We’ve learned a lot about our country the past several weeks simply by watching our most powerful leaders fling cash around with the abandon of drunken relatives tossing rice at a wedding.
Folks in the Trump administration are splurging on jets for cabinet officials, on bailouts for Argentina, on weapons for ICE so agents can bully people with more lethality. And now we’re watching demolition crews wreck the East Wing of the White House to make way for a $250 million ballroom so our more privileged elected leaders can invite wealthy pals to celebrate their luck at being born sliding into home plate. (Our president says the ballroom won’t cost taxpayers a dime, but he also said he wouldn’t touch the existing White House and then sent in the demolition crews, so we’re calling bullshit.)
The announcements on spending we’ve seen in just the past few weeks amount to tens of billions of dollars (up to $40 billion alone to Argentina). It’s enough to take someone’s breath away. Tragically, we mean that literally. We learned this Wednesday from Dr. Paula Jernigan, a Pittsburgh pulmonologist.
“The great thing about my job is that I help people breathe,” she explained. It’s a job now complicated by new patient concerns that are a direct result of GOP spending priorities.
Last week Jernigan talked with a patient who’d been unable to get his asthma under control until a new treatment became available. Now he can breathe more easily, and this allows him to work, Jernigan said. “He told me, ‘I’ve never felt this good.’ ”
His relief may prove temporary, though. He fears he’ll lose his health insurance and thus his ability to pay for the treatments that allow him to breathe — all because of Republicans’ insistence on ending insurance subsidies under the Affordable Care Act, otherwise known as Obamacare. He has plenty of company. Without those subsidies, set to expire at the end of the year, health care costs will skyrocket for millions of Americans.
“It’s cruel, and it’s not OK,” Jernigan said of the Republican position. And it’s causing anxiety for her patients. “I have these conversations every day, multiple times a day,” she said.
Health care is at the heart of the budget struggle between our two major political parties on Capitol Hill. Democrats, who are in the minority, refuse to agree to a GOP budget that fails to renew the subsidies. Renewal is a no-go for Republicans. The impasse resulted in a federal government shutdown three weeks ago.
We caught up with Jernigan after she spoke at a Wednesday morning news conference that included U.S. Rep. Chris Deluzio, D-Fox Chapel; State Rep. Arvind Venkat, D-McCandless; and Allegheny County Executive Sara Innamorato – three Democratic officials at different levels of government who are becoming increasingly alarmed at the potential damage their constituents will face should Republicans prevail with their plans.
Deluzio pointed out that 24,000 people in his district buy health care through Pennie, the state’s Obamacare exchange. His district includes red as well as blue areas and includes all of Beaver County and Pittsburgh’s northern and western suburbs and boroughs. Deluzio represents residents of Wilkinsburg, where the news conference was held. Many of those people are now “staring down the barrel of massive increases” in health care premiums.
“A 60-year-old couple in my district making around the typical average household income, $80,000 or so, would see their premiums go up $12,000 for the year,” he said. “That is a budget-crushing increase. People will have to make horrible decisions about whether they’re going to buy health care on the exchange, whether they might forgo health care, or risk bankruptcy.”
On average, he said, people seeking health care through the exchange in Allegheny County will face a 75% increase in premiums. In Beaver County, the increase is 74%.
It’s an urgent matter. Open enrollment in Pennsylvania begins Nov. 1. That’s nine days from now.
“It’s a scary time for a lot of people in our region,” he said.
A scary time, at least, for working people. This era of government by crisis, chaos and cruelty has one big advantage for billionaires. Venkat, who wore a white lab coat to reflect his job as an emergency physician, pointed this out. The same GOP Big Beautiful Bill (Venkat called it the “Big Ugly Bill”) that axes health care subsidies for everyday people also extends tax cuts for the country’s most obscenely wealthy occupants.
“That is a deliberate policy choice that is jeopardizing the health and well-being of our community, our commonwealth and our country,” said Venkat, who represents Allegheny County’s northern suburbs. “And so as an emergency physician I find it horrendous that we’re sitting here playing chicken with people’s lives.”
Pennsylvania is in a special jam because leaders in Harrisburg can’t agree on a state budget. This has been going on for more than 100 days. The Republican-led Senate and the House remain locked in impasse over spending levels.
“There is no question that what is happening with this federal shutdown is having an immediate, devastating effect on our ability to come to an agreement on the state budget,” Venkat said.
“There are huge holes that are being blown in the state budget related to our not knowing what is coming from the federal government.”
A big problem, he said, is Republicans’ unwillingness to compromise. “It can’t be that, at every moment, we’re looking over our shoulder at political consequences that happen because our party doesn’t get everything they want,” he said.
Of course, the trouble generated by these budget logjams trickle down to the county level, an issue Innamorato addressed.
“We’re doing everything in our power to shield the residents of Allegheny County from the chaos that’s happening at the federal level and the fact that we’re at a budget impasse in Harrisburg,” she said.
With its greater reserves and borrowing power, Allegheny County is in a better position to weather the current budget crisis than many surrounding counties that are majority Republican, she said.
“We are continuing to move incrementally,” Innamorato said. “We do not want to cause chaos. We do not want people to shut down programs and stop delivering services. So we are being a steady hand. We will have to make incremental changes that reduce our discretionary spending, probably proceed with a hiring freeze of the county. But we are moving deliberately in chunks so that we’re not just moving in big and disruptive ways.”
Both Venkat and Jernigan stressed the importance of Obamacare, a program demonized by the right, and provided glimpses of what life was like for people needing treatment before the ACA made health insurance widely affordable.
“I remember a woman who had to choose between groceries and her home oxygen,” Jernigan said. “She chose to eat. I remember a young man with congenital kidney disease who was no longer disabled after his transplant, so he went to work. His job was part time and didn’t provide health insurance.”
Without insurance, he couldn’t afford his anti-rejection meds, so he lost his transplanted kidney, lost his job and went back on disability.
“I remember a single mother working three part-time jobs to support her teenage daughter,” Jernigan said. “Because all of her jobs were part time, she had no health insurance, and she delayed getting care until it was too late, and her pneumonia turned to sepsis. She died in the ICU, leaving her daughter alone in the world.”
Venkat recalled treating a woman who sought emergency room treatment for back pain.
“I thought maybe she had pulled a muscle in her back and that she was seeking primary care in the emergency department,” Venkat said. “But I was wrong.”
The woman was diagnosed with metastatic breast cancer. She came to the emergency room only when she had lost all ability to move or function in her home. After stabilizing the patient, Venkat asked why she had waited so long to seek treatment.
“And she said, ‘I didn’t have insurance. I was already in medical debt. I came in when I had no other choice,'” Venkat said. “And that is the circumstance that we are facing today with the expiration of these premium tax credits.”
Steve is a photojournalist and writer for the Pittsburgh Post-Gazette, but he is currently on strike and working as a Union Progress co-editor. Reach him at smellon@unionprogress.com.