Senate Republicans Are Crueler Than You Thought
There’s a line in the movie Dumb and Dumber, when Harry Dunne looks at Lloyd Christmas and says, “Just when I thought you couldn't possibly be any dumber, you go and do something like this... and totally redeem yourself!” I remember watching this scene for the first time and laughing hysterically because there was absolutely nothing redeemable about what Lloyd just did. I cannot think of a movie scene that more accurately describes the Republican Party in Congress at this moment in history.
The problem is, unlike the relatively harmless antics of Harry and Lloyd, we’re not just dealing with innocent idiocy; we’re dealing with callousness and an utter disregard for people’s lives.
When the House of Representatives released their version of an Obamacare repeal, the American Health Care Act (AHCA), in May, many people were certain it couldn’t get much worse. Surely, the GOP could not outdo their heartlessness on health care reform. But then the Senate released their version of the repeal plan, the Better Care and Reconciliation Act (BCRA), and it was as if someone dared them to be even more horrible than their colleagues and they accepted the challenge.
In short, this bill is immoral, heartless, and cruel. It is an assault to anyone who is poor, disabled, sick, a woman, mentally ill, may become sick, pregnant or may become pregnant, elderly, substance-addicted or in recovery. Many argue it’s even worse than the House version.
One of the key ways the Senate bill differs from the House bill is it takes the already severe cuts to Medicaid and goes further. Both bills indicate they may shift to what's called a “per capita cap.” This would be a fundamental change to how our country finances Medicaid, a system where both the federal government and the states provide the money to care for those enrolled. Currently, Medicaid is funded at the federal level according to the rise and fall of the cost of providing care. In other words, if the cost of nursing home care goes up, so does Medicaid funding, and there’s no limit on what the federal government contributes. A per-capita cap takes away that flexibility. Funding is determined and increased by a pre-specified amount, regardless of whether the state is required to spend more money to cover the rising cost of care. This means states would have to pick up the slack in coverage, which gives them incentives to restrict benefits and eligibility for enrollees who require that high-cost care. But the Senate bill would allow annual spending on Medicaid to grow even more slowly than the House bill, meaning the cuts would be even steeper. Along with these proposed cuts in Medicaid comes the ending of the Obamacare Medicaid expansion, which allowed all people below a certain income level to enroll in Medicaid and gave 14 million poor, disabled, and elderly people access to Medicaid services
Arguably, the people these cuts would hit the worst are the disabled and the elderly. Medicaid currently covers 30 percent of all adults with disabilities and 60 percent of children with disabilities. While disabled and elderly individuals make up a minority of Medicaid enrollment, they require a majority of Medicaid spending – about 63 percent goes toward disability and age-related care. People with disabilities could lose access to therapies and services, mobility aids, medical services provided in public schools, and in-home care, which allows them to live more independently and stay out of institutional care. And while Medicaid currently covers 64 percent of all nursing home residents (Medicare, the healthcare system for those 65 and older, does not cover long-term age related care like nursing homes or Alzheimer’s facilities), this type of coverage clearly would not be possible at reduced funding levels.
The BCRA could also decimate the working poor in America. Instead of allowing states to opt into a Medicaid expansion program, the Senate bill is claiming to help those in poverty by offering individuals a tax credit to individuals. But there’s a catch - under Obamacare, a tax credit is given based on the amount an "average" health plan would cost, and currently, an “average” plan is one that covers 70 percent of your health costs. The GOP plan ties their tax credit to less expensive plans that would cover 58 percent of your health care costs. This would result in much higher copayments and deductibles, which poor families can’t afford. In short, the working poor are expected to pay the same amount or more on health insurance that would get them less coverage.
