It might be useful to also analyze how loss of care affects longer term overall health care costs. Do more people end up in the emergency room for care? If so, do health care costs increase overall and drive up insurance costs for everyone. Maybe these arguments would be more/additionally persuasive among those who don’t feel as morally inclined.
Thank you for laying it out. As a healthcare provider in a southern state I am very concerned about what is going to happen to my patients, their families, and our rural safety net hospitals. My entire Congressional delegation predictably voted for this bill, and they did not even play hard to get like Murkowski and get something out of it.
I have a severely autistic, intellectually and developmentally disabled adult son, in his late 30s. He has been determined disabled by SSA four (4) times. First, when he qualified for SSI at age 18. Next, when he qualified for SSDI after accumulating enough disabled work quarters (fewer than 40), at the rate of 7 hours per WEEK and with a 1:2 job coach all the time, thanks to his day program which offers Supported Employment 2 days a week. (A Medicaid waiver program.) Third, when he qualified as a disabled adult for a chunk of my own SS when I retired and started drawing it. And fourth, when my husband did the same, and his check increased by $20 per month. I even asked if he could keep the smaller check, based on my retirement, instead of getting the extra $20 a month based on my husband's, and not have to submit the paperwork again. The answer was no. His lifelong disability had to be redetermined at every step. Hint: it is not a close call.
Massachusetts automatically provides Medicaid health insurance to SSI recipients. So when he lost his SSI for being over income from his own SSDI and our SS retirement, he had to qualify for MassHealth/Medicaid on his own. Yes, we had to yet again establish his FROM BIRTH, LIFELONG DISABILITY. It took the disability determination office 4 months to process the 70 pages of application and documentation required. And now the feds want me to do this twice a year instead of ONLY once.
I wish we could all wake up one day and he was suddenly not autistic. That would be wonderful. Autism is not his superpower, it's his lifelong disability. Maybe this process could be simpler? No, we're going to make you go through it over and over again, more slowly now because there are not enough systems and people in place. Some people will go without care while they wait months or years, and are incorrectly denied. And the paperwork burden will have to pass to someone else when caregivers are dead and gone.
2:49 pm Central 212 to 212 vs 8 Repubs NV as Chris Erickson shifted from NV to Nay. Repub speaker Mike Johnson lacks the votes to proceed?
2:54 shifted to 213 Yay vs 212 Nay, with 7 NV. They are presumed to still be talking things out beforehand, as may not get much time to discuss once official vote starts.
4:30ish Central, 5;30ish DC, Yays rose to 216. 4 NV
At 1ish Wed, CbsNews had Face the Nation report. Reporter said House voting difficult, as storms delayed re-arrivals into DC, one Rep's return taking 14 hrs. Reporter noted the July 4 deadline by Pres T is artificial, invented by him.
First vote "procedural", whether to "consider the Resolution", presume that means what came in from the Senate, but am not an expert here, am learning as I go. Think "Yay" means consider the resolution as is, as it came from the Senate, while "Nay" means we need to talk about what the Senate changed and make our own changes before we vote. Of over 400 allowed to vote, its 181 to 203, with 181 saying Yea, while 203 say Nay (let's talk first), That makes a total of 384 taking a side, with 48 NV for "not voting", The NVs were 9 of the Dems and 39 of the Repubs. Not clear on reasons for Not Voting (not present yet? abstaining? or want to hear more before committing.?)
Darn, looks like our maga-loving nephews are going to lose their health insurance again (maybe except for the one still in prison). Back to Trumpcare (aka GoFundMe)...
Don’t be too impressed by Thom Tillis. He was Speaker of the NC House and voted against expanding Medicaid for NC, one of the few states not to expand Medicaid.
While the Medicaid cuts are problematic, the tax cuts must be extended, and the debt ceiling must be raised. Those are non-negotiable to all traditional Republicans. Everything else in the BBB is either an uncomfortable compensation (like the populist tax provisions on tips), gravy, or otherwise expendable.
Tillis isn’t needed to pass this bill. Collins will be given a pass, because she is up for reelection in 2026, and is the only blue state GOP Senator left. Rand Paul may vote No on the principle that the bill increases the deficit. That leaves 50 plus Vance. And that is how it will pass. Bet on it. The spice must flow, after all.
