An Immodest Proposal: What If We Treated Gun Rights Like Abortion Rights?

constitution_gunThis is a thought experiment. The mass shooting in Las Vegas two days ago killed and wounded more Americans in 30 minutes than the battle of Fallujah. Attempts to legislate gun regulations to make it harder for criminals to obtain weapons of war have failed because of powerful gun lobbyists with deep pockets and spineless congressional representatives who value campaign contributions more than the safety of their constituents.

I see many parallels between the gun rights arguments and abortion rights arguments. For example, abortion opponents will argue that the right to an abortion isn’t specifically spelled out in the Constitution and any claim to that right is the result of judicial activism. When the Supreme Court determined in Roe v. Wade (1974) in a 7-2 decision that the right to privacy in the 14th Amendment extended to health care, decisions regarding abortion became no one’s business but the woman and her doctor.

And while the 2nd Amendment does offer some specific gun rights, until District of Columbia v. Heller (2008) the right to bear arms was considered a collective right, that is a right given to the states, not individuals. In a 5-4 decision, SCOTUS overturned more than a century of precedent to say the 2nd Amendment applied to individuals. For some reason, conservatives didn’t see that as judicial activism.

So, given that both individual abortion rights and individual gun rights are the result of split decisions by SCOTUS, we can look to how legislatures’ attempts to regulate these rights can inform each other. Perhaps, through creative thinking, we can find some common ground. Or at least lay bare the hypocrisy.

I mean, conservatives bent on curtailing abortion rights are nothing if not creative. They have come up with dozens of “TRAP laws” (Targeted Regulations at Abortion Providers). They have legislated waiting periods, scripts for doctors to read, regulations for clinic facilities, hospital affiliations, invasive ultrasounds, and affirmed the rights of protesters to line the sidewalks outside clinics to offer street-level “counseling.”

What if we applied some of that creativity to the problem of gun violence? Below are some suggestions for how this might work.

All Gun Stores Should Be Required To Build and Maintain A Below-ground Shooting Range

Think about it. It offers gun buyers access to better information about the gun they are considering. If something terrible happens, like a misfire or a stray bullet, the range is surrounded by earth and no outsider would be injured. The range can be limited to one person at a time to ensure no “lone wolf” decides to use their weapon on anyone but themselves. 

“But wait,” you say. “My local gun shop is located in a place where an underground shooting range can’t be built.” That’s unfortunate, but your safety is our main concern. This legislation undoubtedly will lead to closings of sub-standard gun shops around the state. But in the name of safety, and providing potential gun owners with necessary information with respect to their options and their rights, this is a good thing for gun owners.

“But wait,” you say. “My local gun shop can’t afford to take on such expensive renovations.” You’re not alone. Some estimate that these new regulations will close upwards of 90 percent of gun shops in your state. But those remaining 10 percent are going to be reeaaaallly successful and busy. In fact, you may have to start making appointments to purchase weapons because of the demand. 

All Gun Purchases Should Require a three-day waiting period.

Potential customers may use these three days to fire the gun in the underground firing range, read various pamphlets offered by the state, and a law enforcement officer will offer counseling about the dangers and responsibilities of gun ownership.

“But wait,” you say. “I don’t need three days to make my decision. I’ve got to drive a four and a half hours to get to a gun store. Why should I have to wait three days after I get there?” We like to think of this part of the legislation as “reflection enhancement time.” If you make a rash decision, you will regret it for the rest of your life and there are psychological implications to that of which you need to be aware.

All Gun Purchasers Should Be Required to View Images of Gunshot Victims

You may never fire your weapon at another human and we really hope you don’t. But if you decide to take that momentous step, you need to do so with your eyes open to the results of your decision. Studies show that people who use their guns to kill, even in defense of their own lives, often suffer from post-traumatic stress disorder. It is important that you understand the deadly nature of your decision and how it may affect you for the rest of your life. Firing your gun at someone could result in you being unable to fire your gun at anyone else. Then where will you be?

