The first projections for Trumpcare 2019 are in: Expect rate increases of up to 30%

By Covered California’s estimate, the marketing cutback is penny-wise and plain foolish. On the assumption that individuals who are eligible to sign up but fail to do so are on average 25% healthier, or less costly to the insurance pool, than the average enrollee, its actuaries estimate that premiums in the federal marketplace states will rise by about 1.3% in 2019 because of the cutback alone. That increase will cost about $1 billion nationwide, swamping the $90 million in so-called savings in marketing expenses.

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Insurers Show Little Interest In Selling Trumpcare Policies

President Donald Trump on Jan. 5. (Photo by Win McNamee/Getty Images)

As the Donald Trump administration begins to roll out its new rules to allow cheaper less regulated health plans into the individual and group insurance market, there’s yet to be much interest from health insurance carriers to offer such policies or help administer them for small employers.

It’s still early, but this month could be key to the Trump effort to offer less regulated health plans as major carriers report earnings. UnitedHealth Group, Aetna, Humana and Anthem in particular are the health plans to watch, given they exited or scaled back from offering individual coverage known as Obamacare on public exchanges under the Affordable Care Act.

Trump’s executive order designed to spur competition in the individual insurance market is closer to being implemented. Among other things, the Trump administration is easing rules to allow small businesses and other groups to band together to create “association health plans.”

Last week, the U.S. Department of Labor announced its proposal to “expand access to healthcare through small business health plans.”

“The proposed rule, which applies only to employer-sponsored health insurance, would allow employers to join together as a single group to purchase insurance in the large group market,” the labor department said in announcing the new plans, also known as “Association Health Plans.”

“These improvements stand to open health insurance coverage for millions of Americans and their families by making it more affordable for thousands of small businesses and sole proprietors,” the labor department said. “By joining together, employers may reduce administrative costs through economies of scale, strengthen their bargaining position to obtain more favorable deals, enhance their ability to self-insure, and offer a wider array of insurance options.”

Retailers believe there will eventually be interest from the health insurance industry.

“Although it’s a little premature to speculate given there’s merely a proposed rule and more details will be sorted out as the regulatory process moves forward, we believe insurers are more likely to help administer AHPs established by bona fide trade associations, such as NRF or state retail associations,” National Retail Federation vice president of health care policy Neil Trautwein said. “Associations have a long track record, are financially stable and accountable to their members. All of these factors suggest insurers will view associations as attractive business partners and help make these plans available to small employers.”

It could be a sizable market. The labor department said “up to 11 million Americans working for small businesses/sole proprietors and their families lack employer-sponsored insurance.”

But there’s been little interest from major insurance carriers in selling such group plans to smaller employer buyers, let alone helping them administer them as they do worker coverage for large self-insured employers. The major insurance lobbies have actually been concerned and continued to criticize Trump administration rules last week after the labor department came out with its “notice of proposed rulemaking” on Friday. It is available for public comment for 60 days.

“Americans deserve affordable choices, and we are concerned that the changes proposed would lead to higher prices and weaker consumer protections in the small group and individual markets, where nearly 40 million Americans get their coverage,” America’s Health Insurance Plans, which represents large carriers including Anthem, Centene, Oscar Health, Humana and many Blue Cross and Blue Shield plans said Friday.

Eventually, Trump also wants “short-term, limited duration health plans” that may be cheaper but will cover less and attract healthy, younger purchasers away from individual health plans with richer benefits. By siphoning off healthier Americans to cheap plans Trump wants, those sold on public exchanges under the Affordable Care Act could become more expensive if a higher concentration of older and sick patients are enrolled.

Consumer groups have described the Trump administration’s proposals as a way to create “junk” policies.

“Under the rule by the Trump administration, junk health plans would compete against insurance that provides comprehensive benefits and abides by other safeguards protecting people who need and buy health care,” Families USA senior director of health policy Eliot Fishman said. “This will endanger both those who are sold cheap, junk plans and the older adults and people with pre-existing conditions who get left behind. Couched in terms of serving small employers, the proposed rule’s extraordinarily broad definition of employers will let substandard plans flourish in a way that is clearly calculated to gut the ACA’s core insurance safeguards that are critically important to people with pre-existing conditions, like asthma, diabetes or even cancer.”

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Interest Lacks In Selling Trumpcare Policies

President Donald Trump on Jan. 5. (Photo by Win McNamee/Getty Images)

As the Donald Trump administration begins to roll out its new rules to allow cheaper less regulated health plans into the individual and group insurance market, there’s yet to be much interest from health insurance carriers to offer such policies or help administer them for small employers.

It’s still early, but this month could be key to the Trump effort to offer less regulated health plans as major carriers report earnings. UnitedHealth Group, Aetna, Humana and Anthem in particular are the health plans to watch, given they exited or scaled back from offering individual coverage known as Obamacare on public exchanges under the Affordable Care Act.

Trump’s executive order designed to spur competition in the individual insurance market is closer to being implemented. Among other things, the Trump administration is easing rules to allow small businesses and other groups to band together to create “association health plans.”

