GOP "Skinny Repeal": A 'Trojan Horse' To Screw 16 Million Out Of Their HealthCare

"Yeah, we gonna sneak this skinny plan through when folks least suspect it!"

As Mitch McConnell's  ACA Repeal "Vote A- Rama" continues, assorted lone voices in the wilderness have tried to warn sane citizens not to mark victory too early. They point to McConnell and the GOOPs pushing a series of "mini-bill" votes through until a conference with the House can get the final job done - likely by 51 votes to 50 (Pence casting the tie breaker then relatively fast reconciliation with an earlier House bill). An end game that will emerge as a classic Trojan Horse move, as even the GOOPs now admit (see link at bottom).

Yes. it is true that yesterday a vote to "repeal and delay"  failed by 55-45 with 7 Republicans joining with Dems to reject the bill. This is the same ill-advised plan that had been favored by small-government conservatives, such as Rand Paul from Kentucky, who have been clamoring to repeal the law for years. The CBO estimated that 32 million people would lose health insurance over the next decade under this plan compared to current law.

So no wonder seven Republicans found their sanity long enough to reject it. But the $64 question is whether they can continue to do so as McConnell pushes the iterations toward "skinny repeal".

To set the legislative scene again: one  day after the Senate narrowly voted to open debate on repealing the Affordable Care Act (ACA) despite not knowing where it would lead, the so-called “skinny repeal” seemed the most probable of a number of options for the repeal or replacement of the ACA to succeed.

How or why is the skinny repeal a Trojan horse?

The “skinny repeal” would eliminate the individual mandate, the least popular provision of the ACA that requires all Americans to have health insurance or face a fine. It would also remove the employer mandate, requiring certain businesses to provide health insurance to employees, as well as a tax on medical device manufacturers. But, importantly, it would not touch the Medicaid program for the poor.  The danger here ought to be automatically evident to everyone as we note these aspects:

i) This cowardly mutant would barely meet the definition for "repealing Obamacare" and hence is most likely to get most small -c conservatives on board to vote for it.

ii) The Republican moderates - like Susan Collins and Lisa Murkoswki - would probably come on board because Medicaid would be left alone.

This means the "skinny repeal" has a damned good chance of being pushed through at the last minute.

Let's pursue this further.   If this measure passes the Senate with a simple majority, it would likely then enter a conference committee with the House, where Republicans could reconcile the differences and produce a larger repeal-and-replace measure later.  They could immediately claim 'victory' and that they succeeded in what they set out to do: repeal Obamacare (at least minimally).

Let's further observe that the Democrats are largely unable to stop this bill from moving forward. Saddled with only 48 votes (two of them - Angus King of Maine, Bernie Sanders of Vermont, independents) the party has remained united in opposition to any measure that would repeal the law, but has enjoined Republicans to work with them on solutions that would stabilize the insurance markets and lower premiums.

But as Republicans continued to work their way through a planned 20 hours of debate and prepared to vote for a series of amendments in the so-called “vote-a-rama”, it is still  unclear whether anything would be passed by the deadline of the end of this week set by the Senate majority leader, Mitch McConnell.  But what I am saying is don't put anything past McConnell to pull out all the stops to get it done.

This is exactly why Democrats have urged  ACA activists to continue putting pressure on lawmakers as the Senate enters the final, frenetic push toward repeal. For months, voters and activists have inundated the telephone lines of Republican lawmakers and protested at their offices and even some of their homes.  Up to now it has worked, but the key issue now is whether it will be sustained into the most critical '4th quarter'.

At a Planned Parenthood protest on the Capitol lawn Wednesday evening, Democratic lawmakers laid out the stakes.   Senator Kamala Harris, a Democrat from California, told the crowd:

"Keep doing your thing!. Keep being you. Keep doing what you’ve been doing because it’s working and it matters and it counts.”

"Thirty-six hours,” she added, referring to the amount of time left before the repeal vote.

“So let’s keep calling. Let’s keep tweeting. Let’s keep writing. Let’s keep marching. Let’s keep shouting and we will win."

And what happens if "we" don't win and McConnell sneaks this revolting bill through? Well the consequences will be too horrific to contemplate.

The insurance markets would be roiled beyond belief, namely for people in the ACA exchanges.  Basically, minus the mandates, health care hell breaks loose. First, faced with a 20- 25 % spike in premiums even from next year, many will simply bail out.  These will likely be people who want insurance but feel they can't afford the increases. Their only option if seriously ill will be to visit ERs - jacking up even more expanses on the system.

