So Much for “Insurance for Everybody”…

Donald Trump promised “insurance for everybody”:

“We’re going to have insurance for everybody,” Trump said. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” People covered under the law “can expect to have great health care. It will be in a much simplified form. Much less expensive and much better” [Robert Costa and Amy Goldstein, “Trump Vows ‘Insurance for Everybody’ in Obamacare Replacement Plan,” Washington Post, 2017.01.15].

Donald Trump must plan to veto the House Republican health care plan, which will take coverage away from 24 million Americans:

CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under the legislation than under current law. Most of that increase would stem from repealing the penalties associated with the individual mandate. Some of those people would choose not to have insurance because they chose to be covered by insurance under current law only to avoid paying the penalties, and some people would forgo insurance in response to higher premiums.

Later, following additional changes to subsidies for insurance purchased in the nongroup market and to the Medicaid program, the increase in the number of uninsured people relative to the number under current law would rise to 21 million in 2020 and then to 24 million in 2026. The reductions in insurance coverage between 2018 and 2026 would stem in large part from changes in Medicaid enrollment—because some states would discontinue their expansion of eligibility, some states that would have expanded eligibility in the future would choose not to do so, and per-enrollee spending in the program would be capped. In 2026, an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law [Congressional Budget Office, summary of report on American Health Care Act, 2017.03.13].

The Trump Administration is trying to poo-poo the CBO’s well-researched numbers by pointing out that the CBO overestimated the number of people who would get health coverage under the Affordable Care Act.

Um, Donald… (1) that’s not the argument you want to make, because if CBO is making the same mistake here, then they are overestimating the people who will remain insured under your plan, and (2) lower-than-expected enrollment came from employers making good decisions and several states making bad decisions:

The number of people who have signed up for insurance through the health law’s exchanges is lower than expected, in part because employers did not drop coverage to the extent that had been anticipated. In addition, the Supreme Court ruled that states could not be compelled to expand Medicaid — and many Republican-led states did not [Thomas Kaplan and Robert Pear, “Health Bill Would Add 24 Million Uninsured But Save $337 Billion, Report Says,” New York Times, 2017.03.13].

And heck, even if we generously assign the White House some lingering thread of credibility, their calculations show even more people losing coverage than the CBO’s:

According to documents viewed by POLITICO, the OMB analysis intended to assess the coverage and spending outcomes of the legislation.

The analysis found that under the American Health Care Act, the coverage losses would include 17 million for Medicaid, 6 million in the individual market and 3 million in employer-based plans.

A total of 54 million individuals would be uninsured in 2026 under the GOP plan, according to this White House analysis. That’s nearly double the number projected under current law [Paul Demko, “White House Analysis of Obamacare Repeal Sees Even Deeper Insurance Losses Than CBO,” Politico, updated 2017.03.14].

I stand by my three criteria for health care reform: show me a plan that insures more people, provides better care, and decreases how much Americans pay for health care, and I’ll vote for it over the Affordable Care Act. The CBO and the White House apparently agree that the current Republican plan does not meet the first criterion. Trump’s “insurance for everybody” lie is now laid bare.

Trump White House—Home of the Whopper

House GOP, take two?


24 Responses to So Much for “Insurance for Everybody”…

  1. mike from iowa

    Gingrich calls on wingnuts to abolish the CBO.

  2. Better yet. Let’s have Noem explain this since she is all for it

  3. There are two issues here: 1) medical coverage for all Americans and how Trumpcare sets back the gains made by the Affordable Care Act and 2) the MASSIVE tax break to the rich created in Trumpcare – The Joint Committee on Taxation puts the number at almost $200,000 going to each of the wealthiest 0.1%.

    Moving $4 Trillion in wealth to the 1% in 2016 wasn’t enough. Now the GOP with the help of Trump will deny healthcare (including Medicaid cuts) to further line the pockets of the most wealthy.

  4. Big liar, I predict another recession in about 18 months. I also predict this will likely cost him reelection.

    Yep, I’m afraid Trump was just another mean republican after all.
    Republicans just can’t possibly do anything decent for the working poor.

  5. wheres the queens town hall meeting at.guess what the trumpys voted for this.

  6. John Kennedy Claussen, Sr.

    It’s not a health care act, rather it is merely a deficit reduction plan. TrumpCare offers non of the self proclaimed panacea features, that Republicans often advocate, like buying insurance across state lines, or tort reform. And why is this? Because the GOP doesn’t want to save or improve ObamaCare. Rather they merely want to walk from it, in order to give a massive tax cut to the rich, while claiming with crocodile tears that they have saved health care for all Americans, but really in name only…. The AHCA is to the ACA, what the “Coming to America” McDowells was to the real McDonalds….

  7. Darin Larson

    The question is do Trump supporters even care that Trump lied and that millions of people will lose their coverage?

