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Reich writes: "Senate Republican leaders just unveiled their newest attempt to repeal (and 'replace') the Affordable Care Act. It's almost as bad as the one McConnell pulled because he couldn't muster 50 Senate votes for it."

Robert Reich. (photo: Steve Russell/Getty Images)
Robert Reich. (photo: Steve Russell/Getty Images)

The New Republican Healthcare Bill Is Almost as Bad as Their Last One

By Robert Reich, Robert Reich's Facebook Page

14 July 17


enate Republican leaders just unveiled their newest attempt to repeal (and “replace”) the Affordable Care Act. It’s almost as bad as the one McConnell pulled because he couldn't muster 50 Senate votes for it. (The Congressional Budget Office had concluded that 22 million people would lose coverage under it.)

In this newer version:

1. Medicaid would still morph into a system of fixed per-person payments to the states – payments that wouldn’t keep up with the expected rise in healthcare costs. And the Medicaid expansion would still be rolled back. (These provisions would hurt so many lower-income and elderly people that Maine Senator Susan Collins, along with possibly several other Republican senators, are unlikely to go along.)

2. Insurers could offer health plans without the minimum benefits available under the Affordable Care Act. That means sicker people would sign up with insurers offering bigger benefits packages – driving up costs for those insurers and requiring them to jack up premiums, co-payments, and deductibles so high that sicker people couldn’t even afford them. (Another huge problem for Republican senators from states with large numbers of lower-income people.)

To address this concern, the Republican bill would create a fund to make payments to insurers for the costs of covering high-risk people enrolled in health plans on the exchanges. But the fund isn’t nearly big enough.

3. People could get tax credits to help pay for catastrophic health insurance plans, and could also use tax-favored health savings accounts. Republicans love to dole out tax credits. But lower-income Americans don’t have enough income to use them.

4. Like the previous bill, this would end the requirement that most Americans have health coverage. So younger and healthier people wouldn't have to be in the same insurance "pool" as older and sicker people. This would also raise premium costs for the older and sicker.

5. But here's the interesting thing. In a notable change, the bill would keep the two taxes imposed by the Affordable Care Act on people with high incomes: the 3.8 percent tax on investment income and the 0.9 percent payroll tax. The taxes apply to individuals with income over $200,000 and couples with income over $250,000.

What's going on here? Wasn't the whole purpose of this "repeal and replace" exercise to cut the taxes of the wealthy?

My guess is that Senate Republican leaders want to use the budget savings from this bill to allow them to pass an even bigger tax cut for wealthy Americans under the "reconciliation" rule requiring just 51 votes. So wealthy Americans would still come out way ahead.

The Congressional Budget Office will report on the new bill early next week. McConnell wants to take up his revised bill next week but he won’t move ahead if doesn’t have the votes to pass it. If the CBO finds that millions will lose their coverage -- and I'm almost certain the CBO will -- it's going to be hard for McConnell to round up the votes he needs.

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+26 # ReconFire 2017-07-14 13:05
I think it proves the reason for replacement of the healthcare bill is to get Obama's name off of it. Racism at its finest.
Repugs. might just be dumber than a bag of hammers.
+6 # ericlipps 2017-07-15 07:01
It doesn't have to be just because of racism. Personal hatred of Obama would do it.
+9 # ReconFire 2017-07-15 08:26
True, but isn't most "personal hatred of Obama" because of racism?
+21 # PABLO DIABLO 2017-07-14 17:33
Democrats should propose "Single Payer". They would only need three votes to pass it and would certainly give them a leg up in 2018. Time to shove the "loser" Clintons out of the Democrat Party and go "progressive" It is the only chance we have for a future.
+2 # ericlipps 2017-07-15 07:02
The "loser" Clintons were the ones who broke the GOP hammerlock on the presidency in 1992 and won the popular vote in 2016.
+4 # vicnada 2017-07-15 08:28
...with the price that the Democratic Party became Republican-lite .
-22 # skylinefirepest 2017-07-14 17:49
Of course it's bad...the GOP had eight years to put a plan together that would stomp obummacare but they slept through it and now have embarrassed themselves...bu t, we really need a good plan and obummacare is NOT IT! I suggest that the democrats work with the republicans ( now isn't that a novel idea? ) and put together a plan that will work for America. It can be done folks!
+9 # ericlipps 2017-07-15 07:04
If only it could. But it can't be done while the GOP is under the thumb of what used to be its lunatic fringe.
+12 # ReconFire 2017-07-15 08:24
"I suggest that the Democrats work with Republicans". Get real. How many times did Obama try to work with them, only to be snubbed every time?
-2 # skylinefirepest 2017-07-16 10:28
Try "none" reconfire. Obama was not interested in any input from Republicans on his signature healthcare!
+4 # ReconFire 2017-07-16 14:43
Turn off Fox News and research this issue. You will find Repugs. had all the input they wanted.
+26 # Carol R 2017-07-14 17:56
How long will it take before the public realizes that Republicans don't care about the health of Americans. (Not mentioned is that Congress doesn't have to live with any of these bad bills. They have their own healthcare.)