Last week, the U.S. Department of Labor announced its proposal to “expand access to healthcare through small business health plans.”

“The proposed rule, which applies only to employer-sponsored health insurance, would allow employers to join together as a single group to purchase insurance in the large group market,” the labor department said in announcing the new plans, also known as “Association Health Plans.”

“These improvements stand to open health insurance coverage for millions of Americans and their families by making it more affordable for thousands of small businesses and sole proprietors,” the labor department said. “By joining together, employers may reduce administrative costs through economies of scale, strengthen their bargaining position to obtain more favorable deals, enhance their ability to self-insure, and offer a wider array of insurance options.”

Retailers believe there will eventually be interest from the health insurance industry.

“Although it’s a little premature to speculate given there’s merely a proposed rule and more details will be sorted out as the regulatory process moves forward, we believe insurers are more likely to help administer AHPs established by bona fide trade associations, such as NRF or state retail associations,” National Retail Federation vice president of health care policy Neil Trautwein said. “Associations have a long track record, are financially stable and accountable to their members. All of these factors suggest insurers will view associations as attractive business partners and help make these plans available to small employers.”

It could be a sizable market. The labor department said “up to 11 million Americans working for small businesses/sole proprietors and their families lack employer-sponsored insurance.”

But there’s been little interest from major insurance carriers in selling such group plans to smaller employer buyers, let alone helping them administer them as they do worker coverage for large self-insured employers. The major insurance lobbies have actually been concerned and continued to criticize Trump administration rules last week after the labor department came out with its “notice of proposed rulemaking” on Friday. It is available for public comment for 60 days.

“Americans deserve affordable choices, and we are concerned that the changes proposed would lead to higher prices and weaker consumer protections in the small group and individual markets, where nearly 40 million Americans get their coverage,” America’s Health Insurance Plans, which represents large carriers including Anthem, Centene, Oscar Health, Humana and many Blue Cross and Blue Shield plans said Friday.

Eventually, Trump also wants “short-term, limited duration health plans” that may be cheaper but will cover less and attract healthy, younger purchasers away from individual health plans with richer benefits. By siphoning off healthier Americans to cheap plans Trump wants, those sold on public exchanges under the Affordable Care Act could become more expensive if a higher concentration of older and sick patients are enrolled.

Consumer groups have described the Trump administration’s proposals as a way to create “junk” policies.

“Under the rule by the Trump administration, junk health plans would compete against insurance that provides comprehensive benefits and abides by other safeguards protecting people who need and buy health care,” Families USA senior director of health policy Eliot Fishman said. “This will endanger both those who are sold cheap, junk plans and the older adults and people with pre-existing conditions who get left behind. Couched in terms of serving small employers, the proposed rule’s extraordinarily broad definition of employers will let substandard plans flourish in a way that is clearly calculated to gut the ACA’s core insurance safeguards that are critically important to people with pre-existing conditions, like asthma, diabetes or even cancer.”

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Concerns Grow About Cheaper Trumpcare Plans

U.S. President Donald Trump, right, acknowledges US Senator Rand Paul (R-KY), left, prior to signing H.J. Res. 38, disapproving the rule submitted by the US Department of the Interior known as the Stream Protection Rule in the Roosevelt Room of the White House on February 16, 2017 in Washington, DC.  (Photo by Ron Sachs-Pool/Getty Images)

New rules from the Donald Trump administration that would allow cheaper less regulated health plans into the individual insurance market have alarmed healthcare providers, insurance companies and consumer groups.

Health groups are warning state regulators that the new regulations have flaws that could harm consumers and local markets. “We urge state insurance regulators to take action to protect consumers in your states,” the American Cancer Society Cancer Action Network, the American Heart Association, America’s Health Insurance Plans and other health groups wrote last week in a letter to state departments of insurance.

President Trump’s executive order, first announced in October, is designed to spur competition in the individual insurance market. The executive order comes after Trump and his fellow Republicans in Congress were unable to repeal the ACA, also known as Obamacare.

After several failed attempts to get rid of the ACA, the Trump administration instead is trying to make changes via executive order. It would, among other things ease rules to allow small businesses and other groups to band together to create “association health plans” that could form across state lines to offer coverage.

In addition, Trump wants “short-term, limited duration health plans” that may be cheaper but will cover less and attract healthy, younger purchasers away from individual health plans with richer benefits. By siphoning off healthier Americans to cheap plans Trump wants, those sold on public exchanges under the Affordable Care Act could become more expensive if a higher concentration of older and sick patients are enrolled.

“Expanding and extending short-term, limited-duration health plans, increasing enrollment in association health plans (AHPs), and relaxing rules for employer health reimbursement arrangements (HRAs) all increase adverse selection in insurance markets that serve millions of individuals and employers,” the health groups wrote to insurance regulators.

Given such concerns, it’s unclear if there will be any insurance carriers that want to sell Trump’s plans , which likely wouldn’t be available to buy until late next year for 2019 at the earliest.  And analysts worry those policies that do reach the market won’t provide adequate benefits.

