The latest Republican healthcare proposal is such a horror, it is hard to think about anything else. There is in fact no plan—just a scheme that gives money to the states for them to figure it out. It is underfunded (the non-participants in Medicaid expansion are now covered too but with overall less money); there is no longer any guarantee of a minimal level of coverage (including for pre-existing conditions); and in the longer term it shuts the door on Medicaid entirely. It increases the complexity and uncertainty of the system to such a degree even the insurance companies are upset—and it’s not just their problem. We’re talking about small, more expensive risk pools and significantly greater administrative costs.
Since this level of incompetence is just about unthinkable, one asks how anyone could come up with it. There are three immediate answers—all bad: Trump’s pledge to get rid of Obamacare, the proposal’s massive shift of funding from blue states to red, and the simple fact that this is the last chance to pass something before the special 50-vote rule expires September 30.
Let’s focus on the first point—what did Trump voters think they were voting for? They were told he had a much better, cheaper plan. After all he was a businessman and great negotiator. Since the current proposal is no plan, we now know beyond all doubt that what Trump sold was a lie. That fact by itself is an under-reported outrage.
We need to explore the scope of that outrage.
It’s not just Trump. The Republicans have been repealing Obamacare for six years. They clearly never had a plan either, just lies.
It’s not just healthcare. What do Republicans want for the country?
That actually has straightforward answer. It is slightly different for Trump and the Congress:
– For Trump it is simple: “What’s good for me is what’s good for the country.”
– For the Congress the target extends only a little wider: reduce taxes for very rich people. Based on contributions this is the Koch brothers’ Congress. The Koch’s political organization (not just their own money) employs 1600 people and has a larger budget than the Republican party itself. They are the dog wagging the Republican party tail.
What’s the plan for jobs—reduce on taxes on the rich (with no serious look at whether that addresses real problems)
What’s the plan for infrastructure—reduce taxes on the rich (private financing takes infrastructure off the budget and assures spending will go where the money is)
What’s the plan for healthcare—reduce taxes on the rich here too (defund medicaid & push other care to the states with declining funding)
That is the plan. There is no plan. Just lies.