Did the Marquis de Sade Write This Health Care Bill?

President Donald Trump pumps his hands to GOP House members after the House pushed through a health care bill, in the Rose Garden of the White House, Thursday, May 4, 2017, in Washington. (Photo: Evan Vucci/AP)

Did the Marquis de Sade Write This Health Care Bill?

Nope. Republicans did.

Even the great Stephen King might find this story implausible.

Republican leaders in the House and White House wanted to implement a massive tax cut for the wealthiest Americans (the health care bill passed Thursday) as a prelude to adopting a second massive tax cut for the wealthiest Americans and big corporations (the tax bill that's next on their agenda).

"You'd think the 217 heartless legislators who voted for this monstrosity would be hiding their heads in shame. Instead they engaged in a raucous celebration, wheeling a sled full of beer into the Capitol and then holding a victory rally in the White House Rose Garden with President Trump."

They needed the first tax cut so they could pass both bills through a process called "reconciliation" which allows them to enact both massive gifts to the 1 percent by a simple majority in the Senate without the 60-vote threshold in the Senate for other legislation.

The first tax cut for the very rich is called the American Health Care Act, the not so hidden fine print in a bill that is also a horror story for tens of millions of Americans who would be deprived of health coverage and millions more who are threatened with bankruptcy for being sick.

And, no doubt many of the 217 Republican Congress members who narrowly passed the bill are among those expected to benefit from the nearly $600 billion tax cut in the AHCA, most of which goes to those with incomes of over $1 million a year.

What does the rest of America get? A nightmare, which ought to violate the Constitutional ban on cruel and unusual punishment.

The bill was rushed through for a final vote without a Congressional Budget Office analysis which predicted the last version, which failed in March, would slash health coverage for 24 million people. And, to line up votes from the most far right members of the House, they made it worse.

Most notably, the legislation, if enacted, would eviscerate $880 billion from Medicaid, affecting low income Americans, with a cap on federal reimbursements to states, an open invitation for states to cut eligibility and reduce covered services.

It is especially punitive for people with what the insurance companies endearingly call pre-existing conditions, which is virtually any existing health status from asthma to cancer, with the added discrimination against women, notably higher costs for pregnancy.

Under the AHCA, 40-year olds could be hit with massive increases in costs for premiums of $142,650 for metastatic cancer, $26,580 for rheumatoid arthritis, $18,720 for congestive heart failure, $17,320 for pregnancy, $8,490 for certain mental health conditions, $5,600 for diabetes, and $4.340 for asthma, according to the Center for American Progress.

While most of the focus has been on those on Medicaid, or under the Affordable Care Act newly able to buy individual insurance coverage with restrictions on all the noxious those insurance industry abuses, the bill also undermines employer-based coverage.

An inconvenient truth uncovered by the Wall Street Journal exposes that the bill would allow individual states to opt out of the ACA minimum benefit standards. Employers could just reduce covered benefits they offer by hunting the most bare bones standards offered by the most regressive state, limiting, for example, existing ACA requirements that cap out of pocket expenses.

There's far more to this sadistic show. The bill would:

  • Eliminate the Prevention and Public Health Fund, which will worsen the health of our communities, spread infectious disease, and increase health system costs;
  • Phase out coverage for Medicaid expansion in Medicaid expansion states beginning in 2020, while preventing new states from receiving enhanced Federal Medical Assistance Percentage in order to expand Medicaid;
  • Eliminate funding to Planned Parenthood which will worsen women's health, and create burdens for women, families and society from unsafe pregnancies and other health conditions no longer treated;
  • Eliminate the definition of "essential benefits" - a move that makes all patients vulnerable to the distortions and marketing games of insurance companies;
  • Repeal the cost-sharing subsidies of the ACA, and destroy the ability of 80% of people currently buying insurance on the Exchanges to maintain coverage;
  • Open the door for junk insurance. The bill includes a penalty for lack of continuous coverage, creating a big incentive for patients to buy low-cost, no-coverage plans;
  • Fail to encourage low-cost coverage, because the legislation shifts thousands of dollars in spending from insurance company spending to the individual's out of pocket costs;
  • Reproduce the failed "high - risk pools" of the 1990's and 2000's, through the "Patient and Stability Fund". It is inevitable that the number of eligible patients will overwhelm the resources of these high risk pools;
  • Repeal the Medicare Hospital Insurance Tax, which will reduce funding and destabilize for the Medicare program that our nation's seniors rely on;
  • Allow insurers to charge seniors five times the amount of a younger person. This revision will prove to be deadly for our nation's seniors, and it reveals the extent to which this reform will benefit the profit margins of insurance companies, at the expense of patients' lives.

You'd think the 217 heartless legislators who voted for this monstrosity would be hiding their heads in shame. Instead they engaged in a raucous celebration, wheeling a sled full of beer into the Capitol and then holding a victory rally in the White House Rose Garden with President Trump.

Their joy may be short lived the next time voters in their districts, who have been protesting this disgrace for months, go to the polls.

Let's not let Democrats off the hook here either. The Affordable Care Act, with its improvements, also was undermined with significant weaknesses, that included leaving 28 million uninsured, and failing to control ever increasing out of pocket costs.

The solution is not making our broken healthcare system even worse, it's by achieving real reform, once and for all, by improving Medicare, one of the signature reforms in U.S. history, and expanding it to cover all Americans.

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