By Jay Bullock Special to OnMilwaukee.com Published Aug 24, 2015 at 1:16 PM

The opinions expressed in this piece do not necessarily reflect the opinions of OnMilwaukee.com, its advertisers or editorial staff.

You know, I want to write about other things. There's this Opportunity School district business that's barreling down on Milwaukee's children. There's a Bucks arena and a streetcar and so much new development coming to revitalize this city. There's a reasonable chance China's economy will tank and kill us all. But Scott Walker keeps ... talking.

Just when I thought I was out, in other words, he pulls me back in.

Last week, we covered how Walker clearly isn't qualified to lead American foreign policy. In the past week, he's shown that he is no better at domestic policy.

The obvious policy fail last week was when Walker waded into the "birthright citizenship" debate over whether to repeal the 14th Amendment to the US Constitution. In less than a week, he offered three different positions to various reporters on the subject; at least one of his statements, he said, was offered because he was "tired." I don't know what to make of that. Is he saying that he forgets what he believes when he hasn't slept? Or that if he's tired he lets the mask slip, the one that usually hides his true beliefs?

Either way, I can't even understand why Republicans are so het up about birthright citizenship and so-called "anchor babies." The whole business is basically a fallacy; according to current law, US citizens can only petition to have citizenship granted to their non-citizen parents after they turn 21. And even then, it takes years to get it done. I highly doubt immigrants are sneaking into the U.S. to play a con that is three decades long.

(Parenthetically, it's nice to know that conservatives are interested in changing or repealing constitutional amendments when their guarantees lead to sub-optimal outcomes in practice. Let's talk about the 2nd Amendment then sometime, okay?)

But the headline news about Walker's domestic policy last week was, of course, his health care plan. Rolling it out in a factory with the word "screw" in its name (seriously, Walker road team, think about what you're doing), Walker explained that he would "on day one" of his presidency do everything he could to repeal the Affordable Care Act, colloquially known as Obamacare, and replace it with a collection of dream conservative policies, which I'm going to term Walkercare, because fairness.

He calls it the "Patient Freedom Plan," though, which is such a misnomer. I mean, yes, technically, his Walkercare document offers a "plan" buried among the logos and empty pages. But it does not offer "freedom" to anyone who is or might ever be a "patient." For those of you uninterested in reading to the end, here's the punchline: Walker's plan would benefit the wealthy and hurt the poor, and leave millions who currently have health insurance and access to care without either.

Walker telegraphed just how awful his Obamacare-replacement plan would be by writing a piece at the National Review that starts with the sentence "Let's be honest" and then proceeds to offer a slate of falsehoods and half-truths. Perhaps the biggest of those is when Walker writes, "we must pull this dysfunctional and destructive law out by the roots," while his actual plan lists all the things about the hated Obamacare he wants to keep, from protections for pre-existing conditions and subsidies to help people buy coverage, to taxing expensive employer-provided health insurance plans (the "Cadillac tax" under Obamacare, the "gold-plated plan tax" under Walkercare).

Let's talk about those Walkercare subsidies, though, because it's in how Walker changes subsidies that it becomes most clear how Walker's plan will hurt the poor most (it's not the biggest way it hurts the poor, but I'll get to that in a moment). Walker care offers subsidies based on age, not on financial need, to help people under 65 who don't get insurance at work buy private insurance. On the surface, that might almost make sense – older people tend to have more and more expensive health needs. But that also means that Bill Gates would be eligible for the same subsidy as, say, a 60-year-old former coal miner with black lung. When you do the math, median income households, and even those somewhat above that, lose out under Walkercare compared to what they currently receive through the ACA.

Luckily for that coal miner, though, he'll be able to buy crappy insurance that won't cover his treatment for pretty cheap. Walker's big solution to controlling health insurance costs is not to create a state-based marketplace the way the ACA does. Rather, Walkercare removes the minimum requirements for insurance plans set by the ACA, the regulations that say your insurance company has to spend your premiums on your health care and that they must cover some basic kinds of care. And, because Walkercare also allows patients to shop for insurance from any state, it also effectively undermines any possible state regulation of insurance companies.

In the same way you could pick up a used Daiwoo and say you technically have a "car," under Walkercare you can technically have "insurance" purchased from some unregulated, race-to-the-bottom state. I am really curious how this will work – it's something conservatives have dreamed of for a long time – since I highly doubt the health care clinic down the street from me run by a Milwaukee-based health care concern is going to be "in-network" if I buy my insurance from some company in Mississippi.

Interestingly, as much as Walker thinks this will drive down costs, it doesn't do anything to address the cost of care. The ACA currently requires Medicare and hospitals to be more careful and more efficient in how they offer and pay for care. That's currently saving money and lives, and many studies are underway about how to be even more efficient with care in Medicare and Medicaid. All of those would be reversed under Walkercare, and even conservatives are critiquing the skyrocketing costs this will cause.

The cost of repealing those savings, along with the costs of his subsidies – even if they are less than the projected Obamacare subsidies – and other changes like repealing all the Obamacare taxes except the Cadillac tax, and adding more tax credits for wealthy people who buy health savings accounts, puts Walkercare deep in a hole in terms of funding. The funding deficit will be massive – as conservative Avik Roy estimates in that last link, one trillion-with-a-T dollars over the first decade of the plan (liberal critics suggest it will be even higher). Those savings have to come from somewhere, and Walker seems to expect that those savings will all come from Medicaid.

It's in these changes to Medicaid that Walker will really hurt the poor. We know, because Walker has steadfastly refused to accept Obamacare's expansion of Medicaid (and the hundreds of millions of dollars that would flow to the state with it), that he doesn't really care about making sure the poor have access to quality health care. And let's be clear: To save hundreds of billions of dollars through Medicaid, you have to cut off care to tens of millions of poor people.

Under Walkercare, Medicaid would become simply block grants to states, rather than the program it is now. This is, like much of the rest of his plan, a long-time conservative wish. In fact, such a plan was proposed in Congress earlier this year. Independent analyses of these plans, including by the Congressional Budget Office and the Center on Budget and Policy Priorities, show clearly that any kind of a block-grant plan that cuts so much from Medicaid spending is going to hurt millions of people currently eligible for coverage as well as dry up significant sources of income to providers all across the country.

In the end, since Obamacare passed, nearly 20 million people now have insurance and access to quality health care who didn't before, with the number of uninsured people in America at all-time lows. Most of those people would lose the coverage they now have and be stuck with fewer quality options to choose from if Walkercare becomes the law of the land. That doesn't sound like patient freedom to me.

So let's be honest about this: Scott Walker is clearly unfit to lead this country on domestic policy, too.

Jay Bullock Special to OnMilwaukee.com
Jay Bullock is a high school English teacher in Milwaukee, columnist for the Bay View Compass, singer-songwriter and occasional improv comedian.