Abortion Adds Obstacle as Republicans Plan to Unveil Health Bill
"The Secret Republican Health Care Bill Is an Affront to Enlightenment Values"
By ROBERT PEAR and THOMAS KAPLANJUNE 21, 2017
Senator Mitch McConnell of Kentucky, the majority leader, hopes to unveil the contents of Republicans’ health bill on Thursday and pass it next week. Credit Doug Mills/The New York Times
WASHINGTON — Abortion flared up Wednesday as the latest hot-button issue to complicate passage of a bill to repeal and replace the Affordable Care Act, which Senate Republican leaders hope to unveil on Thursday and pass next week.
If that provision is dropped, a bill that has already elicited deep misgivings among moderate Republicans — and stiff resistance from Democrats, health care providers and patient advocacy groups — could also generate concern among abortion opponents, as well as conservative lawmakers.
The changes being considered in Congress could “amount to a 25 percent shortfall in covering the actual cost of providing care to our nation’s neediest citizens,” the top executives of 10 insurance companies wrote this week. “These amounts spell deep cuts, not state flexibilities, in Medicaid.”
[...]
Senator Rand Paul, Republican of Kentucky, made clear on Wednesday that he was not on board with the Republican bill.
“I’m still hoping we reach impasse, and we actually go back to the idea we originally started with, which is repealing Obamacare,” Mr. Paul said, adding, “I’m not for replacing Obamacare with Obamacare lite.”
.. lol, Double, double toil and trouble; Fire burn, and caldron bubble. .. http://www.potw.org/archive/potw283.html .. shortsightedness rules the day .. is there anyone in the room who doesn't expect America will have universal healthcare within 20 years, or so .. grr.
US Senate Republicans have launched their plan for shrivelling Barack Obama's health care law, edging a step closer to their dream of repeal with a bill that would slice and reshape Medicaid for the poor.
Release of the 142-page proposal aimed at repealing Mr Obama's Affordable Care Act ended the long wait for one of the most closely guarded bills in years.
[...]
The former president opened and closed the letter by stressing that the Affordable Care Act — also known as Obamacare — was implemented by his administration not to score political points, but to make people's lives better on both sides of the political spectrum.
"After all, this debate has always been about something bigger than politics. It's about the character of our country — who we are, and who we aspire to be," Mr Obama wrote.
[THE LETTER]
Barack Obama on Thursday
Our politics are divided. They have been for a long time. And while I know that division makes it difficult to listen to Americans with whom we disagree, that’s what we need to do today.
I recognize that repealing and replacing the Affordable Care Act has become a core tenet of the Republican Party. Still, I hope that our Senators, many of whom I know well, step back and measure what’s really at stake, and consider that the rationale for action, on health care or any other issue, must be something more than simply undoing something that Democrats did.
We didn’t fight for the Affordable Care Act for more than a year in the public square for any personal or political gain – we fought for it because we knew it would save lives, prevent financial misery, and ultimately set this country we love on a better, healthier course.
Nor did we fight for it alone. Thousands upon thousands of Americans, including Republicans, threw themselves into that collective effort, not for political reasons, but for intensely personal ones – a sick child, a parent lost to cancer, the memory of medical bills that threatened to derail their dreams.
And you made a difference. For the first time, more than ninety percent of Americans know the security of health insurance. Health care costs, while still rising, have been rising at the slowest pace in fifty years. Women can’t be charged more for their insurance, young adults can stay on their parents’ plan until they turn 26, contraceptive care and preventive care are now free. Paying more, or being denied insurance altogether due to a preexisting condition – we made that a thing of the past.
We did these things together. So many of you made that change possible.
At the same time, I was careful to say again and again that while the Affordable Care Act represented a significant step forward for America, it was not perfect, nor could it be the end of our efforts – and that if Republicans could put together a plan that is demonstrably better than the improvements we made to our health care system, that covers as many people at less cost, I would gladly and publicly support it.
