No, Mr. and Mrs. Newly Insured, I Expect You to Suffer (And Possibly Die)!

The Republican budget presents a clear Republican health care plan:

The Republican Party’s greatest health-care triumph is that it has managed to pass off its position on health care as some kind of undefined work in progress rather than a decision that has been made. Six years after the start of the health-care debate, Republicans keep telling reporters that they’re working on a plan. (Jeffrey Young has a hilarious, frequently updated timeline of the perennially just-over-the-horizon Republican Obamacare replacement plan.) In fact, the Republicans do have a health-care plan: It is to repeal Obamacare and replace it with what we had before Obamacare. They don’t want to admit that’s their plan, but it is. It’s right there, in the new budget released by House Republicans this week.

As we’ll get to in a second, the boldfaced bottom line is actually too charitable. I also enjoy the discussions with the reformicons who want to deny that the Republican offer to those who would be uninsured if the ACA is repealed is “nothing.” (Can you tell the con artists from the conned? When it’s bad faith all the way down, is the distinction even relevant anymore?)

The reasons for the lack of candor are not hard to discern:

Worried about the number of Americans who still don’t have health insurance? If House Republican leaders get their way, the number will be much bigger — maybe even twice as big.

That may sound ridiculous. But health care analysts tell The Huffington Post that it’s a fair interpretation of the proposed 2016 budget that Rep. Tom Price (R-Ga.), the chairman of the House Budget Committee, released on Tuesday.

The Republican budget would, in fact, be worse than the status quo ante, because “block grants” are weasel for “savage cuts to programs than benefit the poor”:

And Obamacare repeal is only the first way in which Price’s health care agenda would increase the number of uninsured. Turning Medicaid into a block grant, as the House budget seeks to do, would mean ending the program’s current guarantee: that, as more people fall into the program’s eligibility guidelines, the federal government will provide more money. Under a block grant scheme, by contrast, the federal government would start giving states fixed sums of money with which to administer the program. Given the funding levels Price’s budget appears to set, the money almost certainly wouldn’t keep up with demand for the program.

In reality, these block grants are huge budget cuts by another name. States would find it impossible to maintain the Medicaid rolls at those funding levels, and start removing people from the program as a result. How many? Price’s budget doesn’t provide the same level of detail that Ryan’s early budgets did. But the proposals appear to be very similar. And an estimate of Ryan’s 2012 scheme, put together by researchers from the Urban Institute and published by the Kaiser Family Foundation, suggested that by 2022, turning Medicaid into a block grant would reduce the number of people receiving insurance through the program by between 14.3 million and 20.5 million.

Again, this would be on top of the people who would lose insurance thanks to repeal of Obamacare. Add the numbers together and, come 2022, something like 60 or 70 million people who would have gotten insurance through either Medicaid or Obamacare would no longer have it.

And let’s remember the very real consequences involved:

This is more personal for me than usual. Scary, too. There are no guarantees in life, and there’s no guarantee that MoJo will employ me forever. If I lose my job, and Republicans repeal Obamacare, I will be left with a very serious and very expensive medical condition and no insurance to pay for it. And I feel quite certain that Republicans will do nothing to help me out.

But all the freedom!