All Gun Dealers Should Be Required to Properly Dispose of Waste

This includes spent shells, casings, used targets, etc… Reusing these materials creates an environment where ammunition isn’t strictly regulated. An unsuspecting gun owner could inadvertently use substandard ammunition which can cause injury to him or herself or others. Therefore, reloading and reusing ammunition components is prohibited. Proper disposal of spent rounds, casings, targets, and shells will require proper labeling, packaging, and disposal using a commercially licensed handler of hazardous waste material, all of which must be buried or incinerated in the presence of a licensed disposal agent. 

All gun dealers should be required to have an off-duty law enforcement officer on the premises 24 hours a day.

This will facilitate the required counseling as well as create jobs and give law enforcement a better access to information about gun ownership in the state. Also, if an emergency occurs, having law enforcement on hand will better protect the gun owner and gun dealer from danger. 

“But wait,” you say. “However many guns I own or want to own or plan to own isn’t anyone’s business but mine.”  Sure, sure. You’re fine. You’ve got nothing to worry about. It’s the shady, back-alley gun shops that we’re going after. “But I can’t afford to pay an armed guard/counselor to be on site 24 hours a day.” Again, this may cause the closure of some substandard gun shops, but that’s the price you pay for safety and access to good information about your decision to buy and own a gun.

All gun purchases must be done in person with a licensed gun dealer and law enforcement officer present.

If something does go wrong during the purchase, to protect the health and safety of everyone involved, we’d feel better about having some professionals present. This isn’t the sort of decision one should make via computer or through the mail. There may be questions to be answered. Plus, this way, we can ensure that you’re in compliance with the other regulations we’re creating. So, no gun purchases online or over-the-counter. You need to see a licensed professional and have someone present with jail-admitting privileges should an emergency happen.

All Gun Store owners and employees should be screened for lead poisoning every six months.

The health and safety of everyone involved in the totally legal and constitutionally guaranteed right to own a firearm dictate that steps be taken to head off any potential risks to the wellbeing of gun shop owners and employees. So regular inspections of the facilities including sweeps for carcinogens, the presence of lead, and other environmental contaminants will help ensure the safety of all involved.

Gun Purchase Counsellors Shall Remain Outside the Fixed Buffer Zone of the Gun Store and Outside the Floating Buffer Zone of Individual Gun Purchasers.

In the interest of ensuring you have all the information you need to make your gun purchasing decision, some gun stores may attract the attention of street-level counselors who may shout helpful information at you while you walk toward the store. They may also show you giant images of gun-shot wounds or dead people who suffered from gunshot wounds. They may use bullhorns or PA systems to yell their advice at you. They may take your photo or write down your license plate number. This is all for your benefit and depending on the state, they may be required to stay back a few feet from the door and a few feet from you. Your gun store may provide an escort to help you navigate these well-wishers.

All Gun Purchases Will Be Recorded and Filed with the  State Government Health Departments.

We need to study the effects of gun ownership on a variety of public health issues. To do this, we need the best information available. So the Department of Health will keep a file on every person who buys a gun and every gun bought. This way, we can know and others can find out.

Do these regulations sound unreasonable? Do they sound like attempts to stop you from exercising your rights to purchase and own guns? Do they sound like excuses and pretenses? They are. But so are TRAP laws.

Now imagine the government enacting some or all of these regulations, resulting in the closure of all but one or two gun shops in your state. Now, to purchase a gun, you have to take off from work, drive several hours, get a hotel room, navigate a gamut of protesters screaming at you, begin the process (which includes your gun dealer and law enforcement officer reading a state-mandated script about the evils of gun ownership), wait two or three (or five) days (and in some states weekends and holidays don’t count toward this waiting period); and then have an unnecessary and invasive medical procedure (such as a prostate exam) before you’re allowed to make your purchase, which the Constitution and the courts say is legal. Oh, and the government may spend your tax dollars funding stores that look like gun shops but don’t actually sell guns, just advice on why you don’t really want to own a gun anyway. The government might also pass legislation saying your liability insurance doesn’t cover shooting anyone, so you’ll have to get a special mass shooting rider which they will make illegal to sell to you.

Every one of these regulations, which seem silly and unnecessary are based on actual legislation proposed or enacted by states to limit a woman’s right to abortions. All the justifications which seem egregious are based on the justifications for various TRAP laws. If you can recognize it when applied to gun rights, then you should be able to see it with respect to abortion and understand why so many fight against them.

