The GOP Health Plan -or-If You're Not Wealthy You're Screwed

[dales]

By STEPHEN OHLEMACHER, Associated Press


WASHINGTON (AP) — The House Republicans' health care bill adds up to big tax cuts for the rich.


The bill would cut more than 20 taxes enacted under President Barack Obama's heath law, saving taxpayers nearly $600 billion over the next decade. The bulk of the money would go to the wealthiest Americans.


Low- and moderate-income families would lose their subsidies to buy health insurance in state and federal marketplaces. The subsidies would be replaced by tax credits to help them buy insurance.


Official estimates for how these people would fare under the bill have not been made public, even as House committees move ahead with the legislation.



The new health bill was released this week as congressional Republicans and President Donald Trump try to make good on campaign promises to repeal and replace Obama's health law. House GOP leaders say they want to give consumers more access to affordable health care with less government interference.


The effort, however, has been criticized by both the left and the right. Democrats argue that fewer people will have health insurance, while some conservatives are calling the plan "Obamacare Lite."


The biggest tax cut would eliminate a 3.8 percent tax on investment income for high-income individuals and families. Eliminating the tax would save these taxpayers $158 billion over the next decade, according to the nonpartisan Committee on Taxation, the official scorekeeper for Congress.


About 90 percent of the benefit from repealing the tax would go to the top 1 percent of earners, who make $700,000 or more, according to the nonpartisan Tax Policy Center.


Another big tax cut would repeal an extra 0.9 percent Medicare tax on wages above $200,000 for individuals and $250,000 for married couples. Repealing the tax would save higher income families $117 billion over the next decade.





Repealing the Medicare tax would also speed up the depletion of the Medicare trust fund. It would run out of money in 2025 instead of 2028, as is currently projected, said Sen. Ron Wyden of Oregon, the top Democrat on the Senate Finance Committee.


Wyden said that "breaks a clear Trump promise not to damage Medicare."


"This bill sends a loud and clear message: Tax cuts for special interests and the wealthy matter more than your health care," Wyden said.


Rep. Kevin Brady, chairman of the tax-writing Ways and Means Committee, said the health care taxes hurt consumers, businesses and economic growth.


"They hurt the economy. They hurt health care. They achieve nothing," the Texas Republican said at a news conference. "I don't want Americans to continue to struggle under the Obamacare taxes."


Despite the lost tax revenue, Brady said the overall bill would not add to long-term budget deficits. However, no official estimates have been released.


The bill would not repeal the health care program's "Cadillac" tax on high-cost health insurance plans. Instead, it would delay the tax until 2025. The tax has already been delayed once, until 2020.


This tax would hit many middle-income families, according to the Tax Policy Center. Delaying it by five years would save taxpayers $49 billion.


Among the health care taxes repealed in the bill:


—Health providers pay an annual fee based on market share. Repealing the tax would save health insurers $145 billion over the next decade.


—Prescription drugmakers and importers pay an annual fee. Repealing it would save pharmaceutical companies $25 billion over the next decade.





—Taxpayers can deduct out-of-pocket health expenses if they exceed 10 percent of their income. The bill would return the threshold to 7.5 percent of income, which it was before the Affordable Care Act. Taxpayers would save $35 billion over the next decade.


—Medical device makers and importers pay a 2.3 percent excise tax. Repealing it would save them $20 billion over the next decade.


___


Associated Press Writer Ricardo Alonso-Zaldivar contributed to this report.

[Econoline]

[Econoline]

[BoSoxGal]

OMG these Trump/GOP drones are truly brainless! FOX News, Limbaugh, Alex Jones, et al. have created a whole class of total morons.

[Lord Jim]

[Econoline]

Further proof that the Tea Party and the Trumpanees are *NOT* in fact actual conservatives, by any reasonable definition of the term....

[Lord Jim]

I don't think that folks who are concerned about this bill passing have anything at all to worry about; at the end of the day, the odds are overwhelming that absolutely nothing is going to pass. And the reason for this is basic math.

