Voters Want Funding Increased For Medicaid, Medicare, And Social Security

 

The charts above reflect the results of the Economist / YouGov Poll -- done between February 2nd and 4th of a nationwide sample of 1,423 registered voters, with a 3.3 point margin of error.

The GOP Will Make Health Care Worse To Give Tax Cuts To The Rich

The following is part of an article by Aaron E. Carroll in The New York Times:

The Trump administration faces a dilemma: The president has promised to extend the 2017 tax cuts (nearly half of which will go to the wealthiest 5 percent of Americans) at a hefty cost of $4 trillion over the next decade, but many Republicans are reluctant to add to the federal deficit.

How do they square the math? It appears they are prepared to do so at the expense of the poor and middle class, by yanking health care coverage from children, new mothers, people with disabilities and seniors. Republican leaders in Congress have suggested that one option they are considering to bankroll their tax breaks would be to cut hundreds of billions from Medicaid; another proposal would roll back subsidies that have helped middle-class families pay Affordable Care Act premiums. 

It’s hard to overstate how catastrophic the proposed cuts would be. Medicaid alone covers more than 40 percent of births in the United States. Far from being a handout, it is one of the most cost-effective insurance programs in the country, meaning there is very little fat to cut without immediately harming people. It’s because of Medicaid that children, seniors and people with disabilities — groups that make up more than 75 percent of the program’s spending — can see doctors and fill prescriptions without going bankrupt.

In their menu of options, House Republicans propose adding work requirements to Medicaid, which would cut benefits to some recipients and, they claim, save billions. Proponents of work requirements argue that such measures incentivize employment, but the evidence overwhelmingly shows that they don’t. This is because nearly every adult in Medicaid who can work alreadydoes, or is a student, disabled or a caretaker for someone else. Instead, people lose access to care because of bureaucratic red tape and difficulty proving they qualify. Work requirements bloat the bureaucracy and result in worse care for fewer people.

Republicans are also considering distributing a set amount of money to states, regardless of what care actually costs. But states are already struggling with tight budgets. They don’t have hidden, untapped solutions to magically fund health care. With less money, they must refuse coverage to more people or pay providers even less, which means fewer doctors will see Medicaid patients, which reduces access for everyone. Twelve states have trigger laws on the books that might end Medicaid expansion programs or severely cut them if the federal government reduces funding.

Medicaid isn’t the only potential victim. Congressional Republicans are also eyeing the Affordable Care Act’s premium subsidies — the same subsidies that help working Americans buy private insurance at more affordable rates. Roll back these credits, and families could see their monthly premiums soar by hundreds of dollars. . . .

We should be honest about these trade-offs: Families lose health insurance if we cut Medicaid or slash A.C.A. premium credits. Children go without care. Clinics and hospitals in rural areas close. People suffer. . . .

Gutting Medicaid, or making it impossible for middle-class Americans to afford A.C.A. exchange plans, is callous. No parent should choose between taking a child to the emergency room and paying the grocery bill. 

Most Oppose The Cuts Republicans Are Considering

 

The charts above reflect the results of the AP / NORC Poll -- done between January 9th and 13th of a nationwide sample of 1,147 adults, with a 3.9 point margin of error.

Three Options The DOGE Billionaires Have To Kill Medicaid

 

The following is part of a post by Robert Reich:

Medicaid is less politically popular than Social Security or Medicare, because it mainly supports poor children and families who have little or no political voice.

 

But Medicaid covers far more Americans. 

Medicaid insures nearly half of all children in the United States. It covers 1 in 5women of childbearing age. It also pays for a large portion of the nation’s nursing home care and mental health treatment. States and the federal government share its costs, which totaled $880 billion last year. 

How are the DOGE billionaires planning to gut it?

 

First, by turning Medicaid into “block grants,” in which states get lump sums regardless of how many people sign up for the program. Republican senator and founding DOGE caucus member John Cornyn has already publicly stated that he favors this approach.

As more poor children and needy families sign up, block grants will force states to increase their own spending on Medicaid or restrict who gets it. Given the strain on state budgets and the negligible political voice of Medicaid recipients, it will almost surely be the latter.

 

A second method for gutting Medicaid favored by Musk, Ramaswamy, Cornyn, and other DOGE caucus members is to impose work requirements on Medicaid recipients. They claim this would save the federal government at least $100 billion over the next decade. 

But the reason for the saving is that work requirements would cause an estimated 600,000 people — most of them unable to work — to lose coverage (according to estimates from the Congressional Budget Office). 

The third idea DOGE is considering is to cut back on the expansion of Medicaid that came with the Affordable Care Act. That expansion enabled adults in families earning up to $43,000 a year to get health care coverage. (Under it, the federal government pays 90 percent of the costs.)

Step back for a moment and consider what’s being proposed. 

If the Affordable Care Act’s expanded Medicaid is cut back, hundreds of thousands of Americans in families earning up to $43,000 a year will lose their health care.

 

If Medicaid is turned into block grants or if work is required of people unable to work, many hundreds of thousands more will lose their only access to health care, including large numbers of children.

The presumed goal of the DOGE exercise is to reduce the federal budget deficit. 

Yet Trump and his billionaires are planning to extend the 2017 Trump tax cuts, which disproportionately have benefited large corporations and wealthy people like themselves, along with additional tax cuts and loopholes for the wealthy. 

The estimated cost of extending the Trump tax cuts is at least $5 trillion — more than twice the amount Musk has stated DOGE will cut in “wasteful” government spending.

 

The richest man in the world and his billionaire colleagues are seeking to reduce money spent for the health care of the poorest and most vulnerable Americans, at the same time they’re seeking to reduce taxes on themselves and others who are the richest and most privileged.

Anything wrong with this picture?

Many of the Americans who will be shafted by all this voted for Trump in 2024. 

They may never discover that Trump is behind this because Trump won’t have his fingerprints on the Medicaid cuts. He’ll hide behind Musk and Ramaswamy’s DOGE and the newly formed DOGE caucus in Congress.

 

Not even their fingerprints will be obvious because block grants to the states, work requirements, and elimination of the Affordable Care Act’s Medicaid expansion will all do the dirty deed quietly.

Nor will working Americans discover that big corporations and the wealthy are reaping most of the savings from the gutting of Medicaid in the form of lower taxes. Most working Americans haven’t yet discovered how skewed the 2017 Trump tax cut has been to the wealthy and big corporations, so why should they discover it in future years?

One more thing. 

Employer-sponsored health insurance — available to most salaried workers in large corporations but rarely to hourly workers or contract workers — remains untaxed. 

This is one of the largest tax expenditures in the federal government. 

As I said, Medicaid costs about $880 billion a year. The exclusion from taxes of employer-provided health insurance costs the federal government a very large fraction of that — the Joint Committee on Taxation estimated $299 billion in 2022; the Congressional Budget Office projects $641 billion by 2032.

It’s another well-disguised benefit for the privileged that’s underwritten by the non-privileged. Yet I’d be astonished if DOGE touched it. 

Why go after the costs of Medicaid and not the costs of employer-provided health insurance? For the same reason Trump’s billionaires will happily cut taxes on themselves even as they gut health care for millions of poor kids and working-class families. 

What’s considered “waste and fraud” often depends on whether one is looking downward or upward, and the billionaire DOGEs look only downward. But the biggest waste and fraud is found at the high rungs — in tax loopholes and tax expenditures used by wealthy individuals and big corporations. (Did I hear anyone say “carried interest?”) 

When Trump chose Dr. Mehmet Oz, the multimillion-dollar celebrity doctor (who infamously promoted hydroxychloroquine while holding over $615,000 in shares of the drug’s distributor) to lead the Centers for Medicare and Medicaid Services, Trump said Oz will “cut waste and fraud within our country’s most expensive government agency.”

Believe that, and you should believe in hydroxychloroquine.

Public Opposes Cutting Funding For Medicaid, Medicare, Social Security, And SNAP

 

The charts above reflect the results of the Economist / YouGov Poll -- done between November 23rd and 26th of a nationwide sample of 1,590 adults, with a 3.2 point margin of error.

Note that a majority of the public wants funding for all these programs to either be increased or remain the same. Only a tiny minority wants funding cut.

Texans Want Medicaid Expansion & Marijuana Legalization

 

The charts above reflect the results of the new University of Texas / Texas Tribune Poll -- done between June 10th and 21st of 1,200 registered voters in Texas, with a 2.83 point margin of error.

The poll shows huge support among Texas voters for the legalization of marijuana (60%)  and the expansion of Medicaid under the ACA (67%). Of course, the Republican controlled state legislature ignored both issues in this year's legislative session.

The Texas legislature only meets once every two years, so it would be at least 2023 before either of these issues could be considered,

It's A GOP Lie That Social Security/Medicare Causing Deficit

Republicans have ballooned the federal deficit to about a trillion dollars a year, and they want you to believe it is Social Security and Medicare that is causing that deficit.

That is an outrageous LIE! Social Security has never added a penny to the deficit or national debt, and Medicare has added very little.

The real cause of the ballooning deficit is twofold -- the enormous tax cuts for corporations and the rich, and a huge increase in the military budget (which was already bloated). But Republicans only care about the rich and corporations (including the corporations in the military-industrial complex). They never liked Social Security and Medicare (or Medicaid), even though those programs have been very successful and enormously popular, so they are now trying to use the deficit they created to damage those programs.

Here is how former Labor Secretary Robert Reich describes this GOP malfeasance:

When asked about America’s soaring debt and deficits, Senate Majority Leader Mitch McConnell lamented  “It’s disappointing, but it’s not a Republican problem,” and he blames Social Security, Medicare and Medicaid.

Rubbish. It’s not social spending that’s causing the federal deficit to soar. It’s Republican tax cuts, especially on corporations and the wealthy. 

Look at the evidence. Of all 35 advanced economies, America’s spending on social programs like Medicare, Social Security, and Medicaid is among the lowest, as you can see.

Also, Americans pay into Social Security and Medicare throughout their entire working lives. 

The biggest reason America has the highest deficit relative to our total economy among all 35 advanced economies is because of a shortage of tax revenue. Of all these countries, we’re bringing in the fifth-lowest total revenue as a share of GDP.

And why is that? Mainly because of Republican tax cuts on corporations and the wealthy. The big Trump Republican tax cut is already breaking the bank. It will cost us 1.9 trillion dollars over the next decade. Let me repeat that: 1.9 trillion dollars. 

Remember, Trump and Republicans in Congress claimed that their tax cuts for the wealthy and corporations would pay for themselves by boosting economic growth. It’s the same trickle-down fairy tale they’ve been telling for decades. But according to the Congressional Budget Office, they haven’t paid for themselves, and the deficit continues to balloon. 

If there’s one area where America spends too much, it’s the military. Since taking office, Trump has increased military spending by more than $200 billion a year, straining the federal budget even further. The United States already spends more on the military than the next 10 nations combined. 

Mitch McConnell, Donald Trump, and other Republicans in Washington want to cut Social Security, Medicare, and Medicaid. That’s been the Republican goal for decades. And they want to use the deficit to justify these cuts.

They also argue that we can’t afford a comprehensive healthcare system that the rest of the advanced world has figured out how to afford. 

Baloney. If the rich and corporations pay their fair share and we rein in defense spending, America can afford what we need. 

Know the truth. Spread the truth about the deficit.

Election Saw Some Good Ballot Initiatives Passed

Both Democrats and Republicans can celebrate the election day choices made by voters on politicians. The Democrats can celebrate winning control of the House of Representatives, while the Republicans can celebrate retaining control of the Senate. We'll just have to wait and see how this divided Congress works out -- whether it will be good or bad for the citizens of this country.

But it wasn't just politicians on the ballot in some states. There were also some ballot initiatives -- and the ones that won are good news for all Americans. Here are some of the initiatives that passed.

VOTER RIGHTS

The voters of Florida approved an initiative to restore voting rights to felons that have completed their sentence. This could reinstate voting rights to about 1.4 million people (who under the old Florida law had lost their voting rights forever).

MEDICAID EXPANSION

Until this election, only 33 states had expanded Medicaid to provide health insurance for the poor. The other 17 states had Republican administrations that refused to expand Medicaid. On election night, ballot initiatives were passed in three of those GOP-dominated states (Utah, Idaho, and Nebraska) to expand Medicaid in those states -- and the measures passed rather easily.

Tow other states (Maine and Kansas) elected Democrats to be governor. Those states had Republican governor's who had blocked Medicaid expansion, so they now could also join the now 36 states expanding Medicaid.

MARIJUANA LEGALIZATION

A couple of states voted to approve medical marijuana (Missouri and Utah). But the really important vote came in Michigan. Michigan voters easily approved a ballot initiative to legalize marijuana for recreation use. They join nine other states that have legalized marijuana -- Colorado, Oregon, California, Washington, Alaska, Nevada, Vermont, Massachusetts, and Maine.

This means 10 states, or 20% of all the states, now have legalized marijuana. I expect the 2020 election will see that list grow.

(Chart is from governing.com.)

Medicaid Directors In The 50 States Oppose Trumpcare

Doctors, Hospitals, AARP, insurance companies, and a host of medical societies have all come out against the latest version of Trumpcare (the Graham-Cassidy bill) in the Senate. Now the NAMD, representing Medicaid directors in all 50 states, has joined in that opposition. Here is part of an article by Jessie Hellmann in The Hill:

The National Association of Medicaid Directors (NAMD) warned Republicans on Thursday that the Senate's latest ObamaCare repeal bill would place a massive burden on states.

The bill, sponsored by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), would eliminate ObamaCare's Medicaid expansion and subsidies beginning in 2020, converting the funding to state block grants.

It would also change the federal government's funding of the traditional Medicaid program from an open-ended commitment to the states to a per capita cap on each enrollee.

"Taken together, the per-capita caps and the envisioned block grant would constitute the largest intergovernmental transfer of financial risk from the federal government to the states in our country’s history," the NAMD's board of directors wrote in a statement Thursday.

The NAMD, which is a coalition of Medicaid directors from every state, noted that while the proposal is intended to create maximum flexibility, it does not provide the statutory reforms necessary "commensurate with proposed funding reductions."

The GOP bill would also require states create their own health-care programs by 2020, which the directors argue is a massive undertaking.

"The scope of this work, and the resources required to support state planning and implementation activities, cannot be overstated," the directors said. 

"States will need to develop overall strategies, invest in infrastructure development, systems changes, provider and managed care plan contracting, and perform a host of other activities. The vast majority of states will not be able to do so within the two-year timeframe envisioned here, especially considering the apparent lack of federal funding in the bill to support these critical activities."

The directors also hit Senate Republicans for not having a full Congressional Budget Office score before a possible vote on the bill, "which should be the bare minimum required for beginning consideration." 

"With only a few legislative days left for the entire process to conclude, there clearly is not sufficient time for policymakers, Governors, Medicaid Directors, or other critical stakeholders to engage in the thoughtful deliberation necessary to ensure successful long-term reforms," the directors said. 

Trumpcare Would Shift The Financial Burden To States

(This chart shows the amount the states would need to increase taxes to cover current Medicaid patients if the Senate bill is passed -- with the darker the color the more taxes would have to increase. You can go here for an interactive version of the map, where you can click on an individual state to see exactly how much taxes would have to rise in that state.)

The Senate Republicans are bragging that their version of Trumpcare will reduce the cost to the federal government of sustaining the Medicaid program. What they won't tell you is that they are just shifting the financial burden of Medicaid to the individual states. And to meet that burden, states would have to raise taxes or kick people off the Medicaid insurance program -- probably both.

The sad part of this is that there is no reason why we need to pay more taxes (on federal or state level) or make citizens go without health insurance coverage. Other developed nations cover all their citizens with health insurance, and they do it at less cost per capita than the United States. There is no reason why the United States could not cover all its citizens, and do it for less than is currently spent.

The easiest way would be to institute a single-payer insurance system (something like Medicare-For-All). How could costs be lowered in such a system? By cutting out insurance profits, lowering the costs of administering the insurance program (Medicare has much lower administrative costs than private insurance), and by negotiating medical costs with providers (doctors, hospitals, pharmaceutical companies, etc.).

And such a system would also be good for businesses. They would no longer have to provide insurance coverage for their workers (and their share of the program cost would be far less than they currently pay for employee insurance). They could use to money saved to compete more effectively, increase profits, or increase worker pay (thus increasing loyalty and longevity).

Unfortunately, the congressional Republicans (and some Democrats) are not ready to support a single-payer system. They (and the public) need to be educated.

U.S. Public Gives A Resounding NO To Trumpcare

Senate Republicans are still wrestling with their version of Trumpcare, and it's unknown whether McConnell can get 50 votes to pass it. But the American people have delivered their verdict, and it's not good. Only 28% now say they support Trumpcare as a replacement for Obamacare, while a substantial majority of 61% say they oppose it.

Meanwhile, about 50% now say they support Obamacare (although a lot of them would like for it to be improved) and 44% oppose it. That means Obamacare has nearly twice as much support as Trumpcare does among the general population.

Why doesn't the public like Trumpcare? The bottom chart gives one reason. About 65% of Americans don't want large cuts in federal funding for Medicaid. They know this would mean millions of Americans would no longer have any health insurance coverage -- and they don't like that.

These charts were made from information in a new Kaiser Family Foundation Poll -- done between July 5th and 10th of a random national sample of 1,183 adults, with a 3 point margin of error.

CBO Says Senate Bill Will Take Insurance From 22 Million

The Congressional Budget Office (CBO) has released its analysis of the Better Care Reconciliation Act of 2017 (BCRA) -- the Senate Republican bill to cut taxes for the rich disguised as a health care bill. And it's just as bad as we expected.

The bill would cause about 22 million people to lose their health insurance by 2026 -- raising the number of uninsured to 48 million Americans by that year. While that's a million fewer than the House bill (AHCA), the Senate cuts to Medicaid would continue after 2026 -- and that means the number of uninsured Americans would continue to rise after 2026.

While some of the rise in the uninsured would come from those currently purchasing their own policies or from employers no longer being required to purchase insurance for employees, most of those losing insurance would be people currently getting insurance help through Medicaid. The Medicaid program would be devastated.

The CBO also projected that insurance premiums would rise by 20% in 2018 and another 10% in 2019. After that, the average premium cost would go down. But that is not a cause for celebration. Current policies (under Obamacare) are required to pay about 70% of medical costs. But in 2020, they expect policies to cover only about 58% of costs -- meaning those policies will have fewer benefits and higher deductibles.

This means those buying individual plans might pay less for premiums, but if they get sick, they'll pay a lot more out of their own pockets for medical care. And it probably won't just be those who buy individual policies. We can expect a lot of employers to start buying plans for their employees that have fewer benefits and much higher deductibles.

The BCRA will do what it was intended to do -- give the richest Americans a huge tax cut. But to do that, the Senate Republicans will throw the poor, the working class, and even many in the middle class under the bus. It's a truly bad plan, and we can only hope it's defeated.