A health care protest at the U.S. Capitol in July 2017. Photo: kellybdc

Mark Trahant: Republicans target health care and education to pay for tax cuts

Here we go again: The congressional attack on health care, higher education

By Mark Trahant
Trahant Reports
#IndigenousNewsWire #NativeVote18
TrahantReports.Com

Here we go again. The Congress is hell bent on wrecking the Affordable Care Act.

This time the mechanism is the so-called tax reform bill that will be voted in the U.S. Senate. The logic is rich (and, yes, “rich” is absolutely the right word and sentiment) because this tax cut will wreck the individual health insurance market so that the rich will pay less in taxes. But the problem gets at the core of insurance itself. How do you make sure there is a large enough pool to cover high cost patients? The Affordable Care Act did this by requiring everyone to buy health insurance or pay a penalty. Without that provision people who are healthy are free to skip out. But sick people always want coverage. And that creates an imbalance that does not work.

Senate Republicans added the provision because it saves money, some $338 billion according to the Congressional Budget Office. It estimates 13 million people will drop health insurance.

“We’re optimistic that inserting the individual mandate repeal would be helpful,” Senate Majority Leader Mitch McConnell said Tuesday.

The Senate bill is now being shaped into its final form. Wait. That’s funny. That’s what they say. But both the Senate and the House will change these tax bills all the way up until the final vote (unless it’s a sure thing, anyway). One of the reasons the bill will evolve is what’s called the Byrd Rule. This Senate is using the reconciliation process, like the Affordable Care Act repeal bills, so only 50 votes are required to pass. But that means the bill has limit of $1.5 trillion in new debt over 10 years and cannot add more after that. None of the bills, so far, accomplish that.

So the health care fight is back. And the Senate majority is confident this time they have the votes to pass the legislation.

There are other provisions in Senate tax bill that will impact American Indians and Alaska Natives.

One of the key ideas is to increase the size of the standard deduction so that fewer taxpayers will have to itemize. But to pay for that the simplicity the Senate bill is getting rid of some popular deductions, including the ability to deduct state and local taxes from your federal tax return. The bill also gets rid of deductions for dependents. The math works out so that families with fewer than three children will pay about the same. But if your family size is larger, then you will pay more. This is Indian Country. The average American family has 3.2 children, but in Indian Country it’s 4.2 children per family.

And this is where it gets weird. The Senate bill does increase a tax credit, from $1,000 now to $1,650 per child. But, and this is huge, the additional $650 credit is only available to those who owe federal income taxes. It’s not refundable. This is important to people who are not rich because so many pay more in payroll taxes (Social Security, Medicare, etc.) than in income taxes.

Add it all up and the Senate bill would increase taxes on 13.8 million moderate income households. But, hey, at least the rich get a break, right?

The House of Representatives could vote on its version of tax reform this week. The House bill is similar but takes a different tack on mortgages and the deduction of state and local taxes. The House would also eliminate the ability of families to deduct medical expenses. (Think about that when matched with the Senate’s plan to mess up health insurance.)

And the House bill really goes after university graduate students.

Many graduate students earn a small stipend for working on campus, doing research or teaching, and get a break on tuition. The stipend is already taxed. But the House would tax the tuition waiver, thousands of dollars. The average cost of graduate school is $30,000 a year at a public university and $40,000 at a private school. The Washington Post explains the problem this way: “Say you’re a married graduate student at Princeton. Your spouse has a full-time job and makes $50,000 a year; you have two school-age children. You’re filing a joint tax return. For sake of simplicity, you have no other deductions beyond the standard. According to H&R Block’s tax calculator, you would owe about $5,000 under the current law. Under the proposed Republican plan, you would owe about $15,000.”

The House bill also eliminates the deduction for interest on student loans and it eliminates tax credits for higher education.

This is terrible public policy. The digital age demands more education, not less, and the tax code should be in alignment. The House bill does the opposite. It will make higher education more expensive and less likely for too many people.

And just to make sure that higher education gets the message about what the country values, the House bill also would tax the larger university endowments, such as Harvard, Princeton, and even smaller colleges that have reserves of more than $250,000 per student.

But both the House and Senate do have one group in mind when writing this new tax code, business. The total “tax cuts” in the bill add up to $1.4 trillion over the next decade and of that amount, $1 trillion goes to businesses and corporations. It does this by reducing the corporate tax bracket from to 20 percent.

The other side of this tax debate is that it will reduce the amount of revenue that goes into the federal treasury. That means that soon after one of these measures passes, Congress will be required to look again at cutting spending.

Already the Congressional Budget Office estimates the tax bill will require $136 billion cuts from Medicare, Medicaid, and other entitlement programs. “Without enacting subsequent legislation to either offset that deficit increase, waive the recordation of the bill’s impact on the scorecard, or otherwise mitigate or eliminate the requirements of the [pay-go] law, OMB would be required to issue a sequestration order within 15 days of the end of the session of Congress to reduce spending in fiscal year 2018 by the resultant total of $136 billion,” CBO said Tuesday.

The Center for Budget and Policy Priorities pegs these coming budget cuts at $5.8 trillion. “These include $1.8 trillion in cuts in Medicaid, Medicare, and other health care entitlement programs and $800 billion in cuts below the already austere sequestration levels in ‘non-defense discretionary’ programs, the budget area that includes education and training, transportation, scientific and medical research, protection of the food and water supply, child care, low-income housing assistance, services for frail elderly people, and much more,” the center reports.

So we are just at the beginning of the debate. The conservative dream is to sharply cut taxes for corporations and the wealthy — and then to shrink government. The House and Senate tax bills do just that.

Mark Trahant is the Charles R. Johnson Endowed Professor of Journalism at the University of North Dakota. He is an independent journalist and a member of The Shoshone-Bannock Tribes. Find him on Twitter @TrahantReports

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