The AHCA: the perfect bill…to hate

Deeply flawed health-care bill will raise taxes, unemploy local Congress members

By Mike McGann, Editor, The Times

Having read through the new Republican replacement for the Affordable Care Act, the — the American Health Care Act — I’m left with just one thought:

I guess we’re going to find out how Lloyd Smucker, Pat Meehan and Ryan Costello fare in the private sector if this mess somehow passes through the U.S. House of Representatives.

From the accelerated process to the actual details of the bill, there’s just so much wrong here, its hard to know where to start.

How about here:

If our three local Congress members vote for this mess, they will either lose a GOP primary in the spring of 2018, or lose in the general election in a wave like 2010.

Having read through the information released by the Republican Party — including the 123 pages of the proposed legislation — I have to say this bill is just about perfect: there’s something for everyone to hate. (And, boy, folks have made that clear quickly from across the political spectrum). Watching Speaker of the House Paul Ryan defend it this week, PowerPoint presentation and all, was like watching someone with a severe head injury try to explain quantum entanglement.

As many issues as the ACA has and it needs a lot of reworking, the AHCA — sigh, let’s just call it TrumpCare and be done with it — is vastly, vastly worse.

Short form: it cuts benefits for the poor, boosts premiums on the middle class and older folks and cuts taxes for the rich and corporate America. It does nothing to slow or reverse the spiraling costs of health care or pharmaceuticals. On paper, it is a mess.

But the real world implications are actually worse. I ran the impact on my family — we’re moderately well to do, mostly healthy and have always had health insurance.

As small business owners who are self insured, my wife and I (and our teenage twins) pay around $2,400 a month — not counting ACA tax credits — in our current policy, a “Gold” level policy from Independence Blue Cross and Blue Shield. The net after taxes (both ACA credits and applicable tax deductions) is about $20,400 — an increase over last year with higher deductibles, too — more than our mortgage. We weren’t thrilled with the recent rate increases and co-pay hikes, but sucked it up.

Under the GOP plan, we’d see that yearly subsidy drop to less than $4,000 yearly. And with the removal of the 3x rate provision — health care plans had a limit under the ACA in premiums for older subscribers of 3x that of younger, healthier folks — which now becomes 5x for those of us in the 50 to 65 age group.

So, because insurance companies are insurance companies, our base rate will likely jump from $2,400 to about $4,000 monthly — or maybe more, with the end of the insurance mandate, less healthy, young people will sign up for coverage, further shifting costs on those of us over 50 but not yet eligible for Medicare. With the the reduction in the tax credit, our net comes out to something like $44,000 for the year — or more than twice what we’re paying now.

While Ryan claims magical “market forces” will force insurers to reduce premiums, I’m not buying it. Anyone notice the insurance industry cut pricing before 2011 (when premiums were skyrocketing)? Or in the history of ever? So what do you think is going to happen?

My guess is that a lot of us will be in the same boat and will see sticker shock — whether you get insurance from your employer or on your own — that make last year’s hike look tiny.

I’m not alone in this: the American Association of Retired People (AARP) said pretty much what I’m saying in a letter from Joyce A. Rogers, a senior vice president at AARP, Tuesday:

“This bill would weaken Medicare’s fiscal sustainability, dramatically increase health care costs for Americans aged 50-64 and put at risk the health care of millions of children and adults with disabilities, and poor seniors who depend on the Medicaid program for long-term services and supports and other benefits.”

So, to sum it up, TrumpCare as proposed, could double our premiums, relieve us of some badly needed protections from insurance companies — all while hurting poorer people and putting local hospitals at risk of closing, thanks to less coverage for the poor — meaning hospitals will again be stuck footing the bill for services.

Conservative Republicans (The Club For Growth, Cato Institute, FreedomWorks, Heritage Action for America, Tea Party Patriots and so on) hate it — because it basically uses the framework of the ACA, but a lot less well. Moderates hate it because it means “big league” premium hikes for average to moderately well off families and poor folks hate it because it means for many of them, the end of health care coverage and a return to being back to one health crisis from bankruptcy or homelessness. Liberals hate it because of instead of expanding Medicare as a public option “buy-in,” this goes in the opposite direction and embraces a failed market forces model.

So basically, the House GOP couldn’t have crafted a bill hated by more people — it’s almost an achievement in awful legislation — done in secret and rushed (in a matter of weeks — as opposed to the year it took to craft the ACA — ironically Republicans criticized that process for being too fast). Hilariously, President Donald Trump said Tuesday that there would be a “bloodbath” in the 2018 elections if Congress (read the GOP members of that body, as exactly zero Democrats will support this) doesn’t pass it.

As the bill doesn’t have Congressional Budget Office scoring, we have no formal estimates on how many millions will lose health insurance — there seems to be a growing consensus of its being about 10 million, although some say as many as 15 million. Additionally, it’s unclear how much worse this will make the deficit, but again, it appears likely to have a negative impact, largely driven by the $600 billion tax cut for mostly very wealthy people. Lastly, the bill would also speed up the crisis in the Medicare Trust Fund, making it insolvent by 2025.

You know who will love it, though? The top 1% of earners — they get a big tax cut, estimated at as getting the vast majority of the $600 billion in tax cuts, that beloved deficit ballooning measure  — and Health Insurance CEOs, who will now see much more of their crazy multi-million salaries become tax deductible for insurance companies.