Then, with no mandate or penalties hanging over their heads, the younger, healthier people will simply opt out of insurance altogether.  They will believe they don't need it, so why pay hundreds a month especially when they have college loans to pay off. This, logically, will leave the remaining insurance pool (again in the exchanges) older and sicker.

Such a trend - and it is expected to become a trend - will clearly  freak out insurers.  Facing the loss of the relatively healthy - who ordinarily would have helped pay for sicker citizens - the insurers will simply do what they did before the ACA and jack up premiums for everyone in the "sick" pool.  The federal government would then spend more providing subsidies to people who buy health insurance on their own - but save money by not providing subsidies to those who bailed. In other words the proponents of the bill - like Ted Cruz - are betting on the healthier folks bailing to save money to provide subsidies for those who buy their own.

Other adverse consequences are also projected. For example, with far more people uninsured, hospitals would be on the hook to provide  more care that they don't get paid for. Again, this would be mostly via ER visits by those with no insurance.   This will definitely threaten many hospitals' ability to stay open.

All in all, the "skinny" repeal, if pushed through and passed via a conference gambit, would be just about the worst calamity to happen to this nation's health care.

See also:

Republicans admit it: 'Skinny repeal' is a Trojan horse to turn Trumpcare over to the House

Update:

Thanks to Sen. John McCain (recall he was insulted during the '16 campaign by Trump as not being a 'real' war hero) the skinny bill has been sunk into oblivion. Along with Senators Lisa Murkowski (who Trump tried to blackmail into voting for the bill) and Susan Collins, McCain provided the needed 3rd opposition vote to deny the Reeps the 'skinny' majority (of 51) to pass it.  You can read more here:

http://www.bbc.com/news/world-us-canada-40750071

Another GOP Stealth Bill Moves Toward Passage - While We're Distracted By The Senate Health Bill

You have to hand it to the Machiavellian Repukes who love to make legislative moves of a dastardly nature, and now more covertly than ever before.  This is especially true with the cynically named 'Better Care Reconciliation Act. of 2017.'   which has now been scored by the CBO.  Let's also note that  the Director of the Congressional Budget Office is  Keith Hall - a card carrying Republican - not a Dem!  This is important to reference as assorted 'pukes try to blast Hall's report as "inaccurate" or "incomplete".

What the CBO scoring found is that an estimated 22 million Americans would lose their health insurance under the "Better Care" Act the Senate GOP is trying to foist on the country.  Worse, no fewer than 15 million would lose out next year alone. How would this occur, by what processes? As noted on p. 8, the biggest attrition would arrive by massive increase in deductibles for low income people.   Thus, a deductible soaring to $10,000 a year for a low income family would mean they simply wouldn't purchase health insurance, hence they'd be left out in the cold - with the only option to go to ERs.

The other aspect concerns the soaring premiums which the CBO report estimates will spike as much as 74 percent.  While the "individual market" premiums would average about "20 percent lower" this is precisely because these markets would be composed almost entirely of the young and healthy who'd make few annual health visits or exact much cost.  Meanwhile, older Americans - say 64 years of age and earning $56 k/yr. - would see their premiums go to $16,000 year from $4,400 currently under the ACA formula.

The 74 % premium  increase figure outside the individual market is based on an 'apples to apples' comparison between what ACA covered citizens have now and what they'd get under "Trump Care".  To fix ideas, if ACA insured folks (say for a family of 4)  are currently paying a $500 a month premium they'd pay $870 if the GOP "Better Care" scam passes.   This spike would also clear many off health care rolls, which is exactly what the GOP's free market denizens hope for.

Left unreferenced amidst all the distraction with the "Better Care"  bill is how another disastrous GOP stealth regulatory bill is working its way toward manifestation. This "Financial Choice Act" - so called-  would give Trump the automatic power to fire the heads of the Consumer Financial Protection Bureau (CFPB) and the Federal Housing Finance Agency.  The former keeps oversight over the behavior of players in the financial market place to ensure they don't screw you, overcharge you for services or unload Ponzi schemes masquerading as proper investments. The latter oversees Fannie Mae and Freddie Mac, which oversees housing matters to ensure consumers aren't buying bogus mortgages, overpaying in interest or processing charges and generally ensuring that realtors, sellers are abiding by the laws.

