I hope Republicans pass Graham-Cassidy

These are the geniuses solving America’s health care crisis.

Pressed by their donors who have vowed no new contributions without an ACA repeal, Republicans are making one last effort to roll back health care access. Their health care “reform” bill, Graham-Cassidy, is a clusterfuck on a scale that only Trump Era Republicans could possibly engineer.

I hope they pass it.

Republicans have already earned every ounce of the hatred and vitriol that a move like this will spark, but perhaps only this bill can bring that anger pouring into the streets. Graham-Cassidy breaks our healthcare system in a uniquely universal way. Almost no one will benefit from this bill. If you want to live in a country with universal healthcare without having to move to Canada, this proposal may open up the best opportunity in our lifetimes.

If someone set out to destroy America’s health care system they would probably design something like Graham-Cassidy. It starves Medicaid of funding to an extent likely to cripple the program in most states. It converts much of the funding delivered by the ACA to block grants, with very few restrictions on how that funding can be used (abused). It strips away the legal protections that people enjoyed most about the ACA (without realizing where those protections came from), including provisions allowing children to remain on their parents’ insurance until 26, protections against discrimination based on pre-existing conditions, and lifetime spending caps. Meanwhile it retains almost all of the ACA’s taxes on individuals. Graham-Cassidy also includes the Republican Holy Grail, terminating Medicaid entirely after a decade. It is basically the death panel of Republican wet dreams. Call it the “kill off the stinking poors bill,” because that’s what it is.

Fun facts: 93% of Medicaid enrollees in West Virginia are white. Two thirds of Medicaid enrollees in Indiana and three-quarters in Kentucky are white. I wonder who they voted for?

Graham-Cassidy is a complex bill that looks different depending on your perspective. Here’s an assessment from a supporter, Avik Roy. Here’s the explainer on the bill from Senator Cassidy’s office. And here are summaries from the LA Times and the Kaiser Family Foundation.

Graham-Cassidy has two glaring weaknesses that make it a unique poison pill for Republicans. First, they’ve spread the pain very broadly. Normally Republicans work hard to shelter white people, especially whites in the suburbs, from the impact of their stupid ideas. They have failed to do that here. Second, by stripping most of the federal government’s involvement in the health care industry, it opens the door to state-level innovations, including single-payer. That opening is the most exciting possibility and the reason why this bill could offer a silver lining to Democrats.

Although the bill would begin to cripple the exchanges from day one, the bulk of its most outlandish features would be deferred until after the 2018 election. At the state level, this will create an enormous tail-wind for legislative candidates promising to build state-level universal health insurance. Meanwhile, Congressional Republicans would find themselves strapped to the dead weight of this terrible bill going into the election cycle.

By passing this bill, Republicans would face the consequences at the ballot box before anyone gets killed by their stupidity. If you want to see universal health care someday, and you want to see Republicans gutted in the 2018 mid-terms, Graham-Cassidy is an ironic gift.

Since 2009, Republicans have campaigned on the evils of the ACA in the same way they campaign on abortion restrictions – protected from the consequences of their idiotic positions by the fact that they couldn’t possibly deliver on their promises. Perhaps the best thing that could happen to this country is to experience the results of Republican governance at a broad, personal level. Graham-Cassidy promises to punish Americans for electing Republicans in some particularly cruel, even lethal ways. I’m ready to step up and experience the consequences of this bill for the chance to see this country wake up and change directions. Let Trump’s voters have what they want, then let’s make sure every Republican in the country feels the impact of this mistake.

80 Comments

    1. Rand Paul’s not an impossible flip (he voted for the last one), but Murkowski’s been stubborn in her demands here, and it doesn’t look like any bribery that’s been thrown her way is going to change her mind. This thing isn’t dead by a long shot, but it’s near on its last leg if things stay as they are.

      1. I will not say it’s dead, but McCain saying NO will fortify Collins and Murkowski. It’ll probably also make Paul less likely to flip. We’ll just have to wait and see. Nevertheless, the opposition has really solidified and the pressure is steadily building. Maybe the “Rock” coming at them with increasing force and velocity from the opposition is feeling less threatening than the hard place from the rich donors??? Time will tell!

      2. Assuming that Graham-Cassidy is dead though, it assuredly imperils whatever comparatively serious effort there was for tax reform (or, really, just tax cuts). Their donors are obviously pissed off that they feel their money’s been wasted, and Republicans will grow increasingly desperate to try to have something, ANYTHING to take back home as the year winds down. Who knows if that’ll let them get anything done, but the implications are huge regardless.

