The Washington Post summarizes the findings of the CBO report on the House AHCA bill, noting that in about one sixth of the country states are likely to behave in a manner as to effectively leave about 23 million sicker non-elderly people uninsured. Complicating this is less federal support for Medicaid.
One obvious “fix” would be that the federal government would have to make up all the differences with real subsidies (to assigned risks), not “just” tax cuts. But that would eat into Trump’s deficit reduction plans.
Which brings us to all the other stuff. Trump will cut a lot of other programs, like food stamps assistance. So we can imagine going to the effort to get everyone covered somehow under the AHCA and letting everything else drop.
There’s even the hackneyed debate that working young people make the sacrifices, and nothing is asked of seniors (who have more political clout). But on Social Security seniors have a point. Whatever the legalities of Flemming v. Nestor, most seniors feel they paid for their benefits with FICA taxes over their lives. You could, of course, bring back the debate on Cost of Living increases and bumping up retirement ages, and increasing floors on FICA. All of this could set up an ugly confrontation on the debt ceiling later this year.
The GOP is certainly playing the libertarian ‘personal responsibility” card on this one. States will be able to impose work requirements (at minimum or tip wages) on some benefit recipients. Particularly on food issues, organizations (in the DC area) like Food and Friends and Arlington Food Assistance Center will campaign even harder for funds. And efforts like these don’t work well without recruiting more dedicated volunteers, who don’t prejudge whether their indirect clients are “worthy” of this kind of personal priority.