of ways, to be patched up by McConnell’s stealthy wheeling and dealing. The bill needs to be withdrawn or defeated. Then, perhaps, a decent effort to improve Obamacare might ensue.
Joseph Stalin, the Soviet dictator and consummate cynic, was reputed to have said that “a single death is a tragedy, a million deaths is a statistic.” He didn’t mind the statistics. It doesn’t look as if McConnell does, either.
For what Medicaid means to one person, one among many, there is the Miami Herald’s touching account last week of Haylee Kalick, 21, who lives with her father and grandparents in Weston. She suffers from a number of conditions, including Tourette Syndrome, bipolar disorder and obsessive compulsive disorder, so severe that she had been hospitalized nearly 20 times and tried to take her life. But that was before she signed up for Medicaid in 2015. It provides the five prescription drugs, counseling and psychiatric therapy that are keeping her out of hospital and on the road to a productive life.
“I can leave the house now and do something,” she said.
Sen. Rubio must know that millions of people owe their health — and even their lives — to the programs that McConnell and Trump are hell bent to destroy.
Here’s how to remind him: His Washington telephone number is 202-224-3041. At his Palm Beach office, the number is 561-775-3360. Editorials are the opinion of the Sun Sentinel Editorial Board and written by one of its members or a designee. The Editorial Board consists of Editorial Page Editor Rosemary O’Hara, Andrew Abramson, Elana Simms, Gary Stein and Editor-in-Chief Howard Saltz.