        If Roy Moore becomes Senator Moore, that’ll be one less loyal foot soldier for McConnell, already imperiling his narrow majority as is. Donors could close off their checkbooks entirely and some may even decide just to try to throw their chips in with Democrats for a time. And, of course, we’ve the huge gerrymandering case going before the SC next month. Depending on how Kennedy sides, the whole political landscape could change.

      3. I find myself in rare agreement with Mitch McConnell on Moore….

        As for GOP fundraising – They seem to always be able to pull a rabbit out of the hat, but it would be delicious to watch them struggle…

        The WI case is probably the most important single case to come before SCOTUS in a very long time. It could literally change the course of Democracy in America.

      4. This morning in the NY Times (linked below) there was an article stating that the contributions to the National Republican Senatorial Committee dropped to $2 million in July and August”. It was $7 million in April. In other words this donor drought is really getting serious. If Graham-Cassidy fails, the drought will likely get worse, and it could have serious implications for 2018. I am sure this pinch is also hitting other national Republican Party groups. Of course, the donors can fund other groups that are not subject to the reporting requirements of the national Republican groups and no doubt they are. Still this is a big problem.

        https://www.nytimes.com/2017/09/22/us/politics/republican-donors-obamacare-repeal.html?action=click&contentCollection=politics&region=rank&module=package&version=highlights&contentPlacement=1&pgtype=sectionfront&_r=0

      5. Governing is hard. Republicans have become so convinced that their success with disinformation, distortion, and obstruction, that they have confused these tactics with “governing”.

        If there were a national referendum that allowed the American people to rank order their priorities, and everyone voted, I wonder if the top three ranking would surprise our MoC? I honestly believe that the Republican Party has become so deeply entrenched in their own message that they can no longer understand the fundamental needs of the American people. There are good people in the GOP but they are too few and too quiet. The party hierarchy is governing for their donor base and voter base, girdled by the web of gerrymandering that has created and strengthened the Freedom Caucus, the Religious Right, and those who publicly espouse misogyny, xenophobia, and racism. Is it any wonder Republicans are struggling to govern?

        I noted in the NYT link that the GOP group that met in Colorado were meeting in a Chick-Fil-A….your old nemesis, Chris…Probably just a coincidence….

      6. EJ

        I would have thought that McCain’s opposition would have made Paul more likely to support the bill, if anything. Paul seems to enjoy nothing quite as much as waiting until defeat is inevitable and then taking a stand on principle in order to impress his ideological peers.

      7. Paul is a charlatan. Je makes a lot of noise about a piece of legislation or an issue then folds. His district would be very hard hit if the ACA were repealed. Nationally, 32 states expanded Medicaid and 19 refused – TN was one of them. Paul, as a physician, thinks he is all knowing on the issue of health care, yet he is rarely found among those included in planning replacement plans….His focus: Why is that?

      8. For a little closer look at the AL senatorial candidate, Moore, the Guardian from across the Atlantic reminds us of his bizarre views:

        “Moore has mused about making “homosexual conduct” illegal and suggested that the terrorist attacks of 11 September may have been divine retribution for the United States turning away from God.”

        That man.

        The one endorsed by T and Dr. Ben Carson.

        https://www.theguardian.com/us-news/2017/sep/23/kim-jong-un-the-nfl-and-screaming-at-senators-donald-trumps-strange-night-in-alabama?

    1. Yes, blue states suffer and red states win. California and New York suffer the most because their large population centers reduce their effective sway in governance, and there’s pretty much nothing they can do about it except get told at once and the same time that they’re liberal coastal elites, and also they should listen to other people’s problems more.

      But swing states get reductions too. And if you recall, the election was swung by a margin smaller than the number of elderly Trump voters in those swing states who have died since the election has been held.

      So, we’ll see, I guess.

  1. Do you want to know how you get to 50 in the US Senate?

    “Over the past two days, it’s become clear that Senate Republicans are doing everything they can to funnel more money to Alaska and persuade Murkowski that this is the Obamacare repeal bill she should back. Take a look:
    Business Insider eyed an oddity in Sen. Bill Cassidy’s spreadsheets that suggests Alaska could end up receiving an additional bump to its block grants under the bill.
    Politico noticed that Alaska could also end up being exempted from the bill’s Medicaid spending caps.
    Now IJR is reporting that the plan might be revised to allow Alaska (along with Hawaii) to keep the Obamacare tax subsidies, while also still receiving block grant money.”

    https://www.vox.com/policy-and-politics/2017/9/21/16347012/graham-cassidy-murkowski-standards-health-reform

    For all the GOP criticism foisted on Democrats that they were voting “blind” for the ACA because the bill was so long and bundled so late (it did, however go through umpteen committee hearings, did accept Repub amendments, and this process did last for almost one year), the Graham/Cassidy Bill has been: (1) written in secret; (2) may have one hearing; and (3) offer Senators (and Congressmen) a scant few days to be read or studied.

    https://www.vox.com/policy-and-politics/2017/9/21/16339524/republicans-obamacare-repeal-graham-cassidy-nobody-cares

    Republicans have shamed themselves once again. I am so tired of this and so disappointed.

