The Zombie Trumpcare bill, the American Health Care Act (AHCA) which narrowly passed the House this month, would increase the projected number of people without health insurance by 14 million next year, would reach 19 million by 2020, and 23 million in 2026, according to a new Congressional Budget Office (CBO) report (.pdf) released on Wednesday.
The CBO issued two reports on earlier versions of the House bill in March. Both said that the legislation would increase the number of uninsured by 14 million next year and by 24 million within a decade, compared with the current law.
The New York Times reports, G.O.P. Health Bill Would Leave 23 Million More Uninsured in a Decade, C.B.O. Says:
The AHCA would reduce the federal deficit by $119 billion over a decade, less than the $150 billion in savings projected in late March for an earlier version of the bill [Trumpcare 2.0]. And in states that seek waivers from rules mandating essential health coverage, the new law could make insurance economically out of reach for some sick consumers.
CBO projects premiums would increase by an average of about 20 percent in 2018 and 5 percent in 2019. “Starting in 2020, however, average premiums would depend in part on any waivers granted to states and on how those waivers were implemented and in part on what share of the funding available from the Patient and Stte Stability Fund was applied to premium rediction.”
“People living in states modifying the essential health benefits (EHBs) who used services or benefits no longer included in the EHBs woud experience substantial increases in out-of-pocket spending on health care or would choose to forgo the services.”
“Premiums would vary significantly according to health status and the types of benefits provided, and less healthy people would face extremely high premiums,” the budget office concluded.
The new forecast of the nonpartisan Congressional Budget Office, Capitol Hill’s official scorekeeper, is another blow to Republican efforts to undo President Barack Obama’s signature domestic achievement. The Senate has already said it will make substantial changes to the measure passed by the House, but even Senator Mitch McConnell of Kentucky, the majority leader, is sounding uncertain about his chances of finding a majority to repeal and replace the health law.
“I don’t know how we get to 50 at the moment,” Mr. McConnell told Reuters on Wednesday. “But that’s the goal.”
Mr. Trump is proposing to cut $610 billion from Medicaid benefits. This could come on top of more than $800 billion in cuts to Medicaid sought in the health care overhaul bill passed by the House on May 4.
The new report from the CBO is sure to influence Republican senators, who are writing their own version of the legislation in secret behind closed doors. Health Care Leaks Get the Clampdown From McConnell:
At a meeting of his health care working group last Tuesday, Senate Majority Leader Mitch McConnell excused all nonleadership staffers after expressing annoyance over the number of leaks about the private discussions, GOP senators and aides said.
Staff has since been allowed back into the meetings, the lawmaker said, explaining that the initial dismissal was viewed as a warning. A McConnell spokesman did not respond to a request for comment.
* * *
Republican leadership has faced criticism for the manner in which the legislation is being crafted. Several members say the bill is not expected to go through the formal committee process. GOP leaders defend their methods and say all Republican senators will have the opportunity to contribute to the measure, but some members are warning that the conference as a whole will need ample time to review any final product.
Senator Bob Corker (R-TN) was critical of McConnell’s AHCA “working group” today. GOP is writing health care bill in secret, without experts:
[I]n the Senate, the chamber’s health care working group – 13 conservative white guys – have been quietly crafting their own legislation.
In fact, “quietly” is a polite way of describing the Senate process. Majority Leader Mitch McConnell (R-Ky.) has insisted on as much secrecy as he can muster, and he’s made a deliberate decision to exclude all Senate Democrats – 48% of the chamber, representing more than 50% of the country – from the deliberations. (There is some irony to the fact that Donald Trump is looking for ways to force Democrats to the negotiating table, while GOP leaders block Dems from reaching that table.)
Making matters quite a bit worse, one Republican senator shed new light on just how ridiculous his party’s process has become. The HuffPost reported:
Sen. Bob Corker (R-Tenn.) on Tuesday unexpectedly torched his party’s process for crafting an Obamacare repeal bill behind closed doors.
“It’s a very awkward process, at best,” he told reporters. “There are no experts. There’s no actuarials…. Typically, in a hearing, you’d have people coming in and you’d also have the media opining about if a hearing took place, and X came in and made comments.”
The Tennessee Republican reportedly added that a public process generally helps “shape policy.”
By one account, the GOP’s health care working group did receive some information yesterday from actuaries, but the discussion was held behind closed doors, and only the 13 Republican members of the working group were allowed to participate in the discussion.
Not to put too fine a point on this, but the GOP’s approach isn’t how legislating in the United States is supposed to work. What Bob Corker described is a great example of a post-policy party – trying to write a bill in the dark with little to no input from subject-matter experts, authorities, or stakeholders – but it’s a pretty ridiculous way to craft life-or-death legislation affecting one-sixth of the world’s largest economy.
Perhaps Republican lawmakers need a refresher. When writing legislation of this significance, senators are supposed to schedule hearings, invite knowledgeable witnesses, listen to testimony, host bipartisan debate, and welcome scrutiny from the public and the media in an open process. It’s a little something civics nerds might call “American legislating.”
For all the talk about Donald Trump’s antics being at odds with the political norms of the United States, it’s worth pausing to remember that his pals on Capitol Hill made a right turn at normal quite a while ago, and they’re not looking back.
This is what authoritarian Tea-Publican tyranny looks like. Mitch McConnell personifies it. He will be remembered as a villain in American history.