This "Financial Choice Act" - unknown to most - also gives congress the power over the Consumer Financial Protection Bureau's budget,  which means lawmakers could defund the agency entirely.  In other words, it would literally give Trump and the GOP congress absolute power to wreck consumers' credit and financial stability - by leaving them open to all manner of shyster exploitation with zero protections.  (The CFPB has cracked down on debt collectors, the credit card industry, payday lenders, for profit colleges, banks and mortgage lenders)

For reference, in the past six years the CFPB has provided nearly $12 billion in relief for more than 29 million consumers - many victims of financial or credit card scams. Trump and the GOP may sympathize with the plight of possible future shyster victims, but the bottom line is that they don't want to shell any money out to victims.   Recall here that the CFPB was created out of the Dodd-Frank banking legislation to enforce federal consumer financial laws and protect consumers in the financial marketplace.  The agency's main goals have been to:

- Root out unfair, deceptive or abusive practices by writing appropriate rules, supervising companies and enforcing laws.

- Solicit and respond to consumer complaints.

- Enhance financial education.

- Research consumer experiences for assorted financial products, e.g. annuities.

- Monitor financial markets for new risks to consumers.

All of these have been found to be more than warranted, which is why the CFPB reaped $12 billion in relief for more than 29 million consumers the past six years. Had the assorted financial outfits been adhering to the existing laws the CFPB would not have been needed by all those citizens. The fact that 29 million got screwed shows the need for thorough regulation and an agency to oversee such. That Trump and the Republicans would destroy this agency shows they have no more concern for the financial welfare of their voters than they do for wayward bugs that might invade their vacay homes.

Section 841 of the Financial Choice Act has been particularly noteworthy in its potential to undermine and overturn the interests of investors, especially retirement savers.   Under Sec. 841 the Labiior Department's fiduciary rule would e repealed. To refresh memories, that rule stipulates that anyone handling retirement assets - and gives financial advice to savers - has a duty to work in their clients' best interests and disclose any conflicts where and when they exist.   By Jan. 1, 2018, under the impetus of the GOP's Sec. 841 of the "Financial Choice Act", the fiduciary rule will no longer likely to be enforced.

If your financial planner doesn't inform you of his conflicts, or takes you for a ride by selling you some mutual fund that is front loaded with fees he can make $$$ off of, it's all on you. Added to your new healthcare spiking premiums, welcome to Trump World, Year II.

This elicits the question of what new nightmares await us next year compliments of Trump and his Reptiles.

Neolib Hack Robert Samuelson: Determined To See Oldsters Eating Cat Food!

"What's happening is simple: Spending on the elderly is slowly overwhelming the rest of the federal government" - Robert Samuelson

Well, seems that columnist Robert Samuelson is at it again, beating the drums for elderly austerity and more money for the war machine. It seems this guy never gives up. He's thoroughly Neoliberal after all, having committed himself for years (even in a response email to me some 7 years ago) that no one ought to be receiving money just for breathing. (As most seniors do).

In his latest screed ('The Twisted Priorities of a Graying Nation') we're informed "government is being gutted" and "priorities are being skewed" by a reckless,  profligate over-spending on the elderly. Meanwhile, spending is behind on "vital activities" like defense and financial markets - he references their "regulation"- but if you've read any of his past articles it's really about their expansion, i.e. using further globalization such as the TPP. He and we know the GOOps will never allow more genuine financial regulation, especially as they already killed what was left of Dodd-Frank  in the 2014 end of year spending bill. (This was via a poison pill amendment that was stuck in the spending bill, enabling the banks to once again use FDIC monies to back up their risky trades - leaving us open to another 2008-style meltdown)

As usual he harps on the CBO projection that annual federal spending will grow by $2.6 trillion or 75 percent from 2104 to 2025 and "almost 90 percent of the increase comes from three sources: Social Security, health spending and interest on the federal debt."

Why he includes Social Security is mystifying for a number of reasons, including that Social Security. has never added to deficits given its payroll taxes essentially more than fund its outlays. Right now, in fact, the size of the S.S. Trust Fund is at $2.74 TRILLION which exceeds the $2.6 trillion Samuelson cites as federal spending for S.S., healthcare and interest on the debt! And we're not even including  as S.S. revenue  the taxes on Social Security income which none of these austerity nabobs factor into the mix. Namely, that up to one third of your Social Security benefits can be clawed back once you exceed a specific threshold. Why do none of the austerity fetishists mention that? Well, because it inveighs against their "entitlement" cutting agenda!