    1. Disgusting article. For every mea culpa there’s a “but the elitist liberals think every conservative is an ignorant racist yahoo.” I don’t think every conservative is a racist, but anyone who voted for Trump is okay with a racist in the White House. Not to mention an ignorant narcissistic sex offender with the temperament of a spoiled six year old, as long as they get their tax cut.

    2. EJ

      A paradox: Mr Sykes is able to use polysyllabic words, but is somehow also able to write a history of the American Right which completely ignores race.

      It is possible that Mr Sykes understood the part it has always played, but somehow neglected to mention it. It is also possible that racism is, to him, like water is to a fish: the natural state of affairs, worth pointing out only when someone tries to take it away.

      Given that he described Tea Party rallies as “diverse”, my money’s on the latter.

  2. I thought that the GOP was toast for a generation after the Shrub
    Nobody would trust them with a used match
    But there they are back in power!

    As somebody with no skin in the game I hesitate to say it but Hilary losing may be the best thing that could have happened as it gives the GOP the opportunity to demonstrate their horribleness

    1. I felt at the time that Obama’s election came too soon after the financial crisis for there to be significant effects on the way people view the GOP. Corrective measures were applied fairly rapidly and relatively effectively (no thanks to the GOP). Therefore we had a “Great Recession” rather than a prolonged depression such as in the 1930’s. Make no mistake, if the GOP had remained in power there would have been an even worse depression than the 1930’s.

      The other factor is that Obama is Black, which allowed the underlying racism in America to be exploited by the right wing, of which they took full advantage. Furthermore, the D’s then nominated Hillary, which then allowed the underlying misogyny to be exploited. Having a black as president, followed by a woman was too much for many voters. Trump very cleverly exploited that. He told his hard core what they wanted to hear and there were just enough of them in key states.

      Additionally, there is the continuing effort to suppress votes and the gerrymandering that occurred in 2011 and earlier redistricting cycles. The GOP is betting that those and white male supremacy will be enough to keep them in power.

      1. Add to the list the fact that millions just did not vote. Those votes were not suppressed or gerrymandered. the people just, for whatever reason, stayed home. I know there is a lot of anger out there about what the Republicans are doing. But I do not think we can assume that anger will result in a lot more people voting Democrat!

      2. You are correct about voter turnout….whether because people were turned off by both candidates or because they just chose not to vote, almost 38% of registered voters in America stayed home. Some voted 3rd party – as is their right. The election is over and we now have a president who is awful and has chosen a cabinet and agency leaders who are destroying the institutions of our country. That motivated me but evidently not many others.

      3. Mary, Do you remember a comment from sometime back, that listed reasons for Clinton’s loss? I can’t remember who the commenter was, but I remember you asked if you could post it elsewhere. It was not long after the election and posted by one of the very smart people here.

        I would like to have it as a starting point for a list of reasons why we are where we are. Really just to add to and come up with an aggregation for my own amusement.

      4. Poor voter turnout is a perennial in America. You are correct that this election perhaps had a lower than normal turnout than normal for presidential elections. That was certainly true for the African-American community and urban areas in some key states. To me that is one of the secondary effects of voter suppression and gerrymandering. Note that the key states of PA, WI and MI all had significant gerrymandering and voter id laws implemented. I feel those suppressed the vote by simply discouraging voter participation which shows up as poor voter turnout, though technically many of these votes were not suppressed.

        Ever since the election I have been struggling to rationalize the results. I have slowly come to the conclusion that white supremacy and misogyny had a much greater role in the election than is generally acknowledged. I have just finished reading the Atlantic article, “The First White President” and that has had considerable influence on my thinking. There are other articles, such as one from Politico, I read regarding a rural Wisconsin county, that went for Trump. That was the first time in generations it had voted Republican. There was a considerable element of white supremacy there. The article is linked below – I’ve inserted some comments. And of course, there are Chris’ numerous posts on racism.

        https://www.dropbox.com/s/486h9sbg1p6n24n/Election%202016%2C%20Pepin%20County%2C%20WI_Politico%20Magazine%2C%20Jan-Feb%202017.pdf?dl=0

        Very few of the political scientists or pundits focus on these factors; they all focus on working class dynamics, the media, the decline of the rust belt communities and industrial America, etc. Those are all factors, but there is something else behind this. Why did all these voters, go for a charlatan who obviously had no real plans and was not qualified as opposed to a woman who was obviously well prepared, highly qualified and had developed a real plan for governing? I am struggling the understand this and am concluding that the factors of white supremacy and misogyny, were key underlying elements.

