Trump Screws the 99%
Mar 14, 2017 16:13:13 #
woodssprite 17 wrote:
It seems to be a matter of pride for some Trump supporters to rubber stamp any proposal that comes out of the oval office. It's like a knee jerk reaction. On the other hand, there seems to be a absence of clear thinking in a good majority of the posts appearing here. Trump is a con man and a criminal, a front man for a group of incompetents playing at being a government. The sooner he is made to pay for his crime's the better off this country will be.
Trump is a living example of a knee-jerk reaction himself....he worries more about SNL's impersonations of him than he does world affairs..........these people follow him in a cult-like manner as he screws them over. I feel sorry for the old racists but trump said he could do whatever he wanted and they would still approve....lets see these people have to pay for their parents healthcare once the ObamaCare subsidies are gone. I want to see if they are loyal to trump to the extent they become stupid...so far so good......'sigh'............
Mar 14, 2017 20:09:09 #
This is a public service announcement:
Made possible by loser Prog One and other Street People;
Why do liberals side with a Billionaire elitist like George "Giorgi" Soros?
PO; do you believe this should be what guides America?
“This system to be controlled in a feudalistic fashion by the central banks of the world acting in concert, by secret agreements arrived at in frequent private meetings and conferences.” - Insider, Professor Carroll Quigley – ‘Tragedy and Hope’,( p. 324)
10 Things You Didn't Know About "Giorgi" George Soros
https://youtu.be/tfBHYxEojZk
SOROS ROTHSCHILD RACE WAR PROPAGANDA EXPOSED
https://youtu.be/lhqqz3QFQKE
Made possible by loser Prog One and other Street People;
Why do liberals side with a Billionaire elitist like George "Giorgi" Soros?
PO; do you believe this should be what guides America?
“This system to be controlled in a feudalistic fashion by the central banks of the world acting in concert, by secret agreements arrived at in frequent private meetings and conferences.” - Insider, Professor Carroll Quigley – ‘Tragedy and Hope’,( p. 324)
10 Things You Didn't Know About "Giorgi" George Soros
https://youtu.be/tfBHYxEojZk
SOROS ROTHSCHILD RACE WAR PROPAGANDA EXPOSED
https://youtu.be/lhqqz3QFQKE
Mar 14, 2017 20:35:32 #
You have the right if it. Trump could care less, but we all must pay attention to his ranting tweets. If they are ignored there will be hell to pay. The man has no business being President and his cabinet knows it
He is a means to thier ends. However it remains to be seen if he can stay out of jail long enough to help achieve at least some of their goals. Left to himself I really don't see him lasting out the first year, now that the bricks are starting to fall. His "house" I's on shakey ground.
He is a means to thier ends. However it remains to be seen if he can stay out of jail long enough to help achieve at least some of their goals. Left to himself I really don't see him lasting out the first year, now that the bricks are starting to fall. His "house" I's on shakey ground.
Mar 15, 2017 10:43:26 #
woodssprite 17 wrote:
You have the right if it. Trump could care less, ... (show quote)
so woodssprite;
This is your savior?
Why do you side with a Billionaire elitist like George "Giorgi" Soros?
10 Things You Didn't Know About "Giorgi" George Soros
https://youtu.be/tfBHYxEojZk
SOROS ROTHSCHILD RACE WAR PROPAGANDA EXPOSED
https://youtu.be/lhqqz3QFQKE
George Soros: Evil Puppet Master Exposed
https://youtu.be/1eRFTHD2CTg
Mar 15, 2017 13:17:11 #
The GOP’s dilemma on healthcare
The party of small government tries to protect an entitlement program that most people want to keep.
By Lisa Mascaro
WASHINGTON — The House GOP effort to repeal and replace Obamacare appeared in deep trouble Tuesday, underscoring the limits of a party that has traditionally put a priority on cutting taxes and government spending over digging into the details of safeguarding Americans’ healthcare.
Many Republicans in Congress remain in outright revolt over the bill, warning it does not have enough votes to pass the House or Senate against stiff Democratic resistance.
A few moderate Republicans emerged from a Senate lunch Tuesday optimistic that House leaders would amend the legislation to meet their concerns. They want to preserve coverage for the millions of Americans who are projected to be left without insurance.
But conservatives were pulling the bill in the opposite direction, demanding deeper, faster cuts.