Beyond the Medicaid cuts, the Senate bill includes other provisions that would put health care out of reach for so many Americans. Under Obamacare, insurance companies were no longer allowed to deny applicants access to insurance based on preexisting conditions. While the Senate bill still requires insurance companies to accept all applicants, even if they have a preexisting condition, it doesn’t mean the insurance companies have to provide them coverage for those conditions. It’s a weird language loophole that lets insurance companies off the hook. And because the Senate bill allows states to waive the requirement that insurers to cover “essential health benefits,"a list that includes everything from pediatric services to chronic disease management, companies may have the freedom to deny you coverage based on your health, or just charge you more if you have a preexisting condition. Here’s an example: Currently, I am a recipient of mental health treatment for depression and anxiety. I go to counseling and receive prescription medication, both of which are covered by my insurance. Under Obamacare, this care is classified as an “essential health benefit.” If the GOP plan goes into effect and I need to buy new insurance, an insurance company would have to allow me to buy insurance, but they could choose not to cover my preexisting condition because it’s an “essential health benefit” that the GOP gave them the right to waive.
The waiving of essential health benefits means that insurers could, like they did prior to Obamacare, decide to offer plans that do not to cover pregnancy, maternity and newborn care, which is a huge affront to women’s health. They could also choose not to cover mental health and substance abuse services and recovery programs, including counseling, prescription drugs and psychotherapy – which goes against the very same party’s plan to combat the opioid crisis. If a plan didn’t cover essential benefits, that would mean no affordable access to rehabilitative and habilitative services and devices, which helps everyone from car crash victims to autistic children like my 7-year-old son, who receives multiple therapies on a weekly basis. And insurers could deny coverage for emergency services like on-site EMT care and ambulance rides, which are high-cost items that could drain bank accounts in the span of minutes. My husband recently fractured his spine (he’s since made a full recovery) and was transported by ambulance. Before insurance coverage, the bill for the ambulance ride alone – not including his emergency room care – was $2,500.
Needless to say, the Better Care and Reconciliation Act is giving Americans anything but better care. It not only guts access to vital health services to the poor, elderly, disabled and more, it gives a massive tax cut to the rich and corporations. It’s like reverse Robin Hood – steal from the poor and give to the rich.
Faith leaders across the board are condemning the bill. “Part of loving our neighbors is ensuring they have access to quality, affordable health care,” Rev. Jennifer Butler, the CEO of Faith in Public Life stated. “I pray that senators will listen to their consciences and their constituents, and defeat this immoral bill.” The US Conference of Catholic Bishops released a statement saying, “the discussion draft stands to cause disturbing damage to the human beings served by the social safety net.” Specifically citing the changes to Medicaid funding, the Bishops said, “These changes will wreak havoc on low-income families and struggling communities, and must not be supported.” And Rev. Dr. William Barber, the chair of the NAACP’s Legislative Political Action Committee, founder of Moral Mondays, and a prominent faith leader in resisting the Trump administration, called the fight for health care “a fight for the soul of America.” He went on to say, “You’ve not seen this kind of attack on poor people and poor bodies since the days black people were used to make free money as slaves.”
In a stinging rebuke, President Obama used social media to comment on the repeal bill via his Facebook page. “To put the American people through that pain – while giving billionaires and corporations a massive tax cut in return – that’s tough to fathom," he wrote. "But it’s what’s at stake right now. So it remains my fervent hope that we step back and try to deliver on what the American people need.” Senate Democrats are unified in their opposition to the bill, and thankfully, there are now five Republicans who have said they cannot support the bill as it is written now. Senator Dean Heller of Nevada, a Republican facing reelection next year, stated, “I cannot support a piece of legislation that takes insurance away from tens of millions of Americans and tens of thousands of Nevadans.” As heartening as it is to hear a Republican oppose such an immoral bill, some GOP senators who oppose it think it doesn't goes far enough (my own senator, Mike Lee of Utah is one of those).
This is from the party that, for generations, has positioned itself as the party of family values, and a vehemently pro-life party. With the revealing of the Senate’s health care bill, it’s become clear that they don’t actually care about people’s lives at all and certainly not the most vulnerable among us.
Right when you think Republicans couldn’t possibly be anymore heartless, hypocritical, and callous, they go and do something like this and totally redeem themselves.
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