Twenty in '20

January 18, 2017, 2:24 am

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Tom Williams/CQ Roll Call via AP Images

From left, Senators. Mark Warner, Elizabeth Warren, Bernie Sanders, and Amy Klobuchar, leave the Senate Democratic Caucus leadership elections in the Capitol, November 16, 2016.

Even as Democrats brace themselves for the inauguration of Donald Trump as the nation's 45th president, they are focused on 2020 and on who can help them recapture the White House.

No Democrat has yet declared any interest in running for president, but the successful candidate for 2020 will have to be somebody who has a record of accomplishment, played a key leadership role in opposing Trump’s policy initiatives, can win Democratic primaries that will be dominated by liberals, turn out black, Latino, young, and low-income voters, and win back some white, working-class, swing-state voters who voted for Trump.   

One has to assume that the next Democratic candidate will by facing off with Trump, but it is possible that he won't want to run again or that he will be dethroned by the Republicans after causing enormous chaos and intra-party division. In that case, the most likely GOP candidate will be House Speaker Paul Ryan. Vice President Mike Pence will want to run, too, but he’ll be saddled with the Trump legacy and, in any case, won’t have Trump’s wider appeal.

For the past half century, the path to the White House has been easier for governors than for senators. The current pool of Democratic governors, particularly those from swing states who could appeal to independent voters, is particularly shallow.

A strong Democratic candidate will need to draw a sharp contrast with Trump, Ryan, or Pence, all extreme conservatives. She or he can’t be too close to Wall Street, and must have a credible plan to promote jobs, improve the safety net for families, expand health care while controlling drug and insurance costs, expand workers’ rights, protect reproductive health, limit military-style assault weapons, challenge racism in the criminal-justice system, and strengthen consumer and environmental protections. To win, the Democratic nominee will also need to be someone with charisma, able to withstand the Republican attack machine, and be free from personal controversy.

It’s a tall order—and none of the close to two dozen Democrats who might be considered contenders passes every single one of these litmus tests. Nevertheless, here is a handy user’s guide that shows how 20 potential Democratic presidential hopefuls stack up. They are ranked here according to two criteria—whether they are progressive and electable—on a scale of 1 to 5, with 5 being the highest. 

In the "progressive" column, the ranking takes into account the individual’s track record in office (including voting records where applicable), and comments on issues, especially on economic and social topics. Only a few of them have much experience with foreign policy. The "electable" column ranks potential candidates on their own electoral track records, their potential appeal to both swing voters in battleground states and Democratic base voters, and their ability to deliver 270 Electoral College votes.

Two Democrats on this list—Kamala Harris and Tammy Duckworth—are newly-elected Senators who will only have served four years by 2020, but that didn't hurt Barack Obama in 2008.  Several others are wild cards, such as businessmen Mark Cuban and Howard Schultz. Like Trump, who also had no electoral experience, both have potential popular appeal.

Here is a Progressive/Electable ranking for 20 Democrats whose names have been mentioned as potential White House candidates:

 

-                                                                                Progressive | Electable-

Senator *Elizabeth Warren* of Massachusetts:                      *5                     4.5*

The charismatic Massachusetts  
senator leads the party’s progressive
wing as a foe of Wall Street.

 

 

Senator *Sherrod Brown* of Ohio:                                           *5                      4*

*
*

If Ohio’s Brown wins re-election in
2018, he could help the Democrats win
back the Rust Belt in 2020, particularly
with his longstanding record in support
of fair (not "free") trade.

 

Senator *Bernie Sanders* of Vermont:                                    *5                      3.5*

*
*

Many of his supporters and some pundits
thought Sanders could have beaten
Trump, but others question his
commitment to the Democratic Party,
and he’ll be 79 in 2020.

 

Secretary of Labor *Tom Perez*:                                               *4.5                   2.5*

*
*

The most progressive member of Obama’s
cabinet has lots of government experience
and a broad following within the party, but
hasn’t yet been tested in a major election.

 

* *

California Lieutenant Governor *Gavin Newsom*:                 *4.5                   2*

*
*

The former San Francisco mayor—who led
the fight for same-sex marriage and
municipal health insurance—is now the
frontrunner to succeed Jerry Brown as
governor in 2018.

 

Senator *Kamala Harris* of California:                                     *4                     2.5*

*
*

The Senate’s only African American woman
was a popular consumer advocate as
California’s attorney general.

 

 

Senator *Kirsten Gillibrand* of New York:                              *3.5                    4*

*
*

Many Democrats view her as a young
version of Hillary Clinton, but without
the baggage and the decades-long
resume.

 

* *

Former Maryland Governor *Martin O’Malley*:                     *3.5                    3*

*
*

The one-time Baltimore mayor was
overshadowed in the 2016 Democratic
presidential primaries by Clinton and
Sanders.

 

* *

Senator *Tim Kaine* of Virginia:                                              *3.5                      2.5*

*
*

The former Richmond mayor and
Virginia governor has wide-ranging
experience and a down-to-earth
personality, but disappointed a lot of his
fans as Hillary Clinton’s running mate.

 

Senator *Tammy Duckworth* of Illinois:                                 *3                       3.5*

*
*

This newly elected senator is a disabled
Iraq War veteran who was a popular
congresswoman with a compelling
personal story.

 

* *

Senator *Amy Klobuchar* of Minnesota:                                 *3                       3*

*
*

With Midwestern roots, an Ivy League
pedigree, and “Minnesota nice,"
Klobuchar has twice won Senate
elections in what might be turning
into a key Midwestern swing state.

 

Senator *Cory Booker* of New Jersey:                                     *3                        3*

*
*

The charismatic black senator and
former Newark mayor has a great
personal story, but some progressives
consider him too close to Wall Street,
and too cozy with wealthy charter
school advocates.

 

Montana Governor *Steve Bolluck*:                                         *3                       3*

*
*

While Trump won red state Montana with
56 percent, Bullock was elected to his
second term as governor, raising the
prospect that the prairie populist (he
expanded Medicaid and is pro-union,
pro-gay marriage, and pro-choice) could
help Democrats win back some key Western states.

Colorado Governor *John Hickenlooper*:                               *3                       3*

*
*

He’s popular in this important swing state,
but environmentalists say he’s too close to
the fracking industry.

 

* *

Former Massachusetts Governor *Deval Patrick*:                 *3                       2.5*

*
*

A former civil rights lawyer and two-term
governor who was raised by a single
mother in Chicago, Patrick went on to
Harvard College and Harvard Law School,
but since leaving office he’s become a
corporate lawyer—not the best credential
for winning over progressive Democrats.

New York Governor *Andrew Cuomo*:                                   *3                        2.5*

*
*

New York’s progressives have a love-hate
relationship with the unpredictable and
often abrasive Cuomo, who has recently
been moving left to catch up with the
Democratic base.

 

Senator *Chuck Schumer* of New York:                                  *3                       2.5*

*
*

Wall Street’s favorite Democrat, now the
Senate minority leader, is a progressive
on social issues but would be a hard
sell outside blue states.

 

Starbucks CEO *Howard Schultz*:                                          *  2.5                    3*

*
*

A moderate Democrat with liberal social
views, Schultz was raised in public housing,
played sports in college, and wound up
piloting Starbucks’ dramatic expansion as
its CEO.

 

Entrepreneur/investor *Mark Cuban*:                                    *2.5                     3*

*
*

The billionaire businessman owns the
NBA’s Dallas Mavericks, chronicled
his success in How to Win at the Sport
of Business, likes to pontificate about
politics on TV talk shows, and once
claimed that if he ran for president
he “could beat both Trump and Clinton.”

Outgoing HUD Secretary *Julian Castro*:                                *2.5                    2*

*
*

The Latino cabinet member was briefly in
the national spotlight when Clinton
considered him as a possible running mate,
but he was viewed as too young and too
conservative to make a big enough dent
in the electorate.

 

  Reported by The American Prospect 18 hours ago.

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Obamacare Repealers: Trickle Downer of the Week

January 18, 2017, 2:24 am

≫ Next: Tom Price, Trump's pick for HHS secretary, will face the Senate today — here's his plan to dismantle Obamacare

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(Photo: AP/Tom Williams)

Vice President-elect Mike Pence, House Majority Leader Kevin McCarthy, Speaker Paul Ryan, and House Majority Whip Steve Scalise laughing after a meeting of the House Republican Conference in September. 

 

Last week, the Republican-controlled Senate and House began the first steps in repealing President Obama’s landmark Affordable Care Act, with no semblance of a real replacement plan in sight.

Health-care coverage for the roughly 20 million Americans who gained access under Obamacare is now in serious jeopardy—a life-threatening prospect for many. Beyond that, the cost of repeal (without a replacement) is astronomical. A new report from the Congressional Budget Office, which scored the costs of the Republicans’ 2015 repeal, found that 18 million people would lose their insurance within the first year, and premiums for all would climb by as much 25 percent. After the elimination of Medicaid expansion and insurance subsidies, the number of uninsured would increase to 32 million by 2026 and premiums would be about 50 percent higher.

