And America’s most distressed continue to VOTE GOPher…


GOP health care bill would make rural America’s distress much worse…


The passage of the Affordable Care Act (ACA) in 2010 began to change this as more rural Americans gained insurance coverage and the government invested more money into regional health facilities and training.

“The working class here in what they are now calling the ‘heartland,’ (all the stuff between the big cities)” he writes, “exists on a continuum ranging from complete insecurity to the not-quite-complete insecurity of having a decent but endangered job. It is a continuum extending from the apathy of the poorest to the hard-edged anger of those with more to lose. Which ain’t a lot, brother, when your household income hovers around $30,000 or $35,000 with both people working… Until those with power and access decide that it’s beneficial to truly educate people, and make it possible to get an education without going into crushing debt, then the mutt people here in the heartland will keep on electing dangerous dimwits in cowboy boots.”

“Along with the concept of American Dream runs the notion that every man and woman is entitled to an opinion and to one vote, no matter how ridiculous that opinion might be or how uninformed the vote. It could be that the Borderer Presbyterian tradition of “stand up and say your rightful piece” contributed to the American notion that our gut-level but uninformed opinions are some sort of unvarnished foundational political truths. I have been told that this is because we redneck working-class Scots Irish suffer from what psychiatrists call “no insight”. Consequently, we will never agree with anyone outside our zone of ignorance because our belligerent Borderer pride insists on the right to be dangerously wrong about everything while telling those who are more educated to “bite my a$$!”

Joe Bageant, Deer Hunting with Jesus: Dispatches from America’s Class War



Now for the reality check. First off, we’re not talking about rates being lower in 2020 than they are today — just that they wouldn’t be as high as they would be under current law. And second, the main reasons premiums would be comparatively lower, the CBO predicts, are that the policies would be worth less, and federal taxpayers would be kicking in more. As the CBO put it, “A combination of factors would lead to that decrease — most important, the smaller share of benefits paid for by the benchmark plans and federal funds provided to directly reduce premiums.”

This gets a little weedy, but the bottom line for consumers is insurance plans that cover less and carry lower premiums but impose far higher out-of-pocket costs. As in, two-thirds higher.

The “benchmark” plans are the ones that determine how large the premium subsidies for qualifying individuals will be. Under current law, such plans cover 70% of a consumer’s expected medical costs; under the Senate bill, the benchmark will cover only 58% of those costs starting in 2020. The report goes on to note that because of the insurance regulations in current law, which the Senate bill would not change, insurers would have no choice but to impose very high deductibles on their policies.