Why The CBO Report On The Senate Republican Health Care Bill Is Devastating

The Congressional Budget Office released its scoring of the Senate health care bill. The New York Times summarizes:

The Senate bill to repeal the Affordable Care Act would increase the number of people without health insurance by 22 million by 2026, a figure that is only slightly lower than the 23 million more uninsured that the House version would create, the nonpartisan Congressional Budget Office said Monday.

Next year, 15 million more people would be uninsured compared with current law, the budget office said.

The legislation would decrease federal deficits by a total of $321 billion over a decade, the budget office said.

The results can be seen in the above graph.

The American Medical Association gave this assessment of the bill:  “Medicine has long operated under the precept of primum non nocere, or ‘first, do no harm.’ The draft legislation violates that standard on many levels.”

The increase in uninsured would come from reductions in the number of people covered by Medicaid and by private coverage. Beyond the severe cuts in Medicaid, the Senate bill would provide less assistance in purchasing private plans. One devastating paragraph from the CBO report has been receiving attention:

Under this legislation, starting in 2020, the premium for a silver plan would typically be a relatively high percentage of income for low-income people. The deductible for a plan with an actuarial value of 58 percent would be a significantly higher percentage of income — also making such a plan unattractive, but for a different reason. As a result, despite being eligible for premium tax credits, few low-income people would purchase any plan, CBO and JCT estimate.

The plan also fails to lower premiums for most people, or help to increase the number of insurance plans offered. In other words, it fails to solve the problems which Republicans criticize Obamacare over.

The Republicans face two fundamental problems in trying to develop their own health plan. The first is that Obamacare is essentially the Republican alternative to Hillary Clinton’s health care plan. Obamacare does more than the old Republican plan to regulate insurance companies, but the basic structure is the same. Republicans widely supported the individual mandate and the other aspects of Obamacare which they now attack before it was proposed by Obama. This forces them to come up with something different, and there really are not that many ways to handle health care coverage.

The other problem is that the problems we now see on the individual market were not created by Obamacare. Insurance coverage has always been expensive for those buying coverage on their own, as opposed to being in an employer or government plan, provided that the insurance provided decent coverage. The market has never been able to solve this problem and the only realistic options short of a single-payer plan are ones which involve further government involvement, such as a public option or Medicare buy-in. Republicans are not going to back this.

It is also questionable if enough Republicans will back their current plan for it to even pass in the Senate.

Republicans Use Health Care And Tax Law To Help Themselves

Previously Republicans wanted to have members of Congress be included in the exchanges established under the Affordable Care Act. Now that the Republicans are trying to repeal and replace Obamacare, Republican members of Congress are fighting to keep the benefits of Obamacare for themselves. Vox reports:

The new Republican amendment, introduced Tuesday night, would allow states to waive out of Obamacare’s ban on preexisting conditions. This means that insurers could once again, under certain circumstances, charge sick people higher premiums than healthy people.

Republican legislators liked this policy well enough to offer it in a new amendment. They do not, however, seem to like it enough to have it apply to themselves and their staff. A spokesperson for Rep. Tom MacArthur (R-NJ), who authored this amendment, confirmed this was the case: Members of Congress and their staff would get the guarantee of keeping these Obamacare regulations. Health law expert Tim Jost flagged this particular issue to me.

Republicans seek to take away coverage from others but not themselves. There is no way to both cut costs and cover more people–except with going to a single payer plan which Republicans are unlikely to support.

After this was exposed, Republicans say they are looking at this and might change the  language which benefits members of Congress and their staff. We will have to see how the legislation actually looks if and when it actually comes to a vote.

This was revealed shortly before Donald Trump released his tax plan which would provide substantially lower tax rates for companies like his. In case anyone is reading quickly, Trump released his tax plan–not his tax returns, which he still refuses to release.

Trump will face considerable opposition to his tax plan, especially as it would eliminate popular deductions such as for mortgage interest. It remains to be seen how many Republicans will object because of how the plan will greatly increase the deficit. To Republicans, deficits are only a problem when a Democrat is in the White House.

