Why the Republican Health Care Bill Presages a Dark Era in America

Tomorrow, March 23, which also happens to be the seventh anniversary on which President Obama’s crown legislative achievement, the Patient Protection and Affordable Care Act (ACA), was signed into law, House Republicans will vote on the The American Health Care Act (AHCA), the Republican Party’s long-awaited repeal-and-replace plan. Ultimately, this replacement plan would be different from the ACA in two particularly consequential ways.

First, it would drastically raise healthcare costs for elderly Americans and low-income Americans, while lowering costs for young Americans.  For example, according to analysis produced by the Congressional Budget Office, a 21 year old today pays, on average, $1,700 in premiums for ACA-market insurance insurance, whereas the same individual would pay only $1,450 under the AHCA; by comparison, the average 64 year also pays only $1,700 in premiums under the ACA, but would pay a whopping $14,600 under the AHCA, representing more than half of that individuals annual income.


It would do this primarily because the AHCA would allow insurance companies to charge older Americans substantially more than they are able to under the ACA, without correspondingly increasing the subsidies given to elderly Americans. It would also substantially raise healthcare costs for rural Americans, given that the AHCA does not provide larger healthcare subsidies to individuals who live in areas where healthcare competition is lower, and thus costs are higher, which disproportionately tend to be rural areas where the population is diffuse and spread out.

Given that Trump supporters tend to be both low-income elderly Americans and tend to live in rural areas, many of the individuals who would suffer the most under this plan would be, counter-intuitively, Trump supporters. A graph produced by the New York Times, attached below, highlights this fact quite clearly, with the individuals that lose more than $1,000 in tax credits under the AHCA all tending to cast their vote for Trump; the voters facing the biggest losses, losses more than $5,000, tended to support Trump by 19-25 points.


While healthcare prices for elderly, poor, and rural Americans, again, mostly Trump supporters, would increase, the AHCA would simultaneously cut taxes for the wealthiest 2% of Americans, by a cumulative total of nearly $600 billion.


According to an analysis completed by the Tax Policy Center, by the time the AHCA takes full affect in 2022, 40 percent of the tax breaks included in the bill would go to the top one percent of households, or households making more than $772,000, amounting to an average of $37,240 per year. The top .1 percent of households, or those earning more than $3.9 million per year, would receive an average of $207,390 in tax breaks per year.

Meanwhile a significant majority of Americans would pay essentially the same in taxes in 2022 as they do today: households earning between $52,600 and $89,400 would receive only $300 in tax breaks, while individuals earning below that threshold would only receive around $150.

Insurance company executives would see substantial benefits as well. One section of the bill would allow insurance companies to deduct up to $1 million that they pay to their executives from their corporate tax bill as “business expenses;” currently, compensation deductions are capped at $500,000. According to the chief of staff for the Joint Committee on Taxation, this would cost the federal government $400 million in revenue.

In other words, the AHCA would effectively serve as a drastic redistribution of wealth away from the poorest Americans to the wealthiest.

To put this into perspective, the wealthiest .1 percent of Americans (about 160,000 families), who would gain the most out of the AHCA’s adoption, already own about 22% of national wealth. Likewise, the top 1 percent and 10 percent of Americans, accounting for only 1.6 million and 16 million households, respectively, already own 42 and 77.1 percent of all national wealth. Meanwhile, the bottom 80% and 60% of Americans own less than 15% and 2.5%.

Paul Ryan and other Republicans argue that the intent of this bill is to increase freedom for Americans. Sure, the AHCA could be seen as doing this: extremely wealthy Americans will have the freedom to buy another yacht or another house, while the poorest Americans will have the freedom to die, without healthcare or dignity.

To quote the Athenian historian Thucydides, the AHCA will allow “the strong [to] do what they can and the weak [to] suffer what they must.”

Throughout the campaign, Trump continuously framed himself as the voice of the voiceless. During his acceptance speech at the Republican National Convention, Trump proudly claimed that he would stand up for those who have felt “ignored, neglected, and abandoned. These are people who work hard, but no longer have a voice. I am your voice!”  In his first speech following his November victory, Trump proudly stated that “The forgotten men and women of our country will be forgotten no longer.”

What Trump’s support for the Republican replacement plan makes clear is that not only will Donald Trump’s first major legislative achievement break the fundamental promises that underwrote and drove his victory, but he will do so by backstabbing, and effectively spitting on, the most needy and downtrodden of his supporters.

While this legislation is unlikely to pass the Senate, the mere fact that it was introduced as a serious option should bring about, in the minds of individuals who care about our society, the fundamental question of: Why? Why is Donald Trump seemingly able to break the core promise of his campaign and support legislation that would be devastating to his core supporters? Why is the Republican Party able to put forward legislation that directly works against the interest of a large portion of their base, only to empower a relatively small few who, as I have already shown, have already gained enormously over the last three decades? Does not the mere existence of this legislation represent a fundamental breakdown of democratic institutions?

