By Alan Guebert
If only Julius Caesar had listened to the soothsayer who, in plain Latin, warned him, “Beware of the Ides of March.” Instead, the powerful, arrogant Roman tweeted, er, complained, “He is a Dreamer, let us leave him.”
And leave he did — forever — on the Ides of March, March 15, 44 B.C. Someone should have given American farmers, ranchers, and rural residents a similar warning earlier this month when House Republicans and the White House said they had an Obamacare repeal-and-replace plan.
Defending the plan
When the plan was unveiled, though, its author, Speaker of the House Paul Ryan, dodged brickbats from fellow Republicans, derision from Democrats and, on March 13, a loud “Yikes!” from much of the country when a Congressional Budget Office (CBO) review showed that 24 million Americans would lose their health care coverage under it.
It’s even worse for old aggies, reports the Boston Globe, because a disproportionate number of those 24 million are older and rural — exactly the people “whose votes helped catapult Donald Trump into the White House.”
Ryan, however, scoffed at the CBO numbers and went into full-wonk mode to defend the pure magic of his plan. The marketplace, he promised, would jump in with new, competitively priced insurance policies to cover the dropped millions.
To many Republicans, the Ryan plan isn’t so much about repealing and replacing Obamacare; it’s more about cutting “unnecessary” government spending. The Speaker’s plan does that in spades: it cuts nearly $1 trillion from government sponsored health care costs in the coming decade.
The majority of that savings, however, is not flowing back to you or me. Indeed, $594 billion goes for new tax cuts, the largest of which, $145 billion, will go to the wealthiest 0.1 percent of Americans who earn $250,000 or more per year.
At the rural level, an Obamacare repeal will be measured more by life and death than dollars and cents, say two university researchers writing for the Scholars Strategy Network.
In fact, explains the University of California’s Claire Snell-Rood and Cathleen E. Willging of the Behavioral Health Research Center of the Southwest, “Because healthcare facilities and workforces are often at the heart of local rural economies, repeal could set off economic death spirals.
“If Obamacare’s mandate for people to buy insurance is eliminated along with subsidies that make plans affordable, insurance premiums will soar and coverage will shrink, leading insurance companies to abandon many rural counties altogether.”
And, they add, “In practice, Obamacare repeal at the federal level will simply shift massive extra costs to state and local governments and to local care facilities, especially in rural areas.”
It’s a cost few state and local governments can bear and it’s one element of RyanCare that no one ever mentions: eliminating health insurance coverage to 24 million Americans does not mean these people won’t need medical care.
They will, of course; so who pays for it? You and me — just as we did before Obamacare. It won’t be cheap.
In 2015, Florida estimated that its insured citizens paid an additional $2,000 per hospital stay, or $1.4 billion in total, to cover the cost of health care for the state’s uninsured. Nationwide, the Kaiser Family Foundation pegged that same cost in 2013 at $85 billion.
It would be nearer to $100 billion in 2018, or almost equal to any government savings under RyanCare. That’s exactly why, as President Donald Trump remarked recently, health care reform is “so complicated.”
Barack Obama learned that lesson in 2010. Still, the goal now is the same as then: provide the best health care with the most choice to the largest number of Americans at the fairest price. Throwing 24 million Americans under the bus neither meets that need nor delivers on Donald Trump’s campaign promise of “insurance for everybody.”
By that standard alone, RyanCare already is a loser no matter its fate in Congress. And you don’t need a soothsayer to tell you that.