There was a time when the deficit was supposed to be non-negotiable to Republicans. Did you forget to mention that part or is that no longer a traditional Republican value? “The spice must flow” comes from a book about feudalism, is that also a Republican value?
As Dick Cheney said, Reagan proved deficits don’t matter. I’m definitely not a deficit hawk. But, thanks for the history lesson on my quote. Most people think that came from the original Dune movie.
I live in the NC6 where Salisbury is and emailed the article to our Rep with a brief message. Dunno if it will help but it should. Very good reporting. Thank you!
I'm in Asheville, a blue dot on this overwhelmingly red region that's still struggling to recover after Helene. WNC is always one of the poorer regions in the state, and hospital closings and loss of coverage that will devastate wherever they happen will add that devastation to the already insane burden of trying to rebuild people's housing, infrastructure, and economy.
this lousy bill will create mass suffering all over the country, but right here it will make already dire conditions worse, as it will in every region in America that's already struggling to provide medical care to at-risk populations.
We already know that efforts to reduce fraud via constant requests to prove that one is trying to work are counter productive. That is the admin costs exceed the savings.
If we hear what conservatives are concerned with, they are worries that Medicaid has expanded beyond its original mission.
But so what? Yes it did expand and the expansion works to help the working poor get health care.
But expecting conservatives to acknowledge the truth or to accept change is a fools errand.
Medical debt accounts for 66% of bankruptcies (last I checked). I would expect to see some outcomes from the bill such as: percentage of medical bankruptcies will increase;. many people will forgo care and end up in emergency rooms or worse; hospitals and community health centers will continue to provide health care to uninsured, increasing their uncovered costs. The people impacted likely have zero ability to ever pay back their medical debt. The end financial result will be that we (employers and employees) will all be paying even more for our insurance premiums to cover all this.
Hospital and community health centers will close in the most vulnerable areas in the country. American will fill up with health care deserts. We’ll be in a great position for RFK Jr’s first epidemic.
It might be useful to also analyze how loss of care affects longer term overall health care costs. Do more people end up in the emergency room for care? If so, do health care costs increase overall and drive up insurance costs for everyone. Maybe these arguments would be more/additionally persuasive among those who don’t feel as morally inclined.
Thank you for laying it out. As a healthcare provider in a southern state I am very concerned about what is going to happen to my patients, their families, and our rural safety net hospitals. My entire Congressional delegation predictably voted for this bill, and they did not even play hard to get like Murkowski and get something out of it.
I have a severely autistic, intellectually and developmentally disabled adult son, in his late 30s. He has been determined disabled by SSA four (4) times. First, when he qualified for SSI at age 18. Next, when he qualified for SSDI after accumulating enough disabled work quarters (fewer than 40), at the rate of 7 hours per WEEK and with a 1:2 job coach all the time, thanks to his day program which offers Supported Employment 2 days a week. (A Medicaid waiver program.) Third, when he qualified as a disabled adult for a chunk of my own SS when I retired and started drawing it. And fourth, when my husband did the same, and his check increased by $20 per month. I even asked if he could keep the smaller check, based on my retirement, instead of getting the extra $20 a month based on my husband's, and not have to submit the paperwork again. The answer was no. His lifelong disability had to be redetermined at every step. Hint: it is not a close call.
Massachusetts automatically provides Medicaid health insurance to SSI recipients. So when he lost his SSI for being over income from his own SSDI and our SS retirement, he had to qualify for MassHealth/Medicaid on his own. Yes, we had to yet again establish his FROM BIRTH, LIFELONG DISABILITY. It took the disability determination office 4 months to process the 70 pages of application and documentation required. And now the feds want me to do this twice a year instead of ONLY once.
I wish we could all wake up one day and he was suddenly not autistic. That would be wonderful. Autism is not his superpower, it's his lifelong disability. Maybe this process could be simpler? No, we're going to make you go through it over and over again, more slowly now because there are not enough systems and people in place. Some people will go without care while they wait months or years, and are incorrectly denied. And the paperwork burden will have to pass to someone else when caregivers are dead and gone.
2:49 pm Central 212 to 212 vs 8 Repubs NV as Chris Erickson shifted from NV to Nay. Repub speaker Mike Johnson lacks the votes to proceed?
2:54 shifted to 213 Yay vs 212 Nay, with 7 NV. They are presumed to still be talking things out beforehand, as may not get much time to discuss once official vote starts.