Industry analysts say consumers should be leery of these new policies and proposed rules.

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Viewpoints: The Move To ‘Trumpcare’; GOP’s Threat To Medicare; Opioid Epidemic’s Hidden Threat

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Republicans Can’t Kill Obamacare, So They’re Turning It Into Trumpcare

Republicans haven’t figured out how to kill the Affordable Care Act. But they are transforming it into a weaker, less efficient and more dysfunctional version of itself.

They’ve been at it since the very first days of Donald Trump’s presidency, when officials in his administration canceled advertising for the final week of open enrollment for coverage at healthcare.gov. At the time, they justified it as a cost-cutting move, although the dollars were a pittance and internal research, which later became public, showed that earlier advertising had boosted enrollment.

Now GOP lawmakers are on the verge of taking a more visible and potentially more consequential step. The tax cut bill Senate Republicans passed earlier this month would eliminate the individual mandate, a key piece of the program’s architecture that requires people to get insurance or pay a penalty to the government. If final legislation includes the same provision, and if the legislation becomes law, then fewer people will have insurance and premiums will be higher, according to experts in and outside the government.

The cumulative effect of Republican changes to Obamacare won’t be tantamount to repeal. That’s largely because of the Affordable Care Act’s other core elements: tax credits for people buying insurance on their own, regulations on who and what insurers must cover, and special federal funding for expanded state Medicaid programs. As long as those rules are in force and as long as that money keeps flowing, the insurance system that President Barack Obama and the Democrats created in 2010 will continue to put decent, affordable coverage within the reach of millions.

But the health care landscape already looks a lot different than it did when Obama left office. In many states, old problems with insurance markets have become worse, while new problems have appeared. Rules for Medicaid are changing in ways that make it harder to get on and then stay on the program. The number of people without insurance has started to creep up, and, following this year’s open enrollment period, which ends Friday, it’s likely to rise more significantly.

If the transformation continues, it could work out just fine for some Americans. In some cases, it might even seem like an improvement. But for the country as a whole, it would almost surely mean worse access to care and more financial hardship from medical bills. After three years of progress, the country would be backsliding.

How Private Insurance Is Changing

The most well-publicized changes of the last year have affected private insurance for people who buy coverage on their own rather than through employers.

The Affordable Care Act reorganized this troubled part of the insurance market by requiring carriers to cover people with pre-existing medical conditions ― and then setting standards for coverage of 10 “essential” benefits, including mental health, maternity care and prescriptions. To make sure plans are affordable, the law introduced tax credits for anybody with an income below four times the poverty line, or $98,400 for a family of four. The law created the mandate to make sure healthy people sign up, which ensures that insurers have enough money to pay bills for their sicker customers.

The transition to the new system has been difficult. When the law took effect in 2014, insurers canceled old plans (despite Obama’s “keep your plan” vow) and charged higher premiums for new ones. Consumers who qualified for little or no financial assistance felt the brunt of it. For the next few years, the majority of insurers lost money, largely because they weren’t attracting healthy people in the numbers they’d expected.

But in states like California, where officials were fully committed to the program’s success, the new markets have mostly worked smoothly. And by 2016, most carriers were finding their way to profitability. Although plenty of people continued to struggle with high premiums or out-of-pocket costs, millions had decent, affordable coverage they could not get before. And there were credible ideas on the table, from the likes of Democratic presidential candidate Hillary Clinton, to help the rest.

Then Trump took over, unleashing a campaign of neglect and sabotage. He stopped paying a series of special payments to insurers that were the subject of a legal dispute. Insurers raised premiums in response. And that initial reduction in spending on healthcare.gov ads turned out to be a harbinger of more sweeping cutbacks ― not just on advertising but also on the official “navigators” and “assisters” that the Affordable Care Act authorizes to help sign up new customers. Those groups are now operating at lower capacity, which means they’ll enroll fewer people. 

Until this year, getting people to shop for coverage was a priority for the federal government, with Obama personally promoting enrollment through venues like the comedy show “Between Two Ferns.” Trump, by contrast, has declared the law “finished” and “dead.” Seema Verma, chief administrator at the Center for Medicare and Medicaid Services, hasn’t issued a single tweet through her official account encouraging people to investigate their options ― even though, as Politico’s Dan Diamond observed, she sent out multiple messages encouraging seniors to check out their options for Medicare next year.

The people for whom advertising makes a difference tend to be the ones who don’t think about insurance because, at least for the moment, they are healthy. That’s a problem for insurance companies, who need those customers ― and it’s going to be an even bigger problem if the mandate goes away.

Economists have historically considered the mandate essential to a well-functioning market system, and the nonpartisan Congressional Budget Office has said that, without the mandate, the number of people buying private coverage on their own would drop by 5 million and premiums for these people would rise by 10 percent as insurers adjust for a customer base more tilted toward people with serious medical problems.

It’s possible that estimate is high, and CBO may yet revise that prediction downward. As HuffPost’s Jeffrey Young reported Saturday, not every insurer faces the same kind of market ― or is likely to react in the same way. But changes to the mandate are bound to interact with other changes soon to come.

