Zirpoli: Trump, GOP Congress don't care if Americans have access to affordable health care

The fascinating thing about the failed Republican plan to replace the Affordable Care Act, better known as Obamacare, is that it failed to secure enough Republican votes because it was too generous. Democrats wouldn't have voted for the plan because it added 24 million Americans to the uninsured rolls, because it would significantly reduce minimum standards of coverage for insurance companies (especially for women), because it shifted the cost of national health care from the rich to the poor, and because it eventually terminated federal funding for Medicaid.

Despite all of these issues, however, President Donald Trump could not get the votes he needed because Republicans still thought the plan was too generous to their constituents.


Speaker Paul Ryan, however, had an inkling of how bad the plan was perceived by average Americans. Knowing he did not have enough votes for the bill anyway, he pulled the bill instead of having "yes" votes to his plan tied around the necks of Republicans running for re-election in 2018.

Before we move on, as President Donald Trump recommended, Americans need to stop and understand what Trump and a majority of Republicans in Congress were willing to do to the American people. And when you look at the details of the plan that they were trying to shove down our throats, there is only one logical conclusion: President Trump and a majority of Republicans in Congress don't care if Americans have access to affordable health care.

During the presidential campaign, President Donald Trump promised affordable health care for "everyone." But, like so many other things Trumps says, that statement was a lie. By supporting the House plan to replace Obamacare, Trump communicated that he did not care if 24 million Americans would be added to the uninsured. Nor did he seem to care about our elderly parents and grandparents or our family members with disabilities on Medicaid. If you read the final bill and how easily Trump gave up important protections for the American people, even people covered by their employer, it is clear that he was only looking after himself, not us.

According to those involved in the negotiations, Trump just wanted a win and didn't seem to be concerned about the details of the replacement plan or the impact on the American people. His win, however, would have been devastating to a majority of Americans and for the provision of health care in the United States.

During final negotiations, desperate to secure more votes from conservative Republicans and a win at any cost, Trump sold ordinary Americans down the drain. He gave away requirements that insurers offer "essential health benefits" in their plans. These benefits included maternity care (the war on women continues), addiction treatment (in the middle of our nation's overdose epidemic), mental health care, hospitalization coverage (you can get sick but you can't go to the hospital), newborn and pediatric care (sorry, kids, they want you to be born but you are on your own after that), prescription drugs and laboratory services (blood tests are overrated). Trump also agreed to delete mammograms from insurance plans. What a deal for insurance companies — collect premiums and cover very little. Americans who would pay lower premiums for these new basic plans would have had almost no coverage at all.

The latest Congressional Budget Office estimate released last Thursday found that instead of saving $337 billion over 10 years, as originally estimated, Trumpcare would save about $150 billion, but still add 24 million Americans to the uninsured.

The bill trashed the Medicaid program, which provides insurance for over 70 million Americans (mostly the elderly and people with disabilities) by simply transferring the costs to state governments as federal funding was deleted. Even Republican governors knew that their states could not pick up billions of dollars in Medicaid funding.

Trump encouraged Americans to "Go with our plan. It's going to be terrific." But to whom was the plan terrific? The plan provided a significant tax break for those making over $250,000 per year, while those making less than $50,000 would see a reduction in their health care benefits. The plan would have cut almost a trillion dollars over 10 years from federal subsidies for health care so that Republicans could cut taxes for businesses and the rich under the guise of a future "tax reform" bill. But at what cost to the public?

The public, however, was not sold on Trumpcare as an adequate replacement for Obamacare. A Quinnipiac national poll found that only 17 percent of Americans supported the Republican's plan. Even among Republicans, only 41 percent believed that the plan was "going to be terrific" as described by Trump.

Tom Zirpoli writes from Westminster. He is program coordinator for the human services management graduate program at McDaniel College. His column appears Wednesdays. Email him at