Commentary: The biggest victims of the Senate health bill (and other Trump plans)

Donald Trump asked Senate Republicans to introduce a healthcare bill with “more heart.” They didn’t.

Senate Minority leader Chuck Schumer addresses a Capitol Hill press conference after Senate Republicans unveiled their draft healthcare bill, June 22, 2017. REUTERS/Joshua Roberts

The senators’ draft legislation, introduced last Thursday, will strip tens of millions of low-income and middle-class Americans of their health insurance. Millions more will face higher costs for lower coverage. The Congressional Budget office estimates 22 million more people will likely be uninsured by 2026 than would be if the Affordable Care Act remained law.

The Senate bill will cut the number of people eligible for subsidies that reduce monthly premiums and lower out-of-pocket costs for insurance bought on the Affordable Care Act health exchanges. It will defund Planned Parenthood for one year, which is an important source of preventive and primary care services for millions of low-income women and women of color. It strikes at the heart of health care services for the poor by ending Medicaid expansion in 2021 and changing the way states receive federal funding – another measure that will cause cuts in the program.

These cuts will be on top of the $600 billion that the president’s budget seeks to eliminate from the program over the next 10 years.

During his election campaign, Trump’s outreach to black voters effectively comprised the question “What do you have to lose?” That answer has become clear.

The president’s effort to repeal Obamacare, coupled with rollbacks in civil-rights enforcement and massive cuts to safety net programs, are moving the country backward. The Senate health bill is the latest in a string of efforts to dismantle programs and policies that benefit all Americans, and are especially critical in closing racial disparities in health, income, education, housing and policing.


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The administration’s effort to do away with the Affordable Care Act is at the top of the list of actions that will hit people of color hardest. Although every racial and ethnic group benefited from greater access to insurance, the reduction in the uninsured rate for African Americans, Native Americans and Latinos, was near double that experienced by whites in the first year the law took effect. Much of this improvement was because of Medicaid expansion under the Obama program.

The attack on Medicaid is especially concerning given its role in providing rural and urban children and families with access to health care. Medicaid covers one in five Americans, including poor adults, seniors and people with disabilities. Half of all births nationwide are covered by the program.

Beyond the assault on health care programs, the president’s budget will cut taxes for the wealthy and increase defense spending by $54 billion while slashing programs that provide help to low-income individuals, families and communities. It will cut billions of dollars from food and nutrition, housing, and community development programs that poor families and communities rely on to meet basic living needs.

The Supplemental Nutrition Assistance Program provides food stamps to help working families meet their nutritional needs. Funding for the program will be reduced by more than 25 percent, or $193 billion, over 10 years. The Temporary Assistance for Needy Families program, which provides federal funding for state-based income support and work programs for poor families, would be cut by $22 billion during the same period. And the Department of Housing and Urban Development’s budget will be slashed by nearly 15 percent or $7.4 billion. At a time the nation faces an affordable housing crisis, funding for homeless programs, direct rental assistance and home-buying programs are being drastically reduced.   

If Trump has his way, other programs, such as the Low-Income Home Energy Assistance Program that helps pay for heat and electricity, and the Community Development Block Grant program that helps revitalize economically depressed neighborhoods will be eliminated.

The environmental justice program within the Environmental Protection Agency is also slated to be shut down. Low-income communities are more likely to have poorer air and water quality and have historically been targeted for dumping of toxic pollutants. Environmental justice initiatives have been key in remedying this imbalance. The Flint water crisis was an unfortunate reminder that our communities remain vulnerable to high levels of lead and other environmental inequities that have lasting impact on health.

The closing of the environmental justice office at EPA is part of the Trump administration’s broad strategy to reduce civil rights enforcement by federal agencies. The office of civil rights within the Education Department is also targeted for cuts and a similar office in the Labor Department will be eliminated.

Then there are the efforts to roll back Obama-era criminal justice reforms. Attorney General Jeff Sessions has called for harsher sentences for low-level drug offenders - again a measure that will disproportionately affect racial minorities. Blacks and Hispanics are more likely to be charged and to receive longer sentences than whites for similar crimes regardless of prior criminal history or severity of the crime. Despite similar rates of drug use, blacks are 10 times more likely to be incarcerated for drug use compared to whites. Sessions has also signaled that his Justice Department will not enforce consent decree agreements that have played a key role in holding police departments accountable for civil rights abuses – another area in which minority communities have been disproportionately singled out. 

These policies are chipping away at the nation’s health and sustainability. The U.S. will be a minority-majority nation in a few decades. It is not in our national interest to marginalize Americans of color. 

 (Judy Lubin, PhD, MPH, is Director of Allies for Reaching Community Health Equity at the Center for Global Policy Solutions, co-founder of Sociologists of Justice and an ARCHE Public Voices Fellow of The OpEd Project. Twitter: @judylubin)

The views expressed in this article are not those of Reuters News.