The new Senate bill's major provisions

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And they're playing fast and loose with the most vulnerable people's healthcare coverage in order to ram their healthcare law through (which will also hit the most vulnerable)..

Shame on them.

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The CBO report is a dense 49-page document that you can read here. But you can find its clearest explanation of the Senate bill on page 48. This is where the CBO report explains how premiums would change for low- and middle-income Americans — and what type of health insurance they would get for those monthly payments.

This page shows, in no uncertain terms, that low-income Americans would be asked to pay higher premiums for worse health insurance coverage. Look at what happens to people who earn $26,500 (175 percent of the poverty line). I've circled the most relevant numbers below.





You can see that across the board, premiums go up for Americans with low to moderate incomes. People who purchased bronze-level plans would see their premiums go up a little. People who purchased silver-level plans would see their premiums go up a lot.

What is harder to see is that the premiums are up while the quality of the health insurance is going down. Those numbers in the gray boxes represent actuarial value, which measures how much a health plan, on average, covers of its members' costs. You can see that the actuarial value drops as premiums rise. This, in simple terms, means enrollees will be asked to pay higher premiums and in return get coverage with higher deductibles and copayments.

The reality, of course, is that many of these people just wouldn't buy coverage. They would find the plans prohibitively expensive and the coverage not worth the price. This is what the CBO concludes in one especially devastating paragraph (bolding mine):

Under this legislation, starting in 2020, the premium for a silver plan would typically be a relatively high percentage of income for low-income people. The deductible for a plan with an actuarial value of 58 percent would be a significantly higher percentage of income — also making such a plan unattractive, but for a different reason. As a result, despite being eligible for premium tax credits, few low-income people would purchase any plan, CBO and JCT estimate.

Page 48 is the most important page in the CBO report - Vox

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And this is how their media defend it..

We’re all going to die. Many of us, however, hope to put that day off as long as possible. That insight appears to be lost on Fox News’ Lisa Kennedy Montgomery. During a discussion about Senate Republicans’ decision to temporarily pull the plug on Trumpcare on Tuesday evening, Kennedy criticized progressive “hysteria” about the bill, which would cost 22 million Americans their health care, since “we’re all going to die” anyway. “You know what, at least they are not employing any hyperbole at all. No exaggeration, no hysteria,” she said. “You know what the crazy thing is? We’re all going to die. And they can’t predict — there’s no way unless they are absolutely psychic and have a party line to heaven, they don’t know who’s going to die or when or how many people.”

Fox News host argues stripping coverage from millions is no biggie since ‘we’re all going to die’

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Ted Cruz's possible fix:

No legislative text of Cruz’s proposal is yet available, but this is the gist: As long as a health plan offered at least one Obamacare-compliant plan in a state, the plan would also be allowed to offer non-Obamacare-compliant plans in that state. Nothing is certain, but I’m told this is the main conservative ask on the health care bill right now.

Senate Majority Leader Mitch McConnell (R-KY) is working hard to find a compromise by the end of the week, after the embarrassment of postponing a vote on the legislation until after July 4. If conservatives get that win on insurance regulations, they might be willing to accept fewer tax cuts for the wealthy in the bill.

Smaller tax cuts would, in turn, free up more money for McConnell to spend on Medicaid and insurance subsidies for poor and middle-class Americans. Those concessions are likely necessary to win over moderates who currently oppose the bill, some of whom are already agitating to scale back the tax breaks for the rich. Every part of the plan is fickle, and McConnell’s margin for error is nil. But as he scrambles for a deal in the next few days, this might be his best bet. If it came to pass, it would represent a significant restructuring of who picks up the tab to cover the most vulnerable Americans.

Ted Cruz has a big idea that just might unlock a Senate health care deal - Vox

The more people (the young and healthy) chose these light programs, the higher the premiums for the regulated (that is, containing the minimum coverage standards) will be though..

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And make no mistake, people will die as a result of Obamacare repeal, commensurate with the number of people losing insurance:

On substance, Democrats are on firm footing. The Center for American Progress and Harvard researchers estimated that the Senate bill could cause between 18,100 and 27,700 additional deaths in 2026. The Washington Post’s Philip Bump reported that it’s “hard to pin down” exactly how many people would lose their lives, but acknowledged, “The available evidence suggests that there will be a human toll from an increase in the number of uninsured.... In broad strokes, Sanders’s assessment that thousands more would die annually appears to be supported by the data.” PolitiFact similarly “found ample evidence in the academic literature to suggest that legislation on the scale of the House bill would produce ‘thousands’ of additional deaths.” It’s also just simple logic that being uninsured imperils one’s health, which can lead to death (an obvious example being someone discovered to have late-stage cancer, which could have been caught earlier through a routine medical checkup)..

Democrats Are Warning That Trumpcare Will Kill People. Is It Convincing? | New Republic

A real life experiment came when Romney introduced Romneycare in Massachusetts, which increased coverage and mortality declined.

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Republicans have made lower insurance premiums one of their biggest promises on healthcare. Despite this goal, an analysis by the Kaiser Family Foundation found that, once you factor in tax credits, the end point premium payment for most Americans in the individual health insurance market would actually increase under the Senate's Better Care Reconciliation Act (BCRA) healthcare overhaul bill.

The nonpartisan health policy think tank broke down just how much premiums, factoring the effect of tax credits in the proposed law, for a silver-level plan in the individual insurance market would increase for people of different ages.

While the individual market only makes up around 7% of the population, the premiums in the market have become a central part of the debate over the future of healthcare. Republicans often bring up the increase in premiums in this market as a reason that the Affordable Care Act, or Obamacare, needs to be replaced. Overall, Kaiser found that premiums after tax credits in the market would increase by 74% under the BCRA compared to the ACA.

Additionally, older Americans would see an even steeper increase for a variety of reasons. For one thing, older people can be charged more under the BCRA than the ACA. Under current law, older Americans can only be charged three times as much for premiums as younger Americans. Under the Senate bill, this age band would increase to five times.


Additionally, the premium tax credit structure would be changed. The formula for how much of a person's income is supposed to be spent towards premiums would gradually increase as individuals age under the BCRA. Add it all up and almost everyone would see an increase in their premiums for a silver plan, with the increases getting more dramatic the older someone gets.

Premium increase from Senate Republican healthcare bill, BCRA - Business Insider

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Not only coverage and premiums, also jobs are likely to be a victim..

The Congressional Budget Office estimates 22 million fewer Americans would have insurance under that plan. But health coverage isn’t the only thing at stake. The Senate bill could slash hundreds of thousands of jobs and stunt growth in an industry that has boosted post-recession job creation. It’s unclear exactly how many jobs are on the line. But public health experts at George Washington University estimate that 912,000 health care workers in the United States could lose their jobs if Congress rolls back the Medicaid expansion and removes tax credits to help people buy private insurance. (The BCRA phases out Medicaid expansion and caps, but does not eliminate, tax credits).

Hundreds of thousands of workers could lose their jobs if Senate health bill passes - Vox

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Among gunshot survivors, 51-year-old House Majority Whip Steve Scalise is an outlier. Such victims are more likely to be low-earning black men between the ages of 15 and 24. Scalise, who is white, does share one fundamental characteristic with these younger men: Being shot means he now has a preexisting condition in the eyes of health insurers. For most people, that status could mean more financial suffering under a Republican rollback of the Affordable Care Act.


The ever-increasing ranks of American shooting victims could face higher insurance costs and less coverage if the ACA is replaced by a bill mirroring those pending in Congress. Survivors could run up against annual or lifetime dollar caps on coverage, which are prohibited under the ACA. That could mean death for some and financial ruin for others, since costs for lifetime care can run into the millions of dollars. Lower-income survivors, which are the majority of victims, benefited from expanded state Medicaid coverage in recent years. Some of them could lose their health-care coverage altogether.

The consequences of such changes, according to a report published Thursday by the Brady Campaign and Center to Prevent Gun Violence, is that taxpayers and consumers with private insurance will wind up paying much of the cost for that care. The gun-control group’s logic? Emergency treatment centers will have to offset debt from uninsured patients by raising prices for those who can pay and will require “greater contributions from other taxpayer-funded programs at the local and state level, which will result in higher private insurance rates and higher taxes.”

Don’t Expect Health Coverage If You Survive a Gunshot Wound - Bloomberg

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Krugman summing it up:

Consider ... Republican leaders’ strategy on health care..., here are a few low points. ... 

Despite encountering some significant problems, the Affordable Care Act has extended health insurance to millions of Americans... And these numbers translate into dramatic positive impacts on real lives. ... How do Republicans argue against this success? You can get a good overview by looking at the Twitter feed of Tom Price,... secretary of health and human services... 

First, he points to the fact that fewer people than expected have signed up on the exchanges ... and portrays this as a sign of dire failure. But a lot of this shortfall is the result of good news: Fewer employers than predicted chose to drop coverage and shift their workers onto exchange plans. ... 

Second, he points to the 28 million U.S. residents who remain uninsured... But nobody expected Obamacare to cover everyone... And you have to wonder how Price can look himself in the mirror ... when his own party’s plans would vastly increase the number of uninsured. 

Which brings us to Republicans’ efforts to obscure the nature of their own plans. ... On one side, they claim that a cut is not a cut, because dollar spending on Medicaid would still rise over time. ... 

On the other side ... senior Republicans ... dismiss declines in the number of people with coverage as no big deal, because they would represent voluntary choices not to buy insurance. How is this supposed to apply to the 15 million people the C.B.O. predicts would lose Medicaid? ... 

Political spin used to have its limits: Politicians who wanted to be taken seriously wouldn’t go around claiming that up is down and black is white. Yet today’s Republicans hardly ever do anything else. It’s not just Donald Trump: The whole G.O.P. has become a post-truth party. And I see no sign that it will ever improve.

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Not a single U.S. governor has fully endorsed the Senate’s health care repeal bill, according to a new report from advocacy group Protect Our Care released Friday. Just two governors, Gov. Matt Bevin of Kentucky and Gov. Dennis Daugaard of South Dakota — both of whom are Republicans — have come out in support of the bill, though neither fully endorsed it. Bevin told a radio host last month that the proposal was “not really a good bill” but that it would give states more control, and Daugaard said the bill’s Medicaid cuts were an opportunity to shrink the federal deficit.

Trumpcare isn’t popular with any U.S. governors – ThinkProgress

Now why would that be...