Dear Jonathan:

Thank you for responding to my emails to Senator Cruz, your boss. I try to call his offices, and Senator Cornyn’s, but nobody ever answers. In fact, Senator Cornyn’s office doesn’t even respond to emails, so I guess you guys are at least better at responding to constituents once they figure out how to reach you to say their piece.

I’m writing an open letter because I want everyone to see what I say this time. Also, I want to practice what I preached in my last post.

Because I feel like either you’ve never looked at a CBO report (probably intentionally, I mean, if my boss was Ted Cruz I’d probably need to not read these things either so I can do things like brush my hair and put on eyeliner – which require being able to look at myself in a mirror) or you think I have never looked at a CBO report.

So I’d like to go through some things you said in your response.

“Thank you for contacting Senator Cruz regarding the repeal and replacement of the Affordable Care Act. Input from fellow Texans significantly informs the Senator’s decision making.”

I’ve not seen evidence of this. For what it’s worth, Senator Cruz was elected by a small portion of the state because gerrymandering and low voter turnout (which are totally connected – it’s hard to convince people to go vote when it seems like even if their county is blue, the red of the rest of the state will drown out their vote).

Only 23 percent of Texans want Obamacare repealed immediately. Pretty much everyone else would like a good replacement plan voted in first, then a repeal (if you must repeal, but more on that later).

So no, it doesn’t seem like Senator Cruz is listening to us at all. 

“While disagreements remain on the best way to repeal and replace Obamacare, the Senator believes that the American people rightfully expect those in Congress to keep their promises and get the job done. The Senator voted to support the motion to proceed to begin the repeal and replacement process, in order to fulfill his promises to constituents to work to try and fix the problems with our current healthcare system.”

Sir. Seriously. Only 37 percent of Americans want to repeal and replace Obamacare.  In fact, an ABC poll revealed that Americans, 43 percent (compared to the 26 percent who said the opposite) say they want President Trump to work with Democrats rather than conservative Republicans to change the existing Affordable Care Act. Additionally, 24 percent wanted him to work with both.

To rephrase, the majority polled did not trust the Republicans to craft changes to the ACA that would do no harm to them.

“Although it is unclear which legislative solutions will carry the day, of the various approaches that have been discussed, there are two that Senator Cruz can support. The first is to take up the Senate’s 2015 Obamacare repeal bill and pass it which would give the Senate two years to formulate a replacement plan that lowers premiums and gives Americans access to quality healthcare. The second approach is to adopt the Better Care Reconciliation Act, which includes the Senator’s Consumer Freedom amendment. Consumer Freedom not only expands coverage and has a dramatic impact on premiums, but it also once again gives Americans the freedom to decide which healthcare plan is best for them.”

Let’s break this down. The first part – repealing and then giving Congress two years to create a replacement plan – is the opposite of what your boss’s constituents want, as I pointed out earlier.

Now let’s talk about the BCRA. For one, several provisions in it violate the Byrd Act.  CBO estimates see the BCRA would raising the number of uninsured by 22 million by 2026.

“While the draft BCRA and the AHCA would have similar effects on the number of uninsured Americans, the BCRA would lead to significantly larger job losses and deeper reductions in states’ economies by 2026,” analysis from the Commonwealth Fund reveals.

“A brief spurt in employment would add 753,000 more jobs in 2018, but employment would then deteriorate sharply. By 2026, 1.45 million fewer jobs would exist, compared to levels under the current law.”

The analysis says that every state but Hawaii would have fewer jobs and a weaker economy under the BRCA. The health care sector would be hardest hit employment-wise – estimates say 919,000 fewer jobs there, but other sectors would also experience higher rates of unemployment.

Gross state products would eventually take a hit as well – in 2026, they would be $162 billion lower. States that participated in Medicaid expansion would be punished especially hard.

Let’s not forget either that the ACA includes 160 amendments from the senator’s colleagues.  And that what severely hamstrung the whole thing was the fact that states – including Texas – opted out of Medicaid expansion, which means that a vast chasm exists where people make too much for Medicaid, but don’t make enough to afford even the lowest tier of coverage.

This, sir, is fixable, and your boss refuses to do that. Instead, he would like to rip out the bathtub and throw it out with the baby and the bathwater and gut the bathroom entirely without providing any facilities for anyone to use in the meantime.

I’m reminded of a line from Margaret Atwood’s “The Handmaid’s Tale” (great book, if you haven’t read it, let me know and I’ll send you a copy), where someone in authority tells someone subjugated to him, after explaining the benefits of the new government, “Better never means better for everyone… It always means worse, for some.”

No doubt, the BRCA will be better for some, but worse for many. And I am hesitant – no, wholly unwilling, to sign on for a country that willingly and capriciously rules for the benefit of a few, on the backs of many.

So in conclusion, thanks for writing back. But please don’t think the people writing your boss are gullible. We’re not.