In short, repealing the law without a replacement plan could be a political disaster for Republicans—and yet, it remains their top priority. That’s probably because the GOP’s Obamacare repeal—quarterbacked by Paul Ryan and Mitch McConnell—is, at its core, a thinly veiled trickle-down policy of tax cuts for the rich. Because the Affordable Care Act is funded largely through a progressive measures—taxes on the wealthy and corporations that fund subsidies for low- and middle-income households—repealing it would directly shower the nation’s rich with huge tax breaks, while everyone else would either see a tax hike or no discernable tax benefit at all.

The top 0.1 percent would receive, on average, a tax cut of about $197,000—an after-tax income boost of 2.6 percent—according to the Tax Policy Center.

(Tax Policy Center)

Tax savings at the very, very top would be even greater. By repealing the two Obamacare taxes (the Hospital Insurance tax and the Medicare tax on unearned income), the country’s 400 wealthiest taxpayers—whose annual incomes average roughly $300 million—would each receive a tax cut of about $7 million a year, according to an analysis by the Center on Budget and Policy Priorities.

For these 400 mega-millionares, that's a total tax cut of a whopping $2.8 billion a year. As the analysis found, that tax break is the same value as the premium tax credits that enable some 800,000 Americans of modest means in 20 states and Washington, D.C., to purchase insurance on the ACA exchanges.

(Center on Budget and Policy Priorities)

Meanwhile, the roughly 160 million households earning less than $200,000 a year would see no benefit from the repeal of those taxes. In fact, repeal would mean a significant tax increase for seven million low- and moderate-income households.

Furthermore, the repeal of Obamacare would generate massive tax breaks—about $180 billion, according to an earlier CBO report—for pharmaceutical companies, health insurers, and medical device manufacturers. Eliminating the tax on brand-name drug importers and manufacturers would result in $130 billion in lost revenue over ten years. Repealing the program’s “HIT” tax on health insurance companies and the tax on medical device manufacturers—both of which are top political priorities of the U.S. Chamber of Commerce—would lead to an estimated loss of $130 billion and $20 billion respectively.

The permanent tax savings secured for the wealthy with the Republicans’ removal of the Affordable Care Act could become the 1 percent’s largest tax break of the year—and that’s in a year where proposed GOP tax reforms are supposed to heap additional massive tax cuts on them already.

For this ostentatious preference for private wealth over public health, the Republicans leading the charge to repeal Obamacare are our Trickle Downers of the Week.  Reported by The American Prospect 18 hours ago.

Tom Price, Trump's pick for HHS secretary, will face the Senate today — here's his plan to dismantle Obamacare

January 18, 2017, 5:18 am

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Rep. Tom Price of Georgia is headed to Capitol Hill to face the Senate Health, Education, Labor and Pensions Committee on Wednesday in the first day of his confirmation hearing.

A former orthopedic surgeon, Price has an impressive record in the healthcare field.

He is also a vocal critic of the Affordable Care Act, the healthcare law better known as Obamacare, and his appointment perhaps signals Trump's seriousness in intending to dismantle the law.

"The Trump administration's mantra has been that the ACA is a disaster and the only way to fix it is to repeal and replace it, and this appointment seems to confirm that idea," Timothy Jost, a law professor and health-policy expert at Washington and Lee University who supports the ACA, told Business Insider.

Price has been at the forefront of congressional fights to repeal and replace President Barack Obama's signature legislation.

While Trump's own details on how to replace the law have been spotty, Price has written legislation called the Empowering Patients First Act, which would repeal most of the sections of Obamacare and shift toward what Republicans call a "market-based" approach.

*How it would work*

Price's plan would significantly restructure the benefits given to Americans without health insurance through their employer or the government. Price's plan structures tax credits based on age brackets — $1,200 for people ages 18 to 35 and up to $3,000 for those 50 and older. This is different from the ACA, which bases its tax credits on the income of the patient.

Another key aspect of Obamacare — one Trump has said he would consider keeping — that prevents insurers from denying coverage based on a preexisting condition, would change. Under Price's proposal, people would be able to continue coverage if they shifted from the employer market to the individual market, but only if they have no interruptions in coverage. Thus, a break in care would allow insurers to deny coverage to people with an illness.

For those who do not maintain that care, Price's plan would institute state-level high-risk pools to help cover them. The Price plan would provide $1 billion in federal funding to help control costs for these pools. The Commonwealth Fund, however, a nonpartisan health-policy think thank, estimates that these pools would require well over $170 billion a year in federal funding to cover those who today have ACA-based plans.

Additionally, such high-risk pools typically have premium costs double those of normal individual-market plans.

The expansion of Medicaid under Obamacare would also be rolled back under Price's plan, shifting roughly 15 million people from the government-sponsored insurance to the individual marketplace. The expansion provided coverage for those making roughly $16,490 and below annually. Questions loom over, even with a subsidy, how affordable it will be for those people to obtain plans on the individual market.

In total, Price's proposal bears much of the same hallmarks of plans from Republican other congressional leaders, such as House Speaker Paul Ryan, who called Price the "absolute perfect choice" for the position in Trump's Cabinet.

"We could not ask for a better partner to work with Congress to fix our nation's healthcare challenges," Ryan said in a statement.

*'Asking the fox to guard the hen house'*

The appointment of Price has drawn criticism from Democrats and advocates of the Affordable Care Act. Sen. Chuck Schumer of New York, the Senate minority leader, said Price's healthcare proposals were "far out of the mainstream of what Americans want."

"Nominating Congressman Price to be the HHS secretary is akin to asking the fox to guard the hen house," Schumer's statement said.

Jost said Price's proposals would, incidentally, end up hurting many of the people who elected Trump to the White House.

Price's plan "shows where we're heading," Jost told Business Insider. "It will help wealthier people and does nothing to help the working-class people who actually voted for Trump."

Critics point to potential rollbacks of provisions in the ACA that compel insurance companies to provide certain types of care, meaning insurance companies could exclude comprehensive coverage needed by sick people. For older individuals, Price's plan would take away the provision linking what insurers can charge young people compared with seniors, providing the potential for insurers to increase rates for older people with chronic-care needs.

Even the majority of Americans who get their insurance through their employer, Jost said, might see their costs increase under a Price-type plan. Those with insurance through their workplace currently do not pay federal taxes on premiums and other health-related payments — such as health savings accounts and health reimbursement arrangements — paid to these plans.

Price's plan would cap the amount of healthcare spending that is non-taxable at $20,000 for a family and $8,000 for an individual. While such a provision could hurt affordability for those with employer-based insurance, according to the Tax Policy Center, the exemption cost the federal government $250 billion in lost taxes in 2015.

Jost also suggested many of the provisions in Price's plan — such as state-level tribunals for malpractice cases and limitations on what patients may use in cases as evidence against a doctor — are designed to guard physicians from patients.

"The bill should probably be called 'Empowering Doctors First,'" Jost told Business Insider. "He's a doctor, and it's clear he is trying to shield doctors."

*SEE ALSO: CBO: The GOP's Obamacare repeal could leave 27 million people without health insurance and cause premiums to skyrocket*

Join the conversation about this story »

NOW WATCH: Trump makes baseless claim that he lost the popular vote only because 'millions' voted illegally Reported by Business Insider 15 hours ago.

Trump on Healthcare: 'Nobody is Going to Be Dying on the Streets'

January 18, 2017, 7:45 am

≫ Next: Greg Arms, Insurance Industry Veteran, Joins MSH INTERNATIONAL as Senior Advisor to Develop US Operations

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Americans will have health insurance coverage once Obamacare is repealed and replaced, and "nobody is going to be dying on the streets," because of lack of coverage, President-elect Donald Trump promised in an interview airing Wednesday. Reported by Newsmax 13 hours ago.

Greg Arms, Insurance Industry Veteran, Joins MSH INTERNATIONAL as Senior Advisor to Develop US Operations

January 18, 2017, 5:08 am

≫ Next: Obamacare enrollment up in Illinois, U.S. despite fears about program's future

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Gregory Arms has recently joined MSH INTERNATIONAL as Senior Advisor to provide his expertise on the US and Latin America health and employee benefits markets.

Calgary, AB (PRWEB) January 18, 2017

During his thirty year industry career, Greg has been a recognized leader in the insurance sector in both US and international venues. Formerly senior vice president and global head of Chubb's Accident & Health business that spanned 28 countries, Greg also held senior positions at Marsh & McLennan Companies where he served as global co-leader of Mercer Marsh Benefits. Before that, Greg was with the Willis Group, UnitedHealth Group, and for more than twenty years at AIG during which time he lived and worked overseas in the Middle East and in Europe.

Greg serves on the international committee (previously as Chairman) of the Self-Insured Institute of America (SIIA); is a Senior Advisor to eShare, the U.K. technology firm that specializes in pensions and Board governance; is Senior Advisor to WorldCare International, the global telemedicine firm; and, is an active participant at the National Foreign Trade Council (NFTC).

