Tuesday was all about the Congressional Budget Office and just how much of a disaster it has found Trumpcare to be. The reactions to that have been pretty disparate. House Speaker Paul Ryan continued his happy talk about how the CBO just confirmed everything great that is in his bill (maybe because he thinks 24 million people losing insurance is a good thing?) while the White House continued to trash the CBO. In fact, the White House trashing the CBO was one of the bigger features of the day, as press secretary Sean Spicer faced a hostile press corps and ramped up the rhetoric. Luckily for us, fact checkers have found their reason for being in the most fact-free administration ever.
Spicer dings the CBO for having greatly underestimated the number of people who would buy insurance on the Obamacare exchanges, in particular a projection that 23 million would be on the exchanges by 2016; it actually was 10 million.
But this was just one part of a larger estimate—how many would gain insurance—that CBO got largely right. CBO projected that 30 million people (89 percent of the population under 65) would lack insurance in 2016, when the actual number turned out to be 27.9 million (89.7 percent).
So Spicer is playing a bit of a shell game here. He is trying to discredit CBO’s larger coverage estimate—that 24 million fewer people would have insurance by 2026 than under current law—by focusing on an error in an element of the larger forecast. But apples to apples, CBO got the larger forecast mostly correct.
Then there was this part of Spicer's attack: "CBO coverage estimates […] do not take into consideration the comprehensive nature of this three-prong plan to repeal and replace Obamacare with the American Health Care Act." Yeah, as the fact checkers say, the other two prongs "have not been unveiled and thus CBO could not consider them."
Here's the thing, though: this bill is probably going to get worse, and this CBO score will look rosy compared to what's coming. Because in his press briefing, Spicer confirmed that Trump is working on a "manager's amendment"—a legislative package to send to the floor—that will appease the maniacs in the House, probably by making the Medicaid dismantling happen sooner.
Oh, and Trump really doesn't want you to call it Trumpcare.
The House Trumpcare bill is not a serious healthcare plan, and falls short of Trump's claim that any replacement would "get insurance for everybody." Call the Capitol Hill switchboard at (202) 224-3121, and demand they reject it.
Here are some other highlights of the day.
- It turns out that the White House had done its own analysis of the bill, and instead of 24 million people losing their insurance, they predicted 26 million would! Apparently Trump hasn't even blinked about how his campaign promise to not cut Medicaid has gone down the toilet.
- More details emerged about all the really bad stuff that this bill will do, like defunding Planned Parenthood and leaving 15 percent of people in some communities "without services that help women avert pregnancy." Which in turn would lead to "several thousand more births to Medicaid patients, and, in turn, a number of those children will themselves qualify for Medicaid." That would increase Medicaid costs by $21 million. Unless states decide that they can't use their now-discretionary Medicaid block grant to pay for care for pregnant women and their babies.
- Here's a silver lining in it all for granny-killing Paul Ryan: the CBO also estimates that Social Security will save $3 billion in the next 10 years because of reduced outlays. Because people will die before they can get Social Security.
- Here's something else Ryan is really proud of: the $833 billion in tax cuts to the very, very wealthy in this bill are paid for entirely by the $880 billion cut out of Medicaid. That's his kind of math.
- And Ryan's "lower premiums?" They're lowered at the expense of older people who won't be able to afford insurance, and therefore will die sooner, and therefore will save Social Security money. Because Paul Ryan is a sociopath.
- But not all Republicans are sociopaths, and that means the bill's path through Congress got quite a bit tougher following the release of the CBO's numbers. This thing is by no means dead, because you can never underestimate a Republican’s ability to do the worst possible thing for the nation. But it's going to be much tougher for Ryan to accomplish.