Stephen Colbert Shows That John McCain, Like Donald Trump, Is A Stupid Idiot

With all the bad things which happened this week, we should be relieved that the term nuclear option did not pertain to this week’s military action, in which Donald Trump showed his compassion for the Syrian children he has banning from entering the country by bombing Syria. Stephen Colbert explained the nuclear option, which culminated in the confirmation of Neil Gorsuch to the Supreme Court, in the video above. He also managed to show that John McCain is a stupid idiot.

The news started out good with the Democrats denying Gorsuch the sixty votes needed. As Colbert put it,  “Whoo, they did it, hell yeah! The Democrats won, for about an hour.”

The Republicans responded with the nuclear option:  “It’s like the saying goes. If at first you don’t succeed, change the rules and now you win.”

Initially not all Republicans supported this. Colbert quoted John McCain: “I would like to meet that idiot, I would like to meet that numbskull that would say that. That after 200 years of this tradition where the Senate has functioned pretty well. They think it would be a good idea to blow it up…Whoever says that is a stupid idiot.”

Colbert pointed out, “You have to be pretty dumb for John McCain to call you a stupid idiot, because he thought Sarah Palin could be president.” He then reported that McCain voted for the nuclear option and concluded,  “Senator McCain, In the words of an American hero, ‘You’re a stupid idiot.’”

Colbert then transitioned, “Speaking of stupid idiots, Donald Trump…”  See the video above for the rest.

As for McCain, if we need more evidence that he is a stupid idiot, today he praised Trump’s airstrikes against Syria.

Another Prediction That Trump Could Cost Republicans Control Of The House

The failure of Donald Trump to repeal and replace Obamacare, as he repeatedly claimed he would do as soon as he took office, has led to a further deterioration in public perceptions of Trump’s job performance, and risks hurting the entire Republican Party. I have previously looked at predictions that a low approval rating for Trump could cost Republicans control of the House. National Journal has another prediction that Dems Could Take House in 2018:

Demo­crats now have a real­ist­ic shot at re­tak­ing the House in 2018. Each of the past three midterm elec­tions have swung wildly against the party in power—re­flect­ive of the long­stand­ing dis­sat­is­fac­tion of voters to­wards polit­ic­al lead­er­ship, no mat­ter who’s in charge. Trump’s job ap­prov­al rat­ing is hov­er­ing around 40 per­cent, a tox­ic level for the dozens of Re­pub­lic­ans run­ning for reelec­tion in swing dis­tricts. Re­pub­lic­ans would be fool­ish to as­sume that Pres­id­ent Obama’s co­ali­tion of mil­len­ni­als and non­white voters—many of whom stayed home in past midterm elec­tions—re­mains dis­en­gaged giv­en their aver­sion to Trump.

Polit­ic­ally speak­ing, the health care bill couldn’t have been more dam­aging for Re­pub­lic­ans. In a dis­cip­lined Con­gress, safe-seat Re­pub­lic­ans would be more will­ing to take risky votes so those in com­pet­it­ive seats could main­tain some in­de­pend­ence from the party. But this time, hard-line con­ser­vat­ives in the Free­dom Caucus de­clared their un­stint­ing op­pos­i­tion early on, for­cing some vul­ner­able Re­pub­lic­ans to go on re­cord in sup­port of the un­pop­u­lar le­gis­la­tion—which didn’t even come to a vote. Adding in­sult to in­jury, Trump bragged on Twit­ter that the health care ex­changes would col­lapse as a res­ult of his in­ac­tion—the worst pos­sible mes­sage to send to any­one who viewed Trump as a can-do ex­ec­ut­ive…

There are already signs that Trump’s sag­ging ap­prov­al rat­ing is rais­ing the pos­sib­il­ity of a stun­ning up­set in an up­com­ing con­gres­sion­al elec­tion in sub­urb­an At­lanta. The race, to fill the va­cant seat held by Health and Hu­man Ser­vices Sec­ret­ary Tom Price, couldn’t be more rel­ev­ant to the health care de­bate. One pub­lic poll shows the Demo­crat­ic front-run­ner, Jon Os­soff, nar­rowly lead­ing sev­er­al of his GOP op­pon­ents in a run­off—this in a con­ser­vat­ive dis­trict that has elec­ted Re­pub­lic­ans to Con­gress for over four dec­ades. Fear­ing an em­bar­rass­ing de­feat, the party’s lead­ing House su­per PAC is spend­ing over $2 mil­lion on at­tack ads con­nect­ing Os­soff with Nancy Pelosi.