A graduate of Colgate University with a B.A. in international relations and economics, Greg also has a Chartered Life Underwriter (CLU) designation from the American College. He has served the last seven years on Colgate's Presidents' Club membership committee including on-campus student career mentoring.

In his new role for MSH INTERNATIONAL, Greg will continue to be based in the Greater New York City area and will be active in the marketplace with strategic carrier partners, reinsurers, brokers, consultants and industry associations. Thanks to Greg's knowledge and extensive industry network, MSH is aiming to strengthen its footprint across the Americas.

"This really is a fantastic opportunity to help design and further develop MSH's capabilities to 'serve with distinction' the expanding international mobility markets for both corporate groups and individual lives, Greg commented on finalizing the new role. MSH already has a tremendous global footprint with main offices in Paris, Calgary, Dubai and Shanghai and solid medical provider network. I've always had a great passion to be a 'market maker' - and now look forward to working with the MSH leadership team to take their successful business to the next level."

“We are delighted to have Greg onboard. I am excited about the many opportunities that lie ahead for our company in the United States. Greg truly understands the complexity of our market and is a perfect fit to lead our growth initiative”, says Philippe de Dreuzy, President and CEO of MSH INTERNATIONAL.

About MSH INTERNATIONAL
MSH INTERNATIONAL provides groups and individual expatriates with global health insurance solutions, with a network of over a million healthcare providers and 14 offices worldwide. As a subsidiary of Paris-based SIACI SAINT HONORE Group, MSH INTERNATIONAL is one of the largest and most comprehensive suppliers of expatriate insurance services in the world with more than 330,000 insured participants. Reported by PRWeb 16 hours ago.

Obamacare enrollment up in Illinois, U.S. despite fears about program's future

January 18, 2017, 5:21 am

≫ Next: AP-NORC Poll: Americans of all stripes say fix health care

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Despite Obamacare's shaky future, more Illinois residents signed up for health insurance through the law's exchange this year than last, the U.S. Department of Health and Human Services said Wednesday.

This year, 247,818 people in Illinois signed up on the exchange by the Dec. 19 deadline to purchase... Reported by ChicagoTribune 15 hours ago.

AP-NORC Poll: Americans of all stripes say fix health care

January 18, 2017, 8:19 am

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WASHINGTON (AP) — Sylvia Douglas twice voted for President Barack Obama and last year cast a ballot for Democrat Hillary Clinton. But when it comes to “Obamacare,” she now sounds like President-elect Donald Trump. This makes her chuckle amid the serious choices she faces every month between groceries, electricity and paying a health insurance bill […] Reported by Seattle Times 12 hours ago.

Another insurer steps back from Illinois Obamacare exchange

January 18, 2017, 10:45 am

≫ Next: Fatal Flaws of Any Post-ACA Republican Replacement Plan

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Some Illinois consumers soon will have fewer health insurance plans to choose from on the Affordable Care Act exchange, with news Wednesday that yet another insurer will no longer offer new plans on the marketplace.

Health Alliance Medical Plans announced Wednesday that it is removing its plans... Reported by ChicagoTribune 10 hours ago.

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Fatal Flaws of Any Post-ACA Republican Replacement Plan

January 18, 2017, 9:32 am

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The recent first step by the Republicans for repeal of the ACA (by a vote of 51-48 in the Senate and 227-198 in the House) (1) opens up an intense debate among Republicans as to how and when to replace it. President-elect Donald Trump is pressing Congress to replace it concurrently, or nearly so, with its actual repeal, with which House Speaker Paul Ryan now seems to agree. Recent talk of a two to four-year delay is quickly fading away. Having embarked on the budget reconciliation process, the GOP can expect to pass repeal with just a bare majority vote in Congress, thereby avoiding filibuster by Democrats, but knows it will need 60 votes in the Senate to pass any real replacement package, thus requiring some help from the Democrats.

Some say the GOP still has no replacement plan, after almost seven years contesting the ACA, But they actually have published their principles, and have somewhat similar competing plans on the shelf, with some variation as to details. Republicans now realize the political dangers of a two to four-year delay after repeal, and are now trying to gain consensus among these plans as two House committees report out by the end of this month. The question of Tom Price's role in the outcome lingers as his committee hearings are delayed into February, when we will learn if he is to be confirmed as incoming head of the Department of Health and Human Services (DHHS).

In the meantime, we already know a lot about what to expect in the final Republican post-ACA replacement plan. First, these are the principles upon which it will be based:
1. States, not the federal government, should have primary responsibility for health policy;3. Patients and doctors should be in control;5. There should be more competition among health plans to give patients more choices; and7. Small business should have more discretion and flexibility to configure health benefits for their employees. (2
Released last summer, Paul Ryan's 37-page white paper, A Better Way, includes continuation of consumer-directed health care (CDHC) (with patients having "more skin in the game"), health savings accounts, high-risk pools, selling insurance across state lines, association health plans among businesses, and further privatization of Medicare and Medicaid (3) Tom Price (R-GA), as leader of the House Budget Committee, proposed in 2015 the complete repeal of the ACA, as well as privatization of Medicare, sharp cuts in Medicaid funding, and defunding of Planned Parenthood. (4)

The problem with all of these proposals is--they won't work. Each of these directions has been used for years, and have all failed to assure Americans with better access to affordable health care. They have been discredited by long experience. Here are four fatal flaws to these proposals:
1. Market failure. Like the ACA, any of their replacement plans are still based mainly on the private for-profit market place. Insurers, the drug industry, and other parts of the medical-industrial complex, including their shareholders, have enjoyed bonanza years on Wall Street under the ACA without any significant cost containment. Most people are unaware of how extremely privatized and for-profit the current health care system is, as these examples show: free-standing laboratory and imaging centers (100 %), surgical-centers (95 %), dialysis centers (90 %), home care (76 %), nursing homes (65 %), and hospice (63 %) (1) (2016 Annual Survey by the Commerce Department or most recent available data for share of establishments.) Instead of increased competition, we have seen increasing consolidation and less competition under the ACA.3. Failure to learn from past failed health care policies. Republicans conveniently forget that the ACA was modeled on a health plan brought forward by the Heritage Foundation and enacted as the Massachusetts Health Plan by Governor Romney in 2006. Three years later, a study comparing safety net hospitals with non-safety net hospitals found that the former played a disproportionately large role in caring for disadvantaged patients and were hurting financially. (5) Many reasons for the ACA's failure have been discussed elsewhere, including its reliance on a failing multi-payer financing system with some 1,300 private insurers, mostly dedicated to profits rather than coverage of patients' health needs. How they continue to discriminate against the sick, profiteer, and inflate their overhead has been described elsewhere, to the point where the industry is not sustainable without taxpayer support. (6)5. Further privatization. Contrary to experience, evidence and GOP ideology, privatization is less competitive, less efficient, and more expensive for patients than the public sector, as already demonstrated by private Medicare and Medicaid plans. Privatized plans offer less choice, are more volatile and less accountable than their public counterparts. They game the system and demand ongoing overpayments (e.g. more than173 billion to Medicare Advantage between 2008 and 2016 (7) All that amounts to corporate welfare at taxpayer expense.7. Dependence on larger role of states. There are already wide variations in states' definitions of eligibility and coverage, which are likely to increase further as more restrictive federal block grants to states become widespread. Safety net resources will be hit hard, seriously impacting the most vulnerable among us.
The GOP is taking us over a cliff, not yet realizing it may well be political suicide for the party. We can expect that any GOP replacement plan will cost patients, families, and taxpayers more, and that we will all get less. This is all so foolish since there is a real solution in plain sight--single-payer national health insurance (NHI) if Republicans were not so blinded by ideology and unaware of the failed policies already proven by the last 25-plus years' experience, including those of the ACA, much of which are still baked into their supposed "better way." They also seem to be unaware of the most recent public polls strongly favoring NHI, regardless of political party. As just one example, a Gallup poll in May 2016 found that 41 percent of Republicans and leaners favored replacing the ACA with NHI. (8)

Defying experience and reason, we can anticipate that the GOP's principles and approaches will make an imploding ACA system even worse. We can then expect a huge backlash from the public and even the private insurance industry when it doesn't get all that it wants.

