Thursday, March 23, 2017

A Picture Worth A Thousand Words. Or Who Needs Mammograms.


A picture is worth a thousand words, they say*.  This one is about today's meeting between our Dear Leader and the so-called Freedom Caucus, an arch-conservative wing of the Republican Party which wants freedom for themselves only.  A central topic in the meeting:

Whether or not maternity care and mammograms should be considered "essential" treatments covered by all health insurance policies under the Republican proposal. ("I wouldn't want to lose my mammograms," quipped Sen. Pat Roberts (R-Kan.), who supports scrapping the requirement. He apologized.)



The probability of breast cancer in that particular room is, of course, lower than the probability of prostate cancer.

It would be hard to find a better example why diversity in the corridors of power is important.

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* We are so inured seeing men as the default humanity that a picture of a large demonstration or protest in the Middle East, say,  showing nothing but men is routinely captured as "people protesting/demonstrating."  And we are certainly extremely accustomed to seeing only men in most pictures depicting people in power, with a few exceptions (such as Angela Merkel) who stick out because of being exceptions.

In the US this homogeneity also has a racial and ethnic characteristic.  But women tend to be absent in most countries of the world when power is depicted.  A few examples:

From China:



And from Saudi Arabia (about the founding of an organization to help young girls be their best):


How The Conservatives View Childbirth And Its Costs: Lessons from the Trump Care Debacle


The approach conservatives of all stripes take when it comes to having children is extremely weird, and I do mean extremely.  They interpret childbirth from three utterly and completely different angles:

1.  The race and religious wars angle, which demands that white and/or Christian women maximize the number of children they can possibly have.  The Quiverfull movement is an example of that line of thinking in the religious context:  Children are arrows in the man's quiver, of course prepared by their women.  Women are part of the war artillery and must keep shooting out babies. 

2.  The forced-birth angle, which values the lives of people extremely highly before they are born but pretty much not at all after they are born.  Because of the immense value of fetuses, women, in general, have the value of containers for the fetuses.  Decisions about children, before birth, are socialized.  Decisions about children, after birth, are privatized, and even that is viewed narrowly as the obligation of only their mothers.

3.  The children as ice-cream cones angle.  This is the one which comes up whenever people debate whether firms should provide maternity leave for childbirth or paid parental leave.  It also crops up whenever there's discussion about how the reason why women earn less, on average, is related to their childbirth and child-rearing duties.

In those situations you will hear conservatives pipe up about "choice."  If women "choose" to have children, well, they must expect to bear the costs of that choice all alone, just as others are not expected to pay for their BMWs.  From this angle childbirth is something private,  like buying a new pair of shoes, something which has nothing to do with the reproduction of the next generation.  There's certainly no need for the employers to coddle women by providing them with maternity benefits!  What are they going to demand next?  BMW vacations?

From that third angle, children are conceived through parthenogenesis and all costs and burdens of childbearing should fall on only their mothers.

I may have exaggerated a little here, but not a lot.  The basic rule in all of them is an attempt to socialize the benefits of children (as the conservatives view them) but to privatize all costs of children.  The women giving birth are regarded as the only people truly responsible for the costs of children.

The most recent example of 3.  can be found in what White House secretary, Sean Spacer, said:

White House press secretary Sean Spicer on Thursday defended a newly promised provision in the GOP plan to repeal and replace Obamacare by saying that older men "can generally say" they will not need coverage for maternity care.
Republican leaders on Thursday signaled to hardline conservatives that the Senate may add a provision to the bill gutting Obamacare's Essential Health Benefits (EHB) rule, which mandates that insurance plans cover a basic minimum of health care services, including maternity care.
"A lot of people buy insurance not knowing what they're going to need," RealClearPolitics reporter Alexis Simendinger noted to Spicer during his daily briefing.
"Well, I think if you're an older man you can generally say you're not going to need maternity care," Spicer replied.
Such fun.  Unless that older man in the example is one of us divines, he was once born and needed obstetric care.


P.S.  If you are interested in knowing the parts of health insurance that I am never going to use, check out my two earlier posts on this topic.



Wednesday, March 22, 2017

The Neil Gorsuch Hearings



They should not have taken place at all, given that Merrick Garland was appointed by a lawfully elected president and never got a hearing.  If being a lame duck president is a valid excuse for something like that, then surely we have much  more valid excuses for refusing to give Gorsuch a hearing, what with the Russian connections, under investigation, and the possibility that Vlad "the Impaler" Putin put a finger or two on those election scales?  Whose candidate IS Gorsuch, after all? 