That remains true. So I still hope that there are enough Republicans in Congress who remember that public service is not about sport or notching a political win, that there’s a reason we all chose to serve in the first place, and that hopefully, it’s to make people’s lives better, not worse.
But right now, after eight years, the legislation rushed through the House and the Senate without public hearings or debate would do the opposite. It would raise costs, reduce coverage, roll back protections, and ruin Medicaid as we know it. That’s not my opinion, but rather the conclusion of all objective analyses, from the nonpartisan Congressional Budget Office, which found that 23 million Americans would lose insurance, to America’s doctors, nurses, and hospitals on the front lines of our health care system.
The Senate bill, unveiled today, is not a health care bill. It’s a massive transfer of wealth from middle-class and poor families to the richest people in America. It hands enormous tax cuts to the rich and to the drug and insurance industries, paid for by cutting health care for everybody else. Those with private insurance will experience higher premiums and higher deductibles, with lower tax credits to help working families cover the costs, even as their plans might no longer cover pregnancy, mental health care, or expensive prescriptions. Discrimination based on pre-existing conditions could become the norm again. Millions of families will lose coverage entirely.
Simply put, if there’s a chance you might get sick, get old, or start a family – this bill will do you harm. And small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, cannot change the fundamental meanness at the core of this legislation.
I hope our Senators ask themselves – what will happen to the Americans grappling with opioid addiction who suddenly lose their coverage? What will happen to pregnant mothers, children with disabilities, poor adults and seniors who need long-term care once they can no longer count on Medicaid? What will happen if you have a medical emergency when insurance companies are once again allowed to exclude the benefits you need, send you unlimited bills, or set unaffordable deductibles? What impossible choices will working parents be forced to make if their child’s cancer treatment costs them more than their life savings?
To put the American people through that pain – while giving billionaires and corporations a massive tax cut in return – that’s tough to fathom. But it’s what’s at stake right now. So it remains my fervent hope that we step back and try to deliver on what the American people need.
That might take some time and compromise between Democrats and Republicans. But I believe that’s what people want to see. I believe it would demonstrate the kind of leadership that appeals to Americans across party lines. And I believe that it’s possible – if you are willing to make a difference again. If you’re willing to call your members of Congress. If you are willing to visit their offices. If you are willing to speak out, let them and the country know, in very real terms, what this means for you and your family.
After all, this debate has always been about something bigger than politics. It’s about the character of our country – who we are, and who we aspire to be. And that’s always worth fighting for.
Senate health-care bill faces serious resistance from GOP moderates
"The Secret Republican Health Care Bill Is an Affront to Enlightenment Values"
Play Video 1:27 Dean Heller (R-Nev.) announced on June 23 that he would not support the Republican Senate health-care bill. (Reuters)
By Juliet Eilperin and Amy Goldstein June 24 at 6:53 PM
A small group of moderate Republican senators, worried that their leaders’ health-care bill could damage the nation’s social safety net, may pose at least as significant an obstacle to the measure’s passage as their colleagues on the right.
The vast changes the legislation would make to Medicaid, the country’s broadest source of public health insurance, would represent the largest single step the government has ever taken toward conservatives’ long-held goal of reining in federal spending on health-care entitlement programs in favor of a free-market system.
That dramatic shift and the bill’s bold redistribution of wealth — the billions of dollars taken from coverage for the poor would help fund tax cuts for the wealthy — is creating substantial anxiety for several Republican moderates whose states have especially benefited from the expansion of Medicaid that the Affordable Care Act has allowed since 2014.
Their concerns that the legislation would harm the nation’s most vulnerable and cause many Americans to become uninsured have thrust into stark relief the ideological fault lines within the GOP. Though Senate conservatives were the first to threaten to torpedo the bill, contending that it is too generous, the potential loss of nearly half a dozen moderate lawmakers’ votes may be the main hurdle. Since the bill will get no support from Democrats, Senate Majority Leader Mitch McConnell can afford defections from no more than two Republicans as he tries to bring it to a vote this week.