4:30ish Central, 5;30ish DC, Yays rose to 216. 4 NV
Live at Youtube 2:20-2;25ish Chicago time, amended for re-vote--211 Yea, 212 Nay, (NV 9 Repubs)
At 1ish Wed, CbsNews had Face the Nation report. Reporter said House voting difficult, as storms delayed re-arrivals into DC, one Rep's return taking 14 hrs. Reporter noted the July 4 deadline by Pres T is artificial, invented by him.
First vote "procedural", whether to "consider the Resolution", presume that means what came in from the Senate, but am not an expert here, am learning as I go. Think "Yay" means consider the resolution as is, as it came from the Senate, while "Nay" means we need to talk about what the Senate changed and make our own changes before we vote. Of over 400 allowed to vote, its 181 to 203, with 181 saying Yea, while 203 say Nay (let's talk first), That makes a total of 384 taking a side, with 48 NV for "not voting", The NVs were 9 of the Dems and 39 of the Repubs. Not clear on reasons for Not Voting (not present yet? abstaining? or want to hear more before committing.?)
Outstanding reporting, Jonathan. Telling the stories of real people in NC puts a face on this awful bill.
Darn, looks like our maga-loving nephews are going to lose their health insurance again (maybe except for the one still in prison). Back to Trumpcare (aka GoFundMe)...
Don’t be too impressed by Thom Tillis. He was Speaker of the NC House and voted against expanding Medicaid for NC, one of the few states not to expand Medicaid.
While the Medicaid cuts are problematic, the tax cuts must be extended, and the debt ceiling must be raised. Those are non-negotiable to all traditional Republicans. Everything else in the BBB is either an uncomfortable compensation (like the populist tax provisions on tips), gravy, or otherwise expendable.
Tillis isn’t needed to pass this bill. Collins will be given a pass, because she is up for reelection in 2026, and is the only blue state GOP Senator left. Rand Paul may vote No on the principle that the bill increases the deficit. That leaves 50 plus Vance. And that is how it will pass. Bet on it. The spice must flow, after all.
There was a time when the deficit was supposed to be non-negotiable to Republicans. Did you forget to mention that part or is that no longer a traditional Republican value? “The spice must flow” comes from a book about feudalism, is that also a Republican value?
As Dick Cheney said, Reagan proved deficits don’t matter. I’m definitely not a deficit hawk. But, thanks for the history lesson on my quote. Most people think that came from the original Dune movie.
I live in the NC6 where Salisbury is and emailed the article to our Rep with a brief message. Dunno if it will help but it should. Very good reporting. Thank you!
I'm in Asheville, a blue dot on this overwhelmingly red region that's still struggling to recover after Helene. WNC is always one of the poorer regions in the state, and hospital closings and loss of coverage that will devastate wherever they happen will add that devastation to the already insane burden of trying to rebuild people's housing, infrastructure, and economy.
this lousy bill will create mass suffering all over the country, but right here it will make already dire conditions worse, as it will in every region in America that's already struggling to provide medical care to at-risk populations.
We already know that efforts to reduce fraud via constant requests to prove that one is trying to work are counter productive. That is the admin costs exceed the savings.
If we hear what conservatives are concerned with, they are worries that Medicaid has expanded beyond its original mission.
But so what? Yes it did expand and the expansion works to help the working poor get health care.
But expecting conservatives to acknowledge the truth or to accept change is a fools errand.
Medical debt accounts for 66% of bankruptcies (last I checked). I would expect to see some outcomes from the bill such as: percentage of medical bankruptcies will increase;. many people will forgo care and end up in emergency rooms or worse; hospitals and community health centers will continue to provide health care to uninsured, increasing their uncovered costs. The people impacted likely have zero ability to ever pay back their medical debt. The end financial result will be that we (employers and employees) will all be paying even more for our insurance premiums to cover all this.
Hospital and community health centers will close in the most vulnerable areas in the country. American will fill up with health care deserts. We’ll be in a great position for RFK Jr’s first epidemic.
Yes, closure of rural health care facilities - hospitals etc is another likely outcome I forgot to add to the list. RFJK is an abomination.
Thank you for this reporting.
Thanks for highlighting our state, Jonathan. It will be devastating. But hey, the rich'll get richer, which is all that matters, right?