    2. Duncan,
      I agree. Jason Chaffetz was going to run his House Committee as a full time impeach, investigate and oh yeah check to see if she broke any actual laws. Nothing would have been done and left the GOP in a largely reactive, not accountable situation for governance. Tag! you’re it, you are the government now…where is the better than ObamaCare Plan? Tax Plan, Immigration reform, civil rights enforcement..They never had a plan or a vision of governance beyond their tax cuts for the wealthy because you know it trickles down and then market forces and and you know Jesus.

  3. Negative reinforcement (punishment) only works under the following conditions:

    > The behavior itself is being targeted, and being targeted for an increase or a decrease in the behavior.

    > Then comes the observation of what leads to an increase or decrease in the targeted behavior.

    > Be consistent and non-arbitrary to each instance of the behavior, or periodic enough to constitute a recognized ‘risk’.

    > The behavior is ‘operating’ in the environment which consequently leads to ultimately a ‘reward’ or ‘punishment’ so as to increase or decrease the said behavior.

    In other words, the subject must be aware of what behavior is being targeted, understand the punishment as a response to the behavior, understand that the behavior is being targeted, and understand the environment the subject is in is set up to punish the behavior, for negative reinforcement to work.

    In real life, cause – effect is too messy and desperation is an vicious cycle. Desperate people lash out, causing damage resulting in more desperation, lashing out causing more damage. This is how the GOP has been gaining power for decades, and transparently so since Gingrich unveiled the whole ‘ our job is to get the majority ‘ tactic, which — as our current federal government and most state and municipal governments show — WORKED.

    Cut 45million Americans from their healthcare, they’ll be too desperate looking for ways to survive to stop to think that maybe it’s not the Muslims that are killing them. Promise they’ll get their healthcare back if they help you kill the Mexicans, and you got yourself a pogrom.

    So no, I don’t agree that making things worse for ‘regular folk’ will wake them up. They were convinced that the world was going to shit even when the world was getting technically, objectively, statistically, scientifically better. Now that the world IS going to shit, they’re not going to recognize “Well things WERE getting better until we elected zealots and idealogues,” they’re just going to be vindicated that their impression that the world was getting worse is true.

    And it’s the liberals’ fault. Liberalism is a mental disorder, or so says the radio voice that talks to me for hours every morning.

    1. Conservatives have a mental disorder and live in a world full of heightened fear and anxiety of their own making and bolstered by Fox and other right wing media. They are completely brainwashed into fear and loathing of the “others”. Maybe this oldie will cause you to chuckle at their idiocy. Nicole Sullivan cracks me up.

  4. Thanks for the link to the CAP Report, this is the first thorough analysis of the impact on health care coverage, I have seen. Other projections have been off the cuff. One I heard was 43 million people without insurance. The CAP analysis actually uses a CBO score to arrive at its analysis and projection of 32 million fewer people with insurance. It then states that most likely even fewer people would have insurance and indicates the reasons. This is a really good report. I’ve picked the insurance losses for several key states below:
    AK – 41,000
    AZ – 511,000
    CA – 4,552,000
    CO – 468,000
    FL – 3,217,000
    GA – 1,192,000
    LA – 422,000
    ME – 161,000
    MI – 862,000
    NV – 243,000
    NY – 2,212,000
    NC – 1,148,000
    OR – 526,000
    OH – 809,000
    PA – 1,066,000
    TX – 2,759,000
    WA – 657,000
    WI – 414,000
    WV – 156,000

    I attempted to get the states where the participants of PO of which I aware live, the states of the Senators that might vote NO and the largest states. This makes it clear how disastrous this bill will be.

    1. This is a game with Republicans. They are toying with us, and it’s sickening. Chris’ idea is tempting but I know too much about who will pay the price for the GOP plan. I have resolved this position, however, and that is that if the bill passes, it passes. It will destroy health care for a bit, but it will destroy the Republican Party for a long time. It doesn’t have to come to this but it could, and if it does, it will be interesting to watch the destruction of the GOP.

