After all the drama and secrecy, the GOP Senate’s health-care proposal turns out to closely mirror the House version.
Certainly, the bottom line is the same:
Both bills cut $800 billion from Medicaid, which covers health care for poor children, for the disabled and for the elderly in nursing homes. Through tax cuts, both bills then redirect that $800 billion to those who are deemed much more in need.
You know, those in the top 1 percent of income.
The Senate bill should also silence those who argued that Republican policy shouldn’t be judged on the Republican bill that passed the Republican House and that Republicans went to the White House to celebrate with our Republican president. That bill was so bad that even Donald Trump complained later that it was too mean, that it lacked “heart.”
The Senate bill is just as mean, but in a few slightly different ways.
Let’s be clear about what’s at stake:
Medicaid pays the bill for roughly two-thirds of Americans in nursing home care. In Georgia it pays for 74 percent of that care. Medicaid covers health care for almost 40 percent of America’s children. In Georgia, it’s 45 percent. And in a letter this week to Senate leaders, chief executives of some of the largest managed-care providers in the country made another important point:
"In 2015, more than 2 million Americans had an opioid use disorder. Nationally in 2016, Medicaid paid for 24 percent of the medications that are used for treating opioid addiction. In the five states with the highest opioid overdose mortality rates (West Virginia, New Hampshire, Kentucky, Ohio and Rhode Island) Medicaid covered 41 percent of opioid treatments. Cutting Medicaid coverage will only worsen the opioid crisis."
Look at those states hit hardest. One is Kentucky, home state of Senate Majority Leader Mitch McConnell. It’s so bad that emergency responders in Louisville dealt with 151 emergency overdose calls in just a four-day period recently. Another is New Hampshire, where candidate Trump made seemingly heartfelt promises that he cared, that he would bring help.
“We’re going to set up programs,” he promised. “We’re going to try everything we can to get them unaddicted.”
He made similar promises in Ohio.
“We’re going to take all of these kids—and people, not just kids — that are totally addicted and they can’t break it,” he said back in August. “We’re going to work with them, we’re going to spend the money, we’re gonna get that habit broken.”
As political strategy, it was brilliant. In the industrial Midwest, where Trump in essence won his victory, 95 percent of the counties where he outperformed Mitt Romney also had higher than average rates of drug mortality. This is the thanks they get. (Both the House and Senate bills would also gut a requirement that private health-care plans cover addiction treatment.)
I’ve been to funerals of young people — children, really — who couldn’t shake this addiction. One was for a young girl whom I coached in soccer for a decade. I’ve seen neighbors and children of neighbors succumb to it, and I don’t live in the rural communities and small towns where its impact is greatest, and where government-funded addiction programs are really the only option.
Now, the very people who promised to help those communities want to strip them of help and hope, all in the service of tax cuts for the wealthy. There’s a lot of anger out there in the political process, but you look at things like this and you realize that maybe there’s not as much as there ought to be, as there needs to be.
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