The Congressman from Flint, Michigan, explains why the American Health Care Act isn’t really about healthcare at all.
By now, you’ve surely seen it: The beer bash at the White House where House Republicans jubilantly celebrated robbing an estimated 24 million Americans (and counting) of their health insurance after their “repeal and replace” vote on the American Health Care Act (AHCA).
To Congressman Dan Kildee, that smug, insensitive display says it all.
“An American billionaire standing in front of a bunch of white men who have government-paid healthcare, ripping healthcare out of the hands of poor people who really need it,” he told me. “I guess they can say they were trying to be health-conscious because they ordered Bud Light” for their party.
But health really doesn’t have anything to do with it. There’s no ignoring that fact. House Republicans defied the pleas of major medical societies, patient and consumer advocacy organizations, doctors and nurses when they voted to pass the AHCA. They didn’t care that the Congressional Budget Office (CBO) hadn’t scored the latest version of the bill yet, so no one knew how many people will lose health insurance and how much it will cost. They didn’t care about tearful constituents pleading with them not to let their loved ones die. They didn’t care that repealing the Affordable Care Act (ACA, or Obamacare) and replacing it with the AHCA will throw the insurance marketplace into chaos — and is backed by absolutely zero proof of Republican claims that the AHCA will lower costs and give every American health insurance, including those with pre-existing conditions. Those claims are untrue and unsubstantiated, but they don’t care.
Republicans don’t care because the AHCA isn’t really about healthcare at all. It’s about appeasing the interests of the only group of Americans Republicans care about: the wealthy, including themselves.
That’s not really a surprise, but Rep. Kildee confirms what many of us have long suspected, in a conversation we had the day after the House passed the AHCA.
“The only winners in this legislation are people who make more than $200,000 a year,” says Rep. Kildee. “Everybody else will help fund a huge tax break for the people at the top, pay more for their health insurance and have less care and coverage than they had before.”
According to Rep. Kildee, that logic is the only way to make sense of why Republicans voted overwhelmingly in favor of the AHCA, even though most of them didn’t think it was very good legislation.
They made a political commitment to each other that they’d overturn the signature achievement of Barack Obama — they still can’t accept Barack Obama or anything associated with him. And in doing so, they gave themselves an opportunity to transfer wealth from poor and working people to the richest people in the country. That’s what their bill does. It’s a tax cut for wealthy Americans disguised as a healthcare bill.
There are many disastrous aspects of the AHCA, but one of the worst is the $880 billion that will be cut from Medicaid — cuts necessary to pay for the massive tax cut being handed to the richest Americans, Rep. Kildee explains.
What’s more, no one knows yet exactly where those cuts will happen, because Members of Congress were given a 600-page bill less then one day before the vote. Even some Republican representatives admitted no one had time to read it.
“We’re poring over it, and if our assumptions are correct it’s a lump sum cut to Medicaid, giving power to states to change how Medicaid is administered,” says Rep. Kildee. “House Republicans are absolving themselves of responsibilities for the worst things that will happen if this bill becomes law. By putting the hard decisions they refuse to make in the hands of states, they get to pretend they didn’t kick people off healthcare, when they did. It is one of the most cynical legislative ploys that I recall in my lifetime.”
The decision about whether to axe protections for people with pre-existing conditions and the essential health benefits provided by the ACA will be left to the states, along with the decision about Medicaid funding. Whether or not Medicaid expansion is officially withdrawn or just falls prey to deep cuts to the program, people will suffer — including those in Flint who became eligible for Medicaid expansion after they were poisoned by toxic levels of lead through careless decisions by Michigan Governor Rick Snyder and others.
Not only will millions of Americans lose their healthcare coverage, Rep. Kildee says, but everyone will pay more. The only way the Republican “promise” that premiums will go down will happen is because insurance companies will once again be allowed to offer policies that don’t actually cover much. Hospital visits, for example, may no longer be covered.
“Insurance-supported health coverage that’s lost will mean more uncompensated care,” Rep. Kildee explains. “When care is delivered by a hospital, let’s say, and it’s not paid for, it ends up getting paid for by people who have insurance or Medicare. Sooner or later everyone gets sick, and someone is going to pay for it.”
In another maneuver to fool Americans into thinking the AHCA is good for them, Republicans also went against their long-standing insistence that a bill needs to be scored by the CBO before it is voted on or even brought to the floor. The revised CBO score is expected the week of May 8, but House Republicans just couldn’t wait that long. Rep. Kildee knows why:
They wanted to make sure they held this vote before they had the CBO analysis that shows the impact both in terms of people losing coverage and the total cost. As long as I’ve been here and watching Congress, Republicans have said the CBO score determines whether a bill even goes to the floor, let alone has an impact on the deficit. It shows just how duplicitous they are.
They also made sure this vote took place before these Members went home for recess and faced their constituents. They know if those Republican Members of Congress went home for a week with this bill hanging out there, they’d never get the votes to pass it. They want to send those Members back to their district with the excuse that it’s too late, that the vote already happened. It’s absolutely shameful and anti-democratic, and people need to know that.
Rep. Kildee points out that 20 “courageous” Republicans voted against the AHCA. But the rest of the Republicans who voted for the bill should be held accountable.
“People need to raise their voices, go to town hall meetings, show up at the offices of the people who voted for this bill,” Rep. Kildee says. “Turning up the heat will make a difference — because this is not over yet.”
After the bill goes to the Senate, the House will vote on the AHCA again. Although Rep. Kildee says polling isn’t the end-all, the majority of Americans want Congress to fix the ACA instead of throwing it out.
“That should be the message,” Rep. Kildee says. “Democrats and Republicans need to de-weaponize healthcare, roll up their sleeves and fix the problems we know we can fix — and not buy the idea that we can let Republicans get away with a tax cut and call it healthcare. Americans are going to be really angry when they find out what this legislation is actually all about.”
Read part two of my interview with Congressman Kildee, in which he shares three Democratic proposals for improving the ACA that Republicans have refused to consider.
[Photo courtesy of Congressman Kildee’s office.]