Trumpcare: What Do Black People Have to Lose? Everything

By M. Jawando and C. Maxwell

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Trump promised “affordable healthcare for everyone”. Just more empty promises. Photo: Gage Skidmore-Flickr

[Commentary]

Yesterday Senate Republicans voted to proceed with a process that could strip health care coverage from tens of millions of Americans. Instead of building on the successes of the Affordable Care Act (ACA) and finding ways to improve it, they want to repeal key parts of the ACA and gut the Medicaid program so that they can cut taxes for the rich.

Each Republican health care proposal currently being considered would devastate low income communities, communities of color, and the wellbeing of millions while also significantly impacting our economy. If they succeed, they will have redistributed hundreds of billions of dollars in resources from the most vulnerable in our society to the wealthiest among us. Make no mistake, even with a few votes already having failed, the most devastating cuts to lifesaving health coverage are far from off the table.

With each proposal from Senate Majority Leader Mitch McConnell and Donald Trump we have seen an unprecedented and shameless abuse of power that would strip healthcare, drive up premiums, and eliminate tax credits. The process by which they are considering each proposal is also dangerous. Rather than holding public hearings, letting Committees mark up the bills, and giving time for Senators to read and fully understand each proposal, they are writing them in secret and trying to force a last-ditch effort through with no input from Senate Democrats, patients, stakeholders, or the general public.

In the hours ahead, the Senate will vote on the so-called “skinny” repeal, that would repeal the ACA’s coverage mandates and the medical device tax. But this is not a legitimate policy proposal. Instead, if the measure passes, it would allow Senate leadership to conference with their counterparts from the House of Representatives. During this process, the harshest parts of the ACA repeal bills would be reinserted. What little we do know about this “skinny” bill is that it would skyrocket premiums to an average of $1,238 next year alone.

The initial senate repeal proposal, the Better Care Reconciliation Act (BCRA) would devastate communities of color by defunding Planned Parenthood, applying an “age tax” for older Americans, and slashing Medicaid. According to our recent state-by-state analysis, the dramatic cuts to Medicaid could result in 8.7 million fewer people of color having coverage by 2026. In places like New York, where people of color represent over 60 percent of Medicaid enrollees, these cuts would result in 190,000 Black people, 310,000 Hispanic people, and 100,000 other non-whites losing coverage. In California and Texas, three in four Medicaid enrollees are people of color. In those two states, a combined 400,000 Black people, two million Hispanic people, and 300,000 other non-whites would lose coverage.

While Senate Republicans seek to advance proposals that would eliminate coverage for those who need it most and expand racial disparities in health outcomes, the Affordable Care Act did just the opposite. The ACA expanded Medicaid, eliminated denials of coverage for people with pre-existing conditions, increased funding for community health centers, and promoted culturally and linguistically appropriate services. As a result, the ACA reduced the uninsured rate for African Americans, Hispanics, American Indian and Alaska Natives, Asians, Native Hawaiians, and Pacific Islanders. It also increased the federal agencies’ focus on addressing health disparities and created new programs for public health and disease prevention. Importantly, Congress also passed the Affordable Care Act through an open process by allowing 106 Congressional hearings, hundreds of amendments, and 25 consecutive days on the Senate floor.

Regardless of what happens in the coming days, the public should not forget who voted to help and who voted to hurt the most vulnerable members of society. Next November, the people must hold their elected officials accountable and send a message that access to high-quality health care is a civil right and human right that all people unequivocally deserve.

Donald Trump famously implored black communities during the campaign to vote for him, with admonishments of “What do you have to lose?” With Donald Trump and Mitch McConnell moving to rip healthcare from millions and devastate communities of color once again to lack of healthcare access, using emergency rooms as primary care options, and making health care unaffordable once again – the answer is simple – everything.

By Michele Jawando and Connor Maxwell

www.americanprogress.org