Senate Republicans failed to reach agreement on a new version of their bill to cut $1.2 trillion from government spending on health care and effectively dismantle Medicaid, the government insurance program for the poor, prior to the 10-day Independence Day congressional recess, putting off a vote on the measure until mid-July at the earliest.
The more that becomes known of the Senate version of a similar Republican measure passed last month by the House of Representatives, the more rapidly popular opposition grows. On Wednesday, a USA Today/Suffolk University poll was released showing popular support for the Senate bill at a mere 12 percent. According to the survey, conducted among registered voters from last Saturday to Tuesday, 45 percent oppose the bill, 40 percent do not know enough about it to form an opinion, and 3 percent fall into the category of “other.”
Even among Republicans, support is minimal. The poll showed 26 percent supporting, 17 percent opposing and 52 percent saying they need more information.
Far from seeking to mobilize the anger among working people over the assault on health care, Democrats are appealing to President Donald Trump and the Republicans to reach a bipartisan agreement to impose new cuts and make further concessions to the insurance industry, by making the current “Obamacare” system even more pro-corporate and anti-working class.
On Wednesday, as Republican Senate Majority Leader Mitch McConnell and Vice President Mike Pence were meeting with various far-right and “moderate” Republican senators who have expressed opposition to the current draft of the bill, Democratic Senate Minority Leader Charles Schumer was stepping up his bid for talks on a bipartisan “compromise.”
“President Trump,” the New York senator declared, “I challenge you to invite us—all 100 of us—to Blair House to discuss a new bipartisan way forward on health care in front of all the American people. It would focus about what you, Mr. President, have talked about in your campaign: lower costs, better health care, covering ‘everybody’—not on tax cuts for the rich, not on slashing Medicaid.”
The New York Times, which reflects the views of the Democratic Party establishment and its Wall Street backers, hinted at the actual content of the “compromise” on offer from the Democrats in its front-page lead article Thursday, bearing the hopeful sub-headline “Deal on Existing Health Law Could Emerge if Senate Bill Fails.” The article noted longstanding talks between members of the two parties on “avenues for changing or improving President Barack Obama’s health care law, from tweaks to the requirement for employers to offer health insurance to revisions involving how the marketplaces created under the law operate.”
These are code words for watering down already weak requirements that businesses provide health coverage for their employees and for implementing the insurance giants’ demands for tighter eligibility and more leeway to jack up premiums, copays and deductibles on policies purchased on the Obamacare exchanges.
Whatever emerges from the largely stage-managed political maneuvers in Washington, the result will be a new point of departure in the decades-long attack on health provision and working class living standards, leading to the privatization and gutting of the basic social reforms dating from the 1930s and 1960s—Medicaid, Medicare and Social Security. Obamacare, passed by the Democrats and signed into law by Obama in 2010, was itself a milestone in this direction, imposing massive cuts on Medicare funding, weakening the system of employer-sponsored health insurance and further subordinating health care to the private market.
Trump and the Republicans have no intention of pulling back from a qualitative escalation of this process, singling out in the first instance Medicaid, which presently covers 70 million poor, elderly and disabled people. The negotiations going on within the Republican Senate caucus have to do with changes at the margins of the bill that was released last week, not its basic content.
Maine Senator Susan Collins, a “moderate” opponent of the current bill, announced Thursday that Trump and Senate Republican leaders had agreed to increase a set-aside for opioid addiction treatment from $2 billion to $45 billion in an effort to win over recalcitrant Republicans from states particularly devastated by the opioid epidemic. However, as even some Republicans pointed out, this will be a drop in the bucket compared to the impact of the draconian cuts in Medicaid—$772 billion over ten years—in the bill. Medicaid pays for a large share of the cost of substance abuse treatment and prevention in many states.
There are also proposals from some Senate Republicans to retain one of the Obamacare taxes targeted for repeal in the original Senate bill—part of a $700 billion tax cut designed to benefit overwhelmingly the corporations and the wealthy. Retaining a tax on investment income for individuals earning $200,000 and couples taking in $250,000 a year would, according to the Congressional Budget Office (CBO), save some $172 billion over 10 years that could go to somewhat paring back cuts in health care subsidies and increases in deductibles and copays. However, more far-right factions within the Republican caucus have already denounced any such move.
Some of the most right-wing senators, including Rand Paul of Kentucky and Ben Sasse of Nebraska, are calling for the Republicans to ditch their effort to “repeal and replace” Obamacare and instead simply repeal the current law, with a replacement to come sometime in the future. This would likely destabilize the entire health care system and strip even more people of health insurance than the 22 million who would lose coverage under the Senate bill.
Trump posted a tweet Friday morning backing this approach, proposing that if the Senate Republicans failed to pass their bill, they should simply put an end to Obamacare and worry about a replacement later.
Meanwhile, the CBO published an update on its earlier scoring of the Senate measure, which had estimated that Medicaid funding would decline by 26 percent over ten years from the projected level under current law. The CBO said that over 20 years, by 2036, the decline would reach 35 percent.
The Wall Street Journal noted on Friday that little-discussed provisions in the Senate bill would have a devastating impact on people currently covered by employer-provided health plans, as well as those seeking to purchase insurance plans as individuals. The bill would, the newspaper reported, remove 4 million people from such plans in 2018.
This is because under both the House and Senate bills, some large firms would drop coverage since they would no longer face a penalty for not offering health benefits. The bills would also lift a requirement that employer plans cover at least 60 percent of costs such as deductibles and copays. This would allow businesses to offer skeleton plans that limit the number of physician visits, days in the hospital and prescriptions.