Donald Trump, running for president, said he would not cut Medicaid.
He said that though he would eviscerate the Affordable Care Act with a mighty and swift sword, “Everybody’s going to get covered” under his alternative. “I don’t care if it costs me votes or not.”
So, America, do you think he would veto any bill that would violate these campaign promises?
That would only happen if so much as a single word Trump has uttered can be believed.
This is a means of saying that whatever healthcare legislation reaches his desk, if indeed it ever does, don’t call it Trumpcare. Trump doesn’t care.
Really. He doesn’t care if it’s “mean, mean, mean,” as he described the House bill. He doesn’t care if it “transitions” millions of Americans off of Medicaid, and if it cripples the health-care exchanges that have served millions more.
He just wants something he can call his own. Something with which he can advertise his daddy’s last name in gold plate.
“Trumpcare”? No. “American Health Care Act”? You kid. For what has oozed from behind closed doors of the Senate GOP caucus, the only suitable name is the Unconscionable Congressional Knock-off. Acronym: UCK.
With UCK, giant tax cuts for people who don’t need a break would be financed by giving the boot to people who need a break to maintain basic health care.
UCK would spit in the face of states that boldly have expanded Medicaid. They embraced the spirit of the Affordable Care Act and made the most of a historic law that has provided a measure of security for Americans who had none before.
That’s 31 states and the District of Columbia, with 10 million people getting coverage through Medicaid expansion.
My family is a Medicaid family. No, not because we are poor. It’s because my state wisely expanded Medicaid under the ACA, meaning that both of my sons had health coverage through Medicaid in between jobs and after college. Now both have employer-provided health coverage.
Medicaid for them didn’t cost much. They are young and healthy, and needed very little medical care while on the rolls. But the peace of mind they had in that tender interval was priceless.
Taking this kind of protection away is the kind of betrayal congressional Republicans are proposing for the people of America.
Meanwhile, Republicans have done everything they can to make what they giddily tout as the “collapse of state exchanges” a self-fulfilling event.
The first blow came last year when a budget rider championed by Sen. Marco Rubio dramatically cut subsidies to insurers via so-called “risk corridor” payments. The subsidies are there to encourage insurers to cover high-risk individuals and stay in the game for a broad base of customers.
Count this as the biggest reason why some insurers have pulled out of state health exchanges. Political foes of Obama encouraged the ACA’s unsoundness so they could then crow about insurers leaving.
Underhanded measures like this, and the general uncertainty projected by policymakers who really don’t want to help as many people as the ACA has helped, are the reasons why so many insurers are balking about participation.
A national survey of insurers just released finds that 42 percent say they would pull out of the state exchanges if the cost-sharing subsidies aren’t funded.
That matter, by the way, has been batted back and forth in federal court. Stark uncertainty for insurers, thanks to Republican conspirators.
Meanwhile, measures that would remove the individual and employer mandates would make participation much more risky, as the more participants they have, the more likely that insurers cover all who need it.
With UCK, the Republicans would stick it to those very people. “Cover everybody”? Donald Trump and the millionaires in the Senate mean “everybody in our tax bracket.”
Longtime Texas newspaperman John Young lives in Colorado. He can be reached by email at email@example.com.