Day: June 23, 2017

The Senate’s Unaffordable Care Act

aidspicIt would be a big mistake to call the legislation Senate Republicans released on Thursday a health care bill. It is, plain and simple, a plan to cut taxes for the wealthy by destroying critical federal programs that help provide health care to tens of millions of people.

The Senate majority leader, Mitch McConnell, and other Republicans have pitched the bill as a fix for the Affordable Care Act, or Obamacare. But their true ambition is not to reform Obamacare, which, whatever its shortcomings, has given 20 million Americans access to health insurance. If passed in its current form, the Senate bill would greatly weaken Medicaid, the federal-state program that provides insurance to nearly 69 million people, more than any other government or private program. It would do this by gradually but inexorably shifting more of the financial burden of Medicaid to states, in effect, forcing them to cover fewer people and to provide fewer services. Over all, the Senate would reduce federal spending by about $1 trillion over 10 years and use almost that much to cut taxes for rich families and health care companies.

In the days ahead, while the Congressional Budget Office totes up the bill’s cost, and before a floor vote, some Republicans, President Trump included, might be tempted to see the Senate bill as an improvement over the draconian House measure passed in May that would take insurance away from 23 million people. Mr. Trump previously expressed the hope that the Senate version would be less brutal. It isn’t. True, Mr. McConnell and his colleagues have made a few superficial improvements; the rollback of Obamacare’s intended expansion of Medicaid would proceed more slowly than under the House’s timetable. But the long-term damage might be worse. That is because the Senate bill would cap federal spending on Medicaid on a per-person basis. Currently, federal spending varies from year to year based on demand for medical services and the cost of care. Starting in 2025, the cap would be allowed to increase at the rate of inflation in the economy. But the overall inflation rate has typically been much lower than the inflation rate for medical services; in 2016, the overall inflation rate was 1.3 percent, whereas medical costs increased by 3.8 percent. Over time, this would means states will get a lot less money than they do under current law. The inevitable shrinkage in Medicaid will be particularly devastating to older Americans. Contrary to what many people think, the program does not just benefit the poor. Many middle-class seniors depend on it after they have exhausted their savings. Medicaid pays for two-thirds of the people in nursing homes. The disabled and parents who have children with learning disabilities also rely on Medicaid. The program covers nearly half of all births in the country. And in recent years, it has played a very important role in dealing with the opioid epidemic, especially in states like Kentucky, Massachusetts, Maryland, Ohio and West Virginia. Medicaid pays between 35 percent and 50 percent of the cost of medication-assisted addiction treatment, according to two professors, one from Harvard and one from New York University.

Like its House counterpart, the Senate bill would also hurt millions of non-Medicaid beneficiaries of Obamacare, those who buy insurance on federal and state marketplaces. It would greatly reduce federal subsidies that help low-income and middle-income families buy health coverage, while allowing insurers to increase deductibles, forcing people to pay more for medical services. It would let states waive rules that now require insurers to cover essential health services like maternity care, cancer treatment and mental health care, which is likely to happen because this will be the only way that states can lower premiums. In sum, it will make health insurance more expensive and less useful, to the great misfortune of the poor, elderly and sick.

Mr. McConnell seems determined to steamroll this travesty through the Senate before July 4, despite complaints by conservatives and moderates. Expect him and his colleagues to try to buy support of wavering lawmakers by offering sweeteners like a few billion dollars for addiction treatment and some extra cash for states with high medical costs. Republican senators like Susan Collins of Maine, Lisa Murkowski of Alaska, Shelley Moore Capito of West Virginia, Rob Portman of Ohio and Dean Heller of Nevada ought not to fall for these cheap gimmicks. Instead, they should vote no on a bill that will take a devastating toll on millions of Americans and that no amount of tinkering around the edges can make better.

T r u m p ’ s L i e s

EYESMany Americans have become accustomed to President Trump’s lies. But as regular as they have become, the country should not allow itself to become numb to them. So we have catalogued nearly every outright lie he has told publicly since taking the oath of office.

Jan. 21 “I wasn’t a fan of Iraq. I didn’t want to go into Iraq.” (He was for an invasion before he was against it.)Jan. 21 “A reporter for Time magazine — and I have been on their cover 14 or 15 times. I think we have the all-time record in the history of Time magazine.” (Trump was on the cover 11 times and Nixon appeared 55 times.)Jan. 23 “Between 3 million and 5 million illegal votes caused me to lose the popular vote.” (There’s no evidence of illegal voting.)Jan. 25 “Now, the audience was the biggest ever. But this crowd was massive. Look how far back it goes. This crowd was massive.” (Official aerial photos show Obama’s 2009 inauguration was much more heavily attended.)Jan. 25 “Take a look at the Pew reports (which show voter fraud.)” (The report never mentioned voter fraud.)Jan. 25 “You had millions of people that now aren’t insured anymore.” (The real number is less than 1 million, according to the Urban Institute.)Jan. 25 “So, look, when President Obama was there two weeks ago making a speech, very nice speech. Two people were shot and killed during his speech. You can’t have that.” (There were no gun homicide victims in Chicago that day.)Jan. 26 “We’ve taken in tens of thousands of people. We know nothing about them. They can say they vet them. They didn’t vet them. They have no papers. How can you vet somebody when you don’t know anything about them and you have no papers? How do you vet them? You can’t.” (Vetting lasts up to two years.)Jan. 26 “I cut off hundreds of millions of dollars off one particular plane, hundreds of millions of dollars in a short period of time. It wasn’t like I spent, like, weeks, hours, less than hours, and many, many hundreds of millions of dollars. And the plane’s going to be better.” (Most of the cuts were already planned.)Jan. 28 “Thr coverage about me in the @nytimes and the @washingtonpost gas been so false and angry that the times actually apologized to its dwindling subscribers and readers.” (It never apologized.)Jan. 29 “The Cuban-Americans, I got 84 percent of that vote.” (There is no support for this.)Jan. 30 “Only 109 people out of 325,000 were detained and held for questioning. Big problems at airports were caused by Delta computer outage” (At least 746 people were detained and processed, and the Delta outage happened two days later.)Feb. 3 “Professional anarchists, thugs and paid protesters are proving the point of the millions of people who voted to MAKE AMERICA GREAT AGAIN!” (There is no evidence of paid protesters.)Feb. 4 “After being forced to apologize for its bad and inaccurate coverage of me after winning the election, the FAKE NEWS @nytimes is still lost!” (It never apologized.)Feb. 5 “We had 109 people out of hundreds of thousands of travelers and all we did was vet those people very, very carefully.” (About 60,000 people were affected.)Feb. 6 “I have already saved more than $700 million when I got involved in the negotiation on the F-35.” (Much of the price drop was projected before Trump took office.)Feb. 6 “It’s gotten to a point where it is not even being reported. And in many cases, the very, very dishonest press doesn’t want to report it.” (Terrorism has been reported on, often in detail.) READ MORE:https://www.nytimes.com/interactive/2017/06/23/opinion/trumps-lies.html?action=click&pgtype=Homepage&clickSource=story-heading&module=opinion-c-col-left-region&region=opinion-c-col-left-region&WT.nav=opinion-c-col-left-region&_r=0