Trumpcare’s CBO Score Spells a Political—and Public Health—Disaster
The Congressional Budget Office projects that the Senate bill would create 15 million more uninsured by 2018. That’s next year. An election year.
We’ve long since stepped out of real life and into a Dalí painting. We know that. Either a Dalí painting, or a point of such Himalayan irony that all we can do is laugh about it all and make Twitter jokes. It’s the only way to stay sane.
But seriously. The Congressional Budget Office report on the Senate health bill is a moment. It should make any serious person, of any ideology, stop and ask: What do these people think they’re doing? And why on Earth would anyone—anyone—vote for this? (Monday evening, after the CBO release, Maine Republican Senator Susan Collins tweeted that she’ll be voting no.)
Go ahead; click on the link above and read it. It’s not really very long. You can read it in 10 or 15 minutes. You won’t get much out of some passages, if you’re not a wonk. But you’ll get the idea.
The idea: The bill is a policy monstrosity. A health-care monstrosity. It will dramatically increase the number of uninsured, by 22 million over 10 years, as you’ve heard. But it will also increase premiums for most people, at least at first. The long and the short of it is you knew this was going to be a policy monstrosity—the way they did it so fast (after having years to write an Obamacare replacement bill, years they spent saying don’t worry, it’ll be easy), the way they did it in secret, the way they’re trying to ram it through before Americans realize what they’re doing. You knew that.
But here’s the slight surprise that emerges from the CBO report. The bill is even a political monstrosity. That is: Even as a Machiavellian, Mitch McConnell-esque, cynical political move, the bill is a failure.
Here’s why. All the cable networks on Monday night led with the 22 million uninsured, because it’s the biggest number and because it’s the “out-year” projection, which is what these reports always emphasize. But politically, the far more important number is 15 million. The CBO projects that the Senate bill would create 15 million more uninsured in 2018. That’s next year. An election year.
That is to say that 68 percent of those expected to lose their coverage are going to lose it in the bill’s first year. The Republicans are gonna throw 15 million Americans off the insurance rolls in an election year? That’s a lot of people. Divided by 435, it’s around 34,000 people per congressional district, but of course the distribution won’t be even, and there will be many districts—toss-up districts—where 60,000 or 80,000 people will stand to lose their coverage. And states where half a million will lose coverage. How’d you like to be a Republican incumbent House member or senator defending that next fall?
Usually, people writing draconian legislation know how to write it in such a way that the CBO says, well, the big problems are well down the road. But in this case they couldn’t even do that. And remember, by the way: The CBO is run by a Republican. A conservative Republican named Keith Hall. Back in 2015, Republicans—led by John Boehner then, in case you’re sitting there wishing they could again have a reasonable leader like Boehner—fired the incumbent CBO director and replaced him with Hall. Quite obviously, it was done to get someone in there who’d say their LSD numbers add up.
But even he can’t say it. They haven’t added up in 37 years, really, since Ronald Reagan ran promising that he’d fix Jimmy Carter’s dangerous $60 billion deficit and nearly quadrupled it. But Reagan looks like René Descartes next to these people. The epitome of mathematical precision. Numbers mean nothing to these people. Not the number of uninsured. Not the number of nursing home patients who’ll be given the boot. Not even the poll numbers showing fewer that one in five Americans want this.
Just now as I write, Rand Paul and Dean Heller have followed Collins and said they’ll vote no. That means it’s dead. For now. We’ll have to see what McConnell does. And what about the President? He said the House bill was “mean.” He wanted a bill with “heart.” Is that this bill? Really?
I’m not sure McConnell even wants this anymore. He’s seen how the Democrats have owned the health care mess for seven years. It’s made him majority (not minority) leader. Maybe he wouldn’t mind seeing it die. As for the rest of them, how they can read this report and contemplate casting this vote with anything other than shame is beyond me. That’s all of them.
McCain, Hatch, Alexander, all these people who do, or did, have a serious side; Flake, the others who’ve tricked people into thinking of them as reasonable; and of course the “moderates,” the biggest laugh of all. A CBO run by a conservative Republican has just laughed their numbers out of the park.
Can’t they just turn the lights out?