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

NAFTA Must be Fought from the Ground Up

A group of local labor leaders, activists, and politicians met in Pittsburgh on Wednesday to take part in a forum regarding NAFTA renegotiations, which were set to begin this week in Washington. Of course, the main focus was how to rework the free trade deal to instead be fair for all workers instead of favoring CEOs.

“It’s urgent that workers’ voices be heard,” said USW President Leo W. Gerard. “If the agreement is renegotiated and doesn’t meet the standard that workers have a voice, we’ll have a very aggressive campaign to stop this new NAFTA.”

Pennsylvania Sen. Bob Casey also touched on one point that perhaps many in the debate tend to miss, which is that NAFTA can't just be reworded with the hope that it solves all of our economic problems. The countries must also tackle policies put in place outside of the failed trade deal in all three nations involved—the United States, Canada, and Mexico.

One of these things, Casey pointed out, is tax reform. As of now, there is no financial incentive to keep U.S. companies operating on U.S. soil. Our tax code does the opposite and encourages them instead to ship jobs overseas and into Mexico.

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A New NAFTA for Workers

A New NAFTA for Workers