How Toomey can atone for his health care bamboozlement

Whew! That was a close call for U.S. Sen. Pat Toomey, For a second there, it looked like Pennsylvania's GOP junior senator would have to actually take a vote on whether a tax cut that mostly benefits America's billionaires and millionaires is worth throwing at least some — if not many — of roughly 700,000 of his constituents off their Medicaid health coverage they now get thanks to Obamacare. In stark contrast to Toomey, there were enough other Republicans who saw the potential political suicide in voters not being able to afford a doctor, or having their aging mom kicked out of her nursing home, to prevent a vote on the Senate's ironically named Better Care Reconciliation Act, or BCRA, until after the congressional July 4 recess…if ever.

So maybe we'll never know how Toomey would have voted, since he while he called the measure "a constructive first step" when it was finally made public after weeks of secret, closed-door deliberations, he also assured Pennsylvania: "I will thoroughly examine this draft and welcome all feedback from my fellow Pennsylvanians in the coming days." Ha, who was he kidding? The reality is that the draft that Toomey and the Senate is considering is, in good measure, Toomey's own work. As Philadelphia Magazine's Claire Sasko reported last week, it was Toomey who — without holding a single public hearing (something that we here in Pa. call the Toomey Way) — drafted the $800 billion in reduced Medicaid spending which the senator said is "necessary to make it a sustainable program" yet in the real world seem to have disappeared mostly to pay for those tax cuts for the Maserati crowd.

So you could also say that Toomey's posturing on Medicaid and on the BCRA tax-cut-disguised-as-health-care bill was disingenuous, at best — but then it got worst, a lot worse. On Sunday morning, the Pennsylvania Republican went on CBS' "Face the Nation" and, facing the nation, proceeded to blatantly attempt to bamboozle it. To the casual coffee-cake-munching Sunday a.m. TV viewer, Toomey delivered a rap that made it sound like he'd found a magical way to make Medicaid better by spending less money — and no one gets hurt. The senator uttered words that were true only if you parsed the English language in a way that 320 million  Americans, minus about 40 U.S. senators and a few brain-dead Trump administration officials, do not. In that kind of "it depends on what the meaning of the word 'is' is" way.

Here's some of what Toomey told CBS' John Dickerson:

Yes, listen, it's going to be a challenge, but I have to strongly disagree with the characterization that we're somehow ending the Medicaid expansion.In fact, quite the contrary. The Senate bill will codify and make permanent the Medicaid expansion. And, in fact, we will have the federal government pay the lion's share of the cost. Remember, Obamacare created a new category of eligibility. Working-age, able- bodied adults with no dependents for the first time became eligible for Medicaid if their income was below 138 percent of the poverty level. We are going to continue that eligibility. No one loses coverage. What we are going to do, gradually over seven years is transition from the 90 percent federal share that Obamacare created and transition that to where the federal government is still paying a majority, but the states are kicking in their fair share, an amount equivalent to what they pay for all the other categories of eligibility.

That was Sunday. About 30 hours later, the Congressional Budget Office came out with its devastating report on so-called Trumpcare which projected that 22 million fewer Americans will have health insurance by 2026 including — more relevant to Toomey's CBS comments — a whopping 15 million fewer to be covered by Medicaid. That's a lot more than "no one."

Even some of Toomey's colleagues from across the aisle, normally reluctant to call out a peer, were aghast at the senator's performance.

In the spirit of, ahem, civility, I reached out on Monday to Toomey and his staff, and his staffers were civil back in offering their background thoughts on their boss' comments. His defense is essentially that the Senate bill retains the eligibility for the working poor that was added in 2010 — the only thing that's changing is dramatically fewer federal dollars to pay for that coverage. In theory, states receiving Medicaid block grants could somehow increase their own ante, or else states could cut services but not the rolls of the insured. Those more-than-highly unlikely things could keep Medicaid enrollment at the same levels! Also in theory, the last place Phillies could suddenly win their final 87 games and still make the playoffs. That's about as plausible as the Toomey Medicaid scenario.

Here's what Toomey's spokesman Steve Kelly sent me tonight: "Senator Toomey's comments related to Medicaid and the current Senate health care bill—the federal government is not ending Medicaid expansion coverage or eligibility for anyone. States are still free to offer the coverage to anyone who meets the Obamacare's expanded criteria. However, instead of funding it at 90 percent in perpetuity, the Senate bill asks the states to contribute the same amount for the expanded population as they do for every other category of Medicaid."

That said. you can and probably should note that Toomey's CBS Sunday statement is demonstrable false, since 8 states that expanded Medicaid coverage after 2010 have so-called "trigger" provisions that automatically kill their program if federal funding drops below 90 percent, which is exactly the plan that Toomey is pushing. That would end Medicaid coverage for 3.3 million people. Again, not "no one." The Pulitzer Prize-winning Politifact looked at Toomey's appearance and — citing his parsing on the eligibility issue — gave him a "half-true" rating. I think they were more than generous. The truth is that Toomey didn't want to level with Pennsylvanians — or the American people — about what's in the bill or what it does. There's a word for that: Bamboozlement. And when it's a matter of life and death for the elderly, the working poor, and the sick people that Toomey represents, bamboozlement is an outrage.

Toomey won't tell you the whole truth because, politically, he can't. Because he helped design this scheme to cut Medicaid solely for the purpose of benefiting the people that he really represents. People like the oil-billionaire Koch Brothers, who bankrolled Toomey's 2016 re-election and whose retreat in sunny California the senator fled to while his Pennsylvania counterpart Sen. Bob Casey was at Philadelphia International Airport fighting for the rights of migrants. Or like hedge fund billionaire Paul Singer, whose Elliott Management employees are Toomey's largest corporate source of campaign funds. Or Wall Street billionaire (and former New York mayor) Mike Bloomberg, another key 2016 backer. These are the folks who will gain millions while states are struggling to decide which sick truck driver gets to see a doctor.

The good news? The temporary collapse of Senate Majority Leader Mitch McConnell's scheme to ram through the BCRA this week means that Toomey comes home for the July 4 break with a wonderful opportunity to both atone for his bamboozlement and follow up on his promise. You know, sir, the one where you said that you "welcome feedback from my fellow Pennsylvanians…" That would mean doing something that you haven't done in at least a couple of years, senator — holding a public, in-person town hall in the state that you represent. That would give you a chance to explain in long form — and not tortured TV soundbites — why you think reducing Medicaid is such a good deal for Pennsylvania. And it will give you, Pat Toomey, a chance to do something else you so rarely do, which is listen to regular people, and not lobbyists. You'll hear something that might even sound a little strange to you.

The truth.