The Militant (logo)  

Vol. 81/No. 14      April 10, 2017

(front page)

Medicaid support, Republican splits sink
‘Trumpcare’ plan

Amid seemingly unbreachable divisions from both the conservative and moderate wings within the Republican Party majority in the House of Representatives, President Donald Trump’s plan to repeal the Affordable Care Act, commonly known as Obamacare, was pulled from consideration right before the scheduled vote March 24.

The Trump administration’s bill, like Obamacare, is not based on providing health care for all who need it, but pressuring more people to purchase health insurance, with rising premiums and deductibles for plans that offer less and less coverage. All these moves aim to maximize the superprofits of insurance, hospital and pharmaceutical companies.

The setback for Trump and the Republicans reflects the broader problems the propertied ruling families have today — especially the crisis wracking both of their political parties, the Democrats and Republicans. The Democrats are in shambles while the GOP thought they had papered over their differences by Trump winning the White House. The failure of the health insurance bill showed the crisis they continue to face.

One of the central issues Trump campaigned on was the inadequacies of Obamacare. But his proposed bill offered no alternative for working people to the unpopular one in effect now.

Instead of requiring individuals without health coverage to pay an annual “tax” of more than $2,000 per year per family — one of the most hated aspects of Obamacare. Trump’s plan extends tax credits to people who buy insurance.

Anyone who lets their insurance lapse for more than a couple of months would have to pay a 30 percent surcharge to the insurance company, on top of their premiums, to get a plan.

The overall impact of the Trump administration’s proposal would have been to increase the number of people without health care by 24 million people, the Congressional Budget Office said.

If left in place, “health insurance rates under the Obama administration’s un-Affordable Care Act will rocket between 30 and 60 percent in many states in 2017, and some 1.5 million working people will lose the plans they’re currently covered by,” Steve Clark writes in his introduction in Pathfinder’s The Clintons’ Anti-Working-Class Record: Why Washington Fears Working People by Socialist Workers Party National Secretary Jack Barnes.

The capitalist rulers aim to pit younger against older workers for what they claim is a “shrinking pie” for health care costs. Obamacare was designed to force young people, who use less health care, to buy it to create a bigger “pool” for the insurance bosses. The Trump plan aimed to make older people pay more, because they’ll likely use more.

After Trump pulled the bill, he said Obamacare would become a bigger disaster and everyone will demand change. One thing is for certain; working people will have to pay more for less.

These rising costs leave many workers with the cheapest, most shoddy plans, forced to pay thousands of dollars in annual deductibles before any insurance kicks in. And under Obamacare 28 million people remain without any coverage.

At the NorthCrest Medical Center in Springfield, Tennessee, for instance, nearly 90 percent of people with private insurance end up paying 100 percent of medical costs, Randy Davis, the hospital’s president, told the Financial Times. “They don’t hit their deductible when receiving an MRI, a CT scan, when they’re here for a $500 colonoscopy,” he said.

Attack on Medicaid entitlement
Trump’s health care proposals included steep cuts to Medicaid, enacted as an entitlement program in 1965, a result of the massive Black-led proletarian struggle that eliminated Jim Crow segregation. It provides medical care for workers with the lowest incomes and the disabled. It currently covers more than 70 million people.

During the election campaign Trump promised not to cut Medicaid, but his administration’s final proposal involves the biggest structural alterations to the program since it was created. Block grants would replace federal matching funds. States for the first time could impose work requirements, drug tests, or place a cap on the number of years a person could be covered by Medicaid.

Some of these proposed attacks were the result of demands made on Trump by members of the House Freedom Caucus, a group of some 35 conservative House members, many elected pledged to the Tea Party.

More importantly, a number of Republicans felt pressured to oppose the attacks on Medicaid in the bill, at a time when the carnage being visited on working people by the crisis of capitalism is deepening. Medicaid covers health care for one in five people in the U.S., including four of 10 children, nearly half of all births, and the cost of care for two-thirds of people in nursing homes.

Medicaid is widespread and popular. Two-thirds of everyone in the country — over 215 million people — either are covered by the program or have family or friends who are.

“I was not willing to gamble with the care of my constituents,” Rep. Frank LoBiondo, a Republican from New Jersey said, reflecting fear of the political price he would pay if he voted for the bill.

Many Republicans opposed the bill because they said its cuts would deepen the opioid epidemic ravaging their districts.

Workers are facing rising “deaths of despair” from deteriorating health care compounded by the unavailability of full-time work, a report issued March 23, by two Princeton University economists says. The study describes rising mortality of Caucasian men and women ages 45 through 54, from suicides, drug overdoses and alcohol-related deaths. In 2015 overuse of opioids killed more than 30,000 people in the U.S.  
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