John Geyman, M.D. is the author of The Human Face of ObamaCare: Promises vs. Reality and What Comes Next and How Obamacare is Unsustainable: Why We Need a Single-Payer Solution For All Americans

visit: http://www.johngeymanmd.org
1. Robert Pear, Obamacare Repeal Moves a Step Closer to Reality, The Atlantic Online, Jan. 13, 2017 - https://www.theatlantic.com/politics/archive/2017/01/obamacare-repeal-moves-a-step-closer-to-reality/513143/3. Senate Republican Leaders Vow to Begin Repeal of Health Law Next Month, New York Times Online, December 6, 2017 - https://www.nytimes.com/2016/12/06/us/politics/senate-republican-leaders-vow-to-begin-repeal-of-health-law-next-month.html?_r=05. Rovner, J. House Republicans unveil long-awaited plan to replace health law. Kaiser Health News, June 22, 2016 - http://khn.org/news/house-republicans-unveil-long-awaited-plan-to-replace-health-law/7. Petito, J, Hyatt, A, Zingman, M. We condemn the AMA and AAMC endorsements of Tom Price for HHS secretary. Common Dreams, December 12, 2016 - http://www.commondreams.org/views/2016/12/01/we-condemn-ama-and-aamc-endorsements-tom-price-hhs-secretary9. Mohan, A, Grant, J, Batalden, M et al. The health of safety net hospitals following Massachusetts health care reform: Changes in volume, revenue, costs, and operating margins from 2006 to 2009. Intl J Health Services 43 (2): 321-335, 2013 - https://www.ncbi.nlm.nih.gov/pubmed/2382190811. Geyman, JP. How Obamacare Is Unsustainable: Why We Need a Single Payer Solution for all Americans. Friday Harbor, WA. Copernicus Health Care, 2015 - https://www.amazon.com/How-Obamacare-Unsustainable-Single-Payer-Americans/dp/098879969313. Geruso, M, Layton, T. Upcoding inflates Medicare costs in excess of2 billion annually. UT News. University of Texas at Austin, June 18, 2015 - https://news.utexas.edu/2015/06/18/upcoding-inflates-medicare-costs-in-excess-of-2-billion15. Republican support for single-payer. Gallup poll, May 16, 1016. Keith Ensminger. Kramer Translation, Merced, CA. Personal communication, September 8, 2016 - http://www.gallup.com/poll/191504/majority-support-idea-fed-funded-healthcare-system.aspx

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Trump Health Pick Says It's 'Imperative' People Get To Keep Obamacare Coverage

January 18, 2017, 10:17 am

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Rep. Tom Price (R-Ga.), President-elect Donald Trump’s choice to run the Department of Health and Human Services, just put down some potentially important markers on health care policy.

During a Senate hearing Wednesday, Price said is “absolutely imperative” that people with insurance get to keep their coverage even if Republicans repeal Obamacare.

Price also said that, as far as he knows, Trump continues to oppose cuts in Medicare and Medicaid.

Making sure nobody loses coverage and maintaining existing funding for Medicaid isn’t consistent what Republicans, including Price, have said or endorsed in the past.

In fact, it’s pretty much the opposite. Republican proposals to repeal Obamacare and transform Medicaid into a block grant would result in far less federal spending on health care ― and, as a direct consequence, many millions of Americans losing their health insurance.

But Price’s comments contained the usual ambiguity, making it impossible to know exactly what he was trying to say ― or what the statements tell us about policy decisions by the Trump administration.

Price made the comments to the Senate Health, Education, Labor and Pensions (HELP) Committee. The HELP meeting is part of the confirmation process, although it’s considered a “courtesy” hearing because the Finance Committee, not HELP, will vote on Price’s appointment.

Price, a physician, phrased his answers carefully, leaving plenty of room for different interpretations.

The quote about people keeping coverage, for example, came in response to a question from HELP Chairman Lamar Alexander (R-Tenn.). It wasn’t entirely clear whether Price was speaking strictly about the short-term while Republicans consider and construct their “replacement” for the Affordable Care Act, or whether he was also referring the long term, once that replacement plan is in place.

But Price’s full quote certainly suggested that maintaining levels of insurance coverage would be a priority for the Trump Administration:

“Nobody’s interested in pulling out the rug from under anybody,” Price said. “We believe that it’s absolutely imperative that individuals that have health coverage be able to keep health coverage and move hopefully to greater choices and opportunities for them to gain the kind of coverage they want for themselves and for their families.”

Price went on to say, “I think there has been a lot of talk about individuals losing health coverage. That is not our goal nor is it our desire nor is it our plan.”

Later in the hearing, Sen. Bernie Sanders (I-Vt.) presented multiple quotes from the presidential campaign, during which Trump had indicated he opposed cuts to Social Security, Medicare, and Medicaid.

Here’s how that exchange went:

SANDERS: Is the president-elect, Mr. Trump, going to keep his word to the American people and not cut Social Security, Medicare, and Medicaid? Or did he lie to the American people? 

PRICE: I haven’t had extensive discussions with him about the comments he made. But I have no reason to believe that he has changed his position.

SANDERS: So you are telling us that to the best of your knowledge, Mr. Trump will not cut Social Security, Medicare, and Medicaid.

PRICE: As I say, I have no reason to believe that position has changed.

If Trump actually opposes cuts to Medicaid ― and if he is actually determined to preserve coverage for people who have it ― he’s going to have a hard time reconciling those views with the proposals that congressional Republicans have floated over the years.

A prime example is legislation that Price has introduced in the House of Representatives.

That bill would devote significantly less money to help lower-income people buy health insurance. In addition, Price has repeatedly advocated cutting Medicaid spending for poor Americans, in ways that experts say would lead to millions losing coverage.

Enacting either of those bills, or some variation of them, would mean reversing Obamacare’s progress on the uninsured. The law has helped around 20 million people get health insurance, according to multiple estimates, and reduced the number of uninsured Americans to a record low.

The law also disrupted some existing insurance arrangements, leaving some people to pay higher prices or face higher out-of-pocket costs than they did before. This is largely because the law now requires insurers to cover a wide swath of benefits and to insure everybody, regardless of pre-existing conditions.

Price and other Republicans have promised to make insurance cheaper, primarily by scaling back or eliminating those requirements.

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Paul Ryan Is Lying In Order To Destroy Medicare

January 18, 2017, 3:08 pm

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Medicare works. It’s far more efficient, cost effective, and affordable than private sector health insurance. Not surprisingly, it’s also a lot more popular. It should be extended to all of us.

Instead, House Speaker Paul Ryan is working hard to destroy Medicare and force seniors and people with disabilities into the arms of private, for-profit health insurers. Ryan wants to end Medicare as we know it and, instead, simply give seniors and people with disabilities fixed cash stipends to fend for themselves, unprotected, on the private market.

Ironically, Ryan is proposing to convert Medicare into the very system he is rushing to repeal — the Affordable Care Act (“ACA” or “Obamacare”) — but without its protections, such as the requirement that private insurers cover those with pre-existing conditions.

Ryan claims that the ACA must be killed quickly because “we have to bring relief as fast as possible to people who are struggling under Obamacare.” Out of one side of his mouth, he asserts that young, healthy Americans are struggling to buy private health insurance, even though the government provides them with subsidies to help with the cost and requires that they can’t be turned down because of pre-existing conditions. Out of the other side of his mouth, Ryan claims that seniors and people with disabilities will be just fine with a government provided subsidy in the form of a voucher, and no other protection!

Before the enactment of Medicare, many seniors and people with disabilities couldn’t get health insurance at any price. And those that managed to find an insurance company willing to cover them were charged premiums that would be out of the reach of most seniors even with a government voucher.

To accomplish his goal of ending Medicare as we know it, Ryan and his allies are dusting off the same playbook that they use for Social Security. One play is to falsely claim that the program is in crisis and that the solution, to “save” it from the supposed crisis, is to dismantle it. In a particularly shameless use of this strategy, Ryan is blaming Obamacare for the “need” to cut Medicare — even though the ACA, in truth, improved Medicare’s finances. It also closed the Part D donut hole and added important preventative care benefits to Medicare, all of which will be lost if Republicans go ahead with repealing the ACA.

Another play from the Destroy Social Security Playbook is to claim that those aged 55 and over will not be affected. (This play — and indeed the entire Destroy Social Security Playbook — can be read in an illuminating article, Achieving a Leninist Strategy, which was written in frustration, shortly after President Ronald Reagan signed legislation restoring Social Security to long-range balance, rather than dismantling it, as the authors wanted.)

Consistent with Achieving a Leninist Strategy, Ryan, in a recent town hall, kept reiterating that no one currently on Medicare would be affected by his plan to destroy it. Besides being deeply insulting — assuming that those on Medicare are selfish, caring only about themselves and not about what happens to their children and grandchildren — it is also a lie.

First, Ryan proposes to increase current beneficiaries’ out of pocket costs, limit their access to Medicare supplemental plans, known as Medigap, and restrict their ability to litigate actions in the event of malpractice. But that is just the immediate cuts. Over time, his proposal is likely to destroy Medicare completely, even for those now on it.

By raising the initial age of Medicare eligibility to 67, as he proposes, and providing those younger than age 55 simply with a voucher to purchase health insurance, Ryan would leave traditional Medicare with an aging group of beneficiaries. Currently, Medicare covers the oldest and sickest. Under Ryan’s Medicare, that group would be even older and sicker — and continually shrinking in size.

What protects Medicare is that its beneficiaries are 55 million-strong and rapidly growing in number as the Baby Boom ages. And that large group of Americans are consistent voters. Once Ryan’s voucher plan went into effect, the number of people covered by traditional Medicare would start to shrink, as current beneficiaries die. And those that remain would be older and, likely, in poorer health.

