No, they’re not going to see *this* coming

The health-care legislation passed today by Republicans in the House of Representatives is beyond the pale — beyond anything you’ve seen before. It’s primary function is to slash Medicaid by about $1 trillion, using that money to fund an equivalent amount in tax cuts for the wealthy. But it does a lot more than that. It also revokes the possibility of health insurance for tens of millions of Americans. Anyone who needs such insurance — the sick, those with “pre-existing conditions” — will be unable to afford it.

This is horrible legislation, passed in a hurry by 217 House Republicans who conducted zero public hearings on it and who are not even claiming to have had enough time themselves to have read the bill.

Paul Waldman states the matter plainly and correctly, “Every Republican who voted for this abomination must be held accountable.” I’m going to excerpt a big chunk of his summary and evaluation, borrowing his anger because my own, right now, is preventing me from writing as clearly as he does here:

I won’t mince words. The health-care bill that the House of Representatives passed this afternoon, in an incredibly narrow 217-to-213 vote, is not just wrong, or misguided, or problematic or foolish. It is an abomination. If there has been a piece of legislation in our lifetimes that boiled over with as much malice and indifference to human suffering, I can’t recall what it might have been. And every member of the House who voted for it must be held accountable.

… Here are some of the things it does:

  • Takes health insurance away from at least 24 million Americans; that was the number the CBO estimated for a previous version of the bill, and the number for this one is probably higher.
  • Revokes the Affordable Care Act’s expansion of Medicaid, which provided no-cost health coverage to millions of low-income Americans.
  • Turns Medicaid into a block grant, enabling states to kick otherwise-eligible people off their coverage and cut benefits if they so choose.
  • Slashes Medicaid overall by $880 billion over 10 years.
  • Removes the subsidies that the ACA provided to help middle-income people afford health insurance, replacing them with far more meager tax credits pegged not to people’s income but to their age. Poorer people would get less than they do now, while richer people would get more; even Bill Gates would get a tax credit.
  • Allows insurers to charge dramatically higher premiums to older patients.
  • Allows insurers to impose yearly and lifetime caps on coverage, which were outlawed by the ACA. This also, it was revealed today, may threaten the coverage of the majority of non-elderly Americans who get insurance through their employers.
  • Allows states to seek waivers from the ACA’s requirement that insurance plans include essential benefits for things such as emergency services, hospitalization, mental health care, preventive care, maternity care, and substance abuse treatment.
  • Provides hundreds of billions of dollars in tax cuts for families making over $250,000 a year.
  • Produces higher deductibles for patients.
  • Allows states to try to waive the ACA’s requirement that insurers must charge people the same rates regardless of their medical history. This effectively eviscerates the ban on denials for preexisting conditions, since insurers could charge you exorbitant premiums if you have a preexisting condition, effectively denying you coverage.
  • Shunts those with preexisting conditions into high-risk pools, which are absolutely the worst way to cover those patients; experience with them on the state level proves that they wind up underfunded, charge enormous premiums, provide inadequate benefits and can’t cover the population they’re meant for. Multiple analyses have shown that the money the bill provides for high-risk pools is laughably inadequate, which will inevitably leave huge numbers of the most vulnerable Americans without the ability to get insurance.
  • Brings back medical underwriting, meaning that just like in the bad old days, when you apply for insurance you’ll have to document every condition or ailment you’ve ever had.

It is no exaggeration to say that if it were to become law, this bill would kill significant numbers of Americans. People who lose their Medicaid, don’t go to the doctor, and wind up finding out too late that they’re sick. People whose serious conditions put them up against lifetime limits or render them unable to afford what’s on offer in the high-risk pools, and are suddenly unable to get treatment.

Those deaths are not abstractions, and those who vote to bring them about must be held to account. This can and should be a career-defining vote for every member of the House. No one who votes for something this vicious should be allowed to forget it — ever. They should be challenged about it at every town hall meeting, at every campaign debate, in every election and every day as the letters and phone calls from angry and betrayed constituents make clear the intensity of their revulsion at what their representatives have done.

I second all of Waldman’s recommendations there: town hall meetings, public forums, letters, phone calls, etc. But those are only a starting point. Just as this legislation audaciously exceeds almost anything we’ve ever seen in terms of its harm and its malice, so too must our response exceed almost anything we’ve ever seen or done before.

It’s time to read up on ACT UP. They knew how to flood all the usual, proper channels of protest and constituent calls, and then they went beyond that. They made their protests and their voices inescapable, omnipresent. Lawmakers who fled the sit-ins in their offices went home to find a full choir on their lawn.

I joked on Twitter about a Kickstarter to fund hiring Hannah Waddingham — in full Septa Unella costume — to follow Paul Ryan around ringing her “Shame!” bell. Forever.

shame-gif-1465520937

The idea of a Kickstarter or of hiring the actual Game of Thrones actress to do this was a joke. The idea that such relentless, 24/7 shame is what the disgraceful Ryan deserves is not a joke. Not at all. Nor is the determination to make that happen.

Here is the list of the 217 Republicans who voted to harm millions of their fellow Americans. It’s not enough to fight to ensure that none of them gets re-elected. The goal should be to ensure that none of them any longer even has the strength or the will to attempt to run again. Seeing them ousted in a 2-to-1 landslide a la Rick Santorum is the fall-back position. The aim is to see them all resign in disgrace — to remind them of that self-inflicted disgrace so loudly and constantly and persistently that they, even they, will come to realize the enormity of it.

Fill their voicemail boxes. Fill their inboxes. Visit them. Camp out in front of their offices. Get yourself known by first-name by every member of their staff. Learn their favorite restaurants and camp out there. Ring some bells.

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