After almost a decade of decrying the Affordable Care Act as the worst thing to hit hospitals since polio, Paul Ryan and the GOP finally unfurled their replacement bill. Of course, Obamacare was a bad plan; it did a terrible job of covering people and was centered around forcing people to participate in a market even if they couldn’t afford the care, all without providing a public option that was more affordable. It was a bill born out of the Obama administration’s masochistic need to gather a bipartisan consensus, even when the other side you want to work with absolutely hates your guts; the essence of weak-tea liberalism that runs like a cancer through the Democratic party.
One of course would suspect that the majority of the new bill would be more libertarian nonsense, dropping regulations and kicking the poor out into the cold once again. Yet, I can unequivocally say that this new bill is absolutely worse than anything within the Affordable Care Act; it’s a Randian horrorshow which feeds the poor into a woodchipper while giving more and more money to healthcare executives.
First off, they seem to have outsourced the naming of their bill to Mrs. Terwilliger’s Fourth Grade class, as the actual name of the bill is “World’s Greatest Healthcare Plan of 2017“. Perhaps they’re trying to appeal to Trump’s childlike ego and for him to support the bill? Ostensibly it seemed to work, since he tweeted support for the bill; strangely though, administration officials don’t want people calling the bill “Trumpcare”. Surprising, given this is a man who likes to put his name on everything, usually in gaudy gold lettering.
Second, this bill astoundingly keeps one of the most hated aspects of the Affordable Care Act, and made it even worse. Under the ACA, if you don’t have healthcare for a certain tax year, you pay a penalty on your taxes. However, under this new bill, if you go without healthcare for that period of time, the healthcare company you buy insurance from will be allowed to (read: will absolutely) charge you a 30% surcharge penalty on your premiums for an entire year. Effectively, all they’ve done is replace the federal boot on your neck with a privatized one.
Third, this new bill phases out the Medicaid expansion that was a centerpiece of the ACA. This means no-one will be able to enroll in the program after 2020. Now it doesn’t remove the people who got in before 2020 outright; it just kicks people off who go without coverage for more than a month after December 31st, 2019. So if someone can’t afford coverage for more than a month, they won’t have coverage at all. On top of that, the bill introduces benefit caps to Medicare, creating limits to funding per enrollee for states. This means that someone on Medicare getting chemotherapy can suddenly stop receiving coverage because they hit their cap.
To top it all off, this bill offers a nice fat tax cut for healthcare companies, offering them a mechanism by which they can deduct executive’s compensation on their taxes as a “business expense”. Right now the ACA provides something similar, capping the deduction at $500,000 a year. This bill removes that cap. As we all know, the group in society that really needs a big transfer of wealth are healthcare executives.
This bill is a work of free market Darwinism, saying that access to healthcare is exclusively the purview of those with money, and those without are not worthy to receive it. Both this bill and the ACA disregard one of the foundational moral arguments of our time: healthcare is a right, not a commodity. Everyone should have access to care in a decent society, and to treat it as a product to be bought and sold like a Shake-Weight or an iPhone is disgusting. Having a single payer system would be cheaper, more cost-effective, and would cover anyone needing healthcare, unlike the half-measure ACA or the monstrosity that is the new healthcare bill.
Thankfully many in public life are vocally protesting against this bill, with groups like the American Academy of Family Physicians, the American Academy of Pediatrics and the American Medical Association speaking out against the bill. Democrats, and even some Senate Republicans, are gathering to oppose the bill as well. We can only hope that this bill is soundly defeated.