House Passes Healthcare Bill; Now What?

Who Gets Hurt? Who Gets Helped? Will The Senate Make Changes? We Break It Down:

If you want a blow-by-blow, Politico published a good one early this A.M.

House Republicans joined together with enough votes to pass their healthcare bill. The vote, 217 to 213, had no Democratic supporters and 20 Republicans also said no. The vote came prior to completion of a Congressional Budget Office report on how much the new plan will cost, or how many people will (or won’t) be covered. One former CBO director called the hasty vote “a terrible mistake”, while another said it’s not that big a deal since the numbers should be in line with the bill that failed a couple of weeks ago.

Senators May Ignore The House Bill and Start Fresh

Senate Majority Leader Mitch McConnell called the House bill “an important step”–hardly a ringing endorsement. And while President Trump and House Republicans celebrated their victory, some Republican Senators say they are going to bypass the details of the House bill and write their own version. Alaska Republican Senator Lisa Murkowski says she hopes the Senate will start with “a clean slate.” [Bloomberg].

Most observers say the House bill, as is, would not get the votes of 50 Senators needed to pass. (In a 50-50 tie, Vice President Pence would cast the tie-breaking vote.) There are 52 Republicans in the Senate, 46 Democrats, and 2 Independents (one whom you are likely very familiar with.)

So, Why Did It Pass In The House?

“I don’t think we should pass bills that we haven’t read and don’t know what they cost.” Guess who said that? Paul Ryan, back in 2009. Of course, that’s exactly what Ryan’s House just did. [CNBC]

So why did they do it? The best explanation we’ve heard comes from Vox’s Ezra Klein. He calls it the hot potato theory. He says Republicans don’t really want their healthcare bill to pass, but “none of them want to be the cause of its failure.” The Freedom Caucus took the blame last time, and they came up with face-saving amendments so they could support it this time.

For years, Republicans made their goal getting rid of Obamacare. So politically, they score with their base. (Perhaps until their supporters see what it means to them. See below.) And Trump needed to keep his promise to get rid of Obamacare.

The details of what’s in the bill are pretty much irrelevant to many of them. That’s a potentially disastrous way to run a country on a bill that impacts one-sixth of the economy, and virtually everyone’s health.

Who Gets Hurt?

Virtually everybody who has a body. For most people, either premiums will go higher, or “essential” coverage will become “non-essential”, or may be lost altogether due to pre-existing conditions or severe cuts to Medicaid. This will be offset some by things like healthcare savings plans, but that assumes you’ll have money to put into them.

Indivisible put together a top 10 list for the worst parts of the Trumpcare bill:

1. Takes away healthcare from 24 million Americans. (Based on previous CBO estimates.)
2. Hikes deductibles by $1,500 on average.
3. Ends the federal protections for people with pre-existing conditions.
4. Allows insurance companies to charge older Americans significantly more.
5. Cuts $880 billion from Medicaid
6. Puts lifetime and annual benefit caps back on the table.
7. Makes women pay more for health insurance than men.
8. De-funds Planned Parenthood.
9. Harms children with special needs.
10. Provides $600 billion in tax breaks for the wealthy and corporations.

You Think If You Get Your Insurance Through Your Job You’re Safe? Think Again

This one’s a little complicated: Because the new house bill passes so many things back to states, each state could now determine minimum coverage. And if you get your health insurance through your employer, they could choose to use the minimum coverage levels for any state. This ABC News story uses Alabama as an example, saying if that state cuts coverage, employers all over the country would only have to match that coverage, regardless of what state you’re actually in.

Who Gets Helped? This One Is Easy…

Yes, if you’re young and healthy, your premiums might go down, but no one will get more dollars out of this bill than the very, very wealthy.

According to the Tax Policy Center the top 1% of earners will save $25,000 in taxes, while the top 1/10th of 1% will get a break in the neighborhood of $165,000.

A Job-Killer For The GOP?

An earlier version of the healthcare bill was very unpopular. Just 17% supported the bill and 56% opposed it. Measures added by the Freedom Caucus are likely to make support even weaker. 538’s Nate Silver says the bill could “endanger the job prospects of the Republican members of Congress who voted for it and make a Democratic takeover of the House substantially more likely in 2018.” [538] We suggested this possible outcome yesterday.

Editorial: Shame On You, President Trump!

Shame on you for callously dropping one of the few campaign promises people actually expected you to  try to keep! You repeatedly said you wouldn’t let anyone touch Medicaid. No way, no how. Now the House healthcare bill cuts Medicaid a whopping 25% or 880-billion dollars, and you are out in the Rose Garden loving it.


People: If you’re on Medicare or Social Security, hold on to your hats! Trump pledged he wouldn’t touch those under any circumstances either…

And we know Paul Ryan wants to mess with both.

But let’s get back to the President promising to “take care” of everyone’s healthcare. That he’d “beautifully cover” everybody. That he’d replace Obamacare with “something terrific.” That it’s an issue of “human decency.” (OK, maybe we didn’t buy into all of that.) But the President was right: it is an issue of human decency. And the House passed a bill that is indecent.

Some thoughts on getting through your day without getting too angry: this bill’s still got a long way to go before it becomes law. Next stop, the Senate. There are reasons to believe significant changes could come there. Just as we predicted the bill would pass in the House, we believe it will not die in the Senate. And for substantially the same reason: if it doesn’t pass this year, changes will become exponentially harder to sell to the public next year. Senate Majority Leader Mitch McConnell is a far stronger shepherd than Paul Ryan. And while Senators tend to be more consistent and steadfast than Representatives, only a couple would have to flip, as opposed to a couple of dozen in the House. That could lead to even more focused deal-making on the part of the White House.

We’ve been presented with a strong threat to human dignity. But it’s not over. We need to confront these harsh realities with some harsh realities of our own. This needs to be, and can be, a catalyst for resistance on a level we have not yet seen.