The Plum Line | Opinion
July 17, 2017 at 10:41 AM
THE MORNING PLUM:
In recent days, the Trump administration's lies about the GOP health-care bill have reached impressive new heights of cruelty and disingenuousness. The falsehoods have focused mainly on disguising what the bill would do to Medicaid — in one way or another, they are designed to cover up the fact that Trump is eager to sign a bill that would absolutely decimate health-care spending on poor people, in violation of both the letter and spirit of his campaign promises.
There's a good explanation for all this lying buried in the new Post-ABC News poll: Large majorities say that the federal government should prioritize expanding health coverage to low-income people over cutting taxes. And this includes pretty much every core Trump voter group, too.
The Post poll asked: "On health care, which of these do you think is more important for the federal government to do: provide health care coverage for low-income Americans, or cut taxes?"
Americans overall picked providing health coverage to low-income Americans by 63 percent to 27 percent. And according to the crosstabs, pretty much every Trump-friendly demographic agrees:
Republicans, to be sure, lean toward cutting taxes by 48-39, but that's pretty tepid — taken all together, this suggests there are probably a lot of "soft" or reluctant Trump supporters who favor providing coverage to low-income Americans over cutting taxes. (Other polls have also found wide opposition to Medicaid cuts.) Separately, as many have already detailed, Trumpcare's cuts to Medicaid and subsidies would directly hit a lot of the older and working-class whites who make up the Trump and GOP base.
This may help explain why the Post-ABC News poll also finds that Americans favor the Affordable Care Act over the GOP replacement by 50-24. Even Trump-friendly non-college whites are divided on this by 33-33, per the crosstabs. But the question pitting expanded coverage for poor people against cutting taxes strips down the core ideological battle over the GOP bill to its essence — at bottom, it is mainly about gutting Medicaid and subsidies to lower-income people to facilitate tax cuts. Americans broadly oppose this.
And it is precisely the truth that all the latest lying and dissembling from the Trump team are designed to obfuscate.
Over the weekend, Vice President Pence got hammered on social media for claiming in a speech that because of the Medicaid expansion in Ohio, "nearly 60,000 disabled citizens are stuck on waiting lists," leaving them without care "for months or even years." But as The Post pointed out, this has nothing to do with the Medicaid expansion, and the office of the state's GOP governor, John Kasich, flatly declared that this is "the opposite of what happened." In a related claim, Pence has been saying that the Senate GOP bill "strengthens and secures Medicaid for the neediest in our society," which it would do, Pence asserts, by returning Medicaid to its "original purpose," rather than covering so many "able-bodied adults."
What Pence means is that, by rolling back the expansion of Medicaid to cover that category of "able-bodied adults," the bill would protect coverage for the most vulnerable, which the program was originally designed to cover. But as the Kaiser Family Foundation has pointed out, one of the main points of the expansion was to cover people who are working — i.e., people who are "able-bodied" — yet cannot get coverage anyway. So all Pence's demagoguery really means is that the Senate bill would cut the ACA's assistance to the working poor. What's more, the Senate bill's $772 billion in Medicaid cuts would force states to make cuts well beyond the expansion population, which, as Jonathan Cohn explains, would likely hit at least some disabled people. So the cruelty of this lie needs to be appreciated clearly: Pence is falsely claiming that the disabled in Ohio have been hurt by the ACA, to push a policy that likely would hurt the disabled.
Meanwhile, in his weekly address, President Trump played down the bill's enormous cuts to Medicaid by claiming that it "also expands the opportunity for people on Medicaid to purchase a private plan with federal financial assistance." Health and Human Services Secretary Tom Price, similarly, has been preposterously saying that under the GOP bill, more people will get coverage "than are currently covered." The suggestion here is that the cuts to Medicaid will be more than offset by the increased access to private coverage that the GOP bill will allegedly bring. Suffice it to say that the Congressional Budget Office disagrees: It found that 22 million fewer people will be covered after 10 years, 15 million of those getting knocked off the Medicaid rolls.
All of this dishonesty becomes more understandable, once you see polling such as the above, which shows that large majorities fundamentally reject these priorities. Which gives rise to another question: Is it really true, as we keep hearing, that Trump and/or GOP voters will erupt in fury if this bill does not pass? As noted above, majorities of Trump voter groups oppose its core goals, and even Republican voters are tepid on them. During the campaign, we were told endlessly that Trump's appeal in part lay precisely in his strong signaling that he was not ideologically aligned with Paul Ryan's designs on the safety net. Now we're told his bond with his supporters will be threatened, if he doesn't get to sign a bill that guts the safety net in spectacularly Ryanesque fashion, including for untold numbers of Trump voters?