      They have sold their souls to the highest bidders and now their markers are being called. Game over. Put up or shut up.

    2. I forgot to list IL losses at 965,000. My apologies to Chris.

      Also regarding Ryan’s remark that insurance markets would not be able to withstand losses of that amount, the CAP report actually mentions that the CBO report states the individual insurance market would essentially disappear and that 11 million fewer people would have insurance through an employer.

      The CBO score which CAP used was the Obamacare Repeal Reconciliation Act, which failed in the Senate in July. The CAP report stated that Graham-Cassidy was similar to that bill, but was worse and indicated the differences.

      IMO, the net effect would be that the only people who would have insurance would be the fairly well off who are reasonably healthy. No preconditions allowed. If someone got seriously ill, then they would probably lose their insurance in short order. That would even be true for those who obtain insurance through large group policies. If you will recall there were significant restrictions on those policies before Obamacare.

      Truly Graham-Cassidy is disastrous legislation.

      1. It’s genius, really. Install a health care plan that cuts millions of less healthy, poorer, probably minority Americans, while de-funding one of the crucial safety nets, and, voila! You haven’t just suppressed the vote, you’ve killed ’em good and dead.

        There is really only one problem with this brilliant plan – these “deplorables” will clearly know whose gift this disaster is, and there will be consequences. Counting on implementation until after the 2018 mid-terms is a sleight of hand that is pure con. It will be seen for what it is. Even by those who thus far have managed to live in a “nether land” of denial.

        I simply cannot humanly grasp the cruelty of these people. They truly live in an alternate universe of morality and conscience.

  5. I don’t know how many of you opened Chris’ link regarding contributions. But, opening the linkage and reading the article is well worth the time. It explains a lot regarding why the GOP will not accept the common sense approach of modifying the ACA to eliminate the problems. The big money contributors want the ACA repealed and replaced. Of course, they want a system that gives the States power over health care, where the big donors can dictate the terms. Graham-Cassidy would suit their purposes just fine, since it gives the most money to the states where they have the most power. They are also insisting on tax reform giving a big tax cut to themselves before they will open the spigots again. No wonder ACA Repeal refuses to die.

    1. BTW, Politico reports that: ” the Congressional Budget Office said it will not have details about the practical implications of the bill, including how many people could lose coverage and the impact on insurance premiums, “for at least several weeks.”

      Hmm, so one of two things is gonna happen here: Republicans will pass it without CBO scoring meaning no one will know the fiscal or human impact of the bill; or, they will run out the clock for Reconciliation and not be able to garner 60 votes. That’s what Sen. McCain has asked for all along but he’s been “coy” about whether he would cast the killing vote against his best buddy Lindsay Graham’s bill.

      At this point, it’s hard to know what is real…I hate that the Republicans (including T) have “played” the American people like this! The disrespect and arrogance of the GOP on this and other issues is truly amazing.

    2. I believe that scheduling the vote without a CBO score has been done deliberately. From everything that I’ve seen, the number of people who will lose insurance will be far larger than any of the bills the Senate voted on in July and higher than the AHCA. McConnell, Graham and Cassidy all know that if the CBO scores the bill it will be defeated. Trump wants a win badly and he wants the ACA repealed, without understanding the ramifications. Furthermore McConnell wants to please Trump. He thought he had done so in July, but then McCain torpedoed the Skinny Repeal and Replace.

      The big additional factor is they need the money for the proposed Tax Cut for the wealthy (AKA tax reform).

      1. “They need the money (from the cuts in Graham/Cassidy to Medicare) to pass tax reform….”

        Ah, we finally get down to the nub of the issue. It’s never really been about replacing the ACA, it’s always been about repeal and replace with more tax cuts for the wealthy!

        Duh!

    3. Insofar as I can see, Susan Collins looks like the safest “no” vote. Honestly surprised if she flipped. That’s one.

      Rand Paul is trying to thread a fine political line here, not wanting the scarlet cross of the vote who saved the dreaded Obamacare, hence why he’s calling for a root and branch repeal, knowing that it’s a sure loser. Still, this is the last hurrah, so I could see him flipping at the last minute. Dunno where he lands.

      McCain sunk the last vote, and by all rights, nothing’s changed this time around. Still says he wants “regular order”, but this is his best friend’s bill after all. Tentative “no” right now. That’s two.

      All eyes are on you, Senator Murkowski. Voted now last time, but Republicans are going all out to try and flip her. We’ll see.

      Like last time, this is almost assuredly going to come down to a single vote. If you haven’t called McCain or Murkowski yet, I urge you to do so. Not one of their constituents? Screw it, this is way too important to worry about crap like that.