Any day now, the Trump administration will unveil a proposal to change the regulation of short-duration insurance plans. These are plans that don’t typically include mental health or other essential benefits the Affordable Care Act requires, and they are almost never available to people with pre-existing conditions ― which means insurers can sell them for a lot less money.

Once the Affordable Care Act took effect, the Obama administration decided short-term plans would not count toward satisfying the individual mandate and that, as of this year, they could last no more than three months. As with so many other decisions the Obama administration made, this was both an effort to protect people from insurance that would leave them exposed to catastrophic medical bills as well to make sure insurers selling comprehensive, regulated plans weren’t losing healthy customers to cheaper alternatives unavailable to the sick.

The Trump administration plans to alter those rules, and, although the details are not public, it’s likely that the plans will officially be available for up to a year, as they were previously, and that they will count toward the mandate, if the mandate still exists. If healthy people can buy these plans for longer than three months and can do so without incurring a financial penalty from the mandate, many more are likely to choose that option ― causing insurance markets to deteriorate even more as premiums for comprehensive policies go up and more people seek out cheaper, if less secure, alternatives. 

How Medicaid Is Changing

It’s through the Affordable Care Act’s expansion of Medicaid that the majority of newly insured Americans have found coverage. The expansion offered states extra money if they’d open up the program to anybody with income below or just above the poverty line. Thirty-two states plus the District of Columbia have done that.

Now that progress is in jeopardy. Republicans want to end federal funding for the expansion because, they say, Medicaid should only be for a few narrow classes of people: children, pregnant women, the elderly and people with disabilities. Republicans also want to reduce federal spending on Medicaid more generally, because they say the program costs too much. The long-term goal is to do all of this through legislation. For now, the Trump administration is making headway by using its executive authority to scale back the program, bit by bit.

Federal law sketches out the basics of the Medicaid program, including who and what it must cover. But states can apply for waivers from some of these requirements and, in order to save money, they frequently seek to serve fewer people or provide them with weaker guarantees of coverage.

The Obama administration tended to look upon such applications skeptically, arguing they violated Medicaid’s federal guidelines. In March, the Trump administration announced it would look upon such applications more favorably. Already the Trump administration has approved several state requests to eliminate what’s known as “retroactive eligibility,” under which Medicaid pays the prior three months of medical bills for newly enrolled people who would have been eligible during that time. It’s a way to reimburse the hospitals, clinics, and other health care providers who take care of people who show up without insurance. It’s also a way to protect people who are eligible for Medicaid, but don’t realize it until they get sick.

Going forward, the Trump administration has also said it will approve state requests to impose work requirements on Medicaid. This is a big issue for Republicans who say that government-financed health insurance should be conditional upon having a job or actively looking for one. As it happens, that’s already true for the majority of people on the program ― and of that small percentage who are not working or seeking work, a substantial proportion are busy caring for relatives, according to studies. But imposing work requirements reliably reduces enrollment, partly by adding one more layer to the application and qualification process, making it more difficult to get on and then stay on the program.

A less obvious way the administration and its allies are scaling back Medicaid is by trying to take away the mandate, which creates an expectation that everybody should have insurance, prompting people to investigate their coverage options. Inevitably, some portion discover they are eligible for Medicaid, which is essentially free. This was very much how the Affordable Care Act’s architects hoped the program would work. But it means more people end up on Medicaid, and that’s not what Republicans want. 

Who Will Get The Blame

It’s impossible to be certain how all of these changes, taken together, would play out. But one possibility is that private insurance markets in much of the country would split into two groups, as observers like Duke University’s David Anderson and Vox’s Dylan Scott have sketched out in the last few weeks.

Here’s how it’d go: As premiums go up, the tax credits would too, guaranteeing a lucrative market that at least some insurers would always want to serve. People who qualify for those credits would continue to have comprehensive coverage available at reasonable prices. And they represent the majority of people buying insurance on their own.

But the tax credits aren’t free. They come out of the federal treasury, which means that, ironically, Republican efforts could mean more federal spending to maintain the subsidized markets. More important, the people who don’t qualify for tax credits ― the ones with incomes that are more than four times the poverty line ― would increasingly find comprehensive, regulated coverage simply unaffordable, even more so than they do today.

Some would react by figuring out ways to reduce their income in order to get just below the subsidy threshold. The rest would seek out cheaper alternatives, like those short-term plans and “health care ministries,” in which Christians share each other’s medical bills. These options, although generally better than no coverage at all, provide less reliable protection from medical bills, as writers like Julie Appleby of Kaiser Health News and Laura Turner of BuzzFeed have detailed.

For people who don’t qualify for tax credits, the market for insurance would look a lot like it did before the Affordable Care Act took effect ― with coverage that works primarily for people who are in good health and stay that way. “I think we could get to that point relatively quickly in some markets,” Sean Mullin, a senior director of the consulting firm Leavitt Partners, told HuffPost. “This isn’t 10 years off. This could be the case next year.”

