Trump and the GOP's Frightening Plan for Healthcare

While it has received nowhere near enough coverage, the results of the 2024 elections could have a huge negative impact on healthcare coverage for millions of Americans. If Republicans prevail, they want huge cuts in federal spending on healthcare - so that the wealthy can pay less in taxes - and could potentially repeal the Affordable Health Care Act an leave millions without healthcare coverage, throw families at the mercy of insurance companies and large hospital systems, and see prescription drug costs soar.  Added to this is a desire to slash Medicare and Medicaid spending - harming poor working class whites the most - while also attacking Social Security.   Amazingly, many of those who would suffer the most are allowing GOP calls to racism and culture war issues to distract them from the catastrophe of what would happen to their healthcare coverage and even impact the continued financial viability of many rural hospitals. A piece in The Atlantic looks at both what the Biden administration and Democrats want versus they nightmarish Trump/Republican proposals.  The take way is that voters best wake up and realize the threat Republicans pose to their wellbeing.  Here are article highlights:

Expanding access to health care has been a shared policy priority for Joe Biden and the former Democratic presidents who joined him onstage at a lucrative New York City fundraiser last night, Bill Clinton and Barack Obama. But the politics of health care look very different for Biden than they did for his two predecessors.

Clinton and Obama faced widespread public resistance to their health-care plans that forced them to play defense on the issue. Biden and his campaign team, by contrast, see health care as one of his best opportunities to take the offensive against Donald Trump and the GOP.

Health care is one of the few major issues that more voters say they trust Biden than Trump to handle, according to national media polls. And Trump has ensured that voters will see a clear choice on the issue by renewing his pledge to repeal the Affordable Care Act passed under Obama, which now provides health insurance to more than 45 million people.

House Republicans dramatically sharpened that partisan contrast last week when the Republican Study Committee—a conservative group whose membership includes more than four-fifths of the House Republican Conference’s members and all of its leadership—issued a budget proposal that would not only repeal the ACA but also fundamentally restructure Medicare, Medicaid, and the federal tax incentive for employers to provide insurance for their workers.

“At the root of a lot of these Republican Study Committee proposals is reducing what the federal government spends on health care, and putting the risk back on individuals, employers, and states.”

Expanding access to health care has been a priority for Democratic presidents since Harry Truman. . . . Obama succeeded where Truman and Clinton (and, for that matter, Republican Richard Nixon) had failed, by passing the ACA in 2010. But the deeply polarizing legislative fight over the law fueled the Tea Party backlash . . . . The turning point for the ACA came when Trump and congressional Republicans tried to repeal it in 2017. House Republicans passed legislation revoking the law in May that year, and Trump, who had endorsed the effort, immediately marked the occasion by summoning them to the White House Rose Garden for a victory celebration. Trump’s repeal drive failed, though, when three GOP senators voted against it—including the late Senator John McCain, who sealed the effort’s fate with a dramatic thumbs-down gesture on the Senate floor.

During the legislative struggle, public opinion on the ACA flipped. For the first time since Obama had signed the law, more Americans that spring consistently said they supported than opposed the law . . . . KFF’s latest survey last month produced one of the most positive ratings ever for the ACA, with 59 percent supporting it and only 39 percent opposing.

Particularly important was the Democrats’ shift from emphasizing the ACA’s expanded coverage for the uninsured to stressing its provisions barring insurance companies from denying coverage or raising premiums for the millions of Americans with preexisting health problems.

In office, Biden has advanced his agenda as effectively on health care as on any other issue. Between the massive COVID rescue plan, passed in 2021, and the Inflation Reduction Act, approved in 2022, he won big increases in subsidies to help people buy private insurance under the ACA and a suite of policies controlling drug prices for the elderly. Those include obtaining, for the first time, authority for Medicare to negotiate with drug companies for lower prescription-drug prices, a $35 monthly cap on insulin expenses for Medicare recipients, and a $2,000 cap on total annual drug spending for seniors.

