Zirpoli: 'Trumpcare' bad for seniors, poor

We were told by President Donald Trump that the Republican replacement plan, now being dubbed "Trumpcare," for The Affordable Care Act (Obamacare), would cover everyone currently covered under the ACA and cost less. According to Trump, the new Republican plan would provide "insurance for everybody" with "lower numbers, much lower deductibles." But like so much of what Trump says, this, too, is not true.

Instead, Trumpcare, as currently proposed by House Republicans, will cover far fewer people than Obamacare and end up costing individuals and families more. The Congressional Budget Office (CBO) estimated that under Trumpcare, 14 million more Americans would be uninsured next year and 24 million more uninsured by 2026 than if Obamacare was left in place. That's a total of 52 million uninsured Americans in 10 years under the GOP plan.


While The Affordable Care Act was developed after significant input from doctors and hospitals who then provided their endorsement, House Republicans would not let anyone see their plan before it was presented to the public last week. As a result, hospital, doctor and nursing associations had no input into the plan. When they did read it, they rejected it because it would knock millions of Americans off their coverage and increase costs to those who remain.

"More than 20 million Americans currently have health care coverage due to the Affordable Care Act and among the AMA's highest priorities for on-going health system reform efforts is to ensure that these individuals maintain that coverage," said James Madara, the CEO of the American Medical Association, who criticized the Republican plan. Their rejection was joined by the American Nurses Association.

Hospital groups, such as America's Essential Hospitals, the Federation of American Hospitals, the Association of American Medical Colleges and the Children's Hospital Association are against the House plan because it will force millions of Americans to resort to what they did pre-Obamacare: Go to the emergency room for routine medical care instead of a family physician paid for under Obamacare. This will cost hospitals billions of dollars; a cost that will be passed on to the rest of us.

Many insurance companies are against the House GOP plan because when millions of people are dropped from coverage, the risk and cost of insurance is spread among fewer people — leading to greater cost per person or family, and greater risk for the insurance companies.

Trumpcare also fades out federal funding for the Medicaid program so that by 2020 all federal funding for Medicaid will end. Most of the people using Medicaid are elderly and disabled. The House plan passes Medicaid on to the states in the form of block grants. But individual states don't have the money to make up for the federal cuts to the program. Again, this will result in less coverage for the 73 million Americans currently receiving Medicaid assistance.

While Speaker Paul Ryan estimates that Medicaid cuts will save the federal government $530 billion over 10 years, this cost is merely shifted to the states, just to maintain current services, never mind deal with the growing elderly population. The Center on Budget and Policy estimates that this will result in a 33 percent cut in Medicaid funding in 10 years. Nursing homes, for example, will be devastated.

"It appears that the effort to restructure the Medicaid program will have the effect of making significant reductions in a program that provides services to our most vulnerable populations, and already pays providers significantly less than the cost of providing care," wrote Richard J. Pollack, CEO of the American Hospital Association.

Trumpcare will cut taxes on the wealthy and companies, such as medical equipment companies, that profit from the health care industry in America. These taxes currently help pay for subsidies received by millions of Americans who can't afford to pay the full price of health insurance. Republicans have yet to say how this revenue source will be replaced, if at all.

The American Association for Retired People (AARP) has come out against the House plan because millions of older and poorer seniors will not be covered. In addition, the GOP plan calls for seniors to pay a greater proportion of the costs for Trumpcare than they pay now under Obamacare.

The House bill, if passed, will need to clear the Senate. Will Senate Republicans allow their friends in the House to tie the GOP to a plan that cuts millions from health insurance, raises everyone else's costs so the rich can get yet another tax cut, and reduces Medicaid funding to seniors and people with disabilities?

Will Trumpcare do to Republicans next November what Obamacare did to Democrats?

Tom Zirpoli writes from Westminster. He is program coordinator for the Human Services Management graduate program at McDaniel College. His column appears Wednesday. Email him at