The problem is, though, it is really tough to win elections with 1% of the vote.

I have news for the president he probably won’t see on Breitbart (which also panned the bill, by the way): if Congress passes this mess, they will lose 90% of the suburban house seats they currently hold and lose control of the U.S. Senate, which could make his life rather, um, interesting starting in January, 2019. “Bloodbath” probably doesn’t fully describe that.

Were I advising Meehan, Smucker or Costello — I’d suggest using the right-wing opposition to the bill for cover and oppose it for not being fiscally conservative enough and hope the entire process gets bogged down past the 2018 elections. The choice is to anger Ryan or lose your seat, here. As Ryan helped create this unGodly mess, I’d be picking keeping my seat over kissing the Speaker’s butt.

At least then, they can avoid primary challenges from the right – a real issue for those GOP members voting for this bill, while not taking the fury over lost insurance, higher premiums and exploding deficits.

But to date, they seem to be being good soldiers on Paul Ryan’s legislative Titanic — so now might be a good time to start rehearsing “Nearer to God To Thee.”

Smucker even put out a statement this week, largely in support:

“While more work needs to be done, the American Health Care Act is a good start to ensuring Pennsylvanians will have access to the care they need at a price they can afford. I will work with my colleagues in the House to advance this critical legislation, and will fight for a stable transition to a better system for everyone.”

Costello and Meehan appear to have less to say, understandably, as Meehan serves on Ways and Means, the first committee to approve the bill (I have been unable to find a vote-by-vote breakdown on who voted yes, but it appeared to be a party-line vote) and Costello serves on Energy and Commerce, the second committee to approve the bill (same issue on finding how specifically they voted), it appears both support the legislation, at least moving it forward to a full house vote.

That appears to be setting up a worst-case scenario for the three: an on-the-record vote for this mess that then goes down in flames in the U.S. Senate. For would be challengers, the campaign lit almost writes itself.

So, fellas, best wishes on those private sector careers. I’m sure you’ll find something.

***

Like the villain in a dreary 70s horror movie — it’s back.

State Senate Bill SB 76 — which apparently still hasn’t been filed as yet — appears headed back to save our schools, much like the the Great White shark in Jaws saved those swimmers, by ending the property tax.

It’s died during at least the last two sessions, and rightly so. But this time it appears we’re going to need a bigger boat.

The concept involves a massive net tax hike for most area residents — the school funds will come from sales tax rate increases and being applied to many more products and services, even as property taxes are ended.

As such, it will flatline the state’s struggling economy and dramatically worsen the state’s basket-case finances. It is a giant tax windfall for big business in the state, which already sees some $800 million tax breaks (most of which have proven to be little more than corporate welfare).

Let me be clear on this for you: your personal taxes will go up — a lot — and some fat cat CEO will get an even bigger bonus, while the state economy goes south and you get screwed (again) by the rich and powerful.

And if that’s not bad enough — and if that’s not bad enough, you’re not paying attention or have a single-digit IQ — it would mean that all school funding decisions would come from the state legislature and the governor, those same people who can’t run the state, agree on much of anything or go 20 minutes without some embarrassing scandal or ethical fiasco.

You really want these clowns making decisions about your school district? Do you really want to surrender local control — as opposed to the votes of members of your community, maybe even your neighbors — to let some knucklehead in Harrisburg decide your school’s fate? Didn’t think so and with good reason.

Consider this if this mess somehow passes: if you live in a district with exceptional schools, as many do in Chester County, kiss ‘em goodbye. Also, kiss your property values goodbye, too. Your exceptional schools will become very average (at best) and your $400,000 home will very quickly become a $250,000 home.

Nice.

If you live a funding challenged school district: well, just look at Chester-Upland or Philadelphia for reference to see what it looks like when the state directly funds and manages education.

Let’s be blunt: any local state legislator voting for this mess needs to understand that voting for this is a firing offense. Vote yes and say goodbye to your job, your pension, your career and your reputation.

It’s that simple.

But, maybe, just maybe, they could instead do something smart: like really fix state education funding.

Here’s how to do it: first, let’s get rid of all of the $800 million in corporate welfare — and push that into the state education funding pot. Then, a mild expansion of the sales tax, to include some professional services, such as lawyers, political consultants, and the like. The goal would be to slowly get — on average — 50% of education funding should come from state sources. I would also augment Act 1 of 2006 to require districts to match state funding increases (except for struggling urban districts) dollar-for-dollar back to the taxpayers to cut property taxes.

This way, you allow continued local control by you, the voter, and still cut property taxes. Eliminate property taxes? No. We should all have some skin in the game — and derive benefits (such as property values) from having excellent schools.

SB 76 would do none of these things and is little more than a sham covering a massive tax hike and a state government takeover of our schools.

***

Whether they are encouraging it or not, it appears growingly clear that the Republicans have an aggressive ally in Russian hackers. This week’s revelation that said Russians are holding the IT system for the state Senate Democrats hostage is yet another indication that one party is being targeted and the other, at least covertly, being supported, potentially by the Russian government.

Although there have been a handful of calls for Pennsylvania Attorney General Josh Shapiro to take on investigating the Russian attempts to subvert our democracy, until this happened, with all due respect to Alan Dershowitz, it seemed like a stretch.

Now, though, Shapiro has every reason to dig in and see where this rabbit hole leads, up to and including the White House.

It is high time for him to launch a formal investigation.

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