The truth is that we need gun control regulation. Not to prevent law-abiding citizens from protecting themselves. But to prevent someone accumulating an arsenal and murdering 50 people and injuring 500 in a matter of 30 minutes. Currently, Congress wants to make it easier to purchase suppressors for weapons under the guise of “hearing protection” and armor-piercing bullets under the guise of . . . well, I’m not sure why civilians need armor-piercing rounds. But it seems like we’re moving in the wrong direction here.

Contact your members of Congress. Tell them to return the blood money the NRA has given them. Tell them to take action to protect your right to be safe in public. Because the answer to the shooting in Las Vegas isn’t hotel security screenings or limits on outdoor events. It’s regulations on ammunition and weapons. We can do better than what we’re doing.

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They’re Coming To Take Me Away Ha Ha Ho Ho Hee Hee (The Trump/Nixon Tapes Part 5)

Trump Jackson Screwball[What follows is a transcript of President Donald Trump speaking into the Oval Office recording device originally used by President Richard Nixon. This series of recordings encompasses the president’s communication to his inner circle.]

To: The Trump Circle of Trust (TCT)

cc: Speaker Paul Ryan

I swear. You people are going to put me in the looney bin. Why is everyone talking like I’m crazy? Morning Joe? George Will? The Washington Post? CNBC? NPR? They’re all talking about how I’m losing it. Like I got a screw loose! Can you believe it? I mean, I expect that sort of thing from Keith Olberman, but Terry Gross? What did I ever do to her?

This is completely unfair. So I occasionally have trouble getting the words out. Or I confuse names. Or I repeat simple phrases over and over again. Or I talk about dead people as if they’re still alive. Or I forget how government works. Or I’m afraid of stairs. Or I compliment dictators and strongmen around the world.

Speaking of which, I heard Kim Jong-un’s dad has a hell of a golf swing. Maybe I should invite him out to Mar-a-Lago for 18 holes and we can work this whole nuclear thing out. Sheila? Get me Kim Jong-il on the phone. What? Dead? When? Does Kim-Jong-un know? He’s a smart cookie. I bet he does know. Any word on how his golf game is? If he’s anything like his old man, it’s tremendous.

Someone might have mentioned that Andrew Jackson died 16 years before the Civil War started. Or that the Civil War is one of the most researched questions historians have written about. Am I the only 70-year-old white man who hasn’t watched a thousand documentaries about the Civil War? To see my Twitter mentions, you’d think so. Don’t worry, though. I fixed it.

I genuinely believe Andrew Jackson saw the Civil War coming and was really mad about it. Look at a $20 bill. Doesn’t he seem angry? Someone ask Steve Mnuchin if we can put me on some money. I’m thinking we bring back the $20 gold coin and put my face on one side and me standing at the 14th hole at Trump National on the other. Just make sure it shows the plaque memorializing that “River of Blood” Civil War battle that the fake news people at the failing Golf Digest say never happened.

How about that health care bill, huh? Great job everybody. We twisted arms and prodded those squishy moderates then all of a sudden we got us an Obamacare replacement that does everything I promised it would do. It covers everybody. What was that, Shiela? 27 million? Really? Well, it protects people with pre-existing conditions. What? No? Are you sure? I’m pretty sure I saw Paul say it would protect pre-existing conditions. It will jack up their premiums? But I promised it would lower premiums. I said it would cost a tiny fraction of what Obamacare costs. I remember it clearly because that was a huge applause line. Ugh, am I going to have to read this bill? Shiela? Get someone in here to read this bill for me.

[tape pauses for 8 minutes]

Enough! Enough! Get out! Who knew health care could be so boring? Am I right? Shiela? Tell Paul, I’ll take his word for it. Man, I thought I was going to die listening to that. Good thing I’ve got great health insurance. Whew. I’ll tell ya, that was brutal. I did catch something about Medicaid in there. I assume we’re keeping my promise to not cut Medicaid, right? I really gave ole’ Huckabee the business on Twitter that time he copied me.

Wait, what was that, Shiela? You were mumbling something. Block grants to the states? What’s that? Oh. Well, that doesn’t sound too bad. I mean what’s $880 billion? It’s not like that’s serious money. It’s probably mostly fraud and waste, right? What? What’s a “special-needs kid?” Oh, come on. Really? What about vets? Them too? So who gets the $880 billion? Tax cuts for billionaires? And they voted for that? Wow. Unbelievable. I’m sure everyone else is okay with it, though. What? Well, yeah, I’ll sign it. I promised, didn’t I?

Man, I’m bushed. I hope I don’t say something to undercut our entire argument when I meet with the Australian prime minister tonight. You know how I get when I haven’t had my well-done steak with ketchup.

Okay. Now that we’re finished with repeal and replace can we move on to something else? I am so tired of pretending I care about health care. I need to get out of Washington for a few days. Maybe I’ll go visit Melania in New York. That’s the one place in the country where I know they love me. New York is my town. What’s that, Shiela? Mike Pence has another executive order for me to sign? I sure do sign a lot of these things for someone who used to really hate the idea of presidents signing executive orders.

What’s this one about? Religious Freedom? Is it the one where we let Christians discriminate against gay people or the one where we let churches fundraise for politicians? Both? Ask Mike if he can combine them into one, I don’t want to sign two of them. I’ve only got so much left in in the old tank today and I’m trying to make a tee time at Trump National. Oh, has Ivanka signed off on this? Well, at least no one can get mad about this one, right?

Shiela? Tell Steve Mnuchin that when he’s done with his weekly meeting with Ivanka that I need to see her. I want to give her a hug and tell her it’s going to be okay. Everybody puts fake quotes in their book nowadays. Nobody cares except a bunch of nerds that are going to find something to complain about no matter what you write. Shiela? Get the State Department on the phone. They’re not doing anything important. Maybe they can help goose her book sales a bit.

You know, I’m getting a little sick of the attitudes around here. Maybe some of you need a little refresher course in who is in charge. Shiela? What can I do to punish a bunch of federal employees that requires virtually no effort on my part?

Okay, I’m off the New York. Good job on the . . . uh . . . health care thing . . . and stuff. Just terrific. Really. I’m sure that’s going to be a huge, huge, part of my legacy.

 

Trump and Ryan Celebrate Bullying Their Own Party Into Supporting A Bad Bill That Will Never Become Law

trump-and-paul-ryanThe House voted 217 to 213 to pass the American Health Care Act (AHCA). This cynical divisive act of cowardice served one (and only one) purpose — to give Donald Trump a legislative “victory.” But what did they win, exactly? I can guarantee you that, even as Trump talks about how great this plan is, he has no idea what the bill does. None. He just knows it must be a good plan because it passed.

During the campaign, Trump promised universal coverage at “a tiny fraction of the cost” and “it will be so easy.” It was only after he was elected that he realized how complicated health care is. By most estimates, it counts for a sixth of our economy and House Republicans passed it without knowing what was in it.

I know what you’re thinking. Didn’t Nancy Pelosi, when she was the speaker, say they had to pass Obamacare to find out what was in it? No. That’s one of the enduring myths of Obamacare — a quote, truncated and removed from its context then used as a bludgeon. The Affordable Care Act took 18 months to develop. There were hours and hours of hearings and debates. President Obama toured the country promoting it and taking ownership of it. During that year and a half, we lost Sen. Ted Kennedy and had to endure a special election. Democrats (though they controlled both houses) negotiated away popular provisions such as the public option to garner bipartisan support, incorporating demand after demand from Republicans only to have them vote no anyway. So no, the ACA wasn’t “rammed through” like so many Republicans claim.

The bill that passed the House yesterday was debated for six hours. No amendments were allowed. No hearings were held. There was no score from the Congressional Budget Office letting us know how much it would cost or what the impact would be on the people. The previous version (the one that didn’t make it to a floor vote) was going to kick 27 million people off their health insurance. It was polling at 17 percent. Somehow, I doubt this version will be any better and, when the CBO score comes out in a week or so, we’re likely to find that it is much worse.

Why did they have to rush this? What was the hurry? One reason is that the Trump administration needed some legislative victory to tout. The president just held a 100-day rally in a town he once referred to as a “war zone” and all he could say was that he nominated a Supreme Court justice (which was McConnell more than Trump) and he signed a bunch of executive orders, which were themselves broken campaign promises. The evidence of this assertion is that after voting on the bill, House Republicans got on buses and rode to the White House for a Trump victory celebration. What were they celebrating? Paul Ryan and Donald Trump had bullied their own party into supporting bad legislation? That’s a win?

Trump said Obamacare is “dead” well, “essentially dead.” He described the Republican bill as “something that is very, very, incredibly well-crafted.” I can guarantee you with all certainty that he has no idea what is in that bill. Most of the Republicans who voted for it hadn’t read it.

Now, I can break down for you all the terrible things in this bill, such as how it declares being a woman a pre-existing condition, screws over special-needs kids, cuts Medicaid funds that help the poor to fund a tax cut for the wealthy, and offers states a waiver to allow insurance companies to jack up rates on pre-existing conditions and old people. But what’s the point? This bill will never become law. The Senate is going to start from scratch. That’s the thing that really bothers me about this. The AHCA will be DOA in the Senate. So all the arm twisting and bullying to get the votes they needed in the House was just so Trump could have his Rose Garden photo op:

It was a sea of white men all celebrating killing health care for at least 27 million people and passing a tax cut for people making more than $250,000 a year. They are so proud and happy. But most of them don’t even know what they voted for because what they really voted for was for Paul Ryan to keep his leadership post. Aside from Trump’s photo op, that was the priority here. Because if Ryan failed to pass a bill on this third try, then his speakership was going to be over. In fact, the entire House leadership team would have been kicked out.

Think about that. If you were a rank-and-file member, that conversation had to go something like:

“We need you to support this bill.”

“Can I read it?”

“We don’t have draft language yet.”

“What about a CBO score?”

“Nope.”

“Is it popular with the public?”

“Polling nationally at about 17 percent.”

“This bill sounds awful.”

“Don’t worry. You and your staff will get an exemption from whatever is in it.”

“Why should I vote for it?”

“If it fails again, the entire House leadership will be fired and you might have to take one of the posts.”

“Oh hell no!”

The American Medical Association, the American Nurses Association, the American Hospitals Association, the AARP, insurance companies, and editorial boards across the country all oppose this bill. Perhaps the president has succeeded in uniting this country afterall.

Next week (or maybe the week after) the CBO is going to tell everyone exactly what the Republicans passed yesterday. Your congressman needs to hear from you. One of the easiest ways to make that happen is to use ResistBot to send faxes and letters to your representatives for free (though they would appreciate donations). I use it three or four times a week to let my congressman, Dr. Phil Roe, know that his district isn’t as safe as he believes. If we can’t make these people feel uneasy about something as egregious as this dumpster fire of a bill, then we’ve lost already. Next year will be the midterms and every member of congress needs to be held accountable for what they did yesterday. I’ll do my part. I’m counting on you to do yours.

None Dare Call It TrumpCare?

In all fairness, President Donald Trump had very little to do with the ACA replacement bill making it’s way speedily through the House of Representatives right now. No one wants to put their names on it, (including Trump) so the Republicans call it the American Health Care Act. I’m hard pressed to think of a way you could have written a worse bill to replace Obamacare (We’re keeping all the fees and penalties, cutting your subsidies and coverage, defunding Planned Parenthood, and gutting Medicare). But let’s take a look at what we’re being fed.

First of all, though this claims to be a healthcare bill, it’s a budget bill. The House presented it as a budget bill so they could get it through the Senate with a simple majority. This also means you can’t have any real non-budget-related policy changes in the bill. That’s why we’re not seeing anything in that doesn’t have to do with how the government spends money.

There’s nothing about such Trump promises as selling insurance across state lines, transparency in pricing, or repealing the McCarren Ferguson Act. That would make the bill subject to the filibuster.

Obamacare took a year to pass — there were public hearings, debates, speeches, countless hours of TV coverage, a special election in Massachusetts when Sen. Ted Kennedy died, and an entire summer of Tea Party Town Hall meetings. The president moved off his positions to help bridge the gap with Republicans who had plenty of demands, but no interest in voting for it even when those demands were met. The result was an imperfect legislation-by-committee that nonetheless provided insurance coverage for millions of Americans who could not get it before.

It passed seven years ago. Republicans have been promising to repeal and replace it all this time including voting to repeal it more than 60 times. So it is unconscionable that they didn’t have a replacement ready to go on day one. But now that they have a replacement, they don’t want to debate it. It passed through the first committee at 4:30 a.m. without any markups. That’s unheard of — unless you’re trying to ram it through. Speaker Ryan wants to pass the bill next week and Sen. McConnell promised to have a vote in the Senate by April.

Neither of them can tell you how much the bill will cost or how many people will lose insurance because the Congressional Budget Office hasn’t scored the bill yet. And while Ryan argued that it was a sham to vote on Obamacare without a CBO score, now Republicans are attacking the CBO (which is an office filled with non-partisan number wonks).

Personal Mandate

Healthy people pay for insurance they don’t use to offset the costs of sick people. That’s how insurance works. That’s how it’s always worked. So Speaker Ryan’s contention only makes sense if your goal isn’t to provide health care. The goal is a tax cut for the rich.

Why do we have a personal mandate anyway? If you make a law that says insurance companies can’t turn away sick people, then you have to also make it a law that everyone has to have insurance. Otherwise, no one buys insurance until they get sick.

Under Obamacare, If you don’t have health insurance, you pay a fine. This drives healthy people into the marketplace:

“I have to buy insurance or I have to pay the IRS a penalty. I’m going to buy health insurance.”

Trumpcare flips this on its side. There is no penalty for not buying health insurance. But if you have a gap in coverage, you have to pay a 30 percent surcharge on your premiums for a year:

“I didn’t buy health insurance while I was looking for a job out of school, now I don’t want to buy it because I have to pay a 30 percent penalty. I’ll put that off until I get sick and have no choice.”

This alone makes this bill worthy of the name “Trumpcare” because it solves a problem that nobody thought was a problem. Seriously, during the entire year of debate over Obamacare, did anyone ever suggest that the issue with the penalties for not having coverage was who got to keep the money? The entire SCOTUS case over Obamacare was about whether the penalty was a fee or a tax. This bill doesn’t eliminate the penalty. It just changes who gets paid. How is that an improvement for anyone except insurance companies?

Premium Subsidies

If you have a personal mandate, you have to subsidize those who can’t afford it. Obamacare based subsidies on income as well as other factors. If you couldn’t afford your coverage you could receive subsidies to help pay for your health insurance. That’s the way it was supposed to work, anyway. But there was a donut hole in the law that left some people in a bind if they made too much money for a subsidy but still couldn’t afford coverage.

The expansion of Medicaid was designed to cover those people. Originally, the Medicaid expansion was mandated for every state. But several states sued and the courts said the fed couldn’t require states to expand Medicaid or build state insurance exchanges. The result was that states that expanded Medicaid saw a dramatic drop in uninsured. Those that refused, saw a lot of angry poor people.

The bill bases these subsidies on age. The older you are, the more money you get. This makes no sense because poverty affects young and old alike. And instead of increasing the subsidy with need, you get a flat rate.

Trumpcare doesn’t make sense as a health care bill. It doesn’t make sense as a budget bill. It only makes sense as a tax cut for the wealthy.

Goodbye, Medicaid

Medicaid under Obamacare was expanded. Medicaid under Trumpcare gets gutted. Speaker Ryan bragged that the bill does something that’s never been done before — it defederalizes an entitlement program, capping both spending and rate of growth. What he means by that is that rather than administering Medicaid. The fed will give block grants to states to run their own version of Medicaid. Capping spending and rate of growth is Ryanspeak for cutting funding and letting that states make up the difference in costs. I don’t know about your state, but Tennessee can’t afford it.

The bill calls for the savings from these Medicaid cuts go toward tax cuts for upper brackets. What this does is shift the money designated for poor people to rich people. In fact, according to the Center for Budget and Policy Priorities, this bill will transfer $370 billion from the poor to the top one percent of earners over ten years.

By the way, healthcare for the poor (according to Speaker Ryan) is an entitlement. But the tax breaks for the rich aren’t. Sounds like “Trumpcare” to me.

Compare and Contrast

Republicans want to compare the two plans using odd benchmarks like how many pages it took to print the bills.

Image: US-POLITICS-SPICER-BRIEFING

Incidentally, despite being so many fewer pages than the ACA, the Trumpcare bill has six pages dedicated to how to deal with a poor person who wins the lottery. It devotes a not-insignificant amount of space to allowing insurance companies to write off huge salaries for CEOs. I don’t recall that being part of the Tea Party chants. I don’t remember Trump campaigning on giving insurance companies a big tax cut. This only makes sense if the bill is a tax cut for the rich and not a healthcare bill.

When it comes to more important and relevant benchmarks, the Republicans don’t want to hear it. Literally. How much will Trumpcare cost? We don’t know. The Congressional Budget Office hasn’t scored it yet and the GOP doesn’t want to wait on them. How many people will be left uninsured? Speaker Ryan can’t say.

The House is trying to rush through a vote and the Senate has already indicated that they’ll vote on it by April. That’s crazy. The only reason to do that is to hide the cost. They don’t want to know. Trumpcare.

They don’t care because the purpose of the bill is not to ensure healthcare for all Americans but to ensure profits for all insurance companies. If this bill makes it to Trump’s desk and he signs it, it won’t be while surrounded by old people, children, or the sick. He will be flanked by insurance executives in suits all tenting their fingers and licking their chops.

The ironic thing to me is that the people who will be hurt worst by this bill (those who stand to lose at least $5,000 in subsidies) voted for Trump by 59 percent. Is there a better name than “Trumpcare?”

Coverage

Let’s get something out of the way about insurance coverage. Republicans in the House don’t understand how it works. Later in the exchange in the video above, a House Republican yells that what he wants is for people to buy their insurance ala carte — picking the coverage they want to pay for. But insurance isn’t sold that way. It’s never been sold that way and Republicans don’t have the power to change the way an industry does business (not with a “budget” bill).

Think of it like your cable bill. You want HBO, but you don’t want CSPAN. You watch “Game of Thrones” but have no interest in watching our government’s dysfunction first hand.

You buy a package. The package includes CSPAN and HBO. You don’t get a break on your bill for not watching CSPAN. You don’t get to pick and choose which channels are part of the package. CSPAN isn’t for everyone, but it is important and so everyone gets access.

The same goes for things like prenatal coverage. I know a couple who owns a successful business, have no children, and no plans to adopt. Their health insurance covers prenatal care. This couple won’t use it. But their package will help subsidize the Duggers’ 21st kid instead. We can’t mandate the number of children people can have. So we spread the cost around. That’s how it works.

Republicans like to frame this debate as about access to healthcare, rather than affordability of healthcare. They seem to believe the problem is not enough patient choice, rather than not enough patient money. Along those lines, Trump and his surrogates have made some crazy promises about coverage that this bill cannot keep.

We’re going to have insurance for everybody. There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us. You can expect to have great health care. It will be in a much-simplified form. Much less expensive and much better.” — President-elect Trump, January 15, 2017.

“I firmly believe that nobody will be worse off financially in the process that we’re going through. They’ll have choices that they can select the kind of coverage that they want for themselves and for their family, not the government forces them to buy.” — HHS Secretary Tom Price, March 12, 2017.

S&P Global says between 6-10 million will lose coverage. Brookings says at least 15 million will lose coverage. The Congressional Budget Office (which released a report while I was writing this) estimates 24 million will lose coverage.

So How’s It Going?

The AARP is out.

The Heritage Foundation is out.

The House Freedom Caucus is out.

Breitbart is out.

Sen. “Tehran Tom” Cotton is out.

Sen. Rand Paul is out.

The American Medical Association is out.

The American Nurses Association is out.

The American Hospital Association is out.

Freedomworks is out.

Americans for Prosperity is out.

That’s some heavy hitters from the industry and from conservative politics. Well, if liberals don’t like it and conservatives don’t like it, who does support it?

Trump, Ryan, and The US Chamber of Commerce.

There is every indication that this bill won’t pass in its current form. Speaker Ryan said not passing it could stall the Republican’s agenda. Trump said if the bill fails, his plan B is to let Obamacare fail (because, you know, “death spiral”) and blame the Democrats.

The bottom line is that this bill is a travesty that fixes none of the problems Obamacare has and creates a whole new set of issues. To fix the problems with Obamacare, you’ll have to spend more money. Republicans are not interested in spending money to fix it. They’re not interested in providing healthcare to poor people. They just want to transfer more wealth to the upper earners.

I can’t think of a better name for that than “Trumpcare.”

 

EDIT: Here’s the CBO report.