TREMENDOUS SPIRIT

Trump’s health care bill is the first true test of his powers as salesman-in-chief

Obsession
"America First"
Obsession
"America First"

US president Donald Trump is in “sell mode,” and plans to throw his full deal-making prowess behind the new healthcare bill designed to replace Obamacare in coming weeks, the White House said this week.

“The president is very proud of the product we have produced,” White House press secretary Sean Spicer told a packed press briefing on March 7.

Since then, Trump has hosted Tea Party and traditional Republicans at the White House, dined with Ted Cruz and Cruz’s wife, and offered a dark message about Obamacare to Americans in his weekly address, warning “The law is collapsing around us.” Bowling appears to be a key part of the charm offensive, with House Republicans hitting the lanes under the White House this week, and Tea Party ones scheduled to bowl next week.

But opposition is unrelenting. Retirees, doctors, hospitals, right-wing talking heads, conservatives Republicans, Tea Party Republicans, and even Trump campaign booster Breitbart have come out against the bill. They all want changes, but sometimes diametrically opposed ones.

Sure, other White House-backed bills introduced in Congress have faced stiff bi-partisan opposition in recent history, and still passed. The “TARP” bill, for example, which bailed out the US’s big banks at the end of George W. Bush’s term, was ultimately backed by an unexpected number of Republicans. But they made it plain at the time that decision was to avoid an absolute calamity—”an economic slump the likes of which we have never seen,” as Republican leader John Boehner said after the vote.

That’s not the case here. Despite the Trump team’s insistence that Obamacare is failing, the uninsured rate in the US is at an all time low of 10.9%, and a majority of Americans would like to see the health insurance system remain as it is. The new healthcare bill will need 218 votes to pass the 435 seat House and the vote is expected to be a “nailbiter.” Then it goes to the Senate, where if it loses more than three of the 52 Republicans in the Senate it will not pass. And before it goes to Trump’s desk to be signed, it needs to go back to the House, which needs to approve changes in the Senate.

Here’s why so many people are against it.

Democrats

While it is no surprise that Democrats don’t like a bill that tears down former Democratic president Barack Obama’s legacy, their disgust with its replacement, which will cut $600 billion in taxes on the wealthy while potentially increasing the cost of health insurance for many Americans, has sparked new levels of condemnation of the Trump administration.

Joe Kennedy III, a representative from Massachusetts, berated Paul Ryan in the House just after midnight on March 8 for suggesting the plan was an “act of mercy” and calling it an “act of malice” instead. Nearly 8 million people have viewed Kennedy’s remarks on Facebook so far.

“There is no mercy in a systems which makes healthcare a luxury,” Kennedy said.

Doctors

The American Medical Association, a group of nearly 225,000 physicians, issued a letter to Congressional leaders on March 8, saying it cannot support the bill as drafted because of the “expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations.” The letter went on:

As drafted, the AHCA would result in millions of Americans losing coverage and benefits. By replacing income-based premium subsidies with age-based tax credits, the AHCA will also make coverage more expensive—if not out of reach—for poor and sick Americans.

The group spent $19 million lobbying in 2016, and is a key donor to many regional political campaigns.

Hospitals

Both the American Hospitals Association and The Federation of American Hospitals, which collectively represent over 6,000 hospitals, are concerned about the plan’s effect on Medicaid. It would reduce enhanced funding levels to Medicaid that 31 states rely on to extend health coverage to the poorest Americans, by banning new enrollments after December 2019, and by capping the amount states can spend on individual Medicaid recipients.

“The effort to restructure the Medicaid program will have the effect of making significant reductions in a program that provides services to our most vulnerable populations,” the AHA said in a letter to Congress.

“We want to make sure that whatever comes out of this change really supports particularly those low-income Americans, who frankly don’t have the resources to afford coverage,” said Chip Kahn, CEO of the Federation of American Hospitals.

Traditional Republicans

Four Republican Senators have already vowed not to support the bill as written. They, too, are worried about the Medicaid reductions.

“We are concerned that the February 10th draft proposal from the House of Representatives does not provide stability and certainty for individuals and families in Medicaid expansion programs or the necessary flexibility for states,” they wrote in a letter to Senate Majority Leader Mitch McConnell.

The AARP

The American Association of Retired Persons, the US’s largest nonprofit with about 38 million members, quickly dubbed the provisions in the bill that give tax credits based on age and not income an “age tax.”

In a letter to Congress, the nonprofit estimated premiums for current coverage could “increase by up to $3,200 for a 64 year old.” The AARP spent over $8 million lobbying in 2016.

Breitbart and Ann Coulter

The white nationalist website Breitbart has dubbed the new healthcare plan “Obamacare 2.0” and slammed it for failing to fully repeal Obamacare, while Coulter, the anti-immigrant talk show circuit regular, asked on Twitter “What are names of the brain trust that wrote this piece of crap?” Coulter did not explain why she thought the bill was so bad, but has espoused “free market” health care in the past, which seems to mean no government involvement at all.

Tea Party Republicans

Tea Party politicians, which hold 48 House seats (and four in the Senate), want exactly the opposite of traditional Republicans: they’re say the plan doesn’t get rid of the Medicaid expansion that made Obamacare work fast enough, and they do not support the tax credits included for lower-income Americans.

After a meeting at the White House, at least one Tea Party group sounded an optimistic note, though. “We believe we can get to yes on the bill and throw Obamacare into the dustbin of history,” said Adam Brandon, president of FreedomWorks, a DC-based libertarian advocacy group.

Despite the opposition, Trump remains upbeat. “We have some great results. We have tremendous spirit,” Trump said on Friday. “And I think it’s something that is just going to happen very shortly.”

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