As that number diminished, so would the program’s political clout. Who could trust, as Medicare covered fewer and fewer people who were more and more costly the older and sicker they became, that a future Congress wouldn’t end it? And even if they didn’t end it outright, who can trust that a future Congress wouldn’t save the government money by raising the premiums and other out of pocket costs for those who remained? And who can trust that a future Congress wouldn’t reduce the reimbursement to doctors and hospitals, resulting in fewer and fewer health care providers covering Medicare patients? Indeed, Ryan is proposing to lower those reimbursement rates now.

What Ryan and his fellow Republicans refuse to admit is that Medicare is the best part of the nation’s health care system. This is true despite Medicare covering the most expensive part of the population. Other industrialized nations, which have substantially older populations and less wealth than we do are able to spend half what we spend on health care while providing health care to all their people as a right. Perhaps not surprisingly, they can spend less, cover everyone and still have better health outcomes, like longer average life expectancies. They do it by having what amounts to Medicare for all.

Insurance is most inexpensive and efficient when it has the broadest risk pool possible without what is called adverse selection. That is, insurance is best when everyone is covered under the same plan and everyone must participate, not just opt in when the protection is needed immediately. Only the federal government has the power and the ability to cover everyone, spreading the risk and responsibility as broadly as possible.

No other nation has the crazy patchwork system we have, which includes employer-sponsored private insurance, means-tested insurance, and individual private insurance, in addition to government-run Medicare. Ryan proposes to make the patchwork system even more of a hodgepodge, with less coverage and higher costs. Even insurance companies aren’t clamoring for this — they make their money by covering young and healthy people, not older and sicker ones.

So why is Ryan determined to replace a system that works with one that all evidence says will not? Among his many lies, he has told one truth, which sheds some light on his true motives: ideology and greed.

Ryan accurately states that his plan will save the government a huge amount of money. What he doesn’t state, though it is also true, is that the government saves this money by shifting costs to individuals least able to afford it. Those unable to afford the costs will presumably forego treatment. Either way, the government is off the hook and its costs remain low. What he also doesn’t state is that while the government’s costs are reduced, the nation’s health care costs will increase, because the system will be much less efficient.

So, what is the ideology and what is the greed? Republicans believe, with what amounts to religious fervor, that the private sector is always superior to the government. But there are some things the government does better than the private sector. And Medicare is one of them. It puts the lie to the Republican belief and so, in their eyes, must be destroyed.

A second motive is simple greed, and the related motive of retaining power. They want to balance the unified federal budget on the backs of seniors and people with disabilities to make room for tax cuts for the richest and most powerful. (The unified federal budget is something the law doesn’t even recognize, but that is another story.) They want to shower benefits on millionaires and billionaires – the group that makes up the bulk of GOP campaign donors and is also well represented among the politicians themselves.

Notwithstanding Republican lies to obscure their true motives and fool the American people, the fight over Medicare is a question of values, plain and simple. We are the wealthiest nation in the world at the wealthiest moment in our history. Indeed, we are the wealthiest nation in the history of the world. The question is how we choose to spend that wealth: Do we funnel even more of it up to the richest people in the country, or do we use it to ensure that seniors and Americans with disabilities have access to health care?

That is a debate worth having. It would be an honest debate. But it is one in which not even the Republican base would side with Republican politicians and elites. So instead Ryan and his fellow believers have chosen simply to lie. Senator Al Franken got it right when he chose to title his 2003 bestseller about Social Security privatization and other Republican policy prescriptions, Lies And the Lying Liars Who Tell Them.

An honest debate would be whether we, as a nation, prefer to expand Medicare, cut it, or end it? An honest debate over Social Security raises the same alternatives. That is a debate supporters of Social Security and Medicare relish. But it is a debate opponents will do anything, including lying, to avoid.

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Clueless, Reckless, Graceless, Mindless and Heartless: Our President-Elect

January 18, 2017, 12:39 pm

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There have been giants who served as president: George Washington helped found the country; Abraham Lincoln freed the slaves; Teddy Roosevelt established the national parks; Franklin Roosevelt pulled us out of The Great Depression and defeated fascism; Lyndon Johnson established Medicare; Bill Clinton gave the nation with a budget surplus; and Barack Obama provided access to health insurance for all Americans.

Now we await Donald Trump, and I am deeply concerned for our country and the world. He has demonstrated he is both dangerous and unfit for office. Does he understand the magnitude of the job? Did he just run for president to get even with President Obama who once made jokes about him at a White House Correspondents’ Dinner? Does he want to get rid of Obamacare just because of the name? 

He doesn’t just bring economic policies I happen to disagree with, or an approach to healthcare funding that could hurt millions of people. This isn’t simply a matter of Republican versus Democratic. This is a man who, on record and often on video, disparaged or outright ridiculed women, immigrants, the disabled and others. He lost the popular vote by nearly three million votes, and yet cannot seem to grasp that the president’s obligation is to at very least attempt to unite and respect all Americans.


I cannot respect a racist, xenophobic sexist who puts us all at risk with his behavior.

I have great respect for the experienced politicians who have served our nation with sincere regard to improve and protect the republic, even those I have often disagreed with. I cannot, however, respect a racist, xenophobic sexist who puts us all at risk with his behavior.

A series of studies by the Financial Times showed Trump was bailed out of bankruptcy by Russian entities more than once. This, we can only assume, is the real reason he won’t release his tax returns, as it’s proof that he is literally indebted to Russia. If Trump claims this isn’t true, he is welcome to release his returns, but I don’t think they will ever see the light of day or public scrutiny.

There are now reports of possible Russian blackmail material on Trump, and that he and President Obama were briefed on this by our intelligence agencies. The Washington Post reminded us that his son, 

Donald Trump Jr. — who is also an executive with Trump’s business — makes clear how the company in 2008 sought business from wealthy Russians. ‘In terms of high-end product influx into the U.S., Russians make up a pretty disproportionate cross-section of a lot of our assets,’ he said at a conference that year, according to news reports. ‘We see a lot of money pouring in from Russia.’

It took Trump until the January 11^th press conference to acknowledge our 17 intelligence agencies’ findings that Russia had indeed manipulated our election with their hacking. Trump’s siding with Vladimir Putin and Julian Assange over our expert intelligence officials is a dangerous harbinger for American democracy.

He will not divest his assets or put them in a real blind trust. We can not see his charitable donations – if he has any. The head of the Office of Government Ethics said Trump’s plan to avoid conflicts of interests is “meaningless.” Experts say he will be in Violation of Article 1, Section 9 of the Constitution on the first day of his presidency. His claim that he will never talk to his sons about his business is laughable.

Meanwhile, FBI Director James Comey knew of the potential Russian blackmail on Trump and didn’t release it, because it was too close to the election. Yet he didn’t pause to release detrimental and unsubstantiated information on Hillary Clinton that likely cost her the presidency. Addressing allegations of Russia’s election hacking, Comey recently told the Senate Intelligence Committee, 

I would never comment on investigations — whether we have one or not — in an open forum like this so I can’t answer one way or another.” Senator Angus King of Maine said it perfectly when he responded, “The irony of your making that statement, I cannot avoid.

The irony is also unavoidable in Trump’s claims of “fake news” and a media “witch-hunt” against him. He refused to call on CNN at his press conference, blaming the station for factually reporting that he had been briefed about the potential Russian blackmail. The Russian and GOP operators along with Steve Bannon and Breitbart News helped to create fake news and true witch-hunts that didn’t just derail elections, but put people’s lives in danger. One month ago, a man who believed ridiculous, fake conspiracies against Hillary Clinton took an AR-15 rifle and .38 caliber pistol into a pizzeria and said he would sacrifice the “lives of a few for the lives of many”?

While preparing to become the president of the United States, he finds the time to tweet ― seemingly without anything more important to distract him ― about all of the TV shows, magazines and newspapers that don’t bolster his ego enough or that dare to print the facts of his lies. He used the 9/11 anniversary in 2013 to address his “haters.” He did the same this year in a New Year’s greeting “to my enemies.” This is unlike anything we’ve ever seen before. Our presidents are usually magnanimous and have a sense of the gravity the office and our democracy.

Meanwhile, he says he does not need to spend time sitting through intelligence briefings, but finds the time to start Twitter fights with Gov. Arnold Schwarzenegger over television ratings. I’m not the first to say it, and you need only peruse top ten lists of his most horrifying or childish tweets to see his own words as evidence. Donald Trump behaves like a petulant child. 

How can we forget the endless “birther” conspiracy that Trump created around President Obama’s legitimacy as an American citizen and then claimed that he ended it? Back in 2012 he tweeted: “An ‘extremely credible source’ has called my office and told me that @BarackObama’s birth certificate is a fraud.” This, much like his secret plan to defeat ISIS or have Mexico pay for a border wall, is typical of Trump’s claims; no evidence, no names, made-for-reality-TV faux suspense, and absolutely no credibility.

