When I read about the Republican plan to repeal and replace Obamacare with what we may as well start calling “Trumpcare,” I called Sandy, my good friend who lives in New York City.
As a self-insured freelance writer, he’s been one of my go-to guys for stories about how flawed Obamacare can be for someone who depends on it. And sure enough, he filled me in on the latest details of his skyrocketing deductibles and copays.
“So you’re glad Trump’s getting rid of Obamacare?” I asked.
“Are you kidding me?” he responded.
In other words, as bad as things are with Obamacare, he’s pretty sure Trump will only make them worse.
So it goes these days. Just when you think things couldn’t get worse, along comes a politician—President Trump, Governor Rauner, Mayor Rahm—to prove you wrong.
At this point, I must concede that, in regards to Obamacare, President Obama at least tried to solve a seemingly intractable problem, one that no previous president had succeeded in doing: as of 2013, more than 41 million Americans lacked health insurance.
As a civilized society, we had to extend coverage so everybody—rich and poor, healthy and sick—could afford treatment. Or as the late, great Hyde Park activist Dr. Quentin Young once put it: “Everybody in, nobody out.”
Obamacare extended coverage to tens of millions of people who hadn’t had it previously.
But many peoples’ premiums went up, many insurance companies dropped some preferred plans, and by the end of 2015, there were still 28.5 million people without coverage.
The most sensible plan for America to adopt would be a single-payer system, where the federal government acts like a middleman, collecting premiums from patients in the form of taxes and paying out bills to health-care providers.
But that would cut out insurance companies, who profit from the current system. And Obama couldn’t pass a single-payer system in the face of insurance companies funding commercials blasting Democrats in swing districts as socialists, as though a single-payer system was the first step in an inexorable march toward communism.
So Obama cobbled together the Affordable Care Act—a Rube Goldberg scheme intended to bring the insurance companies on board so they wouldn’t join Republicans in opposing it.
One provision compelled healthy people to buy insurance by making them pay a fine if they didn’t. Another provision slapped a tax on the wealthy to help pay the cost of covering low-income people.
The Republicans went crazy over this plan largely because (1) they hate paying taxes, (2) they really hate when their taxes go to anyone other than themselves, and (3) they really, really hated when Obama got credit for doing anything.
For the last six or so years, they’ve been firing up their faithful by vowing to get rid of Obamacare just as soon as they could. In fact, the first executive order signed by President Trump on the day of his Inauguration was a measure toward that goal.
So now the Republicans want to ram Trumpcare through Congress in a matter of weeks.
In comparison, Mayor Daley was turtle paced in getting the City Council to approve his parking meter deal.
It’s too early to determine the full consequences or costs of the Republican plan. But we do know they want to replace the “stick” with a “carrot.” That is, instead of forcing healthy people to buy insurance by fining them, they want to induce them to buy it by handing out tax credits.
Also, they want to get rid of the tax on wealthy people that helps funds Obamacare. So a billionaire like Bruce Rauner will get a sweet tax break. Like he needs it.
I guess I shouldn’t drag Rauner into this mess. There are plenty of rich Democrats who will also benefit from Trump’s tax cut.
It’s just that Rauner’s been on my mind lately, what with Chance the Rapper trying to force him to extend state aid to Chicago Public Schools, so the system doesn’t go bankrupt.
Also, I’m starting to realize that Trump may have a similar government-bankrupting scheme in mind.
Think of it like this: He’s getting rid of a tax that helps pay for Obamacare—so that means less money coming in. And he’s proposing a tax credit to get people to buy coverage—that means more money going out.
If all goes to plan, he and his congressional allies can eventually cut government “to the size where we can drown it in the bathtub,” as Grover Norquist, the antigovernment ideologue, once put it.
You know things are bad when guys like Norquist have more influence than people like Dr. Young.
Of course, there’s always the possibility that outrage over Trumpcare will spark a rebellion that drives Republicans out of power and fortifies the Democrats to come up with a single-payer plan.
Even in the midst of doom and gloom, I try to remain hopeful.