The House Republican plan to repeal Obamacare, for all its shortcomings, achieves two fundamental GOP goals: it redistributes wealth back up to the 1%, and it block-grants Medicaid.
Jessie Drucker reports in "Wealthy Would Get Billions in Tax Cuts Under Obamacare Repeal Plan" that "Two of the biggest tax cuts in Republican proposals to repeal the Affordable Care Act would deliver roughly $157 billion over the coming decade to those with incomes of $1 million or more, according to a congressional analysis."
Thad Kouusser wrote in The Hill recently, "GOP's Medicaid block grant plan should trump other concerns" --
Medicaid block grants seem at first glance like an obscure debate for the few policy wonks who care about federal funding formulas. But the outcome of this particular fight in D.C. will reverberate across all 50 states for decades to come.
Shifting from “matching rates” to a block grant for Medicaid is not a new demand from the insurgent populist Trump, but the recycling of an idea that has been proposed by small-government advocates from Newt Gingrich to George W. Bush to Paul Ryan. In January, Kellyanne Conway made it clear that they will form a centerpiece of the Trump administration’s health care policy, and they have appeared in what Trump called on Twitter “Our wonderful new Healthcare Bill.”
Though they have garnered little attention in the campaign or even today, block grants would allow Trump to unwind the biggest gains that ObamaCare made for our most vulnerable citizens, radically reduce government investment in healthcare over time, force states to make even deeper cuts when the next recession comes along, but leave no political fingerprints.A lot is riding on the CBO scoring of the House bill. According to Kevin Quealy and Margo Sanger Katz in "The Five Big Numbers to Look For in the C.B.O. Report on Health Care Reform":
The Republican plan to replace the Affordable Care Act was released early last week, and it has already marched through consideration in two important committees. Yet members of Congress debated the policy details without essential information: The bill had not yet been “scored” by the Congressional Budget Office, a nonpartisan group of budget analysts and economists whose job is to forecast the bill’s consequences over the next decade or so.
That score is expected this week, and its estimates could make or break the Republicans’ plan. (The White House has pre-emptively cast doubt on the C.B.O. report.)We'll see how politicized the CBO is. The big number for political purposes will be the increase in the federal deficit over ten years. If it is large, it will be hard for the Tea Party wing of the GOP to back it.