  8. W R Old Guy

    Let us not forget who gets to pay healthcare bills for the uninsured who can’t. The counties and states pick up the tab.

    Moving MEDICAID to a program that provides money to the states with a cap on the amount per individual is supposed to give the states more freedom to manage the program. Guess who picks up the bill if the expenses exceed the fixed rate. We do with higher taxes.

    Speaker Ryan has tried for years to move the entitlements (MEDICARE, MEDICAID, Social Security, etc.) to block grants or privatize them. Note that he likes the part of the CBO Report that estimates there could be a drop of 10% in premium costs and save 334 billion by 2026. He doesn’t want to talk about the uninsured.

  9. Darin Larson

    TrumpDon’tCare

  10. mike from iowa

    What about all those jobs Medicaid expansion created in yer state and others?

  11. O mentions transferring wealth back up the scale, from poor to rich. The poor spend more of that wealth and stimulate the economy more than the rich will.

    Mike mentions jobs created by federal spending (stimulus!).

    WR mentions the cap that will drastically reduce Medicaid spending (which alarms Daugaard but which he has to sugarcoat as deficit-reduction).

    Jenny mentions recession. The evidence to support her prediction is all right here in the repeal of the Affordable Care Act. Trump and Ryan aren’t just peddling bad health care policy; they are peddling bad fiscal policy.

  12. Wildly enjoying the near reality that the morons may soon receive what the voted for. We should not deny them. There is no other way that will force them to see the error of their myths, legends, folklore, and magical beliefs.

  13. magical beliefs… abolish the CBO… such is the nature of the GOP. They don’t want to govern on reason. They want to govern on slogans, impulses, and ill intent toward anyone not like themselves (i.e., rich, white, powerful, Christianist…).

    Research, statistics, and facts need to matter. The CBO exists to provide at least some opportunity to base policy on such things. The Trump Administration just wants to do whatever the heck it wants, without regard to research, statistics, facts, or even the stable, reliable meaning of words.

  14. What really amazes me is the high percentage of people the GOP Party can fool just by telling really big, audacious lies. Nobody’s going to be worse off. Everybody’s going to have insurance. It’s going to be cheaper. Unicorns are going to poop rainbows. 40+% of the public believes the lies.

    Meanwhile, the GOP Party’s base of low to moderate income Christian (many in name only) gun owners remains oblivious to the GOP Party’s main game of massive tax cuts for the rich.

  15. Yoo hoo, all you Trump supporters – where are you, feel free to chime in. (they’re in hiding I guess) Come on, we want to hear from y’all and how great of a plan this is.
    Come on Troy and Ryan Deplorable….

  16. Thune, Rounds and Noem are more worried about their political health and it’s going to cost South Dakotans.

    Check out the map at the bottom of this story that shows the impact or GOP tax that will be levied against SD:
    http://www.businessinsider.com/ahca-obamacare-replacement-winners-and-losers-tax-credits-2017-3

    Add to that a Trump inspired trade war with Mexico and China, a EPA that wants to end the ethanol mandate and roll back CAFE standards.

    http://thehill.com/blogs/congress-blog/energy-environment/323193-scott-pruitt-will-have-to-change-epa-policies

    You really have to wonder who John, Mike and Kristi are working for. Sure doesn’t look like its us.

  17. Right on, Jana. Why aren’t John, Kristi, and Mike holding town halls to hear from their constituents? Come on, Democratic Party, put some pressure on them. If you want to catch John and Kristi for some conversation, they both always show up at the boys state B basketball tournament in Aberdeen on semifinal night this Friday. The PA announcer will let the large crowd know that they are in attendance, so let’s welcome them with some good old South Dakota boos and jeers.

  18. bearcreekbat

    The Republican argument mentioned by JKC –

    TrumpCare offers non of the self proclaimed panacea features, that Republicans often advocate, like buying insurance across state lines, or tort reform.

    – has been around for a while. If I recall correctly Rounds recently used this as a talking point for repeal of the ACA and I seem to recall Thune and Noem making similar arguments.

    Trumpcare addresses neither policy argument because they are “alternative fact” arguments. To the best of my knowledge (please correct me if I am wrong) there are no federal prohibitions in the ACA or otherwise against ” buying insurance across state lines, or tort reform.” These already are, and have always been, matters of state law. Likewise the decision whether to sell in a state is up to individual insurance companies – they simply seek out which states have state insurance regulations that make it attractive for the company to sell policies. As for “tort reform,” each state sets its own laws and rules governing medical malpractice rights and responsibilities. Tort lawsuits have never been a federal issue, rather state laws govern such matters. Indeed, a tort plaintiff cannot even get into federal court absent some unique circumstance such as a diversity claim involving residents of two or more different states, and even in such cases the federal courts are required to resolve the case using state, not federal, substantive law.

