Senate Republicans released a new version of their Obamacare repeal yesterday. They called the bill a "tamer" version of the barbaric law they originally pitched, but the new measure would still hack deep cuts to Medicaid funding for poor people. According to all currently available science, cutting Medicaid kills poor people, who can't pay for preventative care and can't go the emergency room for cancer screenings if they don't have insurance.
Florida Sen. Marco Rubio has said on the record that he does not believe this fact is true. Instead, he said yesterday he's officially onboard with the new measure, because he is nothing more than a machine through which the health-care industry can launder campaign money into barbaric policies that hurt poor people.
In his now-daily Facebook Live addresses to the public, in which he smugly tells his critics they're imbeciles, Rubio announced he's in favor of pushing the Obamacare repeal forward for a vote, because in Rubio-land this is somehow the best way to "amend" the bill and make it better. Rubio has said he wants more Medicaid spending for Florida hospitals, the ability for people to buy into plans that cover only "catastrophes," and provisions for states to apply for more Medicaid funding during public-health emergencies. He used the Zika virus as a reference.
"I am prepared to vote to proceed next week so we can get on the bill and begin to make those changes," Rubio said in his Facebook live-stream yesterday.
For the past few weeks, Rubio has tried to play coy with the public and has not technically admitted how he plans to vote when push comes to shove. He told the Miami Herald yesterday that he "supports" the measure but that if "Florida's not treated fairly, it'll be a problem." But that's literally what he always does, and anyone who thinks this vote might turn out differently is a rube.
According to the Center for Responsive Politics, Rubio has accepted more than $2.5 million in campaign donations from the health industry, including insurance companies, hospital associations, and pharmaceutical developers, since he first ran for Senate in 2010.
As it stands, the new version of the Better Care Reconciliation Act (BCRA) still might not make it to a floor vote, even with Rubio's support.
Here's what Rubio did not say in his address yesterday: There's no reason to push the bill forward unless he plans to vote for it in the end. He's not calling a massive overhaul of the BCRA's Medicaid cuts or a revamping of the new provision that lets insurers discriminate even more against sick people by charging them extra money. Other senators who are actually opposed to the measure, such as Arizona's John McCain, Maine's Susan Collins, and Kentucky's Rand Paul, don't want to bring this to a floor vote at all. Senators can just write a new dang bill if this one doesn't pass. They have control of the Senate, House, and presidency until at least 2018. The fact is, Rubio is cool with this bill.
(Let's not give Paul too much credit: He's opposed to the Senate's plan because it's not harsh enough.)
Furthermore, Rubio wants to rush this thing to a vote before the media can really analyze it or the Congressional Budget Office can confirm how many poor people the BCRA would disenfranchise.
But here's a brief recap of what we knew about the last iteration of the Senate's bill: It was slated to cut 22 million people off their insurance plans, including an estimated 2 million in Florida. A George Washington University study also warned that the bill would cost Florida 78,000 jobs and cut nearly $8 billion from the state economy.
The newest Senate plan is slightly tamer, but that's no reason to cheer. The bill would still certainly sever something in the realm of 20 million from access to basic health coverage.
As for what's new in the newest Senate bill: a provision that lets insurers charge people more after they get sick. The bill allows insurers to create plans that don't cover everything Obama's Affordable Care Act (ACA) mandated, such as preventative care or protections for people with preexisting conditions. As long as insurers offer one plan that meets the ACA's "Title I" provisions, they can offer a slew of cheaper plans that skimp on basic essentials. This could mean insurers charge a massive amount for plans that cover sick people: Your grandmother with emphysema or nephew with leukemia might be forced to pay (no pun intended) an arm and a leg for coverage, while young people would be priced out of plans that cover basic things such as checkups.
Provisions such as these apparently please Rubio, who does not seem to have ever spoken with a millennial who isn't the descendant of a Standard Oil baron. During Facebook Live posts this week, Rubio repeated the canard that millennials somehow "want" cheap plans that cover only catastrophic injuries or illnesses. But that's simply a joke: Young people typically choose to pay less for insurance because they're broke, but are willing to take the risk that they won't contract terminal illnesses until they're older.
The Senate could make access to care easier for everyone by instead mandating universal coverage, which works in every other developed nation on Earth according to virtually every objective measure, but Rubio has instead decided to pretend millennials enjoy the constant fool's bargain they're forced to endure, in which they cross their fingers, take a deep breath, choose cheap plans with $6,000 deductibles, and hope to God they don't secretly have brewing cases of Hodgkin's lymphoma.
Rubio has repeatedly tried to make this gambit sound like a fun and reasonable choice to force upon young people. In fact, the senator tried last week to incorrectly exploit the story of a dying baby to slam the growing single-payer movement in this country, which is a much easier move than trying to debate the idea on its merits.
Rubio has also repeatedly tried to claim the bill won't kick anyone off Medicaid, a claim that has repeatedly been debunked. Sen. Mitch McConnell said the same thing this week, and the Washington Post gave that lie three "Pinocchios" out of a possible four. Politifact also rated Rubio's claim that Florida wouldn't lose Medicaid funding as "mostly false."
Rubio was also behind a provision designed to hamstring Obamacare and make sure it fails. He inserted a provision into a 2014 spending bill that barred the U.S. Department of Health and Human Services from bailing out insurers who might lose money on Obamacare exchanges. This, in part, helped lead to insurers pulling out of some Obamacare exchanges, which then took away insurance options for poor people.
These are some of my priorities. I will continue to push for them & other FL priorities with amendments on the floor.— Marco Rubio (@marcorubio) July 13, 2017
The Senate's new bill would also let people who put money into health-savings accounts (HSAs) use that cash to pay for insurance premiums, which was not previously legal. This sounds great — data shows that the only people who can afford to stash money away regularly in HSAs are the nation's highest earners. Half of all American families live paycheck-to-paycheck. You're welcome to guess how many are willing to voluntarily put money away in new savings accounts.
The new Senate deal at least rolls back some of the tax breaks for the ultrawealthy that were included in the first draft and were also the most nauseating parts of the bill. But the bill still represents the largest attack on American welfare spending in decades and is expected to chop more than $774 billion from Medicaid over the next decade. The changes Rubio is asking for won't substantially fix this problem.
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Fun reminder: Medicaid expansions lower the mortality rate:
Rubio simply wants to make a few floor tweaks to the new measure, which Vox yesterday called "terrible for anyone who is sick, has been sick, or will be sick." Perhaps he's pushing for the bill because the new law wouldn't even affect him.