We can expect Trump, as Trevor Noah pointed out, to spend the next four years denying things he has said that are documented in print and on video. In other words, we can expect him to lie, and lie prodigiously. He projected on Hillary Clinton his own characteristics, “corrupt,” “crooked,” and “lying.”

I lived through President Bush, who was elected even though he lost the popular vote. His administration also used the intelligence agencies to falsify evidence to justify war. That president led us into a war that still rages today, a decade and a half later, and gave rise to ISIS. I am terrified at what risks Trump poses to the world as well.

I hope all our representatives and senators, hopefully even Republicans, will do all they can to ensure that some semblance of justice is served in America, and the world is not put at great, unnecessary risk. The rest of us must remain vigilant. Write your representatives and senators. Make donations to groups that fight for equal rights, civil rights, freedom of the press, anti-climate change measures, gun control regulation and healthcare mandates. Protest. Speak up. Help others. We are all in this together, and it is our right and responsibility to protect our freedoms and help our fellow citizens.

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Meet 10 Women Who Rushed To Get An IUD Before Inauguration Day

January 18, 2017, 3:20 pm

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Since the morning of November 9, when it was clear that Donald Trump would become the 45th president, droves of women have gone to their gynecologists seeking low-cost, long-acting reversible contraception before Trump’s inauguration ― and before the GOP dismantles the Affordable Care Act. 

Planned Parenthood reports that the demand for IUDs has gone up *900 percent* since the election.

And women’s health care providers say they have heard from women who are frightened about what the next four years will bring for their reproductive rights. 

Some got their IUDs and implants months ago, and others are still scrambling to get an appointment with mere hours to go before Trump is sworn in.

Here 10 women explain why they are part of the post-election IUD rush:*“I worry about being priced-out of birth control in the future. “ ― Anonymous, 31, Wash.*

I made the IUD decision by the time Trump made his victory speech on election night. I couldn’t watch it. I was sick. I worry about being priced out of birth control in the future since I tried to get an IUD with my insurance pre-Affordable Care Act and couldn’t afford it ― and other methods make me extremely ill. Conservatives are getting more and more rabid and extreme with regard to reproductive services, and I also have this sick feeling that not only is abortion on the verge of being fully outlawed, but that these methods of birth control are at risk of being classified as abortifacients and subsequently becoming outlawed.

*My physician said her office, which is a non-Planned Parenthood, fairly standard primary care practice, had seen a huge uptick in requests for IUDs since the election. I told her that I was scared about the future of healthcare and worried about being able to access birth control after Trump takes office. She agreed and admitted her colleagues share in those fears and uncertainties.* My IUD was actually on backorder, so it took about a month for me to get an appointment. Overall, it was not a heartening experience. 

*“I knew I needed to get that IUD before the chance was taken away.” ― Cassie, 25, N.C.*

I live in a progressive college town, but it is still the South. Leading up to the election, I just had this feeling of dread from the atmosphere around me. I really felt that healthcare was under attack and could very well change. Since my 26th birthday is only a few months after the election, I called my gynecologist and scheduled an appointment to get an IUD. I’m a rape survivor, and after the assault, I’ve always made sure I had some type of protection.

It doesn’t make me happy that I predicted what might happen and to be honest, the last few days I’ve been like a petulant child, plugging my ears against what’s being said about the fate of the ACA. *I have grown so weary of hearing that such an important piece of legislation for millions of Americans is considered as something that “needs” to be repealed.* 

*“Just because I don’t have an ACA plan doesn’t mean I’m not impacted by it in general.” ― Maggie, 31, Ohio*

I’ve been on birth control for over a decade. Before the Affordable Care Act, I was spending $60 a month on the NuvaRing. With the ACA, it was free. I’d always thought about getting an IUD because I have no intention of ever having children, but it didn’t seem necessary. When Trump won the election, I felt panicky. It was suddenly something I needed to do. 

I’m on my husband’s insurance and I spent a few days on the phone with the insurance company and his HR department trying to make sure it was approved. Every time I got on the phone with someone I said, “I have to get this before January 20th.” And they were all like, “Yes. I understand.”

Just because I don’t have an Affordable Care Act plan doesn’t mean I’m not impacted by it. *I remember what it was like to pay $60 a month on birth control. I work for a non-profit, and I don’t make a ton of money. Sixty dollars a month for the rest of my fertile years is a significant amount of money to me. *

*“I’m worried Obamacare isn’t going to stick, and I need something that is going to protect me.” ― Becki, 31, Wash.*

I recently got on Obamacare because I made the decision to go back to school full-time and I have no income right now. I’ve been on the pill since I was 17, but three weeks ago I got an IUD. 

I’m worried Obamacare isn’t going to stick, and I need something that is going to protect me. It didn’t cost me anything, because I have no income at this point.* *In the past, care providers warned me it might be painful because I haven’t had children yet, but* I’ll tell you, I actually marched into my doctor’s office and told her I needed one. After, I just felt this great sense of peace of mind.* It was painful, and I did have some minor complications, but I do not regret it for a second. 

*“I’m on my husband’s plan, which is Grandfathered.” ― Andrea, 30, Calif. *

I had never gotten an IUD before because I was under the impression they were only for women who were done having children.* Then after the election I saw all the headlines saying to get an IUD now. I felt like, I’m not taking any risks under this administration so if I’m able to get one through my doctor, I’m definitely getting one.*

It took a lot of back-and-forth with my insurance. I’m on my husband’s plan which is Grandfathered, so they don’t have to follow Obamacare’s rules. I told them my doctor wanted me to get an IUD, and my insurance told me they didn’t cover that. Then they gave me a bunch of different co-pays. They said $10, then $20, but when I called the specialty pharmacy department, they told me $600.

On January 1, my insurance actually stopped charging copays, so my IUD cost $0, but if I had it two weeks before it would have cost me $600. That’s crazy. The only IUD they covered was the Skyla, which only lasts three years, so I don’t know what’s going to happen in that last year under Trump. I’m not thrilled about it.

*“The thing that really motivated me to get an IUD was the appointment of Jeff Sessions.” ― Kate, 28, Calif.*

I graduated with my Ph.D. in December and I am planning to stay in scientific research for my career. It’s such a commitment that I don’t want to have children, though I do have incredible respect for women who do both.

The thing that really motivated me to get an IUD was the appointment of Jeff Sessions. *With his positions on women’s rights, it just feels like we’re headed back in time.* I truly feel like I’m personally making a decision that will really allow myself to dedicate my life to improving the country through scientific research, and controlling whether or not I have children lets me do that. So, you’re welcome, Jeff Sessions! 

*“After my IUD insert, my reproductive health improved dramatically.” ― Amanda, 28, Mich.*

During high school, my periods became incredibly painful and heavy to the point where I was throwing up and missing school each month. Finally, I was diagnosed with endometriosis and put on Seasonique, the 91-day birth control pill. I don’t remember being talked to about options.

After college, I worked as a health care specialist at Planned Parenthood and I learned about the IUD. I paid $350 for my first Mirena. At the time, birth control was not 100-percent covered by insurance, but thankfully I was under 26 and still on my parent’s insurance plan, which included a Health Savings Account. My mom allowed me to use it to pay for my Mirena, which otherwise I would not have been able to afford. After, my reproductive health improved dramatically. My periods did not stop, but they did become lighter and shorter with barely any cramping or pain. 

*My Mirena was due to be replaced in March, but after the election I opted for an early replacement with another IUD so I would be guaranteed protection for the next five years. *My experience working at Planned Parenthood made it clear to me that reproductive health is an extremely personal issue. There is a reason behind each and every woman’s decision to opt for her unique contraceptive method that politicians will never be able to fully understand.  

*“I knew that if I was ever going to be able to afford an [IUD], this was my window.” ― Katie, 22, Calif.*

I have insurance through the Affordable Care Act and co-pay and IUD insertion were, fortunately, covered. I wasn’t even necessarily ready for one, but I knew that if I was ever going to be able to afford one, this was my window of opportunity. 

I am really frightened, especially for women who rely heavily on the ACA for care. I am terrified of what outcomes may result due to the repeal. Women’s bodies are not identical and what may work for one woman may not work for the next. *For women with strong family histories of breast cancer, like me, hormones are not always ideal. My mom’s breast cancer is fueled by estrogen and progesterone so it terrifies me to think about using a hormonal contraceptive that could possibly increase my risk in the future. Because of this, I don’t have as many options for birth control.* One of the amazing benefits the ACA offers is coverage for a variety of birth control options, because it truly isn’t a one-size-fits-all matter.

*“I’ve always been on the pill for heavy periods. “ ― Andrea, 43, Kan.*

I’ve always been on the pill for heavy periods, not for contraception at this point (I have two children and my husband has had a vasectomy). I’d played around with the idea of getting an IUD before, but after the election, I immediately decided to get one. *It cost me zero dollars, but I got an explanation of benefits from my insurance company that said it would have cost $1,700 if not for the Affordable Care Act*. I feel empowered by having it. It’s such a great option, because it’s so low-key and low-maintenance and cost effective … for now.