His odds worsened Friday when Sen. Dean Heller (R-Nev.), who is up for reelection next year, said he could not support the bill in its current form. Heller specifically cited its cuts to Medicaid, not just by ending its expansion in Nevada and 30 other states but by restricting government spending for the program starting in 2025.
Play Video 3:26 - The Fix's Amber Phillips explains four ways the Senate health-care bill could be in jeopardy. (Peter Stevenson/The Washington Post)
This bill “is simply not the answer,” he declared, describing some of the 200,000 Nevadans who have gained health coverage through the expansion. He rhetorically asked whether the Republican plan will ensure that they have insurance in the future. “I’m telling you, right now it doesn’t do that,” he said.
Though three of the other four wavering GOP centrists also come from Medicaid-expansion states, not all were as explicit as Heller in their reactions after the Better Care Reconciliation Act was finally unveiled late last week. Both Sens. Shelley Moore Capito (W.Va.) and Lisa Murkowski (Alaska) said that they would evaluate it with an eye toward its effect on low-income residents.
“It needs to be done right,” Murkowski said in a tweet. “I remain committed to ensuring that all Alaskans have access to affordable, quality health care.”
Part of the pressure the moderates now face is that Medicaid consistently draws widespread support in surveys. A poll released Friday by the Kaiser Family Foundation found that three-fourths of the public, including 6 in 10 Republicans, said they have a positive view of the program. Just a third of those polled said they supported the idea of reducing federal funding for the expansion or limiting how much money a state receives for all beneficiaries.
Even among Republicans, the foundation found, only about half favor reversing the federal money for Medicaid expansion.
Congressional budget analysts plan to issue their projections as early as Monday on the legislation’s impact on the federal deficit and the number of Americans with insurance coverage. Already, proponents and critics alike are predicting that the Senate proposal would lead to greater reductions through the Medicaid changes than the estimated $834 billion estimated for a similar bill passed by House Republicans last month.
“The focus of Republican efforts largely has been on costs,” said Lanhee Chen, a research fellow at Stanford University’s Hoover Institution. “You do have a different set of issues that the two sides have been focused on, which partly explains why this has been such an intractable and difficult debate to find common ground on.”
Under the Senate GOP version, 2021 is when Medicaid’s transformation would begin. The expansion, which has provided coverage to roughly 11 million people, would be phased out. What is now an open-ended entitlement, with federal funding available for a specific share of whatever each state spends, would be converted to per capita payments or block grants.
Then, four years later, the federal government would apply an inflation factor to spending increases that would be equal to the urban consumer price index rather than the higher medical inflation rate used in the House bill.
“There has never been a rollback of basic services to Americans like this ever in U.S. history,” said Bruce Siegel, president of America’s Essential Hospitals, a coalition of about 300 hospitals that treat a large share of low-income patients. “Let’s not mince words. This bill will close hospitals. It will hammer rural hospitals, it will close nursing homes. It will lead to disabled children not getting services. .?.?. People will die.”
To some extent, the division within the GOP’s ranks reflects geography. Some of the most reticent senators come from states where health-care systems stand to lose the most financially if the bill passed.
According to an analysis by the Commonwealth Fund, hospitals in Nevada would be saddled over the next decade with at least double the costs in “uncompensated care” — bills for which neither an insurer nor a patient paid. It examined the House legislation but noted that the Senate bill would doubtless hit harder because of its deeper reductions in federal Medicaid payments.
Hospitals in West Virginia would suffer an even greater spike in uncompensated care, about 122 percent during the decade. But the analysis showed that the greatest damage would come in McConnell’s own state: Kentucky, which has had the nation’s largest Medicaid expansion under the ACA, would see a 165 percent jump in unpaid hospital bills.
