Analysis of Senate ‘Obamacare’ repeal and replace bill

The “discussion draft” of the Senate GOP health care bill has been released (online in its entirety here) by evil GOP bastard Mitch McConnell, and it is even worse than many anticipated.

Still, four far-right Tea-Publican senators say that it doesn’t go far enough in its cruelty to Americans. “Let the poor die! Rich people want their tax cuts!” Their moral depravity knows no limits.

President Barack Obama offered a succint summation of the bill in a Facebook post:

The Senate bill, unveiled today, is not a health care bill. It’s a massive transfer of wealth from middle-class and poor families to the richest people in America. It hands enormous tax cuts to the rich and to the drug and insurance industries, paid for by cutting health care for everybody else. Those with private insurance will experience higher premiums and higher deductibles, with lower tax credits to help working families cover the costs, even as their plans might no longer cover pregnancy, mental health care, or expensive prescriptions. Discrimination based on pre-existing conditions could become the norm again. Millions of families will lose coverage entirely.

Simply put, if there’s a chance you might get sick, get old, or start a family – this bill will do you harm. And small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, cannot change the fundamental meanness at the core of this legislation.

I hope our Senators ask themselves – what will happen to the Americans grappling with opioid addiction who suddenly lose their coverage? What will happen to pregnant mothers, children with disabilities, poor adults and seniors who need long-term care once they can no longer count on Medicaid? What will happen if you have a medical emergency when insurance companies are once again allowed to exclude the benefits you need, send you unlimited bills, or set unaffordable deductibles? What impossible choices will working parents be forced to make if their child’s cancer treatment costs them more than their life savings?

To put the American people through that pain – while giving billionaires and corporations a massive tax cut in return – that’s tough to fathom. 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.

Ezra Klein writes at, The Senate GOP health bill in one sentence: poor people pay more for worse insurance:

There are a lot of moving parts in the health bill Senate Republicans just released, but the bigger picture is straightforward. Health care expert Larry Levitt condensed it to fewer than 140 characters:

Screen Shot 2017-06-22 at 3.28.03 PM

That’s it. That’s what this bill does. In fact, it does it over and over again. Policy after policy in the bill is built to achieve the same goal: making poor people pay more for less health insurance.

[F]irst, it resets the benchmark plan to one that only covers 58 percent of expected health costs. Under Obamacare, the sparest plan that insurers can generally offer at all has to cover at least 60 percent of expected health costs — so the plans subsidized by the GOP bill won’t just have higher deductibles and less coverage than the plans at the center of the ACA; they’ll have higher deductibles and less coverage than the plans at the bottom of the ACA.

Second, it increases the percentage of your income you can pay for a benchmark plan before it’s deemed unaffordable and additional subsidies kick in.

If all this sounds a bit in the weeds, here’s the bottom line: Low-income Americans get less money to buy crummier insurance. In the GOP bill, the measure of what is affordable has gone up and the definition of what counts as decent insurance has gone down.

This basic idea is also present in the plan’s changes to Medicaid. The Senate’s plan begins to phase out the Medicaid expansion in 2021, and fully repeals it in 2024. Low-income people who were on Medicaid get moved to the exchanges, where the plans cover less, cost more, and require more out-of-pocket spending.

Once the Medicaid expansion is repealed, Republicans get to work on Medicaid itself, tying the amount it can spend to an inflation index that lags behind how much health care actually costs. The result is Medicaid will be able to cover fewer people and cover less of their health care in the future.

Similarly, right now the Affordable Care Act’s subsidies go to 400 percent of the poverty line. This bill caps them at 350 percent of the poverty line. People above that limit will have to pay more for their insurance, which means they’ll be able to afford less.

* * *

The bill [McConnell] has written leads to more people who aren’t covered. The premiums, deductibles, and copays people actually pay for their care will skyrocket. More people will end up in bad insurance that has deductibles so high that it’s really not worth much to them. In a particularly Orwellian flourish, the name of this bill dedicated to diminishing the quality of the insurance coverage Americans can afford is “The Better Care Act.”

Remember, “in May of 2015, one month before he launched his campaign for president, Trump told the conservative Daily Signal that he would not touch the Social Security, Medicare or Medicaid programs.”