I'm not talking about the math of the bill itself; I'm talking about the math of Congressional votes needed for passage in both Houses. (Note to rube: you should probably just scroll past this post; there are a lot of numbers coming.)

Let's start by looking at the basic numbers:

They need 50 of the 52 Republicans in the Senate and 216 of 237 Republicans in the House to get the legislation adopted.

https://fivethirtyeight.com/features/se ... obamacare/

(There are currently five vacancies in the House, which is why the number needed for passage at the moment is 216 rather than 218)

This means that on the House side, Ryan can afford to lose a maximum of 21 GOP votes to pass a bill...

But many members of the so-called "Freedom Caucus " (made up of the Tea Party members and other assorted Radical Randians) are already coming out against the Ryan bill:

(CNN)Members of the House Freedom Caucus appear still convinced House leadership doesn't have the 218 votes it needs to pass its version of Obamacare repeal, and they aren't buying the arguments made by the bill's supporters Tuesday evening that the House bill is a take-it-or-leave-it proposition.

"No new position tonight. Our position is the same," caucus chairman Mark Meadows told reporters following a closed-door meeting of his caucus. "We believe we need to do a clean repeal bill."

House Speaker Paul Ryan "is going to need a lot of Democrat votes to pass what would be the largest welfare program sponsored in the history of the Republican Party," [there isn't one single vote for this on the Democratic side]said Rep. Mo Brooks, a Republican from Alabama.

http://www.cnn.com/2017/03/07/politics/ ... y-meeting/

The Freedom Caucus has 36 members, so even if a few of them vote for the bill, if the bulk do not, (and remember these are the same folks who thought nothing of shutting down the government and would have been happy not to raise the debt ceiling; they're not known as big compromisers) it won't pass...

So this means that to attract enough votes from this bunch to gain passage for his bill, Ryan is going to have to accept amendments that will make the legislation even more draconian...(like completely repealing medicaid expansion)

However if he does that, then he will risk losing votes from more moderate Republicans (there are 24 that represent districts that Hillary Clinton carried, and more that represent districts in states like West Virginia, that have been big beneficiaries of medicaid expansion)

But let's assume a best case scenario from Ryan's standpoint; somehow he manages to make the bill sufficiently harsher to appeal to enough of the Freedom Caucus types while still holding on to enough of the more moderate members to avoid losing 22 votes, and he pushes a bill past the finish line in the House...

Whatever emerges will be absolutely doomed in the Senate; the math makes this conclusion inescapable:

The bill that comes out of the House can only afford to lose a maximum of 2 votes in the Senate to gain passage, but four GOP Senators have already signed off on a letter saying that even the phase out of Medicaid expansion in the current Ryan bill is unacceptable:

Four Republican senators from states that passed Obamacare’s Medicaid expansion—Alaska’s Lisa Murkowski, Colorado’s Cory Gardner, West Virginia’s Shelley Moore Capito, and Ohio’s Rob Portman—also oppose the House GOP’s plan and wrote a letter to Senate Majority Leader Mitch McConnell saying so.

“We are concerned that any poorly implemented or poorly timed change in the current funding structure in Medicaid could result in a reduction in access to life-saving health care services,” they wrote, “and we will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states.”

http://www.slate.com/blogs/the_slatest/ ... _bill.html

But the resistance from Republican Senators doesn't end there:

Five senators (Bill Cassidy of Louisiana, Susan Collins of Maine, Bob Corker of Tennessee, Lisa Murkowski of Alaska and Rob Portman of Ohio) unsuccessfully pushed for a bill that would delay Congress’s start on the Obamacare repeal process. (Saying that something is being rushed or calling for its delay is a common tactic that members of Congress use to oppose things.)

Sens. Lindsey Graham of South Carolina, Johnny Isakson of Georgia and Shelley Moore Capito of West Virginia, along with Cassidy and Collins, have proposed allowing states to keep their Obamacare programs as they are now if they choose, including retaining the Medicaid expansion, with no expiration date. Nevada’s Dean Heller and Colorado’s Cory Gardner have also raised concerns about shifting how Medicaid is funded.

