Saturday, March 18, 2017

Trumpcare: Paul Ryan's gambit to destroy Medicaid and Medicare (joan Mccarter) · Friday, March 17, 2017, 9:34 am

It's never been a secret that Paul Ryan's fondest dream has been to blow up the social safety net, every single part of it, but particularly the big three: Social Security, Medicare, and Medicaid. In no small part that's because they are a direct refutation of his dystopian, Ayn Rand-inspired philosophy of government as a force for evil. Ironic, yes, given he got to where he is today with the Social Security survivor benefits his family received after his father died when he was still a teen. But a pretty typical Republican response: I got mine, the hell with you. So here we arrive at Trumpcare and his big opportunity to take down both Medicare and Medicaid.

One of the key things Trump care would do is to undermine Medicare's finances. Where Obamacare has significantly extended the solvency of the program, Trumpcare would shorten it. Drastically. It's a twofer for Ryan—he ends the payroll tax on high earners that has shored up Medicare, giving his favorite people (the rich ones) a big gift and takes health care away from the his least favorite people (everyone else). But what it does to Medicaid:

But the bill’s major pay-for, to the tune of nearly a trillion dollars, is its overhaul of Medicaid and that’s where most of its coverage losses come from too. The Congressional Budget Office said this week that 14 million people would lose their coverage due to the legislation's Medicaid provisions, though it's unclear how many of those are a result of the phase out of Medicaid’s expanded eligibility versus its transformation of the larger program into a per-enrollee block grant.
Either way, that uninsured number stands to get bigger as we get beyond the 10-year window for which the CBO scored, according to Robin Rudowitz, associate director for the Kaiser Family Foundation’s Program on Medicaid and the Uninsured.

“The change to the per capita financing system is a much bigger, fundamental change to the program,” she said, compared to the expansion phaseout that so far has gotten more pushback from GOP moderates.

That’s because the metric Republicans propose to increase the amount of funding the feds give states per enrollee over time does not increase as quickly as health care costs rise, nor does it anticipate other unanticipated hikes in per enrollee costs, like the introduction of a new but very expensive drugs.

TrumpCare is a travesty: It cuts taxes for the rich, kills Medicaid expansion for the poor and defunds Planned Parenthood. We can defeat it in the Senate, if you call the Capitol Hill switchboard at (202) 224-3121 and contact your senators.


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