*“My health insurance doesn’t cover any form of birth control.” ― Linnea, 21, Colo.*

I had thought about it getting an IUD or the Nexplanon implant, so I went to a doctor where I learned my health insurance (which I have through my father’s union) doesn’t cover any form of birth control. Not the pill, not the IUD, nothing. I was able to go to a children’s hospital in Colorado that gets grants from the government where I could get the implant ― and get tested for HIV ― all for free.

*I’d actually decided on it before the election, and I had my appointment at 8 a.m. on the morning after. I just remember sitting there thinking, ‘This is incredible timing. In a couple of months, this might not be an option anymore.’* I spoke to a nurse, a nurse practitioner and a doctor and every single person made a comment about it. They were like, “You’re really lucky getting this today.” 

Accounts have been edited and condensed for clarity

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 5 hours ago.

Trump Filling 'Swamp' With 'Alligators' -- Wall Street Tycoons and Billionaires

January 18, 2017, 3:56 pm

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It's not very difficult to run for political office as an outsider and claim that you'll do everything differently than anyone else. When you have never held office and governed, you have the advantage of having no track record at all.Throughout the campaign, President-elect Donald Trump led his rallies with chants of "Drain the swamp," his catch phrase about getting rid of politicians he called corrupt and ending Wall Street control over our economy. But before he's even taken office, we've learned that "Drain the swamp" actually means, "Drain the swamp and then fill it with advisors who are ready to pursue their Wall Street agenda, whether that means getting rid of consumer protections from abuses of the Big Banks, rejecting efforts to pay workers' overtime wages, or vowing to privatize the Medicare program that has done so much for our nation's seniors."Soon up for Senate confirmation will be Rep. Tom Price to head the Department of Health and Human Services. This is a disturbing choice for many reasons.Price has led the charge to privatize Medicare, which would seriously jeopardize the lives of millions of Americans and particularly harm seniors.In Congress, he received hundreds of thousands of dollars in contributions from big drug and insurance companies that would benefit from his privatization agenda -- and hurt working families. Price has said, "Nothing has had a greater negative effect on the delivery of health care than the federal government's intrusion into medicine through Medicare." The Washington Post called him a "longtime advocate" of Medicare privatization, where the government would "provide assistance for seniors to buy private health insurance plans."After campaigning for months against Wall Street "getting away with murder," Trump chose Steve Mnuchin for Treasury Secretary. Mnuchin is a former Goldman Sachs banker who tried to foreclose on the home of a 90-year-old woman for a 27-cent payment mistake.It's difficult to think of a nominee who better embodies the culture of Wall Street greed than Mnuchin, who personally profited from families' losses during the Great Recession by foreclosing on tens of thousands of working and middle-class families.Mnuchin already has proclaimed that cutting corporate taxes will be his number one priority as Treasury Secretary, which tells you all you need to know on whether he is looking to serve regular Americans or corporate special interests.Price and Mnuchin are a great fit with Trump's other picks. Trump picked Exxon Mobil CEO Rex Tillerson to be Secretary of State. He named Wilbur Ross -- a billionaire known as the "king of bankruptcy" who devastated communities by buying up companies and shipping the jobs overseas -- as his pick for Secretary of Commerce.He selected Andrew Puzder, the CEO of CKE Restaurants, for Labor Secretary. Puzder doesn't like many of the programs that working people count on, like fair pay and overtime requirements. In fact, it seems as though he doesn't like working people at all. In 2016 Puzder told Forbes that in contrast to human workers, machines are "always polite, they always upsell, they never take a vacation, they never show up late, there's never a slip-and-fall, or an age, sex, or race discrimination case."This corporate dream team cabinet also includes Goldman Sachs president Gary Cohn as director of the National Economic Council, and Elaine Chao, who made $1.2 million while overseeing Wells Fargo as it faced record fines for creating millions of fraudulent bank accounts, for Transportation Secretary.The Wall Street Journal says that with the incoming Trump Administration and Republican control of Congress, the banking industry is excited "to usher in a new era of financial deregulation."This Wall Street cabinet of billionaires running our government isn't what Trump voters voted for. They heard "drain the swamp" and thought there would be a new direction and accountability, especially from Wall Street. Sadly, these cabinet picks show that the needs and wish list of corporations, the wealthy, and Wall Street will be front and center yet again.The billionaires whose greed caused the Great Recession in 2007 and who have shipped millions of good jobs overseas now control the White House and Congress. My union and the entire labor movement are fighting back against this corporate takeover. We will hold the President accountable for the big promises he made to the American people.-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 5 hours ago.

Trump health pick defends stocks, says Americans won’t lose insurance

January 18, 2017, 3:51 pm

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President-elect Donald Trump’s nominee to head the U.S. Department of Health and Human Services defended his stock holdings and proposals to dismantle Obamacare on Wednesday, saying Americans would not suddenly lose health insurance. Price told the Senate Committee on Health, Education, Labor ... Reported by Raw Story 5 hours ago.

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Actually, Tom Price, Women Have Been Fired For Their Reproductive Choices

January 18, 2017, 4:45 pm

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During his Senate confirmation hearing Wednesday, Rep. Tom Price (R-Ga.) said he didn’t believe employers were currently able to fire women for their reproductive decisions, specifically their choice to use birth control. 

Back in 2015, Price voted for a resolution that would have dismantled the District of Columbia’s protections for women from being fired for their reproductive health decisions. The description of the resolution clearly states that it disapproves of the D.C. Council’s vote to approve the Reproductive Health Non-Discrimination Amendment Act of 2014, which protects people from workplace discrimination based on their reproductive health decisions. 

But during Wednesday’s senate hearing, Price insisted that the resolution he voted for would not have the effect of allowing employers to let workers go because of their personal health decisions. Here’s part of the exchange, with Sen. Maggie Hassan (D-N.H.): 

Hassan: No, the question is whether an employer, who, let’s say, in a self-insured, employer-provided health insurance plan, finds out that a female employee who earned the benefit with her hard work is using the benefit to provide health ― to provide birth control, to buy birth control, which the benefit provides, and then fires her because the employer disapproves of the use of birth control. 

Price: I don’t think that’s the case. 

Hassan: You don’t think that ― would you like us to provide examples for you? 

Price: Yeah, I’d be happy to. 

Hassan: So, you would be willing to say that employers may not — you would support a law, a rule, that employers may not discriminate against women for their reproductive health decisions?

Price: I don’t think that employers ought to, that employers have the opportunity right now to be able to let somebody go based upon their health status or the medications that they use.

To help Price out, here are just a few examples of women being fired for reproductive choices their employers didn’t agree with, compiled by the National Women’s Law Center:  

1. Christa Dias was fired from her job as a Catholic school teacher in Cincinnati in 2010, after school administrators found out she was unmarried and had become pregnant through artificial insemination. A jury awarded her more than $170,000 in 2013 after she filed an anti-discrimination lawsuit against the Roman Catholic Archdiocese of Cincinnati. 

2. Kelly Romenesko was fired from her teaching job at two Catholic schools in Wisconsin after she and her husband became pregnant through in vitro fertilization. The termination took place in 2004, just a few days after she told her boss that the fertility procedure had worked. Romenesko and her former employer, the Appleton Catholic Educational System Inc./Xavier, reached a settlement in 2007.

3. Emily Herx was fired from her job at a Catholic school in Fort Wayne, Indiana, in 2011 after school administrators found out that she and her husband were undergoing in vitro fertilization treatments. A jury awarded her $1.9 million in damages in 2014 after she filed a gender discrimination lawsuit. 

4. Christine John was fired from her job at a Seventh-day Adventist school in Michigan after school officials found out she was pregnant before she got married in 2005. 

5. Shaela Evenson was fired from her job at a Catholic school in Montana in 2014 after an anonymous letter to the Roman Catholic Diocese of Helena revealed that she was pregnant and unmarried. She had become pregnant through artificial insemination. In 2016, Evenson and the school reached a private settlement. 

6. Michelle McCusker was fired from her job at a Catholic school in New York in 2005 after she disclosed that she was pregnant and not planning to get married. The New York Civil Liberties Union filed a discrimination complaint on her behalf, and the U.S. Equal Employment Opportunity Commission ruled in 2006 that she had been the victim of unlawful pregnancy discrimination. 

7. After being compelled by a state law to offer employees insurance plans that included birth control coverage, the Madison Catholic Diocese in Wisconsin told employees that they could be fired if they actually used the benefit to get contraception. 

Price’s vote on this resolution is one of many legislative decisions he has made against reproductive choice and the right to an abortion. He has sponsored unsuccessful legislation that would have granted constitutional rights to fertilized embryos, voted for legislation that would have banned abortions nationwide 20 weeks after fertilization, and is against the Affordable Care Act’s birth control coverage mandate. 

This reporting is brought to you by HuffPost’s health and science platform, The Scope. Like us on Facebook and Twitter and tell us your story: scopestories@huffingtonpost.com. 

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 4 hours ago.

