In 2003, Iowa used part of its portion of the 1998 Tobacco Settlement monies to help build a new Supreme Court Building. During those years and later, Iowa Republican legislators sought to reduce the funding and scope of the Iowa Tobacco Use Prevention and Control Commission, which was created to use the settlement monies to help Iowans to either quit smoking or not start. I said at that time that using the Tobacco Settlement monies for any use other than health care was wrong. As a former chair of the Tobacco Commission, I viewed this money as blood money because it was being paid out to partially compensate for the death and disease that cigarettes had caused Iowans for many decades.
Similarly, I use the same term, blood money, today regarding the U.S. Republican House and Senate efforts to repeal and replace the Affordable Care Act with a plan that will reduce wealthy individuals’ taxes by more than $600 billion over 10 years by taking a similar amount of money from the Medicaid program and from subsidies used to supplement poor and low-income individuals’ effort to pay for premiums in the individual health-insurance market.
If this effort is successful, people (the Congressional Budget Office (CBO) estimates 23 million Americans under the House bill and 22 million under the Senate bill) will lose health-care coverage. Additionally, regarding the individual insurance market, the CBO said, “Under this legislation, starting in 2020, the premium for a silver plan would typically be a relatively high percentage of income for low-income people. The deductible for a plan … will be a significantly higher percentage of income, also making such a plan unattractive … . As a result, despite being eligible for premium tax credits, few low-income people would purchase any plans.”
Some of those people will die and many will suffer without health-care coverage. Both the House bill and the proposed Senate bill will transfer money to the wealthy at the expense of the lives of others. This is the new explanation of “blood money.”
As Paul Krugman said in The New York Times this week, “More than 40 percent of the Senate bill’s tax cuts would go to people with annual incomes over $1 million … while …, according to best estimates, around 200,000 preventable deaths” would occur with the loss of health-care coverage for 22 million to 23 million Americans.
How do you have a credible public-relations campaign with this stark contrast between greed and suffering? Rod Whitlock, a lobbyist for hospitals and individual with disabilities, whom I knew when he worked with Iowa’s U.S. Senator Chuck Grassley, said on National Public Radio last Saturday that both House and Senate Republicans explain and sell this idea by separating the tax cuts immediately and forestalling the Medicaid cuts for a few years.
The separation of tax cuts and Medicaid cuts by a period of time is designed to distract the public from the connection. The other way to hide this transfer of wealth from low- and moderate-income Americans to the wealthy is by couching the effort as a way to eliminate the individual mandate, which works, and which the CBO supports, and which Medicaid patients and low-income Americans buying into the individual health-insurance market are not affected by because they are exempt from paying the income-tax penalty fee. Warren Buffet, one of the wealthiest men in the U.S., described it best, saying the Senate bill was the “Relief for the Rich Act.”
As I have said before regarding the ill-fated CoOportunity Health — the Iowa and Nebraska health-care cooperative that sold policies on the Exchange in the individual market — after three months of operation, this health-insurance company had requests for 24 solid-organ transplants (hearts, lungs, kidney, liver, etc.). People with these conditions will again be without health-care coverage and subsequently without health care if either the House or Senate Bill passes.
President Trump called the House Bill “mean.” If the Senate Bill forces 22 million people off of health-care coverage instead of 23 million Americans, can that be considered less “mean”? Polls regarding the Senate bill seem to agree with the “mean” assessment. I prefer Paul Krugman’s “cruel and immoral” assessment.
Wikipedia says, “After the crucifixion of Christ, Judas returned the payment to the chief priest, who took the silver pieces and said, ‘It is not lawful for to put them into the treasury because it is the price of blood.'” This quote is drawn from Matthew 27:6.
For me, using Tobacco Settlement money for an Iowa Supreme Court Building while trying to cut funding to help Iowans quit smoking defined the price of blood in 2003 by our state government. Similarly, exchanging tax cuts for the rich with the loss of health-care coverage and subsequent morbidity and mortality for the poor and people with low income is the 2017 definition of “price of blood,” this time by the federal government.
Two addenda: 1) If the Republicans actually wanted to lower the cost of health care and improve health-care coverage for Americans, their bill would address the travesty of the ever-increasing cost of medicines. The recent obscene jump in the price of long-acting insulin is only one of hundreds of examples. 2) As I have said before, health-care coverage helps create a society where mental-health needs are met; where individuals with addictions to various legal and illegal substances such as alcohol, tobacco, opioids, and methamphetamines are addressed; where cancer is prevented or caught early; and where the effects of chronic illnesses are lessened. The overall effect is a safer, less violent, happier, healthier society, from the youngest to the most elderly among us.
To the wealthy, I say the taxes you pay to support health-care coverage under the Affordable Care Act (ACA) is a great investment. It is time to let our conscience and morality guide us to do what is right.