President Trump has taken a page from the Sam
Brownback playbook, the one about wrecking
institutions by throttling their budgets. It’s from
the chapter entitled “Undermine and Underfund”.
Trump campaigned on a lie that the Affordable
Care Act was “failing,” that it was bankrupting
both the government and the people it was
designed to help. Premiums had skyrocketed, he
said, people could not afford it, businesses were
gasping under its pressures, doctors and hospitals
loathed its confusing bureaucracies. Trump and
his venomous Republican sycophants were determined
to slander this law, to cast “Obamacare” as
an obscenity.
Trump harped on, while more than 20 million
Americans – including rural and urban Kansans
– were signing on for what they viewed as affordable
health care. And most continue to be better
served by their health insurance than they were
before the law came into effect.
The Congress was unable to repeal this popular
law, even with its (fixable) flaws. Nonetheless,
Trump threatened and cajoled to no real effect until
he moved to end the ACA subsidies that reduced
health insurance premiums. He’s ended payments
that reimburse insurers for lower co-pays and
deductibles for people with modest incomes. His
administration has cut the length of open enrollment
in half and slashed federal grants to groups
that help consumers navigate the process.
Brownback and his Republican faithful had
shown the way. When a mountebank moves to
dismantle a government agency, the first step is
to slash its budget. The agency struggles, people
are laid off, the work piles up; remaining staff are
overworked and, ultimately, it begins a downward
spiral. The agency is then pronounced to be “failing.”
In one form or another this is what has happened
in Kansas. There are many examples, starting
with Brownback’s cruel plan to slash local school
funding until the state aid formula withered to the
unworkable, then claim it is failing, too hard to
“understand,” and demand reform on his terms.
Most glaring, though, was Brownback’s systematic
corrosion of state support for Medicaid, subsidized
health care for low-income citizens and for
the infirm. The sabotage worked, so-called “proof”
that the government program, in this case, needed
to be “privatized.”
The plan became KanCare, farmed out to three
private companies that had donated heavily to
Brownback’s election campaigns. KanCare is an
abysmal failure, layered with incompetence and
inefficiency. Thousands of Kansans, poor and in
need of medical attention, have been under-served
or un-served, and left to spin in futility.
There are other examples but there’s the idea:
Bleed a program or an agency until it begins to die
and then pronounce it “ineffective.” That’s how
Brownback and his crowd worked their magic,
until our state nearly drowned in red ink. That’s
how Trump hopes to work his witchcraft – starve
Affordable Care, bang on its battered frame, then
proclaim it weak and demand something else.
The “else” has never been clear. But what is
clear, is that Trump isn’t leading us toward better
health care. He is taking this crucial issue to
the fetid corners of his malevolence and casual
disaster, where chaos rules and decency is seen as
immaterial, if not worthless.
Our governor is packing off to the world to
peddle religiosity for Trump, while we’re left
with Brownback’s wreckage to clear up and a
president’s rush to utilize the same wrecking ball.
It will take decades for Kansas to recover from
Brownback’s savagery. Will our nation survive
Trump’s nagging torrents of destruction?
