An odd thing often happens in the national media as a vote on major legislation begins to draw nigh. The press coverage of the bill — even a bill that threatens to strip health care from tens of millions of people — gets much narrower. Outlets focus on whip counts, obsessing over the parochial concerns of the most marginal members of Congress. Controversies over relatively minor parts of the bill dominate the coverage — because those controversies matter to a single undecided lawmaker.
Right now, for example, there’s a huge amount of attention focused on the “Upton Amendment,” which will slightly alter the amount of funding available to offset harms caused by other parts of the bill. This amendment is an $8 billion tweak to a $1.2 trillion health bill that’s unlikely to have a significant policy impact on the legislation as a whole. It would only alter the bill’s financial footprint by 0.66 percent.
Nonetheless, the Upton Amendment is a Really Big Deal right now because it appears to have transformed Reps. Fred Upton (R-MI) and Billy Long (R-MO) from “no” to “yes” votes on the legislation.
The problem with this kind of coverage is that it tends to obscure the big picture. Members of Congress aren’t really arguing over a small amendment favored by Mr. Upton — they are arguing over a massive overhaul of the American health system that has the potential to endanger thousands of human lives and to immiserate millions.
So let’s put the focus back where it belongs. Here’s what will happen if the American Health Care Act becomes law:
- Tens of millions of Americans will lose health coverage: The non-partisan Congressional Budget Office (CBO) estimates that 24 million people will lose health insurance by 2026 under an earlier version of Trumpcare. The Trump White House, meanwhile, estimates that 26 million will lose coverage over the next decade. And since Congress is currently debating a somewhat altered version of the bill that is harsher to people with pre-existing conditions, it is likely that the real number is even higher.
- Tens of thousands of people will die every year who otherwise would have lived. A study of Massachusetts’ health reforms determined that “for every 830 adults gaining insurance coverage there was one fewer death per year.” If this figure is applied to the estimated 24 million who will lose health insurance under Trumpcare, that amounts to nearly 29,000 preventable deaths in 2026 alone among people who don’t have access to the medical care they need.
- The poorest Americans will be the hardest hit. Trumpcare will reduce Medicaid spending by an estimated $880 billion over the next decade, according to the CBO. That’s a whole lot more than the cost of the Upton Amendment.
- People with pre-existing conditions will suffer. The “MacArthur Amendment” to Trumpcare allows states to opt out of many of Obamacare’s protections for people with preexisting conditions. As a result, many individuals will no longer be able to obtain coverage.
- Donald Trump make out like a bandit. While there are many losers under Trumpcare, there is one big winner — the rich.
Of course, it’s understandable that many reporters are dwelling on minor matters like the Upton Amendment. The Upton Amendment is new news. The fact that Trumpcare strips health care from millions of people has been known for a while.
But the fact that Fred Upton just flipped his vote due to a small change to the underlying bill is hardly the most salient thing that news consumers need to know right now in order to assess the merits of Trumpcare.
Congress isn’t simply debating some minor amendment. It isn’t debating whether a single lawmaker can be coaxed to vote yes by a little more federal funding. It isn’t debating whether a phone call from Mike Pence will convince some backbencher into supporting the bill.
It is debating whether to put the health and lives of millions of people at risk in order to line the pockets of the rich.