Health and Human Services Secretary Tom Price, center and Aetna Chief Executive Mark Bertolini, right, listen to President Trump speak at the White House on Feb. 27. (Kevin Lamarque/Reuters)
The updated Medicaid estimate from the [Congressional Budget Office], which shows how spending would shrink over the next 20 years, underscored the extent to which McConnell’s plan would squeeze the longstanding public insurance program.
The current draft already cuts $772 billion over 10 years from Medicaid, which covers poor Americans as well as the elderly, children and pregnant women.
The updated analysis, requested by Sen. Ron Wyden (D-Ore.) and other Senate Democrats, calculated the impact of pegging the program’s inflation rate to the Consumer Price Index for urban consumers, as opposed to the medical inflation rate.
According to analysts at the health consulting firm Avalere and the Committee for a Responsible Federal Budget, this would translate into a cut of at least $330 billion in 2036.
That amounts to a 35 percent cut in Medicaid over the next 20 years. At a time President Trump is spouting the fiction that his bill does not cut Medicaid and Senate Majority Leader Mitch McConnell (R-Ky.) is trying to buy off moderates with $45 billion to fight opioid abuse, the CBO report deals another blow to Trumpcare’s prospects.
Meanwhile, more Republicans are talking about keeping the 3.8 percent Medicare tax imposed by Obamacare so as to tamp down on the criticism that they are cutting Medicaid to give big tax cuts to the rich.
The likelihood that massive Medicaid cuts will be acceptable to GOP moderates from states that expanded Medicaid is diminishing. Senate Minority Leader Charles E. Schumer (D-N.Y.) blasted the bill again, citing the new numbers. “The Senate version of Trumpcare is even worse than we thought,” he said. “This new CBO report makes clear that the Senate’s Trumpcare bill would cause people to lose their Medicaid coverage, blow a huge hole in state budgets that would make states choose between raising taxes on the middle class or gutting funding for priorities like health care and education, and make it harder for families with a loved one in a nursing home or a disabled child to afford get the care they need.”
There are, however, two interesting developments on the GOP side. First, Republicans have finally figured out that the Obamacare taxes cannot go away, at least not all of them. It is progress when Republicans realize how unseemly it is to give rich people huge tax cuts while slashing Medicaid. The problem — slashing Medicaid — nevertheless remains. Second, even Sen. Ted Cruz (R-Tex.), who once forced a government shutdown over his insistence of repealing Obamacare, now would leave Obamacare in place — so long as there was an unregulated option for consumers. However, as soon as it became obvious that the alternative plans wouldn’t protect those with preexisting conditions, its chances of success dropped dramatically. (Of course allowing healthier and younger people to buy non-Obamacare plans would just leave sicker, older people in Obamacare plans, with even greater increases in premiums.)
Republicans seem flummoxed. They’ve called Obamacare a disaster for so long, they’ve never really wrestled with the problems endemic in health-care reform. The need to balance access, affordability, consumer protection and the demands of a humane safety net can be daunting. Yes, who knew health care could be so complicated? You do wonder how long it will be before GOP moderates make a break for it and set out to come up with an Obamacare fix-it plan with the help of Democrats. After all, in reconciliation they’d need only 51 votes.
