About 12.2 million Americans signed up for health insurance through the Affordable Care Act’s exchange marketplaces by the Jan. 31 open-enrollment deadline, the government announced Wednesday.
Reported by Wall Street Journal 3 hours ago.
Health Plan Enrollment on ACA Exchanges Drops Off in 2017
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HUFFPOST HILL - So Much For Our 'Make Holland Geert Again' Headline
*Like what you read below? **Sign up for HUFFPOST HILL** and get a cheeky dose of political news every evening! *
Today we learned that the “Tweede Kamer” is the Netherlands’ lower legislative chamber and not, apparently, a store in Bushwick that only sells buttons. A preliminary 2020 survey out of Iowa suggests Cory Booker might soon develop an affinity for fried butter and beehived diner waitresses named Doris. And thanks to arcane Senate parliamentary rules, we might all soon be treated to “Nevertheless She Persisted” t-shirts stamped with Robert Byrd’s face. This is HUFFPOST HILL for Wednesday, March 15th, 2017:
*SHARP CUTS FOR EPA IN TRUMP’S BUDGET - *Congratulations to all the Canadian winegrowers on their International Wine Challenge 2042 Champion of Champions trophy. Glenn Thrush and Coral Davenport: “*President Trump’s budget blueprint for the coming fiscal year would slash the Environmental Protection Agency by 31 percent and cut State Department spending by a similar amount* in a brash upending of the government’s priorities, according to congressional staff members familiar with the plan. The budget outline, to be unveiled on Thursday, is more of a broad political statement than a detailed plan for spending and taxation. But it represents Mr. Trump’s first real effort to translate his bold but vague campaign themes into the minutiae of governance. The president would funnel $54 billion in additional funding into defense programs, beef up immigration enforcement and significantly reduce the nondefense federal work force to ‘dismantle the administrative state,’ in the words of Mr. Trump’s chief strategist, Stephen K. Bannon.” [NYT]
*DEMOCRACY: GOING DUTCH ON HUMANITY’S PROBLEMS - *We’ll wait for your notes of adulatory congratulations for that headline. Eline Gordts and Nick Robins-Early: “*Preliminary results indicate that incumbent Prime Minister Mark Rutte will win the Dutch election.* Exit polls released at the end of a long election day show Rutte’s VVD party is expected to be the Netherlands’ biggest political party. Millions of Dutch voted Wednesday to elect a new government as the rest of Europe watched anxiously to see whether the far-right populist Party for Freedom would become the largest.Voting in the Dutch national election started at 7:30 a.m. Turnout was significantly higher than in the previous election: In the capital, Amsterdam, so many people headed to the polls that the city had to print extra ballots. Officials in several polling stations posted photos of ballot boxes filled to the brim.” [HuffPost]
*Imagine having to take anything issued by the “Tweede Kamer” seriously: *“But Wilders and his party, the Party for Freedom (PVV), are far from the only force in the election. A record 28 parties are competing for the 150 seats in the lower house of Dutch parliament, known as the Tweede Kamer. In practical terms, this has a very obvious effect on voting day: The Dutch ballots are enormous. So enormous, in fact, that people can’t stop sharing photos of them.” [WaPo’s Adam Taylor]
*HOUSE INTEL CHAIR POURS SALT ON WIRETAP CLAIM* *-* Sam Stein and Jessica Schulberg: “House Intelligence Committee Chairman Devin Nunes (R-Calif.) conceded on Wednesday that he had found no evidence to substantiate President Donald Trump’s claim that former President Barack Obama had wiretapped Trump Tower. *Nunes, a fierce White House ally, told reporters that absent such evidence, he could conclude only that no wiretap had ever been put in place. *If you ‘take the tweets literally,’ Nunes said of Trump’s tweets on the matter, ‘then clearly the president was wrong.’ One day prior to Nunes’ comments, White House press secretary Sean Spicer had said that Trump was ‘extremely confident’ that the Department of Justice would produce evidence to support his claim. Nunes and fellow California Rep. Adam Schiff, the ranking Democrat on the House Intelligence Committee, sent a letter to the Justice Department last week asking officials to turn over any existing evidence that would substantiate Trump’s claim.” [HuffPost]
*ELECTION OFFICIALS ON TRUMP’S FRAUD CLAIMS: *¯\_(ツ)_/¯ - Sam Levine: “Despite insistence that widespread voter fraud exists and pledges to investigate the matter fully, it seems the Trump administration has not bothered to contact top state election officials across the country. The Huffington Post asked all 50 secretaries of state and election officials in the District of Columbia if they had been contacted by the White House or Department of Justice regarding the forthcoming investigation. Not a single secretary of state’s office responded to say that it had.” [HuffPost]
*JEFF SESSIONS REALLY NEEDS TO GET HIGH -* On the other hand, maybe he’s paranoid enough already. Matt Ferner: “Attorney General Jeff Sessions hates marijuana, but it appears unlikely that he’ll send the federal government to war against states that have legalized it…. *After delivering prepared remarks comparing marijuana to heroin and insisting that ‘using drugs will destroy your life,’ Sessions told reporters that much of the Obama-era guidance that paved the way for states to legalize marijuana is ‘valid.’* It’s the clearest indication yet that he may not be readying for a nationwide crackdown as some drug policy reformers have feared…. Marijuana remains illegal under the federal Controlled Substances Act…. President Barack Obama’s Justice Department allowed states to forge their own way on marijuana policy by issuing guidance in 2013.” [HuffPost]
*Like HuffPost Hill? Then order Eliot’s book*, The Beltway Bible: A Totally Serious A-Z Guide To Our No-Good, Corrupt, Incompetent, Terrible, Depressing, and Sometimes Hilarious Government
Does somebody keep forwarding you this newsletter? Get your own copy. It’s free! Sign up here. Send tips/stories/photos/events/fundraisers/job movement/juicy miscellanea to eliot@huffingtonpost.com. Follow us on Twitter - @HuffPostHill
*MARTIN O’MALLEY LEADING POLL OF PEOPLE WHO AREN’T ELIZABETH WARREN OR BERNIE SANDERS -* Congratulations to the former governor on still being in third place. Gabriel Debenedetti: “The leadership PAC of former Maryland Gov. Martin O’Malley commissioned a Public Policy Polling survey of the first-in-the-nation caucus state earlier this month, according to a copy of the results obtained by POLITICO.* The poll, which shows O’Malley at 18 percent of Democratic caucus-goers in a field of nine potential candidates..... O’Malley...was joined at the top of the poll by Booker, who was at 17 percent.* Klobuchar, who represents a neighboring state and who’s been a frequent visitor to Iowa over the years, got 11 percent. All other candidates were under 10 percent…. *A number of high-profile potential 2020 candidates were left out of the poll, including Massachusetts Sen. Elizabeth Warren, Ohio Sen. Sherrod Brown and Sanders*.” [Politico]
*BIG DADDY THWARTING GOP FROM BEYOND THE GRAVE *- Robert Byrd: from Klansman to feminist hero. Laura Bassett: “Lawmakers on both sides of the aisle are warning that *a provision ‘defunding’ Planned Parenthood could doom the GOP’s Obamacare replacement plan in the Senate because the language violates a key rule about what can be legislated with a simple majority vote*. The ‘Byrd rule,’ named for the late Sen. Robert Byrd (D-W.Va.), requires that if a provision’s budgetary effect is ‘merely incidental’ to a budget bill, it does not qualify for the fast-tracked reconciliation process in the Senate. This means that the legislation would have to meet the Senate’s usual 60-vote threshold to pass ― a much more challenging number for the 52 Senate Republicans to meet than a 51-vote majority. The Congressional Budget Office confirmed in an analysis this week that the anti-abortion language in the American Health Care Act would only affect Planned Parenthood, even though the legislation does not specifically name the provider. Because this ‘defunding’ provision appears to be politically motivated and would have little effect on the federal budget, it likely would not survive the Byrd test.” [HuffPost]
*YELLEN ANNOUNCES FED HIKE - *We can’t wait for the president to question whether Janet Yellen is even real. Daniel Marans: “The Federal Reserve raised its benchmark interest rate on Wednesday, a sign of its continued confidence in the economy in the wake of President Donald Trump’s inauguration. *The move, which reflects the Fed’s satisfaction with job growth and its mounting concern about inflation, is the first rate hike since Trump took office. *The central bank’s Federal Open Market Committee increased the target federal funds rate — what banks charge one another for overnight lending — by 0.25 percentage points, to a range of 0.75 percent to 1.0 percent. Congress gave the Fed a dual mandate: to maximize employment, and to keep prices stable. The Fed raises the federal funds rate to tame inflation by putting downward pressure on job market growth…. Although Wednesday’s rate hike is just the third increase since the Fed lowered the influential rate to zero in December 2008, it is the second hike since December 2016, suggesting the Fed is finally accelerating its efforts to raise borrowing costs.” [HuffPost]
*TENSIONS AT DOD *- In case you were worried that our military leaders’ jaws weren’t clenched tightly enough. Aaron Mehta and Joe Gould: “*Sources who support Mattis have grown increasingly vocal about frustrations with Mira Ricardel, a top defense voice on the Trump campaign who also served as a part of the defense transition team for the administration. *Ricardel is positioned at the Office of Presidential Personnel and has been a vital part of the nominee review process, including conducting personal interviews with prospective nominees. A number of sources, including one inside the administration, said Mattis and Ricardel have directly clashed over nominees. Two of those sources speculated that Ricardel had hoped for a Pentagon position when the transition ended, perhaps as the undersecretary of defense for policy. But where supporters of Mattis see Ricardel as a roadblock to progress, those on the Trump team view her as a loyal soldier who is looking out for the interests of the President.” [DefenseNews]
*MATTIS RINO’S SO HARD *- It’s going to be so fun when we learn the president thinks we can combat rising global temperature with more classy ice sculptures. Andrew Revkin: “*Secretary of Defense James Mattis has asserted that climate change is real, and a threat to American interests abroad and the Pentagon’s assets everywhere*, a position that appears at odds with the views of the president who appointed him and many in the administration in which he serves. In unpublished written testimony provided to the Senate Armed Services Committee… ‘Climate change is impacting stability in areas of the world where our troops are operating today,” Mattis said in written answers to questions posed after the public hearing by Democratic members of the [Armed Services] committee. ‘It is appropriate for the Combatant Commands to incorporate drivers of instability that impact the security environment in their areas into their planning.’” [HuffPost]
*TRAVEL BAN CHALLENGED IN COURT - *“That’s right, your honor, 50,000 letters from children addressed to one Donald Trump, calling him a ‘ginormous tool.’” Maria Sacchetti, Kalani Takase and Matt Zapotosky: “*A federal judge in Hawaii says he will rule on whether to halt President Trump’s new travel ban before it takes effect hours from now. *U.S. District Judge Derrick K. Watson said he would issue a written ruling before 12:01 a.m. Eastern Thursday — which is 6:01 p.m. Wednesday in Hawaii. Watson was the second of three judges to hear arguments Wednesday on whether to freeze the ban. A federal judge in Maryland said he also could rule before day’s end after a morning hearing, and the same federal judge in Washington state who suspended Trump’s first travel ban was set to hear arguments starting at 5 p.m. Eastern. The hearing in Hawaii came in response to a lawsuit filed by the state itself. Lawyers for Hawaii alleged the new travel ban, much like the old, violates the establishment clause of the First Amendment because it is essentially a Muslim ban, hurts the ability of state businesses and universities to recruit top talent and damages the state’s robust tourism industry.” [WaPo]
*REPEAL AND REFACEPLANT - *This is going great. Laura Barron-Lopez and Jonathan Cohn: “A harsh Congressional Budget Office assessment of the Republican House bill to repeal the Affordable Care Act had GOP senators on Tuesday calling for changes, including more financial assistance for low-income Americans…. *[S]ome GOP senators said they were concerned with the House legislation’s potential effects on low-income people, seniors and Medicaid patients. *Of particular concern to these senators was the way the GOP bill would redirect health insurance tax credits, leaving the poorest consumers with less money than they get under the Affordable Care Act.” [HuffPost]
Trump needs at least eight Democratic senators to support his health agenda. He’s not even trying.
*BECAUSE YOU’VE READ THIS FAR *- Here’s the latest in virtual piglet technology.
*STATE SHUTS OUT MEDIA - *Really solid follow-up to that whole “no press conference” episode. Brian Stelter: “*State Department reporters are strongly protesting Secretary of State Rex Tillerson’s decision to fly to Asia without his traveling press corps. Instead, Tillerson invited a single reporter from a startup news site with a conservative bent. *The site, Independent Journal Review, or IJR for short, does not have a well-established track record of covering foreign policy. IJR calls itself a ‘social first, mobile first news company.’ The decision stirred complaints because it broke with decades of tradition and may impede news coverage of Tillerson’s foreign policy moves. Some veteran reporters privately described it as insulting. The State Department Correspondents Association said in a statement that the group ‘is disappointed that Secretary Tillerson chose to travel this week to North Asia without a full contingent of the diplomatic press corps or even a pool reporter.’” [CNN]
*COMFORT FOOD*
- “Mr. Bean” recast as a violent psychological thriller.
- Man updates computer with every edition of Windows and sees which original programs successfully update to the latest version .
- Looking back at Ruth Bader Ginsburg’s best moments on her 84th birthday.
*TWITTERAMA*
@aedwardslevy: POLLSTER: beware the self-reported party IDs of March
CAESAR: what man is that?
BRUTUS: a pollster bids you use the voter file
@Caissie: If anyone has access to any of Donald Trump’s other tax returns, please microwave them to me.
@jbendery: “Smells like legislation in there.” — tourist walking out of House balcony
Got something to add? Send tips/quotes/stories/photos/events/fundraisers/job movement/juicy miscellanea to Eliot Nelson (eliot@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 8 hours ago.