The answer to this question is quite obvious. While Trump did indeed claim that he would finally give voice to the voiceless, the “voiceless” were framed not in terms that emphasized their stagnant socioeconomic status, but rather their declining status atop the social hierarchy. That is, the “voiceless” in Trump’s mind are those rural, white Americans who feel that the rapid political and cultural change that has occurred over the last five decades has happened largely without their support or consent. In other words, what I argue below, is that Trump’s support for the AHCA does not break the promise of his campaignas the fundamental promise of his campaign was rooted in a cultural, rather than economic, resurgence.

While the changes that led certain Americans to feel “voiceless” are numerous, some are especially important to highlight, including: the rise of women in the workplace, the media, and positions of power more generally; an increase in long-term unemployment among non-college-educated white men and, for those who remain employed, a shift from rugged manufacturing employment to degrading service-sector employment; an increase in the political and cultural representation and status of minorities, which most importantly includes the election of the first African-American president and the legalization of gay marriage; and trends which portend the downfall of white, Christian Americans as a racial and social majority.

Those responsible for this rapid change, especially Muslims and Mexicans, were often framed by Trump as an “other” whose unabated assimilation into and empowerment within our society would bring with it an inherent instability. Countless studies have shown that Trump supporters are driven by an inherent racial-resentment and view social change as a threat to their status.

For example, a Pew Research Center study found that, when asked what issues facing the country were most important, the issue mentioned that determined most whether an individual would feel “warmly” about Trump was: “Growing number of newcomers from other countries threatens U.S. values.” Tied for second, was “Bad for country that blacks, Latinos, Asians will be majority of the population.

Another study, completed by Stanford University Professor Robb Willer, titled “Threats to Racial Status Promote Tea Party Support Among White Americans,” argued that “various political, economic, and demographic trends and events,” most notably, the election of the first African-American President, help explain varying levels of support for the Tea Party movement. Respondents in the study were given a set of information, with some respondents receiving a “framing” of this information that was meant to heighten the perceived threat to the relative standing of whites; those respondents, in turn, were found to express greater support and enthusiasm for the Tea Party. Indeed, when respondents were shown the racialized aspects of its platform, rather than the economically-libertarian aspects, “threatened white respondents reported strong[er] support for the Tea Party.”

In other words, Trump’s campaign slogan, “Make America Great Again,” was not implying that America would be made great through sound and reasoned economic policy; rather, it implied that making America great again required the reassertion of White, Male, god-fearing Americans as the top of the social hierarchy. Much of Trump’s campaign platform and rhetoric served as both a literal and symbolic effort to protect this hierarchy, and increase the figurative and literal distance between us “good Americans” and those “bad Americans.” As President, Trump has already started acting on many of these promises: he is already starting to build a wholly unnecessary wall along the U.S.-Mexico border, is ramping up deportation efforts of undocumented immigrants, and has already implemented an illogical ban on Muslim-majority countries.

In totality, what I am arguing is that Trump supporters have become so filled with anxiety and blinded by a hatred of “others” that the Republican Party and Donald Trump believe they can put forward policies that damage their supporter’s economic welfare, as long as their status atop the social hierarchy is maintained. This mindset can also be seen in the willingness of many Trump supporters to accept and spread blatant and obviously-false news storiesthat is, Trump supporters don’t care about the obvious falsity of a news story, as long as it ultimately serves their personal agenda.

What does all of this mean for the future of America? It means that the extremely wealthy who, again, benefit overwhelmingly from this legislation, will be able to use the inherent and innate social and cultural anxiety that drove much of this election, and will continue to drive elections unless the status quo changes, to coerce them into voting against their own interest. This is likely to create an unstoppable electoral coalition that will exert a tyrannical control over our society, empowering a wealthy few at the expense of everyone else. The saddest part of this is that those Americans who enable this tyrannical coalition, by empowering the wealthy through their vote choice, will be suffering immensely at the same time, from economic anxiety, drug addiction, a broken family life, and the downfall of their own communities.

Can this coming tyranny be stopped? Absolutely. Is it likely to, given our inability to confront the deep racial and social anxieties that are rooted in nearly all aspects of American culture? Not at all.

Photo Credit: The Blaze




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Ethan Paul http://Thegreatbernanke14

Ethan Paul is a junior Economics & Political Science major. He enjoys writing about current affairs, politics and economics, from a progressive perspective. He conducts research for the political science department, and is currently writing a thesis about the relationship between polarization and political representation. He can be found on Twitter (@sandersforprez) and contacted at ethanpaul@undergroundvoices.co