Cogito Ergo Non Serviam

GOP Senate Tax Cut, Health Cut Bill in Trouble

The Republican Party's working group in the US Senate finally revealed their version of the tax cut bill that is posing as healthcare reform. The House passed similar legislation pretending that giving the rich a trillion dollars in tax relief was going to improve the health of America some weeks ago. The Senate bill is in some trouble, however, because some Republican members of the Senate believe it doesn't cut enough in health spending to fund enough tax cuts, while some others fear it will harm their states in particular. The vote threatened for next week is in jeopardy.

The bill pretends to be a health care reform bill, as most of its 142 pages are devoted to how the tax cuts will be funded. However, there is no doubt this is a bill about taxes. Gone is the penalty for not having health insurance. Gone is the 3.8% tax surcharge on those making more than $200,000 ($250,000 per couple) that went to fund health insurance for the poor. Medicaid expansion is halted to keep spending down, and subsidies for health insurance are gone. Tax credits replace them, and that means only people who pay income tax benefit. The truly poor get nothing. In all, about $800 million in spending is gone and about $1 trillion in taxes surrendered.

In the Senate, the Democrats are acting in a surprisingly united way. Their 48 members as a bloc are voting against the alleged repeal and replacement of the Democratic Party's signature social reform known as Obamacare. That leaves the Republicans with 52 votes. Two defections and it would require a tie-breaking vote from Vice President Mike Pence. Three defections and the bill doesn't pass.

No fewer than four right-wing GOP senators have said they oppose the bill in its current form: Rand Paul of Kentucky, Mike Lee of Utah, Ted Cruz of Texas and Ron Johnson of Wisconsin. They believe the bill doesn't go far enough. As Mr. Paul put it, it's Obamacare-Lite, and that isn't what he ran for office supporting.

Meanwhile, there are more who fear it goes to far. Susan Collins of Maine is undecided. Dean Heller of Nevada is concerned about Medicaid cuts hurting his constituents. Lisa Murkowski of Alaska is bothered that the bill ceases funding for Planned Parenthood. Shelley Moore-Caputo of West Virginia and Rob Portman of Ohio worry about the negative effects the bill will have on dealing with the opiod abuse epidemics in their states.

The challenge for Senate Leader Mitch McConnell (R-KY) is going to be finding sweeteners to bring all of them on board, with a two-vote margin of error. Less cutting of Medicaid won't help win over Mr. Paul, and deeper cuts could cost the votes of Mr. Portman or Ms. Murkowski. According to the Washington Post, Mr. McConnell has only 40 definite yes votes. Finding 10 out of 12 is going to be tricky.

Of course, if the votes aren't there, he probably won't call the question. The deadline of next week is entirely artificial. The point of it was to have the vote over and done with so that when everyone goes back to their home states for the July Fourth break, they won't get an earful from people who are upset. In all likelihood, they will hear from the disgruntled whether they have voted or not, but Mr. McConnell is calculating that the yelling and screaming won't change things if the vote has happened.

In the end, the Republicans don't have a lot of time. The debt ceiling and budgetary issues loom large after the recess. The real work they want to accomplish is reform of the tax code, which requires a healthcare settlement in order to have some idea of what spending will look like. That said, they do have more than a week.

This journal expects the Senate to pass something between now and the end of the year. It will be different from what the House has already passed, and that is where it will all get interesting. Speaker Ryan can either opt for a conference committee to thrash out a compromise version which both houses will have to approve before it can be signed into law. Or he can simply vote on the Senate's bill, which is much faster and less fraught with complications. Either way, millions will lose their health insurance. That should have some effect on the mid-terms and the general election of 2020.

© Copyright 2017 by The Kensington Review, Jeff Myhre, PhD, Editor. No part of this publication may be reproduced without written consent. Produced using Ubuntu Linux.



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