Body Count

The body count from the terrorist attacks on September 11, 2001 was just under 3000 persons.

If Republicans succeed in repealing the Affordable Care Act (“ACA”), the body count is likely to be quintuple that in 2018 alone, escalating thereafter as more Americans lose their insurance.

The precise numbers may be unknowable until the unthinkable happens, but the outlines are readily discernible. The Congressional Budget Office estimated that the failed “American Healthcare Act” would cause 14 million people to lose their insurance next year, with totals rising to 21 million by 2020 and 24 million by 2026. And the most recent, pre-ACA study estimated that for every million persons lacking health insurance, one thousand had died as a result, according to FactCheck.Org.

Do the math. Apparently some House Republicans did, which is one reason the odious Paul Ryan was unable to deliver the “body count” (using its alternate meaning of “the number of persons involved in a particular activity”) needed for repeal.

But now, like Freddy Krueger , they’re back, and the revised bill appears to be just as big a killer as the original plan. It’s unclear at this point whether it will garner enough support among the wingnuts in the Freedom Caucus (who might object that the body count still isn’t high enough) to offset the concerns among the (oxymoronically identified) “moderate” Republicans to make it through the House, much less the Senate.

Of course Mr. Trump thinks it’s a terrific idea: “The plan gets better and better and better, and it’s gotten really, really good, and a lot of people are liking it a lot,” according to a report in The New York Times. (If you thought you’d never miss W’s fractured English, think again.)

The amended bill would retain the ACA’s requirement that insurers offer plans to individuals with pre-existing conditions but allow states to override the indispensable accompanying provision that insurers cannot charge sick applicants a higher premium than they charge healthy applicants of the same age. The obvious effect, and possibly also the intent, is that insurance will become unaffordable for anyone with a pre-existing condition, as was the case prior to enactment of the ACA. In addition, the plan cuts Federal funding for state Medicaid programs, thus
depriving millions more of coverage (and thus, thousands more of their lives).

Why would Republicans expose themselves to the wrath of voters in the midterms? Perhaps they believe voters will not notice; after all, Trump’s most rabid supporters have voted against their economic interests for decades. Yet voting against your very life is not only a more serious matter, but something likely to come to the attention of Trump voters if the ACA is repealed  After all, nothing “concentrates the mind” like impending death, and the ten states whose residents will lose the most in financial aid all gave their electoral votes to Trump.

Or perhaps Republicans are afraid they’ll be punished at the polls if they do nothing. After all, they’ve been promising voters for six years that they had a much better plan, so killing some of their supporters may be preferable to looking like liars or idiots before the country and world (or, rather, those parts of the world before which they don’t already look like liars and idiots).

My view is that if the ACA is repealed, the core reason will be because Republicans are less afraid of angering their constituents than angering big donors (who, after all, are their real constituents). Big Republican donors always vote for their economic interests, and they know that repeal will eliminate the 0.9% surcharge on their wages as well as the 3.8% surcharge on their dividends and capital gains that help underwrite the subsidies for lower-income Americans. And when you apply those percentages to 8- or 9-figure incomes that ain’t exactly chopped liver.

So even if some of the little guys who voted for Trump get mad, or die, the big guys who fund Republican campaigns will get richer, and at the end of the day, those are the bodies that count.

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