A lot would depend on where people live. States including California and Maryland where officials are most committed to expanding health insurance would probably continue doing what they do now: promote enrollment aggressively, using their regulatory powers to restrict plans that don’t live up to the Affordable Care Act’s standards, and maybe even creating their own versions of the individual mandate. These states would be unlikely to seek the Medicaid waivers that the Trump administration is so eager to grant.

It’d be a different story in the places where officials are seeking to limit or even undermine the Affordable Care Act’s reach. A handful of states, such as Iowa, already have deeply damaged markets ― with premiums that are way too expensive for most people who don’t qualify for subsidies ― and Medicaid programs that have been weakened. If Republicans continue to remake the Affordable Care Act as they have so far, more states will be in the same situation.

If this comes to pass, Trump and the Republicans will surely continue to blame Obama and demand repeal. But for all of the Affordable Care Act’s very real shortcomings, it has helped millions to get coverage and provided guarantees that Americans happen to value. If those trends reverse ― if more people end up struggling with access and medical bills ― it won’t be on the people who created the Affordable Care Act. It’ll be on the people running it now.

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Most Frequently Used Hashtag by Congress: #Trumpcare

Members of Congress used the hashtag #Trumpcare most in 2017, according to a social media analysis by Quorum.

The analysis looked at hashtags the lawmakers used on Facebook and Twitter. Other hashtags that also were popular in legislators’ posts included #aca, #taxreform, and #protectourcare.

The most viral Twitter post from a Republican legislator was from Sen. Bob Corker in October, when he compared the White House to an adult day-care center. The tweet has been shared more than 148,000 times.

The analysis reported that the most popular tweet from a non-Republican legislator was from Sen. Bernie Sanders, I-Vt. The senator posted a tweet from the women’s march the day after Trump’s inauguration that has been shared more than 450,000 times.

Republicans are slightly more frequent users of Instagram, posting an average of 49 pictures per year, while Democrats post an average of 47, according to the analysis.

Democrats are more active on Twitter, the analysis found — they average almost twice as many tweets in 2017 as Republicans.

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#Trumpcare was lawmakers’ most popular hashtag in 2017

#Trumpcare was the most used hashtag by members of Congress in 2017, according to a new study.

Other top hashtags used by lawmakers on Twitter and Facebook included #aca, #taxreform and #protectourcare. The social media analysis was conducted by Quorum.

The most viral Twitter post from a Republican lawmaker in 2017 was Sen. Bob CorkerRobert (Bob) Phillips CorkerFormer Dem Tenn. gov to launch Senate bid: report McConnell ‘almost certain’ GOP will pass tax reform Former New Mexico gov: Trump’s foreign policy is getting ‘criticized by everybody’ MORE‘s (Tenn.) tweet mocking President TrumpDonald John TrumpHouse Democrat slams Donald Trump Jr. for ‘serious case of amnesia’ after testimony Skier Lindsey Vonn: I don’t want to represent Trump at Olympics Poll: 4 in 10 Republicans think senior Trump advisers had improper dealings with Russia MORE. It has been retweeted more than 148,000 times.

The most popular tweet from a politician on the left was Sen. Bernie SandersBernard (Bernie) SandersSchumer: Franken should resign Franken resignation could upend Minnesota races Avalanche of Democratic senators say Franken should resign MORE’s (I-Vt.) tweet from the Women’s March on Jan. 21.

The analysis also looked at app usage. Republican lawmakers are more slightly fond of Instagram then their Democratic counterparts, posting an average of 49 pictures a year compared to 47 for Democrats.

Democrats far out-tweet Republicans though, averaging almost twice as many posts on Twitter over the past year.

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Hey, Senate Republicans, if you pass this tax bill you’ll have to take on Trumpcare again

WASHINGTON, DC - JULY 26:  A protestor holds up a sign during a rally against the GOP health care plan, on Capitol Hill, July 26, 2017 in Washington, DC. GOP efforts to pass legislation to repeal and replace the Affordable Care Act, also known as Obamacare, were dealt setbacks when a mix of conservative and moderate Republican senators joined Democrats to oppose procedural measures on the bill. (Photo by Drew Angerer/Getty Images)

Sen. Lindsey Graham (R-SC) two weeks ago:

“You can make an argument that Obamacare is falling of its own weight—until we repeal the individual mandate. […] Then there is absolutely no excuse for us not to replace Obamacare because we changed a fundamental principle of Obamacare. So I hope every Republican knows that when you pass repeal of the individual mandate, it’s no longer their problem, it becomes your problem.”

Kaiser Family Foundation’s Larry Levitt told Axios, “I think next year will be even crazier” if Congress does pass an individual mandate repeal in their tax bill. That means even more insurers pulling out of markets and trying to figure out how to set premiums. More chaos as plans change and more chaos and confusion for people who are trying to buy or keep insurance.

