Gutting Healthcare for the Poor to Give Tax Breaks for the Rich

Unlike Speaker of the House Paul Ryan, I no longer belong to the Catholic Church and make no claims about my religiosity and loyalty to the Church - even as Ryan backs policies opposed to both the Gospel message and the Church's social gospel teachings.  I'd go even further and say that I don't even like to be called a Christian because of the negative connotations that term now carries thanks to the evangelical and fundamentalist Christians and their hate and bigotry fueled beliefs.  Yet I can recognize the moral bankruptcy of the GOP healthcare "reform" plan that will deprive millions of health insurance coverage in order to fund massive tax cuts to corporations and the most wealthy individuals.  Paul Ryan's "freedom to choose" coverage is simply a total lie since millions will have no choice and no financial ability to purchase coverage, including the elderly.  Both Ryan and his plan are despicable.  Here are highlights from a piece in The Atlantic:

If the terminology of Republican Medicaid policy—“per-capita caps,” “block grants,” “inflation targets”—seems a bit arcane, Monday’s release of the Congressional Budget Office’s report on the GOP’s repeal-and-replace bill makes it pretty simple: The current health-care proposal is about rationing care to fund tax cuts for the U.S.’s highest earners.

In the past, accusations of care-rationing have been a favorite attack on the Affordable Care Act by Republican leaders such as House Speaker Paul Ryan and House Majority Leader Kevin McCarthy. Yet Republican efforts to cap and cut Medicaid make pretty clear that the strategy is to pay for tax cuts that largely benefit the highest earners by forcing governors to become rationers-in-chief—making painful choices regarding how to best ration or deny health care to those in nursing homes, with disabilities, and/or near the poverty line (and that’s in addition to the 14 million Americans who are projected to be completely denied Medicaid coverage over the next decade under the Republican proposal).

[T]he current Republican bill would lead to painful limits on treatment that would “force states to ration care and deny some Americans lifesaving treatments or nursing home care.”Rationing care to fund high-income tax cuts is not just the byproduct of the Republican Medicaid plan, but rather at the heart of it. The motivation of nearly every GOP health-care proposal past and present—to end the guarantee of coverage for those eligible for Medicaid, and replace it with spending caps—has always had more to do with supply-side fiscal policy than health-care reform.

[T]he AHCA seeks to accomplish the GOP’s long-sought goal of undermining Medicaid’s guarantee of necessary health care for all those eligible through an effort to artificially cap and constrain spending. This time, Republican congresspeople have modified the vehicle for capping Medicaid spending, opting for what’s called a per-capita-cap (PCC) over block grants, which are lump-sum transfers from the federal government to states. The PCC limits federal contributions to states based on the number of people in five different categories of health-care needs. Like a block grant, the per-capita cap offers no flexibility for unexpected costs, which will put governors in the position of having to ration care anytime there are spikes in health-care costs—even if they occur due to reasons beyond any state official’s control.

On virtually every measure, Medicaid is far more efficient than any other part of the American system. A study from the Kaiser Family Foundation found that, after adjusting for differences in health status, Medicaid costs 22 percent less per adult beneficiary than does private insurance. And its growth rates have also shown an effective use of funds. So, it’s misleading to suggest that Medicaid should be targeted because it’s inefficient.

A likelier motivation is that while Medicare and Social Security have more funding and thus are larger spending-cut targets for supply-siders, many Republicans (perhaps including Donald Trump) fear a middle-class backlash if either of those programs are tinkered with. But many Republicans seem to believe they can mislead middle-class families into believing that Medicaid is only for the poor, and cuts to it would not impact them.Yet those making such a cynical calculation might come to regret it.

First, there has already been significant backlash against pulling back from the Medicaid expansion included in the Affordable Care Act.

Second, even beyond that expansion, Medicaid is a lifeline for about 70 million Americans—a little more than 20 percent of the population—many of whom rely on it for long-term health services. For instance, nearly two-thirds of all Americans in nursing homes are covered by Medicaid. And Medicaid covers 44 percent of all children with special health-care needs, as well as half of all women with serious disabilities.

Third, the program has made care more equitable for children: Under Medicaid, over 40 million children are eligible for guaranteed comprehensive health coverage—including access to physical and mental-health therapies, dental and vision care, and medical equipment—so that childhood health conditions can be discovered and treated before they become serious or disabling.

And finally, many, many Americans care deeply about the hardship such Medicaid cuts would bring to their country’s poorest citizens. Which leads to the question: Since Medicaid is already among the most efficient uses of health-care dollars, what crucial services will be rationed to cut projected spending by 25 percent in 2026?  

Obviously, Paul Ryan and the GOP care nothing about the poorest Americans who they seemingly wish would simply just die.