      1. We are encouraging those with relatives and friends in these states (McCain’s, Paul’s, Murkowski) to call too. They won’t log the call if the zip codes are from out of state even if they react to the number of calls.

      2. Let’s be clear, the only reason the Graham Cassidy Bill retains the Cadillac Tax on health care plans as well as the tax on investment income is to meet Reconciliation requirements to not cut more than prior health care bills have….This is really bad legislation. Here’s a very detailed report from the Center for American Progress. Even though the CBO may not have time to fully score this bill prior to the 9/30 deadline, this report and others are clear as to the impact of the bill on each state and on people generally. NO excuses.

        https://www.americanprogress.org/issues/healthcare/news/2017/09/20/439277/coverage-losses-state-graham-cassidy-bill-repeal-aca/

  6. Seeing single payer on the horizon, the Heritage Foundation came up with the outlines of what became the ACA in order to head single payer off. But then when it got passed by the wrong people, Republicans immediately turned against it. Regarding the congressional Republicans, one is forced to ask along with Casey Stengel “Can’t anybody here play this game?”

    1. That is a typical move by the Heritage Foundation. They’ve done it many times before. Romney in MA was OK, because he is R. The R’s did that with redistricting in WA to head off true non-partisan redistricting, so we ended up with bipartisan redistricting, which I’ve discussed previously. Finally CA implemented redistricting by a citizen’s panel.

      The R’s have moved so far to the right that even the Heritage Foundation looks liberal. Eventually, this will catch up to them. 2018 may be the year.

      The current crop of R’s have probably never heard of Casey Stengel and his trenchant statements.

  7. Chris, I fear you vastly overestimate the intelligence or simple common sense of a large segment of the electorate. got99percent and others have already specified what will happen. The people in charge at the time medical care starts falling apart will bear the brunt of the anger, and I even doubt that the impact would be much. The electorate has the memory of a goldfish with ADD and is far too much absorbed in important issues like the Kardashians to keep track of who voted for what. Remember how the 2008 crash and subsequent deficits were Obama’s fault?

    Further, the disciples of the far-right will never, ever move too far from their religion. And this is what we are witnessing: a religion of racial hate, combined with a fanatical nationalism, and doctrine over science. That religion has been around for a long long time and is enjoying a resurgence. Those disciples have no use for logic and facts.

    When this thing kicks in, you are likely facing a vastly different country, if it still exists in its current form. True data and information will be even more suppressed than it is today. There is a non-zero possibility that the U.S. will slide into near-totalitarianism before this abomination flowers into is full murderous glory. So even if by some miracle the Democrats are in power in 2020, or 2022, the masses will never know who is truly responsible, as they are too busy watching cat videos on their smartphones.

    While a significant percent of the population believes in libertarianism and making money off the medical misery of others, there is no hope. Especially when so many people in positions of power are beholden to the medical industry bribes.

    If this thing passes, it will not be reversed, and the political impact down the road against the murderers will be minimal.

    1. Dinsdale, with all due respect, I say once more that you need to calm down. Your dystopic vision leaves nothing but a bloody rebellion as the inevitable outcome.

      We’re in a tough spot to be sure, but our current struggles are no greater than what Americans have faced in the past. As a citizen and an individual, think things through; alert others to the reality of what’s going on and band together with like-minded others so you can try to change things from the ground up. That’s how far-right activists changed the Republican Party and it’s how we can make a difference as well.

      1. That’s sound advice, Ryan, although I know how easy it is to be overwhelmed by the sheer frustration of the current situation.

        Dins – Ryan is correct. Take heart, there are good people still in our country and the very best are right here on this blog. Draw your strength from them. I yield to pessimism as well because I simply cannot grasp how this can all be happening. But I do know this much: each of us can make a difference. You are making a difference by staying aware and doing what you can to inform others and resist in a safe, constructive manner. Do something really constructive and it will help you cope with the sordid mess we are witnessing. Otherwise, it’s easy to get sucked into despair and then they win. That may happen despite our best efforts but by damn let’s fight every inch of the way!

      2. Ryan-

        While dinsdale may be a little dramatic, I think you may be a little too sanguine. There is such a thing as survivorship bias: assuming what we’re facing is survivable merely because anyone who didn’t by definition no longer exists.

        Civilizations eventually go away and are replaced. Britain ruled the world for centuries, then became a middling island nation within a few decades thanks to WWII.

        Rome ruled for a thousand years before becoming so internally weak that the ‘barbarians’ outside the gates merely had to breathe on it for it to collapse.

        I’m not an ‘America-hater’ but Pax Americana is already over. It started after WWII, and ended after our self-immolation following 9/11. It’s breathtaking to see how far we’ve fallen since Clinton’s time. Things did not get better: Trump makes GWB look like George Washington. We are as self-delusional about our global importance as Britain after it lost all Its colonies and its cities were destroyed by nazis bombs.

        If you’ve ever traveled to China or India or even Europe lately you’ll see that no one thinks of us as anything beside the crazy old uncle who’s at best embarrassing, at worst dangerous and either way irrelevant. Our leader is literally laughed at during his trips abroad (not that he doesn’t deserve it). Even south America, a place we’ve explicitly declared as our back yard since the Monroe doctrine, looks to China for its economic future.

        Civilizations tend to fall (pretty rapidly) once they no longer have the capacity to solve its internal problems. It’s rarely because some external threat becomes too strong (Britain may be an exception). If that doesn’t explain our current state, I don’t know what does.

        Just take the debt limit fiasco. It has been a fiasco for the past 8 years, and it shows no signs of getting better. In most civilizations, a debate about defaulting on your national debt only occurs once. After that, usually a new flag flies on your capital building…

  8. >] “Second, by stripping most of the federal government’s involvement in the health care industry, it opens the door to state-level innovations, including single-payer. That opening is the most exciting possibility and the reason why this bill could offer a silver lining to Democrats.”

    Yeaaaaaaaah, about that…

    http://thehill.com/policy/healthcare/351344-gop-senator-eyes-ban-on-states-single-payer-systems

    States’ rights and all that, amrite? Except when it leans against Republicans political priorities, in which case screw you and your family. Stomach churning hypocrisy, you say? What’s that?

    1. There’s a reason we have a IOKIYAR acronym and not a IOKIYAD version. If you are old enough to remember the Clinton Administration and HRC’s failed attempt to reform the healthcare system – what was one of the biggest drivers of conservative caterwauling over that? The “behind closed doors” aspect. They have jettisoned all capacity for shame.

  9. But, but, but we get the gift of Trump’s razor sharp wit (“rocket man”). Surely that is worth voting GOP and possibly losing health coverage.

    I truly wish that there was a way to let them go ahead and pass this bill, and that the negative effects smacked Trump voters and ONLY Trump voters. Then I would be 1000% enthusiastically on board with Chris’ modest proposal, and lobbying my MoCs to vote for it.

    1. Trump’s deplorables are stupid and will stand by him not matter what. Here is the funniest and most deluded Trumptard post I’ve seen today.

      ” I have no doubt that mueller has his MoleS in the WH. With the most Lawless and Immoral Racist Israel Hating man to ever be in our White House…I don’t doubt that obama himself installed bugs throughout the building… Remember…there was ALOT of remodeling going on during his 8 year reign or terror…. I wouldn’t trust one word or action from that Godless man… I pray always that the Lord will protect President Trump and his family from the very Evil forces and principalities of darkness obama brought into our White House… I also pray that the Lord will bring down ALL of the evil thoughts and action that those working against President Trump, will be brought down on those evil people working against him…. In Jesus name…”

      I almost, almost feel sorry for them.

      1. Poor education and extreme religiosity are a bad, sad combo. Add some possible mental illness to it and you have what we read above. I’ve always wondered if extreme religion causes mental illness or does it merely exacerbate existing illness? Wonder if any studies have been done?

      2. To pray in the Name of Jesus is to pray in His authority, character and will. It is not a sorcerer’s chant or magic. There are quite a few PhD holders in my church. Not all people of faith are ignorant and uneducated. Most of them I think voted Hillary. But some unhinged people do give faith a bad name.

  10. The other concern I have is that the Republican base appears to be rabidly committed to ACA repeal. That they haven’t given much intelligent thought to how their health care will be compromised doesn’t even surprise me anymore. After watching the GOP repeal effort in NV of 3 legally elected Democratic MoC – with NO stated reason – other than their party affiliation, the efforts by the “so called” Election Integrity Commission, and the recent vote by SCOTUS along partisan lines on the TX Redistricting case from 2011!!!!, it is patently obvious to me that the Republican Party has sunk to such low depths of moral responsibility that they are just as deluded as the messages they’ve promoted for the last 20 years.

    It’s disturbing, disgusting, and it doesn’t appear to have an end. This is when your concept of “letting them fall on their own sword” makes sense. But, oh, the price that innocent people will pay for the heads of those who perpetrate this political nightmare.