This intensified federal effort has driven down the share of Americans without health insurance to less than 8 percent, according to federal surveys. That’s the lowest number ever recorded, and about half the level before the passage of the ACA. A record 21 million people signed up to buy private insurance coverage through the ACA this year, and about 25 million more are covered through its provision expanding access to Medicaid for low-income working adults.

Among other things, the House Republican Study Committee blueprint would: repeal the federal protections the ACA established for people with preexisting conditions and instead allow states to decide whether to retain such reforms, transform Medicare into a “premium support” or voucher system that instead of paying seniors’ health-care bills directly would give them a stipend to purchase private insurance, end the federal entitlement to Medicaid and instead bundle the program into a block grant for states along with a separate federal program that covers children, and rescind the authority Biden won for Medicare to negotiate lower drug prices. (The Project 2025 plan embraces many of these same ideas.)

[L]iberal—and many centrist—health-care analysts see the proposal as a trigger for chaos in the medical system. It’s “a recipe for taking the health-care system, throwing it up in the air, and letting it drop to the ground and seeing who survives,” . . . the GOP plan would likely at least double the share of Americans without health insurance, raising the percentage of uninsured to a level even higher than it stood before the passage of the ACA.

[The biggest losers in these GOP proposals would include the lower-income, older white adults who have become the cornerstone of Republicans’ electoral coalition. Severely retrenching Medicaid would doom many hospitals in red rural communities. The GOP plans to reverse the ACA’s insurance reforms, meanwhile, would likely cut premiums for younger and healthier people at the cost of raising prices and eroding access for those with greater health needs—who tend to be the older lower-income voters Republicans rely on. “It is a war on their base,” Nichols said.

The cumulative impact of the GOP plan is breathtaking: It calls for cutting federal spending on health care by $4.5 trillion over the next decade for people younger than 65. . . . The cuts would mean not only “a lot more people without health insurance” but also massive turmoil for health-care providers, Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms, told me. “It would have a huge impact on hospital revenue and provider revenue,” she said.

A Biden victory would allow him to defend, and perhaps further advance, his policies to reduce the number of uninsured and to more aggressively leverage federal buying power to lower health-care costs. If Trump wins, he will roll back federal health-care spending and regulation, and cede more power to providers and insurance companies—by legislation if he can, and by regulatory action if Democrats win enough seats to block him in Congress.

The choice could not be more stark.

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Trump's "America First" Has Ugly Antecedents

At the risk of being accused of another round of complaints about Americans' ignorance of history and how so many seemingly never learn from the past, a very long column in the Washington Post looks at Donald Trump and a segment of the Republican Party's desire to go back to an "America First" agenda akin to that pushed by certain "elites" and industrialists in the 1930's and even 1940's.   This mindset was fueled largely by a desire for high tariffs (which only increased costs for American consumers), anti-immigrant xenophobia and bigotry, anti-Semitism, isolationism with a heavy dose of racism, The consequences of this agenda had horrific consequences in that it allowed Nazi Germany to seize much of Europe and green lighted Japan's conquests in Asia.  America and the world paid dearly for this policy that delayed American intervention.  Now, those with amnesia of the lessons of the past or, in the case of Trump, a love for dictators he seeks to emulate, are setting to have America repeat the mistakes of the 1930's and first years of the 1940's.  Here are column excerpts:

Many Americans seem shocked that Republicans would oppose helping Ukraine at this critical juncture in history. Don’t Republican members of Congress see the consequences of a Russian victory, for America’s European allies, for its Asian allies and ultimately for the United States itself? What happened to the party of Ronald Reagan? Clearly, people have not been taking Donald Trump’s resurrection of America First seriously. It’s time they did.

