No wonder Sen. Mitch McConnell hasn’t wanted anyone to see his plan for taking health insurance away from millions of poor and working-class Americans.
McConnellcare — more accurately called McConnelldoesn’tcare — would set new limits on Medicaid spending for the poorest 20 percent of citizens and two-thirds of elderly people in nursing homes. It also would phase out the 2014 Medicaid expansion, which brought coverage to more than 400,000 uninsured Kentuckians.
McConnelldoesn’tcare would end the Affordable Care Act’s “individual mandate” that requires people to have insurance. That would make coverage more expensive and harder to get for the people who need it most. The bill also would allow states to drop many required benefits, such as maternity and mental health care.
The Senate plan would give wealthy Americans a huge tax cut by repealing almost all of the taxes the Affordable Care Act, which Republicans dubbed Obamacare, levied against high-income people and medical companies to pay for itself.
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A handful of Senate GOP leaders developed the plan in secret, without any input from most Republicans or any Democrats. It was unveiled Thursday to bad reviews from, among others, consumer groups, insurance companies and the American Hospital Association. Still, McConnell wants a Senate vote on the 142-page bill next week before anyone has much time to study or try to change it.
Few states stand to lose more than Kentucky from McConnelldoesn’tcare and a similar plan passed by House Republicans, which President Donald Trump first endorsed and then called “mean”.
Let’s call the House bill Barrcare after Rep. Andy Barr of Lexington, a vocal supporter. That is a good name for it, because the bill would bar many low-income workers from having access to care they received under the ACA.
The main difference between Barrcare and McConnelldoesn’tcare seems to be that the Senate bill is a bit more generous with subsidies to help low-income people afford insurance. Sen. Rand Paul of Kentucky hates that.
Paul complained about the subsidies Thursday, saying he wants a more thorough repeal of the Affordable Care Act. Apparently, the Bowling Green eye doctor won’t be happy until only the healthy and wealthy have insurance.
The non-partisan Congressional Budget Office determined that Barrcare would take insurance away from 23 million Americans. The CBO said it “score” the Senate bill by early next week.
Former Gov. Steve Beshear embraced Obamacare by creating a state insurance exchange and expanding Medicaid, which reduced Kentucky’s uninsured rate from 19 percent in 2013 to 7 percent in 2015. Gov. Matt Bevin killed the exchange and is looking at changes that would reduce Medicaid eligibility. If some version of this Republican repeal becomes law, expect tens if not hundreds of thousands of Kentuckians to lose their insurance.
Previously, many uninsured Kentuckians either went without care or sought expensive treatment at emergency rooms, forcing hospitals to eat the cost. Expect that to again be the case under the GOP plans.
In addition to having more sick residents, the GOP plans could cost Kentucky thousands of jobs, especially in health care industries. One estimate, by the Commonwealth Fund, a health care non-profit, placed Kentucky’s job losses at almost 45,000 by 2019.
Republicans’ big complaint about health care for poor people is that it is expensive, and their main goal is cutting taxes and regulation for wealthy people and corporations. Some analysts think that is why McConnell wants to get the health care issue out of the Senate, win or lose. He wants to focus on his priorities before the Trump administration implodes and costs him a Senate majority.
The irony here is that the Affordable Care Act was never a liberal plan, but a conservative one. The basic structure of this market-based insurance approach was devised by the right-wing Heritage Foundation and tried out in Massachusetts by then-Gov. Mitt Romney, who was later the 2012 Republican presidential nominee.
A true liberal health care plan would be some form of single-payer government system like in Canada, Australia and many other nations that doesn’t depend on the costly inefficiencies of for-profit insurance companies. One sensible model would be extending Medicare from elderly people to everyone, or allowing some people to buy into Medicare. The insurance lobby will fight that at all costs.
Even if this Republican debacle does not become law, we can count on Kentucky’s GOP politicians to keep sabotaging health care reform and blaming the damage they do on Democrats. Why shouldn’t they? The strategy has worked well so far.