  • The Senate’s tax bill would eliminate the ACA’s penalty for being uninsured, starting on Jan. 1, 2019. That might seem like a long way away, but it’s not.
  • Insurers will start deciding this coming spring whether they want to participate in the exchanges in 2019 — and if so, where. Without the mandate, insurers would likely begin to pull back from state marketplaces early next year, likely leaving many parts of the country with no insurance plans to choose from.
  • Insurers will then have to finalize their 2019 premiums next fall. Those rates would likely be substantially higher (10% higher, on average, according to the Congressional Budget Office) without the mandate in place — and that news would hit just before next year’s midterms.

Yep, all that chaos peaks with next year’s midterm elections. Republicans are now taking affirmative action to destroy Obamacare by repealing the individual mandate in the tax bill. They completely own this, and they have nothing in the hopper to fix it. They’re going to have to come up with something fast, and Trumpcare isn’t going to cut it.

Jam your senators’ phone lines at (202) 224-3121. Tell them to vote “no” on the Republican tax bill.

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How to Defeat the GOP Tax Bill: Applying Lessons From the Trumpcare Fight

Protesters walk together to the office of Sen. Marco Rubio (R-FL) to urge him and others in the US Senate to vote against the $1.5 trillion tax cut on November 27, 2017 in Doral, Florida. (Photo: Joe Raedle / Getty Images)Protesters walk together to the office of Sen. Marco Rubio to urge him and others in the US Senate to vote against the $1.5 trillion tax cut on November 27, 2017, in Doral, Florida. (Photo: Joe Raedle / Getty Images)

Welcome to Interviews for Resistance. We’re now several months into the Trump administration, and activists have scored some important victories in those months. Yet there is always more to be done, and for many people, the question of where to focus and how to help remains. In this series, we talk with organizers, agitators and educators, not only about how to resist, but how to build a better world. Today’s interview is the 94th in the series. Click here for the most recent interview before this one.

Today we bring you a conversation with Michael Kink, the executive director of the Strong Economy for All Coalition. Kink discusses how the GOP tax bill benefits only the rich at the expense of everyone else, and how to fight it.

Sarah Jaffe: The last time we did one of these interviews, we were talking hypothetically about a tax bill. Now there is a tax bill that has passed one house of Congress. What are some of the highlights and/or lowlights of this thing?

Michael Kink: I would say that it is almost all lowlights. It is a cartoon parody of the most ridiculously unfair tax plan that anyone could come up with. It literally adds new subsidies for private jets while taking away tax deductions for the parents of disabled kids. It is utterly, utterly ridiculous.

Families making between $10,000 a year and $75,000 a year are going to see tax increases.

The only highlight is that it is tremendously unpopular. The vast majority of Americans don’t like it, don’t want it, understand that it benefits the wealthy over regular people, understand that it doesn’t close any loopholes and opens up some new ones….

I would argue … that the tax bill puts lives at stake in many of the same ways that the health care bills did. It basically includes a $1.5 trillion cut to Medicaid and Medicare. But it’s a tax bill, and so there is certainly a presumption in the media that most people don’t particularly care about tax bills, or most people figure, “They will give a bunch of money to the rich and maybe they will give a little bit of money to me or someone like me and I will be okay.”

The fact is, unless you are incredibly, ridiculously, preposterously rich, you are not going to get much of a benefit at all out of this. And most regular working-class/middle-class people are going to see tax increases. The Congressional Joint Committee on Taxation’s official report on the Senate bill said families making between $10,000 a year — which is fairly poor — and $75,000 a year — which is kind of middle class — most of those families are going to see tax increases.

The tax bill itself sets off $28 billion a year in automatic cuts to Medicare.

The folks who get big tax cuts are the heirs and heiresses of billionaires. They are going to inherit their massive fortunes tax-free. Ivanka Trump and Donald Trump Jr. and the kids of all the hedge fund moguls and private equity titans are going to do really well. Multinational corporations are going to get a massive cut in their tax rate. There are going to be new corporate loopholes, including actual new subsidies for outsourcing jobs…. They are opening up new subsidies for corporations to move profits and jobs overseas.

The carried interest loophole is still wide open and hedge fund managers and private equity managers will benefit from a new pass-through tax scam that will cut their taxes even more. All of these folks are big campaign donors and they use their political contributions to really rig the system. They have got a tax bill that is a dream for them.

Young people with student debt are going to lose their interest deduction for that debt. School teachers are going to lose their deductions for teaching supplies. Families struggling with medical expenses are going to see deductions eliminated. In terms of health care, the Republican budget and the Republican tax bill work together to set up $1.5 trillion in cuts to Medicaid and Medicare. And the tax bill itself sets off $28 billion a year in automatic cuts to Medicare…. They are still trying to pass it even though it is incredibly unpopular. Chris Collins, the congressman from Buffalo, admitted to … The Hill … that “My donors are calling me and they are telling me that they will never return any of my calls again if we don’t pass this bill.” So, they are even admitting that the main pressure for this bill is coming from their biggest campaign contributors.