Well, we know that he is the candidate of the corporations and the extremely wealth handful of extremist right-wing families which fund most of our politics now:  The Koch brothers, the Mercer son-and-daughter, and so on.  But did any foreign power affect that particular choice?

That's preposterous from me.  Of course it is, but we live in an era where sarcasm is impossible, because what is happening is so much more extreme than most things I can create in the sick part of my brain.

Back to Gorsuch.  He is also the candidate of the forced-birthers, of course.  Then there are the questions how he views the rights of pregnant women, based on a law class he held.

One of the students who were present in that class, Jennifer R. Sisk, stated this:

H]e asked the class to raise their hands if they knew of a female who had used a company to get maternity benefits and then left right after having a baby. Judge Gorsuch specifically targeted females and maternity leave. This question was not about parents or men shifting priorities after having children. It was solely focused on women using their companies.
I do not remember if any students raised their hands, but it was no more than a small handful of students. At that point Judge Gorsuch became more animated saying “C’mon guys.” He then announced that all our hands should be raised because “many” women use their companies for maternity benefits and then leave the company after the baby is born.

When one student objected that employers can’t ask about family plans during a job interview, Sisk said Gorsuch denied that this was true: “Instead Judge Gorsuch told the class that not only could a future employer ask female interviewees about their pregnancy and family plans, companies must ask females about their family and pregnancy plans to protect the company.”
The university later confirmed to the committee that Sisk had raised these objections with them shortly after the class discussion.

Gorsuch, when asked about this incident at the hearings, insisted that his point had been the reverse:

Instead, Gorsuch said, he asked for a show of hands of how many students had been asked “an inappropriate question about your family planning” in an employment context.
“I am shocked every year how many young women raise their hand,” Gorsuch said.
Gorsuch also dodged questions from Durbin about whether he thinks it’s legally inappropriate to ask questions like these, and whether a company should be able to take a woman’s family choices into consideration during the hiring process.
Nor did Gorsuch address Sisk’s claims that he had told his law class companies must ask women these questions out of protection.

Hmm.  Won't it be wonderful when Gorsuch removes his hearings-mask and reveals his true opinions about whose side he might take in a legal case where the two sides are corporations and pregnant women?  I can hardly wait, sigh.

P.S.  I have earlier written about  parental leaves as a reason for firms not to hire young women.  Some of those problems could be removed or reduced by requiring new fathers to take some parental leave, too, and in those countries where the employers pay some of the costs of parental leave, requiring that the employers of the man who fathered the child chip in half the money.







  


Monday, March 20, 2017

Comey, Redux


This matters:





It's hard to think of another explanation for the different treatment of the Republican and Democratic emails except for Putin's desire to see Republicans and Trump in power.  His desire not to see Democrats and H. Clinton in power boils down to the same thing.

I have sometimes wondered how Comey sleeps at night, given that at least one analysis suggests that he gave us Trump by insinuating some dreadful law-breaking on Hillary Clinton's part, only about a week before the elections.

But then I remember that if one feels no particular love for democracy or peace or suffers from any other soppy values, well, that one can probably sleep sweetly.
And imagine his fame if Trump starts WWIII!  Comey would be in every history book or their future equivalents, assuming there would be a future.  Other than for cockroaches.

About Draining That Swamp...


Of lobbyists, which our Dear Leader promised to do:

Former House speaker Newt Gingrich (R-Ga.), a Trump adviser, said the president needs to dispatch political allies to the agencies to monitor a bureaucracy that’s being targeted for reduction.
“If you drain the swamp, you better have someone who watches over the alligators,” Gingrich said. “These people are actively trying to undermine the new government. And they think it’s their moral obligation to do so.”
At the Transportation Department, former Pennsylvania lobbyist Anthony Pugliese shuttles back and forth between the White House and DOT headquarters on New Jersey Avenue SE, according to an agency official. His office is just 20 paces from Secretary Elaine Chao’s, the official said.


And

Many of the senior advisers lack expertise in their agency’s mission and came from the business or political world. They include Trump campaign aides, former Republican National Committee staffers, conservative activists, lobbyists and entrepreneurs.


Bolds are mine.

