The Senate Republican healthcare bill, like its House counterpart, escalates the war the Republican Party has been waging against poor and working-class Americans for decades. Even middle-class families now find their elders in the crosshairs of legislation that would decimate Medicaid, the principal funder of our entire nursing-home system. These ugly bills have helpfully exposed political fault lines between the GOP and the Dems, within the Democratic Party itself, and inside the American Left as a whole.
According to the Congressional Budget Office, if the Senate were to pass its healthcare plan, 49 million Americans would be without insurance by 2026 — 22 million more than if Obamacare were to remain in effect. House Democratic Leader Nancy Pelosi (Calif.) inveighed against the “moral monstrosity of Trumpcare,” and her Senate counterpart, Chuck Schumer (N.Y.), described it as “a wolf in sheep’s clothing.”
While the Affordable Care Act (ACA) is experiencing an uptick in popularity as Americans face the prospect of Trumpcare, the fact remains that the GOP has exploited resentment against the ACA to great effect. Neither Pelosi nor Schumer seem able to acknowledge that many Americans of modest means resent that Obamacare mandates they spend a big chunk of their income on insurance premiums (paid to for-profit insurance companies) in exchange for limited coverage with criminally high deductibles.
Sen. Bernie Sanders (I‑Vt.) has taken a different tack. He notes that the Senate GOP healthcare plan would provide $200 billion in tax breaks to the richest 2 percent. In an interview on CNN, he elaborated: “This is what oligarchy is all about. It’s the wealthy and powerful saying, ‘We need even more tax breaks … and if it means people in America dying … hey, that’s not our problem, the only thing we have to worry about is getting even richer.’” Unlike Pelosi and Schumer, Sanders acknowledges what working people know: Obamacare premiums, deductibles and copayments are “too high.” As a remedy, he pledged to introduce Medicare-for-all legislation — a bill that this time around is likely to attract co-sponsors, including Sen. Elizabeth Warren (D‑Mass.), who endorsed single payer on June 27.
In June, as Sanders barnstormed the country in opposition to the GOP bill, he repeatedly pointed out that if the Republicans repeal the ACA, “thousands of Americans will die.” That was not hyperbole. Death is what awaits those cursed with a serious chronic illness and no money to afford the insurance that would guarantee treatment. People who delay needed medical attention for fear of drowning in medical bills are especially vulnerable.
Although Sanders and his allies continue to preach the single-payer gospel, the sad reality is that progressives are now forced to expend their energy and resources defending the ACA from the GOP, rather than agitating for universal coverage. This defensive posture is a consequence of Hillary Clinton’s 2016 defeat, which has been a disaster for the country. The half-baked idea, popular among certain circles on the Left, that things have to get worse before they get better, is manifestly disproved by the grim reality of 2017, as is the related, irresponsible notion that America’s democratic elections are inconsequential bourgeois theater. Concerted engagement in the 2018 and 2020 election cycles is not optional; it is an existential imperative.
Joel Bleifuss, a former director of the Peace Studies Program at the University of Missouri-Columbia, is the editor & publisher of In These Times, where he has worked since October 1986.