Today we learned that the “Tweede Kamer” is the Netherlands’ lower legislative chamber and not, apparently, a store in Bushwick that only sells buttons. A preliminary 2020 survey out of Iowa suggests Cory Booker might soon develop an affinity for fried butter and beehived diner waitresses named Doris. And thanks to arcane Senate parliamentary rules, we might all soon be treated to “Nevertheless She Persisted” t-shirts stamped with Robert Byrd’s face. This is HUFFPOST HILL for Wednesday, March 15th, 2017:
*SHARP CUTS FOR EPA IN TRUMP’S BUDGET - *Congratulations to all the Canadian winegrowers on their International Wine Challenge 2042 Champion of Champions trophy. Glenn Thrush and Coral Davenport: “*President Trump’s budget blueprint for the coming fiscal year would slash the Environmental Protection Agency by 31 percent and cut State Department spending by a similar amount* in a brash upending of the government’s priorities, according to congressional staff members familiar with the plan. The budget outline, to be unveiled on Thursday, is more of a broad political statement than a detailed plan for spending and taxation. But it represents Mr. Trump’s first real effort to translate his bold but vague campaign themes into the minutiae of governance. The president would funnel $54 billion in additional funding into defense programs, beef up immigration enforcement and significantly reduce the nondefense federal work force to ‘dismantle the administrative state,’ in the words of Mr. Trump’s chief strategist, Stephen K. Bannon.” [NYT]
*DEMOCRACY: GOING DUTCH ON HUMANITY’S PROBLEMS - *We’ll wait for your notes of adulatory congratulations for that headline. Eline Gordts and Nick Robins-Early: “*Preliminary results indicate that incumbent Prime Minister Mark Rutte will win the Dutch election.* Exit polls released at the end of a long election day show Rutte’s VVD party is expected to be the Netherlands’ biggest political party. Millions of Dutch voted Wednesday to elect a new government as the rest of Europe watched anxiously to see whether the far-right populist Party for Freedom would become the largest.Voting in the Dutch national election started at 7:30 a.m. Turnout was significantly higher than in the previous election: In the capital, Amsterdam, so many people headed to the polls that the city had to print extra ballots. Officials in several polling stations posted photos of ballot boxes filled to the brim.” [HuffPost]
*Imagine having to take anything issued by the “Tweede Kamer” seriously: *“But Wilders and his party, the Party for Freedom (PVV), are far from the only force in the election. A record 28 parties are competing for the 150 seats in the lower house of Dutch parliament, known as the Tweede Kamer. In practical terms, this has a very obvious effect on voting day: The Dutch ballots are enormous. So enormous, in fact, that people can’t stop sharing photos of them.” [WaPo’s Adam Taylor]
*HOUSE INTEL CHAIR POURS SALT ON WIRETAP CLAIM* *-* Sam Stein and Jessica Schulberg: “House Intelligence Committee Chairman Devin Nunes (R-Calif.) conceded on Wednesday that he had found no evidence to substantiate President Donald Trump’s claim that former President Barack Obama had wiretapped Trump Tower. *Nunes, a fierce White House ally, told reporters that absent such evidence, he could conclude only that no wiretap had ever been put in place. *If you ‘take the tweets literally,’ Nunes said of Trump’s tweets on the matter, ‘then clearly the president was wrong.’ One day prior to Nunes’ comments, White House press secretary Sean Spicer had said that Trump was ‘extremely confident’ that the Department of Justice would produce evidence to support his claim. Nunes and fellow California Rep. Adam Schiff, the ranking Democrat on the House Intelligence Committee, sent a letter to the Justice Department last week asking officials to turn over any existing evidence that would substantiate Trump’s claim.” [HuffPost]
*ELECTION OFFICIALS ON TRUMP’S FRAUD CLAIMS: *¯\_(ツ)_/¯ - Sam Levine: “Despite insistence that widespread voter fraud exists and pledges to investigate the matter fully, it seems the Trump administration has not bothered to contact top state election officials across the country. The Huffington Post asked all 50 secretaries of state and election officials in the District of Columbia if they had been contacted by the White House or Department of Justice regarding the forthcoming investigation. Not a single secretary of state’s office responded to say that it had.” [HuffPost]
*JEFF SESSIONS REALLY NEEDS TO GET HIGH -* On the other hand, maybe he’s paranoid enough already. Matt Ferner: “Attorney General Jeff Sessions hates marijuana, but it appears unlikely that he’ll send the federal government to war against states that have legalized it…. *After delivering prepared remarks comparing marijuana to heroin and insisting that ‘using drugs will destroy your life,’ Sessions told reporters that much of the Obama-era guidance that paved the way for states to legalize marijuana is ‘valid.’* It’s the clearest indication yet that he may not be readying for a nationwide crackdown as some drug policy reformers have feared…. Marijuana remains illegal under the federal Controlled Substances Act…. President Barack Obama’s Justice Department allowed states to forge their own way on marijuana policy by issuing guidance in 2013.” [HuffPost]
*Like HuffPost Hill? Then order Eliot’s book*, The Beltway Bible: A Totally Serious A-Z Guide To Our No-Good, Corrupt, Incompetent, Terrible, Depressing, and Sometimes Hilarious Government
Does somebody keep forwarding you this newsletter? Get your own copy. It’s free! Sign up here. Send tips/stories/photos/events/fundraisers/job movement/juicy miscellanea to eliot@huffingtonpost.com. Follow us on Twitter - @HuffPostHill
*MARTIN O’MALLEY LEADING POLL OF PEOPLE WHO AREN’T ELIZABETH WARREN OR BERNIE SANDERS -* Congratulations to the former governor on still being in third place. Gabriel Debenedetti: “The leadership PAC of former Maryland Gov. Martin O’Malley commissioned a Public Policy Polling survey of the first-in-the-nation caucus state earlier this month, according to a copy of the results obtained by POLITICO.* The poll, which shows O’Malley at 18 percent of Democratic caucus-goers in a field of nine potential candidates..... O’Malley...was joined at the top of the poll by Booker, who was at 17 percent.* Klobuchar, who represents a neighboring state and who’s been a frequent visitor to Iowa over the years, got 11 percent. All other candidates were under 10 percent…. *A number of high-profile potential 2020 candidates were left out of the poll, including Massachusetts Sen. Elizabeth Warren, Ohio Sen. Sherrod Brown and Sanders*.” [Politico]
*BIG DADDY THWARTING GOP FROM BEYOND THE GRAVE *- Robert Byrd: from Klansman to feminist hero. Laura Bassett: “Lawmakers on both sides of the aisle are warning that *a provision ‘defunding’ Planned Parenthood could doom the GOP’s Obamacare replacement plan in the Senate because the language violates a key rule about what can be legislated with a simple majority vote*. The ‘Byrd rule,’ named for the late Sen. Robert Byrd (D-W.Va.), requires that if a provision’s budgetary effect is ‘merely incidental’ to a budget bill, it does not qualify for the fast-tracked reconciliation process in the Senate. This means that the legislation would have to meet the Senate’s usual 60-vote threshold to pass ― a much more challenging number for the 52 Senate Republicans to meet than a 51-vote majority. The Congressional Budget Office confirmed in an analysis this week that the anti-abortion language in the American Health Care Act would only affect Planned Parenthood, even though the legislation does not specifically name the provider. Because this ‘defunding’ provision appears to be politically motivated and would have little effect on the federal budget, it likely would not survive the Byrd test.” [HuffPost]
*YELLEN ANNOUNCES FED HIKE - *We can’t wait for the president to question whether Janet Yellen is even real. Daniel Marans: “The Federal Reserve raised its benchmark interest rate on Wednesday, a sign of its continued confidence in the economy in the wake of President Donald Trump’s inauguration. *The move, which reflects the Fed’s satisfaction with job growth and its mounting concern about inflation, is the first rate hike since Trump took office. *The central bank’s Federal Open Market Committee increased the target federal funds rate — what banks charge one another for overnight lending — by 0.25 percentage points, to a range of 0.75 percent to 1.0 percent. Congress gave the Fed a dual mandate: to maximize employment, and to keep prices stable. The Fed raises the federal funds rate to tame inflation by putting downward pressure on job market growth…. Although Wednesday’s rate hike is just the third increase since the Fed lowered the influential rate to zero in December 2008, it is the second hike since December 2016, suggesting the Fed is finally accelerating its efforts to raise borrowing costs.” [HuffPost]
*TENSIONS AT DOD *- In case you were worried that our military leaders’ jaws weren’t clenched tightly enough. Aaron Mehta and Joe Gould: “*Sources who support Mattis have grown increasingly vocal about frustrations with Mira Ricardel, a top defense voice on the Trump campaign who also served as a part of the defense transition team for the administration. *Ricardel is positioned at the Office of Presidential Personnel and has been a vital part of the nominee review process, including conducting personal interviews with prospective nominees. A number of sources, including one inside the administration, said Mattis and Ricardel have directly clashed over nominees. Two of those sources speculated that Ricardel had hoped for a Pentagon position when the transition ended, perhaps as the undersecretary of defense for policy. But where supporters of Mattis see Ricardel as a roadblock to progress, those on the Trump team view her as a loyal soldier who is looking out for the interests of the President.” [DefenseNews]
*MATTIS RINO’S SO HARD *- It’s going to be so fun when we learn the president thinks we can combat rising global temperature with more classy ice sculptures. Andrew Revkin: “*Secretary of Defense James Mattis has asserted that climate change is real, and a threat to American interests abroad and the Pentagon’s assets everywhere*, a position that appears at odds with the views of the president who appointed him and many in the administration in which he serves. In unpublished written testimony provided to the Senate Armed Services Committee… ‘Climate change is impacting stability in areas of the world where our troops are operating today,” Mattis said in written answers to questions posed after the public hearing by Democratic members of the [Armed Services] committee. ‘It is appropriate for the Combatant Commands to incorporate drivers of instability that impact the security environment in their areas into their planning.’” [HuffPost]
*TRAVEL BAN CHALLENGED IN COURT - *“That’s right, your honor, 50,000 letters from children addressed to one Donald Trump, calling him a ‘ginormous tool.’” Maria Sacchetti, Kalani Takase and Matt Zapotosky: “*A federal judge in Hawaii says he will rule on whether to halt President Trump’s new travel ban before it takes effect hours from now. *U.S. District Judge Derrick K. Watson said he would issue a written ruling before 12:01 a.m. Eastern Thursday — which is 6:01 p.m. Wednesday in Hawaii. Watson was the second of three judges to hear arguments Wednesday on whether to freeze the ban. A federal judge in Maryland said he also could rule before day’s end after a morning hearing, and the same federal judge in Washington state who suspended Trump’s first travel ban was set to hear arguments starting at 5 p.m. Eastern. The hearing in Hawaii came in response to a lawsuit filed by the state itself. Lawyers for Hawaii alleged the new travel ban, much like the old, violates the establishment clause of the First Amendment because it is essentially a Muslim ban, hurts the ability of state businesses and universities to recruit top talent and damages the state’s robust tourism industry.” [WaPo]
*REPEAL AND REFACEPLANT - *This is going great. Laura Barron-Lopez and Jonathan Cohn: “A harsh Congressional Budget Office assessment of the Republican House bill to repeal the Affordable Care Act had GOP senators on Tuesday calling for changes, including more financial assistance for low-income Americans…. *[S]ome GOP senators said they were concerned with the House legislation’s potential effects on low-income people, seniors and Medicaid patients. *Of particular concern to these senators was the way the GOP bill would redirect health insurance tax credits, leaving the poorest consumers with less money than they get under the Affordable Care Act.” [HuffPost]
Trump needs at least eight Democratic senators to support his health agenda. He’s not even trying.
*BECAUSE YOU’VE READ THIS FAR *- Here’s the latest in virtual piglet technology.
*STATE SHUTS OUT MEDIA - *Really solid follow-up to that whole “no press conference” episode. Brian Stelter: “*State Department reporters are strongly protesting Secretary of State Rex Tillerson’s decision to fly to Asia without his traveling press corps. Instead, Tillerson invited a single reporter from a startup news site with a conservative bent. *The site, Independent Journal Review, or IJR for short, does not have a well-established track record of covering foreign policy. IJR calls itself a ‘social first, mobile first news company.’ The decision stirred complaints because it broke with decades of tradition and may impede news coverage of Tillerson’s foreign policy moves. Some veteran reporters privately described it as insulting. The State Department Correspondents Association said in a statement that the group ‘is disappointed that Secretary Tillerson chose to travel this week to North Asia without a full contingent of the diplomatic press corps or even a pool reporter.’” [CNN]
*COMFORT FOOD*
- “Mr. Bean” recast as a violent psychological thriller.
- Man updates computer with every edition of Windows and sees which original programs successfully update to the latest version .
- Looking back at Ruth Bader Ginsburg’s best moments on her 84th birthday.
*TWITTERAMA*
@aedwardslevy: POLLSTER: beware the self-reported party IDs of March
CAESAR: what man is that?
BRUTUS: a pollster bids you use the voter file
@Caissie: If anyone has access to any of Donald Trump’s other tax returns, please microwave them to me.
@jbendery: “Smells like legislation in there.” — tourist walking out of House balcony
Got something to add? Send tips/quotes/stories/photos/events/fundraisers/job movement/juicy miscellanea to Eliot Nelson (eliot@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 8 hours ago.
↧
Reichert breaks silence, defends GOP health plan as a ‘first step’
Breaking his silence on official estimates that a Republican health-care plan will leave 24 million more Americans without health insurance, U.S. Rep. Dave Reichert’s office said Wednesday GOP proposal was only a “first step.”
Reported by Seattle Times 6 hours ago.
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Health Care Is Complex -- No, Really
Two years ago today, I published Unlock Congress: Reform the Rules - Restore the System. The book was a non-partisan effort to assess the defective nature of our legislative branch, its causes, and suggestions on how to upgrade and improve a number of our methods of election and governance. Within that diagnosis of the defective legislative product that Congress delivers was a brief section on health care in the United States. Naturally, it wasn’t pretty.
As a national debate rages right now about who will and who won’t be able to obtain affordable health insurance under the proposed “American Health Care Act,” it is important not to lose sight of the fact that our system is broken in a variety of ways. While it seems unlikely that the president and Congress will address all of these issues within the current bill bouncing around Capitol Hill ― or subsequently ― it would be wise for legislators and voters to keep the full picture in mind. For all of these issues are connected.
The following summary is excerpted from Unlock Congress, Chapter 4, “The Product”:
Throughout the United States, we have a great many excellent hospitals, general and specialty medical practices, as well as outstanding medical universities. Training and research programs at these schools continue to graduate highly skilled and well-intentioned medical professionals. From general practitioners to surgeons, specialists, and researchers, America has produced thousands of accomplished doctors who are expert at what they do. At the same time, so many of these dedicated professionals fully realize that the work and service they provide as individuals cannot alone protect our country from the negative aspects of the collective health care “system.”
Dr. John Noseworthy is one of these individuals. Noseworthy grew up in Melrose, Massachusetts, earned his M.D. in neurology in Nova Scotia, Canada, then obtained additional training through a research fellowship at Harvard University. In 1990 he joined the Mayo Clinic, a renowned not-for-profit health care system that operates in six states and serves more than one million patients every year from all 50 states and 150 countries. In 2009, Noseworthy became president and CEO of the $8.5 billion Mayo system.
Of late, Dr. Noseworthy and his team have been trying to put Mayo’s 150 years of experience into the service of analyzing and diagnosing America’s health care landscape. When asked in late 2013 about the impacts of the controversial Affordable Care Act (ACA), commonly referred to as “Obamacare,” Noseworthy described the health care legislation as limited because it mostly affects Americans with insurance. Taking a broader view, he explained:
The Affordable Care Act, on which we’re all putting so much attention at the moment, is in the context of an anemic recovery in our economy and a marked shift in the demographics of the American people, with the aging population, plus the prevalence of chronic disease, the rising costs of health care, the rising costs of research. All of that contributes to an unsustainable health care system. It’s too costly—we’re spending too much on health care.
