Paul Ryan plots his final battle in the GOP’s war on the poor


The GOP’s alleged boy genius and Ayn Rand fanboy, Paul Ryan, “the zombie-eyed granny starver from the state of Wisconsin” who is leaving Congress at the end of his term — Dude, pack the moving van, I’ll come drive your shit back to Janesville for you this weekend! — is plotting his final battle in the GOP’s war on the poor. This evil GOP bastard can’t leave soon enough.

Politico reports, House GOP budget sets up massive safety net cuts, Obamacare repeal bid:

House Republican budget writers debuted an ambitious deficit-reduction plan Tuesday that would force GOP committees to cut at least $302 billion over a decade and potentially lay the groundwork for another repeal vote on Obamacare.

The GOP’s sweeping budget plan is the first step toward a filibuster-proof bill [under budget reconciliation rules] that could result in real reductions to popular programs like federal student aid or low-income family block grants.

It could also deliver on conservatives’ decades-old promise to rein in entitlement programs like Medicare and Medicaid.

But that proposal faces long odds in the House, let alone the Senate, where moderates have balked at previous calls to rein in so-called entitlement programs. Republican leaders in either chamber have shown little interest in pursuing a welfare reform agenda in an already tough election year.

If approved in both chambers, nearly a dozen House panels would be required to draft legislation by year’s end to dramatically slash funding for mandatory programs under their purview.

“For the first time in a long time, we’re going to try to move this narrative back to the mandatory side of spending,” Rep. Steve Womack (R-Ark.), the House’s first-term budget chief, told reporters Tuesday.

The biggest task would fall on the House Ways and Means Committee, which is asked to cut $150 billion over a decade from a slew of programs, including Temporary Assistance for Needy Families (TANF) and Supplemental Security Income (SSI).

In a win for many conservatives, the House budget would also leave an opening for repealing and replacing Obamacare through the separate fast-track process of budget reconciliation. The two committees that oversee most Obamacare programs — Ways and Means and Energy and Commerce — both receive reconciliation instructions, though there are no specifics about policy.

The GOP budget also sets up potential cuts to federal retirement benefits, Dodd-Frank oversight and federal student loans by giving big saving targets for the Education and the Workforce, Oversight and Financial Services committees.

A bit of relief: “Unlike past years, the House has no obligation to vote on a budget because both chambers agreed months ago on how much to spend in fiscal 2019.”  So for this do less than do nothing Congress, to do nothing at this point is the preferable option.

Joan McCarter adds at Daily Kos:

Republicans have got a 2019 budget proposal that would ostensibly cut the deficit by $8.1 trillion over the next 10 years. How it gets there, in large part, is by slashing mandatory and automatic spending programs. Like Medicare, Medicaid and Social Security. They’d take $5.4 trillion from these programs, “including $1 trillion from Medicaid and $537 billion from Medicare.”

They would cap Medicaid spending and enact work requirements for childless, non-disabled and non-elderly enrollees. They would raise the eligibility age for Medicare as well combine Parts A (hospital coverage) and B (health insurance) and “restructure the program into one where recipients can choose private health care plans.”

They start in on Social Security, too, through a backdoor. This first step is to prevent people who are on Social Security disability (SSDI) from also getting unemployment insurance benefits. This is counter to all their other work requirement objectives—the Social Security program has always encouraged those disabled people who are able to work at least part-time to do so. They can receive SSDI payments if their disability prevents them from working at Social Security’s Substantial Gainful Activity level, which was $1,090 per month, in 2015. When they lose their jobs, they should be eligible to get unemployment insurance, just like everyone else. Here’s the Republican Congress telling one set of poor people they have to be working to get health care and another set who is disabled that they can’t receive the benefits of trying to work.

