This week House and Senate Republicans passed their deficit-busting tax giveaway to corporations and the ultra-rich without a single Democratic vote, clearing it for Donald Trump’s signature. After failing to repeal the Affordable Care Act outright earlier this year, GOP leaders gloated that “doing away with the individual mandate [in the tax bill] makes the ACA unworkable” and “takes the heart out of Obamacare.” Echoing Trump’s own calls to intentionally destroy the ACA, congressional Republicans have now openly embraced the goal of harming as many Americans as possible in order to score a political victory.
And it’s true that repealing the individual mandate will do real damage. According to Congress’s official scorekeeper, the nonpartisan Congressional Budget Office, premiums will rise an extra 10% on average—wiping out any short-term tax cut that low- and middle-income families might see under the bill before their tax rates jump up again in a few years—and 13 million people will lose their health insurance as a result of the Republican tax bill. Republicans promptly took the $340 billion in savings they gain from not providing health insurance to millions and poured it into cutting estate taxes for rich heirs, like the McCain family. Combined with regulatory changes proposed by the Trump administration to make junk plans more attractive to healthy people and the GOP’s ongoing efforts to sabotage consumer protections, the coming year could be turbulent, expensive, and scary for millions of people in need of affordable care.
But while it’s easy to feel despair, Republicans have not taken the “heart” out of the ACA. Not yet. And it will be up to us next year to fight against attacks on the true heart of the ACA: the Medicaid expansion, subsidies to help low- and moderate-income families pay their premiums, and consumer protections for women and people with pre-existing conditions. That’s because GOP leadership has made clear that, having blown a giant hole in the deficit with tax cuts, they intend to use that hole as an excuse to dismantle core safety net programs including the ACA, Medicaid, food stamps, and more.
What conclusions can we draw from this year’s successful fights to save the ACA and upsetting loss on the tax bill? Both the tax bill this fall and GOP attempts to repeal the ACA this summer were rushed through Congress with unprecedented secrecy, slipshod drafting, and no public input. And both faced huge public blowback, with far more people opposed than supportive. But they differed in one important way that likely proved critical to the tax bill’s success this week: members of Congress will personally reap millions of dollars from the tax bill.
It’s unprecedented in the modern era for so many senators to so brazenly trade their votes on major legislation for personal self-enrichment. As Public Citizen noted last week, “Trump has set the tone for Republican officials, from the White House to the administration to Congress: self-dealing by public officials for personal gain is to be treated as business as usual and, if politically possible, no longer subject to ethics constraints. Public officials in the Trump administration and the Republican Congress today have a green light to use their trusted positions to enrich themselves — and they are doing so.”
Senator Ron Johnson (R-WI) made his vote for the Senate version contingent on winning a deeper tax cut for pass-through businesses, like the one he owns. Senator John McCain (R-AZ) abandoned his principled calls for “regular order;” his family will reap a multi-million dollar windfall under the bill. Senator Ted Cruz (R-TX) and a dozen other House and Senate Republicans supported a last-minute loophole for pipeline investors that will mean multi-million dollar tax savings. Perhaps most shockingly, Senator Bob Corker (R-TN) flipped to a yes on the final bill (after initially voting against the Senate version, citing concerns about the deficit) when he was given a massive new tax cut for the kinds of real estate investments that he, Speaker Paul Ryan (R-WI), and Donald Trump are all heavily invested in.
Congressional horse-trading for constituent priorities is nothing new. Before it was removed from the ACA, for example, the so-called “Cornhusker Kickback” that so enraged conservatives was an attempt to win additional Medicaid money for Nebraska. But the Trump era has ushered in a new world of self-dealing, corruption and graft last seen in the Gilded Age. If the “Cornhusker Kickback” was intended to help Nebraska, the “Corker Kickback” was intended simply to help the Corkers.
Meanwhile, our fight for affordable health care isn’t even over for the week. Having now gone on an expensive Christmas shopping spree for themselves and their donors with the national credit card, Republicans are hoping to leave town for the holidays without reauthorizing the Children’s Health Insurance Program (CHIP), which expired in September. CHIP funds health insurance for nine million kids, including two million kids with serious chronic conditions, but without federal support, states are spending down reserves and moving to cut off new enrollments as a first step to shutting down their CHIP programs altogether.
According to congressional Republicans, “the reason CHIP’s having trouble is we don’t have any money anymore.” That’s right. Republicans just voted to add $1.5 trillion to the deficit in order to slash taxes on the idle rich but they are refusing to fund the $14 billion CHIP program unless they can extract deep health cuts from other programs like disease prevention that are critical to women and children.
Republicans hope to push off dealing with CHIP until after the New Year even though states like Alabama have already announced that they will be forced to freeze enrollment on January 1. Two million kids will lose coverage in January if Congress fails to act this week. And by the end of January, 25 states will run out of CHIP funds altogether.
As dispiriting and frustrating as this week has been, there’s still time to push Congress to take action. Don’t let Congress go home to their families without ensuring that 9 million children are taken care of.