I’m not going to cut Social Security like every other Republican and I’m not going to cut Medicare or Medicaid,” Trump said. “Every other Republican is going to cut, and even if they wouldn’t, they don’t know what to do because they don’t know where the money is. I do.

This was always a lie told by a carnival barker con man to a gullible and unsophisiticated electorate willing to believe in magical unicorns.

“President-elect Donald Trump said in a [January] interview that he is nearing completion of a plan to replace President Obama’s signature health-care law with the goal of “insurance for everybody,” while also vowing to force drug companies to negotiate directly with the government on prices in Medicare and Medicaid.” Trump vows ‘insurance for everybody’ in Obamacare replacement plan. “In addition to his replacement plan for the ACA, also known as Obamacare, Trump said he will target pharmaceutical companies over drug prices.”

On this point, the carnival barker con man also lied to a gullible and unsophisiticated electorate willing to believe in his lies. Steve Benen explains After tough talk, Trump is poised to deliver for the drug industry:

One of the few key areas on which Donald Trump broke with Republican Party orthodoxy was lowering prices on prescription drugs. In fact, shortly before taking office, he complained bitterly about the pharmaceutical industry’s powerful lobbyists, and said drug companies are “getting away with murder.”

For some on the left, this offered at least some hope that the Trump administration would be progressive on the issue, though those hopes faded soon after the president took office. In late January, Trump reversed course, saying he no longer wanted to use the government’s buying power to lower costs, denouncing such a policy as “price fixing.”

Vox explained at the time that the White House’s approach appeared to amount to little more than “lowering taxes” and “getting rid of regulations.”

That turned out to be exactly right. Five months later, the New York Times reports on a draft of an executive order the president intends to sign on drug prices that “appears to give the pharmaceutical industry much of what it has asked for.”

The draft, which The New York Times obtained on Tuesday, is light on specifics but clear on philosophy: Easing regulatory hurdles for the drug industry is the best way to get prices down.

The proposals identify some issues that have stoked public outrage – such as the high out-of-pocket costs for medicines – but it largely leaves the drug industry unscathed. In fact, the four-page document contains several proposals that have long been championed by the industry, including strengthening drugmakers’ monopoly power overseas and scaling back a federal program that requires pharmaceutical companies to give discounts to hospitals and clinics that serve low-income patients.

This is entirely in line with a Politico report from last week, which said Trump’s approach to drug prices would be “industry friendly,” and the White House does not intend to push the idea of using federal leverage to negotiate lower prices – which is what the president vowed to do before he was elected.

Before you ask me why I’d be surprised by any of this, I’m not. But sometimes, developments can be predictable and disheartening at the same time.

Indeed, the salient question is no longer whether Trump is ignoring his health care promises, but rather, just how many promises he’s choosing to break. He promised to create a system that covers “everybody”; he swore he wouldn’t cut Medicaid; he vowed to lower deductibles; he “guaranteed” protections for Americans with pre-existing conditions; he said he’d lower the cost of prescription drugs; and on and on.

The president played those who trusted his promises for fools.

When are  Trump voters going to wake up and realize that they have been had by a grifter and con man? Trump is picking their pockets to line his own, and those of his rich friends. How much of America must be destroyed because of these damn fool Trump voters’ blind obedience to the personality cult of the demagogue Donald J. Trump? Admit your mistake and repent.

For more “in the weeds” analysis of the Senate health care transfer of wealth to rich people bill, see Dylan Matthews These are all the people the Senate health care bill will hurt; Sarah Kliff, The Better Care Reconciliation Act: the Senate bill to repeal and replace Obamacare, explained; and Jared Bernstein, The Senate health-care bill is even worse than the House’s version.

The immediate editorial summations are equally brutal. The New York Times editorializes, The Senate’s Unaffordable Care Act. The Washington Post editorializes, Senate Republicans’ Obamacare replacement is bad for America’s health.

Anyone who votes for this abomination of a bill should be considered as having committed a crime: They are consigning millions of Americans to economic ruin and even death by stealing their health care to give tax cuts to the wealthiest Americans, who already own everything. For that they will have to answer to the voters. For the amorality of it all, they will have to answer to God.

