President-elect Donald Trump’s selection of Georgia Congressman Tom Price as his secretary of health and human services makes clear his intention to carry out a fundamental attack on Medicare and Medicaid, the government health insurance programs for the elderly, the handicapped and the poor that cover a combined total of 130 million people.
Trump announced the appointment on Tuesday, calling the diehard opponent of the bedrock government health programs a “problem solver” and “go-to expert on health care policy.” He also named Seema Verma to head the Department of Health and Human Services’ Centers for Medicare and Medicaid Services. Verma worked with Republican leaders in Indiana, including the current governor and vice president-elect, Mike Pence, to substantially privatize the state’s Medicaid program for the poor and impose co-payments on recipients. In the process, she made millions of dollars for her Indianapolis-based firm.
Both Trump and Price have long declared their opposition to the health care overhaul enacted by the Obama administration in 2010, popularly known as Obamacare. But Price’s appointment involves more than the promised repeal of Obama’s Affordable Care Act (ACA). It is part of a scheme to use the total or partial repeal of Obamacare to begin the dismantling of both Medicare and Medicaid as government-run, universal entitlement programs, and their transformation into voucher programs, in which seniors and poor people would be given government subsidies that would cover only a fraction of the cost of private insurance.
The model for this health care counterrevolution is, to a large extent, Obamacare itself, which forces millions of people to buy policies from insurance companies while providing limited government subsidies for low- and middle-income purchasers.
Price was an orthopedic surgeon and assistant professor at Emory University School of Medicine prior to becoming the US House of Representatives member from the Sixth Congressional District of Georgia, which includes the northern suburbs of Atlanta, in 2005. This was the district that sent former Republican Speaker of the House Newt Gingrich to the House for 20 years, from 1979 to 1999.
In 2015, Price took over as chairman of the House Budget Committee after Paul Ryan (R-Wisconsin) became speaker of the house. Price also sits on the powerful House Ways and Means Committee, and has served as chairman of the Republican Study Committee, a collection of far-right, fanatically pro-market House members who are viscerally opposed to government social programs.
Price has consistently taken right-wing positions, including voting to deny funding to National Public Radio, regularly voting to extend the USA Patriot Act and government spying programs, and co-sponsoring a bill to build additional border fencing between the US and Mexico. He has voted to defund Planned Parenthood. In 2007, he co-sponsored a bill that would illegalize same-sex marriages and he voted against another that would forbid employers from discriminating against gay people in the workplace.
Price’s far-right positions have won him accolades from the gun lobby, including the National Rifle Association and Gun Owners of America, as well as anti-abortion groups such as the National Right to Life Center and the Susan B. Anthony List.
He has introduced several versions of his Empowering Patients First Act (EPFA), which seeks not only to repeal the ACA, but to sharply accelerate the privatization and dismantling of Medicare and Medicaid.
The EPFA calls for effectively ending Medicaid as a national program by reducing it to a system of block grants to the states, each of which would have total control over its own program, with the power to restrict eligibility, reduce benefits and impose out-of-pocket costs. According to the Washington-based Center on Budget Policy and Priorities, spending on Medicaid would be cut by as much as 34 percent by 2025 under Price’s block grant system.
Medicare would be transformed from a program guaranteeing a defined set of benefits to a “premium support” model, i.e., it would provide vouchers for seniors and disabled people to apply toward the purchase of policies from private insurers. According to one study, this “reform” would shift the cost-sharing between beneficiaries and the government from the current situation, where the government pays 70 percent and recipients pay 30 percent, to the reverse, with seniors paying 70 percent of health costs.
It is obvious that this scheme will mean a drastic decline in health care for the elderly and disabled and result in increased poverty and disease and premature death for millions of people. This is precisely what corporate America, which considers health care for the elderly and poor an intolerable drain on its profits, intends.
According to press reports, Trump and the Republican-controlled Congress plan to move quickly to enact measures along the lines of those proposed by Price. They intend to pass legislation in 2017 combining the full or partial repeal of Obamacare with the crippling provisions regarding Medicare and Medicaid outlined above.
The Democrats will mount no serious opposition. Typical of their mealy-mouthed response to these plans is the statement by Michigan Senator Gary Peters, who said, “Congress should come together to work on needed reforms and ensure all Americans have access to quality and affordable health care coverage.”
To ensure passage of such legislation, and give the Democrats a certain amount of cover for their capitulation, Trump and the Republican leadership in Congress plan to use the budget reconciliation process, an expedited procedure that bars the use of a filibuster in the Senate to block passage of a measure.
Another provision of Price’s EPFA bars the use of federal funds to pay for abortions or “cover any part of the costs of any health plan that includes coverage of abortion.”
First published in WSWS.org