We’ve already touched on the surge in our country’s senior citizen population as one reason health care spending is accelerating at a faster rate than our GDP. This rising rate has lessened somewhat since the passage of the ACA, although the degree of causation between the two continues to be debated. But beyond the demographics, Noseworthy zooms in on another huge aspect of America’s health challenge: “We’re spending too much on health care because it’s fragmented and the quality is so uneven in our country. There are pockets of outstanding health care, and there are other places not at that level. There are highly efficient, high-quality health care groups, and others that are expensive and don’t deliver that quality.”
One of his colleagues, Dr. Toby Cosgrove, president and CEO of the Cleveland Clinic, expanded on Noseworthy’s observation: “We’ve got to learn how to be more efficient. The health care system in the United States is not really a system. It’s a whole bunch of cottage industries.”
Cosgrove zeroes in on a critical point when he says we don’t have a real “system,” a word Merriam-Webster defines as “a group of related parts that move or work together.” So the word “system” to describe health care in America is a misnomer (remember this definition, for it will be the very heart of our next chapter). Without a more integrated system, quality of care varies greatly. As a result, many millions of Americans receive overpriced care with subpar outcomes. This often leads to additional health crises. It is the worst kind of domino effect.
In the U.S. we spend far more than any other wealthy country on health care, both on a per person basis and as a percentage of our economy (and for years many of these countries have provided coverage for all of their citizens). A research study in 2013 by the Commonwealth Fund reported that “the U.S. spends $8,508 per person on health care. That is nearly $3,000 more per person than Norway, the second highest spender.” Sadly, the study also reported, “In 2013 more than one-third (37 percent) of U.S. adults went without recommended care, did not see a doctor when they were sick, or failed to fill prescriptions because of costs, compared with as few as 4 percent to 6 percent in the United Kingdom and Sweden.” In America, the average cost of a hospital stay is $18,000—nearly three times as high as the $6,200 average for the thirty-three other countries in the Organisation for Economic Co-operation and Development (OECD).
So just what are all these high prices that add up to such exorbitant health care bills? Well, consider: One Plavix pill, which is used to treat heart and chest issues, costs four times more in the U.S. than it does in Spain. Lipitor, a drug used to treat cholesterol and prevent strokes, costs twenty times as much here as it does in New Zealand. A coronary bypass procedure costs approximately $67,000 in our country. The same procedure costs $16,000 in France. A far less complicated surgery, an appendectomy, costs about $13,000 in the U.S.—more than double the price for the same procedure in nine other developed countries. An M.R.I. scan that costs $1,100 here carries a price of just over $300 if you’re in the Netherlands. Bottom line: America has been spending an extra $750 billion per year on health care versus other developed countries (even when income and cost of living are factored in).
And if these products and procedures don’t seem serious enough, consider the price for cancer drug treatments. One out of every three families in America is affected by cancer. And yet even with expanded insurance, cancer is one of the leading causes of bankruptcy. It all comes back to the non-system and the law. Dr. Hagop Kantarjian, who leads the nation’s largest leukemia practice at the University of Texas Cancer Center, explains:
“This is unique to the United States. If you look anywhere in the world, there are negotiations, either by the government or by different regulatory bodies to regulate the price of the drug. And this is why the prices are 50 percent to 80 percent lower anywhere in the world compared to the United States.”
In the 2013 film Nebraska, Bruce Dern plays a craggy old man who mistakenly thinks he’s won the jackpot through a slick solicitation gimmick. After he bloodies his head in an accident and is taken to the emergency room, he randomly says to the ER doctor, “I won a million dollars!” Without missing a beat, the doctor shoots back, “Congratulations—that’ll just about pay for a day in the hospital.” The punchline works because it’s an inside joke that the whole country is in on. But in the real world, it’s a punch in the face.
Again, the Affordable Care Act is an imperfect yet ambitious effort to solve one big part of our health care crisis by expanding insurance. Future effects of the ACA will take time to accurately decipher. Both supporters and opponents of the law agree that defects within the law need to be addressed, and we will return to this in Chapter 6. But even for Americans who are “covered,” what are we actually receiving? Certainly not the full value of that $8,508 per person. Political scientists Jacob Hacker and Paul Pierson’s research reveals that:
“the United States has fewer doctors, hospital beds, and nurses per person than the norm among rich nations, and Americans (while less healthy overall), visit doctors and hospitals less often and have shorter hospital stays. Indeed, by some measures our health care looks surprisingly substandard. For example, recent analyses of ‘amenable mortality’—deaths that could have been prevented with timely care—find that the United States has the highest rate of preventable death before age seventy-five among rich nations, and that it is falling farther and farther behind.”
In possibly the most authoritative evaluation of our poor health in America, we can look to the study commissioned by our very own government. In 2013, citing America’s high average health cost per person and the fact that “Americans have been dying at younger ages than people in almost all other high-income countries,” the U.S. National Institutes of Health directed the National Research Council and the nonprofit Institute of Medicine (IOM) to investigate the “U.S. Health Disadvantage.”
The first glaring finding from the IOM:
“This health disadvantage exists at all ages from birth to age 75 and that even advantaged Americans—those who have health insurance, college educations, higher incomes, and healthy behaviors— appear to be sicker than their peers in other rich nations. The report is the first comprehensive look at multiple diseases, injuries, and behaviors across the entire life span, comparing the United States with 16 peer nations—affluent democracies that include Australia, Canada, Japan, and many western European countries. Among these countries, the U.S. is at or near the bottom in nine key areas of health: infant mortality and low birth weight; injuries and homicides; teenage pregnancies and sexually transmitted infections; prevalence of HIV and AIDS; drug-related deaths; obesity and diabetes; heart disease; chronic lung disease; and disability.”
This set of findings drives home the point that our nation’s health and health care are problematic. However, the IOM study’s conclusion covers a range of outcomes that have a number of causes and are not solely driven by the health care “system” (or lack thereof). Accordingly, and redolent of parts of the “economic well-being” evaluation earlier in this chapter, the study’s results introduce policy questions that stretch beyond just health policy. Deaths from drugs, murders, obesity, and various other causes cannot, and will not, always have a corresponding policy solution in the area of “health care.” But as we can see, a great many of the laws Congress passes work in concert with one another to meet the nation’s problems—to the extent they get passed. All of these issues are constantly bumping into one another, but that cannot be an excuse for ineffectiveness. In fact, the very complexity of these problems demands an optimal process and response from our lawmakers.
The bottom line on health care in our country, as the research confirms, is that we are not even close to receiving a commensurate bang for our buck—and far too many of those bucks are being squandered. As rich a country as we are, our overall health is poor. Certainly many of our own actions and decisions as individuals play a large role. But Congress’s power to legislate for good and bad in this area is undeniable. Dr. Cosgrove from the Cleveland Clinic once again clarifies:
“One of the things Medicare has got to do is incentivize people to take care of themselves. We’re not going to be able to control the costs in the United States unless we deal with the epidemic of obesity, which is now 10 percent of the health care cost in the United States and gradually going up, including diabetes, etc. So we need to have incentives for individuals to take care of themselves, and that’s not really as big a part of new law as it should be.”
The lack of effective legislation on health care year after year has diminished the physical state of our nation, not to mention our fiscal state. ACA supporters claim credit for the slightly lower rate of health care spending since 2010. But even if this rate continues to slow marginally, analyses project that almost 25 percent of our GDP will be consumed by these costs two decades from now. Nightmare proportions.
Dr. Noseworthy knows this and reiterates that despite a laudable benefit in covering Americans with insurance, Congress has many more rungs to scale:
“The Affordable Care Act will take its own path. What we really need to do is the next series of steps … There are things govern- ment must do. First of all they need to modernize the payment system, modernize Medicare, they have to find a way to enable us to bring technology across state borders, to fund the NIH, and ultimately, the nation has to have the courage to step up to the looming insolvency of Medicare. That’s what’s pushing everything.”
Health care and the economy are highly interconnected. Stagnant wages make health care unaffordable for many. Expanded health insurance is starting to provide relief, but the stratospheric costs of many services and medications still squeeze health care consumers. Out-of-whack expenditures and inconsistent quality across the non-system conspire to put pressure on the federal budget. And then the billions we borrow in that budget to cover future health care and social insurance commitments jack up our debt and hurt our economy in the present tense.
(For more information about Unlock Congress, please visit our website. Sources for all information and quotations in the above excerpt are endnoted in Unlock Congress).
-- 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 16 hours ago.
As a national debate rages right now about who will and who won’t be able to obtain affordable health insurance under the proposed “American Health Care Act,” it is important not to lose sight of the fact that our system is broken in a variety of ways. While it seems unlikely that the president and Congress will address all of these issues within the current bill bouncing around Capitol Hill ― or subsequently ― it would be wise for legislators and voters to keep the full picture in mind. For all of these issues are connected.
The following summary is excerpted from Unlock Congress, Chapter 4, “The Product”:
Throughout the United States, we have a great many excellent hospitals, general and specialty medical practices, as well as outstanding medical universities. Training and research programs at these schools continue to graduate highly skilled and well-intentioned medical professionals. From general practitioners to surgeons, specialists, and researchers, America has produced thousands of accomplished doctors who are expert at what they do. At the same time, so many of these dedicated professionals fully realize that the work and service they provide as individuals cannot alone protect our country from the negative aspects of the collective health care “system.”
Dr. John Noseworthy is one of these individuals. Noseworthy grew up in Melrose, Massachusetts, earned his M.D. in neurology in Nova Scotia, Canada, then obtained additional training through a research fellowship at Harvard University. In 1990 he joined the Mayo Clinic, a renowned not-for-profit health care system that operates in six states and serves more than one million patients every year from all 50 states and 150 countries. In 2009, Noseworthy became president and CEO of the $8.5 billion Mayo system.
Of late, Dr. Noseworthy and his team have been trying to put Mayo’s 150 years of experience into the service of analyzing and diagnosing America’s health care landscape. When asked in late 2013 about the impacts of the controversial Affordable Care Act (ACA), commonly referred to as “Obamacare,” Noseworthy described the health care legislation as limited because it mostly affects Americans with insurance. Taking a broader view, he explained:
The Affordable Care Act, on which we’re all putting so much attention at the moment, is in the context of an anemic recovery in our economy and a marked shift in the demographics of the American people, with the aging population, plus the prevalence of chronic disease, the rising costs of health care, the rising costs of research. All of that contributes to an unsustainable health care system. It’s too costly—we’re spending too much on health care.
We’ve already touched on the surge in our country’s senior citizen population as one reason health care spending is accelerating at a faster rate than our GDP. This rising rate has lessened somewhat since the passage of the ACA, although the degree of causation between the two continues to be debated. But beyond the demographics, Noseworthy zooms in on another huge aspect of America’s health challenge: “We’re spending too much on health care because it’s fragmented and the quality is so uneven in our country. There are pockets of outstanding health care, and there are other places not at that level. There are highly efficient, high-quality health care groups, and others that are expensive and don’t deliver that quality.”
One of his colleagues, Dr. Toby Cosgrove, president and CEO of the Cleveland Clinic, expanded on Noseworthy’s observation: “We’ve got to learn how to be more efficient. The health care system in the United States is not really a system. It’s a whole bunch of cottage industries.”
Cosgrove zeroes in on a critical point when he says we don’t have a real “system,” a word Merriam-Webster defines as “a group of related parts that move or work together.” So the word “system” to describe health care in America is a misnomer (remember this definition, for it will be the very heart of our next chapter). Without a more integrated system, quality of care varies greatly. As a result, many millions of Americans receive overpriced care with subpar outcomes. This often leads to additional health crises. It is the worst kind of domino effect.
In the U.S. we spend far more than any other wealthy country on health care, both on a per person basis and as a percentage of our economy (and for years many of these countries have provided coverage for all of their citizens). A research study in 2013 by the Commonwealth Fund reported that “the U.S. spends $8,508 per person on health care. That is nearly $3,000 more per person than Norway, the second highest spender.” Sadly, the study also reported, “In 2013 more than one-third (37 percent) of U.S. adults went without recommended care, did not see a doctor when they were sick, or failed to fill prescriptions because of costs, compared with as few as 4 percent to 6 percent in the United Kingdom and Sweden.” In America, the average cost of a hospital stay is $18,000—nearly three times as high as the $6,200 average for the thirty-three other countries in the Organisation for Economic Co-operation and Development (OECD).
So just what are all these high prices that add up to such exorbitant health care bills? Well, consider: One Plavix pill, which is used to treat heart and chest issues, costs four times more in the U.S. than it does in Spain. Lipitor, a drug used to treat cholesterol and prevent strokes, costs twenty times as much here as it does in New Zealand. A coronary bypass procedure costs approximately $67,000 in our country. The same procedure costs $16,000 in France. A far less complicated surgery, an appendectomy, costs about $13,000 in the U.S.—more than double the price for the same procedure in nine other developed countries. An M.R.I. scan that costs $1,100 here carries a price of just over $300 if you’re in the Netherlands. Bottom line: America has been spending an extra $750 billion per year on health care versus other developed countries (even when income and cost of living are factored in).
And if these products and procedures don’t seem serious enough, consider the price for cancer drug treatments. One out of every three families in America is affected by cancer. And yet even with expanded insurance, cancer is one of the leading causes of bankruptcy. It all comes back to the non-system and the law. Dr. Hagop Kantarjian, who leads the nation’s largest leukemia practice at the University of Texas Cancer Center, explains:
“This is unique to the United States. If you look anywhere in the world, there are negotiations, either by the government or by different regulatory bodies to regulate the price of the drug. And this is why the prices are 50 percent to 80 percent lower anywhere in the world compared to the United States.”
In the 2013 film Nebraska, Bruce Dern plays a craggy old man who mistakenly thinks he’s won the jackpot through a slick solicitation gimmick. After he bloodies his head in an accident and is taken to the emergency room, he randomly says to the ER doctor, “I won a million dollars!” Without missing a beat, the doctor shoots back, “Congratulations—that’ll just about pay for a day in the hospital.” The punchline works because it’s an inside joke that the whole country is in on. But in the real world, it’s a punch in the face.
Again, the Affordable Care Act is an imperfect yet ambitious effort to solve one big part of our health care crisis by expanding insurance. Future effects of the ACA will take time to accurately decipher. Both supporters and opponents of the law agree that defects within the law need to be addressed, and we will return to this in Chapter 6. But even for Americans who are “covered,” what are we actually receiving? Certainly not the full value of that $8,508 per person. Political scientists Jacob Hacker and Paul Pierson’s research reveals that:
“the United States has fewer doctors, hospital beds, and nurses per person than the norm among rich nations, and Americans (while less healthy overall), visit doctors and hospitals less often and have shorter hospital stays. Indeed, by some measures our health care looks surprisingly substandard. For example, recent analyses of ‘amenable mortality’—deaths that could have been prevented with timely care—find that the United States has the highest rate of preventable death before age seventy-five among rich nations, and that it is falling farther and farther behind.”