Call your senators and demand that they do the right thing, the moral thing, the Christian thing if you will,  and to vote against this abomination of a bill.

31 thoughts on “Analysis of Senate ‘Obamacare’ repeal and replace bill”

  1. AzBM is really agitated and spewing profanities. Almost makes me think he is going over the edge. Thankfully, he is an uber-liberal (Sorry, progressive.) so no need to call the police to confiscate his guns. But still, Hupp and censored should find a “safe space.”

    • The occasional use of a profanity for emphasis is perfectly aceptable. You must not remember Michael Bryan’s posts on this blog. I’m a Catholic school boy (I was actually) compared to him. Does the legislature know you post on this blog from your legislative email, the same thing that got “Thucky” in trouble when we outed him for being a sock puppet troll? Is this an appropriate use of taxpayer money?

      • I would think trying to mask my identity would be more problematic. Besides, I believe that the public benefits from my transparency and my constituents should know where I stand on public policy issues. But nice try at attempting to “chill” my speech. I am sure you would love for me to go away.

        • And by the way, AzBM, are you saying that when a reporter or constituent calls my office to get my opinion, I cannot answer on my government phone?
          So let’s see regarding out quest to unmask (“out”) you. We can now assume that you went to Catholic school and are not a lawyer.

  2. Ha ha. Truth. Will be a great on a TV ad.

    Jesse Berney‏Verified account @jesseberney Jun 22


  3. You are mouthing swill not based on facts. You are also a hypocrite protecting your rich benefactors.

    The personal income tax rate is now higher than the revenue maximizing tax rate – thus reductions increase tax payments by the “rich”, not reduce them.

    However, there is an entire class of rich liberals protected by hypocritical you and your fellow paid mouthpieces – the Bezos’s, the Gates, the Buffets, the Zuckerbergs, the google boys who pay no taxes, no taxes at all on their earnings.

    So, quit spewing your vomit and start doing some retrospective thinking.

    You are the party of the super rich who pay no taxes and create no jobs for poor people.

    You advocate for bone crushing burdens, in excess of 63%, on Republicans who create jobs for poor people, while your rich benefactors pay nothing.

    • Not one word disputing any of the analysis by those cited, just your usual insane ranting. I am not rich, nor do I have any rich benefactors, so you don’t know what the fuck you are talking about, per usual.

      • and know mention by you on what bezo’s amazon is doing to the white collar working class’s sales job. several women I used to take to work at kmart and sears no longer have jobs. as bill maher democrats should worry about the workers at kohl’s not coal mines!

  4. Trump on the Senate’s bill (Source: Twitter):

    Donald J. Trump‏Verified account @realDonaldTrump 18h18 hours ago
    I am very supportive of the Senate #HealthcareBill. Look forward to making it really special! Remember, ObamaCare is dead.

  5. Trolling Facebook so y’all don’t have to. Sen Flake says he’s going to read the new “healthcare”
    bill. What a relief, huh?

    Senator Jeff Flake
    Yesterday at 9:07am ·
    Just got my copy of the #healthcare bill and I’m going to take time to thoroughly read and review it

    • Sen Flake’ contact info:

      Washington, D.C. Office
      Senate Russell Office Building 413
      Washington, D.C. 20510
      P: 202-224-4521
      F: 202-228-0515

      Phoenix Office
      2200 East Camelback Road
      Suite 120
      Phoenix, AZ 85016
      P: 602-840-1891
      F: 602-840-4092

      Tucson Office
      6840 North Oracle Road
      Suite 150
      Tucson, AZ 85704
      P: 520-575-8633
      F: 520-797-3232

    • Trolled Sen McCain on Facebook. He’s trying to be more reassuring than Sen Flake.

      John McCain
      20 hrs ·
      I am closely reviewing the discussion draft of the Senate health care bill released today. My focus is on protecting the people of Arizona, and I am consulting with Governor Doug Ducey and seeking input from Arizonans before making a final decision.

      Any replacement plan must ensure our citizens have access to affordable and flexible health care, and I look forward to thoroughly examining this legislation and engaging in a robust amendment process in the Senate next week.

