April 7, 2020

The Two Week Slump

By Stephen Tuttle | March 25, 2017

President Trump and his Republican allies are in a nasty two week slump. Perhaps we should check in. 

That American Health Care Act the Republicans rolled out, initially and enthusiastically supported by the president, wasn't received warmly. At all. They're now stuck with it. 

They made the classic mistake of over-promising and under-delivering. Everyone will have health insurance, Trump said. You'll get more options and more coverage for less, they claimed.

Instead, the first phase of their rollout offered us less coverage for, in too many cases, way more money.  

The analysis of Trumpcare (if the Affordable Care Act is Obamacare then the American Health Care Act is surely Trumpcare) by the Congressional Budget Office (CBO) was eye-popping. The non-partisan CBO is responsible for analyzing the true cost and repercussions of major legislation. They have a reputation for ignoring the politics and focusing on the numbers.

The CBO says Trumpcare will result in 24 million Americans losing healthcare coverage in the next decade, including 14 million next year. Medicaid will be severely cut back, leaving states to deal with uninsured low income households.

Premiums under Trumpcare will be age-based instead of income based. Younger people will pay less, older people not yet on Medicare will pay more regardless of income. Subsidies will be replaced by tax rebates. 

Changing the formula to age-based will devastate fixed income people not yet eligible for Medicare, as well as all middle-aged low income families. The proposed tax breaks are swell but don't help make the monthly or quarterly premium payments as the previous subsidies did. Plus, low income people might not even owe federal income tax, so a tax break becomes meaningless. 

In the most egregious example cited, a 60-year-old man making a bit more than $25,000 per year now pays about $1,700 annually for a baseline policy under Obamacare. That same man's premiums will skyrocket to a budget-shattering $14,000 annually under Trumpcare. At the same time, Trumpcare includes significant tax breaks for some of the wealthiest Americans.

Trumpcare advocates tell us this is only the first phase and they're already making necessary changes and the Senate can make more. Plus, they say, Trumpcare will save the federal government a bundle and allow people to decide for themselves if they want health insurance.

The CBO says Trumpcare will save about $337 billion over the next decade compared to Obamacare. Most of that will come from dumping additional Medicaid responsibilities on the states and replacing subsidies with much less costly tax rebates. 

Perhaps the House will have passed some version of Trumpcare by the time you read this, but they should have slowed down. Their rush to eviscerate anything with Obama's name attached has led them into a dark alley. There was never any question Obamacare needed changes; even Obama acknowledged there was room for improvement. Instead, Republicans have created a plan that further disadvantages the already disadvantaged and further advantages the already advantaged. 

The Trumpcare cost-cutting was of a piece with the first Trump budget. He proposes a $54 billion increase in defense spending all paid for by cuts to other programs.

Gone would be most of the money for studying the climate (Trump's budget director said climate science is a “waste of time”), Meals on Wheels, PBS and NPR, Restoring the Great Lakes Initiative, free breakfasts for low income children (“no evidence they improve academic achievement”), National Endowment for the Arts, Community Block Grants, programs to help business start-ups, programs to help seniors, nearly a third of the EPA budget...it's a long list.

It's no wonder Republican members of Congress are afraid to face their constituents in town hall meetings. They can't reasonably defend Trumpcare nor the proposed budget cuts. 

Then, of course, there's the surreal sideshow of Trump accusing Obama of wiretapping him. Even most Republicans backed away from this lunacy quickly. 

Trump started this in one of his late night Twitter storms on March 4. Here's what he tweeted: “Terrible! Just found out that Obama had my 'wires tapped' in Trump Tower just before the victory. Nothing found. This is McCarthyism!” 

Naturally he wasn't quite done. Here's his next tweet, peculiar spelling and all: “How low has President Obama gone to tapp my phones during the very sacred election process. This is Nixon/Watergate. Bad (sick) guy.” 

It simply wasn't true. We've had enough former and current officials testify under oath to know nobody wiretapped Donald Trump; not Obama, not the FBI, not our intelligence community or that of the British. The fake news, as usual, came from Trump himself.

Republicans are now stuck. Proposals that will hurt lots of people aren't very popular, and a president living in a paranoid parallel universe is difficult to support or defend. They can improve the first problem but the second is a lot stickier.   

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