Trump Care Must not Pass the Senate: Building a Movement for “Medicare for All”

Statement of the Democratic Socialists of America (DSA) National Political Committee
May 5, 2017

The American Health Care Act (AHCA) that President Trump and the Republican House majority just rammed through Congress—without subjecting the bill to review of its likely consequences by the Congressional Budget Office (CBO)—poses a grave threat to the well-being of all but the wealthy few.

The bill will deny insurance coverage to far more than the 24 million Americans the CBO estimated would have lost coverage under the initial “repeal and replace” bill that the House rejected in late March. The bill that just passed the House cuts health coverage for tens of millions in order to fund a tax cut of $346 billion over the next ten years to the top five percent of income tax payers.

The AHCA will gut Medicaid, a single-payer system that covers 74 million low-income, disabled and elderly Americans. It would cut $880 billion over ten years from Medicaid, over one-quarter of the previous allocation. Not only will the ten million working adults and children added to Medicaid by the Affordable Care Act (ACA) be denied coverage at the end of 2020, but an additional 14 million more recipients will likely lose Medicaid coverage as states trim their rolls to deal with the lost federal revenue.

The bill also cuts $300 billion over ten years for premium subsidies for people who do not get insurance through employers and who must buy their own policies. This would radically increase the already excessive premiums, co-pays, and deductibles faced by many ACA beneficiaries. And by eliminating the individual mandate (which incentivizes younger and healthier individuals to buy insurance), insurance pools would increasingly be dominated by the elderly and sick.

But the above are not even the most inhumane parts of the legislation. States will now be free to deny coverage to people with prior health problems and to place them into unaffordable “high risk” insurance pools. High risk pools were tried by 35 states before the ACA and almost all failed because of state underfunding. The Republicans claim that rates could only go up for individuals with pre-existing conditions who lose their existing coverage for 63 days or more. But over thirty million people per year lose coverage for periods longer than 63 days due to their loss of employment or other changes in life circumstances.

States will also be able to opt out of the federal government’s definition of essential health benefits, thus denying millions maternity coverage and/or mental health coverage. The bill also denies all federal funding to Planned Parenthood and allows states to exclude maternity care from the list of essential benefits.

DSA has consistently argued that the ACA inefficiently expanded health insurance coverage by providing a huge federal subsidy to the private health care industry. The best part of the bill expanded Medicaid coverage to nearly 12 million working people and their children (another ten million would be added if the remaining 19 Republican states took the federal funds for Medicaid expansion). The Republican bill will end that program immediately after the 2020 presidential election.

DSA will work to pressure Senators to reject the House bill and to refuse to pass a substitute bill that would overturn the ACA, as DSA realizes that the ACA imperfectly expands health care coverage to millions. But given the inefficiency and vulnerability of the ACA, DSA will also redouble our efforts to create state single-payer systems (i.e., state-level versions of “Medicare for All”) wherever possible, particularly in blue states, including California, New York, New Jersey and Minnesota. We will join with others to build a mass movement for “Medicare for All,” a movement capable of electing those truly committed to “health care for all” to state legislatures and Congress.