Republican Health Care Plan

I inadvertently gave myself a nice taste of the shit sandwich that is the proposed Republican Health Care Plan, Trumpcare, as far as I can tell from the details I’ve learned.  I heard an interview last night that laid out the main differences between Obamacare and Birthercare and realized– fuck, I did it to myself in 2017!  The Republican plan would greatly increase premiums, co-pays and deductibles on older Americans, an age-based pricing scheme not currently allowed under the ACA.  I’ve had a taste of that in 2017, hoping for better care than I had in 2016 I am paying 600% more for the same coverage I had last year.  You don’t need me to tell you what a shit sandwich tastes like.

Obamacare, basically Romneycare, which was in part based on the Heritage Foundation’s conservative plan to keep private industry in charge of American health care, had two or three major improvements over what came before.  In exchange for the mandate that would force younger, healthier people, on pain of a tax penalty, to buy insurance, thereby funding the pool for older, sicker citizens, American patients were freed from the industry’s “pre-existing condition” loophole and ensured delivery of what are deemed essential medical services.   It used to be possible to sell insurance with serious limitations on, say, preventative services.  No more, under Obamacare.

The details of the secret Republican plan, the culmination of a seven year partisan battle against Obama’s health care law, a law they’ve called “worse than slavery”, probably worse than any holocaust, were to be revealed a week before the up or down vote.  No debate was planned because Republicans, being in the majority, believed, at first, that they could pass the law on a strict party-line vote.  When some of the details were revealed, including the CBO report that 22,000,000 Americans would lose health insurance under the proposed law, the deal quickly went south.  It’s hard to cast a principled vote for something with a 12% public approval rating.  Even in today’s lockstep party-line political environment.

There were tremendous tax breaks to the wealthiest Americans as part of the Republican plan.  This would fulfill one promise the current president made to his wealthy friends and more than reverse the tax hike Obama instituted to help fund Obamacare.   Part of the Republican plan shifted more of the cost to older, sicker customers.  Another part removed the mandate but instituted an alternative punishment, a six month waiting period for enrolling if you allowed your prior coverage to lapse.  Under the Republican plan the customer would pay a higher percentage of the cost of medical care, from Obamacare’s 70/30 split to something much fairer to insurance companies, like 58/42.  A sixty-four year old with an income of $26,000, currently paying $1,700 a year under Obamacare, would see the cost of health care increase to more than $6,500 in premiums.   That number does not include increased co-payments and out-of-pocket expenses, devilish little details that could add up to another quarter of that person’s income.

Fatefully, the Republican plan would eliminate millions from the Medicaid Expansion roles.   Obamacare increased the threshold for Medicaid type coverage to people up to 150% above the artificially low poverty guideline and provided subsidies for people living on up to 400% over the poverty line.  11,000,000 to 14,000,000 Americans now have low cost health insurance that is virtually Medicaid.  

The costs of Medicaid Expansion are paid mostly by the federal government, the federal contribution is currently at 95%.  The Republican bill scales it back 5% a year from 2021 to 2014, until it makes the program impossible for states to continue.  States, under the Republican plan, would also be able to get waivers for in-state insurers to opt out of Medicaid expansion programs and offer less than the Essential Benefits mandated under the ACA. The Republican plan would allow patients currently receiving Medicaid Expansion benefits to be grandfathered in, but it is also still famously easy to be chucked off insurance, and once chucked, it’s chuck chuck bo-buck banana fana fo fuck to you for the rest of your earthly lifetime, under the Republican proposal.  The proposed bill also slashes funding for Planned Parenthood.  USA!   USA!!!!

I’ve written critically of Obamacare, which sucks in many ways, especially its fundamental deal to keep the foxes in charge of the sickening American health care henhouse.   That said, there is no question that it is more decent than the unfettered, bare knuckles medical insurance scheme that preceeded it.  People who receive coverage under the ACA, whatever our many frustrations with the idiosyncrasies  of the industry-written plan, prefer it to the way things were before.  Most Americans, it seems, agree.  

Is there still a serious debate over the “pre-existing condition” loophole that saved insurance companies billions while condemning countless sick Americans to death?  Even Mitch McConnell’s bill doesn’t restore an insurance company’s right to refuse to sell insurance to somebody because they once suffered from an expensive medical condition.

It seems apparent that a big part of the motivation for this Repeal and Replace mania is a vicious partisan hatred of this nation’s first mulatto president.   There’s greed by the wealthiest, sure, you always expect a certain amount of that from wealthy materialists obsessed with getting every government advantage to help them become wealthier.  There’s the old partisan bickering that has become a larger and larger feature of our political landscape since Reagan.  

To understand the Republican jihad to repeal Obamacare we must not discount hatred, pure and simple, of the well-spoken half black man for whom the bill is named.  He comported himself with dignity even as Mitch McConnell announced that the Republicans were dedicated to making sure everything the president proposed failed and a coyly racist movement known as Birthers publicly, continually and counter-factually attacked Obama’s legitimacy to be president.  The highest profile “birther” was the celebrity brand who is the president now.

 “Birthers” spoke the lingua franca of millions of Americans, and said it loud and proud: “this man is a nigger and we do not have to have a nigger president of the United States.  We will simply not allow ourselves to be ruled by a nigger.”  If you doubt this widely shared sentiment, look at a large part of the current president’s base.  Millions of readers of websites like The Stormer, named in homage to the Nazis infamous Der Sturmer, whether affiliated with a hate group or not (and these mothercuckers have proliferated wildly since Obama’s election) will have no problem endorsing this view.  I guarantee that not one of these neo-nazi fucks will ever use the politically correct “n-word” to refer to our former president, except perhaps in gleeful air quotes.  These angry young white men, and their fathers, and grandfathers, voted overwhelmingly for the race-baiting panderer-in-chief, an unrepentant leader of the Birthers.

Are we living in Germany 1938?  I’d like to think not. On the other hand, on the eve of Hitler becoming the full-blown Hitler history remembers, the New York Times opined that the institutions of German democracy were too robust, the German people too cultured and sober, to allow the crass little shit-snot Mr. Hitler to run amok.  Run amok the crass little shit-snot Mr. Hitler did.  I’m not comparing this genius of audacious self-branding to any other would-be tyrant.  I’m just sayin’.   The proposed repeal and replacement of Obamacare would be a giant step toward the final victory of America’s crass little shit-snot-in-chief and the third of the nation on which his legitimacy stands.  

Would it not?


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