Texas Sen. Ted Cruz, Utah Sen. Mike Lee and Kentucky Sen. Rand Paul, like the House Freedom Caucus, have been criticizing the repeal proposals aired by party leaders as “Obamacare lite” and insufficiently conservative, while Tennessee Sen. Lamar Alexander and Arizona’s Jeff Flake have warned Republicans against moving too quickly and overreaching.

https://fivethirtyeight.com/features/se ... obamacare/

So to add to the four that signed the letter, I count seven more (Collins, Graham, Issakson, Corker, Cassidy, Alexander and Flake) who are highly dubious votes for even the current bill, let alone a harsher one...

(BTW, in addition to opposition to repealing Medicaid expansion, Collins and Murkowski are also on record as saying that the won't vote for any bill that de-funds Planned Parenthood, as the current bill does)

So on the Senate side, they will need to moderate the House bill sufficiently to attract at least 9 of those 11 Senators, while simultaneously not losing Paul and Lee ...(or if they lose them, they will need all 11 of those votes to get to 50)

Now let's say that they make the changes needed to get those 11 votes; at a minimum they preserve Medicaid expansion, and they take the de-funding of Planned Parenthood out of the bill, and pass it (barely)

Now you have two bills; one passed by the Senate that cannot pass the House, (if they make those fundamental changes, you can expect the Freedom Caucus to vote against it pretty much en masse) and one that passed the House that cannot pass the Senate...

This is your classic "rock and a hard place"...

[Scooter]

Trump betrays those who believed his health care promises

In the first 24 hours after House Republicans unveiled their new health care reform plan, one of the unexpected mysteries was whether Donald Trump liked it. Mixed signals from the White House raised the possibility that the Republican president may not endorse his own party’s legislation.

A written statement from the White House on Monday night, for example, expressed lukewarm support and notably did not include an endorsement. The next morning, however, the president himself referred to House Speaker Paul Ryan’s (R-Wis.) plan as “our wonderful new Healthcare Bill.” (Trump occasionally capitalizes words he thinks are important.)

HHS Secretary Tom Price endorsed the GOP’s “American Health Care Act” in a letter to Congress, but a few hours later, he hedged during a press briefing. Vice President Mike Pence backed the bill, but Press Secretary Sean Spicer was more circumspect.

It’s likely much of this is the result of a dysfunctional White House, which often struggles to keep its stories straight, but it’s possible Team Trump is struggling because it’s aware of a broader problem: by embracing this Republican plan, the president is doing the opposite of what he told Americans he would do for them. The New Yorker’s John Cassidy explained:

The bill aims to take a wrecking ball to the principle of universal coverage. If enacted, millions of Americans would end up without any coverage. For many people who purchase individual policies, especially older people, it promises fewer services for more money. And it also proposes a big tax cut for the rich, which would be financed by slashing Medicaid, the federal program that provides health care to low-income people. […]

Back in January, Donald Trump promised that the replacement for Obamacare would provide “insurance for everybody.” By endorsing the American Health Care Act, on Tuesday, Trump has broken his pledge.
That’s no small development for a president who hasn’t yet been in office for seven weeks.

As recently as January, Trump took pride in making bold boasts. “We’re going to have insurance for everybody,” he said. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” He went on to point to some fairly specific benchmarks: universal coverage, “much lower deductibles,” and a simpler and less expensive system in which all Americans are “beautifully covered.”

Those comments, from January, followed similar assurances Trump made during his candidacy, when he told voters, “I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now.”

All of those promises, we now know, had no basis in reality. The new Republican plan doesn’t cover “everybody,” doesn’t lower deductibles, doesn’t ensure that all Americans are “beautifully covered,” and doesn’t guarantee that “everybody” is “taken care of.”

