Wednesday, June 28, 2017

Is reducing the national debt a legitimate excuse for gutting the ACA and Medicaid expansion? No.

For the moment it seems that after claiming that the House healthcare bill was “dead on arrival” before proceeding to negotiate in secret a bill that is not only very similar to the House version, but in some ways even worse, Mitch McConnell and his far-right Senate colleagues’ have stubbed their toes in wading into the healthcare quandary. After years of denouncing the Affordable Care Act, yet expecting to do little but use it as a rhetorical tactic for their own re-elections after the expected Hillary Clinton election, Republicans have once more exposed the fact that they not only never had a “plan” of their own, but never expected that they would have to concoct one—and it shows with their rushed, badly thought-out legislation. 

The Congressional Budget Office report suggests that instead of being just as “mean” as the House version, the Republican Senate healthcare bill is actually “meaner,” principally because although it spreads out Medicaid cuts a few years longer, the cuts are in the long-run deeper than the House version. It also continues the House action to essentially deny affordable care for those with pre-existing conditions, and shifts the burden of cost from the wealthy to the low-to-middle-income and older Americans. 

It is now reported that a bi-partisan network of governors worked behind the scenes to derail the Senate bill, persuading a few Republican Senators from their states to oppose the bill. Because of these defections that bill has been shelved for the moment, although one should take a cautionary note since the awful House bill also had its hiccup—and what was eventually passed was even worse than the original. There is some light talk about abandoning a partisan bill and crafting a more “bi-partisan” bill that will likely shed those on the radical fringes of both parties, but might actually pass and be “better.” But no one should be overly sanguine about that possibility.

Meanwhile, we have to discuss one of the reasons why there are still voters who oppose what they admit is in their own best interests. In some locales, low-income Republican voters are questioning the party’s attitude toward affordable health insurance, particularly in regard to ending Medicaid expansion. But The Guardian recently visited a West Virginia country music hoedown and discovered that in spite of reservations about ending the current system, some people insisted that there are “legitimate” reasons for gutting the ACA and replacing it with something worse. “I know it’s risky, at my age” not to have health insurance, one man said. But something should be done about the national debt: “They’ve got to do something to get it under control.”

Another Republican voter, a disabled former construction worker who relies on Medicaid—one of over 500,000 people in West Virginia who do—it’s also about the “debt”: “They want all these things kept in that we just can’t afford to keep in.” He’d rather “suffer now” and do his little bit to reduce the national debt, so that future generations (or rather his) “can have it better”. He added, bizarrely, that “Just like we have to cut the music programs. I hate to see them cut, but they got to be.” When you have voters equating grade school music programs as having the same importance as healthcare, you know that there is something seriously wrong with the thinking of many people in this country.

Is reducing the national debt a legitimate excuse for denying healthcare to 22 million more people? According to the CBO, the House bill will reduce the deficit by a little over a $100 billion over ten years, while the Senate will save over a $300 billion. But those numbers could be subject to change, like the cost of needless military adventures. And is that “savings” really that much in the grand scheme of things? Forget that proposed tax cuts for the wealthy far outstrip those figures; consider this: Even with the Vietnam War and Great Society programs, under the LBJ administration the national debt grew from only $308 billion to $362 billion from 1963 to 1969. The debt only increased marginally during the administrations of Nixon, Ford and Carter. 

But then the national debt tripled under the Reagan administration, thanks to massive military spending, massive tax cuts for the wealthy, and major adjustments to marginal tax rates (not to mention that “trickle-down economics” was a destructive sham that led only to runaway income redistribution to the wealthy). The debt then increased 50 percent during the four years of the elder Bush administration, then 40 percent during the eight years of the Clinton administration, and finally nearly doubling during the second Bush and Obama administrations. Today the national debt is in the neighborhood of $20 trillion. That is a lot, isn’t it? But not to Republicans who told us that ballooning debt is “good”—if it is Republicans who are creating it; it’s only “bad” if it is created during Democratic administrations.

Last year, Jeff Spross wrote in The Week the prevailing view among economists concerning the national debt:

But it can enable wealth creation. The government can hire people to build roads and bridges, to clean up public spaces and parks; to provide education and health care. All that is real economic production made possible by the government's power to borrow and create money. Similarly, while simply giving money to the poor doesn't create wealth, it does give them the initial resources they may need to re-enter the economy — and thus begin creating wealth again.

Furthermore, the “savings” even in the Senate healthcare bill is a relative tiny drop in the bucket even if that was the “goal”—and it isn’t, because if the ACA was a Republican creation they’d be fighting tooth-and-nail to preserve it. And it is nothing compared to estimates of tax evasion in this country, with estimates anywhere from $100 to $300 billion a year. 

Like all the rationalizations of people whose opposition to social programs is based on their racial and class attitudes without consideration to the greater good of all, the national debt rationalization for cutting Medicaid expansion—which like most such expenses actually helps rather than hinders job creation and the economy, and not simply winding up in the pockets of those who already have much more than what they need—has no sense at all to it.

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