The linked article is not about draining the swamp, though of course Newt must  mention the alligators!  It's about having political aides patrol the various departments to see if everybody sings from the same songbook and if everybody is faithful to the Dear Leader!

Still, I found the bits I quote fun.  As fun as the way Trump has leapt into bed with the Wall Street while accusing Hillary Clinton of that all through his campaign.  Well, the pre-election part of his campaign.  He keeps having victory rallies even now...


Saturday, March 18, 2017

Saturday Snacks for Thought: On Citizens United, Religious Fertility Wars and Some Fun


1.  Jane Mayer has written an excellent and important piece about the longer-term consequences of the Citizens United Supreme Court decision which gave every dollar the same political power.  Most of us could foresee what that might mean:  The very rich can now legally buy almost any administration they wish and create almost any laws they want.

And Mayer shows us, very carefully, how that led to Trump and the large number of white supremacists and possibly even a Nazi or two in his administration.  These shadowy super-billionaires Mayer writes about, using Mercer as her example, are the true deep "state" in the United States, our true overlords.

Granted, we still have voting for the hoi polloi, though it's more and more restricted for the black Americans every day.  But if you think of voting somewhat like picking a meal in a restaurant, remember that it's people like Mercer who wrote the menu, who decided what dishes should be on it.


Friday, March 17, 2017

A Question to My Readers



What kind of posts would you like more of on this here blog?  The Trump era creates an abundance of possibilities, and I find it hard to know where to focus my endeavors.

Merkel's Girl Cooties And Our Dear Leader



This is deliciously funny:  Our Dear Leader had to sit down with a female leader, a woman not picked to be near her merely based on her looks or genetic kinship, and he seems to have refused to shake hands with her.  It's those girl cooties.  They might infect this germophobic leader!

Or it could be that Trump is following the most conservative rules about men not being allowed to shake hands with women in some interpretations of Islam, because sexual desire might then result in wanton behavior!

Just kidding.  But here's a picture of the two world leaders:  One the new leader of the liberal West*, the other the new leader of pre-fascist West:





I love the body language in the picture.  The way Trump tries not to connect with Merkel, the way she is turned to him while he tries to turn away and narrow his body so that there would be no possible contact.  And yes, of course the picture might be those weird ones where someone is caught in mid-action and looks nothing like what actually happened.

But then there is this:

The body language was at times awkward. In an earlier photo opportunity in the White House, Mrs Merkel asked him quietly: "Do you want a handshake?" He looked forwards with his hands clasped and did not reply.

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*  The term "liberal" is not used here in its common American meaning.  Merkel is politically fairly conservative, something like a Blue Dog Democrat in the states.

The Vetting of Sebastian Gorka


I followed the Trump campaigns and rallies fairly closely last fall, but I never saw the coming of the Breitbart reign or the direct influence of so many white male supremacists in the administration.  It's as if they skittered and crawled out of the woodwork after Trump's victory, and suddenly we have the apocalyptic (in the sense of wanting one) Stephen Bannon as Trump's chief strategist.

But he is not the only extremist right-wing pseudo-Christianist white patriarch in the Trump administration.  Sebastian Gorka is most likely another one, maybe even a neo-Nazi.

You can decide for yourself by reading this interesting series of articles, in the order I link to them:  Begin with this one, read Gorka's answer and then the response from the author(s) of the original piece.  

An Atlantic article suggests that Gorka's presence in the administration at least demonstrates poor White House vetting skills.  The alternative explanation is, of course, that Gorka is exactly the kind of person Trump wants in his team.  Both are troubling possibilities.

So Trump lifted a rock and all sorts critters crawled out from under it.  This has echoes in the recent apparent rise in hate crimes, including the anti-Jewish and anti-Muslims threats.  Or so I believe.  It's as if such crimes are now more acceptable.  After all, the administration itself doesn't seem to mind.


Thursday, March 16, 2017

Parsing Mulvaney on The Budget: Hard And Stupid Words


Mick Mulvaney, Trump's budget director, speaks like a manly man's man:*

“It is not a soft-power budget,” Mulvaney explained. “This is a hard-power budget, and that was done intentionally. The president very clearly wants to send a message to our allies and to our potential adversaries that this is a strong-power administration.”

STEM fields used to be called hard sciences, humanities soft.  The terms were intended to be derogatory to humanities, but they also captured a gendered flavor, given that the researchers in the former were mostly men and many in the latter were women:  Real men get hard!  Real men do hard stuff!  Girly men and girls can't get hard and can't get clear results.

