The New Senate Bill Is Still Unimaginably Horrible Legislation

“Senator Collins Heller, I also expect you to put up the money for my next re-election campaign personally.”

The “new” Senate bill might have replaced the bologna with sopressetta in the shit-and-cyanide sandwich, but don’t be fooled:

The new Senate Republican health care bill is out. It’s basically the same as the old one.

New legislative language unveiled by Senate Majority Leader Mitch McConnell (R-Ky.) Thursday does include some notable changes, including leaving in place Affordable Care Act taxes on wealthy individuals and giving in to conservative demands that health insurance be further deregulated, according to a summary.

At its core, however, the revised version of the Better Care Reconciliation Act ― which McConnell pulled two weeks ago because too few Republican senators planned to vote for it ― remains a vehicle for massive cuts to Medicaid, less financial assistance for people who buy private health insurance, and the return of skimpy junk insurance policies and discrimination against people with pre-existing conditions. Taxes on the rich would remain, but health care companies would enjoy a major tax cut.

A few remarks:

• Maintaining the ACA’s tax on investment income just fixes a really dumb political blunder. In addition to what Young mentions, the new version of TrumpCare substantially expands Health Savings Accounts, which are a massive tax giveaway to the wealthy.  And, of course, the richest Americans will be getting an equivalent tax cut later in the year anyway.  This is still a huge cut in social spending to pay for huge tax cuts for the rich — it’s just that some of the details and sequencing has changed.
• The Cruz Amendment is a big deal*, and would essentially end the ACA’s regulation of private insurance markets. Under the ACA, insurance companies had to make money by actually providing insurance that covered things to all comers. Under BCRA, insurance companies could go back to making money by selling people useless insurance and effectively locking people with pre-existing conditions out of the market. Admittedly, the ACA’s salutary regulatory reforms were undermined by its insufficiently generous subsidies, but needless to say BCRA makes this problem much worse and will require people to pay much more for equivalent coverage.
• The massive Medicaid cuts are still there, and don’t believe McConnell’s bullshit about how they’re meaningless because they’re phased in later. A lower baseline is a big deal even if you assume that the Dems take power in 2021, repair the cuts and get the statute approved by the Supreme Court — and you’d be crazy to assume that all of this will necessarily happen.
• So, assuming Rand actually votes “no,” the only way this pass can pass is if no more than one Republican “moderate” has so little self-respect that they’ll cave and vote for a literal death-political suicide pact even though McConnell is offering absolutely nothing on their key ask but a feeble “my fingers are crossed” wink. [Update: Collins is a “no,” so that’s the one.] Wait — there’s a really good chance we’re screwed, aren’t we?

*

🚨 Here are the consumer protections the Cruz amendment wipes out: pic.twitter.com/WAWt8zJY0f

— Topher Spiro (@TopherSpiro) July 13, 2017