A law of the physical universe is that for every action, there is an equal and opposite reaction. Today’s politics shows the same dynamic. With Paul Ryan’s health care bill and President Trump’s budget deeply unpopular, people increasingly see health care as a governmental responsibility. What will happen depends in part on citizens continuing to speak up and organize.
Almost 75 years ago, Franklin D. Roosevelt proclaimed Americans have, “The right to adequate medical care and the opportunity to achieve and enjoy good health.” That right took major steps forward with Medicare; Medicaid; the Children’s Health Insurance Program; an enhanced prescription drug program; and the Affordable Care Act, programs passed by Presidents Johnson, Clinton, George W. Bush and Obama.
This January, the Pew Research Center found that 60 percent of Americans agree, “It is the responsibility of the federal government to make sure that all Americans have health coverage” while 38 percent disagree. As Pew notes, “the rise has been particularly striking among lower- and middle-income Republicans.” According to Republican Sen. Bill Cassidy of Louisiana, “There’s a widespread recognition that the federal government, Congress, has created the right for every American to have health care.”
Despite Americans’ desire for the federal government to take greater responsibility, the plan proposed by Speaker of the House Ryan and endorsed by President Trump would lead to 14 million people losing coverage by 2018 and 24 million by 2026. Perhaps an expectation of dismal coverage figures is why Ryan had committees vote before that information was released and is pushing for a Thursday vote of the House on a revised version before an updated estimate can be made.
At the same time, the AHCA gives a $600 billion tax cut to the wealthy. People in the top one-tenth of one percent of income would get an average tax cut of $165,090. If you make under $208,500, as 90 percent of Americans do, you’d get no tax cut.
In Maine, areas Rep. Bruce Poliquin represents would do especially poorly. Rural people and hospitals would be especially hurt. As Jackie Farwell of this paper wrote, “In much of Maine’s 2nd Congressional District — which awarded Trump one of the state’s four electoral votes in a historic split — low-income residents would fare worse under the plan. Particularly hard hit would be older Mainers in those northern counties, even those earning middle-class wages.”
Poliquin issued a statement when the health care legislation was released, saying the plan “will bring health care relief for tens of thousands of Maine families.” He has since said he’s not taking a stance on the proposal.
Ken Voorhees, a 61-year-old Maine builder making between $30,000 and $40,000 a year, would see his premiums rise to one-third of his income. The AARP calls this huge spike in premiums for older people an “age tax.” Interviewed by Joe Lawlor of the Portland Press Herald, Voorhees rejected the AHCA. He’s far from alone, as a recent national Fox News poll found only 34 percent support Trumpcare.
Also getting dismal reviews is the Trump budget proposal, which would drop spending on programs that help elderly people get meal deliveries that keep them in their homes and out of nursing homes, keep homes warm, support low-income students going to college, enable rural airports to compete, clean up toxic sites, and train displaced manufacturing workers.
Trump’s budget director, Mick Mulvaney, falsely claimed that Meals on Wheels and afterschool programs don’t work, when in fact the evidence is clear that they help a lot. Mulvaney even said Trump’s cuts are “compassionate” because single moms and coal workers shouldn’t have to pay for them, while presuming that those people would prefer the tax cuts for the rich proposed by Trump and Ryan.
As opposition to the Trump agenda mounts, people are calling, writing and visiting their federal legislators far more. Civic action matters, particularly as people share stories about the impact of policies on their families. People with small businesses and in the gig economy are talking about how their health coverage is threatened.
Whatever happens when Congress votes on the budget and health care, public opinion’s momentum increasingly favors greater government responsibility for health care. Democrats can seize this moment by talking about a public option that allows people to buy into Medicare, negotiating for lower prescription drug prices, and paths to universal coverage.