7xm The Republicans’ Choice: Tax Cuts for the Rich or Health Care for Americans

Last week was brutal for anyone who cares about the future of health insurance for low- and middle-income Americans. On Tuesday, the federal government’s Medicaid funding portals temporarily shut down, sending doctors, patients and hospitals into a panic. The next day, President Trump’s nominee for health secretary, Robert F. Kennedy Jr., fumbled basic facts about the program during a Senate hearing, despite the fact that it covers more than 70 million Americans. In the House of Representatives, meanwhile, legislators are circulating a so-called menu of spending cuts that would gut access to health care.It’s that last threat that could prove the most devastating and long-lasting. You see, the Trump administration faces a dilemma: The president has promised to extend the 2017 tax cuts (nearly half of which will go to the wealthiest 5 percent of Americans) at a hefty cost of $4 trillion over the next decade, but many Republicans are reluctant to add to the federal deficit.

How do they square the math? It appears they are prepared to do so at the expense of the poor and middle class, by yanking health care coverage from children, new mothers, people with disabilities and seniors. Republican leaders in Congress have suggested that one option they are considering to bankroll their tax breaks would be to cut hundreds of billions from Medicaid; another proposal would roll back subsidies that have helped middle-class families pay Affordable Care Act premiums. They have made it clear they want to finalize legislation in the first 100 days of Mr. Trump’s presidency.

It’s hard to overstate how catastrophic the proposed cuts would be. Medicaid alone covers more than 40 percent of births in the United States. Far from being a handout, it is one of the most cost-effective insurance programs in the country, meaning there is very little fat to cut without immediately harming people. It’s because of Medicaid that children, seniors and people with disabilities — groups that make up more than 75 percent of the program’s spending — can see doctors and fill prescriptions without going bankrupt.

In their menu of options,jolibet login House Republicans propose adding work requirements to Medicaid, which would cut benefits to some recipients and, they claim, save billions. Proponents of work requirements argue that such measures incentivize employment, but the evidence overwhelmingly shows that they don’t. This is because nearly every adult in Medicaid who can work already does, or is a student, disabled or a caretaker for someone else. Instead, people lose access to care because of bureaucratic red tape and difficulty proving they qualify. Work requirements bloat the bureaucracy and result in worse care for fewer people.

Republicans are also considering distributing a set amount of money to states, regardless of what care actually costs. But states are already struggling with tight budgets. They don’t have hidden, untapped solutions to magically fund health care. With less money, they must refuse coverage to more people or pay providers even less, which means fewer doctors will see Medicaid patients, which reduces access for everyone. Twelve states have trigger laws on the books that might end Medicaid expansion programs or severely cut them if the federal government reduces funding.

Medicaid isn’t the only potential victim. Congressional Republicans are also eyeing the Affordable Care Act’s premium subsidies — the same subsidies that help working Americans buy private insurance at more affordable rates. Roll back these credits, and families could see their monthly premiums soar by hundreds of dollars.

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The timeline of the deal allows Congress to sidestep a government shutdown during the campaign season, but it all but ensures that spending disputes will dominate the lame-duck period between the election and the inauguration of a new Congress in January.

The names of the students have not been made public. The family of the targeted student had said in a statement published on Friday in The Gettysburgian, the college newspaper, that their son became “the victim of a hate crime” when a teammate used a box cutter to etch a slur against Black people across their son’s chest at an informal swim team gathering on Sept. 6.

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