Trumpcare adds insult to injury

Thursday, the U.S. House of Representatives will vote on the Republican bill to repeal the Affordable Care Act. This bill, aka Trumpcare, is a raw deal for New York and its people — and New York’s members of Congress will decide its fate.

This is why Republican Reps. Chris Collins and John Faso, of the Buffalo area and the Hudson Valley, respectively, crafted a special carveout for New York behind closed doors. But this “Empire Earmark” would actually harm the state, its hospitals and its safety net programs.

By denying federal matching funds for Medicaid spending by counties, the Empire Earmark would blow a $2 billion hole in the state budget. The state would need to make up for this gap with massive cuts to state spending on county aid and other programs.

That funding cut would come on top of the general funding cuts that are already in the House bill. The bill would cut federal Medicaid funding for New York by $4.5 billion, causing job losses and closures of hospitals in rural areas.

The House bill’s massive cuts to Medicaid and shift to far smaller tax credits — unrelated to income or the cost of a plan — would devastate patients’ access to care. The nonpartisan Congressional Budget Office estimated that 24 million people would lose their health care coverage nationally, a figure that’s lower than the White House’s own estimate.

If the CBO’s estimate is allocated proportionally across states, 2.3 million people would lose their coverage in New York. This includes 196,600 children covered by Medicaid, 43,900 people with disabilities covered by Medicaid and 88,200 seniors who access nursing homes and other care through Medicaid.

It also includes 474,500 adults covered by Obamacare’s Medicaid expansion and 1.3 million who have private insurance through their employers or the state’s exchange.

New Yorkers ought to be asking how the people who they hired to represent them in Washington can possibly be onboard with such a bill.

Take, for example, undecided Republican Rep. Pete King. In his district covering the South Shore of Long Island, 72,300 New Yorkers would lose their coverage if the House bill passes. This includes 3,900 children covered by Medicaid and 1,600 seniors who access nursing homes and other care through Medicaid.

Rep. Daniel Donovan is another undecided Republican. In his district covering Staten Island and parts of Brooklyn, 82,100 New Yorkers would lose their coverage. This includes 7,400 children covered by Medicaid and 3,600 seniors who access nursing homes and other care through Medicaid.

But it gets worse: The House bill would increase costs substantially for New Yorkers even if they remain insured.

For starters, the Congressional Budget Office estimated that the House bill would increase premiums by 15% to 20% in 2018 and 2019. By 2026, the bill would slightly lower premiums by 10% — but mostly because it would price older people out of the insurance pool.

Another factor is that the bill would make insurance coverage skimpier, covering a lower share of costs.

But premiums are only one component of overall costs. The House bill would slash tax credits and increase deductibles and other forms of cost-sharing. All those deductibles people have complained about under Obamacare? They’re about to get even bigger.

Accounting for all these factors, the House bill would increase overall costs for the average New Yorker by $2,708 in 2020, according to an analysis by the Center for American Progress, where I work. Lower-income New Yorkers — with incomes 250% below the official poverty level — would see their average costs increase by $4,694.

The House bill would also increase costs for people ages 55 to 64 by $2,224. Although Republicans are promising to increase tax credits for older people after they pass the bill, the bill itself only has a magic asterisk or promissory note to make unspecified changes in the future. Why should anyone believe that promise?

This is obviously not a responsible way to govern or make policy.

Trumpcare is an unmitigated policy and political disaster. It’s not too late for New York representatives to do the right thing. And it’s not too late for you to make a difference by calling your representative today.