The New Trumpcare Bill Keeps the Single Cruelest Part of the Old Trumpcare Bill

Ian Millhiser

Ian Millhiser Senior Constitutional Policy Analyst, Think Progress

Senate Majority Leader Mitch McConnell (R-KY) is fighting a two front war. At the right end of his caucus, hardliners want deep Medicaid cuts and weaker protections for people with preexisting conditions. More pragmatic conservatives, meanwhile, say they want to keep the legislation from working havoc on Medicaid.

If a new version of the Senate Republican health bill is any indication, however, McConnell’s strategy is to placate the hardliners and ignore the relatively moderate voices within his caucus.

Though the new draft version of Trumpcare, which was released on Thursday, does make some tweaks to the previous bill’s approach to Medicaid, it largely leaves in place a plan that would eventually phase out Medicaid in its entirety.

Medicaid serves nearly 75 million individuals, most of them drawn from very vulnerable populations such as the poor, the aged, and the disabled.

The new Trumpcare bill, like the one McConnell released last month, imposes caps on Medicaid spending. And the caps effectively lose value with each passing year.

The Congressional Budget Office (CBO) predicts that the cost of care for an individual Medicaid beneficiary will increase 4.4 percent each year. Beginning in 2025, however, the Senate’s version of Trumpcare provides that the Medicaid caps will only grow at the rate of general inflation — closer to 2.4 percent per year. Thus, while the absolute number of dollars spent by Medicaid will increase each year, the real value of that spending will diminish more and more with each passing year.

CBO predicted that the previous version of the Senate Trumpcare bill, which also used a similar mechanism to phase out Medicaid, would cut Medicaid by 35 percent by 2036 relative to current law.

In fairness, there are some new provisions included in the new bill that mitigate the impact of the legislation in the short term. One provision, for example, allows the Medicaid caps to be exceeded in the event of a public health emergency — although this provision sunsets fairly rapidly.

But the basic structure of the earlier bill, with its Medicaid phase out, remains intact.

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Reposted from ThinkProgress

Ian Millhiser is a Senior Constitutional Policy Analyst at the Center for American Progress Action Fund and the Editor of ThinkProgress Justice. He received a B.A. in Philosophy from Kenyon College and a J.D., magna cum laude, from Duke University. Ian clerked for Judge Eric L. Clay of the United States Court of Appeals for the Sixth Circuit, and has worked as an attorney with the National Senior Citizens Law Center’s Federal Rights Project, as Assistant Director for Communications with the American Constitution Society, and as a Teach For America teacher in the Mississippi Delta. His writings have appeared in a diversity of legal and mainstream publications, including the New York Times, The Los Angeles Times, U.S. News and World Report, Slate, the Guardian, the American Prospect, the Yale Law and Policy Review and the Duke Law Journal; and he has been a guest on CNN, MSNBC, Al Jazeera English, Fox News and many radio shows.

Posted In: Allied Approaches

Union Matters

Get to Know AFL-CIO's Affiliates: National Association of Letter Carriers

From the AFL-CIO

Next up in our series that takes a deeper look at each of our affiliates is the National Association of Letter Carriers.

Name of Union: National Association of Letter Carriers (NALC)

Mission: To unite fraternally all city letter carriers employed by the U.S. Postal Service for their mutual benefit; to obtain and secure rights as employees of the USPS and to strive at all times to promote the safety and the welfare of every member; to strive for the constant improvement of the Postal Service; and for other purposes. NALC is a single-craft union and is the sole collective-bargaining agent for city letter carriers.

Current Leadership of Union: Fredric V. Rolando serves as president of NALC, after being sworn in as the union's 18th president in 2009. Rolando began his career as a letter carrier in 1978 in South Miami before moving to Sarasota in 1984. He was elected president of Branch 2148 in 1988 and served in that role until 1999. In the ensuing years, he worked in various roles for NALC before winning his election as a national officer in 2002, when he was elected director of city delivery. In 2006, he won election as executive vice president. Rolando was re-elected as NALC president in 2010, 2014 and 2018.

Brian Renfroe serves as executive vice president, Lew Drass as vice president, Nicole Rhine as secretary-treasurer, Paul Barner as assistant secretary-treasurer, Christopher Jackson as director of city delivery, Manuel L. Peralta Jr. as director of safety and health, Dan Toth as director of retired members, Stephanie Stewart as director of the Health Benefit Plan and James W. “Jim” Yates as director of life insurance.

Number of Members: 291,000 active and retired letter carriers.

Members Work As: City letter carriers.

Industries Represented: The United States Postal Service.

History: In 1794, the first letter carriers were appointed by Congress as the implementation of the new U.S. Constitution was being put into effect. By the time of the Civil War, free delivery of city mail was established and letter carriers successfully concluded a campaign for the eight-hour workday in 1888. The next year, letter carriers came together in Milwaukee and the National Association of Letter Carriers was formed.

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There is Dignity in All Work

There is Dignity in All Work