The original America First Committee was founded in September 1940. Consider the global circumstances at the time. Two years earlier, Hitler had annexed Austria and invaded and occupied Czechoslovakia. One year earlier, he had invaded and conquered Poland. In the first months of 1940, he invaded and occupied Norway, Denmark, Belgium and the Netherlands. In early June 1940, British troops evacuated from Dunkirk, and France was overrun by the Nazi blitzkrieg. In September, the very month of the committee’s formation, German troops were in Paris and Edward R. Murrow was reporting from London under bombardment by the Luftwaffe. That was the moment the America First movement launched itself into the battle to block aid to Britain.

Cutting off Ukraine seems like small beer by comparison, but behind it lies the same “America First” thinking. For Donald Trump and his followers, pulling the plug on Ukraine is part of a larger aim to end America’s broader commitment to European peace and security. America’s commitment to NATO, Trump believes, should be conditional, at best: Russia can do “whatever the hell they want” to allies who do not pay their fair share and meet certain defense-spending objectives.

Other Republicans don’t even mention conditions. Sen. Josh Hawley (R-Mo.) has called for the immediate reduction of U.S. force levels in Europe and the abrogation of America’s common-defense Article 5 commitments. He wants the United States to declare publicly that in the event of a “direct conflict” between Russia and a NATO ally, America will “withhold forces.” The Europeans need to know they can no longer “count on us like they used to.” Elbridge Colby, a former Trump Pentagon official praised by Hawley, has written widely (and wrongly) that United States cannot defend both East Asia and Europe. . . .

Can Republicans really be returning to a 1930s worldview in our 21st-century world? The answer is yes. Trump’s Republican Party wants to take the United States back to the triad of interwar conservatism: high tariffs, anti-immigrant xenophobia, isolationism. According to Russ Vought, who is often touted as Trump’s likely chief of staff in a second term, it is precisely this “older definition of conservatism,” the conservatism of the interwar years, that they hope to impose on the nation when Trump regains power.

So it’s time to take a closer look at the 1930s conservative mentality and the America First movement it spawned.

Republican anti-interventionism of those interwar years — “isolationism” as critics called it — was less a carefully considered strategic doctrine than an extension of their battles against domestic opponents. Yes, there were self-proclaimed “realists” in the late 1930s assuring everyone that the United States was invulnerable and that events in Asia, where Japan was also on the rampage, and Europe need not endanger American security.

This “realism” meshed well with anti-interventionism. Americans had to respect “the right of an able and virile nation [i.e. Nazi Germany] to expand,” aviator Charles Lindbergh argued. The leading Republican of his day, Ohio Sen. Robert Taft, ridiculed those who expressed fears of advancing fascism.

It was not fascism that conservative Republicans worried about. It was communism. For them, the foreign policy battle in the interwar years was but a subset of their larger war against Franklin D. Roosevelt and the New Deal, which Republicans insisted disguised an attempt to bring communism to the United States. Conservatives in both the United States and Great Britain had long seen Hitler and Mussolini as bulwarks against the spread of communism in Germany and elsewhere.

Nor were they especially troubled by the dramatic rise of official antisemitism in Germany. In the 1920s and ’30s, influential Republicans and conservatives put Jews at the center of various conspiracies against America. . . . . they opposed intervening in a war in which Jews were among the prominent victims. Lindbergh, among the most admired men in the United States, claimed Jews were pushing the United States into war “for reasons which are not American.”

Conservative Republicans also warned against the creation of an American “liberal empire” no less oppressive than the one Hitler was trying to create.. . . . In May 1940, as the British army faced annihilation at Dunkirk, Taft insisted it was “no time for the people to be wholly absorbed in foreign battles.” It was “the New Deal which may leave us weak and unprepared for attack.”

America’s entry into World War II was, among other things, the triumph of a contrary view of the world. Even before Pearl Harbor, a majority of Americans, prodded by Roosevelt, came to view the advancing power of European fascism and Japanese authoritarian militarism as a threat not just to U.S. security but also to liberal democracy in general.

