The AHCA’s Tradeoff: Giving Up Vital Care to Get Tax Cuts for the Rich
If the terminology of Republican Medicaid policy—“per-capita caps,” “block grants,” “inflation targets”—seems a bit arcane, Monday’s release of the Congressional Budget Office’s report on the GOP’s repeal-and-replace bill makes it pretty simple: The current health-care proposal is about rationing care to fund tax cuts for the U.S.’s highest earners.
In the past, accusations of care-rationing have been a favorite attack on the Affordable Care Act by Republican leaders such as House Speaker Paul Ryan and House Majority Leader Kevin McCarthy. Yet Republican efforts to cap and cut Medicaid make pretty clear that the strategy is to pay for tax cuts that largely benefit the highest earners by forcing governors to become rationers-in-chief—making painful choices regarding how to best ration or deny health care to those in nursing homes, with disabilities, and/or near the poverty line (and that’s in addition to the 14 million Americans who are projected to be completely denied Medicaid coverage over the next decade under the Republican proposal). As Ezekiel Emanuel, Aaron Glickman, and Emily Gudbranson recently wrote in The New York Times, the current Republican bill would lead to painful limits on treatment that would “force states to ration care and deny some Americans lifesaving treatments or nursing home care.”
Rationing care to fund high-income tax cuts is not just the byproduct of the Republican Medicaid plan, but rather at the heart of it. The motivation of nearly every GOP health-care proposal past
