At least Congresswoman Kristi Noem and her fellow Trumpublicans are going big on their upward wealth distribution. Instead of nickel-and-diming us to death, they’re 1,700-dollaring us to death. Noem remains coy about the Republican border adjustment tax, which the Club for Growth says will cost middle-class families $1,700 a year. But Noem is full-throatedly in favor of the GOP health care plan, which will cost people currently covered by the ACA another $1,700 each year:
The House Republican health plan would give consumers in the health insurance marketplace nationally an average of $1,700 less help with premiums in 2020, compared to the ACA’s premium tax credits, according to the Kaiser Family Foundation. The losses would be larger for older and lower-income consumers, and lower-income consumers would also lose help with deductibles and other out-of-pocket costs. Consumers’ costs would probably increase even more than tax credits would fall, since the House plan would likely cause individual market premiums to rise [Aviva Aron-Dine and Tara Straw, “House Tax Credits Would Make Health Insurance Far Less Affordable in High-Cost States,” Center on Budget and Policy Priorities, 2017.03.09].
That’s $1,700 in increased out-of-pocket costs on average. According to the same source, South Dakota is one of eleven high-cost states where Kristi and the Trumpublicans will axe tax credits by more than $3,000.
Nineteen of the twenty states losing the most Affordable Care Act assistance in buying individual market insurance all voted for Trump.
And these losses are just the premium tax credits the GOP will cut and redistribute to richer policy buyers. Noem’s health care plan also eliminates the ACA cost-sharing subsidies that reduce out-of-pocket costs for folks earning 100% to 250% of the poverty level, eliminates small-business tax credits, and allows insurers to charge older folks two-thirds more than the ACA allows*. The Trumpublican plan also shifts $370 billion over ten years in Medicaid costs to the states. That’s $253 billion cut from Medicaid expansion, likely forcing most expansion states to drop that ACA benefit, and $116 billion in new per capita caps cutting funding for seniors, people with disabilities, and families with children in all states. The proceeds of these cuts would mostly fund tax cuts for the rich.
The per-capita caps are supposed to make already lean Medicaid more efficient… yet Noem and her Republican colleagues have no problem allowing private insurers to become more inefficient by allowing insurance companies to deduct more of their executive pay and benefits as business expenses. The ACA capped those executive-compensation deductions at $500,000, encouraging insurers to sink their money into more customer-oriented expenses.
I look forward to Congresswoman Noem’s town halls when she explains to real live South Dakotans the merits of paying more for insurance.
Related Reading: Douglas Wiken spotlights conservative commentator David Brooks’s critique of Noem/TrumpCare. Brooks writes in the New York Times that TrumpCare will kick ten million people off their health insurance, increasing “fear, isolation, social tension, chronic illness, suicide and bankruptcy.” Brooks suggests that the failure of the Noem/Trump plan may finally provoke voters to “destroy market mechanisms to get the security they crave.” Bernie Sanders 2020, anyone?
Update 08:46 CST: Charlie the Squirrel and AARP agree that the TrumpCare Age Tax deserves the ax: