On Friday, December 22, after receiving a “pay-go waiver,” which enabled the GOP to put off immediate cuts to Medicare and a bevy of other programs required to offset the debt increase, President Trump signed the GOP tax bill into law. The anger surrounding this legislation is well warranted. It’s another gift for the donor class. But this tax cut is far more than a bill designed to appease the 1 percent, it’s more than supply-side economics on steroids, it’s the first step in dismantling our current health care system.
The GOP tax bill repeals the Affordable Care Act’s (ACA) individual mandate, an unpopular, but necessary provision of our current health care system. The Congressional Budget Office estimates the elimination of the individual mandate will result in 4 million fewer people insured by 2019, and 13 million fewer by 2027, while raising premiums by an average of 10 percent. While no one can say for sure what the precise impact will be once the mandate penalty moves to $0 in 2019, there is no doubt that millions fewer Americans will have health insurance coverage, and an already unstable marketplace will grow even more turbulent. It’s also worth noting that repealing the individual mandate will result in fewer Americans signing up for Medicaid, which will save the government some money to help offset the enormous corporate and 1 percent-earner tax cuts that will soon be implemented.
The damage from the individual mandate repeal will be substantial, any way you spin it, but what is on the horizon may be even more catastrophic to overall coverage. The GOP has intentionally painted themselves into a corner. They are fine with this tax bill adding a trillion dollars to the national debt because they know just how they’ll address this issue: with cuts to so-called entitlement programs. It’s not like they’re hiding it. Paul Ryan said a major goal for 2018 will be cutting Medicare, Medicaid and welfare programs. As the Washington Post reported, Ryan said, “[I]t’s the health care entitlements that are the big drivers of our debt, so we spend more time on the health care entitlements — because that’s really where the problem lies, fiscally speaking.”
One of the primary achievements of the ACA was its expansion of Medicaid. Overall eligibility for Medicaid and the Children’s Health Insurance Program (CHIP) was expanded dramatically under the ACA, even though 19 states refused to participate. Of the estimated 20 million more insured under the ACA, a large portion gained coverage under Medicaid and CHIP. As a report by the Kaiser Family Foundation shows, states that expanded Medicaid saw significant reductions in statewide-uninsured rates.
While this bill won’t immediately impact Medicare or Medicaid (CHIP, however, is a different story, as its long-term funding remains a question mark), the existence of these programs, as they are currently constituted, is in peril.
The GOP has a plan here: remove the individual mandate, which will serve to destabilize the market even further. Then they can blame the mess on the ACA itself, and work towards another full repeal effort. At this point, the situation may be dire, as our health care system will be a teetering, three-legged chair, so passage should be far easier than last time. Meanwhile, they can work to decrease the national debt — which they are about to add to significantly — by cutting Medicare, Medicaid, Welfare, Social Security, student loan programs and anything else they label an “entitlement program.”
The GOP is aggressively pushing health care in the wrong direction. According to recent data from the CDC, there are an estimated 28.1 million Americans currently without health insurance. Those 28.1 million could easily top 50 million in only a decade if these cuts are implemented. We should be working to ensure every American has insurance coverage. Instead, we’re leaving millions more in the dust each year.
Truthout Is Preparing to Meet Trump’s Agenda With Resistance at Every Turn
Dear Truthout Community,
If you feel rage, despondency, confusion and deep fear today, you are not alone. We’re feeling it too. We are heartsick. Facing down Trump’s fascist agenda, we are desperately worried about the most vulnerable people among us, including our loved ones and everyone in the Truthout community, and our minds are racing a million miles a minute to try to map out all that needs to be done.
We must give ourselves space to grieve and feel our fear, feel our rage, and keep in the forefront of our mind the stark truth that millions of real human lives are on the line. And simultaneously, we’ve got to get to work, take stock of our resources, and prepare to throw ourselves full force into the movement.
Journalism is a linchpin of that movement. Even as we are reeling, we’re summoning up all the energy we can to face down what’s coming, because we know that one of the sharpest weapons against fascism is publishing the truth.
There are many terrifying planks to the Trump agenda, and we plan to devote ourselves to reporting thoroughly on each one and, crucially, covering the movements resisting them. We also recognize that Trump is a dire threat to journalism itself, and that we must take this seriously from the outset.
Last week, the four of us sat down to have some hard but necessary conversations about Truthout under a Trump presidency. How would we defend our publication from an avalanche of far right lawsuits that seek to bankrupt us? How would we keep our reporters safe if they need to cover outbreaks of political violence, or if they are targeted by authorities? How will we urgently produce the practical analysis, tools and movement coverage that you need right now — breaking through our normal routines to meet a terrifying moment in ways that best serve you?
It will be a tough, scary four years to produce social justice-driven journalism. We need to deliver news, strategy, liberatory ideas, tools and movement-sparking solutions with a force that we never have had to before. And at the same time, we desperately need to protect our ability to do so.
We know this is such a painful moment and donations may understandably be the last thing on your mind. But we must ask for your support, which is needed in a new and urgent way.
We promise we will kick into an even higher gear to give you truthful news that cuts against the disinformation and vitriol and hate and violence. We promise to publish analyses that will serve the needs of the movements we all rely on to survive the next four years, and even build for the future. We promise to be responsive, to recognize you as members of our community with a vital stake and voice in this work.
Please dig deep if you can, but a donation of any amount will be a truly meaningful and tangible action in this cataclysmic historical moment. We are presently looking for 231 new monthly donors in the next 2 days.
We’re with you. Let’s do all we can to move forward together.
With love, rage, and solidarity,
Maya, Negin, Saima, and Ziggy