It stands to reason that in an era of alternative facts and alt-right websites generating fake news, we're not getting the whole story on Senate Republicans' bill to overhaul the Obama-era health care law.
On Monday, Tom Ashbrook, the normally measured host of National Public Radio's "On Point," about lost it after failing to get his guests to simply agree on what the bill would do. "It just stinks when Americans can't hear what is actually in this bill!" Ashbrook exclaimed.
A caller to his show said her 13-year-old daughter was born with a genetic anomaly and is covered by Medicaid. They got her on Medicaid through a waiver program after 13 years of waiting. Now she has wonderful care. But under the now-delayed Senate bill, they'd return to private insurance and face high deductibles and less coverage, the mother said. "The for-profit system is not going to cover people like us."
But Avik Roy, president of the conservative Foundation for Research on Equal Opportunity, and also a guest on the show, put a rosier hue on the Senate bill's move away from Medicaid expansion to private coverage. He claimed private coverage "improves medical outcomes in a way Medicaid hasn't been able to."
That incensed Stuart Altman, a Brandeis University professor who worked on the Affordable Care Act and retorted, "This is just so much nonsense!" An estimated 70 million low-income Americans, including 30 million children, are on Medicaid, which was expanded under the ACA. As CNN puts it, the Senate bill would end that expansion and dramatically cut the federal Medicaid budget, leaving funding to the states.
Private insurance won't cover the 1.4 million older Americans in nursing homes on Medicaid. It's reported the Senate bill would eliminate Medicaid funding entirely by 2021. The New York Times puts the cut at $772 billion over a decade.
But President Trump's surrogates Sean Spicer and Kellyanne Conway have insisted Medicaid is protected.
"There's a level of dishonesty with respect to this bill that I haven't seen before," Los Angeles Times health care reporter Noam Levey told "On Point." There's a reason for that: What is being proposed hurts the vulnerable and benefits the richest 1 percent of Americans.
The ACA prevents insurers from turning people away because of pre-existing conditions they can't control, whether from genetic anomalies, accidents or a cancer history. Some people who already have employer-based coverage favor the law because they could lose their jobs or want to start a business or get more education.
I have a friend with a history of breast cancer who couldn't imagine leaving her professional position because she'd either be turned down for private insurance or spend her bottom dollar paying for it. Now she has options.
A woman I wrote about contracted a rare, life-threatening fungal infection after falling into the water on a kayaking trip. Had she not already had insurance, it would have been impossible to get all the care she needed covered. With five weeks on a hospital ventilator and one medicine costing $1,600 a dose, the million-dollar lifetime cap on her insurance would have been depleted. But under the ACA, everything was paid for.
But the Senate bill would let states waive the provision protecting essential health benefits in employer-paid plans such as substance abuse treatment. It would remove the requirement that everyone have health insurance. And still that's not enough for Republican Sen. Rand Paul of Kentucky, who prefers the free-market capitalism approach, with a minimum of regulations. "When you add mandates to insurance you make it more expensive by adding things you think are good for me," he said, offering Lasik corrective eye surgery as an example.
He says the cost of that fell 75 percent over 15 years because of consumer choice. (From what I hear, many people were going to Canada, where it was cheaper.) But Lasik is optional. Without it, no one will lose their eyesight, and many people are fine with glasses or contact lenses. You can't put it in the same category as mental health care, substance abuse treatment and maternity care. If you had to wait 15 years for those prices to come down, you could be dead or institutionalized.
Without mandates to get coverage, consumers might not do it, and without mandates to cover every condition, employers and insurers might not do it.
The nonpartisan Congressional Budget Office found that 22 million Americans would lose insurance in 10 years under the Senate bill. The American Medical Association said the bill violates the profession's Hippocratic oath to "do no harm."
The really outlandish part of the Senate proposal is that the money saved from cutting federal spending on health care would go to cutting taxes for households making $875,000 or more by 2 percent, according to the analysis by the Urban Institute and the Brookings Institution's Tax Policy Center. The lowest-income 20 percent would see a 1 percent cut in taxes and the middle income, less than half a percent.
If curtailing health care access for many Americans to fatten the rich is what lawmakers want, they should say so. But that would cost them votes. So they spin it to make cuts to medical subsidies sound like consumer freedom, leaving everyone confused about what we'd really be getting.
