The GOP's secret health care agenda

In the campaign's waning days, top Democrats have wrongly focused on potential attacks on Medicare and Social Security

The abortion issue has all but disappeared in the nation’s media in the weeks leading up to election day even though virtually every Democratic candidate running for office is proclaiming they will protect a woman’s right to choose. Instead, the press has focused on what might happen to Medicare in a Republican-run Congress.

I blame the Democratic Party’s top leaders and their high-priced consultants for that. With the polls showing inflation as the top voter concern, and races across the country, including ones Democrats were expected to win, tightening up, they’ve turned to raising the specter that a Republican-dominated Congress will attempt to cut Medicare and Social Security. They warn a GOP majority could use the pending debt limit negotiations to hold the country hostage until they get their way.

Those with long memories are remembering how Newt Gingrich (R-GA), during the run-up to the 1994 election (President Bill Clinton’s first mid-term election), vowed to make such cuts. Paul Ryan (R-WI) similarly vowed to take on so-called entitlements ahead of the 2010 election (President Barack Obama’s first mid-term election). Neither succeeded despite winning large majorities in Congress.

Big spenders

In fact, Republicans are responsible for some of the largest expansions of Medicare spending in the past few decades. President George W. Bush signed the taxpayer-financed prescription drug benefit into law in 2003, but only after pharmaceutical industry lobbyists won provisions that prevented the government from negotiating drug prices. Most Democrats backed giving the government that authority.

Republicans in Congress have always been the biggest supporters of insurance industry-run Medicare Advantage plans. They continue to claim the privatized plans, which could cover more than half of seniors after this year’s open enrollment season, will save taxpayers money. It never has. It has always led to more spending for individual beneficiaries in those plans compared to traditional Medicare, not less.

Medicare Advantage ads like this one disguise the insurance industry’s role in running the plans.

In this year’s election, Republican candidates are vowing to repeal the Inflation Reduction Act, which contains the government’s first ever price limits on prescription drugs. The Congressional Budget Office projected the law, which also limits seniors’ out-of-pocket expenses, will save the government $288 billion over the next ten years. Not a single Republican voted for the bill.

The bottom line is that Republicans have consistently supported more Medicare spending as long as it is guaranteed to flow into corporate coffers.

The secret agenda

A Republican takeover of Congress will be a disaster on many fronts, most importantly, the threat the party now poses for our democracy. The vicious assaults on minority, immigrant and LBGTQ rights will expand. Congress will become a shitshow of investigations into trumped-up election fraud charges. There will be McCarthy-ite attacks on Democrats and liberals, culminating in the impeachment of the president.

I am less worried about some secret agenda to slash Medicare and Social Security spending. Given seniors’ voting power, advancing that agenda in the halls of Congress would all but guarantee President Biden’s reelection in 2024.

Rather, look for a Republican-run Congress to attempt to gut Medicaid by turning it into a block grant, which Gingrich and Ryan pursued without success the last two times the GOP controlled Congress. When it comes to governing, there’s nothing that brings more joy to the heartless body of the Republican Party than picking on the poor.

Meanwhile …

There’s one thing we can be sure of. If Republicans win control of Congress after tomorrow’s vote, it will be seized on by abortion opponents as ratifying the biggest change in American health care since the creation of Medicare and Medicaid in 1965.

In the few months since the Supreme Court overturned Roe v. Wade, over 20 million women or nearly one in three American females between 15 and 44 have lost the right to obtain an abortion if they need one. An equal number live in states that are hostile to abortion rights, according to the Guttmacher Institute.

That 40 million is about equal to the number of Medicare beneficiaries in 2003 when Congress passed the prescription drug benefit. It is twice the number of people who benefited from the insurance expansion in the 2010 Affordable Care Act. Unlike those health care expansions, the Dobbs v. Jackson Women’s Health Organization decision restricts access to necessary health care.

The U.S. has become a radical outlier when it comes to reproductive health rights. Around the world only 24 countries, most of them poor or less developed, ban abortion. They contain just 91 million or 6% of the world’s women of reproductive age. While many countries place restrictions on the procedure, an overwhelming majority of nations allows abortion at least during the first trimester of pregnancy, which accounts for well over 90% of abortions in the U.S.

The high court’s decision giving states the right to ban or severely restrict abortion has already increased that worldwide number by at least 25%. By the end of next year, with Republicans firmly in control of both the legislative and executive branch in at least 23 states and possible more after Tuesday’s results, the number of American women of reproductive age losing access to abortion could rise to 40 million, a 33% increase in the worldwide number.

Ponder this: If you’re a woman in the Philippines, Congo, Iraq, Texas or Tennessee, your reproductive health rights are the same.