This Q&A is part of Sarah Jaffe’s series Interviews for Resistance, in which she speaks with organizers, troublemakers and thinkers who are doing the hard work of fighting back against America’s corporate and political powers.
After the House of Representatives approved legislation to repeal and replace significant parts of the Affordable Care Act last week, Sarah Jaffe spoke with Adam Gaffney, a physician in pulmonary and critical care, as well as an instructor at Harvard Medical School. Gaffney, who is a member of Physicians for a National Health Program, which supports single-payer national health insurance, talked to Jaffe about the latest Trumpcare plan and what needs to happen next. It has been lightly edited for length and clarity.
Sarah Jaffe: Adam, what are the Republicans trying to do to us?
Adam Gaffney: Well, if you look at this plan, I don’t really consider it much of a health care plan as a conduit of dollars from working class people to rich people. It keeps [some] of the Affordable Care Act in place, but it denigrates it, it twists it and it corrupts it to the benefit of the very wealthy.
Just from the big-picture perspective, what are some of the things it is doing? Well, on the one hand, it is cutting programs, including a major cut to Medicaid. Over 10 years, we are talking about over $800 billion in Medicaid cuts; that is about a quarter of federal spending. That is going to throw millions of people off of Medicaid. As you know, Medicaid is a program for lower-income people that covers more than 70 million people.
The second thing it’s going to do is weaken the subsidies that people use to buy health plans on the marketplaces, the so-called “Obamacare” plans. Those are still going to be around — the private insurance industry will still be subsidized — but those subsidies are going to be worse, they are going to be more regressive [meaning they take a proportionally greater amount from those on lower incomes] and they are going to be less adequate for many folks. That is one side of the ledger.
On the other side of the ledger there’s just a huge redistribution of wealth upward. Essentially, it eliminates a variety of taxes that the Affordable Care Act put in place, and that is almost entirely going to benefit the…