The soul of our coun­try

Cherokee County Herald - - VIEWPOINTS - By Cokie Roberts and Steven V. Roberts

Don­ald Trump made this prom­ise on the cam­paign trail: “I’m not go­ing to cut So­cial Se­cu­rity like ev­ery other Repub­li­can, and I’m not go­ing to cut Medi­care or Med­i­caid.”

All politi­cians make prom­ises they can­not keep, but this one is a par­tic­u­larly dev­as­tat­ing de­cep­tion. The health care bill now be­ing drafted by the House, and en­thu­si­as­ti­cally en­dorsed by the pres­i­dent, makes ma­jor cuts in Med­i­caid, the joint fed­eral/state pro­gram that pro­tects the most vul­ner­a­ble Amer­i­cans.

Like so many of Trump’s pro­pos­als — on im­mi­gra­tion and refugees, for ex­am­ple — this one is not just bad public pol­icy. It’s also im­moral, vi­o­lat­ing the most ba­sic obli­ga­tion of Chris­tian­ity, de­scribed in the New Tes­ta­ment as car­ing for “the least of th­ese brothers and sis­ters.”

As John Ka­sich, the Repub­li­can gov­er­nor of Ohio, said on NBC’s “Meet the Press”: “We’re talk­ing about lives. ... We bet­ter be care­ful we’re not los­ing the soul of our coun­try be­cause we’re play­ing pol­i­tics.”

The health care de­bate has fo­cused pri­mar­ily on pro­posed al­ter­ations to the in­surance sys­tem es­tab­lished by the Af­ford­able Care Act (Oba­macare), but the Med­i­caid is­sue is equally im­por­tant.

Un­der Oba­macare, states could uti­lize fed­eral funds to ex­pand Med­i­caid el­i­gi­bil­ity to fam­i­lies earn­ing up to 138 per­cent of the fed­eral poverty line. Thirty-one states took ad­van­tage of the op­tion, adding about 11 mil­lion Amer­i­cans to the Med­i­caid rolls.

Un­der the House bill (call it Ryan/ Trump­care), that ex­pan­sion would be phased out in 2020.

Ac­cord­ing to the Con­gres­sional Bud­get Of­fice, about 5 mil­lion peo­ple would be forced off Med­i­caid in the first year, and 15 mil­lion would lose cov­er­age by 2026.

Speaker Paul Ryan de­fends his plan by say­ing, “We’re go­ing to have a free market and you buy what you want to buy.” Nice words, which to­tally ignore the fact that most of those cov­ered by Med­i­caid can­not af­ford any health in­surance at any price.

But that’s not the whole story. Ryan has spent his whole ca­reer plot­ting to do ex­actly what Trump said he would not do: re­duce en­ti­tle­ments. By ar­dently aban­don­ing his prom­ise, Trump has re­in­forced the im­pres­sion that he doesn’t re­ally care about pol­icy at all.

What he cares about is win­ning. So he’s bought into Ryan/Trump­care be- cause he thinks it’s the only health plan with a chance of pass­ing.

For­tu­nately, a num­ber of Repub­li­cans are ap­palled, espe­cially gov­er­nors who ac­tu­ally have to solve real prob­lems in their states. They can­not af­ford Ryan’s the­o­log­i­cal cru­sade against gov­ern­ment spend­ing or Trump’s re­fusal to rec­og­nize the hu­man mis­ery this pro­posal would en­tail.

Many of those gov­er­nors agree with Ka­sich, who notes that 700,000 Ohioans have gained in­surance cov­er­age un­der Med­i­caid ex­pan­sion. “If they don’t get cov­er­age, they end up the emer­gency room, they end up sicker, more ex­pen­sive,” he told state busi­ness lead­ers. “I mean, we pay one way or an­other. And so this has been a good thing for Ohio.”

It’s been a good thing for Mas­sachusetts, too, says Repub­li­can Gov. Char­lie Baker, where about 300,000 have been added to the Med­i­caid rolls. “Med­i­caid is an im­por­tant safety net for a sig­nif­i­cant por­tion of our state’s pop­u­la­tion,” Baker told CNN.

Four Repub­li­can se­na­tors — Rob Portman of Ohio, Shelley Moore Capito of West Vir­ginia, Cory Gard­ner of Colorado and Lisa Murkowski of Alaska — wrote a let­ter to Ma­jor­ity Leader Mitch McCon­nell say­ing that while “struc­tural re­forms” could im­prove Med­i­caid, those changes “should not come at the cost of dis­rup­tion in ac­cess to health care for our coun­try’s most vul­ner­a­ble and sick­est in­di­vid­u­als.”

At­tacks on Med­i­caid of­ten echo the old de­bate about wel­fare, im­ply­ing that ben­e­fi­cia­ries are able-bod­ied slack­ers who don’t want to work. Of course some peo­ple game the sys­tem, but they’re far from a ma­jor­ity. Many suf­fer from a range of dis­abling con­di­tions: phys­i­cal hand­i­caps, mental ill­ness and sub­stance abuse, for ex­am­ple.

Repub­li­can Gov. Brian San­doval of Ne­vada says Med­i­caid ex­pan­sion has “al­lowed thou­sands of Ne­vadans need­ing mental health treat­ment to re­ceive care.” Ka­sich says a “big chunk” of those cov­ered in Ohio “are men­tally ill and drug-ad­dicted and have chronic dis­eases.”

Im­pov­er­ished se­niors who can­not af­ford nurs­ing care are also ma­jor Med­i­caid re­cip­i­ents. Un­der Ryan/Trump­care, says Tom Wolf, the Demo­cratic gov­er­nor of Penn­syl­va­nia, “You’re ei­ther ba­si­cally con­sign­ing the se­niors to less care or the com­mon­wealth of Penn­syl­va­nia to spend more, or a com­bi­na­tion of both. That’s a real prob­lem.”

Those real prob­lems are not limited to gov­er­nors who would have to ad­min­is­ter Med­i­caid un­der Ryan/Trump­care. The Repub­li­cans who vote for it also stand to pay a large price: Their souls, as well as their seats, could well be at stake.

Steve and Cokie Roberts can be con­tacted by email at steve­[email protected] com.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.