It is often claimed that these voters don't really care what's in the bill; they simply want to see Trump triumphantly stomp all over something with Barack Obama's name on it and they want Republicans to fulfill their "promise" to repeal and replace the ACA. Perhaps that's true, but if so, this would confirm, as Brian Beutler has argued, that the only point of Trumpcare is to fulfill promises that were completely divorced from reality all along. And if, at the same time, large swaths of Trump-friendly voters don't support its actual policy goals, this disconnect only underscores why Trump and the White House have to keep lying relentlessly about what it would really do.
* ANOTHER POLL FINDS TRUMP'S NUMBERS IN THE TOILET: A new Bloomberg poll finds Trump's approval at 40-56. His numbers on the economy are 46-44, but on immigration they're at an abysmal 39-55, and on health care, they're even worse, at 28-64.
And: "Two-thirds don't think he'll succeed in building a wall along the Mexican border during his first term. More than half say he won't be able to revive the coal industry." So much winning!
* HEALTH BILL IS DELAYED — NOW WHAT? John McCain's surgery led GOP leaders to put the vote on the health bill on hold. Axios' David Nather notes that this could give them more time to win over moderates. But:
Every day heightens the risk that one more Senate Republican will come out against the bill … The Trump administration may be trying to convince the moderates that their concerns are being taken care of, but Senate GOP leaders may not have a lot of new arguments to make. They've already added $115 billion (including opioid money), and they're reminding the moderates they can't do much more without losing the conservatives.
With the major insurance groups now denouncing the Ted Cruz amendment (which conservatives need to support the bill) as unworkable, passage looks likely to only get harder with time.
* COLLINS: AS MANY AS 10 GOP SENATORS MIGHT OPPOSE HEALTH BILL: On CNN's "State of the Union," Susan Colllins (R-Maine) said:
"This bill would impose fundamental, sweeping changes in the Medicaid program. And those include very deep cuts. That would affect some of the most vulnerable people in our society, including disabled children, poor seniors. It would affect our rural hospitals and our nursing homes … There are about eight to 10 Republican senators who have serious concerns about this bill."
A few more dollars would not meaningfully change this equation, so it's hard to see how moderates who have expressed such concerns about this could ever support the bill.
* RAND PAUL: DELAY WILL HURT HEALTH BILL'S CHANCES: Here's what conservative Sen. Rand Paul (R-Ky.) had to say on CBS's "Face the Nation" about the delay in the vote: "I think the longer the bill is out there, the more conservative Republicans are going to discover that it's not repeal."
And if GOP leaders are forced to mollify moderates by taking out the Cruz amendment — which would segment the risk pools into healthy and sick, driving up premiums for the latter and gutting protections for them — it will be even harder for conservatives to support it.
* MODERATE REPUBLICANS SHOULD BAND TOGETHER: E.J. Dionne Jr. notes that history will be carefully watching how four moderate Republican senators handle their health-care vote and offers them a good suggestion:
Here's a suggestion to Dean Heller, Rob Portman, Shelley Moore Capito and Lisa Murkowski, Republican senators who should feel morally bound to vote no. Like Collins, they have spoken strongly against damaging cuts to Medicaid. If they announced their opposition together, they would lessen the political risk of standing alone and create a critical mass of GOP senators who could join Collins in her declared intention of working with Democrats "to fix flaws" in the ACA.
And if they did stand against GOP efforts to roll back the ACA's coverage expansion, we actually could have the bipartisan talks that Trump says he wants.
* FROM REPUBLICANS, NONSTOP LIES ON HEALTH CARE: Paul Krugman points out that Republicans are conspicuously not openly defending their goal of rolling back health coverage for poor people:
Instead, at every stage of this political fight they have claimed to be doing exactly the opposite of what they're actually doing: covering more people, making health care cheaper, protecting Americans with pre-existing conditions. We're not talking about run-of-the-mill spin here; we're talking about black is white, up is down, dishonesty so raw it's practically surreal. This isn't just an assault on health care, it's an assault on truth itself.
It's so weird the way these courageous ideological warriors consistently refuse to defend their actual priorities, isn't it?