The American Health Care Act is a rich person's bonanza. Under the plan proposed by House Republicans, each of the nation’s 400 richest families will save $7 million per year, as part of a tax giveaway. The plan offers no benefits at all to those who earn $200,000 or less a year. The burden from this cynical wealth grab falls disproportionately on the nation’s black, brown and poor households.
To be clear, people of color cannot be stereotyped. Most black Americans are not poor, and most live in the suburbs. Donald Trump made repeated assertions on the campaign trail that African-Americans live in a “hell” of poverty and violence. Those remarks were rightly condemned as implicitly racist. Wherever they reside, people of color don’t live in “hell.” They live in humanity.
Nevertheless, our economy is divided along racial lines. While more than half of all Americans experience poverty at some point in their lifetimes, people of color are far more likely to be poor than whites. The poverty rate is nearly 25 percent for black Americans and more than 21 percent for Hispanic Americans. By contrast, the white poverty rate is 9.1 percent. Any rate above zero is unacceptable, but the level of racial disparity is striking.
Black and Hispanic households are far more likely to experience food insecurity than white households. Black children are three times as likely to live in poverty as white children. And, while many Americans will experience at least one year of poverty in their lifetime, black poverty is more persistent than white poverty.
Black Americans are also more likely to suffer from the perils of inadequate medical care. A 2000 study cited by the CDC found that blacks are more than three times as likely as whites to have a lower limb amputated, often due to complications from diabetes, and are more than twice as likely to be treated for wound infections and skin breakdowns. Both conditions are associated with inadequate treatment.
Black America is also struggling with an infant mortality crisis. The African-American infant mortality rate is more than double the white rate. That figure is even worse in some places, like San Francisco, where the infant mortality rate for blacks is six times as high as it is for whites.
Black Americans still die 3.4 years earlier than whites on average, although the gap has decreased. Part of this change is explained by the growing opioid crisis among whites. Black Americans, especially women, also disproportionately suffer from disabilities as they age.
While whites make up the largest single group of Medicaid enrollees, at 42 percent, most of the people in this need-based program are non-white. Hispanics make up 31 percent, African-Americans are 19 percent, and 8 percent are classified as “other."
The Republicans also plan to cap Medicaid, which will cut federal support to the program for seniors by $560 billion over the next decade. As Edwin Park of the Center for Budget and Policy Priorities wrote, this would “effectively (end)... Medicaid expansion for 11 million people while also harming tens of millions of additional seniors, people with disabilities, and children and parents who rely on Medicaid ...”
The GOP’s plans to cut Medicare will disproportionately harm people of color and poor Americans, too. The program has been instrumental in lifting Americans out of poverty: 29 percent of seniors were impoverished when Medicare was enacted in 1966. That figure has been cut by more than two thirds today.
The Republican plan to weaken Medicare’s finances is, as Nancy Altman and others have noted, nothing new: it's in line with the the party's long-held desire to abolish the current Medicare system altogether.
Paul Ryan and other Republicans want to replace today's Medicare program with a program of federally-subsidized vouchers to purchase insurance from the private market. These vouchers would quickly become incapable of purchasing equivalent coverage, given the typical rates of medical inflation, and Medicare recipients would be dependent on the inefficient, rapacious, and confusing world of private insurance for their care.
Cuts to health funding aren’t the only aspect of the plan that would disproportionately harm black and brown households. The GOP plan cuts income taxes, and there is a significant income gap between white and black households.
The Republicans plan a steep tax cut for unearned income on investments, property, and other wealth, which will benefit white households even more, since the wealth gap between white and black households is even greater than the income gap. A report based on 2013 data found that white households had nearly 13 times as much wealth on average as black households.
In short, the health care overhaul will cut programs that help black and brown people, while providing tax cuts for the wealthy that would disproportionately help whites. People may wonder whether this racially biased outcome is accidental or deliberate. In the end, does even it matter? Either way, it’s morally wrong, and must be opposed.