Many people who don’t use Medicaid think of it as a federal health-care program for the poor. It’s not. As incomes have stagnated and health-care costs have accelerated, Medicaid has turned into an essential support mechanism for more than 1 out of 5 Americans.
About 60 percent of all nursing-home residents now receive assistance from Medicaid. Kids are also big beneficiaries: Medicaid and CHIP [Children’s Health Insurance Program] now help to provide medical coverage for about a third of all the children in America.
But the Republican Party doesn’t merely want to roll back Medicaid’s expansion under the Affordable Care Act; it wants to shrink the entire program. According to the CBO, the House’s Trumpcare bill would reduce over-all federal spending on health care by about $1.1 trillion over ten years. Of that, $840 billion —fully three-quarters of the savings—would come from cuts to Medicaid. The number of people covered by Medicaid and CHIP would fall by 14 million, accounting for almost two-thirds of the total decrease of 23 million predicted by the C.B.O.
Why is the Republican Party so hostile toward Medicaid?
1. It’s costly to the rich. Under the Affordable Care Act, households with taxable incomes of more than a quarter of a million dollars a year are obliged to pay a 3.8-per-cent tax on their investment income—money from things like stock dividends and interest payments on bonds—and a 0.9-per-cent surtax on their other earnings. The Obamacare repeal would abolish these taxes -- providing significant handouts to families in the top 1 per cent. The cuts to Medicaid pay for these handouts.
2. It’s become an embryonic single-payer system that could be further expanded pretty easily. Paul Ryan and the GOP want to kill it before it grows more.
Keep an eye on what happens to the Medicaid provisions of Trumpcare.
By John Cassidy