In possibly the most authoritative evaluation of our poor health in America, we can look to the study commissioned by our very own government. In 2013, citing America’s high average health cost per person and the fact that “Americans have been dying at younger ages than people in almost all other high-income countries,” the U.S. National Institutes of Health directed the National Research Council and the nonprofit Institute of Medicine (IOM) to investigate the “U.S. Health Disadvantage.”
The first glaring finding from the IOM:
“This health disadvantage exists at all ages from birth to age 75 and that even advantaged Americans—those who have health insurance, college educations, higher incomes, and healthy behaviors— appear to be sicker than their peers in other rich nations. The report is the first comprehensive look at multiple diseases, injuries, and behaviors across the entire life span, comparing the United States with 16 peer nations—affluent democracies that include Australia, Canada, Japan, and many western European countries. Among these countries, the U.S. is at or near the bottom in nine key areas of health: infant mortality and low birth weight; injuries and homicides; teenage pregnancies and sexually transmitted infections; prevalence of HIV and AIDS; drug-related deaths; obesity and diabetes; heart disease; chronic lung disease; and disability.”
This set of findings drives home the point that our nation’s health and health care are problematic. However, the IOM study’s conclusion covers a range of outcomes that have a number of causes and are not solely driven by the health care “system” (or lack thereof). Accordingly, and redolent of parts of the “economic well-being” evaluation earlier in this chapter, the study’s results introduce policy questions that stretch beyond just health policy. Deaths from drugs, murders, obesity, and various other causes cannot, and will not, always have a corresponding policy solution in the area of “health care.” But as we can see, a great many of the laws Congress passes work in concert with one another to meet the nation’s problems—to the extent they get passed. All of these issues are constantly bumping into one another, but that cannot be an excuse for ineffectiveness. In fact, the very complexity of these problems demands an optimal process and response from our lawmakers.
The bottom line on health care in our country, as the research confirms, is that we are not even close to receiving a commensurate bang for our buck—and far too many of those bucks are being squandered. As rich a country as we are, our overall health is poor. Certainly many of our own actions and decisions as individuals play a large role. But Congress’s power to legislate for good and bad in this area is undeniable. Dr. Cosgrove from the Cleveland Clinic once again clarifies:
“One of the things Medicare has got to do is incentivize people to take care of themselves. We’re not going to be able to control the costs in the United States unless we deal with the epidemic of obesity, which is now 10 percent of the health care cost in the United States and gradually going up, including diabetes, etc. So we need to have incentives for individuals to take care of themselves, and that’s not really as big a part of new law as it should be.”
The lack of effective legislation on health care year after year has diminished the physical state of our nation, not to mention our fiscal state. ACA supporters claim credit for the slightly lower rate of health care spending since 2010. But even if this rate continues to slow marginally, analyses project that almost 25 percent of our GDP will be consumed by these costs two decades from now. Nightmare proportions.
Dr. Noseworthy knows this and reiterates that despite a laudable benefit in covering Americans with insurance, Congress has many more rungs to scale:
“The Affordable Care Act will take its own path. What we really need to do is the next series of steps … There are things govern- ment must do. First of all they need to modernize the payment system, modernize Medicare, they have to find a way to enable us to bring technology across state borders, to fund the NIH, and ultimately, the nation has to have the courage to step up to the looming insolvency of Medicare. That’s what’s pushing everything.”
Health care and the economy are highly interconnected. Stagnant wages make health care unaffordable for many. Expanded health insurance is starting to provide relief, but the stratospheric costs of many services and medications still squeeze health care consumers. Out-of-whack expenditures and inconsistent quality across the non-system conspire to put pressure on the federal budget. And then the billions we borrow in that budget to cover future health care and social insurance commitments jack up our debt and hurt our economy in the present tense.
(For more information about Unlock Congress, please visit our website. Sources for all information and quotations in the above excerpt are endnoted in Unlock Congress).
-- 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 16 hours ago.
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GOP health plan: Tax cuts for rich; hits older people hard
WASHINGTON (AP) — The House Republican health care plan provides big tax cuts for wealthy families and insurance companies, but it hits older people hard. Many older Americans would face higher health insurance premiums and smaller tax credits to help obtain coverage. In all, the bill provides $883 billion in tax relief by repealing almost […]
Reported by Seattle Times 1 day ago.
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High stakes for Trump on GOP health care bill
Trump is focused on delivering his "repeal and replace" promise and is likely to be flexible on the fine print dividing moderate and conservative Republicans in the policy fight, said a person familiar with the president's thinking, who spoke on condition of anonymity to share private discussions. Trump made repealing and replacing his predecessor's health care law a core campaign promise, although he has acknowledged he was surprised at how complex the task would be. Failing to pass a bill while his party controls both the House and Senate would be a devastating blow to his party and the premise of his presidency — that he was a dealmaker the country needed. The findings by the nonpartisan Congressional Budget Office that 14 million people would lose health care coverage in the first year alone and 24 million in all by 2026 applied pressure to moderate Republicans wary of being accused in the 2018 mid-term elections of ripping away health insurance. The White House has been courting about 40 conservative House members who are part of the "Freedom Caucus" and have raised objections to the bill's use of tax credits — which they liken to another government entitlement — and the timing on curtailing the expansion of Medicaid to states. GOP Rep Mark Meadows of North Carolina, who chairs the conservative Freedom Caucus that is demanding changes to the bill, said that contrary to claims by GOP leaders that Trump helped craft their bill and fully supports it, the president is open to alterations.
Reported by SeattlePI.com 23 hours ago.
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Cancer Survivor Confronts Tom Price On Medicaid Cuts
Price to man who says Medicaid saved his life: Care he received is “not necessarily true for everybody” #CNNTownHall https://t.co/Qsowip35f5
— CNN (@CNN) March 16, 2017
A cancer survivor who says he’s alive because of Medicaid confronted Health and Human Services Secretary Tom Price on the GOP’s opposition to the program.
“Medicaid expansion saved my life and saved me from medical bankruptcy,” Brian Kline said during a CNN town hall event on Wednesday night.
Kline is from Pennsylvania, one of the states that opted to expand Medicaid coverage under the Affordable Care Act. Republicans leaders in the House are aiming to replace the act with a health care bill that dramatically cuts Medicaid funding.
Kline said that because he only makes $11 an hour, he wouldn’t have been able to afford treatment for colon cancer without Medicaid.
“My life really depends on having access to my doctors and medical care,” he said. “Why do you want to take away my Medicaid expansion?”
Price responded that Medicaid has “real problems” and that the GOP’s health care plans aim to improve coverage for people who currently rely on Medicaid. This echoes comments he made last week that “nobody will be worse off financially” if Congress repeals Obamacare.
Despite Price’s claims, health care experts and the nonpartisan Congressional Budget Office have said that the GOP’s Obamacare replacement bill will leave around 24 million people without health insurance. Among those most at risk for losing coverage are low-income Americans. As the CBO estimates, at least 14 million fewer people will be covered under Medicaid.
-- 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 21 hours ago.
— CNN (@CNN) March 16, 2017
A cancer survivor who says he’s alive because of Medicaid confronted Health and Human Services Secretary Tom Price on the GOP’s opposition to the program.
“Medicaid expansion saved my life and saved me from medical bankruptcy,” Brian Kline said during a CNN town hall event on Wednesday night.
Kline is from Pennsylvania, one of the states that opted to expand Medicaid coverage under the Affordable Care Act. Republicans leaders in the House are aiming to replace the act with a health care bill that dramatically cuts Medicaid funding.
Kline said that because he only makes $11 an hour, he wouldn’t have been able to afford treatment for colon cancer without Medicaid.
“My life really depends on having access to my doctors and medical care,” he said. “Why do you want to take away my Medicaid expansion?”
Price responded that Medicaid has “real problems” and that the GOP’s health care plans aim to improve coverage for people who currently rely on Medicaid. This echoes comments he made last week that “nobody will be worse off financially” if Congress repeals Obamacare.
Despite Price’s claims, health care experts and the nonpartisan Congressional Budget Office have said that the GOP’s Obamacare replacement bill will leave around 24 million people without health insurance. Among those most at risk for losing coverage are low-income Americans. As the CBO estimates, at least 14 million fewer people will be covered under Medicaid.
-- 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 21 hours ago.
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Health-Insurance Startup Clover Health Joins Billion-Dollar Club
Clover, one of a few startups ambitious enough to launch their own health-insurance business, is raising about $120 million at a valuation of more than $1 billion, according to a person familiar with the situation.
Reported by Wall Street Journal 19 hours ago.
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Can’t Find Health Care In TrumpCare Or RyanCare? Probably Because It’s Only TrynaCare
March 2017 started with House Republicans using secret rooms in the Capitol to hide rough drafts of bills to repeal and replace the Affordable Care Act. No really, Republican members of Congress had Capitol Police standing outside a room containing the legislation. Then that legislation went missing, and there was a ridiculous wild goose chase to find the bills. Those antics ended last week when Speaker Paul Ryan and House Republicans presented the American Health Care Act. Now the Congressional Budget Office (CBO) is confirming the assessments of health care providers, hospitals, and senior citizens: the AHCA will wreck healthcare and leave 24 million more Americans without coverage.
There are squabbles over whether to nickname the AHCA TrumpCare or RyanCare. I’m calling it TrynaCare: you can try, but you ain’t getting no health care. Here are the reasons why this bill needs to be permanently locked away in whatever secret room stores terrible ideas.
*1. TrumpCare/RyanCare wrecks Medicaid*
Currently, over 70 million Americans are on Medicaid, including 33 million children, 10 million seniors, and 6 million Americans with disabilities. Despite its lean budget, Medicaid is delivering excellent care that patients rate higher than the private insurance industry. In Washington, DC and the 31 states that opted to expand Medicaid under the Affordable Care Act, 15 million adults with low incomes are covered and reporting high satisfaction.
Under the American Health Care Act, expansion of Medicaid is allowed until the year 2020. Then, the bill requires states to freeze enrollment of new people and the open-ended commitment of federal funding stops. AHCA slashes $880 billion from Medicaid by changing its funding to per person caps, where each state gets a small lump sum of federal money per enrollee in its Medicaid program. The per person cap approach to funding drastically reduces support for Medicaid patients. To run Medicaid under such tight restraints, states will change the rules on who is eligible for the program and kick people off. The CBO reports these drastic changes to Medicaid result in 14 million more people losing coverage, over half of the 24 million more uninsured because of TrumpCare/RyanCare. Patients who can stay on capped Medicaid will see reduced benefits because states will not be able to afford as many services like dental care, physical therapy, treatment for substance abuse, and so on.
By implementing an enrollment freeze and per person caps in 2020, House Republicans ignore the fact that patients and families go on and off Medicaid because their circumstances change. A family may leave Medicaid because a mother finally got a job with health insurance benefits, but then she loses the job when the company transfers somewhere the family can not go. Or maybe a family’s housing situation changes because of a natural disaster. Women who leave abusive partners often qualify for Medicaid for a few years as they get back on their feet. Medicaid is there for all of these struggles, helping families get health care without costing them more peace of mind. Cycling in and out of the program is administratively complicated, but it is part of how Medicaid maintains a lifeline of dignity. TrumpCare/RyanCare’s per person caps ruin Medicaid’s ability to be a nimble first responder to large and small crises for families and communities.
*2. TrumpCare/RyanCare is stingy with support for patients, even when premiums skyrocket.*
Currently, the ACA helps people pay for health insurance premiums through income-based subsidies: the lower your income, the more help you get. TrumpCare/RyanCare plans to give very limited support using tax credits based on age. To understand how devastating this is for low-income older patients (who tend to have more health care needs), consider the Congressional Budget Office’s example of two people, ages 40 years old and 64 years old, both making the same barely-above-poverty income of $26,500 a year. Under the ACA, most of the premiums are covered by subsidies and both people pay about $1,700 a year. Under TrumpCare/RyanCare, the 40 year old gets a tax credit but still pays $700 more a year to cover premiums. The 64 year old gets a slightly larger tax credit because of her age, but still pays nearly $13,000 more a year for premiums.
The older patient is getting less help, and has to pay more for insurance under TrumpCare/RyanCare because the insurance companies are allowed to age-discriminate, charging older patients 5 times higher premiums than younger patients. To make matters worse, the bill has no financial assistance to help people with low incomes pay for deductibles and co-pays. That 64 year old just spent about half her income in premiums, but will continue to pay out-of-pocket for health care.
*3. TrumpCare/RyanCare puts insurance industry profits before patients. *
Like the Affordable Care Act, TrumpCare/RyanCare also bans insurance companies from denying coverage to people with pre-existing conditions. However, the ACHA bill has a catch: Patients with pre-existing conditions must maintain “continuous coverage.” If for whatever reason a patient does not have insurance for 63 days or more, then TrumpCare/RyanCare allows insurance companies to charge that patient a 30 percent surcharge on their premiums for one year. After that year the premiums will go back to the “standard rate.”
Working and middle class Americans know from experience that maintaining “continuous coverage” is incredibly challenging. Lapses in insurance coverage happen for all kinds of normal everyday reasons: time between jobs becomes longer than people think; housing situations change; or people get sick. My colleagues caring for cancer patients see it all the time: 85 percent of cancer patients stop working for 45 days to 6 months while getting treatment. During that time they can lose their job, lose health insurance, and before you know it, there’s a lapse in coverage. TrumpCare/RyanCare allows insurance companies to charge these patients 30 percent more on their premiums. It’s hard enough to fight cancer but now our friends and families will have to watch out for insurance companies just trying to catch them without coverage? Seriously?
Upcharging sick patients is not the only treat for the insurance industry in TrumpCare/RyanCare. Right now, the ACA limits insurance companies on how much executive pay they can claim in their tax deductions. An insurance company can only deduct $500,000 of each top executive’s pay from the company’s taxes. The ACA also closed a loophole lots of corporations use to deduct the cost of stock options and so-called performance-based pay. These limits are very specific to the insurance industry because the ACA figures executives can live with the money they make off of millions of new customers buying health insurance.
TrumpCare/RyanCare gets rid of all those rules on executive pay and taxes. The AHCA bill allows insurance companies to deduct $1 million for each executive’s pay and to deduct the cost of so-called “performance-based” stock awards and options. Speaker Paul Ryan wants insurance companies to enjoy the same tax code treats big Wall Street corporations have. As you might have guessed, the money adds up “bigly.” According to the Institute for Policy Studies, the 10 biggest insurance companies paid their top 57 executives a combined total of $300 million in 2013. The ACA allowed the companies to deduct 27 percent of that from taxes. With TrumpCare/RyanCare, the big insurance companies can deduct 96 percent of that executive pay from taxes. When all the tax breaks in TrumpCare/RyanCare are added up, insurance companies and the super-rich are getting nearly $600 billion.
