It's been 63 days since Trump took office, the apocolypse began, and "the [American] people became the rulers of this nation again." For Trump's administration, yesterday was supposed to be a defining moment of progress. On the seventh anniversary of Obamacare's passage into law, Republicans prepared to take their first solid step towards its repeal and replacement with the AHCA. Instead, yesterday was an embarrassing demonstration of Republican legislators' failure to get their shit together, and Trump closed the day by telling House representatives to either approve the ACA overhaul or reject it so he can focus on other issues. Trump's bill seeks to reduce the federal deficit by $337 billion and would increase the number of people without health insurance by 24 million by 2026. According to the Washington Post, the conservatives' embarrassing setback on Thursday "gives every side opposed to this bill — and there are many — more time to digest what they hate most about it."
So we picked out the conservative comments on healthcare that we hate most.
1. "What about men having to purchase prenatal care? I'm just... is that not correct? And should they?" -Rep. John Shimkus (R-Ill.)
During a debate on March 9th in the House Energy and Commerce Committee, Democratic Rep. Mike Doyle (Pa.) began interrogating Shimkus on his issues with Obamacare's health-insurance plan requirements. These requirements stipulate that all health plans cover "essential benefits," like prescription drugs, hospital and doctor visits, pregnancy, and child birth. Shimkus' response shows that his issue with Obamacare is its cost on men, and that once again, GOP legislators refuse to acknowledge that insurance works by pooling risks. This risk pool is why, like men pay for the potentiality of prenatal care on their plans, women pay for prostate exams and Viagra on theirs.
2. “Well, I think if you’re an older man, you can generally say you’re not going to need maternity care.” -White House Press Secretary Sean Spicer
I can generally say that women are not going to need prostate exams or Viagra, either. But health care policies that separate risks jeopardize anyone on the financial margins.
Rep. Jim McGovern (D-Ma.) noted that, during briefings Thursday about Trumpcare's maternity coverage, not a single woman was present.
3. "I wouldn't want to lose my mammograms." -Sen. Pat Roberts (R-Kans.)
According to Susan Chira from the New York Times, Roberts' comments riterate that, in terms of "essential benefits," "what's essential is in the eye of the beholder, and the deciders here are overwhelmingly men." Aside from the rare instance of male breast cancer, legislators like Roberts are not at risk if benefits like breast cancer screenings are dropped from required coverage.
Also according to the New York Times, Republicans seeking to replace the Affordable Care Act are cutting essential benefits from their bill to garner as much conservative support for it as possible. The bill also — and incredibly sortsightedly — seeks to cut federal funding for Planned Parenthood. The Congressional Budget Office, which is nonpartisan, estimates that cutting off funding for PP would only result in "thousands of additional Medicaid births." Not to mention the fact that since its passage in 1976, the Hyde Amendment has barred PP from using federal funds towards abortion services — proving moral arguments for Trumpcare pointless.
3. "You know what, Americans have choices, and they've got to make a choice. And so maybe, rather than getting that new iPhone that they just love and want to go spend hundreds of dollars on, maybe they should invest in their own health care." -Rep. Jason Chaffetz (R-Ut.)
Wow! I did not realize that healthcare premiums cost as little as an iPhone! Oh wait, they don't.
The Kaiser Family Foundation reports that the average premium for an individual health care plan in the U.S. costs about $235 per month. Comparatively, buying an iPhone 7 from a wireless carrier and paying for it in installments over two years costs about $27 per month.
4. "The fatal conceit of Obamacare is that we're just going to make everybody buy our health insurance at the federal government level. Young and healthy people are going to go into the market and pay for the older, sicker people. So the young, healthy person is going to be made to buy healthcare, and they're going to pay for the person, you know, who gets breast cancer in her 40s or who gets heart disease in his 50s." -House Speaker Paul Ryan (R-Wis.)
Yes, the broad-based pooling of healthcare risks (as in Obamacare) tends to create more financial winners than losers. According to the Health Affairs Blog, this happens because at any given time the healthy population is larger than the sick one. But still, policies that support the separating of health care risks (along gendered, age-based, or socioeconomic lines) place huge financial burdens on the sick, often to the extent that they deny health care to those that need it. While separating risks is affordable for those who can pay for necessary health care out-of-pocket, it completely excludes low- or middle- income individuals from health care options.
5. "Just like Jesus said, 'The poor will always be with us.' There is a group of people that just don't want health care and aren't going to take care of themselves... The Medicaid population, which is [on] a free credit card... do probably the least preventive medicine and taking care of themselves and eating healthy and exercising. And I'm not judging, I'm just saying socially that's where they are." -Rep. Roger Marshall (R-Kans.)
Marshall, I'm not judging, but how can you really care about preventive medicine if the bill you support seeks to cut funding from Planned Parenthood? PP provides preventive care services and screenings to 1 in 5 American women—some from the "Medicaid population," and some more financially able. Unfortunately, the overwhelming need for various cancer screenings, birth control, and sex education doesn't descriminate. Stop being a stupid hypocrite.
6. "I'm not concerned about [tax cuts on the rich] because we said we said we were gonna repeal all the Obamacare taxes, this is one of the Obamacare taxes." -House Speaker Paul Ryan (R-Wis.)
That's right! Unless your annual income exceeds $500,000, Trumpcare can potentially save you literally nothing! Mother Jones' Kevin Drum writes, "You know what really gets me? Even among the millionaires, repeal will only net them about $50,000. That's like finding spare change in the sofa cushions for this crowd. Is clawing back and few nickles and drimes really worth immiserating 20 million people?"
But for conservatives, maybe it is. Since Obamacare's passage in 2010, Republican politicians have made their conservative constituencies one salient promise: that they would repeal it if given the means to do so. Now that a Trump presidency has provided that means, Republican representatives are under incredible pressure to deliver on the promise that's kept them in their seats for the past seven years.
7. "So, Medicaid—sending it back to the states, capping its growth rate. We’ve been dreaming of this since you and I were drinking out of a keg." -House Speaker Paul Ryan (R-Wis.)
At the National Review Institute's Ideas Summit last Friday, Paul Ryan explained to National Review editor Rich Lowry that "health care entitlements are the big, big, big drivers of our debt. There are three. Obamacare, Medicaid, and Medicare."
Again, it's true, broad-based risk pooling places more financial costs on the healthy than the sick; the healthy subsidize the care of those in crisis, and in turn, when those people inevitably get sick one day, the new healthy population subsidizes their care. On the individual or family level, sure—healthcare entitlements are a huge expenditure, perhaps even a debt-causing one. But you know what might also drive America's debt in a big, big, big way? Trump's $54 billion planned increase on military spending. And how about the $300 million reported annual cost of protecting First Lady Melania in NYC—nearly double the NEA's new budget under Trump?
Slate's summation of Ryan's comments is pretty accurate: he's been "dreaming about kicking poors off medicaid since [he] was a frat boy." I hope his Delta Tau Delta brothers are proud.
The House will vote this afternoon on the AHCA.
Top photo: Flickr.com/Gage Skidmore
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