Republicans Willing To See Over 200,000 Die In Order To Give Tax Cut To The Wealthy

The Republican efforts to repeal and replace Obamacare have been stalled due to the devastating report from the Congressional Budget Office showing that 22 million people would lose health care coverage. Only 12 percent of Americans back the plan according to a USA TODAY/Suffolk University Poll. They did find considerable consensus that any health care plan include the following:

  • Pre-existing conditions: More than three-fourths, 77%, say it is “very important” that the health care system permit people with pre-existing medical conditions to buy health insurance at the same price as others. Just 6% say that protection isn’t important to them. The Senate bill requires insurers to accept those with pre-existing conditions, but it allows states to seek permission to reduce required benefits. Some patients could face dramatically higher costs or lifetime limits for treatments no longer defined as essential.
  • Medicaid expansion: Nearly two-thirds, 63%, say it is “very important” that lower-income people who became eligible for Medicaid through the Affordable Care Act continued to be covered by Medicaid. Just 10% say that isn’t important to them. The nonpartisan Congressional Budget Office estimates that the Senate plan, which would cut Medicaid spending by $772 billion over the next 10 years, would result in 15 million fewer people being covered.
  • Lower premiums: Close to six in 10, 57%, say it is “very important” that insurance premiums go down in price; 17% say that’s not important. The CBO predicts that premiums would rise for a few years under the Senate plan, then fall by about 30%. But overall health care costs would go up for most people because deductibles would be higher and some states wouldn’t require insurers to provide some benefits that are now mandated.

A growing number of Republican Senators are also opposing the plan, necessitating major changes if there is any chance for passage.

While Republicans claim that repeal of Obamacare is necessary because the program is collapsing, the CBO report on the Republican plan reaffirms statements in previous reports that these Republican claims are false. The current Congressional Budget Office report states:

Although premiums have been rising under current law, most subsidized enrollees purchasing health insurance coverage in the nongroup market are largely insulated from increases in premiums because their out-of-pocket payments for premiums are based on a percentage of their income; the government pays the difference between that percentage and the premiums for a reference plan.

It also needs to be kept in mind that premiums for plans on the individual market typically had double digit increases annually prior to the passage of the Affordable Care Act, and that this is not a new problem created by Obamacare. Unlike insurance plans sold before Obamacare became law, current plans have limits on out of pocket expenses, no lifetime maximums, and cannot be cancelled by insurance companies when people became ill. Of course there also were no subsidies to assist with paying for the plans. It was also commonplace to have limited options and to see insurance companies leave markets prior to Obamacare.

The actual problem with Obamacare is that it did not go far enough. A public option  or Medicare buy-in was necessary to provide more affordable care for those who do not obtain coverage through an employer or government plan. Expansion of Medicare to all would also have provided a more cost effective solution.

Vox looked at the likely effects on mortality should the Senate Republican plan pass, estimating that there will be 208,500 additional deaths over the next decade:

Drawing on that work, we estimate that if the Senate bill becomes law, 22,900 excess deaths will occur in 2020 — and the figure will grow over time. 26,500 extra deaths will take place in 2026. Over the next decade, we estimate that a total of 208,500 unnecessary deaths will occur if the law is passed (see Table 1).

We also calculate anticipated additional deaths, state by state, using state-level coverage losses for the year 2026 (see Table 2). The predicted excess deaths by state range from 30 in North Dakota to 2,992 in California in 2026 alone.

Some commentators have argued that it’s inappropriate — beyond the pale — to suggest that people will die as a result of this legislation. To the contrary, we contend that no debate over a health care policy can ignore evidence that it could have negative effects on health and mortality.

In making these calculations, we draw on the scientific literature demonstrating that expanding health insurance reduces deaths. We specifically apply the results of a particularly robust study of the effects of health care reform in Massachusetts on mortality. Massachusetts’ health care reform — which expanded Medicaid, offered subsidized private insurance, and included an individual mandate — famously served as a model for the ACA. The Massachusetts study looked at county-level mortality data in 2001 to 2005 (pre-reform) and 2007 to 2010 (post-reform), and compared the changes to carefully selected control groups in other states that had not enacted health reform.

Over 200,000 deaths is a high price to pay in order to provide tax cuts for the ultra-wealthy, which appears to be the major goal of the Republican plan.

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