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

Failing Bridges Hold Public Hostage

From the USW

From tumbledown bridges to decrepit roads and failing water systems, crumbling infrastructure undermines America’s safety and prosperity. In coming weeks, Union Matters will delve into this neglect and the urgent need for a rebuilding campaign that creates jobs, fuels economic growth and revitalizes communities.

The Seattle Department of Transportation (SDOT) gave the public just a few hours’ notice before closing a major bridge in March, citing significant safety concerns.

The West Seattle Bridge functioned as an essential component of  the city’s local and regional transportation network, carrying 125,000 travelers a day while serving Seattle’s critical maritime and freight industries. Closing it was a huge blow to the city and its citizens. 

Yet neither Seattle’s struggle with bridge maintenance nor the inconvenience now facing the city’s motorists is unusual. Decades of neglect left bridges across the country crumbling or near collapse, requiring a massive investment to keep traffic flowing safely.

When they opened it in 1984, officials predicted the West Seattle Bridge would last 75 years.

But in 2013, cracks started appearing in the center span’s box girders, the main horizontal support beams below the roadway. These cracks spread 2 feet in a little more than two weeks, prompting the bridge’s closure.

And it’s still at risk of falling.  

The city set up an emergency alert system so those in the “fall zone” could be quickly evacuated if the bridge deteriorates to the point of collapse.

More than one-third of U.S. bridges similarly need repair work or replacement, a reminder of America’s urgent need to invest in long-ignored infrastructure.

Fixing or replacing America’s bridges wouldn’t just keep Americans moving. It would also provide millions of family-supporting jobs for steel and cement workers, while also boosting the building trades and other industries.

With bridges across the country close to failure and millions unemployed, America needs a major infrastructure campaign now more than ever.

 

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There is Dignity in All Work

There is Dignity in All Work