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*The following is an opinion column by R Muse *

Most Americans comprehend what it means to be cruel, sadistic, and diabolical because they’ve witnessed Republicans exhibit those qualities in every action they take whether in Congress or state legislative bodies. In fact, over the past decade every proposal or action by Republicans has entailed taking something away from the American people purely out of spite and contempt.

Since 2010 the biggest prize for Republicans has been trying to take health care away from millions of Americans just because they can and their pathetic reasons for their crusade is that the Affordable Care Act (ACA) just doesn’t work. For six years Americans have heard, ad nauseam, about the Republican plan to “repeal and replace” the ACA with what House Speaker Paul Ryan is now calling “a better way.” And when he says a better way, he means a better way to take healthcare away from over 20 million Americans that will cost the nation over $2.6 trillion within three years, but that’s not the worst they have to offer.

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Ryan, like all Republicans, must be disappointed that 20 million or so more Americans have healthcare insurance than before implementation of the Affordable Care Act. Added to that remarkable accomplishment, the American health care system is on track to spend $2.6 trillion less between 2014 and 2019 than before the Affordable Care Act was put in place. That $2.6 trillion is no small number, of course, and nothing to scoff at. But when considering that $2.6 trillion is a tad more than 15 percent of the United States gross domestic product according to researchers at the Urban Institute, there doesn’t seem to be a valid reason for Republicans to continue assailing the ACA. And if they were not inherently evil they would abandon their absurd attempts to nullify the law and work tirelessly to help improve it if for no other reason than saving $2.6 trillion.

However, these nasty Republicans are filthy cruel human beings, and as if to cement their place in American history as the epitome of savage bloodthirsty barbarians, they finally came up with their version of “health care reform” after a storied six-year “repeal and replace” crusade. As with any Republican type of “reform,” the GOP plan literally takes healthcare from tens-of-millions of Americans, and that doesn’t even include eliminating Medicare and gutting Medicaid. It is a perfect representation of what any Republican “reform” entails and as usual it will cost Americans and businesses dearly, but the Koch brothers, Heritage Foundation, insurance industry, and ALEC will be orgasmic just imagining the damage to the people.

Despite the ACA saving a record $2.6 trillion, Republicans said their plan will slow the growth of health care spending, but as usual they provided absolutely no cost analysis.

Paul Ryan unveiled the Republican “better way”’ blueprint this week at the American Enterprise Institute with typical conservative ideas, such as encouraging Americans to forgo paying for health insurance coverage to ‘invest’ their money in “health savings accounts” to enrich financial institutions. They also proposed that people buying health insurance across state lines was a better way to reform healthcare insurance.

Of course, Speaker Ryan could not give any explanation as to how health savings accounts or buying across state lines will help insure more than 20 million Americans who will lose out when the ACA is abolished. He also didn’t explain how those “ideas” will save the nation $2.6 trillion in healthcare costs over a four year period. But helping insure 20 million or more Americans or saving money was never their goal.

The “plan” also takes care of two conservative goals at once by raising the eligibility age for retirees to qualify for Ryan’s Medicare coupon scam to correspond with raising the eligibility age to receive Social Security retirement benefits. It is unclear how raising the Social Security retirement age, or the Medicare eligibility age is supposed to help insure more Americans, but again, that is not their goal.

In keeping with Ryan’s notoriously austere budget proposals of the past three years, the Republican repeal and replace proposal transforms Medicare into a “market-based” model known as premium support. Premium support is Republican code for Ryan’s Medicare privatization coupon scam. Under Ryan’s plan, the traditional Medicare fee-for-service program would be forced to compete directly with private plans offered by corporate insurance giants such as UnitedHealth, Aetna and Humana.

The GOP plan will also abolish the requirement that Americans carry health insurance, and if Republicans are in a generous mood when their “better way” is enacted, they may offer a small tax credit to each person or family that buys an individual insurance policy. Under the Republican “repeal and replace” plan, the Affordable Care Act state and federal healthcare exchanges will cease to exist. And, if a person is earning poverty wages and can’t afford to buy health insurance they are just out of luck. A key feature of “the plan” is eliminating the Affordable Care Act’s expansion of Medicaid, but that’s not all the GOP has in store for Medicaid.

Republicans will allot each state a one-time fixed amount of money for a state’s Medicaid program without regard for economic downturns or cost of living increases. The goal is to allow the majority of states run by Republicans to establish work requirements for working Americans earning too little to afford to buy health care insurance. The Obama administration refused to permit Republican states to force minimum wage workers to find more work to receive healthcare under Medicaid whether it was part of the ACA expansion or not.

The House Republican plan also allows states to “charge enforceable premiums for limited Medicaid benefit packages” and to enact “waiting lists and cap enrollment” for certain groups of Medicaid beneficiaries; like children, the disabled and people of color. The Republican goal in eliminating Medicaid expansion and “block granting a fixed amount” to the states is to empower the growing number of GOP-controlled states to “profoundly reshape the [federal] Medicaid program” into something the Koch brothers will accept until they can abolish it completely.

As far as Republicans are concerned, the 70-plus million poor working Americans receiving health care through Medicaid will just have to work more jobs, go on a waiting list, or get sick and die. It is all part of the GOP’s long-promised “repeal and replace” healthcare reform.

One of the Republican priorities in “reforming” healthcare insurance is relaxing (eliminating) the federal rules for health insurance providers – the polar opposite of the real impetus of the Affordable Care Act. In fact, where one of the most important provisions of the 2010 health care law stipulates insurance providers cannot deny coverage or charge higher premiums because of a person’s medical condition or history, the Republican replaces that provision with the same complicated standards in place prior to enactment of “Obamacare.”

The only protection against being denied coverage for a pre-existing condition in the Republican plan requires people to have maintained “continuous coverage” even if they are too poor to have ever afforded coverage. If a consumer had coverage and had a significant break for any reason, insurers could not only charge higher rates, they could take a person’s pre-existing health status into account when they set higher premiums.

The House Republican plan would also punish employers by “reforming” the way employer-provided healthcare plans are taxed, a reform that most employers find objectionable. Under current law employees do not pay federal income tax on contributions that employers make to their health insurance. Republicans want to change that because they claim it is driving up insurance premiums all around. They argument is that workers are paying for better healthcare coverage because they aren’t being taxed. Obviously, Republicans don’t want Americans buying comprehensive healthcare coverage and claim that by taxing employees it “helps lower the cost of coverage;” but they give nothing in the way of proof.

According to the senior vice president of a trade association for large employers, James P. Gelfand of the Erisa Industry Committee, “This would be a new tax on benefits, on working families, and could eventually threaten the employer-sponsored health insurance that so many Americans enjoy.”

Mr. Gelfand stumbled on the real reason for taxing employees with company-provided healthcare coverage: punish working people and eliminate employer-sponsored healthcare insurance once and for all. Remember, part and parcel of the GOP plan is to force Americans to buy individual private plans with all the accompanying restrictions and higher costs to enrich companies like UnitedHealth, Aetna and Humana, the same corporate insurance giants that will gouge seniors enrolled in Ryan’s Medicare coupon scam.

If any American actually believed Republicans, especially savage Ayn Rand acolyte Paul Ryan would offer an “Obamacare” replacement worthy of merit, or to help Americans better afford healthcare, they are insane. It took six years for Republicans to come up with a “better way” and not only did the “better way” have no new ideas, it is actually much, much worse than before the ACA was enacted. Ryan and Republicans’ plan is not a “better way,” it is a sadistic, wicked, and evil way to deny tens-of-millions of Americans access to healthcare and exactly what one expected from Republicans.