When the House came back for its second bite of the apple and finally passed representatives' dream legislation to repeal Obamacare and ensure that the health care system became even worse than it was before, I was on a short hiatus and binge-watching "The Handmaid's Tale." I had planned to stay away from politics as much as possible but this was a big deal so I had to tune in. Seeing all those white, male Republicans grinning and high-fiving each other was a chilling sight and I turned away as quickly as I could, soothed by the nearly unanimous opinion that the Senate, as the "saucer that cools the tea," would stop the abomination. Surely it would never agree to a bill as draconian as the House bill. I told myself that I was so bothered by those images because I was watching a haunting dystopian drama and it was affecting my mood.
Then on Monday when the Congressional Budget Office dropped its expected bombshell report showing that the Senate version of the health care bill was even worse than the House's in some ways, I couldn't help but think of this:
We will know soon enough. The target date for a Senate vote remains Thursday of this week, with a quick getaway to follow for legislators so they can hide their heads in shame. As I write this we have a few GOP senators from different factions of their party saying they won't vote for it without changes. It's either too harsh or not harsh enough or it's moving to fast or the process was improper. Senate Majority Leader Mitch McConnell still has some cards to play and some money to give away, so we'll see how all that unfolds.
This is a ghastly piece of legislation. Indeed, it's so appalling that some people suspect McConnell planned for it not to pass just so that he could say he tried and then get it off his agenda. (I don't think that's true. In fact, he probably floated that idea himself as a cover story, in case this thing blows up.) He couldn't have made it any worse if he tried.
That hasn't stopped the Republicans from defending it. Indeed, a few of them went out over the weekend and appeared on various news programs making the only defense possible: They lied.
Kellyanne Conway is a professional spin artist who has had no trouble transitioning to outright dishonesty in her new job. She was smooth a silk on ABC's "This Week," claiming there are absolutely no cuts to Medicaid and if able-bodied people are kicked off the rolls they will just get a job that has employer-sponsored health insurance. Like she has! Of course 80 percent of Medicaid households do have someone who works — at a job that doesn't provide benefits (an arrangement Conway would be the first to defend as the God-given right of any employer to provide). The vast majority of Medicaid patients who aren't working can't work, such as elderly people in nursing homes. Sixty-four percent of them nationwide are covered by Medicaid.
Conway's rationale for insisting that Medicaid isn't being cut is that legislators aren't cutting its budget, merely slowing its growth. This explanation was also taken up by President George W. Bush's former press secretary, Ari Fleischer, who tiresomely insisted on Twitter that you can't call it a cut when the future budget simply isn't as much as promised.
This is fatuous nonsense, as The Washington Post explained:
Spending “always goes up" in Washington in part because of this little thing called inflation — as prices go up, government spending has to increase, too, just to keep up.
Fortunately, the CBO's scorecard of the bill has been released to help clarify the waters that GOP allies are so diligently muddying. That report is crystal clear: Between now and 2026, the GOP Senate health care plan would carve out "a reduction of $772 billion in federal outlays for Medicaid."
Sen. Susan Collins of Maine — who, as of Monday night, is planning to cast a "no" vote — didn't try to sugarcoat the problem, saying this:
I’m very concerned about . . . the impact of the Medicaid cuts on our state governments, the most vulnerable people in our society, and health care providers such as our rural hospitals and nursing homes, most of whom are very dependent on the Medicaid program. . . . Given the inflation rate that would be applied in the outer years to the Medicaid program, the Senate bill is going to have more impact on the Medicaid program than even the House bill.
Conway and Fleischer may actually be more honest than Health and Human Services Secretary Tom Price, who declared on CNN, ”We will not have individuals lose coverage.” In a way, he's right. They won't lose coverage. It won't even be given to many of them so Republicans can give tax breaks to their rich friends. To put it another way, the tax cuts that 400 wealthy families get from the Senate bill equals the Medicaid expansion for more than 700,000 people.
Sen. Pat Toomey of Pennsylvania, the former president of the Club for Growth, went on CBS News' "Face the Nation" to insist that “no one will lose coverage” if they’re on Medicaid, while Sen. Ron Johnson of Wisconsin appeared on NBC News' "Meet the Press" and compared people with pre-existing conditions to someone with a bad driving record who has to pay more. Evidently, if you don't have a lot of money you should be very careful that you don't recklessly go out and get cancer.
Johnson, at least, has the excuse that he just really doesn't understand anything. Majority Whip John Cornyn of Texas understands very well what he's doing. He tweeted this on Monday:
This one's not a lie. It's true that in 2026 under Obamacare it's projected that 28 million people will still be uninsured. He just leaves out the punchline: The same projections say that if this Senate plan were to take effect, the number of uninsured individuals would be almost 50 million people.
Defenders of this grotesque bill are willing to dissemble, obfuscate and blatantly lie to the public about what is in it. They have no choice. It's indefensible on the merits. And I have to say, the fact that there are only a small handful of Republican senators who are prepared to make some phony mumbling noises against it says everything we need to know about the moral rot at the heart of this Republican congressional majority.