    • McCain’s info:

      Phoenix Office
      2201 East Camelback Road
      Suite 115
      Phoenix, AZ 85016
      Main: (602) 952-2410
      Fax: (855) 952-8702

      Tucson Office
      407 West Congress Street
      Suite 103
      Tucson, AZ 85701
      Main: (520) 670-6334
      Fax: (520) 670-6637

      Washington Office
      218 Russell Senate Office Building
      Washington, DC 20510
      Main: (202) 224-2235
      Fax: (202) 228-2862

    • Well of course he did.

      And Paul Ryan famously relied on Social Security money to pay for his education. His father passed away and from the ages of 16 to 18 Ryan was what the Ayn Randian folks call a “parasite”.

      Republicans – Full of S4!+ since 1980.

        • There was a time when people seemed to understand human frailty and uncertainty, that any one of us could become someone in need of help.

          But, of course, wealthy actors like Mr. Nelson don’t have to worry.

          The lack of empathy is truly stunning.

          • “There was a time when people seemed to understand human frailty and uncertainty, that any one of us could become someone in need of help.”

            When was that, Liza? I haven’t figured out any time when the situation was as you describe it. Perhaps you can enlighten me as to when this golden age occurred. I realize that the times in which we live are the worst times of all, but I have problems seeing a time when things were better.

          • I thought about that later, Steve. I think I just remember it that way because of going to Catholic schools for 12 years and spending all that time with nuns. They taught us a great deal about what it means to be a good person. Some might argue that they also taught a lot of bunk about religion, but most of what I remember was about morality, simple and straightforward, do unto others, etc…

            Perhaps I sense a degradation in morality because everyone is on social media saying what they really think. And maybe the percentages are constant but there’s more people. Maybe in current times we lack real communities where people actually do help each other.

            I don’t know.

          • “I think I just remember it that way because of going to Catholic schools for 12 years and spending all that time with nuns. They taught us a great deal about what it means to be a good person.”

            I understand what you are saying. I, too, spent 10 years going to Catholic Schools. It would have been 12, but I skipped the 4th and 7th grades. The schools were Jesuit, so they put a lot of emphasis on self discipline, but they, too, also emphasized the need to strive to be a good person. Like you, I came away with a strong sense of what it meant to be a good person. I held on to that ideal for many years, and even today I think it is not a bad thing to strive for.

            “Perhaps I sense a degradation in morality because everyone is on social media saying what they really think.”

            That is an excellent point I had never thought of. People let you see themselves without filters and that can sometimes be an ugly thing to see. Those filters, I think, are sort of necessary to make society function smoothly.

            “Maybe in current times we lack real communities where people actually do help each other.”

            That’s another good thought. If you live in a stable small community where neighbors knew each other, or were at least aware of each other, there would be a tendency to feel more of a sense of commitment to ove another. It could be compared to an extended family. I know it would affect me that way.

            Thank you for sharing your thoughts on this. I understand much better what you were referring to. I often think things were better in my earlier days despite knowing that, in a macro sense, there were big troubles going on. I just seem to remember that things seemed a little kinder, people seemed a little gentler and there was more of a sense of community. I am probably wrong, but that is what I remember.

            Perhaps that is the way it is intended to be…fond memories of the past to comfort us in our older days. ;o)

      • “And Paul Ryan famously relied on Social Security money to pay for his education.”

        And you used your “white privilege” to get yourself ahead in life. Now that you have yours, you want to pull the ladder up behind and take that “privilege” away from other whites because it is immoral.

        How are you different from Paul Ryan?

        • How is Tom different from Paul Ryan?

          He’s not made it his life’s mission to decimate the social safety net.

          I’m sure there are other differences as well.

          • I’m taller and better looking.

            And I don’t look down on people less fortunate than me, I don’t consider them parasites or “takers”.

            I don’t rant on about getting my morality from Ayn Rand novels and then pretend to be Catholic when running for VP, and then lecture the Pope about how to Pope.

            And you can’t fold me up and stuff me into a carry on bag because unlike Paul Ryan, I have a backbone.

            Thanks Liza. 🙂

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