Meanwhile, GOP defections continued, including Florida Rep. Ileana Ros-Lehtinen, who said the current bill would be too detrimental to her elderly constituents.
“Is there anyone left in the country who actually likes it?” asked Senate Minority Leader Charles E. Schumer (D-N.Y.), reading the lists of doctors, hospital organizations and others who have registered opposition.
The tribulations now facing Republicans are not hard to understand: The party never set out to revamp the nation’s healthcare system. That was always a Democratic pursuit.
Republicans simply wanted to repeal Obamacare, which they saw as a costly government intrusion.
Only after they took the White House and it became apparent that millions of Americans would lose their health coverage under a straightforward repeal did Republicans begin to take seriously the “replace” part of their campaign promise.
But while Democrats have been churning out healthcare proposals since Franklin D. Roosevelt, Republicans have become increasingly fixed on the Reagan-era goal of reducing the size of government. Most Democrats see healthcare as a fundamental right or entitlement; few Republicans do.
That has left Republicans without a deep bench of healthcare policy experts in Congress, despite a cadre of doctors-turned-lawmakers.
One architect of the latest GOP effort is Tom Price, the former congressman and orthopedic surgeon who is now the Health and Human Services secretary. But to many, his experience in reforming government healthcare programs pales in comparison to the late Sen. Edward M. Kennedy, the liberal lion who for decades set strategy for Democratic reform efforts, including Obamacare.
Lawrence Jacobs, director of the Center for the Study of Politics and Governance at the Hubert H. Humphrey School at the University of Minnesota, said the Republicans’ struggles were not surprising given the difficulties of healthcare reform and the party’s resistance to taxes and government spending.
“We’ve generally seen Republicans steer away from health reform if it involves raising taxes,” he said. “Republicans are allergic to the coverage issue because it requires them at some point to have revenue either for tax credits or spending.”
That resistance has been apparent in the GOP effort to reform Obamacare, where the party’s small-government ideals have sometimes clashed with the task of protecting government benefits for the poor.
For example, its plan ends a key money source by repealing a 0.9% tax imposed under Obamacare on those earning more than $200,000 a year.
And rather than focus solely on fixing Obamacare’s problems, the House plan also seeks to achieve a long-standing Republican goal: capping expenses for the entire Medicaid program, far beyond those covered under Obamacare.
Jacobs noted that even Democrats, with all their experience and commitment, rarely succeeded in advancing sweeping legislation.
“Passing national health reform is one of the hardest things to do in America,” Jacobs said. “There is a reason liberals and progressives failed for over half a century.”
As the House plan appeared on life support, Republican leaders, backed by the White House, fanned out Tuesday with a full-throated defense ahead of a planned House vote next week.
Price and Vice President Mike Pence met behind closed doors with Senate Republicans at their weekly lunch, joined by the chairmen of the House committees who drafted the GOP bill. House Speaker Paul D. Ryan (R-Wis.) spoke by phone later in the day with President Trump.
Leaders balked at a report from the nonpartisan Congressional Budget Office that 24 million more Americans would be left uninsured under the GOP plan — wiping out the health coverage gains under the Affordable Care Act, also known as Obamacare.
Republicans contend that their plan would ultimately lower costs and give Americans more choices, and they complained that deductibles were so high under Obamacare policies that it put access to healthcare out of reach.
“Democrats were concerned about coverage. They’re patting themselves on the back for giving you coverage, but you still couldn’t afford to go to the doctor,” Mick Mulvaney, the administration’s Office of Management and Budget director, said on CNN. “That’s what we are trying to fix.”
The CBO report, however, predicted that while insurance premiums would eventually come down, deductibles under the GOP plan would be higher for many consumers.
Even as some moderate Republicans bolted after the CBO report, pressure mounted from conservative lawmakers and outside groups for a complete repeal of the Affordable Care Act. They want to reduce coverage requirements and more quickly end Obamacare’s expansion of Medicaid for low-income Americans in some states.
“We’re making real good progress with the White House and leadership, and I’m optimistic we’ll see some good results in less than a week,” said Rep. Mark Meadows (R-N.C.), the chairman of the conservative House Freedom Caucus, which is set for a meeting at the White House this week.
Republicans weren’t always at odds with a government role in expanding the nation’s healthcare system. Some voted for President Lyndon B. Johnson’s push to create the Medicare program for seniors.
