Lines in the Sand

So the draft Senate version of ‘Repeal and Replace’ is out and it’s every bit as horrible and disingenuous as its secretive genesis would suggest.

Far from making any substantive changes to the deplorable House Bill, it endorses and reinforces its most heinous aspects.

The principle goal of both Bills is to steal $800 Billion from Medicaid to give to the richest 2% (with the bulk of measurable benefits going to the top .1%). The effect will be to kill around 100 sick people every single day and make 10s of Millions of Senior Citizens homeless.

It can, and no doubt will by the “Moderate” Republicans who think it politically counter productive to be associated with such slaughter (not that they have a soul, just that they want to be re-elected), be claimed it is slightly less Draconian than the House Bill in that the initial cuts are not as steep and the implementation extended, and that the benefits are still based on individual patients rather than being a strict State based cap regardless of the number of sick and old people.

On the other hand in the Senate Bill the cuts are deeper and the benefit base is indexed to the rate of general inflation rather than the medical inflation rate which is much higher (the principle failure of the ACA is that it does nothing at all to address the monopolistic price increases of Big Pharma, Hospital Conglomerates, Medical Device Manufacturers, Testing Providers, et al.).

In short, 98% of U.S. Citizens should die, slowly, in great pain.

No doubt other terrible details will emerge. We’ve only had the Bill to examine for 6 hours or so and most of the text is amendments to existing language that must be studied to understand the import.

And indeed that’s the primary barrier to passage at the moment. Rand Paul (R Ky), Ted Cruz (R Tx), Mike Lee (R Ut), and Ron Johnson (R Wi) have already announced they will not support the Bill as presented because it preserves ‘too much Obamacare’. Pat Toomey (R Pa) wants to repeal Medicaid sooner.

Conventional Wisdom suggests that as many as 30+ Senators from States that expanded Medicaid might find the bill too harsh. Rob Portman (R Oh), Shelley Capito (R WV), Lisa Murkowski (R Ak), and Cory Gardner (R Co) are cited as leading voices in this group. Dean Heller (R Nv) might also be a member as he faces a tough challenge in 2018.

Some Senators (and they are mostly members of that 30+ group being double counted) are alleged to have State based issues that will make it even harder to garner their support. Mostly it means they’ll just be easier to bribe.

Now the basic public lie about “Repeal and Replace” is that it’s going to reduce Insurance Premiums. To the extent that it is it’s going to do so it’s by allowing Health Insurance Mega Corps to sell crappier policies that cover less and are practically useless, and letting Companies and Individuals escape penalties for not purchasing Insurance at all.

Monday it’s expected the Congressional Budget Office will produce a detailed score and if you’re wondering why the Senate is waiting for it when the House did not it’s because there must be a CBO score in order to use the 50 + 1 vote majority Reconciliation process (Republicans clearly don’t have the 60 votes required by normal order). It’s hard to imagine that this Bill, which hews so closely to the House Bill before it, will result in substantially better numbers than the 20+ Million more uninsured and 850% Premium rise for Seniors.