The bill also “includes reconciliation instructions requiring $302 billion in savings over 10 years, almost 50 percent more than the $203 billion in the initial version of the fiscal 2018 House budget resolution.” It appears that those instructions—which would let Republicans push through cuts on a party-line basis, without being subject to a Democratic filibuster in the Senate—are not defined. Meaning they could take that $302 billion wherever they can find it—Obamacare, Medicaid, wherever.

This isn’t about the deficit. This is about punishing poor people, and now disabled people, too. This is Republicans telling the American public exactly what they’re all about. But you know what, Republicans? Go for it. You go out and sell the American people on cutting Social Security and Medicare and Medicaid right before an election. I dare you.

And then there is the ongoing GOP sabotage of “Obamacare” regardless of their utter failure to “repeal and replace” it with something “better.”  Paul Krugman recently wrote, G.O.P. to Americans With Health Problems: Drop Dead:

Polls suggest that the public considers health care the most important issue in the midterm elections. This immediately raises the question: Do voters understand what’s at stake? In particular, do they realize that if Republicans hold Congress, they will strip away protections for the 52 million Americans — more than a quarter of nonelderly adults — who have pre-existing conditions that, before passage of the Affordable Care Act, could have led insurers to deny them coverage?

In fact, the Trump administration is already trying to take away those protections via the courts. It probably won’t succeed. But it might, in which case an estimated 17 million Americans would lose their health coverage.

And even if the lawsuit fails, the administration’s support for an incredibly flimsy legal challenge — one so indefensible that three career Justice Department lawyers withdrew from the case — is a clear signal of Republican priorities: G.O.P. to Americans with health problems: Drop dead.

By the way, some people seem surprised by the administration’s moves here, since Donald Trump has promised many times to protect people with pre-existing conditions. But remember: The campaign against the Affordable Care Act has been based on lies every step of the way.

* * *

But the most enduring lie from A.C.A. opponents — not just Trump, but all of them — is their claim that they want to protect Americans with pre-existing conditions. They don’t, and they never did.

You can see why they claim otherwise. A huge majority of voters, including 59 percent of Republicans, want to maintain rules that prohibit insurance companies from denying coverage based on someone’s medical history. So there is a powerful incentive to pretend that you’ll protect people with past health problems.

But the falseness of the pretense has always been obvious.

This falsity was obvious on sheer logical grounds even before Republicans began proposing supposed replacements for Obamacare. If you’re going to guarantee coverage regardless of medical history, you have to induce people to sign up for insurance while they’re still healthy, so that insurers have a manageable risk pool. That means some combination of subsidies to make insurance affordable and penalties for going uninsured — in other words, it requires a system that looks a lot like the Affordable Care Act.

So demands that the A.C.A. be scrapped always meant taking away coverage from the people who need it most; Obamacare opponents just hoped people wouldn’t notice that fact. And the truth is that they mostly got away with it until last year, when Republicans had to offer specific health care legislation.

At that point the game was up. It immediately became clear that every Republican alternative to Obamacare would, in fact, hang Americans with pre-existing conditions out to dry. And the public backlash against that revelation is basically the reason the G.O.P.’s repeal effort failed. But it only failed narrowly. And if Republicans still hold Congress next year, anyone who has a history of medical problems and doesn’t get health insurance from his or her employer will lose coverage.

In fact, even getting a job with insurance coverage might not be enough: If the Trump-supported lawsuit succeeds, employers could refuse to cover new employees’ pre-existing conditions.

What may seem puzzling about all this is the cruelty. O.K., Donald Trump is obviously a man utterly lacking in empathy. But don’t other Republicans feel a bit bad about the prospect of taking health care away from millions of Americans who have done nothing wrong besides having past medical problems?

Actually, no.

* * *

So, as I said, voters need to understand the stakes in these midterms. They will determine whether people with medical problems get the health care they need.

When the GOP gets done screwing over immigrants this summer, it will turn its attention to the budget in September and return to screwing over America’s poor.

All in the name of preserving tax cuts for  the wealthy plutocrats and corporations for whom Republicans are their lickspittle servants.


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