If all this weren’t bad enough, TrumpCare/RyanCare wipes out Medicaid funding for Planned Parenthood and slashes the Medicare trust fund. To fight back, we must hold Trump accountable for breaking his promises. Since coming down his golden escalator in May 2015, Trump has talked about how he’d come up with “something terrific” to replace the ACA and there’d be “insurance for everybody.” To fight back, we must hold Speaker Paul Ryan and House Republicans accountable for taking more than 60 votes over the past 7 years to repeal the ACA with no replacement, then pushing this plan leaving 24 million more people without coverage. The majority of the American people did not vote for the Trump regime, and they absolutely did not vote for the demolition of American health care while giving away billions to the super-wealthy. To fight back, call 202-224-3121 to tell your House Representative and Senators (it does not matter what party they belong to because politicians who agree will be glad to hear you) to stop the American Health Care Act. TrumpCare/RyanCare is only TrynaCare for our health, and we deserve better.
To hear more about the dangers of TrumpCare/RyanCare, listen to the March 10 episode of Dr America.
Have you or your family benefited from the Affordable Care Act? If you’d like to share your story on HuffPost, email us at ACAstories@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 16 hours ago.
There are squabbles over whether to nickname the AHCA TrumpCare or RyanCare. I’m calling it TrynaCare: you can try, but you ain’t getting no health care. Here are the reasons why this bill needs to be permanently locked away in whatever secret room stores terrible ideas.
*1. TrumpCare/RyanCare wrecks Medicaid*
Currently, over 70 million Americans are on Medicaid, including 33 million children, 10 million seniors, and 6 million Americans with disabilities. Despite its lean budget, Medicaid is delivering excellent care that patients rate higher than the private insurance industry. In Washington, DC and the 31 states that opted to expand Medicaid under the Affordable Care Act, 15 million adults with low incomes are covered and reporting high satisfaction.
Under the American Health Care Act, expansion of Medicaid is allowed until the year 2020. Then, the bill requires states to freeze enrollment of new people and the open-ended commitment of federal funding stops. AHCA slashes $880 billion from Medicaid by changing its funding to per person caps, where each state gets a small lump sum of federal money per enrollee in its Medicaid program. The per person cap approach to funding drastically reduces support for Medicaid patients. To run Medicaid under such tight restraints, states will change the rules on who is eligible for the program and kick people off. The CBO reports these drastic changes to Medicaid result in 14 million more people losing coverage, over half of the 24 million more uninsured because of TrumpCare/RyanCare. Patients who can stay on capped Medicaid will see reduced benefits because states will not be able to afford as many services like dental care, physical therapy, treatment for substance abuse, and so on.
By implementing an enrollment freeze and per person caps in 2020, House Republicans ignore the fact that patients and families go on and off Medicaid because their circumstances change. A family may leave Medicaid because a mother finally got a job with health insurance benefits, but then she loses the job when the company transfers somewhere the family can not go. Or maybe a family’s housing situation changes because of a natural disaster. Women who leave abusive partners often qualify for Medicaid for a few years as they get back on their feet. Medicaid is there for all of these struggles, helping families get health care without costing them more peace of mind. Cycling in and out of the program is administratively complicated, but it is part of how Medicaid maintains a lifeline of dignity. TrumpCare/RyanCare’s per person caps ruin Medicaid’s ability to be a nimble first responder to large and small crises for families and communities.
*2. TrumpCare/RyanCare is stingy with support for patients, even when premiums skyrocket.*
Currently, the ACA helps people pay for health insurance premiums through income-based subsidies: the lower your income, the more help you get. TrumpCare/RyanCare plans to give very limited support using tax credits based on age. To understand how devastating this is for low-income older patients (who tend to have more health care needs), consider the Congressional Budget Office’s example of two people, ages 40 years old and 64 years old, both making the same barely-above-poverty income of $26,500 a year. Under the ACA, most of the premiums are covered by subsidies and both people pay about $1,700 a year. Under TrumpCare/RyanCare, the 40 year old gets a tax credit but still pays $700 more a year to cover premiums. The 64 year old gets a slightly larger tax credit because of her age, but still pays nearly $13,000 more a year for premiums.
The older patient is getting less help, and has to pay more for insurance under TrumpCare/RyanCare because the insurance companies are allowed to age-discriminate, charging older patients 5 times higher premiums than younger patients. To make matters worse, the bill has no financial assistance to help people with low incomes pay for deductibles and co-pays. That 64 year old just spent about half her income in premiums, but will continue to pay out-of-pocket for health care.
*3. TrumpCare/RyanCare puts insurance industry profits before patients. *
Like the Affordable Care Act, TrumpCare/RyanCare also bans insurance companies from denying coverage to people with pre-existing conditions. However, the ACHA bill has a catch: Patients with pre-existing conditions must maintain “continuous coverage.” If for whatever reason a patient does not have insurance for 63 days or more, then TrumpCare/RyanCare allows insurance companies to charge that patient a 30 percent surcharge on their premiums for one year. After that year the premiums will go back to the “standard rate.”
Working and middle class Americans know from experience that maintaining “continuous coverage” is incredibly challenging. Lapses in insurance coverage happen for all kinds of normal everyday reasons: time between jobs becomes longer than people think; housing situations change; or people get sick. My colleagues caring for cancer patients see it all the time: 85 percent of cancer patients stop working for 45 days to 6 months while getting treatment. During that time they can lose their job, lose health insurance, and before you know it, there’s a lapse in coverage. TrumpCare/RyanCare allows insurance companies to charge these patients 30 percent more on their premiums. It’s hard enough to fight cancer but now our friends and families will have to watch out for insurance companies just trying to catch them without coverage? Seriously?
Upcharging sick patients is not the only treat for the insurance industry in TrumpCare/RyanCare. Right now, the ACA limits insurance companies on how much executive pay they can claim in their tax deductions. An insurance company can only deduct $500,000 of each top executive’s pay from the company’s taxes. The ACA also closed a loophole lots of corporations use to deduct the cost of stock options and so-called performance-based pay. These limits are very specific to the insurance industry because the ACA figures executives can live with the money they make off of millions of new customers buying health insurance.
TrumpCare/RyanCare gets rid of all those rules on executive pay and taxes. The AHCA bill allows insurance companies to deduct $1 million for each executive’s pay and to deduct the cost of so-called “performance-based” stock awards and options. Speaker Paul Ryan wants insurance companies to enjoy the same tax code treats big Wall Street corporations have. As you might have guessed, the money adds up “bigly.” According to the Institute for Policy Studies, the 10 biggest insurance companies paid their top 57 executives a combined total of $300 million in 2013. The ACA allowed the companies to deduct 27 percent of that from taxes. With TrumpCare/RyanCare, the big insurance companies can deduct 96 percent of that executive pay from taxes. When all the tax breaks in TrumpCare/RyanCare are added up, insurance companies and the super-rich are getting nearly $600 billion.
If all this weren’t bad enough, TrumpCare/RyanCare wipes out Medicaid funding for Planned Parenthood and slashes the Medicare trust fund. To fight back, we must hold Trump accountable for breaking his promises. Since coming down his golden escalator in May 2015, Trump has talked about how he’d come up with “something terrific” to replace the ACA and there’d be “insurance for everybody.” To fight back, we must hold Speaker Paul Ryan and House Republicans accountable for taking more than 60 votes over the past 7 years to repeal the ACA with no replacement, then pushing this plan leaving 24 million more people without coverage. The majority of the American people did not vote for the Trump regime, and they absolutely did not vote for the demolition of American health care while giving away billions to the super-wealthy. To fight back, call 202-224-3121 to tell your House Representative and Senators (it does not matter what party they belong to because politicians who agree will be glad to hear you) to stop the American Health Care Act. TrumpCare/RyanCare is only TrynaCare for our health, and we deserve better.
To hear more about the dangers of TrumpCare/RyanCare, listen to the March 10 episode of Dr America.
Have you or your family benefited from the Affordable Care Act? If you’d like to share your story on HuffPost, email us at ACAstories@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 16 hours ago.
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Gov. Brown to release analysis of Republican health plan
Gov. Kate Brown will release an analysis today on the impacts the proposed Republican replacement plan for the Affordable Care Act would have on Oregon. News flash: The analysis won't view the proposal kindly. “Our analysis found that for every step of progress that Oregon made, the American Health Care Act will take Oregon three steps back,” Brown said in a written statement. “Since 2014, we have made tremendous progress to ensure that nearly every Oregonian has access to health insurance…
Reported by bizjournals 18 hours ago.
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Trumpcare’s $880 Billion Cut To Medicaid Is An Attack On Seniors
Trumpcare is officially known as the American Health Care Act, but that’s a lie. It isn’t a bill to provide health care, but exactly the opposite ― a bill to take health insurance away from tens of millions of Americans, especially those who are older, poorer, and sicker, in order to pay for massive tax giveaways for the wealthy and corporations. The bill cuts $880 billion from Medicaid, and cuts taxes primarily for rich people by about the same amount.
When people think of Medicaid, they don’t usually think “seniors.” But in fact, about six million seniors receiving Medicare are also enrolled in Medicaid ― and that number doesn’t include people in their fifties and early sixties, who will be increasingly likely to rely on Medicaid if Trumpcare passes and makes their premiums for private health insurance rise by 750 percent.
Medicaid is particularly important to seniors who require long term care and their families. That will be most of us one day: 70 percent of Americans ages 65 and older will eventually require long-term care services and supports, which include nursing facilities, home health aides, personal care, and family caregiving. Medicaid covers sixty percent of nursing home residents and forty percent of long term care services and supports.
Without Medicaid, millions of seniors and their families will not be able to afford long-term care. The median yearly cost for home health help is $46,000 per year, and for a nursing home it’s $92,000! In comparison, the average yearly Social Security benefit is only $14,776. Taking Medicaid benefits away from seniors forces their families (especially women) to provide at-home care even if they don’t have the time or skills to do so adequately. Those seniors who don’t have family members or friends who can take on care responsibilities are condemned to a lonely death.
Social Security Works has released a factsheet detailing the importance of Medicaid to seniors, through protections such as:
·
Protection against high out-of-pocket costs. Medicaid helps to shoulder the burden of Medicare’s high out-of-pocket costs for seniors that live in or near poverty. For seniors living at or below the monthly federal poverty limit, Medicaid pays for Medicare premiums and cost sharing obligations. Medicaid also provides assistance in paying Medicare premiums for seniors living just above the poverty line (typically those with incomes of 100-120 percent of the federal poverty limit).·
Coverage of critical services. In addition to assisting low-income seniors with out-of-pocket healthcare costs, Medicaid provides coverage for a range of critical healthcare services that are not covered by Medicare. These services, which are especially vital to seniors, include prescription drugs, eyeglasses, and hearing aids. Medicaid ensures that seniors who already struggle to cover their basic costs of living do not have to forgo these important healthcare services.·
Long-Term care. The Centers for Medicare and Medicaid Services estimate that at least 70 percent of Americans ages 65 and older will one day need long-term care services and supports, which include nursing facilities, home health aides, personal care, and family caregiving. Because Medicare’s coverage of long-term care is extremely limited, and similar coverage under private insurance is typically unaffordable, seniors with chronic conditions who require assistance with daily living often exhaust their resources paying for long-term care services. For these seniors, Medicaid is often the insurer of last resort. Long-term care is one of Medicaid’s most critical, and invaluable, protections for our nation’s seniors. Indeed, one-fifth of Medicaid’s overall budget is spent on long term care.·
Nursing home services. In addition to covering long-term care, Medicaid provides critical coverage for seniors who rely on nursing home care. Such coverage is usually expensive, especially for seniors with limited means. Without Medicaid, seniors living in or near poverty would be forced to forego much-needed nursing home care.
The method that Trumpcare uses to gut Medicaid (in addition to rolling back the Affordable Care Act’s Medicaid expansion) is a benign sounding policy called “per-capita caps.” What that actually means is that instead of paying a fixed percentage of states’ Medicaid costs, the federal government would only pay a fixed amount per beneficiary. This cap doesn’t account for future economic downturns, unanticipated epidemics, or the expected increases in healthcare costs as the population ages. And it won’t keep track with annual increases in healthcare costs—if Trumpcare passes, Medicaid’s costs per beneficiary will quickly outstrip federal funding. That means that when the costs per beneficiary inevitably go up, states will need to either spend more of their own money or cut their Medicaid programs. Unfortunately, history suggests that most of them are likely to do the latter.
States will be faced with this dilemma sooner rather than later because the population is aging, and a larger percentage of Medicaid beneficiaries will soon be seniors. As we mentioned above, long-term care is not cheap, and seniors ― particularly those over 85 ― cost considerably more to cover than other groups such as children. States will be highly incentivized to kick seniors off the Medicaid rolls.
Alex Lawson is the Executive Director at Social Security Works; Linda Benesch is the Communications Director. Sign our petition demanding Congress reject Trumpcare and its reckless cuts to Medicaid―a direct attack on seniors and people with disabilities.
-- 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 18 hours ago.
When people think of Medicaid, they don’t usually think “seniors.” But in fact, about six million seniors receiving Medicare are also enrolled in Medicaid ― and that number doesn’t include people in their fifties and early sixties, who will be increasingly likely to rely on Medicaid if Trumpcare passes and makes their premiums for private health insurance rise by 750 percent.
Medicaid is particularly important to seniors who require long term care and their families. That will be most of us one day: 70 percent of Americans ages 65 and older will eventually require long-term care services and supports, which include nursing facilities, home health aides, personal care, and family caregiving. Medicaid covers sixty percent of nursing home residents and forty percent of long term care services and supports.
Without Medicaid, millions of seniors and their families will not be able to afford long-term care. The median yearly cost for home health help is $46,000 per year, and for a nursing home it’s $92,000! In comparison, the average yearly Social Security benefit is only $14,776. Taking Medicaid benefits away from seniors forces their families (especially women) to provide at-home care even if they don’t have the time or skills to do so adequately. Those seniors who don’t have family members or friends who can take on care responsibilities are condemned to a lonely death.
Social Security Works has released a factsheet detailing the importance of Medicaid to seniors, through protections such as:
·
Protection against high out-of-pocket costs. Medicaid helps to shoulder the burden of Medicare’s high out-of-pocket costs for seniors that live in or near poverty. For seniors living at or below the monthly federal poverty limit, Medicaid pays for Medicare premiums and cost sharing obligations. Medicaid also provides assistance in paying Medicare premiums for seniors living just above the poverty line (typically those with incomes of 100-120 percent of the federal poverty limit).·
Coverage of critical services. In addition to assisting low-income seniors with out-of-pocket healthcare costs, Medicaid provides coverage for a range of critical healthcare services that are not covered by Medicare. These services, which are especially vital to seniors, include prescription drugs, eyeglasses, and hearing aids. Medicaid ensures that seniors who already struggle to cover their basic costs of living do not have to forgo these important healthcare services.·
Long-Term care. The Centers for Medicare and Medicaid Services estimate that at least 70 percent of Americans ages 65 and older will one day need long-term care services and supports, which include nursing facilities, home health aides, personal care, and family caregiving. Because Medicare’s coverage of long-term care is extremely limited, and similar coverage under private insurance is typically unaffordable, seniors with chronic conditions who require assistance with daily living often exhaust their resources paying for long-term care services. For these seniors, Medicaid is often the insurer of last resort. Long-term care is one of Medicaid’s most critical, and invaluable, protections for our nation’s seniors. Indeed, one-fifth of Medicaid’s overall budget is spent on long term care.·
Nursing home services. In addition to covering long-term care, Medicaid provides critical coverage for seniors who rely on nursing home care. Such coverage is usually expensive, especially for seniors with limited means. Without Medicaid, seniors living in or near poverty would be forced to forego much-needed nursing home care.
