On Thursday, the Senate unveiled its plan to condemn tens of thousands of nonaffluent people to preventable deaths, for the sake of increasing income inequality.
The “Better Care Reconciliation Act” funds a large capital-gains tax cut for the rich by throwing millions of poor people off of Medicaid. It reduces the size of the subsidies available to middle-income people for the purchase of health insurance — and the generosity of the plans they can buy with those subsidies. It allows red states to effectively eliminate protections for people with preexisting conditions, by making benefits like mental-health coverage impossible for many to afford. It repeals Obamacare’s cap on executive compensation at insurance companies, allowing CEOs to extract larger rents from our health-care system. And it defunds Planned Parenthood for a year, making breast-cancer screenings and basic reproductive services more difficult for women to secure.
It is, in short, the largest transfer of resources from the poor to the rich in modern American history — a scheme for sacrificing the lives of men, women, and children on the bottom half of America’s income ladder, so as to pad the bank accounts of those on the uppermost rung.
Minutes after its release, four Republican senators declared their opposition to the bill — on the grounds that it did not cut benefits and subsidies for poor and working people nearly enough.
“It’s going to be hard for conservatives to support a bill that has greater subsidies than Obamacare,” Kentucky senator Rand Paul told reporters. “I didn’t run on Obamacare Lite.”
Paul went on to suggest that the bill does not reduce Medicaid benefits enough, given the size of the national debt and his party’s commitment to cutting taxes.
Ted Cruz, Ron Johnson, and Mike Lee joined Paul in condemning the bill as written — though the tone of their joint statement was decidedly more diplomatic than the Kentucky senator’s remarks to the press.
Cruz released a separate statement in which he called for the bill to “do more to ensure consumers have the freedom to choose among more affordable plans that are tailored for their individual healthcare needs.”
This is, ostensibly, a demand that the bill repeal Obamacare’s regulatory requirements more directly. Under the Affordable Care Act, insurers are required to include a package of essential health benefits in every plan they sell. This provision is, in essence, a means of socializing risk without socializing the health-care system: Healthy people pay for more generous plans than they need (so far), thereby making it possible for for-profit insurers to offer affordable coverage to people with serious medical issues.
In other words: Cruz is effectively arguing that (temporarily) healthy people should have the freedom to buy cheap insurance that won’t actually protect them if they become severely ill, even if that means nonaffluent sick people will no longer be able to afford their medical treatments.
In remarks to reporters, Cruz emphasized that he was not condemning the Senate’s bill outright, but merely insisting that it be revised to ensure that it delivers lower premiums for the American people — an outcome that the bill couldn’t possibly deliver universally, unless one stipulates that the poor and sick are not people.
It’s unclear how the conservatives’ opposition will impact the bill’s prognosis. Paul sounds like he may be a genuine no, which is a conveniant position for a libertarian purist (who happens to represent one of the states that has benefited the most from Obamacare) to take. But the others sound like they just want a little attention, and a concession or two on some pet issues.
It seems unlikely then, that the Senate’s far-right flank will kill the bill by themselves. The only question is whether Team Paul’s complaints will cripple Mitch McConnell’s efforts to appease his “moderate” faction.
Nevada’s Dean Heller — perhaps the GOP’s most vulnerable senator up for reelection in 2018 — expressed his reservations about the bill’s Medicaid cuts.
“At first glance, I have serious concerns about the bill’s impact on the Nevadans who depend on Medicaid,” Heller said in a statement. “I will read it, share it with Governor Sandoval, and continue to listen to Nevadans to determine the bill’s impact on our state. I will also post it to my website so that any Nevadans who wish to review it can do so. As I have consistently stated, if the bill is good for Nevada, I’ll vote for it and if it’s not — I won’t.”
Maine’s Susan Collins expressed similar concerns through a spokesperson, who told reporters, “She has a number of concerns and will be particularly interested in examining the forthcoming CBO analysis on the impact on insurance coverage, the effect on insurance premiums, and the changes to the Medicaid program.”
The public is on the side of the moderates — or, more precisely, the Democrats. The American people overwhelmingly agree with their president — the Republican health-care plan is “mean.”
But what a majority of Americans — or even of Republicans — actually want has been irrelevant to this process thus far. So there’s little reason to have faith that it will make much difference now.