Meanwhile, Trump also vowed, repeatedly, that he’d introduce his own “wonderful” health care reform proposal. As of yesterday, apparently that wasn’t true, either.

To be sure, this isn’t the first time the new president has broken a promise, but it’s almost certainly the most dramatic example. For Americans who believed Trump’s rhetoric about health care, this is an extraordinary betrayal.

[Lord Jim]

Trump was happy to demagogue the issue during the campaign, but the truth is when it comes to really getting involved with this, he doesn't want to touch it with a 10 foot pole...

He has no real interest in it, and sees no personal political benefit being closely associated with an actual plan....

That's why the plan on the table is the Ryan Plan, and not the repeatedly promised Trump Plan (the plan that was going to be magically better for everyone while lowering everybody's cost..."It'll be great, you're gonna love it")

Despite his assertion yesterday that he is "100%" behind the Ryan plan, this lack of personal investment in the issue on Trump's part makes it even less likely that anything at all will ultimately be passed. It's at the kind of impasse that I projected is on the horizon in my previous post that you would expect a President to step in, and start twisting arms to get a deal through. But that's unlikely to happen.

In theory Trump should have substantial clout with Freedom Caucus members to lean on them to accept a more moderate bill passed by the Senate (since he won in many of their districts by large margins) but he's unlikely to exert much, and probably wouldn't be all that effective if he did.

These are the hardcore kamikazes; ideologically driven, and not people with any great sense of loyalty to Trump. (Ronald Reagan was able to get Conservatives to go along with a tax increase because they saw him as one of them, and they felt some trust and loyalty towards him. I think you could count on the fingers of one hand all the GOP members of Congress who feel any true loyalty to Trump, let alone trust.)

ETA:

I also strongly suspect that Trump announced his full support without having any idea what's actually in the bill, (because that's how he rolls) and that it's highly likely that as the process goes forward he will be sending out tweets and making statements that will be all over the map in terms of his support for it and all of its provisions...

[Scooter]

[BoSoxGal]

NOW will his supporters start waking up?!?!

[Econoline]

[Econoline]

From Jim Wright's Facebook page:

• White House spokesviper Kellyanne Conway says the press shouldn't call it "Trumpcare."
  
  Seems Trump doesn't like the idea of his name on Republicans' new healthcare bill.
  
  Now, this is a guy who has his name in 20 foot high golden letters on top of hundreds of buildings around the world. This is a guy who put his name on steaks, wine, hats, and a shady failed real estate University.
  
  Hell, Trump has his name on top of the Trump International Hotel & Tower Baku -- a failed hotel project which sits empty in a rundown, crime ridden section of Baku, Azerbaijan. He was so proud of the project and so eager to put his name on it, that he sent his daughter Ivanka to Azerbaijan -- AZERBAIJAN -- to oversee the project.
  
  Now, the Trump International Hotel & Tower Baku was built in partnership with Garant Holding.
  
  Garant Holding is "owned" by Anar Mammadov.
  
  Anar Mammadov is the son of the Azerbaijan's Transportation minister Ziya Mammadov. And he doesn't really own anything, he just acts as a front for the paper companies run by his dad.
  
  Ziya Mammadov is a newly minted billionaire oligarch and his family is so corrupt and involved in organized crime that US Foreign Policy routinely refers to them as “The Corleones of the Caspian.” (Think Michael Nyqvist's Viggo Tarasov from John Wick and you're in the right ball park).
  
  Oh, and if that wasn't enough, Ziya Mammadov has close financial ties to the Iranian Revolutionary Guard -- the radical Islamic fanatics who control most of Iran and were responsible for holding 52 Americans diplomats for 444 days in 1979-80.
  
  And Trump has his name on top of a hotel he built with THAT guy. A hotel that now sits empty and abandoned in a Baku slum.
  
  But Trump DOESN'T want his name on the GOP healthcare plan.
  
  Think about that.
  
  Take all the time you need.