Trump doesn't have a clue of what is in these bills. He just wants a photo-op of himself signing anything. Then he can pat himself on the back for doing such a great, wonderful, beautiful job. Americans who get sick can be forgotten. This is truly a death panel for anyone who isn't wealthy.
+2 # Cassandra2012 2017-07-15 13:47
Quite. Until these Congress grifters are subject to EXACTLY the same cuts, restrictions, prejudices etc. they readily impose on the rest of us American plebians, little progress will be made on getting single payer which exists in every other first world country but our own!
Right now they get bribes and campaign dough from big Pharma, the corrupt health insurance "industry" etc. and exempt themselves from having to live with what the rest of America must put up with1
McConnell in oarticular has been bribed for years by them as well as the dead coal industry and the other exploitative fossil fuel industries. he is a dishonorable man without a conscience, a sleazy, shamelessly unpatriotic phoney with little or no sense of decency toward the Amercan people.
+26 # Rodion Raskolnikov 2017-07-14 18:07
Thanks for this. The republicans simply don't have the intellect or the ideology to do anything about healthcare.

In a study conducted by the Commonwealth Fund, the US healthcare system came in dead last among the 11 wealthiest nations of the world. The republican bill will push it a lot farther down.

The plan is to cut $800 billion from Medicaid over 10 years, but these same members of Congress have approved $1.5 trillion dollars over ten years to by F-35 fighters from Locheed Martin. Medicaid will save many thousands of lives over ten years and improve the quality of life for millions. F-35 fighters will kill millions of people over ten years.

The US cannot have a world class healthcare system AND weapons systems like the F-35. It can have one or the other, but not both. We know what congress will choose. Time to change the congress.
+13 # economagic 2017-07-14 18:39
I think calling this bill "almost as bad as their last one" gives it far too much credit, for the very reason given in the next-to-last paragraph save for the foolish question. Professor Reich's heart is in the right place but has guts seem to be AWOL. Enough with the "centrist" Democrats.
+16 # PeacefulGarden 2017-07-14 19:05
I think I do not have a government.
+21 # librarian1984 2017-07-14 19:36
Nurses lead the fight for single payer in CA:
+1 # ahollman 2017-07-15 14:08
With their assault on health care, Republicans have continued to chop away at the 3 legs of the middle class' retirement stool: personal savings, employer pension, and social security. They bear a far larger share of the blame than Democrats for this.

To summarize a Robert Reich analysis:

In the 1960's and 70's, one man's earnings became insufficient to support a family, so women went back to work (notice how opposition to married women working dropped around this time).

Social Security recipients once received regular, adequate cost-of-living adjustments. Over the last 30 years, COLAs have become both irregular and insufficient to keep up with rising costs.

Lifetime employment with a defined benefit pension has been replaced by temporary stints at multiple employers. The corporate pension has been replaced by 401k's, portable, but shifting investment risk from employer to employee.

That worked out as poorly as many predicted. For employees lucky enough to even have a 401k, most were poor savers, lacked pension fund managers' investment savvy, and lacked the leverage of a large investment fund to avoid high fees. Worse, when they faced unemployment or ruinous medical bills, they had to raid the 401k, also suffering the 10% early withdrawal penalty.

That left only their home equity to tap in times of trouble. And then the housing market crashed.

That's the decline of the middle class. The poor, with neither savings nor homes, have remained at the bottom.

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