House Speaker Paul Ryan revealed the changes leadership was going to make to Trumpcare to attempt to get conservatives on board. Essentially, the changes can be boiled down to this: "Faster tax cuts for the rich." It does so by making being even meaner to Medicaid recipients by allowing block granting and work requirements for recipients. Of course.
The changes are slap-dash and slightly bizarre, much like the original Trumpcare. They are unlikely to make the Congressional Budget Office's estimates on the 24 million people losing insurance any better.
The mangers amendment is expected to entice some to vote "yes" on the bill, on both sides. For moderate and centrist Republicans, it would set aside funding — about $85 billion, according to Republican sources — for tax credits to help Americans between 50 and 64, who would see their premiums skyrocket under the current repeal plan. The amendment would not set up the tax credits but would instruct the Senate to do so, forcing House Republicans to take a vote on something the upper chamber would do later. It would be paid for by allowing consumers to write off less medical debt. […]
It also includes some red-meat for the right. Two of the changes, first reported on Friday, were essential to winning over the support of the Republican Study Committee. Trump met with leaders of the conservative group last week and agreed to allow work requirements in Medicaid as well as give states the option of converting their Medicaid programs into block grants. Both concessions were heralded by conservatives as necessary modifications to the health entitlement and long-term wins. Some states sought work requirement approval under the Obama administration, but were rebuffed by federal officials.
This is where the bizarre comes in: "Here Senate, you take the hot potato and you figure out what in the hell to do with this $85 billion." That really is an unprecedented trick—trying to convince skeptical House members on a bill with underfunded age-base subsidies by saying "the Senate fill figure it out." That's about as unprincipled, and lazy, and desperate as you're ever going to see coming out of congressional leadership.
The House is scheduled to vote on Trumpcare on THURSDAY, MARCH 23. Even if you already called your member of Congress, do it again by calling the Capitol Hill switchboard at (202) 224-3121. Jam the phone lines, urge them to vote NO.
The Medicaid stuff is just mean, mean and designed to fulfill Paul Ryan's lifelong dream of destroying the program. Nothing more. And it's not going to help getting the bill passed in the Senate, not one bit. It's just there for meanness.
Then there's this:
House GOP leaders also threw the New York delegation a bone to secure a whole host of "yes" votes. The amendment included a targeted change to Medicaid funding that’s specifically designed to garner support from New York’s delegation. It would attempt to transfer more Medicaid spending from counties to the state, by blocking New York from obtaining federal reimbursements for payments made by counties.
That provision? It's a disaster for the state of New York, and has Gov. Cuomo rushing to D.C. to meet with the delegation to convince them that the $2.3 billion hole it's going to create in the state's budget isn't worth it. The whole thing is a mess, but Ryan still plans to push it through on Thursday—before the CBO has a chance to score it again.