The method that Trumpcare uses to gut Medicaid (in addition to rolling back the Affordable Care Act’s Medicaid expansion) is a benign sounding policy called “per-capita caps.” What that actually means is that instead of paying a fixed percentage of states’ Medicaid costs, the federal government would only pay a fixed amount per beneficiary. This cap doesn’t account for future economic downturns, unanticipated epidemics, or the expected increases in healthcare costs as the population ages. And it won’t keep track with annual increases in healthcare costs—if Trumpcare passes, Medicaid’s costs per beneficiary will quickly outstrip federal funding. That means that when the costs per beneficiary inevitably go up, states will need to either spend more of their own money or cut their Medicaid programs. Unfortunately, history suggests that most of them are likely to do the latter.
States will be faced with this dilemma sooner rather than later because the population is aging, and a larger percentage of Medicaid beneficiaries will soon be seniors. As we mentioned above, long-term care is not cheap, and seniors ― particularly those over 85 ― cost considerably more to cover than other groups such as children. States will be highly incentivized to kick seniors off the Medicaid rolls.
Alex Lawson is the Executive Director at Social Security Works; Linda Benesch is the Communications Director. Sign our petition demanding Congress reject Trumpcare and its reckless cuts to Medicaid―a direct attack on seniors and people with disabilities.
-- 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 18 hours ago.
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Latest Polls Show Broad Opposition To GOP Obamacare Replacement
Republican plans to repeal the Affordable Care Act have been met with a largely frosty reception by the public, according to the latest polling released this week.
A Fox News poll published Wednesday night finds that just 34 percent of registered voters support the GOP’s health care plan, with 54 percent in opposition ― 36 percent oppose because it makes too many changes to the Affordable Care Act, also known as Obamacare, and 11 percent because it makes too few.
A SurveyMonkey poll shows similar reactions, with most Americans opposed to the Republican bill, 55 percent to 42 percent. The poll finds more intense opposition than support, with just 18 percent saying they strongly support the bill, while 38 percent say that they’re strongly opposed to it. The Democratic firm Public Policy Polling, meanwhile, puts opposition at 49 percent, with just 24 percent approving.
A fourth poll from Morning Consult and Politico, released Wednesday, finds considerably more positive views of the bill, with 46 percent of voters approving and 35 percent disapproving. (Perhaps relevantly, theirs was also the only survey not to explicitly identify the bill as being a Republican proposal.) While 27 percent don’t think the bill goes far enough in changing the health system, according to the survey, 24 percent think it goes too far, and 17 percent that it goes far enough.Two other recent surveys didn’t ask directly about overall support for the bill, but provide some additional context on how it’s seen by the public.
About a third of Americans expect the bill, if passed, would be worse than the current health care law, according to a HuffPost/YouGov survey released Sunday, with 27 percent expecting it to be better and 13 percent saying it wouldn’t make much of a change. The poll also found many Americans aware of the GOP’s intraparty fractures on the proposal, with just 11 percent believing Republicans in Congress were united in support of it.
A tracking survey from the Kaiser Family Foundation released Wednesday breaks down expectations further, finding that about half, 48 percent, expects the replacement plan to decrease the number of people with health insurance and to increase costs for people who buy their own insurance. A smaller 41 percent plurality expect the replacement to lead to higher deductibles, while 45 percent say the new plan would leave protections for people with pre-existing conditions about the same.The KFF poll also finds some misconceptions about how the plan would affect specific groups. “Compared with current law, lower-income individuals, older adults, and those living in rural areas would pay more for insurance on average under the replacement plan, while younger adults, those with higher incomes, and those living in urban areas would pay less,” the authors write. “However, the public does not see a distinction in how the replacement plan would impact costs for these different groups of individuals, except when it comes to income.”
Most of the surveys find significant splits across party lines. In the Fox survey, for instance, 89 percent of Republican voters, but just 7 percent of Democratic voters, support the plan; in SurveyMonkey’s poll, those numbers are 84 percent and 10 percent, respectively, while Morning Consult and Politico find a relatively modest 65 percent to 30 percent split.
Democrats are 46 percentage points likelier than Republicans to believe the new plan would decrease the number of people with health insurance, according to the KFF poll, 52 points likelier to think the plan would increase costs for people who buy their own insurance, and 44 points likelier to expect higher deductibles.
The debate over the new proposal comes against a backdrop of rising popularity for law currently in place. Americans favor the Obama administration’s Affordable Care Act by an average 5-point margin, according to HufffPost Pollster’s aggregate, up from a negative score as recently as last October.-- 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 17 hours ago.
A Fox News poll published Wednesday night finds that just 34 percent of registered voters support the GOP’s health care plan, with 54 percent in opposition ― 36 percent oppose because it makes too many changes to the Affordable Care Act, also known as Obamacare, and 11 percent because it makes too few.
A SurveyMonkey poll shows similar reactions, with most Americans opposed to the Republican bill, 55 percent to 42 percent. The poll finds more intense opposition than support, with just 18 percent saying they strongly support the bill, while 38 percent say that they’re strongly opposed to it. The Democratic firm Public Policy Polling, meanwhile, puts opposition at 49 percent, with just 24 percent approving.
A fourth poll from Morning Consult and Politico, released Wednesday, finds considerably more positive views of the bill, with 46 percent of voters approving and 35 percent disapproving. (Perhaps relevantly, theirs was also the only survey not to explicitly identify the bill as being a Republican proposal.) While 27 percent don’t think the bill goes far enough in changing the health system, according to the survey, 24 percent think it goes too far, and 17 percent that it goes far enough.Two other recent surveys didn’t ask directly about overall support for the bill, but provide some additional context on how it’s seen by the public.
About a third of Americans expect the bill, if passed, would be worse than the current health care law, according to a HuffPost/YouGov survey released Sunday, with 27 percent expecting it to be better and 13 percent saying it wouldn’t make much of a change. The poll also found many Americans aware of the GOP’s intraparty fractures on the proposal, with just 11 percent believing Republicans in Congress were united in support of it.
A tracking survey from the Kaiser Family Foundation released Wednesday breaks down expectations further, finding that about half, 48 percent, expects the replacement plan to decrease the number of people with health insurance and to increase costs for people who buy their own insurance. A smaller 41 percent plurality expect the replacement to lead to higher deductibles, while 45 percent say the new plan would leave protections for people with pre-existing conditions about the same.The KFF poll also finds some misconceptions about how the plan would affect specific groups. “Compared with current law, lower-income individuals, older adults, and those living in rural areas would pay more for insurance on average under the replacement plan, while younger adults, those with higher incomes, and those living in urban areas would pay less,” the authors write. “However, the public does not see a distinction in how the replacement plan would impact costs for these different groups of individuals, except when it comes to income.”
Most of the surveys find significant splits across party lines. In the Fox survey, for instance, 89 percent of Republican voters, but just 7 percent of Democratic voters, support the plan; in SurveyMonkey’s poll, those numbers are 84 percent and 10 percent, respectively, while Morning Consult and Politico find a relatively modest 65 percent to 30 percent split.
Democrats are 46 percentage points likelier than Republicans to believe the new plan would decrease the number of people with health insurance, according to the KFF poll, 52 points likelier to think the plan would increase costs for people who buy their own insurance, and 44 points likelier to expect higher deductibles.
The debate over the new proposal comes against a backdrop of rising popularity for law currently in place. Americans favor the Obama administration’s Affordable Care Act by an average 5-point margin, according to HufffPost Pollster’s aggregate, up from a negative score as recently as last October.-- 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 17 hours ago.
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Dear young people: Health and youth are fleeting, so do your part and buy a decent insurance plan
To the editor: The linchpin of our health insurance dilemma is the mandate. With everyone “in the pool,” the risk is spread around. (“On Obamacare, Paul Ryan has no idea what he's talking about,” March 14)
House Speaker Paul Ryan (R-Wis.) and President Trump say their proposal to replace the Affordable... Reported by L.A. Times 15 hours ago.
House Speaker Paul Ryan (R-Wis.) and President Trump say their proposal to replace the Affordable... Reported by L.A. Times 15 hours ago.
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Winners And Losers (Sad!) In Trump's Budget
WASHINGTON ― President Donald Trump presented his first official budget proposal on Tuesday, declaring a dramatic philosophical shift in public spending priorities. Put simply, Trump wants to take $54 billion currently flowing to the poor, scientific research, environmental protection and other programs and hand it over to the military-industrial complex. In the process, some popular federal programs would be completely eliminated.
“These cuts are sensible and rational,” Trump said in a statement accompanying the budget proposal. “Every agency and department will be driven to achieve greater efficiency and to eliminate wasteful spending in carrying out their honorable service to the American people.”
Presidential budgets don’t actually create policy. Although they traditionally served as an opening bid for negotiations with Congress, Capitol Hill’s “regular order” budgeting process has been nonfunctional for many years. Trump’s budget should instead be viewed as an ideological statement.
“This is the America First budget,” Budget Director Mick Mulvaney told reporters Wednesday. “We wrote it using the president’s own words. We went through his speeches … we wanted to know what his policies were and we turned those policies into numbers.”
*WINNERS*
*Defense contractors.* The clearest winner in Trump’s budget are defense contractors and the military, which would receive an additional $54 billion to pay for … pretty much anything. Among several other funding targets, the budget document cites “stocks of critical munitions,” “rebuilding readiness,” a “more lethal joint force” and “additional F-35 Joint Strike Fighters” ― the latter of which have proved to be a multitrillion-dollar disaster.
“This increase alone exceeds the entire defense budget of most countries, and would be one of the largest one-year [Defense Department] increases in American history,” the budget document reads.
*People who want to chase down and deport immigrants.* The budget proposes $314 million to hire 500 new border patrol agents and 1,000 new Immigration and Customs Enforcement officers.
*The Wall.* Trump wants to give the Department of Homeland Security an additional $2.6 billion, some of which would be used to “plan, design, and construct a physical wall along the southern border.” The actual wall, of course, would cost much more than $2.6 billion, but Rome wasn’t built in a day.
*LOSERS (SAD!)*
*Poor people.* Trump’s budget eliminates the Low Income Home Energy Assistance Program, which helps a limited number of poor people pay their heating and cooling bills.
“Compared to other income support programs that serve similar populations, LIHEAP is a lower-impact program and is unable to demonstrate strong performance outcomes,” the Trump budget says. The budget would also eliminate the Community Services Block Grant, which partly funds Meals On Wheels programs, for combined savings of $4.2 billion.
Mark Wolfe, the director of the National Energy Assistance Directors Association, a group that advocates for the program on behalf of its local administrators around the country, said the budget’s description was nonsense.
“What they really mean is that they need money to pay for the wall and other administration priorities and LIHEAP and CSBG gets you $4.2 billion of the way there,” Wolfe said in an email. The program helps pay utility bills for 6.1 million poor households annually, he said, adding that 70 percent of those homes include at least one child, senior citizen or disabled person.
“At the end of the day, what is the argument to support freezing grandma?” Wolfe said.
The Obama administration also made a big show of supporting cuts to heating assistance, and Congress actually cut funding significantly at the end of 2011. However, the cut has been offset somewhat by cheaper fuel and warmer winters that have helped reduce heating costs.
*Habitat for Humanity. *Trump’s budget saves $35 million by closing the Section 4 Capacity Building for Community Development and Affordable Housing program. This is money that goes to Habitat for Humanity and other charities that build and refurbish houses for poor people. But don’t worry ― according to the budget, nice rich people are already giving poor people all the housing help they need. “This program is duplicative of efforts funded by philanthropy and other more flexible private sector investments,” the document declares.
*Science. *It’s hard to overstate just how devastating this budget would be to the science and biomedical research community.
In addition to massively reducing the budget of the Environmental Protection Agency (by 31.5 percent), outright eliminating the NASA satellite program, implementing a $900 million cut to the Department of Energy’s Office of Science, ending the Advanced Technology Vehicle Manufacturing Program, and slashing $250 million in grants from the National Oceanic and Atmospheric Administration, it would also slash funds for the National Institutes of Health by $6 billion. That would put the NIH funding level at a 15-year low and would more than erase the funding that Congress had pledged to devote to the institutes when it passed the 21st Century Cures Act at the tail end of the last Congress.
Benjamin Corb, director of public affairs at the American Society for Biochemistry and Molecular Biology, called the budget “unacceptable.” It would erase “years’ worth of bipartisan support for the NIH, and the American biomedical research enterprise which has long been the global leader for biomedical innovation,” he warned.
*Big Bird. *The budget would eliminate the Corporation for Public Broadcasting, which funds PBS, which airs “Sesame Street.”
*People who want to be nurses. *Say goodbye to $403 million in training for health professionals and nursing programs.
*TBD. *Social Security and Medicare ― two of the biggest parts of federal spending ― are omitted from the document, as is the Supplemental Nutrition Assistance Program.
The Center on Budget and Policy Priorities, an influential liberal think tank, noted that while past administrations have created simplified spending blueprints, Trump’s decision to not even include details on such “mandatory” spending programs is unusual.
“In contrast, while all five previous administrations released initial budgets that displayed information in very different ways, they all provided a more complete picture of how their policies affected total spending, revenues, and deficits (or surpluses), and showed them for several years beyond the budget year,” Richard Kogan said in a blog post on the think tank’s website.
On the campaign trail, Trump repeatedly promised not to cut Social Security or Medicare. “I can confirm to you that the president’s going to keep the promises he made with regard to those programs,” Mulvaney told reporters.
Trump also repeatedly promised not to cut Medicaid. The health care bill he is currently pushing would slash the program by $880 billion, taking away health insurance for millions of Americans.
-- 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 13 hours ago.
“These cuts are sensible and rational,” Trump said in a statement accompanying the budget proposal. “Every agency and department will be driven to achieve greater efficiency and to eliminate wasteful spending in carrying out their honorable service to the American people.”
Presidential budgets don’t actually create policy. Although they traditionally served as an opening bid for negotiations with Congress, Capitol Hill’s “regular order” budgeting process has been nonfunctional for many years. Trump’s budget should instead be viewed as an ideological statement.
“This is the America First budget,” Budget Director Mick Mulvaney told reporters Wednesday. “We wrote it using the president’s own words. We went through his speeches … we wanted to know what his policies were and we turned those policies into numbers.”
*WINNERS*
*Defense contractors.* The clearest winner in Trump’s budget are defense contractors and the military, which would receive an additional $54 billion to pay for … pretty much anything. Among several other funding targets, the budget document cites “stocks of critical munitions,” “rebuilding readiness,” a “more lethal joint force” and “additional F-35 Joint Strike Fighters” ― the latter of which have proved to be a multitrillion-dollar disaster.
