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Trumpcare: Senate Republicans Want You to Die—by Neglect or by Opiate Overdose

Chris Roberts

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One of the biggest divides in America is the widening chasm between what Republicans in power say they want for the country, and what they actually do.

Here is Donald Trump, saying he wants to restore jobs and help people and solve the opioid crisis—a president for the people, the working people, not rich people or lobbyists or the Washington establishment! There is Chris Christie, appointed to a commission to solve said crisis, who at every opportunity dismisses out of turn a simple and obvious solution.

And here comes Mitch McConnell, the ur-parliamentarian Senate Majority Leader, the man who loves his country so much he is willing to rip up the Constitution and rewrite the rules whenever it is expedient, with a healthcare bill so transparently injurious, it will sentence millions of Americans—including those now healthy—to death by neglect.

And, in the areas of struggling Appalachia that voted overwhelmingly to enable this mass homicide, McConnell is overseeing a near-certain massive increase in deaths due to drug overdose, by dramatically under-funding basic triage for the crisis, including treatment.

On Thursday morning, the worst-kept secret in America was revealed.

The Republican-controlled Senate has its version of the Obamacare “replace and repeal.” As we suspected, it is all repeal, with little replace. It is nearly identical to the version that emerged from the House of Representatives, which cuts healthcare for 23 million Americans.

The Senate version hands tax cuts to Americans with high incomes and to anyone lucky enough to be a health-insurance company bigwig. To pay for this extravagant gift to the wealthy, Republican senators want to absolutely eviscerate Medicaid, which is the chief source of healthcare for the poor, the unemployed and the working class.

In those same Rust Belt states that handed Donald Trump the White House—Pennsylvania and Ohio, which still has the highest rate of death by opiate overdose in the United States—Medicaid also pays for almost half of what drug-treatment programs there are. Obamacare’s mandate for insurers to fund “essential benefits,” including mental health treatment, is also gone.

“Eliminating requirements for coverage of key benefits, including mental health and substance use disorders and other patient protections that are part of the Affordable Care Act, will have detrimental impacts for millions,” said Dr. Altha Stewart, the president-elect of the American Psychiatric Association, in a statement given to STAT News.

Something snapped over the past month in Donald Trump’s head, to the point where he woke up to reason and realized the House bill was “mean,” too mean to swallow. Somehow, this version is meaner, worthy of a subplot in a bad Charles Dickens knockoff.

Speaking in the halls of the Senate after the bill’s unveiling, Sen. Bernie Sanders called it “by far the most harmful piece of legislation I have seen in my lifetime,” and an “enormous transfer of wealth from working people to the richest Americans.”

Sick Americans are already blockading McConnell’s office in protest. Yet somehow, for Americans in states hit by the opiate crisis—which continues to worsen, with overdose deaths in the Cincinnati area projected to outpace last year’s ghastly record by double digits—the bill manages to adds insult to injury.

Republican senators had asked for $45 billion in funding to address the opiate crisis, cash to be spread out over a decade, as nobody worth listening to believes that the solution to this widening, decades-long crisis is short-term. Instead, this bill gives them $2 billion, and all in 2018.

And again—anything that cuts the Medicaid expansion, as this bill does, will eliminate in the immediate term basic healthcare for the Americans most susceptible to death by addiction: poor people.

“McConnell is rushing a healthcare bill to the Senate floor that will threaten millions of lives by heartlessly cutting life-saving opioid treatment,” said Grant Smith, deputy director of national affairs with the Drug Policy Alliance, in a statement issued Thursday. “We know that yanking away healthcare from people who struggle with addiction dramatically increases relapse and overdose rates. We know that any rollback of the Medicaid expansion will profoundly exacerbate the opioid crisis.”

It sounds basic—because it is—but the Medicaid expansion that Obamacare provided is the central point. Removing it will make it harder for poor Americans to have their basic needs met.

This will kill some of them, guaranteed.

It will kill them if they are physically sick, yes, because they won’t be able to see the doctor, but it will also kill people whose bodies are currently sound, because it will drive them further to despair.

Writing in the Guardian, Jessika Bohon, a native of Appalachia in the heart of Trump country, and ground zero for the opioid plague, reports half of her high school classmates are either dead, in jail or addicted. (Although it bears mentioning that these are the same kind of odds that have been reality for black Americans living in the inner cities, where a similar script has played out since the 1980s, with far less deadly crack playing the role of heroin.)

Often lost in the terrifying statistics are why people end up on opiates. It’s easy. They want to check out, because this reality is terrible and has an amazing knack to get worse at every turn.

“My town does not have a mental health clinic,” Bohon wrote. “Faced with hopelessness and flooded with pills, people self-medicate.”

“They don’t want to die,” a nurse told her. What they want is to “stay blanked out of this world.”

Can you blame them?

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