Meanwhile, a large part of health care spending is on prescription drugs, a little problem that could easily be remedied by allowing Medicare to do what the VA does, and bargain for the lowest drug prices with PhRMA.   As for the large federal interest on the debt, any moron could have informed Samuelson that the main reason for that is too little income, as in revenue - for all the spending that's being done - mainly on the military since 2001 (When ol' Gee Dumbya decided to cut taxes instead of increasing them when he commenced his "war on terror" - that's now sucked up 13 years and nearly $4 trillion)

Samuelson goes on to whine about "the degradation of government"  and points to the National Institutes of Health "losing nearly 25 percent of its purchasing power" in the last decade. Well, whose fault is that, Maestro? It's the fault of the Repukes who cut the NIH (as well as CDC) budgets which money they preferred to spend instead on military toys like the F-35!

In the same breath he also reports:

"The Internal Revenue Service blames budget cuts and reduced staffing for delays in mailing refunds and responding to taxpayer questions"

But again, this wasn't incepted by Social Security but by the Repukes cutting the IRS budgets as "payback" for what they believed to be singling out right wing groups for greater scrutiny, i.e. when claiming any tax exempt status under Internal Revenue code 501(c)(4). As a result, the 'Pukes cut an additional $346 million from the taxman's budget - virtually tying the IRS' hands to assist taxpayers or to expedite refunds. See e.g.

http://brane-space.blogspot.com/2015/01/if-youre-late-getting-tax-refund-thank.html


Samuelson then rightly wails about the "national parks being hit..since 2010 their funding has decreased by 12 percent in inflation-adjusted dollars and the backlog of deferred maintenance has topped $11 billion."

Again, this awful, deficient funding situation has nada to do with Social Security but the same House Republicans and their cruel austerity punks who also de-funded the SNAP food stamps program in 2013 and want to do the same again now. Don't blame the favorite scapegoat of Social Security but rather a bunch that has its own priorities askew and would ten times rather spend on defense and war toys (now taking up 6.3% of GDP) than domestic programs - including out infrastructure which is falling apart.

Instead of lying his ass off about the need to cut Social Security - making it a red herring for Neoliberal austerity groups like "Fix the Debt" he ought to applaud the program's expansion which - if effected- could ameliorate the ongoing low aggregate demand problem that's keeping our economy down. The solution then is not less senior capacity to spend, but MORE! The more senior spending on goods, services - even health care- the more money infused to create more jobs!

But never mind, Samuelson and his ilk won't be satisfied until the elderly are on a permanent cat food (or kibbles) diet!

See also:

http://brane-space.blogspot.com/2011/05/is-robert-samuelson-for-real.html

and:

http://www.smirkingchimp.com/thread/richard-eskow/60951/the-republicanclasswars-new-front-social-security-for-the-disabled

Democrats Must Stop Playing Politics with the Bush Tax Cuts

The just-released Congressional Budget Office (CBO) report on projections of federal deficits over the next ten years was both infuriating and stomach-turning. It also reinforces David Wessel's WSJ column today ('Tracking Missteps Behind World's Economic Slump', p. A4) that "The U.S. government - congress and the White House- has an incoherent fiscal policy".

By that he means that half the time they blabber about "the risk of rising deficits", but on the other hand seek to make them much worse - such as extending the Bush tax cuts for all back in December. The other half of the time they blabber about "fiscal support" and creating jobs, but then set in motion immediate austerity and spending cuts measures that will have exactly the opposite effect. In any other universe, this behavior would be regarded as the evidence for insanity.

Anyway, the CBO sharply reduced its projections of total deficits over the next decade- reduced to $3.5 trillion up to 2021, BUT with major provisos and qualifiers. The biggest one is that ALL the Bush tax cuts will finally be allowed to expire next year as opposed to once again being re-animated like the Zombies of the 'Walking Dead'.