Even if the United States faced no immediate threat of military attack, Roosevelt insisted, in his January 1940 State of the Union address, the world would be a “shabby and dangerous place to live in — yes, even for Americans to live in” if it were ruled “by force in the hands of a few.” To live as a lone island in such a world would be a nightmare.

The Committee to Defend America by Aiding the Allies, formed in May 1940 by progressive Kansas newspaper editor William Allen White and including such prominent Democrats as Dean Acheson, declared the war in Europe was a “life and death struggle for every principle we cherish in America” and urged the United States to “throw its economic and moral weight on the side of the nations of Western Europe, great and small, that are struggling in battle for a civilized way of life.”

This was exactly what the men who formed the America First Committee opposed — and not because they spoke for some mass groundswell of working-class Americans. The poor and working class in these years were with FDR. The America First Committee was founded by a group of Yale students. . . . . Although they railed at “elites” and claimed to speak for real Americans, they were chiefly business executives who represented the nation’s commercial and industrial elites.

Unfortunately for the original America Firsters, most Americans rejected their arguments and embraced FDR’s liberal worldview. Especially after the fall of France, polling showed a majority of Americans wanted to send aid to Britain even at the risk of the United States being dragged into war. The America First Committee, despite its well-funded nationwide lobbying effort — it boasted 800,000 members in 400 chapters across the nation — lost the battle against Lend-Lease and all subsequent attempts to prevent the United States from becoming the world’s “arsenal of democracy.”

We like to think that great accomplishments in American history are the result of broad national consensus. More often they are the triumph of one worldview over another. American entry into World War II was the victory of a liberal worldview over an anti-interventionism rooted in a conservative anti-liberalism.

If Americans care about what happens in Europe, then they must care about what happens in Ukraine. For should Ukraine fall to Russian control, it would move the line of confrontation between Russia and NATO hundreds of miles westward and allow Vladimir Putin to pursue his unconcealed ambition to restore Moscow’s hegemony in Eastern and Central Europe. Should Ukraine fall, the cost and risk of stopping Russia later will be much higher, including the risk of the United States having to confront Russia as it did during the Cold War. My Post colleague Marc Thiessen has thus advised Republicans to give Ukraine the weapons it needs now, lest they come to “own Ukraine’s military collapse” and leave a reelected Trump “with a weak hand.” Yet that sensible advice also rests on the assumption that at some point the United States may have to come to Europe’s defense against an aggressive Putin.

Like those of their 1930s forbears, today’s Republicans’ views of foreign policy are heavily shaped by what they consider the more important domestic battle against liberalism. . . . Republicans insist that Biden is a communist, that his election was a “communist takeover,” that his administration is a “communist regime.”

The GOP devotion to America First is merely the flip side of Trump’s “poison the blood” campaign. It is about the ascendancy of White Christian America and the various un-American ethnic and racial groups allegedly conspiring against it.

This has long been evident in Republican veneration of anti-liberal dictators such as Putin and Hungary’s Viktor Orban. Conservatives applauded when Putin warned in 2013 that the “Euro-Atlantic countries” were “rejecting” the “Christian values” that were the “basis of Western civilization,” “denying moral principles and all traditional identities: national, cultural, religious, and even sexual.”

Trump’s narcissism meshes well with the aims of those yearning to extricate the United States from its commitments in Europe. In his personal life, as people who know him tend to agree, Trump has no allies. As one Republican told the Wall Street Journal, “All relationships with Trump are one-way transactional and the day he decides that it’s no longer beneficial to him, folks are out the door.” It is hardly surprising that he takes the same approach in foreign policy. Trump does not value America’s allies any more than he values any other relationship, including his relationships with Putin, Xi Jinping and Kim Jong Un.

Once other nations realize that America’s commitment to defend treaty allies can no longer be relied upon, the whole configuration of power in the international system will change. All powers, whether friendly or hostile to the United States, will adjust accordingly.