Yet conservative Sen. Patrick J. Toomey (R-Pa.), one of the bill’s champions, said it would establish “a very, very gradual and gentle transition to a normal inflation rate” for a program in which he said costs were spiraling out of control. Beyond Medicaid, it would permit private health plans to cover fewer services and would allow individuals and employers to eschew coverage without penalty — elements that its authors say could lower how much consumers pay for their insurance.
“The idea that there’s a sector of our economy that has to permanently have a higher inflation rate than the rest of our economy is ridiculous,” Toomey said Thursday. “I think that it’s absolutely essential to putting [Medicaid] on a sustainable path so that it will be there for future generations.”
Avik Roy, a conservative health expert who serves as president of the Foundation for Research on Equal Opportunity, said the legislation’s proponents need to show “that competitive insurance markets can work for the poor and the vulnerable and the sick.”
People too often equate federal spending with establishing a safety net, when greater competition and a free market could produce better results at a lower cost, in Roy’s view. The Senate bill would extend “quite robust” tax credits to many people, he said, even to those living in poverty who were not eligible for Medicaid: “Republicans have a different view of what a safety net should look like.”
Pressure is coming from outside groups on the right. Though the four conservatives who have voiced opposition to the bill might be pushed hard — Sens. Rand Paul (Ky.), Mike Lee (Utah), Ted Cruz (Tex.) and Ron Johnson (Wis.) — Heller will be a special target. A super PAC, America First Policies, reportedly is planning a seven-figure ad buy just in Nevada.
But patient-advocacy organizations that focus on an array of diseases are intensifying their own lobbying on the bill, including running print and online ads in several key states. If one health issue has emerged as a flash point, however, it is the nation’s opioid epidemic.
Shatterproof, a national nonprofit organization focused on addressing addiction, estimates that 2.8 million people have gained access to substance-abuse treatment under Medicaid expansion. In Ohio alone, total federal funding provided 70 percent of the $939 million that the state spent to combat the epidemic last year.
Capito and Sen. Rob Portman (Ohio) have asked the chamber’s Republican leaders to provide in the bill $45 billion over 10 years to address opioids; the measure currently provides $2 billion. But that amount, Shatterproof chief executive Gary Mendell said Friday, is less than a tenth of what experts predict will be needed over the next decade. And providing a designated fund while leaving millions uninsured makes little sense, he added.
Shatterproof just launched a six-figure advertising buy in Ohio, West Virginia and Maine — which is represented by another undecided Republican, Sen. Susan Collins — to urge the states’ senators to vote against the bill. Mendell noted that Portman has been a champion on substance-use treatment for years, and it was difficult to run ads targeting him.
“His people need to understand that this has to be a no vote,” Mendell said.
Specific constituencies aside, some policy experts regard the Senate’s plan as a wholesale reversal of the government’s path to offer health insurance to ever-wider groups of Americans, piece by piece. That started with the creation of Medicaid and Medicare as part of President Lyndon B. Johnson’s Great Society and could be ending with the ACA.
“This is bringing us back to where we were before 1965,” said Paul Starr, a Princeton University professor of sociology and public affairs who has written extensively about the history of U.S. health-care policy. “There is no longer the federal commitment to back up the states in terms of health care for the poor.”
Fisherman who said wife went overboard in Lake Erie charged with her murder
July 4, 2017, 9:54 AM
ERIE COUNTY, Pa. -- A commercial fisherman's story about his wife disappearing into the depths of Lake Erie on a boating trip isn't adding up, and Pennsylvania authorities believe they know why. They say he's the one who put her there.
Yes, there are horrible people on earth. So horrible words could not do them justice.
"The Secret Republican Health Care Bill Is an Affront to Enlightenment Values"
No i don't mean to equate the people associated with the so-far failed Republican healthcare bills with those of the three articles above. The Republicans who crafted the bills are just missing compassion and common sense.
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