Last Thursday, U.S. Senate Majority Leader Mitch McConnell (R-Ky.) unveiled the latest Trumpcare bill. There aren’t enough Republican Senators who support this latest version. McConnell has now scheduled a vote on outright repeal of Obamacare for “early next week.”
Drastic Virginia Medicaid cuts
The most remarkably bad thing about Trumpcare is its persistent focus on drastically cutting Medicaid benefits. The per-capita caps would cost Virginia’s Medicaid program at least $1.4 billion over seven years.
U.S. Sen. Mark Warner (D-Va.) previously blasted these cuts:
Virginia historically has run one of the leanest Medicaid programs in the country…. But as a result of the steep cuts to Medicaid in Trumpcare, Virginia would be forced to pick up an additional $900 million in costs for Medicaid over the next ten years in order to maintain the same level of care.
Virginia Republican legislative leaders already are on record condemning these cuts: “Proposals to impose per-capita caps on federal Medicaid spending would put Virginia at a severe disadvantage.”
U.S. Sen. Susan Collins (R-Maine) aptly summarized what’s wrong with her Senate leadership’s approach:
We should not be making fundamental changes in a vital safety net program that’s been on the books for 50 years, the Medicaid program, without having a single hearing to evaluate what the consequences are going to be.
Virginia children disproportionately harmed
The proposed Medicaid cuts would particularly harm Virginia’s children:
The bill would have a disproportionate effect on children, who make up about 60 percent of Medicaid enrollment in Virginia. During the 2014-15 school year, the most recent year for which data is available, Virginia school districts received $33 million in Medicaid reimbursements.
Virginians with pre-existing conditions lose coverage
The latest Trumpcare bill contains a new provision (the so-called Cruz amendment) that major health insurance companies say is “simply unworkable.” It would deny coverage for pre-existing conditions and de-stabilize insurance marketplaces in Virginia and across the nation:
The protections for preexisting conditions are gone. The GOP vision is of health markets where the very sick can buy unaffordable Obamacare-compliant plans that are, maybe, made affordable by subsidies, but most people are back in an insurance market where past allergies or future pregnancy or a history of knee problems will leave you basically uninsurable.
Republicans and Democrats remain divided over their contrasting degrees of respect for the principle of mutual obligation:
If [Trumpcare] passed, the Republican reform would eventually return the country to a system a lot like the one in place before the A.C.A., when older people, sick people, and the working poor struggled to find coverage–or went without.
Supporters of Trumpcare claim it would enable everyone to have access to affordable healthcare. But, the truth is that only those wealthy enough to pay would have access to meaningful healthcare.
Repeal of Obamacare without a replacement would be even worse. The Congressional Budget Office estimated that repeal would cause the number of uninsured people to rise by 18 million next year and by 32 million by 2026.
Both approaches are bad.
U.S. Sen. John McCain (R-Ariz.) has issued a call for a fresh, bipartisan start for healthcare reform. He’s right.
Responsible Republicans and Democrats now should join together to hold open and thoughtful public hearings to fix those parts of Obamacare that need fixing.