    I suppose there is a possibility that Republicans want to take away each state’s individual authority to regulate insurance companies that seek to do business in the state, or force insurance companies to do business in places they do not want to do business, or prohibit the states from establishing state tort and medical malpractice laws. But I doubt whether the state government officials would ever support attempted federal restrictions on the states’ traditional powers.

    As a side note, Governor Daugaard appears to have accurately predicted that Congress would break its Medicaid promises to the states and end the Medicaid expansion. The only problem with making such an accurate prediction is that it did not help South Dakotans in any way that I can see to reject the Medicaid expansion before the Republican takeover in Washington. We could have taken the expansion money and helped poor South Dakotans and the SD economy every single year before the expansion ends. Although Daugaard correctly anticipated the future, his reaction reminds me of the unemployed guy who refuses all job offers because he recognizes he could get laid off at some point in the future.

  19. Roger Cornelius

    It is no wonder that Kellyanne doesn’t want this ridiculous plan called Trumpcare. Should it be passed, that is exactly what it should be called as a daily reminder of the new death panel.

    There were numerous debates with a lot of republican in-fighting this morning on CNN about healthcare and the rising opposition from republicans in both the House and Senate.

    To the heart of the matter is whether the House will have enough votes to pass this hate bill and even a lesser chance to pass it in the Senate. Speaker Ryan seems to be backing away and McCain and Graham in the Senate voicing their strong opposition. It is time to start counting the votes republicans have or don’t have.

    Is this trump’s “Beware of the ides of March”?

  20. I work at a hospital. And most hospitals wouldn’t want to deal with insurance across state lines. Because every time a patient comes in with a new insurance company, the hospital has to fill out a mountain of paperwork just to ‘maybe’ get a payment for that patient. Most of the time it isn’t worth the headache. So selling insurance across state lines doesn’t really benefit the patient as the hospital will be out of network.

  21. bearcreekbat

    Mike J, can you help clarify what the phrase “insurance across state lines” means? What are the characteristics of the insurance companies that a SD hospital would consider to be “insurance across state lines?”

  22. barry freed

    MF Iowa.
    We never had Medicaid Expansion, hence no jobs to lose to the Expansion.

    Ed,
    re: calling all Democrats…
    Tom Dashcle is a Democrat, supposedly versed in Health Care, but he is too busy planning how to spend the $200,000 he will receive. He can’t even be bothered to write a 200 word op-ed for the papers. Does he still get free healthcare too? Don’t hold your breath for leadership from Multi-Millionaire Democrats who hold office and have never had a private sector job, except as a Washington Lobbyist. They too, having never gone without, cannot empathize with, or relate to, those who work for a living.

    The disconnect, or will to lie, was evidenced by the: “People need to put off that new iPhone and buy health insurance”. That is significant lack of thought, or do some people buy a new iPhone every month? …and where do we get that $700 per year health insurance? I want some of that.

    I called the RC Journal’s Two Cents to say: “The CBO was off on the count of sign ups because of States like South Dakota that didn’t expand, or had so few choices that it was still not affordable for millions. Republicans use the results of their own sabotage of the ACA as a weapon to criticize the CBO and the “Media” allows these politicians to use this false logic with impunity.”

    Republican and Democrat leaders drink the Kool-Aid of the American Dream. They have it, they make sure their friends and family have it, and they can’t comprehend that nearly all young people do not, and will not, ever have it. The young recognize that no matter how hard they work, or how lucky they get, they will not do as well as their parents, of whom did not do as well as the Greatest Generation. These politicians can’t see that we will eventually give up, and without the worker bees, the hive won’t have tax cuts to give the rich.

    A pres nous, le deluge: After us, the flood.
    What the thousands of Nobles said to each other in the lead up to the French Revolution. While The People starved, the Nobles would eat the finest and richest food, drink the best wine, then regurgitate and do it all over again, 24/7. The French People were starving and “let them eat cake” is akin to American Nobles in Congress saying: “just buy health insurance instead of a new iPhone”. They can’t comprehend that those working for minimum wage, can afford neither.

  23. mike from iowa

    Barry you are right. Numbnuts Veep Pence talked Daugaard out of expansion because of repeal and replace. The problem I see is now Americans have seen the wingnut ckuster- and a majority already wanted Obamacare to be fixed, they know which plan to repeal and that would be the ginormous cluster wingnuts call Screw America or whatever it actually is called-Trumpdon’tcare, maybe.

    So them expansion jobs are probably just on hold.

  24. Mike J offers a good practical reason to reject the “sell across state lines” fantasy: hospitals, just like insurers, don’t want the hassle.

    Barry, true, we haven’t expanded Medicaid yet, but if we kept the status quo, the Democratic Governor we elect in 2018 would… or Governor Daugaard would do it sooner by pressuring legislators to look at the expansion’s stimulatory effect as a way to reinvigorate our flagging economy and sales tax revenues. We are thus losing an opportunity for stimulus, job creation, and better health care and trading it for a Trump plan that will take even more money out of our state budget.