“This increase alone exceeds the entire defense budget of most countries, and would be one of the largest one-year [Defense Department] increases in American history,” the budget document reads.
*People who want to chase down and deport immigrants.* The budget proposes $314 million to hire 500 new border patrol agents and 1,000 new Immigration and Customs Enforcement officers.
*The Wall.* Trump wants to give the Department of Homeland Security an additional $2.6 billion, some of which would be used to “plan, design, and construct a physical wall along the southern border.” The actual wall, of course, would cost much more than $2.6 billion, but Rome wasn’t built in a day.
*LOSERS (SAD!)*
*Poor people.* Trump’s budget eliminates the Low Income Home Energy Assistance Program, which helps a limited number of poor people pay their heating and cooling bills.
“Compared to other income support programs that serve similar populations, LIHEAP is a lower-impact program and is unable to demonstrate strong performance outcomes,” the Trump budget says. The budget would also eliminate the Community Services Block Grant, which partly funds Meals On Wheels programs, for combined savings of $4.2 billion.
Mark Wolfe, the director of the National Energy Assistance Directors Association, a group that advocates for the program on behalf of its local administrators around the country, said the budget’s description was nonsense.
“What they really mean is that they need money to pay for the wall and other administration priorities and LIHEAP and CSBG gets you $4.2 billion of the way there,” Wolfe said in an email. The program helps pay utility bills for 6.1 million poor households annually, he said, adding that 70 percent of those homes include at least one child, senior citizen or disabled person.
“At the end of the day, what is the argument to support freezing grandma?” Wolfe said.
The Obama administration also made a big show of supporting cuts to heating assistance, and Congress actually cut funding significantly at the end of 2011. However, the cut has been offset somewhat by cheaper fuel and warmer winters that have helped reduce heating costs.
*Habitat for Humanity. *Trump’s budget saves $35 million by closing the Section 4 Capacity Building for Community Development and Affordable Housing program. This is money that goes to Habitat for Humanity and other charities that build and refurbish houses for poor people. But don’t worry ― according to the budget, nice rich people are already giving poor people all the housing help they need. “This program is duplicative of efforts funded by philanthropy and other more flexible private sector investments,” the document declares.
*Science. *It’s hard to overstate just how devastating this budget would be to the science and biomedical research community.
In addition to massively reducing the budget of the Environmental Protection Agency (by 31.5 percent), outright eliminating the NASA satellite program, implementing a $900 million cut to the Department of Energy’s Office of Science, ending the Advanced Technology Vehicle Manufacturing Program, and slashing $250 million in grants from the National Oceanic and Atmospheric Administration, it would also slash funds for the National Institutes of Health by $6 billion. That would put the NIH funding level at a 15-year low and would more than erase the funding that Congress had pledged to devote to the institutes when it passed the 21st Century Cures Act at the tail end of the last Congress.
Benjamin Corb, director of public affairs at the American Society for Biochemistry and Molecular Biology, called the budget “unacceptable.” It would erase “years’ worth of bipartisan support for the NIH, and the American biomedical research enterprise which has long been the global leader for biomedical innovation,” he warned.
*Big Bird. *The budget would eliminate the Corporation for Public Broadcasting, which funds PBS, which airs “Sesame Street.”
*People who want to be nurses. *Say goodbye to $403 million in training for health professionals and nursing programs.
*TBD. *Social Security and Medicare ― two of the biggest parts of federal spending ― are omitted from the document, as is the Supplemental Nutrition Assistance Program.
The Center on Budget and Policy Priorities, an influential liberal think tank, noted that while past administrations have created simplified spending blueprints, Trump’s decision to not even include details on such “mandatory” spending programs is unusual.
“In contrast, while all five previous administrations released initial budgets that displayed information in very different ways, they all provided a more complete picture of how their policies affected total spending, revenues, and deficits (or surpluses), and showed them for several years beyond the budget year,” Richard Kogan said in a blog post on the think tank’s website.
On the campaign trail, Trump repeatedly promised not to cut Social Security or Medicare. “I can confirm to you that the president’s going to keep the promises he made with regard to those programs,” Mulvaney told reporters.
Trump also repeatedly promised not to cut Medicaid. The health care bill he is currently pushing would slash the program by $880 billion, taking away health insurance for millions of Americans.
-- 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 13 hours ago.
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A big part of the GOP's Obamacare replacement may accomplish the opposite of its goal
The Congressional Budget Office announced Monday that the American Health Care Act, the GOP leadership's plan to repeal and replace the Affordable Care Act, would lead to as many as 24 million more people to be uninsured by over the next decade.
And what could be to blame is a major provision in the bill that Republicans say is designed to encourage more people to sign up for insurance.
The AHCA includes a provision that says anyone who does not have health insurance coverage for a period of 63 days or more in the previous year is subject to a 30% increase in premiums for up to the next year as a penalty. The GOP says that the penalty would discourage people from waiting until they are sick to access coverage.
The CBO, however, found otherwise. According to the report, the "continuous coverage" provision would lead more people to sign up for insurance coverage in 2018 (the first year of the law), but reduce that number in the years after.
"By the agencies’ estimates, roughly 1 million people would be induced to purchase insurance in 2018 to avoid possibly having to pay the surcharge in the future. In most years after 2018, however, roughly 2 million fewer people would purchase insurance," the report reads.
Further, the CBO suggested that the people deterred from buying coverage would tend to be healthier than those who did buy coverage.
Richard Frank, a professor of health economics at Harvard Medical School, told Business Insider that the "continuous coverage" provision will come down harshly on both young people and lower-income people. Both groups, according to Frank, tend to have incomes that fluctuate heavily from month-to-month and make financial decisions with the view on the immediate future, often because they have to.
If a person is fairly healthy and doesn't think they can afford insurance to begin with, the possibility of a 30% rate hike if they lose their job, or suffer some other financial misfortune, is a further disincentive to buy insurance, he added.
"It’s a fairly harsh penalty," Frank said. "That doesn’t incentivize people to sign up."
Yuval Levin, a former policy adviser to George W. Bush and a conservative commentator, wrote in the National Review that the provision could actually keep people out of the healthcare market until they get sick.
"It would create a disincentive for everyone who hasn’t been continuously covered to get coverage, by making insurance more expensive for them," Levin wrote. "But that disincentive would do more to drive away healthy people than sick people, since the added premium is more likely to be worth it to someone who otherwise would have higher costs than to someone just looking to get insurance for a rainy day. It would, in other words, exacerbate the problem it is trying to mitigate."
One of the biggest problems for the ACA has been that the risk pools in the individual market — in other words, the demographics of the people signing up through Obamacare's exchanges — are tilted toward older, sicker people. This has led to large losses for some insurance companies, because the pool is more expensive to cover than was expected.
The worry, based on Levin's analysis, is that without any incentive to stay in the pools, more young people will pull out of the plans and wait until they get sick to sign up. Eating the 30% premium increase might be viewed as small potatoes compared to paying expensive medical bills if a person falls ill.
Americans seem to be looking at the penalty with extreme skepticism early on. According to a Morning Consult/Politico poll, only 18% of people surveyed supported the measure.
Another potential issue for Republicans hoping to pass the legislation into law is that the 30% penalty is not paid to the federal government. Since the GOP is using the budget reconciliation process to move the AHCA to avoid a Democratic filibuster, all measures in the bill have to be pertinent to the federal budget.
If there are any extraneous measures to the budget, for which the penalty could qualify, the bill could be blocked using the Senate's Byrd rule.
It appears Republicans may be considering getting rid of the 30% penalty. Axios' Caitlin Owens reported Wednesday that GOP leaders, worried about blowback and the impact of the provision, could drop the penalty to make the bill more palatable.
*SEE ALSO: Trump when told the biggest losers under 'Trumpcare' would be his own voters: 'Oh, I know'*
Join the conversation about this story »
NOW WATCH: 'F--- you for that': Milo Yiannopoulos attacks the media in a press conference after resigning from Breitbart Reported by Business Insider 11 hours ago.
And what could be to blame is a major provision in the bill that Republicans say is designed to encourage more people to sign up for insurance.
The AHCA includes a provision that says anyone who does not have health insurance coverage for a period of 63 days or more in the previous year is subject to a 30% increase in premiums for up to the next year as a penalty. The GOP says that the penalty would discourage people from waiting until they are sick to access coverage.
The CBO, however, found otherwise. According to the report, the "continuous coverage" provision would lead more people to sign up for insurance coverage in 2018 (the first year of the law), but reduce that number in the years after.
"By the agencies’ estimates, roughly 1 million people would be induced to purchase insurance in 2018 to avoid possibly having to pay the surcharge in the future. In most years after 2018, however, roughly 2 million fewer people would purchase insurance," the report reads.
Further, the CBO suggested that the people deterred from buying coverage would tend to be healthier than those who did buy coverage.
Richard Frank, a professor of health economics at Harvard Medical School, told Business Insider that the "continuous coverage" provision will come down harshly on both young people and lower-income people. Both groups, according to Frank, tend to have incomes that fluctuate heavily from month-to-month and make financial decisions with the view on the immediate future, often because they have to.
If a person is fairly healthy and doesn't think they can afford insurance to begin with, the possibility of a 30% rate hike if they lose their job, or suffer some other financial misfortune, is a further disincentive to buy insurance, he added.
"It’s a fairly harsh penalty," Frank said. "That doesn’t incentivize people to sign up."
Yuval Levin, a former policy adviser to George W. Bush and a conservative commentator, wrote in the National Review that the provision could actually keep people out of the healthcare market until they get sick.
"It would create a disincentive for everyone who hasn’t been continuously covered to get coverage, by making insurance more expensive for them," Levin wrote. "But that disincentive would do more to drive away healthy people than sick people, since the added premium is more likely to be worth it to someone who otherwise would have higher costs than to someone just looking to get insurance for a rainy day. It would, in other words, exacerbate the problem it is trying to mitigate."
One of the biggest problems for the ACA has been that the risk pools in the individual market — in other words, the demographics of the people signing up through Obamacare's exchanges — are tilted toward older, sicker people. This has led to large losses for some insurance companies, because the pool is more expensive to cover than was expected.
The worry, based on Levin's analysis, is that without any incentive to stay in the pools, more young people will pull out of the plans and wait until they get sick to sign up. Eating the 30% premium increase might be viewed as small potatoes compared to paying expensive medical bills if a person falls ill.
Americans seem to be looking at the penalty with extreme skepticism early on. According to a Morning Consult/Politico poll, only 18% of people surveyed supported the measure.
Another potential issue for Republicans hoping to pass the legislation into law is that the 30% penalty is not paid to the federal government. Since the GOP is using the budget reconciliation process to move the AHCA to avoid a Democratic filibuster, all measures in the bill have to be pertinent to the federal budget.
If there are any extraneous measures to the budget, for which the penalty could qualify, the bill could be blocked using the Senate's Byrd rule.
It appears Republicans may be considering getting rid of the 30% penalty. Axios' Caitlin Owens reported Wednesday that GOP leaders, worried about blowback and the impact of the provision, could drop the penalty to make the bill more palatable.
*SEE ALSO: Trump when told the biggest losers under 'Trumpcare' would be his own voters: 'Oh, I know'*
Join the conversation about this story »
NOW WATCH: 'F--- you for that': Milo Yiannopoulos attacks the media in a press conference after resigning from Breitbart Reported by Business Insider 11 hours ago.
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GOP health plan could cost 465K Oregonians their coverage, and the state $2.6B in revenue
A new state-based analysis of the impact from the House Republican plan to reshape health reform paints a disastrous picture for Oregon. As many as 465,000 Oregonians would lose health coverage by 2023, including 80,000 next year, if the American Health Care Act continues to advance into law, according to a report from state health and insurance agencies. Requested by Oregon Gov. Kate Brown, the analysis also found the AHCA would cost Oregon $2.6 billion in federal revenue by 2023. The uninsured…
Reported by bizjournals 9 hours ago.
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A Budget Is A Moral Document. The One Trump Produced Is Dark.
A presidential budget isn’t so much a policy proposal as a statement of an administration’s moral vision for the country. The budget presented by President Donald Trump on Thursday is a document fundamentally unconcerned with the government’s role in improving the plight of its most vulnerable citizens.
That message is clear in the budget’s topline proposals and its deeper details. Trump calls for a $54 billion boost in defense spending and immigration enforcement. More border patrol agents, more Immigration and Customs Enforcement officers, more fighter jets that don’t work, and a border wall with Mexico. To offset those fresh expenses, he wants to take an ax to a host of anti-poverty programs ― everything from public housing to food programs helping elderly people with disabilities.
This was an ideological choice. When explaining why it would eliminate a $35 million affordable housing program, the administration declared the endeavor simply wasn’t the government’s business: “This program is duplicative of efforts funded by philanthropy and other more flexible private sector investments.”
Republicans have long believed that communities, religious groups and volunteer organizations are often best equipped to help those in need. But many of them still acknowledge government has some role to play in these endeavors. Over the years, for example, they have supported AmeriCorps ― a national service program that Trump’s budget would eliminate.
That Trump’s budget is devoid of even modest nods to social welfare is not something that the administration is trying to hide. Instead, they’ve turned the argument on its head. At a press briefing Thursday afternoon, Budget Director Mick Mulvaney was asked how he could justify cutting programs for the elderly and the poor while ramping up spending in other areas. In response, he insisted that, on the contrary, taking food from the mouths of hungry children should be seen as an act of “compassion.”
“I think it’s one of the most compassionate things we can do,” Mulvaney said, referring to reducing anti-poverty spending. The government, he declared, has an urgent moral priority to ensure that “the single mom of two in Detroit” doesn’t pay for programs that don’t serve “a proper function.”
As an example of such failures, Mulvaney invoked after-school programs that provide meals to low-income kids. “They’re supposed to help kids who don’t get fed at home get fed so they get better in school,” he said. “Guess what? There’s no demonstrable evidence they’re actually doing that.”
In fact, there is substantial evidence that school meal programs improve academic performance. More to the point, Mulvaney’s argument simply ignored the notion that feeding hungry kids might be something society would deem important ― test score improvements be damned.
He had a similar take on the popular Meals and Wheels program, which delivers food to elderly people and others with disabilities who have trouble leaving their home. Trump’s budget calls for the program’s funding to be slashed as, Mulvaney insisted, the program doesn’t work.
“We look at this as $140 billion spent over 40 years without the appreciable benefit to show for that type of expenditure,” he said.
Mulvaney is just wrong ― unless you believe that feeding the indigent is of no value. Several studies suggest that home meal delivery programs don’t just give senior citizens food ― the meals improve their overall health and keep them out of nursing homes. (It also received only a fraction of the $140 billion Mulvaney mentioned.)