[Big RR]

[Econoline]

Here are 2 paragraphs from an article at Vox.com titled “The GOP health bill doesn’t know what problem it’s trying to solve”:

• “In general,” writes Peter Suderman, “it's not clear what problems this particular bill would actually solve.” This is a profound point. It is difficult to say what question, or set of questions, would lead to this bill as an answer. Were voters clamoring for a bill that cut taxes on the rich, raised premiums on the old, and cut subsidies for the poor? Will Americans be happy when 15 million people lose their health insurance and many of those remaining face higher deductibles?

• This bill has a lot of problems, and more will come clear as experts study its language, the Congressional Budget Office release its estimates, and industry players make themselves heard. But the biggest problem this bill has is that it’s not clear why it exists. What does it make better? What is it even trying to achieve? Democrats wanted to cover more people and reduce long-term costs, and they had an argument for how their bill did both. As far as I can tell, Republicans have neither. At best, you can say this bill makes every obvious health care metric a bit worse, but at least it cuts taxes on rich people? Is that really a winning argument in American politics?

[Scooter]

[Econoline]

From Charlie Pierce:

Paul Ryan said that insurance cannot work if healthy people have to pay more to subsidize the sick.

This is literally how all insurance works. If someone's house burns down, some of your fire insurance money goes to help that person rebuild. If someone gets sick, some of your premium, healthy person, goes toward that person's coverage. Increasingly, I have come to believe that Paul Ryan is a not particularly bright creature from another world. Let us see if we can explain this to the lad.

Let's say that, in 1986, a 16-year-old lad loses his father to a sudden heart attack. Despite the fact that the family's construction firm is relatively prosperous due to its generous share of government contracts, the family's finances are considerably straitened. For the next two years, the young man and his mother receive Social Security survivor's benefits. Of course, these came from millions of people who had Social Security withheld from their paychecks and whose fathers did not die young due to a sudden heart attack. One of them was, say, a 32-year-old sportswriter for the Boston Herald, who had Social Security withheld from what he was paid to watch the Red Sox blow the '86 World Series, and whose father was still alive, but slipping fast into Alzheimer's. Some of his money went to make sure Paul Ryan could complete high school and go on to college and get the BA in economics that made him the smartest man in the world.

Got it now?

[Big RR]

You would think that would be clear to third grader.

[Sue U]

B-b-b-but but but -- that's the soshulisms!!!!!!1111!1!1!

[Lord Jim]

The bottom line is, (for the reasons I have laid out in detail regarding the political dynamics in the House and the Senate) there is not going to be any substantive bill passed by both Houses of Congress and put on Il Boobce's desk for signing...

It's not going to happen...

I have three modest suggestions to improve the healthcare situation in this country, (which address the primary problem; the spiraling cost...which neither Obamacare or Ryan Care addresses...)

Three suggestions which could have a real impact on the cost of healthcare...( bragging that the cost of premiums "only" went up 25% in one year versus 35% , doesn't seem like a great victory to me...)

Here are my Three Suggestions: (two of them are generally supported by Liberals, and one of them is generally supported by Conservatives...but I suspect if a poll was done they'd all be overwhelmingly supported across the board...)

1. Allow the federal government to negociate drug prices (Given the fact that it's the biggest player in the market, it's astonishing that this is not going on...inexcusable...this is a no brainer...)

2. Allow people to buy healthcare policies across state lines ( a lot of Liberals are opposed to this; they call it a "race to the bottom"... when you have numerous counties and even whole states with only one "healthcare" plan and provider available, "the bottom" has already been reached...)

3. Remove the antitrust exemption from the health insurance industry...(I suspect that most people would be surprised to learn that like Major League Baseball, health insurance providers are exempted from the antitrust laws...)

A couple of days ago, I heard a Congressman interviewed on one of the cable news channels who said that an amendment revoking this antitrust exemption was attached to one of the numerous bills passed by the House trying to revoke Obamacare, and that amendment received 400 votes...

400 votes

Out of 435...

Now that's what I call bipartisan...

But surprise surprise, it's not even in the Ryan bill...