Trumpcare contains a brutal secret attack on the working poor


Mike Bishop, Fred Upton and Tim Walberg all voted to gut Medicaid. How many more Michigan Republicans will join them?

Three Michigan Republicans voted to kill Medicaid expansion this week, which covers 640,000 Michiganders and adds an estimated 30,000 jobs to the state’s economy.

The American Health Care Act AKA LoserCare passed out of the House Ways and Means Committee and the House Energy and Commerce Committee this week by party-line votes that included ayes from Michigan Republican Members of Congress Mike Bishop, Fred Upton and Tim Walberg.

Upton, Bishop and Walberg all voted for this plan that will disproportionately harm Republican voters and weaken Medicare for future and current retirees, reminding voters that their real constituency is the richest .01 percent who will get a tax break of $165,000 a year.

Democrat Debbie Dingell forced the Commerce and Energy Committee to clarify that the bill ends Medicaid expansion at around 4:30 Friday morning:

Republican governors claimed to have won a concession from Trump and Republicans in Congress by keeping those who are currently covered through the extraordinarily popular Expansion through 2020. But what they actually got was a cynical provision that allows the expansion to die quietly, as Harvard professor Benjamin Sommers explains in Washington Post.

“[U]nder the GOP bill, the majority of the Medicaid expansion population under the ACA would likely become ineligible for the current level of federal funding in less than two years,” he writes.

The bill accomplishes this by mandating “that anyone experiencing more than a one-month gap in coverage after 2019 would no longer be eligible for the generous 90 percent federal funding the ACA provided to help states expand Medicaid to the working poor.”

Sounds innocuous, but it’s a poison pill:

One study of Medicaid data found that the average enrollee receives Medicaid coverage for only 78 percent of the year, and this figure drops to 68 percent when focusing just on non-elderly, non-disabled adults, the main beneficiaries of the ACA expansion. Another study of national survey data found that 43 percent of adults in Medicaid had experienced a gap in coverage within the first 12 months of enrolling, and 55 percent had a gap within 23 months.

The bill not only aims to make to eliminate all the steps the ACA took to make enrolling in the program easier, it adds a new step designed to kick people off the program running eligibility checks twice a year, instead of once.

And that’s not all! There’s a provision designed to drive America’s working poor into medical bankruptcy:

It also reduces the ability of states to use “presumptive eligibility,” which allows hospitals and other entities to temporarily enroll applicants in Medicaid before their eligibility can be verified. Finally, the bill limits retroactive Medicaid coverage to no more than a month, compared with the current practice of 90 days. This grace period is often critical for people who enroll in Medicaid during health emergencies.

Conservatives are reportedly upset that the GOP’s plan to repeal the Affordable Care Act is just too generous — through, according to a Brooking estimate, it will uninsure 15 million and, according to almost everyone, drive up premiums for almost everyone, especially those older poorer Americans in rural/red areas.

They want the American Health Care Act AKA LoserCare’s elimination of the extraordinarily popular Medicaid Expansion to “accelerate.”

Well, they should be relieved that the bill as is will kill Medicaid expansion quietly and make Medicaid far less effective at keeping poor Americans from being driven into even deeper poverty.

No wonder Walberg is hiding from his constituents.

[Image by Gage Skidmore | Flickr]