There have been many bad laws in U.S. history. Some bills were poorly conceived; some were cruel and unjust; some were sold on false pretenses. Some were all of the above.
But has there ever been anything like Trumpcare, the health legislation Republicans rammed through the House last week? It’s a miserably designed law, full of unintended consequences. It’s a moral disaster, snatching health care from tens of millions mainly to give the very wealthy a near-trillion-dollar tax cut.
What really stands out, however, is the Orwell-level dishonesty of the whole effort. As far as I can tell, every word Republicans, from Trump on down, have said about their bill – about why they want to replace Obamacare, about what their replacement would do, and about how it would work – is a lie, including “a,” “and” and “the.”
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And what does it say about the state of American politics that a majority of the representatives of one of our major political parties has gone along with this nightmarish process?
Before taking back the White House, Republicans attacked Obamacare for many things. For one thing, they claimed that it was rushed through without proper debate.
They also claimed that Americans were getting a raw deal. Deductibles were too high, they claimed; so were premiums. They promised to bring these costs down, to provide, as Donald Trump insisted he would, coverage that was “much less expensive and much better.”
And meanwhile, they promised to keep the things people liked about Obamacare (whether or not voters knew they were getting those good things because of Obamacare). Nobody would be thrown off Medicaid; nobody would be denied affordable coverage because of pre-existing conditions.
Then came the reality of Republican legislation. Obamacare was debated and analyzed for many months; Trumpcare was thrown together so fast it’s hard to believe any significant number of those voting for it even had time to read it. And it was, of course, pushed through the House without giving the Congressional Budget Office a chance to estimate its costs, its effects on coverage, or anything else.
Even without a proper analysis, however, it’s clear that Trumpcare breaks every promise Republicans ever made about health. Deductibles will rise, not fall, as insurers are set free to offer lower-quality coverage. Premiums may fall for a handful of young, healthy, affluent people, but will rise and in many cases soar for those who are older (because age spreads will rise), sicker (because protection against discrimination based on medical history will be taken away), and poorer (because subsidies will go down).
Many people with pre-existing conditions will find insurance either completely unavailable or totally out of their financial reach.
And Medicaid will be cut back, with the damage worsening over time.
The really important thing, however, is not just to realize that Republicans are breaking their promises, but to realize that they are doing so with intent. This isn’t one of those cases where people try to do what they said they would, but fall short in the execution. This is an act of deliberate betrayal: Everything about Trumpcare is specifically designed to do exactly the opposite of what Trump, Paul Ryan and other Republicans said it would.
Which raises two questions: Why are they doing this, and why do they think they can get away with it?
Part of the answer to the first question is, presumably, simple greed. Tens of millions would lose access to health coverage, but – according to independent estimates of an earlier version of Trumpcare – people with incomes over $1 million would save an average of more than $50,000 a year.
And there is a powerful faction within the GOP for whom cutting taxes on the rich is more or less the only thing that matters.
And on a more subjective note, don’t you get the impression that Donald Trump gets some positive pleasure out of taking people who make the mistake of trusting him for a ride?
As for why they think they can get away with it: Well, isn’t recent history on their side? The general shape of what the GOP would do to health care, for the white working class in particular, has long been obvious, yet many people who were sure to lose, bigly, voted Trump anyway.
Why shouldn’t Republicans believe they can convince those same voters that the terrible things that will happen if Trumpcare becomes law are somehow liberals’ fault?
And for that matter, how confident are you that mainstream media will resist the temptation of both-sides-ism, the urge to produce “balanced” reporting that blurs the awful reality of what Trumpcare will do if enacted?
In any case, let’s be clear: What just happened on health care shouldn’t be treated as just another case of cynical political deal making. This was a Freedom is Slavery, Ignorance is Strength moment. And it may be the shape of things to come.