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“Skinny Repeal Bill” — a Trojan Horse for Broader ACA Repeal and Deep Medicaid Cuts


“Skinny Repeal Bill” — a Trojan Horse for Broader ACA Repeal and Deep Medicaid Cuts

Robert Greenstein

Senate Republican leaders have tried and failed this week to pass two measures to repeal the Affordable Care Act (ACA) — a modified version of their “repeal-and-replace” bill and a straight ACA repeal bill. Both measures, like all previous versions of ACA repeal that Congress has considered, would cause tens of millions of people to lose their health coverage and millions more to pay much more, get skimpier coverage, or both.


“Skinny Repeal.” Here comes the true test of D-Party unity.

I’m naming names…Tester, Warner, Heitkamp, McCaskill, Manchin…the whole world is watching.


That has to be Expanded & Improved Medicare For All.


Wouldn’t be the first time they caved to a Republican health care bill. Remember that their much beloved ACA was originally a Republican idea, back when they had at least a little semblance of sanity.

In any case I see the Dems more likely to accept this horror than to give the people what they really want: Medicare For All.


Eh, unless some Congresscritters are trying to muddy the waters by saying that they “only” voted for the “skinny repeal” but then vote for something much fatter that comes out of the conference, I don’t what the big deal is. Sure, not passing something now would put a dagger into the heart of the repeal efforts, so it would be better.

As for the merits of dispensing with the individual mandate (I don’t think the employer mandate is a good idea, except for the fact that it acts as a stealth rise in the minimum wage), it’s also not such a big thing. I mean, the current mandate is pretty weak, and since there is the premium tax credit, any ballooning in the nominal cost of premiums would be painless for anyone getting the tax credit. It’s the folks who are high-income enough who have been doing the bellyaching, so I say let them to the wolves so that can start to become politically loud for Medicare-For-All.


To the extent that it gets healthy people to pay into pools that these rotten and inefficient companies manage, when those healthy people leave those pools those left will necessarily pay higher costs. Healthcare costs have been far outpacing wage growth for decades now, and the ACA did make the situation moderately better, but healthcare costs are still outpacing wage growth even with the ACA. This will make it worse and neither this nor the ACA is sustainable in the long run. These rotten politicians also will not do anything about allowing Medicare to bargain down the cost of drugs and they won’t do anything about drug re-importation, nor will they do anything to change the highly protectionist intellectual property rights regime at the WTO, even though we the taxpayers pay a large share of R& D costs in developing new drugs. It is the developed countries like China, Brazil, Thailand and India that have had to fight for generic drug production, and they’ve had to battle the US more than anything in order to get public health exceptions at the WTO.

This entire debate is a travesty and every other developed country thinks we’re nuts, not only because of debates like this, but because of the scandal that is our healthcare system. Horrible bills like this, or even the ACA for that matter, would be a non-starter in most any other developed country, and it is for reasons like this that Manred Max-Neef says that the US is no longer a developed country, and it isn’t a developing country, it is an under-developing country.


“Here comes the true test of D-Party unity.”

Wait, is there a lobbyist around with a bag of cash? That’ll get them to unify around something.

This political system is dying, and the thing is, we as a society produced these mediocre people and actually voted for them. Says more about us than them. There’s always average people, with no character, morals or passion for justice, it says a lot that a political system time and time again puts them in power. And you watch, the Democrats will produce one of their own in 2020, and they won’t change a damn thing between now and then either.


Is it just my misunderstanding, or is Greenstein missing the obvious danger that the House could just as easily pass the “skinny repeal” that the Senate sends them, and that such an event is quite probably the point, for the Senate to launder its repeal vote in the House, in a false pretense from the Senate that theirs is practically just a procedural vote because the House agrees to then conference with the Senate and on some imaginary jointly approved replacement bill that will somehow be better than what the Senate, and the House prior, have already been unwilling to propose, that is, a bill that makes the simple fixes to the health insurance marketplace (the same stuff that makes Massachusetts Romneycare work, and that federal Republicans have historically passed when they last legislated Medicare Advantage in 2003, and that already exists within the ACA but just needs support or reform), instead of destroying the marketplace now, and sending us back to the days before the ACA, when the only affordable market that existed was for typically large employers offering benefit plans with good professional jobs, and there was no affordable individual insurance market at all for anyone without one of those jobs. Killing the individual marketplace is a victory against the freedom of labor and human enterprise, and a big win for definitionally fascist social control, that is, the collusion of big government, in the form of the national Republican Party, with big corporate power, to narrowly control the resources we all pay for in taxes and out of pocket, thereby dictating individual “choice” in life from the very top.


Well, it could be even MORE sinister.  Suppose that the Senate DOES pass “Skinny Repeal”, and the House votes to accept it “As Is” and sends it to the Presidunce’s desk, and then Tweetle-Dumb VETOES it, telling us tweeting, “That’s NOT what I promised the American People” . . .   In one swell foop fell swoop he has demol­ished what’s left of the “Never Trump”-ers, any chance of Impeachment, and almost guaranteed his re-election in 2020 – no matter what happens to the RePooplicans in 2018.

Just a scary thought, after enjoying one too many glasses of GRAMPS Chromo Crude Triple Chocolate Stout (with capsaicin) this evening.


Unfortunately, it’s not just the national RePooplican Party colluding with Multi-NaZional Korporations; the DamnocRats are equally guilty on economic issues, differing only on the social ‘wedge’ issues that both parties use to distract us “deplorables” from the deplorable laws that keep us under the thumbs and heels of the Korpocrats.


Why would they vote for skinny repeal? It’s a disaster bill for their states as it is. Plus, no way do they want to play a role in whatever monstrous piece of garbage comes out of conference. Finally, Trump isn’t going to do them any favors. They know he’ll take their votes, claim victory, and stomp all over them whenever it’s convenient. I continue to see zero win in a “yes” vote for them.


“Whenever it’s convenient” is 24/7. He tweet-stomps on his own appointees on a daily basis.

That said, I’m pretty much shocked that McConnell only went through the motions so far. I truly thought he’d dangle some shiny baubles in closed door meetings with a few conservadems.

But stay tuned.


Well, I guess you don’t have to worry about that ridiculous idea – at least not until after the August Recess
(if there is one) . . .

Meanwhile, I’ll try to limit my consumption of 10.5% GRAMPS Chromo Crude Triple Chocolate Stout to only
two glasses per day.