Just out is the non-partisan Congressional Budget Office [CBO] report scoring TrumpCare on (a)-(c). Accorcing to the CBO's estimates, (b) the cost of the health program to the US government will be reduced over a 10-year period. However, (a) the key senior constituency is set to pay significantly more than they pay now and (c) coverage would go down because TrumpCare makes healthcare unaffordable to many seniors by reducing their state-provided benefits. Moreover, many states will find little to gain by participating in TrumpCare given its unfavorable terms, making more seniors lose coverage.
As such, there is little care going on in TrumpCare or, more formally, the American Health Care Act. The way "savings" are achieved is by getting rid of older people from government health programs--those most in need of health care and those whose health spending is obviously the highest as a result. No mystery here:
But the way the bill achieves those lower average premiums has little to do with increased choice and competition. It depends, rather, on penalizing older patients and rewarding younger ones. According to the C.B.O. report, the bill would make health insurance so unaffordable for many older Americans that they would simply leave the market and join the ranks of the uninsured.The remaining pool of people would be comparatively younger and healthier and, thus, less expensive to cover. Other changes would help make health insurance skimpier — cheaper, but with deductibles that are higher than those criticized by Republicans under Obamacare.
The American Association of Persons [AARP] summarizes the talking points of how the bill harms its members bigly:
Another interesting facet is that the elderly turned out in yuuuge numbers for Trump. However, they will be among the worst affected--especially those living in rural areas where choices are few and costs are high as a result:AARP reiterates our opposition to this harmful bill. The nonpartisan CBO revealed today that ‘the legislation would increase the number of uninsured broadly, [and] the increase would be disproportionately larger among older people with lower income; in particular, people between 50 and 64 years old…The CBO analysis found that premiums would rise ‘20 percent to 25 percent higher for a 64-year-old.’ Putting the financial burden on older Americans is not the way to solve the problems in our health care system.’ Premiums for a 64 year old earning $26,500 would increase by $12,900 in 2026, from $1,700 to $14,600.
Among the counties where Trump won his biggest victories, nearly all would face deep cuts in tax credits under the Republican plan to replace Obamacare. And, in the parts of the country that would lose the most in tax credits, a majority of voters were Trump supporters.It is not for me to discuss the motivations of American voters for Trump in the limited space available. Even more perplexing are Trump's best efforts to do the most harm to his most committed voters. (I think seniors will still be around come the 2018 elections despite Trump's best efforts. Sorry, Trump.) Suffice to say, little political goodwill appears likely to emerge from the upcoming effort to pass TrumpCare. Either seniors are hurt in a big way--those whose age group has not only the highest voter turnout but also the highest Trump share of the vote--or much useless activity will be expended in promoting an ultimately futile bill in a manner that offends the electorate.
The following chart shows the 25 counties where Trump captured the largest share of votes. In all but one, a typical middle-aged man buying health insurance on his own would lose money under the proposed GOP change, according to recent calculations from the Kaiser Family Foundation.
What will likely happen is that Republicans will suffer large losses in the Senate and, to a lesser extent, the heavily gerrymandered House in the 2018 midterm elections. So, there is a two-year windows before the midterm elections for Trump to get the rest of his wish list done. However, a TrumpCare setback will likely delay or (hopefully) derail other parts of his agenda until such a time that Republicans will not control the White House, House, and Senate simultaneously. The more legislative losses, the fewer congressional backers Trump will have. As Trump has correctly observed, few people back "losers." In the international sphere, his wish list includes:
- the ~$25B Great Wall of Trump on the US-Mexico border;
- the "border tax" discriminating unfairly against exports likely to set off a trade war;
- the massive $54B in additional military spending; and
- further anti-immigrant action
I will elaborate more on the other international elements of Trump's racist-isolationist-protectionist policy package soon, but for now, rest assured that gridlock in Washington is better for the rest of the world. Or at least we should hope. I feel bad for American seniors, but again, they did vote for a known con artist. Caveat emptor.