Wednesday, March 15, 2017

A Toast to Marc Antony, Brutus, and the Original Doctor J

Friends, Romans, countrymen, lend me your ears;
I come to bury Caesar, not to praise him.
The evil that men do lives after them;
The good is oft interred with their bones...
- Marc Antony 
"Julius Caesar" (William Shakespeare)

It was on this very date, a little while back that a historically mercurial leader had a really, really bad day at the Senate.  Interaction between the executive branch and the legislative branch can be a bear, even when you are all dressed in togas and wearing flip-flops. 

But I digress.

On Monday afternoon, the non-partisan Congressional Budget Office produced its Cost Estimate for the American Health Care Act (a/k/a "Trump Care").  The document is thirty-seven pages long and is available for perusal (and printing up if you wish) here.   For those of you who prefer your written works to be in the style of Reader's Digest Condensed Books, the CBO prepared a summary of its thirty-seven-page Cost Estimate, which summary includes the following information: 


Effects on the Federal Budget
CBO and JCT estimate that enacting the legislation would reduce federal deficits by $337 billion over the 2017-2026 period. That total consists of $323 billion in on-budget savings and $13 billion in off-budget savings. Outlays would be reduced by $1.2 trillion over the period, and revenues would be reduced by $0.9 trillion.
The largest savings would come from reductions in outlays for Medicaid and from the elimination of the Affordable Care Act’s (ACA’s) subsidies for non-group health insurance. The largest costs would come from repealing many of the changes the ACA made to the Internal Revenue Code—including an increase in the Hospital Insurance payroll tax rate for high-income taxpayers, a surtax on those taxpayers’ net investment income, and annual fees imposed on health insurers—and from the establishment of a new tax credit for health insurance.
Pay-as-you-go procedures apply because enacting the legislation would affect direct spending and revenues. CBO and JCT estimate that enacting the legislation would not increase net direct spending or on-budget deficits by more than $5 billion in any of the four consecutive 10-year periods beginning in 2027.
Effects on Health Insurance Coverage
To estimate the budgetary effects, CBO and JCT projected how the legislation would change the number of people who obtain federally subsidized health insurance through Medicaid, the non-group market, and the employment-based market, as well as many other factors.
CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under the legislation than under current law. Most of that increase would stem from repealing the penalties associated with the individual mandate. Some of those people would choose not to have insurance because they chose to be covered by insurance under current law only to avoid paying the penalties, and some people would forgo insurance in response to higher premiums.
Later, following additional changes to subsidies for insurance purchased in the non-group market and to the Medicaid program, the increase in the number of uninsured people relative to the number under current law would rise to 21 million in 2020 and then to 24 million in 2026. The reductions in insurance coverage between 2018 and 2026 would stem in large part from changes in Medicaid enrollment—because some states would discontinue their expansion of eligibility, some states that would have expanded eligibility in the future would choose not to do so, and per-enrollee spending in the program would be capped. In 2026, an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law.
The CBO's Summary is available in its entirety (not just the portions I excerpted above) here.  I would commend it - at the very least - to you for your review and consideration.  In the interest of full disclosure, the highlighted language in the preceding paragraphs is my handiwork, not that of the CBO.  Frankly, you owe it to yourself to read - at the very least - the CBO's Summary so that you are not beholden to the "alternative fact-spouting" two-legged fucktard, Sean Spicer.                        
We devote a staggering amount of time in this country to the discussion of politics as blood sport.  It is well-established that the spoils belong to the victor.  The responsibilities of governing belong not merely to the victors, however, but to all.  Each of us has skin in the game.  Be engaged, be informed, and be prepared to discuss not the "black" and "white" that partisans on both sides of the aisle want to utilize as this nation's political color palette but the subtler variations of gray that have historically defined that palette and perhaps, for the sake of all, need to do so again. 
-AK  


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