Let’s first travel back in time to 2013, when Barack Obama was pilloried for saying “if you like your health-care plan, you can keep it.” Remember the furor over that?
Because he said it a lot, and it turned out to be untrue. And the right went absolutely ballistic—not only was Obama a bald-faced liar, but it showed what a shell game the whole health-care overhaul law was. It turned out that only 4 million people out of a total of more than 250 million insured lost their health-care plans, but still, 4 million is 4 million flesh-and-blood Americans. Obama’s lie was, as you might recall, named the “Lie of the Year” for 2013 by Politifact, which counted 37 separate times Obama had said with no caveats that everyone would be able to keep their coverage.
Well, I don’t know exactly how many times candidate and President Donald Trump has said things like everyone will have coverage under his Obamacare replacement. But it was a lot. His plan would be “something terrific.” “I am going to take care of everybody.” “Everybody’s going to be taken care of much better than they’re taken care of now.” It must be dozens. And that’s on top of the dozens of denunciations of Obamacare as a “disaster” that wasn’t helping people.
Well, now we have the Congressional Budget Office’s assessment of the Republican replacement plan (which technically burst from the womb as Ryancare rather than Trumpcare, thought the White House pledged late last week to move heaven and earth to pass it even as it remains the one thing that Trump emphatically doesn’t want to smack his name on). And what does the CBO have to say about this terrific plan that’s going to take care of everybody and rescue America from the disaster?
It has to say: 14 million more uninsured by 2018. That’s a year and change! Fourteen million people thrown back to the wolves. And more—an additional 7 million by 2020, and 3 million more by 2024, making for a grand total of 24 million people who currently have health coverage thrown off the rolls as a direct result of this bill, the Republican “replacement” bill.
If Obama got Lie of the Year over 4 million, what does Trump get over 24 million? True, the competition for lies is a lot more robust than it was in that now innocent-seeming year of 2013. But surely this deserves some kind of prize.
Oh, there’s more. Remember all those times you heard Trump trash the premium increases under Obamacare? Not, I will note, without justification. Premium increases and high deductibles have been a bane of Obamacare for many consumers.
But what does the CBO say TRyancare will accomplish on the premium front? It projects increases in 2018 and 2019 of about 15 or 20 percent higher than under Obamacare.
Also, the CBO says that the Republican plan really socks it to a group that it’s never politically very wise to sock it to. I refer you to Table Four on page 34 of this .pdf, listing the CBO’s estimated premium increases for 21-, 40-, and 64-year-olds at different income levels under the GOP plan. The most striking thing is this: Under current law (Obamacare), a 64-year-old earning $26,500 a year pays a net premium (after the tax credit) of $1,700. RyanTrumpCare whacks away at that earner’s tax credit such that he is left paying a whopping $14,600.
But hey, there’s good news! Premiums for many could be lower by 2026, provided of course they’re still alive in 2026. And the GOP plan would reduce the deficit, which stands to reason, since it cuts back so sharply on Medicaid subsidies.
But somehow, “Republican Health Plan to Reduce Deficit by $337 Billion” is not the headline that’s going to come out of this. This is a bloodbath for the Republican Party, and it is a much-deserved baptism by blood for Trump into the particular brand of duplicity that is the modern GOP.
Because there are two styles of duplicity afoot in Washington right now. There’s Trumpian dishonesty, which consists of his plain-faced lies about his behavior and his evidence-free outbursts like the one he directed at Obama two weekends ago.
Then there’s your more standard Republican duplicity, like promises that health care would be easy to bring to everyone if we just got government out of the way and let the market work its wondrous magic. That may be how it works in Ayn Rand novels, but that isn’t how it works in the actual world. In the actual world, anyone who’s given the matter five minutes of honest thought (emphasis on honest thought) comes to the obvious realization that the only thing that can bring premiums and deductibles down is for more healthy people to have to buy insurance.
And from there, if you’re being honest, you then realize that the only entity that can make people buy insurance is the federal government; and that you have to give them an incentive to do so, which means subsidies. And all that spells Obamacare. It’s complicated and flawed, sure. But any attempt to do it any other way will wind up where the CBO just tossed RyanTrumpCare: in the garbage, where it belongs.
Paul Ryan must know this deep down. Or no—lately we’ve begun to realize that maybe he doesn’t, right? That jaw-dropping line of his about it being the “fatal conceit” of Obamacare that the healthy pay for the sick revealed, as many have by now observed, that he doesn’t seem to understand what insurance even is.
And Donald Trump clearly doesn’t know it. That line of his a few weeks ago, equally jaw-dropping, that “nobody knew that health care could be so complicated” was a howler. No, Donald. We all knew. It’s just that you didn’t, because while you were out there on the stump lying repeatedly about giving people the best possible coverage, you weren’t bothering to actually learn anything about the topic. Now you have to.
Let us hope the voters of 2018 teach you, and teach you well.