Trump HHS nominee: It's 'imperative' people be able to keep health coverage

January 18, 2017, 5:20 pm

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In a nearly four-hour grilling Wednesday, Donald Trump's nominee for health secretary told senators again and again that he doesn't want anyone to lose health insurance. Reported by CNNMoney 3 hours ago.

Thank You President Barack Obama

January 18, 2017, 8:19 pm

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"This is your victory," President Barack Obama said in his 2008 victory speech given at a time when the country was in the worst economic recession in decades, with unemployment soaring, the financial markets near total collapse, and the country immersed with two costly foreign wars.

He inherited a dispirited and scared nation consumed with uncertainty and fear. But his message to the quarter million people gathered in Chicago's Grant Park, and tens of millions Americans watching on television, was one of hope. "The road ahead will be long. Our climb will be steep," he said. "We may not get there in one year or even one term. But, America, I have never been more hopeful than I am tonight that we will get there."

Many of those who voted for President Obama, the nation's first African American president, were seeking change. The government in Washington was failing, the political system was broken, and big money had too much influence. Manufacturing jobs were fleeing the country, millions of Americans had no health care, and the middle class was shrinking. America's place in the world was diminishing, terrorists cast a shadow over daily life, and U.S. soldiers were dying in two distant wars that seemed interminable.

President Obama's message of hope, his intelligence, his thoughtfulness, his incredibly positive demeanor, his decency, his integrity, his fine character, his grace under pressure, his equanimity and good temperament are traits that he lived by every day.

Many challenges faced this president. At the moment he was sworn in for his first term, the Republican leadership agreed to block every initiative, law, or action the president proposed. They proclaimed they wanted to make him a one-term president. Members of Congress, right wing radio talk show hosts and a New York real estate mogul constantly questioned President Obama's religion, citizenship and character. The attempts to delegitimize the president were disgusting and demeaning, and they added fuel to a very combustible situation created by those motivated by their own self-interests.

No president has been perfect. Every president makes mistakes, some more than others. History will ultimately be the judge of Obama's presidency. But, despite the challenges, he leaves office with many accomplishments. He was a truly consequential president.

President Obama saved the country from the Great Recession. He saved the auto industry. Unemployment fell from nearly 10% to 4.7% during his presidency, and the stock market has nearly tripled (almost all of it before his successor was elected). He extended health insurance to 20 million Americans, dramatically slowed the growth of health care costs, and made it possible for those with pre-existing health conditions to get insurance. President Obama supported marriage equality, repealed the military's "don't ask-don't tell" policy, signed legislation to combat pay discrimination against women, and signed the Hate Crimes Prevention Act. He signed the Dodd-Frank Wall Street Reform and Protection Act, and he signed the Credit Card Accountability, Responsibility and Disclosure Act. The president improved school nutrition programs, boosted fuel efficiency in cars, invested more in Veteran's Affairs, and reduced the homeless rate among veterans by 50%. He appointed the first Hispanic Supreme Court justice.

President Obama's administration helped negotiate the historic Paris Climate Treaty. The president helped negotiate the Iran Nuclear Deal, which includes Russia and our allies. He ended the war in Iraq, reduced American military presence in Afghanistan, and ordered the capture and killing of terrorist Osama bin Laden. He reversed Bush-era torture policies, began normalizing relations with Cuba, and he won the Nobel Peace Prize in 2009. However, he has been criticized for his policies toward Syria, Russia and the Middle East, three intensely complex and complicated issues with no easy solutions.

President Obama held his final news conference in the White House pressroom Wednesday, thanking reporters and sending a message to the incoming president about the importance of having the press corps in that location. "Having you in this building has made this place work better. It keeps us honest, it makes us work harder," he said. The president was asked about the election's impact on his daughters. "What we've also tried to teach them is resilience," he said, "and we've tried to teach them hope and that the only thing that is the end of the world is the end of the world."

The president said he plans to take time off with his family, but he will speak about issues he deeply cares about. "I believe in this country. I believe in the American people. I believe that people are more good than bad." He continued, "If we work hard and if we are true to those things in us that feel true and feel right, that the world gets a little better each time. That's what this presidency has tried to be about." He concluded, "At my core, I think we're going to be OK. We just have to fight for it, we have to work at it and not take it for granted."

Thank you President Obama, this was your victory.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 28 minutes ago.

Donald Trump nominee defends access to healthcare

January 18, 2017, 8:38 pm

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US President-elect Donald Trump`s pick to head the Department of Health and Human Services has defended creating a system that allows "access" to health insurance for everyone. Reported by Zee News 8 minutes ago.

Mnuchin’s Promise to Not Cut Taxes for the Rich Is a Giant Farce

January 19, 2017, 4:42 am

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(Photo: AP/Carolyn Kaster)

Treasury Secretary-designate Steven Mnuchin in Trump Tower in November. 

As the confirmation hearing for Treasury Secretary-designate Steven Mnuchin gets started, there will be ample scrutiny—and rightfully so—of OneWest, the neighborhood-eviscerating foreclosure machine that he headed. But as the person on the verge of setting the new administration’s tax policy, Mnuchin should also be questioned about his pledge that “there will be no absolute tax cut for the upper class,” which he made on CNBC back in November.   

“Any reductions we have in upper-income taxes will be offset by less deductions, so there will be no absolute tax cut for the upper class,” he said. “There will be a big tax cut for the middle class, but any tax cuts we have for the upper class will be offset by less deductions that pay for it.”

With this statement, he created a clear standard—the “Mnuchin test”—by which to hold the Trump administration: Any tax reform that comes to Trump’s desk must greatly benefit middle-class taxpayers and any tax rate cuts for the wealthy must be offset by closing tax loopholes and eliminating lucrative deductions.

The three main GOP tax plans—Paul Ryan’s “Better Way”, President-elect Trump’s own proposal, and the tax cuts that are central to the Republicans’ “repeal and delay” of Obamacare—miss Mnuchin’s mark by a long shot, as a timely new report from the Center on Budget and Policy Priorities makes clear. Each plan would generate lavish tax cuts for the rich while either increasing taxes on or bringing little relief to everyone else.

-*Obamacare Repeal*-

For starters, as I previously noted, the Republicans’ plan to repeal Obamacare would throw 18 million Americans off their health insurance while delivering a massive windfall of tax breaks to the wealthy. Millionaires and billionaires would receive 54 percent of repeal’s net tax cuts, getting an average tax break of $57,000 in 2025. At the very top, the richest 400 households in America—with average incomes of $318 million—would get about $7 million in yearly tax cuts from Obamacare’s repeal.

What about those in the middle class? Thanks to the loss of Obamacare’s insurance premium tax credit, those making between $40,000 and $50,000 would actually face a tax increase of about $100. Meanwhile, some seven million low- and modest-income families would lose tax credits worth about $5,700.

Repealing the ACA is a massive violation of the Mnuchin test.

-*Trump’s Tax Proposal*-

Trump’s tax plan, which Mnuchin helped craft, has gotten plenty of coverage for being an unmitigated disaster that would cost the government as much as $5.9 trillion. It would slash the top tax rate, the corporate tax rate, and the capital gains and dividends rates. It would also create a new bargain-basement-level rate for business partnerships and do away with the estate tax for those getting huge inheritances.

Even with limits on itemized deductions and other piecemeal measures like repealing the mortgage interest deduction, those at the top would reap the vast majority of Trump’s tax cuts. Millionaires would get an average tax break of $387,000—raising their after-tax income by a tidy 14 percent.

Those making between $40,000 and $50,000 would only see a bump of about $500. Tax cuts for those making less than $100,000 would be just one-fifth of the size of millionaires’ tax cuts.

Trump’s tax plan, too, is an absolute violation of the Mnuchin test.

-*Paul Ryan’s “Better Way”*-

The Republican House speaker’s vaunted “Better Way” tax plan is quite similar to Trump’s—it cuts the top income tax rate, the corporate rate, capital gains and dividends, creates a new business partnership rate, and eliminates the estate tax for the wealthy. Despite employing the “simplification” rhetoric of fewer tax brackets, don’t be fooled: It would bring about enormous targeted tax cuts to the top 1 percent while leaving crumbs for low- and middle-income households. In fact, those with incomes of more than $1 million would receive 96 percent of the Ryan plan’s tax benefits—giving them an average of $300,000 each. Those making between $40,000 and $50,000 would get just $120 in tax breaks.

If you haven’t caught on to the pattern yet, the Better Way does not meet the Mnuchin test either.

So at his hearing tomorrow, will Mnuchin denounce the repeal of the ACA or Trump and Ryan’s tax plan? Almost certainly not. But senators should hold his feet to the fire and insist that he explain why he supports trickle-down tax policies that are fundamentally antithetical to the pledge he made just two months ago.

That just might shed some light on the fact that “big” middle-class tax cuts aren’t coming, and that there aren’t enough deductions and loopholes in the entire tax code to cover the massive tax rate reductions at the top.  Reported by The American Prospect 17 hours ago.