Now that the nonpartisan Congressional Budget Office has released its analysis, the truth emerges: 14 million people will lose health insurance coverage as of 2018, and 24 million by 2026.

The Medicaid expansion will be "gutted," as will coverage for addiction and mental health services, key elements in combating the increasing opioid epidemic. Furthermore, older, sicker adults will experience sharp increases in out-of-pocket insurance premiums. In sum, the neediest will suffer the most.

How in good conscience can President Donald Trump and our own House Speaker Paul Ryan, R-Janesville, gloat over this "wonderful" bill, which breaks all campaign promises of affordable health care coverage?

Clearly, now is the time for universal single-payer health care (Medicare for all). There is no other way of fulfilling oft-repeated campaign promises. The United States this year has the dubious distinction of being virtually the only industrialized nation without universal health care coverage.

Dr. Stephen Austin, Madison

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