ATLANTA – The Tax and Budget proposals do exactly what Congress has intended for years: devastate Medicaid, dismantle the ACA, ominously cut Medicare and erode, if not totally destroy, any federal responsibility for the public’s health. Congressional plans do all this and more including ending funding to protect our food and water supply while giving the richest 1 percent 80 percent of the tax cut benefits and giving corporations a permanent tax reduction of from 35 to 20 percent over the decade.
The class content of these proposals is transparent. Spanning the years from 2018 and 2027, Medicaid funding would be cut by over a trillion dollars. Funding would be increasingly shunted to the states, resulting in restricted eligibility, cuts in benefits and/or punitive waivers like work requirements, drug testing and increased co-pays in order to balance state budgets. In effect, Medicaid would be block-granted by budget, tax and regulatory decrees.
Seventy-four million people receive health benefits from Medicaid. It is the insurance for 39 percent of all children, 50 percent of all births, 60 percent of nursing home coverage, 25 percent of mental health insurance and 20 percent of all addiction treatment. It provides critical independent living resources for the disability community. The combined public insurances of Medicaid, Medicare, the Veterans Administration, and the uninsured make up about 44 percent of all Americans and is nearly equal to the number of workers with on-the-job insurance. The latter are increasingly unable to access healthcare because of the application of employment-based high deductible insurance plans. These plans offer no reimbursement until the employee has paid the deductible ranging from $1,500 to $6,000. Healthcare is the barefaced expression of the polarization between wealth and poverty even before the enactment of the 2018 budget and tax proposal!
Medicare’s budget would suffer $473 billion in cuts by 2025, setting the stage for its complete privatization through “premium support” schemes. But there’s more. The Affordable Care Act “mandate” to buy health insurance is eliminated in the Senate tax plan, causing projected annual premium spikes of more than 10 percent in the ACA exchanges and an increase of over 13 million uninsured.
The budget and tax processes are complicated and obfuscated. Resistance is scattered. Distractions abound. A vision of what’s possible is fundamental for making a plan of what’s necessary, not only to stop this massive transfer of wealth out of the hides of working and poor people to the propertied class, but to go on the offensive for universal and comprehensive healthcare regardless of ability to pay.
Steps in that strategy are emerging. On the West Coast and in New York, millions are mobilizing for the Campaign for a Healthy California and the New York Health Act respectively. “Medicare for All” bills are in both the U.S. House and Senate. And thousands have hit the streets, town halls and public hearings for this fight. It is teaching us that we can’t go back in history but only forward, to wresting the power of government from the corporate class to our class, so we will have the power to deliver and guarantee healthcare for all!