Even if you don't agree with that comparison, it's exceedingly clear that Mulvaney talks war-talk.  Trump wants to show the world that the US military spending is insufficient, because it only amounts to spending as much as the next seven countries put together.

That's not hard enough!  Let's spend more than the rest of the whole world!  Let's spend double that!

For what purpose?  To protect Americans from death?  The same budget tells us that Trump does not want to do that.  After all, he is cutting medical research and scientific research, the kind of basic research which corporations cannot perform, the kind of basic research that might find cures for all the current killer diseases.

And he is cutting help to the poor.  That those cuts would also apply to Meals On Wheels**, a program which helps some frail elderly stay longer at home and provides them with proper nutrition,  is not surprising, given what Trump's health insurance plan taught us about the age of those most likely to be unable to afford insurance in it: Older individuals.  But do note that this "hard-power," "strong-power" budget plans to pay for more military might by skinning the weakest, oldest and frailest among us.

Mulvaney explained how the programs and contributions to be guillotined were picked:

White House budget chief Mick Mulvaney on Thursday defended the Trump administration’s proposed deep cuts to social welfare programs such as Meals on Wheels and after-school services, saying it’s unfair to taxpayers if such programs don’t show hard results.
“Meals on Wheels sounds great,” Mulvaney said during the White House news briefing, adding that “we're not going to spend [money] on programs that cannot show that they actually deliver the promises that we’ve made to people.”

Did this man's brains leak out without him noticing?  And notice that "hard" word again:  Programs must show hard results.

How has the Meals on Wheels program failed to deliver?  Do the volunteers who transport the meals leave them somewhere en route?  Do they smear them on the walls or poison them with arsenic or what?

What are the hard results Mulvaney expects from a program such as after-school services or Meals on Wheels?  Should an elderly person sip the hot soup, suddenly rise up and do thirty pushups?  Should an after-school service produce PhDs from eight-year old children?  What is sufficiently hard or erect to qualify?

And if we use hard results to determine the budgetary allocations, it might be worth pointing*** that the military made a mess out of Iraq, that it lost the Vietnam war and that the US forces are still in Afghanistan which has not turned into a progressive paradise of equal rights for all.

This budget proposal is not going to be the final budget.  But it tells us what Trump has in his mind.  And that, my friends, is frightening.


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* Among the white supremacists and misogynists,  men who are viewed as not dominant and insufficiently oppressing are called cucks or beta males.  I'm sure the Alt Right and Bannon love this budget proposal.

**  The actual cut in federal aid are a fairly small percentage of the total funding of this nonprofit program and would not kill the program.  But clearly Trump's budget-makers never even noticed that the budget condoned the faster killing of frail elderly homebound individuals.

***  The blame belongs to those who make the decisions, of course.  My point is that the way Mulvaney explains what is to be cut could not explain why military spending is to be increased so much.  In a rational reality, that is.



The Trump Budget: Good News For All Sadists!


Now this budget is fun if you are a sadist.  It drowns the military in money so as to enable it to kill more people and it also withdraws money from those who are the weakest, frailest and the poorest among us.

It slashes the budget of the Environmental Protection Agency (EPA) thereby  revving up the speed with which climate change will make certain parts of the world inhabitable.  That, in turn, will increase the floods of migrants to countries which still remain habitable.  But the budget then cuts US assistance to refugee organizations as well as general foreign aid, including the Food For Peace program which provides food assistance in emergencies.

The State Department will also find its budget severely cut. This decreases the money available for diplomacy, but who needs diplomats when we have guns and will buy many, many more?

It kills the National Endowments for Arts and Humanities, because only the coastal latte-sipping liberals need culture which, in any case, is girly stuff.*  Guns are guy stuff.

The poor get to bear much of the burden of making the military sated with money:

While border guards will have more prisons to lock up unauthorized immigrants, rural communities will lose grants and loans to build water facilities and financing to keep their airports open. As charter schools are bolstered, after-school and summer programs will lose money. As law enforcement agents get more help to fight the opioid epidemic, lower-income Americans will have less access to home energy aid, job training programs and legal services.

And

Trump has unveiled a budget that would slash or abolish programs that have provided low-income Americans with help on virtually all fronts, including affordable housing, banking, weatherizing homes, job training, paying home heating oil bills, and obtaining legal counsel in civil matters.

