The Inherent Racism of Trumpcare: Blackness Is a Pre-Existing Condition

Michael Harriot | The Root

On Friday, 216 white people and Mia Love (R-Utah) voted to take away health insurance for 24 million Americans and replace it with a tax credit for the wealthy. Now 13 white males are working on a Senate version of the proposal.

The repeal of Obamacare won’t simply affect the poor or the elderly—the secret sauce in Republicans’ reasoning for voting for the American Health Care Act is that GOP lawmakers don’t have to worry about the repercussions. More than any other demographic, African Americans will be the group most affected by the erasure of the Affordable Care Act.

When one looks closely at the AHCA and who it affects, it becomes clear that the bill affects some Americans more than others. It is not a health care plan; nor is it simply a tax break for the rich. Here are five reasons why the plan Republicans tout as “health care for all” will have a disproportionate impact on people of color:

1. Tax Breaks

Obamacare paid for health care subsidies by taxing tanning beds (white people) and incomes above a certain threshold (couples making over $250,000, individuals making over $200,000). This progressive tax made sense because higher earners with more income paid less than 1 percent to subsidize lower earners. In fact, 98 percent of Americans don’t make more than $250,000, but under Trumpcare, these people in the top 2 percent of earners won’t have to contribute a dime more than anyone else. The tax plan also repeals investment taxes for capital gains and investment accounts.

So who gets this tax break?

According to Statistical Atlas, 82 percent of the people who make more than $200,000 are white, and less than 4 percent are black. About 36 percent of white households have taxable investment accounts, compared with 22 percent of black households, according to CNBC.

So when you hear the GOP talking point about how its plan saves Americans money on their taxes, they probably aren’t talking about you. They’re talking about people like Warren Buffett, who says the ACHA will save him about $680,000.

2. Medicaid Expansion

Before Obamacare, people who couldn’t afford insurance were out of luck. Only very poor families, the disabled and children were covered under Medicaid. Under the Affordable Care Act, anyone who made less than 138 percent of the Federal Poverty Level could sign up for Medicaid. Trumpcare will end this.

Who does this hurt?

Black people, of course. Before Obamacare, black people were four times as likely as whites to be uninsured. After Obamacare, Bloomberg News says, black people were twice as likely. Most of the black enrollment has been through the Medicaid expansion, and even now, the Kaiser Family Foundation reports that 12 percent of blacks remain uninsured, while only 8 percent of whites do.

3. Employer Mandate

Trumpcare strips away the ACA requirement that employers cover their workers. Over 150 million American have employer-based health coverage, including 45 percent of black people.

According to the Bureau of Labor Statistics, black employees make up 29 percent of part-time workers, even though they are 13 percent of the population. A disproportionate percentage of black employees work for small businesses, which are the most likely to cut employer-based plans.

4. Pre-Existing Conditions

Cancer, heart disease, HIV, asthma, diabetes, obesity and sickle cell disease all disproportionately affect African Americans. These health issues are also on the long list of pre-existing conditions that health insurers could adopt under Trumpcare.

Insurers won’t be able to exclude people because of these conditions; they’ll just be able to charge them more for insurance. If blacks earn less and are less likely to have employer-based coverage, this law would wreak havoc on black households.

Besides, if the purpose of insurance is to help people when they are sick, only Republicans would think it was a good idea to exclude sick people.

5. More Control for States 

Under the Republican plan, states would have almost total control of insurance plans, including individual health care exchanges and high-risk pools.

If states that have already rejected Obamacare’s Medicaid expansion continue their draconian conservative ways, it will be even more dire for people of color. The Kaiser Family Foundation estimates that nearly half of the uninsured people of color live in states that have rejected the Medicaid expansion (pdf)

Plus, we all know what the dog whistle of “states’ rights” means to people of color.

So there you have it. The American Health Care Act is basically a plan to kill off people of color because Republicans know they don’t have to worry about losing minority votes, and they have already bamboozled poor whites into believing that anything that starts with “Obama” must be from the devil.

Hopefully, they will change their minds before Trumpcare moves their upcoming visit to hell to an earlier date.

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