Trumpcare

Updated 2017 March 28: Despite a number of last-second amendments added in a failed effort to attract support from the far-right House Freedom Caucus, opposition to the Trumpcare bill continued to grow and the vote was postponed Thursday and canceled Friday. Since then some Republicans have suggested the bill will be revived but others (including Senate majority leader Mitch McConnell) have said that this will not happen. I’ve updated the post below to correct some typographical errors, and it might still be worth reading for reference to recall how bad the proposal really was even according to Republican assessments.

On Thursday the U.S. House of Representatives is (or was) supposed to vote on the American Health Care Act, which if enacted would drastically increase health insurance premiums for many poorer and middle-aged Americans, and in a year or two would end Medicaid eligibility for millions more. The Congressional Budget Office, incidentally now headed by a Republican, estimates that in 2018 alone 14 million Americans would lose health insurance coverage they now have, and by 2026 that would rise to 24 million in comparison with the number of uninsured under the Affordable Care Act. (A PDF of the full report can be found here.)

According to press leaks, the administration’s own internal report estimated that even more people would lose coverage than the CBO projected. (The White House didn’t deny that, but said it was just their guess of what the CBO would estimate.)

Defenders of the bill point out, rather misleadingly, that the CBO report also says that premiums will eventually go down. Actually, it says that premiums will go up in the short run, after which they would indeed go down — but only because policies would offer less coverage and because so many Americans in their 50s and early 60s would be priced out of the market that the the pool of insured persons would on average be younger and eligible for lower premiums simply because of their age.

How much would insurance costs go up under the Republican plan? According to the CBO, a 64-year-old making $26,000 a year and buying his or her own insurance would on average see the annual premiums rise from$1,700 under the current law to \$14,600 under the Republican proposal — 56 percent of that person’s gross income.

The bill is opposed by the American Medical Association, the American Hospital Association, the American Nurses Association, many consumer groups, the AARP, Democrats from the most centrist to the most liberal, moderate Republicans in the Senate, and moderate and far-right Republicans in the House. But with enough pressure from Paul Ryan and Donald Trump, it might pass the Republican-controlled Congress anyway. (The bill is intended to conform to a Senate rule that would allow it to avoid a filibuster.)

Here’s a very quick comment (just over a minute) from Comedy Central’s The Daily Show about the bill captured during a break in shooting the program:

More seriously, here’s pediatrician and medical school professor Sean Carroll MD summarizing the key points of the CBO’s report:

Here’s more commentary — informative and funny — from The Daily Show: