Opinion

Trumpcare will see some Americans lose health coverage because... 'freedom': Neil Macdonald

Under Trumpcare, which is all about freedom, people will be free to buy no insurance. They will also be free not to be able to afford insurance. Because, well, liberty.

It’s a safe bet this plan is one of the few things Donald Trump doesn't want to see his name on

What has the president said about all this? Not much. He just wants the damn thing passed without too much discussion. (Evan Vucci/Associated Press)

Years ago, when Republicans tried to weaponize the term "Obamacare," Barack Obama smiled that big toothy, socialist smile of his and neutralized it with a few words.

"I like it," the socialist-in-chief proclaimed. "I don't mind it being called Obamacare because it's true. I do care."

In that spirit, and as a tribute to President Donald Trump, who is after all a pretty darned caring fellow himself, his new plan should, without question, be known as "Trumpcare."

A 'beautiful' plan

Trumpcare is the "beautiful, beautiful plan" that Trump promised will bring not only greatly improved coverage, but much lower premiums.

Anyone who understands the basics of health care economics should be able to understand that. Trump will convince America's insurance companies — a bunch of ferociously aggressive profit-generators whose business model is to maximize revenue and minimize spending, and who find any excuse to turn down or slow a claim — to provide much more expensive care for far less money.

Oh, and also freedom. That's actually a talking point.

Trumpcare will deliver freedom to miserable Americans chained up by Obama's statist squid of a system, which, in the words of Ben Carson, one of Trump's cabinet secretaries, was the "worst thing that has happened in this nation since slavery."

The change will take place as soon as possible, Trump says 1:14

The thing about Obamacare that enslaved so many Americans, in the eyes of rightist Republicans, was what's known as "the individual mandate," which is a bureaucratic way of saying "the government trying to force everyone to obtain health insurance."

The individual mandate idea was rooted in the basic concept of insurance: when more people buy insurance, the risk is spread more thinly, and everyone's premium drops as a result.

Trouble is, young people hate buying medical insurance, because they know they don't get sick much. They prefer to wait till they're old to buy insurance, at which point they get very angry if the premiums are too high, and then start demanding that young people buy insurance, too, because if all young people buy insurance….well, you get the idea.

So Obamacare imposed a tax penalty on anyone who decided to remain uninsured. Just like slavery.

Paying the penalty

Even so, many young people preferred to pay the penalty, buying their way out of slavery and screwing the older people, whose premiums pretty soon began rising drastically, which Republicans then held up as Obama's socialist failure.

Under Trumpcare, which is all about freedom, people will be free to buy no insurance. They will also be free not to be able to afford insurance. Because, well, liberty.

But anyone who has insurance and lets his or her coverage lapse, for any reason (even losing a job) shall face a 30 per cent premium increase if that person tries to renew.  

Trumpcare actually directs insurance companies to tack on the big surcharge, not that they need convincing.

This way, the government shifts the job of penalizing from the IRS to the insurance companies, thereby replacing slavery with liberty. If it's government screwing you, like Obama did, that's socialism. If it's a corporation screwing you, and profiting in the process, well, that's the American way. Freedom.

Which is why it's so strange that some of the loudest opposition to Trumpcare is coming from his own party; congressional Republicans who call themselves the Freedom Caucus, joined by right-wing activist groups like Heritage Action and the Club for Growth.

Republican opposition

These insolent, disloyal buggers are running around proclaiming that Trumpcare is just "Obamacare Lite" or "Obamacare 2.0,"and there are easily enough of them to kill Trumpcare before it ever reaches the president's signing desk.

Mark Sanford, a deeply religious Freedom Caucus member – the fellow who was forced to resign the governorship of South Carolina after admitting he'd lied about going hiking and had instead flown to South America to hook up with his mistress – says the bill is just another form of entitlement, which is a poison word to Republicans. Sen. Rand Paul flatly says the slavery-like individual mandate is still in the new law.  

The Freedom Caucus has other issues with Trumpcare, too. Like Obamacare, it socialistically prevents insurance companies from doing the things they used to do: dumping a sick patient whose costs get too high, or refusing to insure someone who has a "pre-existing condition."

Some Republicans also aren't too keen on Trumpcare's rollback of Medicaid, the program that provides care to the indigent and poor. Obamacare expanded Medicaid, paying states to extend the program to tens of millions of uninsured Americans. Trumpcare would cut that money off.

The trouble is, a majority of Medicaid beneficiaries in the Republican states that expanded Medicaid voted for Trump, meaning they probably voted for the Freedom Caucus types, too. And Trumpcare would also cut tax credits most heavily for older and lower-income Americans, especially in rural areas. Guess who most of them voted for?

If Trumpcare becomes reality, those people will quickly discover that freedom's just another word for nothin' left to lose, to quote Kris Kristofferson. And then they won't like Trumpcare very much.

Jason Chaffetz suggests not buying an iPhone and spending the money on insurance instead. (J. Scott Applewhite/Associated Press)

Anyway, Jason Chaffetz, another conservative congressional Republican, says Americans need to understand that under Trumpcare, it'll be time for people to take some personal responsibility for their medical care; he suggests not buying an iPhone and spending the money on insurance instead.

You can imagine how that went down in iPhone-loving middle America.

Rep. Roger Marshall, another House Republican, chimed in that poor people "just don't want health care and aren't going to take care of themselves."

What has the president said about all this? Not much. He just wants the damn thing passed without too much discussion. Next week would be good.

It's also a safe bet that this beautiful, beautiful new plan is one of the few things on this earth Donald Trump doesn't want to see his name on.

This column is part of CBC's Opinion section. For more information about this section, please read this editor's blog and our FAQ.

About the Author

Neil Macdonald

Opinion Columnist

Neil Macdonald is an opinion columnist for CBC News, based in Ottawa. Prior to that he was the CBC's Washington correspondent for 12 years, and before that he spent five years reporting from the Middle East. He also had a previous career in newspapers, and speaks English and French fluently, and some Arabic.

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