Of the 36 at-risk House Re­pub­lic­ans, ac­cord­ing to The Cook Polit­ic­al Re­port’s rat­ings, 28 rep­res­ent urb­an or sub­urb­an dis­tricts where Trump isn’t par­tic­u­larly pop­u­lar. In last year’s elec­tion, most of these GOP rep­res­ent­at­ives sig­ni­fic­antly out­per­formed Trump as voters dis­tin­guished between the pres­id­en­tial nom­in­ee and the re­cord of their own mem­ber of Con­gress. But with Trump as pres­id­ent, that dis­tinc­tion is harder to make…

Demo­crats need to net 24 seats to win back the House ma­jor­ity, which sounds a lot more im­pos­ing than it ac­tu­ally is. As polit­ic­al ana­lyst Nath­an Gonzales noted in a re­cent column, the pres­id­ent’s party has lost House seats in 18 of the last 20 midterms, with an av­er­age loss of 33 seats in those 18 los­ing cycles. Two of the most im­port­ant big-pic­ture factors—pres­id­en­tial ap­prov­al and par­tis­an en­thu­si­asm—are now point­ing against the GOP.

Un­der nor­mal cir­cum­stances, Re­pub­lic­ans would ex­per­i­ence some early gov­ern­ing suc­cesses and rally be­hind their pres­id­ent. With Trump, Re­pub­lic­ans have come up empty-handed so far. We’re more than a year away from the next big elec­tions, but there are already signs that a Cat­egory 5 hur­ricane is build­ing.

The Republicans risk further losses following their defeat on health care. Trump continues to lose credibility, and is losing in his attacks on the press. Many sources, including The Wall Street Journal, have discussed the difficulties they will have on rewriting the tax code. Trump’s executive order to reverse Barack Obama’s efforts to fight climate change could also turn out to harm Republicans. The New York Times, in an editorial describing the harm which Trump’s actions will do, concluded in noting the possible public opinion backlash:

And then there is public opinion. It punished the Republicans severely in 1994 when Newt Gingrich and his allies tried to roll back environmental laws. It punished them again in 2008 after eight years of denialism and prevarication on climate change under George W. Bush and his fossil fuel acolyte, Dick Cheney. There is time enough before Mr. Trump’s ignorance translates into actual policy for the public to make its opposition to this anti-science agenda felt again.

It is possible that the Democrats might benefit from Trump’s unpopularity regardless of what they do, but it must also be kept in mind that the Democrats did lose to Trump in 2016 despite all the blunders from Trump during his campaign. That might be written off as the consequence of the Democrats fielding a weak candidate against him, but it also must be kept in mind how the Democrats also  lost badly in 2010 and 2014 when they ran as a Republican-lite party. The Democrats need to have the courage to stand for something, giving voters a positive reason to vote for them rather than counting on dislike of Republicans to be enough.

Republican Failures On Health Care Raise Calls For Single-Payer Health Plan

The failure of  the Republican attempt to repeal Obamacare is a tremendous defeat for Donald Trump, along with Paul Ryan, which may hinder their ability to pass other parts of the Republican agenda, such as rewriting the tax code. The inability of Republicans to come up with a reasonable solution for our health care problems highlights the inability to solve the problem by relying on the market, and has revived calls for a single-payer health care plan.

The Week has this argument for Why Democrats should push ‘Medicare for all’ now even before it the Republicans gave up on their plan:

The AHCA is a monstrous bill that would leave at least 24 million more people uninsured by 2026. But whether or not it fails, the Democrats shouldn’t sit idly by and wait for Republicans to slowly bleed ObamaCare to death by other means. They need a counter-offer, one that’s more compelling than the creaky status quo. They need a single-payer, Medicare for all plan. Here’s why.

The first reason is that single-payer is quite clearly the best universal health-care policy option for the United States. As Dr. Adam Gaffney explains, the U.S. model of multi-tiered health insurance has generally lousy and highly unequal outcomes, both here and in European countries with similar structures like the Netherlands. Complicated public-private hybrid systems mean much larger administrative costs, and the fact that markets are extraordinarily ill-suited to deliver health care means tons of difficult regulation.

