Monday, December 26, 2016

The GOP's War on Medicaid

Tom Price, President-elect Trump’s choice for secretary of health and human services, has made proposals to deeply cut Medicaid. Credit Joshua Roberts/Reuters        

The reality is that many of the working poor and elderly facing the need for long term care in their declining years depend greatly on Medicaid.  By extension, so do many health care providers, especially non-profit hospital systems that must treat all whether they have insurance or not.  Despite these realities, the Republican Party led by the always heinous Paul Ryan (born into wealth himself) seeks to dismantle the Medicaid system as well as Medicare.  If successful, America will return to the Gilded Age when the wealthy had quality health care and most of the rest of society did not.  The GOP message to the working poor and non-wealthy elderly is "please die and do us a favor."  This from the political party that feigns to cherish "Christian values."  The big question remains on e of when the idiots who gave into appeals to hate and bigotry and voted for Trump and Congressional Republicans wake up and realize that they have cut their own throats and figuratively signed their own death warrants.  As stated before, I have zero sympathy for adults who did this, but the price paid by millions of children will be deadly.  An article in the New York Times looks at this foul GOP agenda.  Here are highlights:
Progressives have already homed in on Republican efforts to privatize Medicare as one of the major domestic political battles of 2017. If Donald J. Trump decides to gut the basic guarantee of Medicare and revamp its structure so that it hurts older and sicker people, Democrats must and will push back hard. But if Democrats focus too much of their attention on Medicare, they may inadvertently assist the quieter war on Medicaid — one that could deny health benefits to millions of children, seniors, working families and people with disabilities.
Of the two battles, the Republican effort to dismantle Medicaid is more certain. Neither Mr. Trump nor Senate Republicans may have the stomach to fully own the political risks of Medicare privatization. But not only have Speaker Paul D. Ryan and Tom Price, Mr. Trump’s choice for secretary of health and human services, made proposals to deeply cut Medicaid through arbitrary block grants or “per capita caps,” during the campaign, Mr. Trump has also proposed block grants.
If Mr. Trump chooses to oppose his party’s Medicare proposals while pushing unprecedented cuts to older people and working families in other vital safety-net programs, it would play into what seems to be an emerging strategy of his: to publicly fight a few select or symbolic populist battles in order to mask an overall economic and fiscal strategy that showers benefits on the most well-off at the expense of tens of millions of Americans.
Without an intense focus by progressives on the widespread benefits of Medicaid and its efficiency, it will be too easy for Mr. Trump to market the false notion that Medicaid is a bloated, wasteful program and that such financing caps are means simply to give states more flexibility while “slowing growth.” Medicaid’s actual spending per beneficiary has, on average, grown about 3 percentage points less each year than it has for those with private health insurance, according to the Center on Budget and Policy Priorities — a long-term trend that is projected to continue. The arbitrary spending caps proposed by Mr. Price and Mr. Ryan would cut Medicaid to the bone, leaving no alternative for states but to impose harsh cuts in benefits and coverage.
Mr. Price’s own proposal, which he presented as the chairman of the House budget committee, would cut Medicaid by about $1 trillion over the next decade. This is on top of the reduction that would result from the repeal of the Affordable Care Act, which both Mr. Trump and Republican leaders have championed. Together, full repeal and block granting would cut Medicaid and the Children’s Health Insurance Program funding by about $2.1 trillion over the next 10 years — a 40 percent cut.
The Henry J. Kaiser Family Foundation estimated that a similar Medicaid block grant proposed by Mr. Ryan in 2012 would lead to 14 million to 21 million Americans’ losing their Medicaid coverage by the 10th year, and that is on top of the 13 million who would lose Medicaid or children’s insurance program coverage under an A.C.A. repeal.
The emerging Republican plan to “repeal, delay and replace” the A.C.A. seeks to further camouflage these harmful cuts. Current Republican plans to eliminate the marketplace subsidies and A.C.A. Medicaid expansion in 2019 would create a health care cliff where all of the Medicaid funds and subsidies for the A.C.A. expansion would simply disappear and 30 million people would lose their health care.
Sweeping cuts to Medicaid would hurt tens of millions of low-income and middle-income families who had a family member with a disability or were in need of nursing home care. About 60 percent of the costs of traditional Medicaid come from providing nursing home care and other types of care for the elderly and those with disabilities.
While Republicans resist characterizations of their block grant or cap proposals as tearing away health benefits from children, older people in nursing homes or middle-class families heroically coping with children with serious disabilities, the tyranny of the math does not allow for any other conclusion.
Democrats at all levels of government must aggressively communicate the degree to which these anodyne-sounding proposals would lead to an assault on health care for those in nursing homes and for working families straining to deal with a serious disability, as well as for the poorest Americans. With many Republican governors and local hospitals also likely to be victimized by the proposals of Mr. Ryan and Mr. Price, this fight can be both morally right and politically powerful. Republicans hold only a slight majority in the Senate. It would take only three Republican senators thinking twice about the wisdom of block grants and per capita caps to put a halt to the coming war on Medicaid.

America, largely thanks to Republicans and their "Christian" voting base, remains the only advanced industrial nation that views the bulk of its citizens as disposable garbage.    We have the least efficient healthcare delivery system and spend far more per capita on healthcare while receiving less benefit. Congressional Republicans want to make a bad system far worse and in the process likely kill thousands, if not millions of Americans over time if their agenda is realized.  It is because of these "Christian" politicians and their evangelical supporters that I no longer call myself Christian.  To me, being a Christian is something reprehensible and evidence of moral bankruptcy.   Sitting in the pews each week while voting for Republicans who push this agenda is the height of hypocrisy.  The Biblical Pharisees were far better than today's "conservative Christians."

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