During Donald Trump’s first address to a joint session of Congress (three weeks or a lifetime ago), the president promised the American people that he was going to spend his term granting wishes, like a carrot-colored genie. During that address, looking just like a president, Trump promised that he’d invest in women’s health. It was the first and only moment in his careening administration that pundits agreed was “presidential.” It was also untrue.
On Monday, the long-awaited Congressional Budget Office analysis of the proposed GOP Obamacare replacement came down the pike. Like many on both sides of the aisle expected, it was an avalanche of bad news for Republicans who thought the American Health Care Act would be an easy sell to their constituents. It was also bad news for President Trump, who will have a hard time peddling a kneecapping of health-care coverage for low-income and older women as some sort of “investment.”
The report put actual numbers on how many people would be left uninsured by the ACA rollback—24 million kicked off insurance and an additional $880 billion gouged from Medicaid, all in the name of a measly 1 percent reduction in the deficit.
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The numbers don’t adequately convey the scope of humanity they debase. Overall premiums decrease under the plan, but that’s only because a large number of people are being kicked off, and older Americans will face a debilitating spike in premiums. Slashing the Medicaid expansion means that low-income families will see reduced access to health care. Allowing premiums for older people to shoot skyward means that a 64-year-old making $24,000 per year will see half of their income go toward the cost of covering medical insurance.
Further, the language some analysts read, at first glance, as a one-year defunding of Planned Parenthood and other health centers was actually language that exclusively applied to Planned Parenthood. One of the nation’s largest women’s health-care providers and a point of entry for many women with limited means was being cut off without even being directly named. Death by shade.
Advocates for women’s health contend that if the AHCA were to be enacted as-is, Trump’s promised investment in women’s health would be a comical falsehood.
“[Republicans] are doing nothing to invest in women’s health,” Jamila Taylor, senior fellow at the Center for American Progress, a liberal think tank, tells The Daily Beast.
Taylor is particularly concerned with the one-two punch the AHCA gives low-income women and women of color. “What’s going to happen to the 2.4 million women who are folks that are accessing their health care through Planned Parenthood clinics?” Taylor says. “Planned Parenthood is the entry point or access points to health care particularly for low-income women. This is not just about Planned Parenthood as a provider. This is about taking services and health care away from people who really need it.”
Taylor is skeptical that the GOP’s proposed ACA replacement is even fiscally conservative. “In the long term, it does nothing to help women be more economically secure,” she says. “We’re just pushing people further down into the hole of poverty. And that’s unacceptable.”
The bill doesn’t have many fans on the left side of the political spectrum. Sen. Patty Murray, ranking Democrat on the Senate Health, Education, Labor & Pensions committee, released a statement condemning the bill again in the aftermath of the CBO report. She called the bill “a broken promise to every patient and family who listened when President Trump and Republicans said that their reckless, mean-spirited bill would somehow provide better coverage—for everyone—at lower cost.” Additionally, she cited the gutting of Planned Parenthood and Medicaid—two programs many women rely on—as a reason the legislation didn’t merit her support.
Conservative Republicans are balking at Trumpcare, too. The party’s libertarian wing has long called for a “full” repeal of the Affordable Care Act, which would ostensibly leave many more than 24 million Americans without insurance. At least they’d be morally consistent, though. Right?
Paul Ryan and Trump, for their parts, have divergent views on the CBO assessment. President Trump, in the past a fan of citing the CBO’s analysis as evidence that then-President Obama was a failure, is suddenly skeptical of the CBO’s findings. House Speaker Ryan took a different tack. He concluded that the CBO report vindicated him, operating in a universe with different math from the one that was used in the report.
Can the plan be both good and bad for Americans? Can it still be awful for half the population if it’s middling for the other half? Does it matter as long as it was a Republican’s idea?