Indeed, the distance in uninsured people between ObamaCare and single-payer is actually greater than that between ObamaCare and the Republican plan. Complicated, janky programs tend to let people fall through the cracks.

..The AHCA is extraordinarily unpopular because it takes coverage and subsidies away from people, and a majority believe that it should be the government’s responsibility to make sure everyone is covered. Fundamentally, Medicare is very popular, a fact only partially covered up by generations of red-baiting and duplicitous austerian propaganda. If Democrats had simply bulled ahead with a single payer-esque plan in 2009, instead of the complicated and heavily means-tested ObamaCare, they almost certainly would have done better than they actually did in the 2010 election.

And even for people who are skeptical of going full-bore all at once on single-payer, it still makes an excellent opening bid. Start with single-payer for all during the next bite at the health-care apple, and you could end up with a plan of combining Medicare and Medicaid, enrolling all people under 26 and over 55, and putting a Medicare buy-in on the ObamaCare exchanges. (That might begin chipping away at the employer-based system and be a somewhat more gradual route to single-payer.) Just witness the original opening bid for ObamaCare, which was far more generous before it got badly whittled down by conservative Democrats…

It also makes an excellent organizing signpost. Medicare for all is simple, easy to understand, and hard to argue against or distort. Most people know someone on Medicare who can testify to the generally good care, or who is counting the days until they can enroll and have the peace of mind that comes with quality coverage. Fabricated agitprop like the mythical ObamaCare “death panels” will be a much harder sell.

Erica Etelson is one of those writing op-eds promoting a single-payer plan, and taking the Democratic Party to task for failing to do so:

With Trumpcare dead on arrival in Congress, Democrats have an opening to propose what they should have pushed for in the first place: single-payer health care for all. Fifty-eight percent of Americans, including 41 percent of Republicans, favor a federally funded health care system that provides universal coverage. Only 48 percent want to keep Obamacare as is.

Though Democrats are loathe to admit it, Obamacare is far from perfect. Some people pay higher premiums and out-of-pocket costs than they can afford. In some areas of the country, choices of doctors are limited. Compared to nations with single-payer systems, health outcomes are poor. And a small but vocal minority of Americans are troubled by Obamacare’s individual mandate which, they believe, infringes on their liberty…

Bernie Sanders ran with remarkable success on a Medicare for All proposal that generated enormous excitement among the progressive wing of the party and sent shivers down the spine of the Democratic corporate establishment. Hillary Clinton, a one-time champion of single-payer, pounced on Sanders with alarmist, counterfactual claims that Sanders’ proposal would increase costs and make people worse off.

While the GOP is still cringing over the humiliating defeat of its seven-year promise to repeal Obamacare, Democrats should kick them while they’re down by introducing single-payer legislation. Even Trump-collaborator, Sen. Joe Manchin, D-WV, is starting to wise up, thanks to his constituents; at a recent town meeting, Manchin praised Canada’s health care system and said he was taking a look at single-payer as an alternative to Obamacare…

We watched the Democratic National Committee undercut Sanders’ candidacy. And we’ve watched the Democrats disappear the single-payer option by refusing to support Rep. John Conyers’, D-MI, single-payer bill (HR 676). Enough.

The Democrats’ lackluster opposition to Trumpism does not match the fierce and relentless resistance of their base. They can and must stop doubling down on the centrist “pragmatism” that has alienated growing numbers of voters and start acting like a party more committed to the health and well-being of the 99 percent than protecting the power and profits of oligarchs.

This populist moment in American politics is the Democrats’ to seize. With a strong majority supporting single payer, the Democrat have a golden opportunity to give their dwindling base a reason to come home. As Trump said moments after conceding defeat, “Here’s the good news: Health care is now totally the property of the Democrats.” Good news indeed, if the Democrats know what to make of it.

Donald Trump now has the opportunity to work with Democrats, and any Republicans who are willing, to fulfill his campaign promises of giving us a great health care plan which will cover everybody. Of course he will not do so, and will probably continue to work to undermine the Affordable Care Act.

