I’m wondering what the results would be if Gallup or Pew undertook a poll and asked the following question of us Americans:

 “In your view, between the airline industry and Republicans in the House of Representatives, which organization do you find to be the more heartless and cruel?” 

It’s a tough one, right?  I mean our de-regulated airlines – at least the four major ones left standing – have been screwing us over for decades now.  Knee-room?  Very comfortable if you’re not over the age of 6. Security?  Bunghole tight but why do we still have to remove our shoes and belts?   Food?  Used to be that we got badly prepared food for free.  Now we pay for the same crap.  Dragging folks off overbooked flights?  Yeah, well enough said.   Customer Service?  The last time America’s airlines actually provided decent customer service? -  Ummm, okay let’s just move along.  What’s next?  Charging us for in-flight oxygen? 

House Republicans.  Just like the airlines, Republicans in the House of Representatives, your "we the people" representatives, have been pretty much screwing you over for about three decades now.  (I use  "you" and “your” because as a resident of the Free Market Capital of the Free World – Washington, D.C. – I don’t have representatives in Congress even though we have more people in our 64 square miles than Vermont and Wyoming.)  Tax cut after tax cut that provides the wealthy with gi-normous windfalls while bestowing a measly month's grocery bill payment for you and me.  Massively increasing our pubic debt every time they are in charge?  Yup!  Lying to drag us into a Middle East Wars that seemingly have no end?  Right.  Pushing religion into our lives despite the very explicit admonition against this contained in the Constitution?  Seven years of 50+ bills to get rid of Obamacare but nothing real to replace it?  Screwing the elderly, the poor, minorities and the disadvantaged?  What the fuck?

See what I mean?  It’s a tough one.  But for me, I’m gonna’ go with the Republican cluster-fuck that was the vote on the American Deathcare Health Act.  

Normally when one party controls the Presidency, the House of Representatives and the Senate, things get done but for some reason Republicans appear to have lost the ability to actually govern as opposed to passing bullshit resolutions and bills that do nothing but stick it to us ordinary Americans.   But yesterday they finally got their act together and passed a major bill to “replace” Obamacare.   Trump needed a win since so far in his 100+ days in office, he’s pretty much reversed himself on every promise he made while running for the office.  Of course, he has managed to create a Muslim Travel Ban through Executive Order that’s still being challenged in court and proposed a budget that basically strips funds for the elderly, the poor, veterans, and just about every American who isn’t rolling in dough like our high income top 10% American earners.  Then too he’s proposed the “hugest tax cut in American history” that provides the hugest windfall ever for the rich and nothing all that much for the rest of us with no way to pay for it.  (Recall, if you will the protracted battles about paying for Obama's budget proposals.) 

But back to healthcare.  Yeah, it’s complicated.  Hillary Clinton (from past experience) and Bernie Sanders knew how complicated it is and so do we.  Given this “it’s complicated” theme, can anyone tell me why it is that the Trump/Ryan Deathcare Act looks like it was cobbled together in the men’s bathroom in the basement of the Longworth House Office Building over on Independence Avenue?  And why is it that what is supposed to be a replacement for Obamacare re-defines the term “replace” to mean “cut all the benefits included in Obamacare to people who didn’t have or couldn’t afford health insurance and drop a few billion dollars into the pockets of the already wealthy?” 

We (and the House of Representatives) don’t know yet just how the American Deathcare Act will impact us since the Congressional Budget Office has not done an evaluation – a “scoring” as it’s called in Republican parlance.  We don’t know how many folks might lose their health insurance as a result.   Is it going to be more or less that the 24 million estimate of the CBO with the first iteration?  Cost?  Who knows?  It does propose some massive transfers of money like nothing we've seen since the Roosevelt era mainly to folks who don't need it.  But these caveats aside,  here’s a short list of what the bill might actually do to us:

1.  Allows sates to determine which pre-existing conditions will and won’t be covered by health insurance companies.

2.  Allows insurance companies to charge older Americans aged 64 and more
up to five times what younger folks pay. 

3.  Allows states to waive rules that require insurance companies to charge the same rates for people with histories of serious illness as everyone else. 

4.  Removes the tax on medical devices that were instituted to pay for Obamacare. 

5.  Removes subsidies for folks just above the poverty line that were instituted in order that they could get and afford health insurance.

6.  Allows large employers to opt out of providing their employees with health insurance coverage with no penalty as Obamacare did.

7.  Strips $800 billion from Medicare over a ten year period and alters the way the program is administered.  

8. Eliminates all Federal funding for Planned Parenthood for one year.

9.  Eliminates a tax on individuals earning more than $200,000 or couples earning more than $250,000.

10.  Eliminates a 0.9% increase on a Medicare payroll tax and a 3-8% tax in investment income that were part of Obamacare designed to help pay for the program.

11.  Allows states to determine which services are covered in insurance plans including emergency room services, pre-natal services, pediatric services, and prescription drug for example. 

In essence, Republicans have ramped up their “cutting taxes creates jobs” mantra by eliminating nearly all the taxes that the ACA enacted to pay for Obamacare.  Like the Trump/Ryan Tax reform bill, I can see no means of actually paying for the AHCA, bad as the bill is.  Also, the States Right’s Party, has turned over health care decision making to the states.  So you could say that the House Republicans have remained true to their primary ideology.  On the other hand, stripping away the funding mechanisms that pay for health insurance for folks who are not wealthy is pretty drastic.  Plus, as of now, no one knows what the fiscal impacts of the bill will be.  And, leaving health care decisions up to the states means that states like Alabama and Mississippi are going to remain at the bottom of the barrel when in comes to the health of their citizens. 

But overall, there is little doubt that the AHCA will provide greater “access” to coverage as lying Paul Ryan has proclaimed over and over again.  But to the not totally stupid or functionally brain dead among us, greater “access” means pretty much less than a bucket of warm spit when you can’t afford your health insurance premiums, and affordability,  along with universal coverage (not just "access"), was one of the major goals of the ACA.   Frankly, the American Health Care Act is a pretty cruel blow to the progress made towards universal health care coverage that Obamacare largely succeeded in achieving.   As far as I can tell, the AHCA bears no resemblance to Donald Trump’s endless promises of “cheap, health care for everyone” but is basically one of the cruelest measures that Republicans have foisted on America in a long, long time.  It represents a massive tax break for folks who don’t need it while cutting the legs out from under folks who truly need help.

The good news?  Well now Trump, Ryan and the rest of the Republican cabal, can go back to their constituents and say "See?  We kept our promise!  We replaced Obamacare!"  Well, good luck to you all.  I’m betting that there are going to be some pretty hot times at town hall forums all over the country for the Republicans who voted “Yay” on the American Deathcare Act yesterday.  They deserve it.

Have A Great Day!    


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