We are working around the country to fight this. A lot of the health care activists and grassroots activists that fought and beat the health care bill are engaged in this and are fighting back against it. The teachers’ union — the American Federation of Teachers, the Communication Workers of America, the National Nurses United, and a bunch of community groups have come together for a national day of action Wednesday, November 29. There is a website with some details of the actions at www.stopGOPtaxscam.com…. We are aiming for a kind of grassroots march on Wall Street on Saturday, December 2…. If the bill keeps going, as we expect it will, into December, we are going to aim for a second wave of direct action/protests on Capitol Hill on December 5.

The … last time we had a Republican president selling us a big package of tax cuts for rich people, it was George W. Bush, and the argument was that it was tax cuts for everybody, and it just so happens that rich people make more money and so they got bigger tax cuts…. They would have passed something by now with much less opposition if they were not being so grotesquely class war about it….

I think that the ownership of the Republican Party by the most aggressive and most entitled and system-rigging rungs of capital is entirely complete. The Bush tax cuts for the rich included a refundable tax credit where families got checks. Working people got an actual check. Now, you can say, “I got a $400 check and some billionaire a dozen zip codes away got a $4 million check,” but regular people who might be Republican or Democratic voters got something.

Nobody gets anything out of this bill. It goes to private equity titans, hedge fund managers, international banks, multinational corporations. I do think that the policy apparatus in Washington in the Republican Party is so completely and utterly broken, so distant from the reality of the vast majority of people who provide the votes to keep these people in power, that they just don’t talk to those people, they don’t listen to those people, they don’t care about those people. They figure, if they feed them racial hatred and division on immigration policy, and they yell at football players, then those people will get their “two-minutes hate” to scream and yell and that will be enough for them.

What is the single-payer of economic policy or fiscal policy? Policies that actually redistribute income and invest in the future.

It shows such utter contempt for their voters that I don’t know how long they can exist as a political party. I don’t think most people that are getting nothing and are getting hurt from public policies are going to put up with it. There is a larger question of whether there is an actual, forceful, populist progressive option that anybody in mainstream politics is going to put out there, but the Republicans are working to pass bills that benefit billionaires and their lobbyists. I don’t think that the Paul Ryans and Mitch McConnells of the world really care about anybody else right now. That is very clear from the legislation that they are presenting to the public.

That is an interesting point that you bring up: What would we like to see as the alternative? What should Bernie Sanders and Keith Ellison and anybody else who wants to be the leadership of a progressive/left alternative to this be pushing forward right now? Single-payer health care was the obvious thing in the wake of the repeated health care disasters, but what should we be demanding in response to this?

I think there are two angles to look at. One, at even the most moderate level, if you look at public opinion polls … most Americans want the wealthy to pay their fair share. Most Americans want to see higher taxes on rich people, not lower taxes on rich people. Most Americans would like to see a lot of loopholes eliminated, particularly the loopholes for outsourcing jobs. Most Americans would like to see a tax system that doesn’t overly reward people that are already wealthy, that doesn’t over-reward people that just invest for a living, that does something to help families that are struggling. We don’t have any legislation that does that.

More aggressively, what is the single-payer of economic policy or fiscal policy? I would argue that if most people want to see the wealthy pay their fair share and most people want to see government budgets that actually invest in and create jobs by hiring people and giving them pay checks — as opposed to just sprinkling helicopter-loads full of cash on rich zip codes — we could talk about fiscal policies that actually redistribute income and invest in the future. We can talk about public goods. We can talk about the opportunity to close loopholes, make the wealthy … invest in an economy that would actually employ a lot more people than we have now. We could make the transition into a clean energy infrastructure. We can move forward with single-payer health care … in a way that responds to our opioid addiction crisis, that responds to the aging [in the US], that provides more independent living options for seniors and for people with disabilities.

There are a lot of things we could do that would create a lot of good, meaningful jobs for Americans with decent pay checks and we have the money to do it. The Republicans are saying they would be willing to spend $1.5 trillion on something. If we were going to spend $1.5 trillion on clean energy and public health and education … a lot of people would be in favor of that. The tax system is a way that can provide the resources to do it… When we have young people supporting socialism over capitalism by significant margins because they have been screwed so badly by the economy, then I think it is incumbent on politicians to provide more effective public policies that were previously extended.

There aren’t too many people that are doing that right now, but there are starting to be some, and I think we are starting to see that the public is rewarding politicians that come out with more forceful and positive solutions. Single-payer health care is very popular. We are seeing the weakness of the center-right system of moderate Democrats that relies on tax incentives. The Republicans get rid of all these tax deductions that Bush and Obama and many that Clinton put in place to try to help working people. It is all done through the tax system. They kept all the deductions for the wealthy and they are eliminating all the deductions for working and poor people. They are basically saying, “Screw all you people. We are not giving you anything.”

The alternative is: Let’s have something big and powerful and forceful like single-payer health care. Let’s have free, affordable, universal childcare for all kids that includes a strong early education program that gets every single kid in [the US] ready to go to school and be a great learner. If other countries do it, we could do it, too. Let’s have a distributed, networked clean-energy system that reduces people’s electric bills, that reduces climate-destroying greenhouse gases, and that creates millions of American jobs for people of every race everywhere in the country. The ability to do big powerful things that people want is there.

