DJT Day 108 - Why Doesn't He Just Shoot Them Now?

Well, Trump smashed right through that 100-day barrier to what turned out to be a truly bizarre week -- even in the Trump world. He spent this last week lying through his teeth, making up his own reality as he went, and breaking virtually every promise he made during his campaign. At the same time, but out of the other side of his mouth, Trump was claiming to have kept every one of those same broken promises. As far as I know, he did not shoot anyone on Fifth Avenue to prove that his supporters would not care. What he actually did will almost certainly prove to be far worse, and it does appear that his supporters and allies really don't care.

On Thursday, Paul Ryan finally got his years-long wish and led 217 House GOP members over the cliff by voting to repeal (i.e., gut) the Affordable Care Act (ACA) and replacing it with the American Health Care Act (AHCA) -- in other words, ACA + the Hateful new provisions = AHCA. The AHCA eliminates the Obamacare individual mandate and the subsidies which made insurance premiums more affordable for many lower income families. Of course, Trump and Ryan were not able to muster the votes to pass the AHCA the first time around several weeks ago. So, they changed it by adding even more hateful provisions to get the support of Freedom Caucus members in the House. Freedom Caucus are euphemistic code words for the most conservative Republican members of Congress. Trump and Ryan were able to a few additional Freedom Caucus votes. All they needed to do was include language allowing the States to opt out of coverage for essential health benefits (such as obstetric care, hospital care, emergency room care, EMS ambulance transportation, mental health care, opioid and drug addiction care). In other words, let States and Republican governors and legislators opt out of health care coverage entirely. But, even with those changes, Trump and Ryan were still a few votes short because the new version of the AHCA just wasn't mean-spirited enough. What to do? Well, late Wednesday night, Trump and Ryan, in cahoots with several sneaky House members from the so-called Tuesday Group, came up with a truly Machiavellian idea to effectively eliminate coverage entirely for all those individuals with "pre-existing conditions". Of course, Trump had promised America and his supporters that he would never do that -- his plan was going to be beautiful and better and cover everyone for a whole lot less. So, the elimination of health care for pre-existing conditions had to be done in a way that would allow Trump to lie and claim he was keeping that campaign promise. He had to be able to lie to the mothers and fathers of those newborn infants with birth defects and congenital conditions. He had to be able to pretend that he actually cares about those women who have somehow managed to survive breast or cervical or uterine cancer or those men suffering from diabetes or cardiovascular disease. And, on and on and on. That cabal of cruel villains gathered on Wednesday evening had their work cut out for them but they were up to the task. They came up with a scheme with a front door of lies and a back door through which to slink away from the consequences of those lies. Under their plan, the AHCA would (i) require insurance coverage for pre-existing conditions (the "front door") to support whatever bald-faced lie Trump wanted to tell the American people (including all of his supporters who fell for the con and believed him) and (ii) simultaneously allow the States to obtain a waiver and opt out of the mandatory coverage (the "back door") by forcing all of those unfortunate souls with pre-existing conditions into "high risk" pools with spotty coverage at best and premiums so high that almost no one can afford to pay them.

With that tricky little maneuver, the AHCA was finally heartless enough to attract the final two or three GOP votes necessary to pass the House by a margin of one single vote.

I don't care what Rep. Raul Labrador (R-Idaho) says. People will die as a direct result of not having those essential health benefits or coverage for pre-existing conditions. Those State waiver provisions added to the AHCA to get the necessary votes to pass the House will prove to be deadly to many. However cruel they may be, those provisions merely return us more or less to the pre-ACA state of affairs as far as private insurance is concerned. The available insurance will not be any better or any cheaper or any more available than it was before Obamacare. In fact, it will probably be worse and more expensive -- particularly if the private health insurance companies are allowed to manipulate the system the way they did before and the way they are doing now. Does anyone really and truly think that the insurance companies dropping out of insurance exchange markets in South Carolina and Iowa and Virginia and elsewhere is anything other than a ploy to pressure the GOP and Trump into eliminating those pesky claims for pre-existing conditions which eat into their profits?

But none of this -- as bad as it is -- is the worst thing Trump and Ryan and their co-conspirators have done this week. All of the other stuff is nothing more than camouflage for the truly cruel elements of the AHCA which will result in the outright killing of thousands of poor people, sick children, and the chronically and permanently disabled who depend upon Medicaid for their very lives. The AHCA eliminates Medicaid expansion entirely (to the detriment of those who live in States that elected to expansion Medicaid coverage under Obamacare) and reduces Medicaid reimbursements and benefits for everyone (including those living in the idiotic or selfish States that never agreed to expand Medicaid in the first place). The cuts to Medicaid amount to almost $900 million over the next ten years. That is the cruelty. The truly sadistic twist to that cruelty is that more than 95% of that $900 million stolen from the health care of the poorest of American families and from single mothers and their children and from disabled and mentally ill Americans goes straight into the already bulging pockets of the wealthiest 1% in the country.

Come to think of it, it might actually be less cruel if Trump just stood in the middle of 5th Avenue and started shooting those thousands of unfortunate Americans down all at once rather than spreading their miserable deaths over the next decade. Unless three Republican Senators can muster a little courage and good sense in the next few weeks, the blame for all those deaths resulting from the cruelty of Trumpcare will fall directly on Trump and Ryan and the rest of those heartless GOP Congressmen who followed them like lemmings over the cliff.

I don't think they are going to be able to lie their way out of this one.