The Republicans’ much embattled Affordable Care Act repeal legislation — the American Health Care Act — was passed by the House Budget Committee, on which Santa Barbara Congressmember Salud Carbajal sits, by a 19-17 vote. Carbajal, a first-term Democrat now entering his eighth week in office, voted against the bill, explaining it “shafted the middle class.” All Democrats on the committee voted against the bill. They were joined in their “no” votes by three Republicans who belong to the arch-conservative Freedom Caucus, who object the bill doesn’t go far enough to contain entitlement creep among Medicaid recipients. “It was closer than I expected,” Carbajal said.
Carbajal voted in favor of seven Democratic-sponsored motions to amend the bill, all of which failed along party-line votes. Only one Democratic amendment elicited any Republican support — but just one Republican vote. That amendment would strike from the bill provisions to defund Planned Parenthood for a year.
Several committee Democrats — Carbajal included — endorsed a Republican amendment that would make sure the tax credits went to middle-income rather than wealthier individuals in the Republican Obamacare alternative. Under the Republican proposal, tax credits would be made available to those earning up to $115,000 a year. Critics of the bill have made much of the Congressional Budget Office report showing that the Republican bill’s subsidies — considerably less generous than those offered under Obamacare — strongly favor younger and higher income earners at the expense of older and low- to middle-income earners. That amendment was offered by Republican Tom McClintock, now of Roseville, who used to represent Ventura County in the California Legislature before moving north.
Outspokenly and colorfully conservative, McClintock has taken considerable heat from his constituents in Town Hall meetings for his support of repeal legislation. At one such meeting, Roseville police offered McClintock an escort out of the hall. Although police insisted the protestors were well-behaved and cooperative, officers suggested the escort as a precautionary measure. McClintock would later denounce the protestors on the House floor as “anarchists,” while delivering a speech on the virtues of civil discourse.
Although McClintock and Carbajal — until recently a multi-term Santa Barbara County supervisor — worked closely for many years, they have not interacted on the House Budget Committee and have had only minimal contact in D.C. “I met him on the elevator,” recounted Carbajal. “He said, ‘Hey aren’t you that guy Carbajal?’”
Carbajal has been vocal in his criticism of the repeal bill, blasting it as “a huge tax break for the wealthy” at the expense of the elderly and working people who benefited from the Affordable Care Act. He noted provisions that would defund Planned Parenthood completely for one year — at a $10 million cost to the Planned Parenthood California Central Coast. Carbajal served on the board of the health-care group’s Action Fund. He has also denounced the $800 million in cuts to Medicaid proposed in the Republican bill. Medicaid provides health insurance to the disabled, infirm, women, and children.
Under the Affordable Care Act, its eligibility requirements were relaxed to include single adults making between 100 to 138 percent the federal poverty level. In California — and Santa Barbara — that provision accounts for the bulk of the 5 million people who’ve managed to secure insurance under the Affordable Care Act since its inception seven years ago. Carbajal also objected that the legislation would limit access to mental-health treatment that had been guaranteed under the Obamacare law.
Among conservative Republicans especially, this jump in Medicaid enrollees has been of intense concern. Not only does it encourage able-bodied adults not to work, they maintain, it expands a government entitlement program for which there’s no sustainable funding. Among the amendments pushed and passed by the Budget Committee’s Republican majority was one allowing states to require Medicaid recipients to work.
Carbajal blasted the bill, saying it also stripped $170 billion from existing Medicare — the federal health insurance program for the elderly — coffers. By so doing, he claimed, Republicans effectively eliminated three years’ worth of savings for the federal government’s largest entitlement program. “They talk about reducing the budget by $377 billion,” he exclaimed. “That’s how they’re doing it: cutting Medicaid and Medicare.” Carbajal reiterated objections leveled by many Democrats that President Trump vowed not to cut either program when campaigning.
The Budget Committee’s vote is strictly advisory and relates to reconciling different versions of the same bill approved by two separate committees — the Ways and Means Committee and the Energy and Commerce Committee — earlier this week. The bill is scheduled to be heard next by the House Rules Committee on March 21. The next day, it’s slated for a House vote.
Although Republicans control both houses of Congress as well as the White House, passage of the bill remains anything but certain. Democratic opposition is complete — even among those members inclined to find common ground with President Trump, like West Virginia’s Senator Joe Manchin. The Freedom Caucus has dismissed the Republican bill — pushed by House leader Paul Ryan of Wisconsin — as “Obamacare Lite,” while many moderates have expressed serious reservations about the depth of the cuts to low- and moderate-income beneficiaries of Obamacare. The Congressional Budget Office report released earlier this week only heightened such concerns.
“They should be alarmed,” said Carbajal. “The numbers aren’t good: 14 million off insurance in the first year, 24 million in year 10, and a total of 52 million Americans without insurance at all.” Trump has denounced the CBO report as inaccurate.