If this isn't done, and Obama and the Dems punk out again by playing politics (e.g. demanding the tax cuts be extended "only for those earning $250k and under") then we are in deep shit. The CBO then projects $5 trillion additional be added to the deficit to make a total of $8.5 trillion by 2021. Of course, honing in on the fine details not all the $5 trillion would arise from extending all the Bush tax cuts - it would more be like $4 trillion. The other $1 in deficits trillion would come from:

a) not stopping the payroll tax cuts ($115 billion each year, for a total of $230b over two years)

b) Allowing "doc fixes" each year for Medicare, so providers aren't dinged by payout cuts, leading them to dump or deny Medicare patients ($200b)

c) Not getting out of Iraq and Afghanistan by 2014.

The worst travesty of all would be that none of the painful forthcoming $1.3 trillion in spending cuts (due by end of Nov.) will lead to a 'savings' if the Bush tax cuts are re-animated again in December. Doubling down, the higher deficits would bring total public debt to 82% of GDP by 2021 up from 23.8% this year, according to The Wall Street Journal (p.A4)

Most interesting to me, was the same Journal piece noting that revenues were down to historic lows of 15.3% of GDP this year, compared to 18% of GDP historically. Clearly, this shows the need for higher revenues in taxes (at the very least repealing all the Bush tax cuts). Yet oddly, in its editorial ('What Austerity?") the Journal's brain trust makes the claim that not extending the Bush tax cuts would have a deleterious effect on jobs!

And yet the historic evidence shows this to be palpable bullshit. So, the Journal editors can say "Beam us up, Scotty!" all they want (ibid.), but THEY are the ones who need beaming up! I mean, they already conceded (even in the editorial) that revenues are at historic lows! Well, then get rid of the Bush tax cuts, which I for one do not regard as a real tax hike but rather returning to tax normalcy.

It would bring us back to the marginal rates of 39.5% in the Clinton era, during which 20 million decent jobs were created, and more importantly, people feltwealthier. (And this wealth effect was a major reason Clinton's impeachment proceedings over the Lewinsky indiscretion didn't get very far.)

Further, as economists James Medoff and Andrew Harless observed in their excellent book, The Indebted Society, 1995, p. 84, 'Let Them Eat Cake',

"high tax rates are associated with higher productivity growth"

There is a consistent and strong relationship. By contrast, for the years when Arthur Laffer's supply side dogma held, productivity retreated by more than 30% and debt exploded- exactly the opposite of what we've been sold. The classic example was the Reagan era for which Medoff and Harless note (p. 23):

"For the health of the economy, Reagan's policies turned out to be just about the worst thing that could have happened: investment did not increase, growth continued to stagnate, and the federal deficit ballooned to new dimensions."

Meanwhile, a more recent Financial Times Analysis of the Bush tax cuts (9/15/10, p. 24) passed in 2001 and 2003, showed they engendered "the weakest decade in U.S. postwar history for real, non-residential capital investment".

The FT analysis also observed that “during each decade from the 1950s to the 1990s, growth in real gross non-residential investment averaged between 3.5 percent and 7.4 percent a decade. During the 2000s it averaged a mere 1%”

This is evidence enough that the Democrats have to stop playing politics with these god damned tax cuts! It isn't good enough to simply pout and whine (as one D-congress critter recently, in an MSNBC interview): "We can't figure out a way to get ahead of the no tax narrative!

Well, too fucking bad! Figure out a way! What are you, imbeciles? Do you need brain transplants?

Start by leveling with your constituents that they can have either tax cuts delivering maybe $400 a year at most now, or their Social Security and Medicare later! BUT ..if they opt for the tax cuts now, they can't depend on getting their benefits later! They can't fucking have their cake and eat it!!!

Got it?

This is not brain science, or rocket science. We're not asking you buttbrains to delineate a trajectory to Mars for a 9-month trip and a payload weight of 20,000 kg. All we're asking is that you craft an efficient and convincing comeback to the Reptiles 'no tax' bullshit and STOP playing into their hands. This you did - whether you realized it or not, when you conceded to allowing "some" tax cuts to go through but not others. You are then defeated! Or, when you blather for a payroll tax cut or holiday when THAT is what helps pay FOR Medicare and Social Security! (Besides which, the evidence so far shows no signficant economic benefit from the payroll tax cut of 2% (WSJ, p. A4, op. cit.).

When the Dems wake up they might be worth more in the way of support. Until then I have to regard them as clueless, incoherent losers - politically deaf and dumb- and who will continue to be beaten like orphaned whelps by the Repups.