In this respect, those Trump Republicans who wish to sever American commitments to allies are not only bringing back a 1930s worldview. If they take power, they will bring us back to a 1930s world.

The stakes will be highest and most immediate for the Baltic nations, which in the eyes of traditional Russian nationalists such as Putin are mere appendages of Russia, with significant Russian-speaking populations that may at any time demand “protection” from Moscow, as the Sudeten Germans in Czechoslovakia demanded protection from Berlin in the 1930s. The Baltic states have never enjoyed sovereign independence in periods of Russian hegemony and owe their independence today entirely to American and NATO guarantees.

Then there is Poland, which during the Cold War and repeatedly in the 18th, 19th and 20th centuries was either subjugated or partitioned by Moscow.

The most important nation in this transformed Europe will be Germany. Germans will quickly find themselves faced with a terrible choice. Either they try to remain in a fundamentally pacifist mode, as they have been since 1945, or they once again become a great military power. To defend themselves in the absence of an American guarantee, Germans will face a staggering uphill climb to match Russia’s conventional-weapons capabilities. But they will also have to address Russia’s overwhelming nuclear superiority, which Putin has not been shy about threatening to use even against the nuclear-armed United States. Will the Germans rely on British and French nuclear capacities to deter Russia, since they can no longer count on the American nuclear umbrella? Or will they choose to become a nuclear power themselves?

Indeed, should the United States make clear that it is no longer bound by its security guarantees, the likelihood is that other industrialized nations will quickly turn to nuclear weapons to try to make up for the sudden gap in their defenses. Japan could build hundreds of nuclear weapons in a very short time if it chose — or do the new America Firsters believe that the Japanese will find reassuring America’s abandonment of the similar treaty commitments in Europe? We will be living in a world of many heavily armed powers engaged in a multipolar arms race, ever poised for conflict — in short, the world that existed in the 1930s, only this time with nuclear weapons. But yes, they will be spending more than 2 percent of their GDP on defense.

And how long before China, watching America abandon its allies in Europe, asks whether Americans still plan to live up to any of their commitments anywhere? Even if one believes that “Asia is more important than Europe,” does it strengthen the Asian allies to abandon the European allies? Hitler also hoped the United States would focus exclusively on Asia and leave Europe to him. It is no surprise that among those most frightened by Trump’s talk of abandoning NATO is Taiwan.

An older generation of Americans, many of whom may vote for Trump this year, may not live to see the consequences — those crises will fall on their children and grandchildren. But they can be sure of this: If they vote for a return to the 1930s, posterity is not going to mistake them for America’s “greatest generation.”

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Trump Bibles Make a Mockery of Christianity

At a time when church attendance continues to fall as reported by a new Gallup poll (only 21% of Americans attend church weekly), Donald Trump has taken to hawking bibles as yet another shameless and utterly disingenuous con to shake money loose from his MAGA followers. The irony is that in addition to the ugliness of evangelicals/Christofascists the merger of "conservative" Christianity with right wing Republican politics is a driving cause of Christianity's decline in America.  Trump's latest money gambit merely underscores how how evangelicals have sold their souls and any shred of morality to their new orange god.  Trump's version of Christianity is much like that of his followers albeit even more morally bankrupt.  In the MAGA universe, "Christian" is a label one wears while engaging in feigned piety while actually ignoring Christ's social gospel.  Hence, MAGA's support for GOP policies slashing the social safety net, cutting fund to feed poor children, and demonizing anyone and everyone who is not a white evangelical Christian.  Indeed, Trump has given evangelicals license to show their true selves and in the process put the toxicity of "conservative" Christianity on open display.  A piece at Salon looks at Trump's latest con and those who embrace it.  Here are highlights: 

Earlier this week, Donald Trump unveiled his newest grift to squeeze money out of his cult followers: Trump-branded Bibles. Claiming the book contains the "King James version" and "also includes the Founding Father [sic] documents," Trump promised "you have to have it for your heart, for your soul." The screenshots of the video are funny by themselves, but I highly recommend watching the ad Trump cut for these Bibles. Trump radiates total contempt for Christianity. 