Obamacare Repeal Fails

Donald Trump and Paul Ryan are both losers.

In a spectacular political defeat for Donald Trump and Paul Ryan, the legislation to repeal Obamacare has been pulled as it was clear it was going down to defeat. It was far easier for Republicans to vote to repeal the Affordable Care Act over fifty times in the past when they knew it would be vetoed if it made it through both houses of Congress than it is now that they would be held accountable for a replacement. The New York Times reports:

House Republican leaders, facing a revolt among conservatives and moderates in their ranks, pulled legislation to repeal the Affordable Care Act from consideration on the House floor Friday in a major defeat for President Trump on the first legislative showdown of his presidency.

“We’re going to be living with Obamacare for the foreseeable future,” the House speaker, Paul D. Ryan, conceded.

The failure of the Republicans’ three-month blitz to repeal President Barack Obama’s signature domestic achievement exposed deep divisions in the Republican Party that the election of a Republican president could not mask. It cast a long shadow over the ambitious agenda that Mr. Trump and Republican leaders had promised to enact once their party assumed power at both ends of Pennsylvania Avenue.

Paul Ryan apparently was  surprised to find that it is complicated to sell Americans on health care plan which will cost them more and provide less.

Trump May Be Terrible, But Few Regret Not Voting For Hillary

Donald Trump has given us numerous reasons to dislike and distrust him. His policies, such as the Republican health care plan, have turned out to be horrible for the bulk of his voters. I have seen multiple media and blog stories suggesting that many Trump voters regret voting for him. A new poll suggests that is not the case. An article in The Washington Post discusses a recent poll to determine if Trump voters regret their votes, and how they wish they had voted:

Our Mood of the Nation Poll from Penn State’s McCourtney Institute of Democracy provides answers. Conducted by YouGov, the poll tracks the mood of the public through traditional survey questions and numerous open-ended questions that allow citizens to express themselves in their own words. The poll’s methodology is described here.

Our Feb. 23-27 poll asked a nationally representative sample of 1,000 Americans to report on how they cast their vote in November. The results of these reports closely align with other national polls, with Hillary Clinton voters comprising 49 percent of the sample, Trump voters 46 percent, with 3 percent and 2 percent for minor-party candidates Gary Johnson and Jill Stein, respectively.

Who would vote differently?

On the next screen, we asked everyone, “Suppose you could go back in time and vote again in the November election. What would you do?”

Respondents were presented with the same choices — Trump, Clinton, Stein, Johnson, someone else, or not vote at all. Of the 339 poll participants who originally voted for Trump, only 12 (3½ percent) said they would do something different.

It will be interesting to see if this changes over time. It is one thing for Trump to propose policies which harm his base. It is a different matter for these voters to realize it. Perhaps this will change if more of Trump’s policies are enacted.

I find it interesting that not only do few Trump voters regret their votes, but that of the twelve people who say they would change their votes, only three said they would vote for Clinton while seven would vote for Jill Stein or Gary Johnson.

I wish we had similar data on those who voted for Stein or Johnson. Not surprisingly, I have seen many comments from Clinton supporters on social media suggesting that Stein and Johnson voters should regret their votes. However, while a few might exist, I have seen no evidence of any Stein or Johnson voters wishing they had for Clinton.

It is one thing to oppose Trump’s policies. It is a different matter to think that we would have been better off if a corrupt, socially conservative,  warmonger such as Clinton had won. There is at least some consolation following Trump’s election in seeing how quickly we have developed strong opposition to his policies. If Clinton had won, those on the left who are actively opposing Trump would be finding ways to excuse and defend Clinton’s actions and policies, as we frequently saw during the campaign. Those who say there has been no evidence of wrong doing by Clinton, despite all the evidence raised of corrupt and dishonest behavior on her part, are objecting to the corruption seen from Trump, making it far less such corruption would become institutionalized as it would have been if Clinton had been elected.

