Thursday, May 04, 2017

Only one way left to fix America's GOP problem

Step 1: Plant a computer virus in the Republican mothership.

Step 2: Nuke the sons of bitches.

Actually, that sounds a lot like how Donald Trump -- with the help of the Russians and Hillary Clinton's own tone-deafness as a politician -- won the presidential election.

And now look:
It was one thing for Donald Trump to pledge on the campaign trail that his plan for health care would assure that every American had coverage. He did so repeatedly, including during a town hall event in February 2016 at which he said his promise to “take care” of everyone might sound as if he was talking about a single-payer system, but he wasn’t. “That’s not single-payer,” he said. “That’s not anything. That’s just human decency.”

It was another thing, though, for Trump to make similar claims after the election. Before the election, it was anything goes in a way that most politicians would avoid. Afterward, one might expect Trump to zero in on his preferences a bit more narrowly, to scrape away the rhetoric and describe, instead, what it was that he wanted to see.

“We’re going to have insurance for everybody,” Trump told The Washington Post’s Robert Costa and Amy Goldstein during an interview less than a week before his inauguration. Although Trump was characteristically confident and equally characteristically light on specifics, he did outline several things that he anticipated the Republican replacement bill for the Affordable Care Act might include.

The plan would have “lower numbers, much lower deductibles.” The “philosophy in some circles that if you can’t pay for it, you don’t get it”? Trump insisted that “that’s not going to happen with us” — implying that there would be universal coverage regardless of income. What’s more, people could “expect to have great health care” that would be “in a much simplified form. Much less expensive and much better.”

Trump told Costa and Goldstein that people wouldn’t keep their existing plans but would have some sort of insurance plan. “[T]hey’ll be beautifully covered,” he said. “I don’t want single-payer. What I do want is to be able to take care of people.”

That is not the proposal that passed the House on Thursday.

Trump promised insurance for everybody.

The AHCA would probably result in 24 million more uninsured people by 2026, according to the Congressional Budget Office’s analysis of the original GOP bill.


Trump promised lower “numbers” and lower deductibles.

The AHCA would probably have higher deductibles. The CBO anticipates that they will be higher under the AHCA than they would have been if the ACA were kept, thanks to a change in the actuarial values used in determining plan costs.


Trump promised “much less expensive” coverage.

The AHCA would probably mean that customers would eventually see lower premiums — after premiums increased, pricing more-expensive patients out of the market.


Trump promised that people who can’t pay for coverage would still receive coverage.

The AHCA would probably reduce the number of lower-income people with coverage. This is in part because they will receive less government support to pay premiums. It’s also in part because the Republican bill cuts funding to Medicaid, meaning that millions fewer people would be covered under the program.


Trump promised that policies would be “much better” and that people could expect to have “great health care.”

The AHCA would probably reduce the quality of insurance plans, thanks to late amendments that would allow states to get waivers so that insurers could separate coverage items out of the default package. The cost of plans would go down — but people who find themselves needing coverage for something that had been removed would end up paying much more.
 YEP. We've seen this movie before.


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