Saturday, November 26, 2016

Millions stand to lose health insurance under Donald Trump, whether they realize it or not

Posted By on Sat, Nov 26, 2016 at 12:24 PM

From a dispatch from Florida in the New York Times yesterday:
Dalia Carmeli, who drives a trolley in downtown Miami, voted for Donald J. Trump on Election Day. A week later, she stopped in to see the enrollment counselor who will help her sign up for another year of health insurance under the Affordable Care Act.

“I hope it still stays the same,” said Ms. Carmeli, 64, who has Crohn’s disease and relies on her insurance to cover frequent doctor’s appointments and an array of medications. 
Donald Trump ran an unusual campaign in that he was both ignorant and indifferent to anything related to policy. His campaign had some policy planks, but Trump himself seemed unfamiliar with them. But he did make some promises, and one of them was crystal clear: He said that he would repeal Obamacare. What that means in practice is anyone's guess, because Trump makes up different things at different times. So, it's possible for someone like Dalia Carmeli, who depends on Obamacare for coverage she desperately needs, to think that maybe Trump is on her side and won't act to snatch away her health insurance.

Unfortunately, whether or not this is what all of his supporters intended to vote for, the most likely scenario is that Trump will enact the right-wing economic agenda of his party, including the dismantling of the healthcare safety net that Republicans have promised for years. Trump's rhetoric sometimes suggests otherwise, which has been an effective tool in running a con on voters like Carmeli (he used the same ploy on taxes, and fooled a good chunk of the media for a spell — he talked a big game about a populist approach that would soak the rich, even as his actual policy platform proposes the greatest tax cut for the rich in the nation's history; see also Wall Street regulation). Here's where it can be useful to take note of the actual policy proposals as opposed to the bluster. Americans dependent on the ACA for coverage have every reason to fear that Trump and the GOP will fulfill their campaign promises — in which case more than 20 million Americans would lose their health insurance.

While Trump will no doubt continue to make gestural or symbolic overtures aimed to please everybody, it's worth remembering who actually passes laws. That would be Congress, in GOP control. The Republican Congress already used the reconciliation process to pass a bill last year that dismantled the ACA's coverage provisions and replaced them with nothing. President Obama vetoed the bill, protecting the law; it's hard to believe that Trump would do the same.

So what would the Republicans' eventual replacement plan be? House Speaker Paul Ryan (recently unanimously chosen for another term by his Republican colleagues) has the outline of a plan in place, known as "Better Way." If you're wondering why Ryan was so willing to back Trump, despite Trump's periodic efforts to humiliate him, "Better Way" is the reason. Ryan correctly ascertained that if Trump was elected president, he would have a good chance to enact his longstanding dream plan to slash taxes for the rich, slash spending on the poor, dismantle the social safety net and dismantle Wall Street regulation.

What would Better Way mean for Americans covered by Obamacare? It would eliminate funding for the Medicaid expansion altogether, ending coverage for 14 million low-income Americans. That includes more than 250,000 Arkansans currently covered by the private option. It's worth keeping this in mind when you hear debates about what the Arkansas legislature might do next year about the private option, the state's unique version of Medicaid expansion. The truth is that the actions of the legislature are irrelevant until we know what Congress and Trump do. Regardless of what state legislators might want, if Ryan's Better Way plan passes and is signed into law (and assuming the GOP nukes the filibuster, there's no reason to think it wouldn't), the private option — or Arkansas Works, or whatever you want to call it — is dead. Better Way also block grants the old pre-expansion Medicaid program, which would in practice amount to a massive funding cut.

So, using Arkansas as our example: The funding that enabled a coverage expansion to 250,000 low-income adults would be gone entirely. The state's remaining program, meanwhile — covering kids, the elderly, the disabled and other vulnerable groups — would likely be forced to slash benefits to deal with a major, ongoing funding shortage.

Better Way would also re-make the Obamacare exchanges, the regulated marketplaces where individuals who don't get their insurance through a job or through a big public program like Medicare can shop for health insurance. Better Way is vague on the details, but the gist is that people who are wealthier and/or healthier would tend to pay less for individual insurance than they do under Obamacare and people who are poorer and/or sicker would tend to pay more (sometimes much, much more). In the case of a trolley driver with Crohn's disease like Dalia Carmeli, insurance which is affordable under Obamacare would likely become prohibitively expensive under Better Way.

Trump was so outrageous that it was easy for the actual policy stakes to get lost in the shuffle of proto-fascist gibberish, casual racism, sexual-assault braggadocio, bellicose disregard for American institutions and dumbed-down nationalism. But now that he's in office, Ryan and company are going to be sending bills to his desk, and the policy stakes are going to become real. Among many other things, that means millions of Americans could lose their health insurance.

Tags: , , , , , ,

Favorite

Speaking of...

Comments (18)

Showing 1-18 of 18

Add a comment

 
Subscribe to this thread:
Showing 1-18 of 18

Add a comment

More by David Ramsey

Readers also liked…

  • Dexter Suggs resigns as Little Rock school superintendent

    This just in from state Education Department: Today, Commissioner Johnny Key reached an agreement with Dr. Dexter Suggs that resulted in Dr. Suggs’ immediate resignation as superintendent of the Little Rock School District.
    • Apr 21, 2015
  • Satanic Temple: Make Rapert pay for Ten Commandments monument

    A petition drive has begun to encourage a demand that Sen. Jason Rapert pay for the legal fees in defending his Ten Commandments monument proposed for the state Capitol grounds. It's more work by the Satanic Temple, which has fought church-state entanglement around the country.
    • Aug 28, 2016
  • More legal headaches for Dexter Suggs

    Dexter Suggs may have cleared out his office before the workday began today, but he still has lingering legal matters as defendant in lawsuits against him and the state.
    • Apr 21, 2015

Most Shared

  • World leaders set to meet in Little Rock on resource access and sustainable development

    Next week a series of meetings on the use of technology to tackle global problems will be held in Little Rock by Club de Madrid — a coalition of more than 100 former democratic former presidents and prime ministers from around the world — and the P80 Group, a coalition of large public pension and sovereign wealth funds founded by Prince Charles to combat climate change. The conference will discuss deploying existing technologies to increase access to food, water, energy, clean environment, and medical care.
  • Tomb to table: a Christmas feast offered by the residents of Mount Holly and other folk

    Plus, recipes from the Times staff.
  • Fake news

    So fed up was young Edgar Welch of Salisbury, N.C., that Hillary Clinton was getting away with running a child-sex ring that he grabbed a couple of guns last Sunday, drove 360 miles to the Comet Ping Pong pizzeria in Washington, D.C., where Clinton was supposed to be holding the kids as sex slaves, and fired his AR-15 into the floor to clear the joint of pizza cravers and conduct his own investigation of the pedophilia syndicate of the former first lady, U.S. senator and secretary of state.
  • Reality TV prez

    There is almost nothing real about "reality TV." All but the dullest viewers understand that the dramatic twists and turns on shows like "The Bachelor" or "Celebrity Apprentice" are scripted in advance. More or less like professional wrestling, Donald Trump's previous claim to fame.
  • Arkansas archeologist does his job, is asked to leave

    Amid Department of Arkansas Heritage project.

Visit Arkansas

View Trumpeter Swans in Heber Springs

View Trumpeter Swans in Heber Springs

Magness Lake, in Heber Springs, is a magnet for swans

Most Viewed

Most Recent Comments

Blogroll

 

© 2016 Arkansas Times | 201 East Markham, Suite 200, Little Rock, AR 72201
Powered by Foundation