Earlier this month, Senate Minority Leader Chuck Schumer tried to turn Donald Trump's signature line – "Make America Great Again" – against him by saying that Trump was trying to "make America sick again." Though Schumer was talking specifically about the Republican attempt to repeal Obamacare, this slogan is becoming increasingly appropriate for the entirety of the GOP platform.
What other conclusion can we reach given the chief policy proposals being put forward by President-elect Trump and the leaders of his Republican Party? There's no definition of "great" that includes millions more people getting sick and dying. Yet, by all measures, everything they're proposing related to health will lead to just that.
Take what Schumer's referring to: Obamacare repeal. Though repeal is far from a certain outcome, the Republican-controlled Congress has taken the initial steps necessary to get rid of President Obama's signature legislative accomplishment. Various Republicans have developed half-baked proposals with which to replace Obamacare, but despite having almost seven years to do so, the party as a whole is as close to coalescing around an alternative plan as they are to finding Jimmy Hoffa's body. In other words, if they do anything, it's going to be repealing Obamacare without quickly replacing it – contrary to what they've recently promised.
What will that mean for Americans? On Tuesday, the Congressional Budget Office gave us the answer: If Obamacare is repealed, nearly 20 million people will lose their health insurance, in the first year alone. Factoring in the complete loss of Medicaid expansion and marketplace subsidies, that number would increase to 32 million.
If it's not obvious, losing health insurance is not just an inconvenience to Americans, but rather quite serious, if not outright deadly. An exchange captured last week between Paul Ryan and a constituent illustrates this: Jeff Jeans, who said he was a Republican who'd been opposed to Obamacare because he thought it would shut down his small business, explained to Ryan that, after he was diagnosed with cancer at 49, his life was saved because of the health care law. "Because of the Affordable Care Act, I'm standing here today," he said. "I rely on the Affordable Care Act to be able to purchase my own insurance. ... I want to thank President Obama from the bottom of my heart, because I'd be dead if it weren't for him."
Trump campaigned on blaming Obamacare for increased health insurance premiums. But the second conclusion from the CBO's report finds that, relative to Obamacare's current framework, if it were repealed, premiums would increase by 20 to 25 percent in the first year of repeal. When Medicaid expansion and marketplace subsidies are eventually eliminated, premiums would almost double.
Tens of millions of Americans losing health insurance, and those with health insurance seeing huge increases in their premiums: that's a disastrous path for American health care.
But it's not only the repeal of Obamacare that will lead to a sicker America. Everything the Republican Party says it wants to do with respect to reproductive health, abortion and trans health care points in the same direction.
The most prominent GOP proposal in this area is to defund Planned Parenthood. This tagline policy is deceptive, as Planned Parenthood does not receive a lump sum from the federal government. Rather, like many other health care providers, when Planned Parenthood treats women who qualify under Medicaid and other federal programs, Planned Parenthood is reimbursed for the services. These reimbursed services – which, because of federal law, do not include abortion – do include other critical services like pap smears, mammograms, STI testing and other routine and non-routine reproductive health care.
The proposed federal law would disqualify Planned Parenthood from being reimbursed for these services. This would affect roughly 2.5 million people who obtain their health care from Planned Parenthood and would have devastating effects, especially for people of color, indigent people, and people in rural areas, all of whom rely heavily on Planned Parenthood's services.
We know this because it's already happened in Texas and Wisconsin. Both of those states have cut state funding for Planned Parenthood, resulting in clinics closing throughout both states. The theory that the states advanced was that community health centers would serve the patients Planned Parenthood used to serve. However, in neither state is there evidence that this has happened. In fact, health officials in both states have seen an increase in STDs, a rise in unplanned pregnancies and longer wait times for services.
If this were replicated nationwide, Planned Parenthood's chief medical officer told The Guardian there would "truly be a national healthcare disaster."
But wait, there's more. Republicans have talked about rolling back requirements that health insurers cover contraception, a key form of preventive medicine for women. Abortion restrictions likely to be tackled by the new Congress would put women's health and safety at risk. And on New Year's Eve, Republicans won a court victory blocking a federal rule from taking effect that would have prohibited discrimination against trans individuals in health care, as well as women who previously had abortions.
Add it all up, and the message is clear. Republicans aren't making America greater; they're making us sicker.