Where the AHCA will (hopefully) die a profound death.
I called Congressman Gallagher's Washington, D.C. office this morning to voice my opposition to the AHCA. I also sent him a letter:
Dear Congressman Gallagher,
I called your Washington, D.C. office earlier this morning regarding the American Health Care Act. When I called in, I voiced my opposition to this bill as one of your constituents. I would like to take this opportunity to expand upon my reasons for opposing this bill.
Any bill that bill result in 24 MILLION Americans losing their health insurance over the next 10 years should not even be considered by the leadership of either party. This bill will hurt real people of all political persuasions and incomes. The only Americans this bill does not hurt are those who are wealthy enough to self-insure or some members of the upper-middle class who have good health insurance plans through their employers.
As to the Affordable Care Act (ACA) exchanges: There are many people who rely upon the health insurance policies offered through the ACA insurance exchanges and the subsides made available under the ACA to pay for those policies. If the AHCA succeeds, these people will have the following options, none of them good: 1) hope that their employer offers group health insurance coverage, hope that they are eligible for enrollment in that plan (under their employer's coverage eligibility guidelines), AND hope their employer does not discontinue offering health insurance coverage altogether (which employers would be allowed to do under the AHCA provision that repeals the corporate coverage mandate); 2) purchase an individual health insurance policy (which, under the regulatory landscape post-AHCA, would not provide anything approaching the coverage minimums currently mandated by the ACA); or 3) forgo insurance coverage altogether and hope they do not get sick. My gut feeling is that most Americans (except for those who are the sickest) will forgo coverage altogether. This is really bad for those forgoing coverage and for America itself. I am a 36-year old male in relatively good health. If I did not have insurance and I was diagnosed with cancer tomorrow, I would 1) most likely die a slow and painful death, unable to afford the usuriously high cost of chemotherapy, and 2) would have to declare bankruptcy while I am fighting for my life. This is the exact scenario that many Americans will face thanks to the cruel forces of environment, genetics, and mere chance. A country as rich as the United States should leave no one uninsured. This is not welfare; this is a basic human right.
As to Medicaid: The vast majority of Americans who gained health insurance coverage under the Affordable Care Act did so through expansion of the Medicaid program. And the Medicaid program has been a god-send for all of them. The Medicaid program is one of the banner successes of the Great Society and its efficacy should in no way be diminished. The ACA called upon the Medicaid system to cover those unlikely to be insurable through employer-provided health insurance or through the ACA exchanges. The ACA (as originally conceived) expanded the Medicaid program, mandating that all states currently participating in the Medcaid program cover all their citizens who do not have employer-provided health insurance coverage and who earn up to 133% of the federal poverty level. In exchange for this federal to state mandate, the federal government offered to pay for a much larger portion of the cost of the Medicaid program, taking a large budgetary albatross off the backs of the states. The United States Supreme Court ruled that the mandatory nature of this expansion is unconstitutional, but instead allowed states to opt-in or opt-out of the expansion. But one major ACA modification to the Medicaid program remained in effect regardless of a state’s decision to accept or not accept the expansion: state Medicaid systems must cover all citizens (including childless adults) up to 100% of the federal poverty line.
There are two major problems with the AHCA’s proposed alterations to the Medicaid program: 1) the block-grant restructuring of the program, and 2) the work requirement provision. The only thing that the block grant restructure is designed to do is to allow the federal government to slowly starve the Medicaid program, resulting in massive losses of coverage and decreases in quality of coverage for those that remain eligible. The only upside from this change is a massive reduction in federal Medicaid expenditures that can be redistributed to the wealthiest Americans through highly regressive tax cuts.
The work requirement provision is out-and-out stupid. It is premised on the belief that Medicaid recipients without a job do not want to work. This is patently incorrect. There are many Medicaid-eligible adults who want a job, but cannot find one. Or they cannot afford the retraining necessary to make them hirable in the industries hiring in their locality. Or they are disabled for one reason or another but are not sufficiently disabled to be declared disabled by the Social Security Administration. And there is actually evidence that Medicaid encourages those who do not work to do out and get a job. The work requirement provision is an insult to those poor and working class Americans those who are looking for a job - and the feeling of self-worth that it gives them – but are unable to secure a job despite their best efforts.
The CBO predicts that the bill will save the American people $337 billion over the next 10 years. That is a mere 1.7% of our national debt. Also, our nation spends close to $600 billion per year on national defense. Ripping healthcare away from 24 million American citizens would SAVE HALF OF THAT OVER 10 YEARS.
Congressman Gallahger, I know you are new to Congress. And I am sure you want to impress House leadership – especially considering that the Speaker is from Wisconsin. But this is one of those rare instances where simply doing the right thing far outstrips your duty to your party or your president. This is one of the first times I can remember where a bill with so many disastrous consequences is so close to becoming the law of the land because so many members of your caucus do not associate real-world reality with the surreal environment of beltway politics. For the sake of all of your constituents in the 8th Congressional District, for the sake of the citizens of the State of Wisconsin, and for the sake of this great nation, you must vote against this disaster of a bill. Enough people have been threatening political careers in Washington for me to eschew any attempt to do so here. But please remember, we are your constituents and vote for our member of Congress every two years. You are ultimately accountable to us; not to Donald Trump, or Paul Ryan, or Americans for Prosperity. This is a district roughly evenly divided between Republicans and Democrats (R+2); this policy would severely hurt both those who voted for you and those who didn’t.
Please do the right thing for all of us.