  11. Too many times recently I’ve had the exact same thought: Let’s let it all go to hell to wake people up.

    But, will it really wake anyone up? The first concern I have is that bills like this are timed to go into effect down the road, when the pendulum has swung back to the Ds, so it’ll be pretty easy to say “Is your life better under the people CURRENTLY in charge?”

    The second concern is the cause for my first concern: we seem to be living in a post-truth world. It’s demonstrably easy to show that people really don’t know (or care) about the details of what’s the cause of our problems, as long as the solutions align with their pre-conceived notions.

    There may well be silver lining by letting this one pass. But things could also get much much worse. We need to buckle our seatbelts.

    1. Much as I understand the sentiment, it’s still not right to throw innocent people (not to condone delusional Trump supporters who do deserve what they have coming to them, but actually innocent people who’ve done nothing to deserve this) under the bus for a chance to try and set things right. This is the worst kind of gamble and one you’d never want to take if given, really, ANY other option.

      We’ve just gotta play the hand we’re dealt here. I’m not going to look at myself in the mirror and know I didn’t do everything I could to stop this atrocity from happening. Maybe it’ll amount to less than nothing, but we should at least make the effort. Whatever happens happens and we’ll move forward from there.

    2. I have black friends who “let it all go to hell to wake people up”. They abstained from voting in the presidential election, feeling that Clinton was insufficient and Trump would expose the racism that black people deal with daily.

      There are certainly more woke white folks these days, true. But was it all worth it? Not if you ask me, but I’m white.

  12. I like the thrust of your column. I have had the same perverse thought. This bill just might be the one thing that will finally push the Republican Party over the edge and make the American people finally realize what the Republicans are. It might just hasten the complete collapse of the Party. The way might be cleared for some truly progressive movement. As I’ve written before America never seems to act until there is a crisis. Churchill was very much aware of that when he stated that America finally does the right thing after trying everything else.

    1. And doing it in the stupidest possible way: Imagining that their racist rhetoric is real. They genuinely do not comprehend that white people are the main beneficiaries of these programs and the white people on these programs are among their political core. Even those voters themselves often seem not to understand that fact. Let them discover it.

      1. The GOP stirring them up with social issues has always worked. Until it doesn’t.

        Hugh Hewitt wrote a nauseating op-ed where he flat out admitted that all of Trump’s downsides were worth getting conservative judicial appointments. Deals with the Devil always look like they are worth it in the beginning- then the bill comes due.

  13. Somewhere I read that 60% of people in long term care nursing homes are on medicaid! Hint! They aren’t all illegal aliens or minorities! In a few years people are going to look back and ask “what the hell happened?”
    States are going to have to decide what they pay for, pitting the very old against the medical bills of children!
    And all these people who will be hurt? , a good portion get their news from Fox and Facebook and either didn’t vote! Or voted Republican! Add all this to the deficits built into the Republican tax plan and the future sure is going to be bleak for the lower economic classes! One must wonder where are all the religious leaders while this is happening!

    1. Plenty of religious leaders are onto this. The so called moral majority are a vocal minority. Human nature has not changed. In Jesus’s day we had the Pharisees. Today we have the religious right. It has been a shock for me to realize about half of my family and church are bigots and racist. Most of them do not even realize Jesus is a middle east dark skin , currly headed Semantic Jew. If he walked our streets many would not like Him or respect Him.

      1. Stephen – Glad to see you’re alive and well. Hope your home and extended family did well also.

        This bill is really worse for the elderly and those with chronic diseases than the other GOP bills. It reinstates “caps” on how much each individual can be helped with federal health dollars. Once again, we are encouraging our elderly and disabled to basically bankrupt themselves and die on their own. The G-C Bill also makes it voluntary for states to adopt the 10 Essential Benefits (things like E.R. care, pregnancy, pediatric care, etc) and allows health insurance providers to utilize medical underwriting to determine health insurance premiums. Pretty slick – the bill doesn’t “outright” deny pre-existing coverage, it just makes it impossible to afford!

        There are so many other elements that are reprehensible that I can’t list them all. I have mixed feelings about the idea of allowing this bill to become law as a way of holding the GOP responsible. If so many people wouldn’t be hurt, it would be an easier decision. I can see value both ways but fundamentally, messing with people’s health care and keeping it in such a constant state of turmoil is unconscionable. I just can’t understand this much hate and disdain for something that is so fundamental. The HELP effort which was bi-partisan, has been put aside. (This was led by Senators Lamar Alexander – R and Patty Murray – D.)

        Flatly, Republicans do not want nor are capable of developing and supporting health care for the people of America.

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