“Home-delivered meal programs improve diet quality and increase nutrient intakes among participants,” according to a 2014 review of eight studies that looked at the programs. “These programs are also aligned with the federal cost-containment policy to rebalance long-term care away from nursing homes to home- and community-based services by helping older adults maintain independence and remain in their homes and communities as their health and functioning decline.”
Of course, Mulvaney’s deep compassion for the burdens imposed on taxpayers evaporates with other Trump administration priorities. He doesn’t bemoan the plight of the poor when discussing how their taxes will be spent on a border wall or a fighter jet. Nor does he grapple with the fact that the single mom of two in Detroit may be among the roughly 45 percent of households who don’t pay federal income taxes precisely because they are poor.
Trump’s budget will almost assuredly never make it into law. Members of Congress are tasked with appropriating money and setting funding level. And even Republicans on Thursday could only offer up the most perfunctory of supportive statements for the blueprint the president has outlined.
But the concept of governance that Mulvaney articulated and that Trump put his name to, has been echoed repeatedly throughout the Republican Party. And it’s apparent in other legislative pursuits they’re undertaking.
Just last week, House Speaker Paul Ryan (R-Wis.) described the GOP health care replacement bill as an “act of mercy” ― even though the Congressional Budget Office estimates that 24 million people will lose their coverage in the next decade if it becomes law. The freedom not to buy insurance, in this case, takes preeminence over the very real likelihood that individuals will suffer (and, yes, die) in the absence of health care coverage they currently have.
Trump, of course, pitched himself as a man with a different set of values than those enshrined in his budget. He offered a new social welfare version of Republicanism in which everyone (excluding immigrants and Muslims) received health insurance, the poor were not shunned and the government cleaned up America’s cities, air and water. His embrace of the health care bill written by Ryan belies that. And his budget makes it even more apparent that the rhetoric was nothing more than an empty sales pitch to struggling households.
-- 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 8 hours ago.
That message is clear in the budget’s topline proposals and its deeper details. Trump calls for a $54 billion boost in defense spending and immigration enforcement. More border patrol agents, more Immigration and Customs Enforcement officers, more fighter jets that don’t work, and a border wall with Mexico. To offset those fresh expenses, he wants to take an ax to a host of anti-poverty programs ― everything from public housing to food programs helping elderly people with disabilities.
This was an ideological choice. When explaining why it would eliminate a $35 million affordable housing program, the administration declared the endeavor simply wasn’t the government’s business: “This program is duplicative of efforts funded by philanthropy and other more flexible private sector investments.”
Republicans have long believed that communities, religious groups and volunteer organizations are often best equipped to help those in need. But many of them still acknowledge government has some role to play in these endeavors. Over the years, for example, they have supported AmeriCorps ― a national service program that Trump’s budget would eliminate.
That Trump’s budget is devoid of even modest nods to social welfare is not something that the administration is trying to hide. Instead, they’ve turned the argument on its head. At a press briefing Thursday afternoon, Budget Director Mick Mulvaney was asked how he could justify cutting programs for the elderly and the poor while ramping up spending in other areas. In response, he insisted that, on the contrary, taking food from the mouths of hungry children should be seen as an act of “compassion.”
“I think it’s one of the most compassionate things we can do,” Mulvaney said, referring to reducing anti-poverty spending. The government, he declared, has an urgent moral priority to ensure that “the single mom of two in Detroit” doesn’t pay for programs that don’t serve “a proper function.”
As an example of such failures, Mulvaney invoked after-school programs that provide meals to low-income kids. “They’re supposed to help kids who don’t get fed at home get fed so they get better in school,” he said. “Guess what? There’s no demonstrable evidence they’re actually doing that.”
In fact, there is substantial evidence that school meal programs improve academic performance. More to the point, Mulvaney’s argument simply ignored the notion that feeding hungry kids might be something society would deem important ― test score improvements be damned.
He had a similar take on the popular Meals and Wheels program, which delivers food to elderly people and others with disabilities who have trouble leaving their home. Trump’s budget calls for the program’s funding to be slashed as, Mulvaney insisted, the program doesn’t work.
“We look at this as $140 billion spent over 40 years without the appreciable benefit to show for that type of expenditure,” he said.
Mulvaney is just wrong ― unless you believe that feeding the indigent is of no value. Several studies suggest that home meal delivery programs don’t just give senior citizens food ― the meals improve their overall health and keep them out of nursing homes. (It also received only a fraction of the $140 billion Mulvaney mentioned.)
“Home-delivered meal programs improve diet quality and increase nutrient intakes among participants,” according to a 2014 review of eight studies that looked at the programs. “These programs are also aligned with the federal cost-containment policy to rebalance long-term care away from nursing homes to home- and community-based services by helping older adults maintain independence and remain in their homes and communities as their health and functioning decline.”
Of course, Mulvaney’s deep compassion for the burdens imposed on taxpayers evaporates with other Trump administration priorities. He doesn’t bemoan the plight of the poor when discussing how their taxes will be spent on a border wall or a fighter jet. Nor does he grapple with the fact that the single mom of two in Detroit may be among the roughly 45 percent of households who don’t pay federal income taxes precisely because they are poor.
Trump’s budget will almost assuredly never make it into law. Members of Congress are tasked with appropriating money and setting funding level. And even Republicans on Thursday could only offer up the most perfunctory of supportive statements for the blueprint the president has outlined.
But the concept of governance that Mulvaney articulated and that Trump put his name to, has been echoed repeatedly throughout the Republican Party. And it’s apparent in other legislative pursuits they’re undertaking.
Just last week, House Speaker Paul Ryan (R-Wis.) described the GOP health care replacement bill as an “act of mercy” ― even though the Congressional Budget Office estimates that 24 million people will lose their coverage in the next decade if it becomes law. The freedom not to buy insurance, in this case, takes preeminence over the very real likelihood that individuals will suffer (and, yes, die) in the absence of health care coverage they currently have.
Trump, of course, pitched himself as a man with a different set of values than those enshrined in his budget. He offered a new social welfare version of Republicanism in which everyone (excluding immigrants and Muslims) received health insurance, the poor were not shunned and the government cleaned up America’s cities, air and water. His embrace of the health care bill written by Ryan belies that. And his budget makes it even more apparent that the rhetoric was nothing more than an empty sales pitch to struggling households.
-- 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 8 hours ago.
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How will Congress repeal and replace its own Obamacare?
No-one really knows where lawmakers are going to have to get their health insurance under repeal.
Reported by Politico 8 hours ago.
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Majority Of Floridians Want To Keep Or Expand Obamacare
A majority of Floridians would like to expand the Affordable Care Act (commonly referred to as Obamacare) or keep the law as is, while nearly three-quarters of them are concerned that people would lose their health insurance if the law is repealed, according to a statewide survey by the Florida Atlantic University Business and Economics Polling Initiative (FAU BEPI).
When asked about the Affordable Care Act, 46 percent of respondents said they approve of the healthcare law, while 39 percent said they disapprove. Similarly, 39 percent of Floridians would like to expand Obamacare and 14 percent want to keep it as is, while 18 percent want to repeal the law and 29 percent said they would like to replace the law.
Overall, 73 percent were concerned that people would lose their health insurance if Obamacare were repealed. When asked if government should be responsible for ensuring all Americans have healthcare coverage, 64 percent said “yes” while 19 percent disagreed.
Respondents also were asked about six healthcare proposals put forth by Republican lawmakers. Only one of the proposals, lifting the $2,600 cap on flexible spending accounts to allow workers to set aside more pretax money to pay out-of-pocket healthcare expenses, had net positive support with 43 percent approving and 29 percent opposing.
A proposal to repeal the 3.8 percent tax on investment income, which helps fund Obamacare and affects households making more than $250,000, garnered 31 percent support compared with 40 percent opposition. Likewise, a proposal to replace healthcare subsidies with a refund tax credit of $2,000-$4,000 depending on an individual’s age and income had 26 percent support and 38 percent opposition.
Respondents strongly opposed other proposals as well, including reducing federal funding to the Medicaid program, which was opposed by 74 percent and supported by only 16 percent. Only 15 percent of respondents support a proposal to increase premiums by 30 percent for a year for those who let their insurance lapse for at least 63 days, while 60 percent oppose. A proposal to allow insurers to increase what they charge older consumers was the least popular, with 76 percent opposing and only 8 percent supporting.
“It is evident that Floridians oppose the new healthcare proposals,” said Monica Escaleras, Ph.D., director of the BEPI. “These proposals are perceived to be hurting low-income and older people, while benefiting those with incomes higher that $250,000.”
U.S. President Donald Trump’s approval rating among respondents was 36 percent.
The online survey, which polled 500 Florida residents from March 10-13, was administered through Survey Sampling International (SSI), a Worldwide Leader in Survey Sampling and Data Collections. The survey has a margin of error of +/- 4.3 percentage points. Responses for the entire sample were weighted to reflect the statewide distribution of the Florida population by gender, race/ethnicity, region, education and age according to latest American Community Survey data. Reported by Eurasia Review 5 hours ago.
When asked about the Affordable Care Act, 46 percent of respondents said they approve of the healthcare law, while 39 percent said they disapprove. Similarly, 39 percent of Floridians would like to expand Obamacare and 14 percent want to keep it as is, while 18 percent want to repeal the law and 29 percent said they would like to replace the law.
Overall, 73 percent were concerned that people would lose their health insurance if Obamacare were repealed. When asked if government should be responsible for ensuring all Americans have healthcare coverage, 64 percent said “yes” while 19 percent disagreed.
Respondents also were asked about six healthcare proposals put forth by Republican lawmakers. Only one of the proposals, lifting the $2,600 cap on flexible spending accounts to allow workers to set aside more pretax money to pay out-of-pocket healthcare expenses, had net positive support with 43 percent approving and 29 percent opposing.
A proposal to repeal the 3.8 percent tax on investment income, which helps fund Obamacare and affects households making more than $250,000, garnered 31 percent support compared with 40 percent opposition. Likewise, a proposal to replace healthcare subsidies with a refund tax credit of $2,000-$4,000 depending on an individual’s age and income had 26 percent support and 38 percent opposition.
Respondents strongly opposed other proposals as well, including reducing federal funding to the Medicaid program, which was opposed by 74 percent and supported by only 16 percent. Only 15 percent of respondents support a proposal to increase premiums by 30 percent for a year for those who let their insurance lapse for at least 63 days, while 60 percent oppose. A proposal to allow insurers to increase what they charge older consumers was the least popular, with 76 percent opposing and only 8 percent supporting.
“It is evident that Floridians oppose the new healthcare proposals,” said Monica Escaleras, Ph.D., director of the BEPI. “These proposals are perceived to be hurting low-income and older people, while benefiting those with incomes higher that $250,000.”
U.S. President Donald Trump’s approval rating among respondents was 36 percent.
The online survey, which polled 500 Florida residents from March 10-13, was administered through Survey Sampling International (SSI), a Worldwide Leader in Survey Sampling and Data Collections. The survey has a margin of error of +/- 4.3 percentage points. Responses for the entire sample were weighted to reflect the statewide distribution of the Florida population by gender, race/ethnicity, region, education and age according to latest American Community Survey data. Reported by Eurasia Review 5 hours ago.
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Robert Reich: An Orgy Of Unnecessary Cruelty – OpEd
The theme that unites all of Trump’s initiatives so far is their unnecessary cruelty.
1. *His new budget* comes down especially hard on the poor – imposing unprecedented cuts in low-income housing, job training, food assistance, legal services, help to distressed rural communities, nutrition for new mothers and their infants, funds to keep poor families warm, even “meals on wheels.”
These cuts come at a time when more American families are in poverty than ever before, including 1 in 5 children.
Why is Trump doing this? To pay for the biggest hike in military spending since the 1980s. Yet the U.S. already spends more on its military than the next 7 biggest military budgets put together.
2. *His plan to repeal and “replace” the Affordable Care Act* will cause 14 million Americans to lose their health insurance next year, and 24 million by 2026.
Why is Trump doing this? To bestow $600 billion in tax breaks over the decade to wealthy Americans. This windfall comes at a time when the rich have accumulated more wealth than at any time in the nation’s history.
The plan reduces the federal budget deficit by only $337 billion over the next ten years – a small fraction of the national debt, in exchange for an enormous amount of human hardship.
3. *His ban on Syrian refugees* and reduction by half in the total number of refugees admitted to the United States comes just when the world is experiencing the worst refugee crisis since World War II.
Why is Trump doing this? The ban does little or nothing to protect Americans from terrorism. No terrorist act in the United States has been perpetrated by a Syrian or by anyone from the six nations whose citizens are now banned from traveling to the United States. You have higher odds of being struck by lightening than dying from an immigrant terrorist attack.
4. *His dragnet roundup of undocumented immigrants* is helter-skelter – including people who have been productive members of our society for decades, and young people who have been here since they were toddlers.
Why is Trump doing this? He has no compelling justification. Unemployment is down, crime is down, and we have fewer undocumented workers in the U.S. today than we did five years ago.
Trump is embarking on an orgy of cruelty for absolutely no reason. This is morally repugnant. It violates every ideal this nation has ever cherished. We have a moral responsibility to stop it. Reported by Eurasia Review 4 hours ago.
1. *His new budget* comes down especially hard on the poor – imposing unprecedented cuts in low-income housing, job training, food assistance, legal services, help to distressed rural communities, nutrition for new mothers and their infants, funds to keep poor families warm, even “meals on wheels.”
These cuts come at a time when more American families are in poverty than ever before, including 1 in 5 children.
Why is Trump doing this? To pay for the biggest hike in military spending since the 1980s. Yet the U.S. already spends more on its military than the next 7 biggest military budgets put together.
2. *His plan to repeal and “replace” the Affordable Care Act* will cause 14 million Americans to lose their health insurance next year, and 24 million by 2026.
Why is Trump doing this? To bestow $600 billion in tax breaks over the decade to wealthy Americans. This windfall comes at a time when the rich have accumulated more wealth than at any time in the nation’s history.
The plan reduces the federal budget deficit by only $337 billion over the next ten years – a small fraction of the national debt, in exchange for an enormous amount of human hardship.
3. *His ban on Syrian refugees* and reduction by half in the total number of refugees admitted to the United States comes just when the world is experiencing the worst refugee crisis since World War II.
Why is Trump doing this? The ban does little or nothing to protect Americans from terrorism. No terrorist act in the United States has been perpetrated by a Syrian or by anyone from the six nations whose citizens are now banned from traveling to the United States. You have higher odds of being struck by lightening than dying from an immigrant terrorist attack.
4. *His dragnet roundup of undocumented immigrants* is helter-skelter – including people who have been productive members of our society for decades, and young people who have been here since they were toddlers.
Why is Trump doing this? He has no compelling justification. Unemployment is down, crime is down, and we have fewer undocumented workers in the U.S. today than we did five years ago.
Trump is embarking on an orgy of cruelty for absolutely no reason. This is morally repugnant. It violates every ideal this nation has ever cherished. We have a moral responsibility to stop it. Reported by Eurasia Review 4 hours ago.
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