While large portions of the pro-Democratic media have shown an extraordinary amount of hypocrisy in accepting Clinton’s actions, there has been opposition to Trump from both the left and segments of the right. For example, even the pro-Republican Wall Street Journal is running an op-ed about Trump’s lack of credibility. The article both gave examples of the frequent falsehoods from Trump and noted the consequences:

If President Trump announces that North Korea launched a missile that landed within 100 miles of Hawaii, would most Americans believe him? Would the rest of the world? We’re not sure, which speaks to the damage that Mr. Trump is doing to his Presidency with his seemingly endless stream of exaggerations, evidence-free accusations, implausible denials and other falsehoods…

All of this continues the pattern from the campaign that Mr. Trump is his own worst political enemy. He survived his many false claims as a candidate because his core supporters treated it as mere hyperbole and his opponent was untrustworthy Hillary Clinton. But now he’s President, and he needs support beyond the Breitbart cheering section that will excuse anything. As he is learning with the health-care bill, Mr. Trump needs partners in his own party to pass his agenda. He also needs friends abroad who are willing to trust him when he asks for support, not least in a crisis.

This week should be dominated by the smooth political sailing for Mr. Trump’s Supreme Court nominee and the progress of health-care reform on Capitol Hill. These are historic events, and success will show he can deliver on his promises. But instead the week has been dominated by the news that he was repudiated by his own FBI director.

Two months into his Presidency, Gallup has Mr. Trump’s approval rating at 39%. No doubt Mr. Trump considers that fake news, but if he doesn’t show more respect for the truth most Americans may conclude he’s a fake President.

Assuming we survive his presidency, there are also long term political advantages to having Trump in the White House destroying the Republicans, as opposed to seeing Clinton destroy the Democratic brand. Getting rid of the Clintons gives the Democrats a chance to reform the party–which they may or may not take advantage of. If Clinton was elected, we would probably see a continuation of the trend for Democrats to lose in Congressional and state governments, with opposition to Clinton likely to give Republicans a super majority in the Senate and potentially control of enough state governments to enable them to rewrite the Constitution. Having Trump in the White House, as terrible as that is, at least means that the Democrats not only have a real shot at taking control of the House in 2018, but Stuart Rothenburg is writing today that Republican “gains probably won’t be anywhere near what they might have been with President Hillary Clinton in the Oval Office.”

CBO Issues Devastating Report On Effects Of GOP Obamacare Replacement

The nonpartisan Congressional Budget Office has projected that twenty-four million more Americans will wind up uninsured under the Republican health care plan (which calls into question whether this should be called a health care plan at all). The plan would provide inadequate funding for Medicaid, and risks destabilizing the individual market–unless you believe Republican predictions that the free market would respond with better products. This is rather hard to believe considering the failure of the market to handle insurance for those not receiving it through employer or government programs prior to the Affordable Care Act.

To put this in perspective, studies have projected that the loss of insurance by twenty million people (which is less than is predicted under the Republican plan) will result in 24,000 more deaths per year. This backs up the statement from Bernie Sanders that “thousands of Americans will die” if the Republican plan becomes law

Remarkably, a White House analysis projected that the plan will result in an even higher number losing insurance–26 million over the next decade. This is hardly consistent with what Donald Trump promised on the campaign trail. The plan also contradicts Trump’s promises that he would not cut Medicaid and would expand payment for treatment of opiate dependence.

The Center on Budget and Priorities notes how millions would be paying more for less coverage, along with facing higher out of pocket expenses. Aaron Blake points out:

According to the CBO, 64-year olds making $26,500 per year would see their premiums increase by an estimated 750 percent by 2026. While they are on track to pay $1,700 under the current law, the CBO projects the American Health Care Act would force them to pay $14,600. Even if you grant that inflation will allow them to make slightly more money by 2026, that’s still about half of their income going to health care.

There is additional information of significance. Despite Republican claims of a death spiral, the CBO report showed that the ACA is not “imploding.” As other studies have also found, it is stabilizing as more people obtain coverage:

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. The subsidies to purchase coverage combined with the penalties paid by uninsured people stemming from the individual mandate are anticipated to cause sufficient demand for insurance by people with low health care expenditures for the market to be stable.

The Washington Post has fact checked White House press secretary Sean Spicer’s spin regarding the CBO report.