The Republicans are so utterly beholden to the donor class that they’re putting forth stuff that’s unpopular. There is a hole wide open… I would argue it is up the middle…. People are going to support something that is clear and effective and powerful.

We talked a lot about the health care fight and how that worked and how at the end of it, we come out with more support than ever for a single-payer health care bill. This could, indeed, work the same way if the pushback to this is actually paired with a positive demand….

One and a half trillion dollars. In terms of public policy, it suggests new areas to go forward. Everyone understands that if you get rid of the estate tax, it is only benefiting these heirs and heiresses of the billionaires…. You could have a 100 percent inheritance tax on fortunes over $1 billion or over $5 billion. You could say, “We do not want dynastic wealth in this country. You can get your first billion and keep it, but we are not going to let you keep this 2nd, 3rd, … 14th and 30th. We are going to take that and put it back into public goods. Because you created Facebook or that hedge fund or whatever with huge amounts of public resources. You use mathematicians trained at land grant universities. You use the advanced research facilities at colleges and universities. You took patents that were in the public realm and you made private profits off of them….” At a high enough level, we have got to do something to protect our democracy.

When the heirs and heiresses of billionaire fortunes can take over an entire political party and force them to pass public policies that the vast majority of even their own voters don’t want, there is a problem with democracy.

The billionaires declared class warfare on everyone.

I don’t know if we will get to 100 percent inheritance tax…. But I do think the same way we saw a lot of the support for single-payer health care, after the GOP tax bill, you are going to see a lot of proposals for higher inheritance taxes. You are going to see tax bills that close loopholes on outsourcing jobs that are going to be taken more seriously. You are going to see continued progress for our state-level bills to close the carried interest loophole. If Congress is so bought and paid for that they won’t do it in Washington, then state lawmakers … can take steps to bring the money back for state governments, until and unless Congress does it. There is going to be more support for fair taxes at the state level…

What lessons did you and the other folks who are planning all these actions learn from the health care bill that is being applied to fighting the tax bill?

From a movement perspective, it was really interesting seeing a lot of different people from different backgrounds realizing how much they have in common…. There was a kind of commonality of purpose and experience with the health care fight that I think is really an antidote to the division, the politics of hate that Trump and Breitbart and the Mercers and Bannon have thrown at us. They really want to keep people divided….

On health care, you saw a lot of people in the same boat and they came from a lot of different places. There were folks from Arkansas and Alaska and New York and California and Connecticut and Vermont and Alabama all working together, all doing teach-ins in church basements, all sleeping in sleeping bags together. That was a very powerful thing to see. I think in tax policy you have seen something of the same thing happening with the Indivisible groups, with the labor unions, with the students, and the Bernie folks and more conventional big national unions jumping into this fight…. Whether or not you agree with fighting class warfare on behalf of people who are workers, the billionaires declared class warfare on everyone. So that kind of puts people in the same boat…. And the fact that the tax fight includes a health care fight made it a lot easier to make that leap.

How can people get involved in some of these various actions that are going to be coming up?

StopGOPtaxscam.com. There are some simple bullets on the plan and there is a whole set of days of actions where folks can click through. That hashtag, #GOPtaxscam, is also going to be in place where you can look on Twitter and Facebook. There will be a lot of local events. I think the face to face is really important; going to events, joining with other people.

There [is] certainly a plethora of online calling tools. You should call your member of Congress, your House member and your Senator…. If you go to www.stoptrumptaxcuts.org … or … www.taxpolicycenter.org … or … www.notonepenny.org, there are a lot of places you are going to get a “Click here, put in your zip code, and we will call your Senator and your House member for you.”

I do think that they need to be getting calls every day next week…. There are a lot of Republican Senators that have expressed concerns. Senator McCain on process; Collins on the health care angles, still has some significant opposition. Senators Corker and Flake and Moran and Langford have all talked about the problems with the bill in increasing the deficit…. They are going to have problems within their own conference passing this bill quickly.

We need every Democratic Senator to oppose it and we need those couple dozen House Republican members … I think the bill that comes back to the House to consider is probably going to be worse than the bill they got before. It is going to hurt more people, it is going to be more destructive to working-class and middle-class voters that will either re-elect these people or kick them out of office.

So, I do think that there are going to be several opportunities over the next couple of weeks for people power to try to work its magic one more time. That is something that has worked over and over and over again this year in stopping the worst of the public policy proposals that Trump is trying to jam through Congress. There is one more thing we have got to stop this year before we can take a break….

How can people keep up with you?

My Twitter is @MKink. Strong Economy for All is at www.strongforall.org. The Hedge Clippers project has tagged a lot of the biggest funds around these campaign contributions — system rigging and billionaire audacity and mendacity is at www.hedgeclippers.org.

Interviews for Resistance is a project of Sarah Jaffe, with assistance from Laura Feuillebois and support from the Nation Institute. It is also available as a podcast on iTunes. Not to be reprinted without permission.

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