Last night everyone seemed to take their focus off the health care hocus-pocus to instead gawk at two pages of President Trump's 12-year old tax filing. I, unfortunately, was attending a National League of Cities conference and watching Paul Ryan on the Fox Business Report (he won't do any other channel for fear of being actually questioned).
The reason that health care and Medicare are being gutted under the Ryancare or Trumpcare plans is quite simple: they need the savings for what comes next. The proposed AHCA -- which is anything but American and everything but healthcare -- is designed to eliminate the nearly $1 trillion in costs to the richest in America. They, under ACA, had to pay to cover the cost of premium support for the most vulnerable -- poor, elderly, pre-existing conditions, etc. In order to mine an even richer harvest, Medicare would be capped and eventually turned into a voucher program. Take a look at Medicare and the population it serves: those with pre-existing conditions, elderly, children, poor. Those populations usually use healthcare services more than those who are young and healthy and just out of school. Do you really think insurance companies want these people? No, and most hospitals aren't that keen either because many come in sicker, require more care, have complications following treatments, and often develop other issues. In other words, you lose money on them.
The ACA was designed to provide premium assistance that would cap what this group could pay (including full subsidy) based on income. Under ACHA, that cap is removed and "free market forces" take over which means they will likely see premiums of $1200 or more per month (based on what we used to see pre-ACA). Imagine if you are making $30,000 and you now have to pay $1200 per month for insurance or eat. Which do you choose? Half your income would be going just to insurance (if you could find anyone willing to write a plan in the first place). My sister used to be in this group. She had had two heart attacks and was paying $900 per month for an "insurance" plan that did not cover any heart-related issues because it was pre-existing. It also did not cover cancer treatments yet she had a history of those as well. Pretty much if she broke a leg or arm, she might get coverage; nothing otherwise. Yes, her cost went up to $1,000 per month under ACA but it covered EVERYTHING. She bitched at first until I showed her how to apply under ACA and she ended with a $200 per month bill. She will certainly not find that "on the open market" under AHCA.
So the dirty secret is that after "saving" the rich $1 trillion with a net overall savings of $337 billion and 24 million more uninsured as well as no Medicaid -- the Republicans will turn to tax reform next! But Ryan must have those "savings" in order to complete the tax overhaul. Mind you this is but "phase I" of the tax reform proposal (the second part would include savings for anyone other than the rich or large business). Phase I cuts the corporate tax rate from its current rate of about 35% to 20%. Two important things to remember: few businesses actually pay this rate because of all the deductions they can take (GE, for instance, pays nothing despite making billions); and the Republicans want to also do this under "reconciliation."
However, in order to do tax reform, the bill needs to be "revenue neutral." If it requires raising taxes or increasing costs, it is subject to filibuster in the Senate and we know where that would go. The $337 billion "savings" is required to get the tax reform bill to neutral -- oh, and add in gutting the EPA (the proposal is to eliminate 3,000 positions, turn clean air and water over to the states for enforcement, eliminate anything related to climate change and only focus on Superfund, Brownfield initiatives, and creating jobs -- right from the EPA Secretary's mouth), gutting Department of Education, elimination of Community Development Block Grant funds, virtually neuter the Secretary of State's office and International Development (except for aid to Israel), and cut or eliminate virtually every other domestic program. The "magic dust" will also be liberally sprinkled showing that the tax reform for the richest and business along with all cuts to anyone else will explode job growth and creation and everyone will be fully employed with tax revenues flowing like manna from heaven.
The Congress can then add $64 billion to the military (which will probably be needed because we won't have any concept of diplomacy), reduce the tax rate to 15% for business, add a trillion to infrastructure (focusing on contracts and business partnerships which usually means money for the well connected), and dismantle any remaining domestic protection programs.
The last time we tried this was under Reagan and Bush II and we saw an explosion in debt and little or no growth in revenues. Who says we need to be able to breath or drink water when we can have jobs, jobs, and more jobs!
