Don't forget what Trumpcare really is all about—tax cuts

The big shocker in the second round of Trumpcare scoring by the Congressional Budget Office has been all about how people with pre-existing conditions are screwed by it, but don't lose sight of what the first CBO score pointed out—how the bill would destroy Medicaid. The CBO pegs the cuts in this version at $832 billion over ten years (not counting what the proposed Trump budget would cut), enough to force 14 million out of the program. The real reason for most of these cuts remains: the big tax cuts for the rich.

Like its predecessor, the revised AHCA has four distinct major components.

1. One would cut taxes paid by high-income individuals (lower taxes on capital gains, divided, and interest income for households with annual income over $250,000) and by companies in specific industries: health insurance, medical devices, prescription drugs, and indoor tanning salons.
2. The second is a grab bag of tax reductions, such as loosened rules for flexible spending accounts and health savings accounts, repeal of the tax on individuals who can afford but don’t buy adequate health coverage, and a further delay of the excise tax on high-cost health plans (the so-called “Cadillac Tax”).
3. The third restructures the tax credits that subsidize health care coverage, moving from existing income-related tax credits for purchasing health insurance on the ACA Marketplaces to age-related tax credits to purchase health insurance.
4. And the fourth cuts Medicaid spending reducing coverage and essentially paying for the tax cuts.

In other words, it's still all about the tax cuts. But those tax cuts are most definitely not distributed evenly.

In fact, TPC estimates that a $37,000 average annual tax cut will go to the 1 percent of the population with the highest earnings (annual income of over $772,000). The top 0.1 percent of the income distribution would receive an annual tax cut of over $200,000 (annual income over $3.9 million).  [….]

The bottom line: CBO estimates confirm the AHCA is largely a tax bill paired up with Medicaid cuts to offset the costs. And, as in the earlier version of the bill, almost all the benefits go to the highest income households in the country.

That's what this is all about. Punishing old, poor, and sick people is just the gravy.

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