The Republican Health Care Plan Screws Many To Help Very Few

It looks like Republicans think that America has been demanding a new health care plan which will greatly reduce the number of people who are insured, increase costs for poor and older Americans, destabilize the individual insurance market, and cut taxes for the wealthy. While waiting for the CBO scoring, the Brookings Institute has made their calculations as to how terrible the Republican health care bill is, predicting that at least 15 million people will lose health care coverage:

There is significant uncertainty about exactly how CBO will model these provisions and how it will expect the various provisions to interact with one another. Nonetheless, we conclude that CBO’s analysis will likely estimate that at least 15 million people will lose coverage under the American Health Care Act (AHCA) by the end of the ten-year scoring window. Estimates could be higher, but it’s is unlikely they will be significantly lower.

 

Many will suffer from the cuts to Medicaid. Many of those who purchase private coverage on the exchanges will suffer because of how the subsidies are restructured, based on age as opposed to income and the actual costs of insurance. The Kaiser Family Foundation has posted projections regarding this.

Medical organizations and those representing the elderly including AARP, the American Medical Association and the American Hospital Association have objected to the Republican plan. AARP issued a statement opposing the “House plan that would make changes to our current health care system, such as shortening the life of Medicare, hiking costs for those who can least afford higher insurance premiums, risking seniors’ ability to live independently, and giving tax breaks to big drug companies and health insurance companies.”

The less affluent voters who backed Trump will be hurt by the changes. Of course some people do benefit. “Nearly everyone in the Top 1%, who earn more than $774,000 a year, would enjoy a hefty tax cut, averaging $33,000, according to the non-partisan Tax Policy Center. Those in the Top 0.1% would get an average tax cut of about $197,000.” Insurance companies also benefit:

Obamacare allowed insurance companies to deduct only $500,000 of their executives’ pay as a business expense. The GOP bill would repeal that limitation, starting in 2018.

Top insurers pay their leaders millions in compensation every year so this provision could mean a nice tax savings for the companies.

One excuse given by Republicans for repealing Obamacare is the increased cost of premiums. However, most people receive health care coverage through either government programs or employer programs, which have not had major increases in premiums. The individual market had frequent jumps in premiums, and that has continued, except under Obamacare most people receive subsidies to help cover this. As a consequence, only about three percent of the country is actually facing the increases in premiums which Republicans are using to justify their plan. In return, we receive more comprehensive coverage which cannot be denied based upon medical problems.

As one of the three percent who purchases health insurance without qualifying for subsidies, I certainly do not see the Republicans as doing me any favors. My premiums will be higher under the Republican plan than they are now, and the even bigger problem is that the plan may “threaten the stability of the individual market” per the Brookings report, possibly making it impossible to obtain coverage.

 

Resistance Is Not Futile

When even John Yoo is saying that Donald Trump is abusing executive power we know both that we have a problem, and that opposition to him is becoming widespread. We have already seen major protests against Donald Trump. Matthew Yglesias argues that resistance works, and provides these examples of where Donald Trump or the Republican Congress has backed down in the face of protest:

Having people get out to protest also makes it more likely that protests will continue: “Political action can be habit-forming. Once you’ve already made a sign and taken it to a protest, it’s easier to just bring it along again in the future. Once you know which of your friends might be interested in going with you, it’s easier to reconnect and do it again.”

What will be less easy to measure, as compared to the items in the list above, are moves to the right which the Republicans might give up on out of fear of protests. Congressmen might even begin to fear that their reelection is in jeopardy, despite gerrymandering designed to make their seats safe, if enough of their constituents protest at their offices.

The most concrete example of the benefits of opposition to Trump and the Republican Congress will be if some Republicans do lose their seats in 2018. This includes not only members of Congress, but also Republicans at the state level. If Hillary Clinton had won, we would now have Democrats defending her record, even when it includes the same types of policies they protest when coming from Republicans. Most likely we would see further Republican gains in Congress and state governments. While Trump will undoubtedly do many undesirable things, Democrats must take advantage of this in 2018. Of course their chances will be far better if they actually stand for something, as opposed to continuing to run as a Republican-lite party.

Related News:

New York Times: How Attorneys General Became Democrats’ Bulwark Against Trump

Der Spiegel: Europe Must Defend Itself Against A Dangerous President