This is Trump in his angry-bored mode, letting viewers know with his listless tone and posture that he thinks all this Bible stuff is dumb. The not-at-all subtle message of the video is that Trump doesn't believe any of this faith-in-God crap, but he definitely believes in using Christian identity as a weapon to make money and dominate his foes. 

Many Trump opponents on social media replied with video clips underscoring how Trump may be the single most ignorant person in the country about the contents of the Bible.

It's a point I've made many times myself. But it's time to consider the strong possibility that Trump's disdain towards the practice and theological beliefs of Christianity is not a surprise to his followers. It's likely a selling point that Trump's version of "Christianity" is void of faith and morality. His pitch to his followers has a certain appeal: They can have the identity "Christian," and all the power that goes with it, minus the parts they don't like. No boring church services or Bible study. No tedious talk about "compassion" and "grace," which only gets in the way of the gay-bashing and racism. And definitely no need to worry about that Jesus guy, with all his notions about "loving thy neighbor" and "welcoming the stranger."

Their new lord is Trump himself. He's a lot more fun for the redhats since his message is "kick thy neighbor" and "build the wall." Frankly, I'm sure most of them find it a huge relief, not having to pretend they ever cared about that peace-and-charity crap. 

Trump products tend to be marketed with claims that range from "deeply dubious" to "FTC violation." While I am not about to waste $60 on a Trump Bible to see where it falls on the misleading advertising scale, I will note some red flags in the quality control department. The ad copy promises that, within this book cover, customers will get the "King James Version translation," as well as a copy of the Constitution, the Declaration of Independence and the lyrics to "God Bless America," among other texts. But it also promises an "[e]asy-to-read, large print, and slim design." People who actually read books should instantly see the contradiction.

[A]nyone can see that this is a lightweight volume. Page count-wise, it looks less like "War and Peace" and more like a user manual for a can opener. . . . It seems impossible to stuff the entire Bible — as well as all those other documents — into that sleek bit of binding, even if you do cut out every passage where Jesus does "woke" stuff like healing the sick and feeding the poor. 

Not that it matters, of course. The pages of Trump's "Bible" could all be blank, and there's a good chance no one would ever know it. In the right-wing publishing industry, books are not made to be read. They are to be displayed on your shelves, unopened, so you can glance at them and feel that somewhere, a liberal is "owned." . . . .The point of a Trump-branded Bible is to use it like their Dear Leader does: As a photo prop, not something to turn to for guidance or wisdom. 

The teachings of Jesus Christ were always a poor fit for Republicans. They're just way more into decimating Social Security than they are into loaves and fishes. What Trump offers when it comes to Christianity is what he offers his followers in every other aspect: permission to stop pretending to be good people. His gift to them is his shamelessness. Through Trump, his followers can realize their fantasies of being unapologetic bullies. This is the same schtick as MAGA members who claim to be "patriots" while attacking the rule of law and democracy. Trump tells them what they want to hear: You can be a Christian without compassion.  

Even before Trump's version of a "Bible" was being sold, his hollowed-out version of "faith" had cannibalized what was left of evangelical Christianity, which had already spent decades remaking itself as the culture war arm of the GOP. This is most easily tracked in the rise of churchless Christians. . . . MAGA is basically their religion. Instead of prayer and Bible study, they "practice" their faith by watching Christian-branded online content that is, in actuality, just about right-wing politics. 

Replacing the real Bible with Trump Bibles is a too-perfect symbol of what has happened to evangelical Christianity. The mistake is in believing Trump's followers are confused or ashamed about their devotion to a godless creep who laughs at true believers. In Trump's hands, the Bible is not a text for prayer and reflection, it's just a weapon. It's much easier to beat people down with a book if it's closed. 

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