During the presidential campaign last year, Trump vowed that the solution to poverty was giving poor people incentives to work. But most of the proposed cuts in his budget target programs designed to help the working poor, as well as those who are jobless, cope.

Ironically, the white working class voters in rural areas, deemed by some to have been the group which won the election for Trump** are among the ones who are going to be whipped by this budget:

The White House budget cuts will fall hardest on the rural and small town communities that Trump won, where one in three people are living paycheck to paycheck — a rate that is 24 percent higher than in urban counties, according to a new analysis by the center.

Perhaps they will not be too unhappy, given that the urban poor appear to be the special focus for this budgetary sadism:

The administration’s reforms include eliminating funding for a $3 billion Community Development Block Grant program, one of the longest continuously run HUD programs that’s been in existence since 1974.

The program provides cities with money to address a range of community development needs such as affordable housing, rehabilitating homes in neighborhoods hardest hit by foreclosures, and preventing or eliminating slums and community blight. It also provides funding for Meals on Wheels, a national nonprofit that delivers food to homebound seniors.

Robert Rector, a senior fellow who focuses on welfare at the Heritage Foundation, a conservative Washington-based think tank, calls the community block grants a “slush fund for urban government.”

During his campaigning Trump repeatedly promised to eradicate all poverty from low-income urban areas.  Is this the way he plans to achieve that?

The budget is unlikely to pass in its present form.  But it's a wake-up call for the new Trump Reich rules, a speech clearer than most of Trump's boasts on how he views the future of this country.

There will be a lot of aggressive posturing, money will not be spent on the poor but on a giant wall against the foreign poor.  Money will be spent on guns, not on plowshares, and money will be spent on preparing for war, not on preventing it.



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* Republicans have always wanted to kill these, always.  And the Corporation for Public Broadcasting is going to get less money, too, despite its sharp recent tilt toward a conservative bias.

It's worth noting here that if Trump didn't take a Florida vacation most every weekend, we could afford to keep the National Endowments for Arts and Humanities.  But as I noted in the text, culture is girly crap.

** In the sense of the straw that broke the camel's back.  The vast majority of Trump voters were the same Republicans who voted for Romney in 2012, and we should not forget this.

Still, Trump is not honoring some of his promises that he gave at the rallies where he was adulated:

Parts of the budget proposal also appear to contradict Trump’s agenda. Trump has said he wants to eliminate all disease, but the budget chops funding for the National Institutes of Health by $5.8 billion, or close to 20 percent. He has said he wants to create a $1 trillion infrastructure program, but the proposal would eliminate a Transportation Department program that funds nearly $500 million in road projects. It does not include new funding amounts or a tax mechanism for Trump’s infrastructure program, postponing those decisions.


Tuesday, March 14, 2017

On Those Lower Insurance Prices After 2020 in (T)Rumpcare


The one thing Republican politicians like about the recent Congressional Budget Office (CBO) assessment of their replacement plan for the Affordable Care Act (ACA)  is that the CBO estimates a drop in the price of individual insurance after 2020.* 

The premia will rise until then, because of the predicted exit of many young-and-healthy individuals from the insurance market.  Under the ACA, the individual mandate demanded that they, too, should buy coverage, but under the (T)Rumpcare that mandate is removed.  The loss of many young, low-risk individuals will raise the average premia for those who remain in the individual market.

So what changes after 2020, to cause a drop in the price of individual insurance? 

Is it the greater price competition in the wonderful "free" markets, as conservatives usually argue?  This

House Speaker Paul Ryan pressed that point in a series of appearances Monday night, suggesting that the budget office had found that the House bill would increase choice and competition and lead to lower prices. The Senate majority leader, Mitch McConnell, issued a statement saying, “The Congressional Budget Office agrees that the American Health Care Act will ultimately lower premiums and increase access to care.”

Sadly, no.  This is how the CBO explains its conclusions about the dropping price of insurance:

Starting in 2020, the increase in average premiums from repealing the individual mandate penalties would be more than offset by the combination of several factors that would decrease those premiums: grants to states from the Patient and State Stability Fund (which CBO and JCT expect to largely be used by states to limit the costs to insurers of enrollees with very high claims); the elimination of the requirement for insurers to offer plans covering certain percentages of the cost of covered benefits; and a younger mix of enrollees. By 2026, average premiums for single policyholders in the nongroup market under the legislation would be roughly 10 percent lower than under current law, CBO and JCT estimate.

