The Partisan Sabotage of America’s Health Care System

By: Daniel Wherley, Senior Policy and Research Analyst, Health Equity (originally posted 3/24/17 on

The last two days represent a crucial moment in the years-long insurgency campaign to sabotage the health care that tens of millions of Americans rely on for their daily well-being, economic security, and peace of mind. The Congressional Budget Office’s scathing assessment of the Republicans’ health care proposal along with President Trump’s draconian austerity budget proposal have been revelations.

Now, after months of empty promises to make America great again for those who have been left behind, the truth is laid bare: the GOP has far less interest in protecting our care than in protecting their own carried interest.

This is borne out in today’s report from Congress’s own analysts. Just a sampling of the pain that the American Health Care Act would unnecessarily inflict on the nation:

  • 23 million fewer Americans would be covered with health insurance than if the current system remained in place.
  • The harm inflicted on American families by cutting over $800 billion from the Medicaid program would not even result in a significant reduction of our national debt — as included tax giveaways for the wealthy would largely offset whatever budget “savings” are achieved through Medicaid cuts.
  • Even after the expected upheaval of initial implementation was over, our health care markets would remain unstable for 1 out of every 6 Americans after 2020 as states begin to allow pre-existing conditions and one’s age to determine your health costs, leaving many residents unable to afford the new rates.
  • A huge increase in consumers’ out-of-pocket spending for drugs or other benefits no longer considered “essential” in states that choose to scale back consumer protections. For instance, the report estimates that in half of all states, this means even a fully-insured woman might have to pay tens of thousands of dollars out of pocket simply to give birth.

All this goes to show that while they may wave a flag of people power and shout about the “forgotten” Americans, this Presidential administration and its Congressional allies are reverse Robin Hoods — shaking down our nation’s most vulnerable to give a tax break handout to our most wealthy.

Our so-called leaders in Washington are pushing a “health” agenda that has little to do with community health reform, rising health care costs, national interest, or even common sense. Their unambiguous attack on Medicaid — and the tens of millions of disabled, poor, and/or senior citizens who rely upon it just to get by — goes far beyond their vows to repeal the Affordable Care Act.

Together, the two Republican proposals would cut almost $1.4 trillion from the Medicaid program over the next decade, gutting a foundational pillar of our nation’s economic security. Here in California, that puts more than 13 million state residents in line for severe care reductions or losing their Medi-Cal benefits outright. Among the worst hit would be California’s communities of color that saw historic health insurance access gains because of the ACA.

These twin proposals are closely linked — if enacted, they would not return us to greatness but rather return us to an unfortunate era in which basic public health, food security, economic mobility, and political representation were out of the reach of many Americans. These proposals would bring our health system back to a time before the ACA — as some experts have argued, it would look a lot like 1965 before Medicaid was first enacted and civil rights were widespread.

These actions are in stark contrast to America’s best moments.

In the United States we have a history of working to reach common understandings about the peril that persistent racial, economic, and health injustices pose not just for the most vulnerable — but for the entire nation. When such rare moments of awareness align with coordinated advocacy and political willpower, our federal government has shown itself capable of creating bold social programs intent on rectifying the burdens of such injustices.

Whether it was retiree poverty and the Social Security Act, health among the impoverished and Medicaid, or childhood hunger and the school lunch program — committed stakeholders, innovative experts, and courageous lawmakers banded together and put the nation’s collective wealth, expertise and ideals to use for the greater good.

In doing so, they not only fulfilled the social compact binding us together as a nation but also provided the foundation of economic and social security upon which all Americans might build a brighter, thriving future.

The peril such programs face today reminds us of our social compact’s fragile underpinnings.

What does the GOP truly want? These twin proposals seem to show they want to repudiate President Obama, expose vulnerable communities to greater insecurity, trade widespread health for focused wealth, and to restrict adult women’s ability to utilize the full range of legal health care options of their own choosing.

Health Secretary Tom Price’s primary complaint about Medicaid was that provider reimbursement was too low — the AHCA does not address this issue. Something else is afoot.

Donald Trump and others have argued that the ACA left Americans who did not qualify for subsidies at the whim of rising premiums and deductibles. Yet, by reducing the amount of folks who qualify for subsidies and delinking subsidies’ alignment with the local premiums, the AHCA has ensured that tens of millions more Americans will now face this dilemma.

It is important to keep in mind that in seven years of Republican campaign promises to “repeal and replace” the Affordable Care Act, the rationale was that, if given the reins of government, they could deliver better, cheaper, more accessible health care to Americans.

Clearly, their approach was one of rebuke and not of real vision. Beyond the callous assault on the common good comes even greater threats.

The current health care proposals deny the right of Americans to decent health care, and ignore the overwhelming opposition of informed experts in creating a policy that fails to address any of the admitted weaknesses of the ACAs.

We cannot let them sabotage the health of all Americans.

What we want is a bi-partisan bill that reflects the needs of all our people. It’s time for Congress to come together to devise health care solutions that equitably spread benefits while reducing harm. Let’s improve the system we have, let’s fulfill the promise of our heritage to ensure a brighter, healthier future for the next generation.

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