The Real Goal of Trumpcare: End Medicaid as We Know It

The purpose of Trumpcare is not only to repeal Obamacare, and with it Obamacare's substantial expansion in Medicaid coverage, but to end Medicaid as we know it by turning it into a block grant program run by the states.

Thomas Kaplan and Robert Pear address the former in "With $8 Billion Deal on Health Bill, House G.O.P. Leader Says ‘We Have Enough Votes’":

But the fight over pre-existing conditions overshadowed a major reason the Congressional Budget Office estimated that the original bill would leave 24 million more Americans without health insurance after a decade: a rollback of the Affordable Care Act’s Medicaid expansion in states that adopted it. The House plans to vote for the latest version before the budget office can finish a fresh assessment of its cost and impact.

Erica Green deals with the latter in "A Little-Noticed Target in the House Health Bill: Special Education":

With all the sweeping changes the Republican bill would impose, little attention has been paid to its potential impact on education. School districts rely on Medicaid, the federal health care program for the poor, to provide costly services to millions of students with disabilities across the country. For nearly 30 years, Medicaid has helped school systems cover costs for special education services and equipment, from physical therapists to feeding tubes. The money is also used to provide preventive care, such as vision and hearing screenings, for other Medicaid-eligible children.

[snip] 

The new law would cut Medicaid by $880 billion, or 25 percent, over 10 years and impose a “per-capita cap” on funding for certain groups of people, such as children and the elderly — a dramatic change that would convert Medicaid from an entitlement designed to cover any costs incurred to a more limited program.

Capping children and the elderly, curtailing school-based Medicaid programs and assisted living for the aged, basically takes an ax to Medicaid. The principle foundation of social democracy in the U.S. after 30 years of neoliberalism remains Medicare, Medicaid and Social Security. With Trumpcare Medicaid becomes more like unemployment insurance -- at the whim of the individual state.

The whip count for this afternoon's vote is 16 Republican No votes with 35 undeclared. Twenty-three GOP No votes sinks Trumpcare. Let's hope for seven more Republican "nays" in the next six hours.