That quote gives three reasons for the decrease in average premia.  Let's look at them in a reverse order:

First, the CBO expects the enrollees to be younger, on average.  Now why would that be the case?  It's not because the US demographics are starting to tilt that way.  Rather, it will be a direct consequence of many older people exiting the insurance market, because they can no longer afford the premia.  Note that the tax credits (which would replace the income-tied subsidies in the ACA) are twice as large for a sixty-year old than a twenty-year old but the premium that can be charged to the former are allowed to be five times as large as the premium charged to the latter.  This combination can be devastating for poorer older individuals:

The C.B.O. estimates that the price an average 64-year-old earning $26,500 would need to pay after using a subsidy would increase from $1,700 under Obamacare to $14,600 under the Republican plan.

Note that the exit of the older, poorer and sicker individuals from the market is not because of greater consumer choice or greater competition or greater efficiency in the insurance marketplace.  It's a direct consequence of increasing the pool of the uninsured, and in one sense the price of insurance to that group is extremely high, so high that they are not buying any coverage.

The second reason for the CBO to predict lower premia after 2020 isn't about consumer choice, greater competition or greater efficiency, either, unless we interpret those concepts in an unusual way. 

That reason is that insurers no longer need to offer plans which cover a certain percentage of the cost of the covered benefits, which means that consumers get less coverage for any given level of premia.

Here's the 60,000 dollar question for you:  Has the price of insurance dropped if the bundle you are buying costs less, but also has a lot less insurance in it?  How can you tell?**

Finally, the CBO points out that the Republicans in power plan to give states grants from the Patient and State Stability Fund, and those grants can be used to pay for the care of high-risk consumers and/or for the subsidies of poor consumers.  They would reduce the average price of insurance in the individual market, true.  But Margot Sanger-Katz in the New York Times suggests that the Patient and State Stability Fund is set to expire after 2026.  Oddly enough, the CBO evaluation period conveniently ends at that year, too.

Thus, it's possible that these particular grants to the states would no longer help keeping the premia down in, say, 2027.

So what are we to conclude from all this? 

That none of the predicted decreases in the price of individual insurance are caused by greater price competition which then produces greater efficiency.  Instead, average premia might drop because many higher-risk older individuals become unemployed (while desperately counting days to the start of Medicare coverage), because the contents of some insurance bundles are watered down, and because of some price subsidies for high-risk and/or poorer individuals.

It's also worth reiterating that the average drop in the price of individual insurance doesn't benefit everyone equally.  Rather, the people most likely to see that drop are the ones least likely to need health care (the young low-risk consumers):

By 2026, the budget office projected, “premiums in the nongroup market would be 20 percent to 25 percent lower for a 21-year-old and 8 percent to 10 percent lower for a 40-year-old — but 20 percent to 25 percent higher for a 64-year-old.” 

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* IHA=I Hate Acronyms
 









Nobody Could Have Predicted! That (T)Rumpcare Would Result in Many More Uninsured!



All the fuss over whether it's 24 million people who will lose their health insurance under (T)Rumpcare or 26 million!  I know that our Dear Leader has promised all Murkans almost free health care with the most excellent quality, and I know that he is still promising great price reductions in a few years.

But our Dear Leader lives in the Alternative Reality where his job is to be adulated and that happens best when he promises people the impossible.

From this reality it was certain-sure from day one that the repeal and replacement of the Affordable Care Act (ACA) would lead to many people losing either some or all of their health insurance. 

After all, there is no other way for the Republicans to achieve the real goal of that repeal and replacement.  This:

Two of the biggest tax cuts in Republican proposals to repeal the Affordable Care Act would deliver roughly $157 billion over the coming decade to those with incomes of $1 million or more, according to a congressional analysis.
The assessment was made by the Joint Committee on Taxation, a nonpartisan panel that provides research on tax issues.
It is not unusual for tax cuts to benefit mostly the wealthiest, but still save some money for a majority of Americans. But the benefits of these reductions would be aimed squarely at the top.

And once we take all that money out of the system, the obvious result will be less coverage for someone.  If the (T)Rumpcare plan passes, it's going to be the poorer consumers who will suffer and also those older consumers whose premia might rise so much that they would drop out of the market altogether.  Ironically, the average price of insurance could then drop, given that the group of older consumers with their higher-than-average health risks has shrunk.

More about that dropping price in my next post!