3 things you need to know about GOP plan to decimate Medicaid


Trumpcare is a plot to gut Medicaid by giving the richest tax breaks and almost no one is talking about this

It took about a century of proposed reforms to our health care system to get the uninsured rate below 10 percent. But we’ve done it as we lowered planned health care spending by trillions.

And we did it in less than a decade — a humanitarian equivalent of a moonshot.

Let’s be clear: The improvements in Obamacare are not perfect, but what the GOP is proposing is a humanitarian catastrophe that would undo progress faster than anything we’ve seen in U.S. history.

Yes, Obamacare’s marketplaces need improvement. And mostly by “improvement,” I mean “more money” for better subsidies to draw in better plans with more lower deductibles, as well as public plans. There are lots of good ideas to make the ACA better now — our buddy Charles Gaba has at least a billion of them. And none of the existing problems justify GOP sabotaging your coverage and adding a Trump tax of up to 40% on millions of Americans’ premiums.

Trumpcare is just about making the health care system worse so rich people who benefit most from our society can pay less. Not just worse than it is now — but worse than it was before the ACA became law.

The GOP focuses on the marketplace to distract from how all of their “reforms” are designed to help the rich and the wealthy at the expense of the sick and the poor.

The centerpiece of this attack is cutting Medicaid by $880 billion — not just rolling back the Medicaid expansion but gutting the program with cuts designed to change how Americans have been covered since the program first rolled out in the 1960s.

The GOP attack on Medicaid needs to be at the center of this debate because it is inexcusable and it’s largely — thanks to the scandalous, disgusting way the GOP has pushed through law through Congress — being ignored.

Here are 5 things every American needs to know now before we let this unprecedented transfer of wealth from the poorest to the richest goes down.

  1. “There’s been no public debate about these drastic cuts to Medicaid.”

    As usual, our man Andy Slavitt, who ran the ACA, Medicaid and Medicare for President Obama, puts the stakes of the GOP’s attack on our health care system in the clearest terms. Half of the people on Medicaid are children; the program pays for about half of the births in America and a similar percentage of the dollars we spend on long-term care for the aged, which leads us to point we cannot ignore.
  2. An attack on Medicaid is an attack on Medicare.
    Cindy Mann and Allison Orris sound an alarm that has not yet broken out of wonkdom in defense of the “11 million Medicare beneficiaries who also rely on Medicaid for key components of their care.” Yes, about 1 of 5 of the poorest Medicare beneficiaries could be hurt by Trumpcare. This could drastically reduce states’ ability to provide home care, which would drive seniors to hospitals, spiking Medicare costs and justifying Republican cries to cut Medicare spending.
  3. The cuts to Medicaid would be immediate and unconscionable.
    There’s no “glide path” path for cutting Medicaid. Right now the debate in the Senate has centered around how quickly to roll back Medicaid expansion to leave millions uninsured. It’s a useless debate because as soon as expansion is frozen, millions would start losing coverage fast as states feel the fiscal pinch, Dee Mahan, Director of Medicaid Initiatives at Families USA notes. “Millions who face tough economic times in the future and need Medicaid’s safety net will become uninsured,” she writes.

These points seem to me to most clearly underline the GOP’s plot against the most vulnerable but there’s so much more including how these cuts could worsen the opioid crisis, punish the disabled and wreak havoc on special education.

Medicaid has a unique name in each state and many people aren’t even aware that they and their family have or will rely on it. STILL, it’s extraordinarily popular — with more than 8 of 10 Americans, including 71 PERCENT OF REPUBLICANS, saying it’s very important for Congress to keep funding for Medicaid expansion.

But it’s not just expansion that’s at risk; it’s Medicaid as we know it. And as long as the GOP can make the Trumpcare debate about anything else, they have a chance to win it.

[If you care about understanding Medicaid, which actually is “akin to mastering rocket science,” make sure you follow Emma Sandoe.]