President Nixon once considered an even more expansive healthcare system, and President George W. Bush launched a new entitlement, the Medicare prescription drug Part D program, which continues today.
But President Reagan famously campaigned against Medicare, deriding it as socialism. And some conservative groups abandoned Bush over the new prescription drug benefit.
Sen. Bill Cassidy (R-La.), a physician who is a leader in his party on health policy, is working to amend the House bill to ensure that millions of Americans — particularly older, low-income adults — don’t lose coverage.
He rejected the premise that Republicans are not as versed in health policy as their Democratic colleagues and noted that not every lawmaker can be an expert on every issue.
“Republicans did Medicare Part D, which is pretty significant, and they certainly collaborated with CHIP,” he said, referring to the Children’s Health Insurance Program.
“My golly, if I’ve been living healthcare for 30 years I’d hope I’d know a little bit,” he added, referring to his work as a doctor. “Someone else knows far more about real estate.”
The challenge now for Republicans is trying to remain the party of small government while also becoming the party that preserves a healthcare entitlement program that a growing number of Americans say they want to keep.
lisa.mascaro@latimes.com
Twitter: @LisaMascaro
The party of small government tries to protect an entitlement program that most people want to keep.
By Lisa Mascaro
WASHINGTON — The House GOP effort to repeal and replace Obamacare appeared in deep trouble Tuesday, underscoring the limits of a party that has traditionally put a priority on cutting taxes and government spending over digging into the details of safeguarding Americans’ healthcare.
Many Republicans in Congress remain in outright revolt over the bill, warning it does not have enough votes to pass the House or Senate against stiff Democratic resistance.
A few moderate Republicans emerged from a Senate lunch Tuesday optimistic that House leaders would amend the legislation to meet their concerns. They want to preserve coverage for the millions of Americans who are projected to be left without insurance.
But conservatives were pulling the bill in the opposite direction, demanding deeper, faster cuts.
Meanwhile, GOP defections continued, including Florida Rep. Ileana Ros-Lehtinen, who said the current bill would be too detrimental to her elderly constituents.
“Is there anyone left in the country who actually likes it?” asked Senate Minority Leader Charles E. Schumer (D-N.Y.), reading the lists of doctors, hospital organizations and others who have registered opposition.
The tribulations now facing Republicans are not hard to understand: The party never set out to revamp the nation’s healthcare system. That was always a Democratic pursuit.
Republicans simply wanted to repeal Obamacare, which they saw as a costly government intrusion.
Only after they took the White House and it became apparent that millions of Americans would lose their health coverage under a straightforward repeal did Republicans begin to take seriously the “replace” part of their campaign promise.
But while Democrats have been churning out healthcare proposals since Franklin D. Roosevelt, Republicans have become increasingly fixed on the Reagan-era goal of reducing the size of government. Most Democrats see healthcare as a fundamental right or entitlement; few Republicans do.
That has left Republicans without a deep bench of healthcare policy experts in Congress, despite a cadre of doctors-turned-lawmakers.
One architect of the latest GOP effort is Tom Price, the former congressman and orthopedic surgeon who is now the Health and Human Services secretary. But to many, his experience in reforming government healthcare programs pales in comparison to the late Sen. Edward M. Kennedy, the liberal lion who for decades set strategy for Democratic reform efforts, including Obamacare.
Lawrence Jacobs, director of the Center for the Study of Politics and Governance at the Hubert H. Humphrey School at the University of Minnesota, said the Republicans’ struggles were not surprising given the difficulties of healthcare reform and the party’s resistance to taxes and government spending.
“We’ve generally seen Republicans steer away from health reform if it involves raising taxes,” he said. “Republicans are allergic to the coverage issue because it requires them at some point to have revenue either for tax credits or spending.”
That resistance has been apparent in the GOP effort to reform Obamacare, where the party’s small-government ideals have sometimes clashed with the task of protecting government benefits for the poor.
For example, its plan ends a key money source by repealing a 0.9% tax imposed under Obamacare on those earning more than $200,000 a year.
And rather than focus solely on fixing Obamacare’s problems, the House plan also seeks to achieve a long-standing Republican goal: capping expenses for the entire Medicaid program, far beyond those covered under Obamacare.
Jacobs noted that even Democrats, with all their experience and commitment, rarely succeeded in advancing sweeping legislation.
“Passing national health reform is one of the hardest things to do in America,” Jacobs said. “There is a reason liberals and progressives failed for over half a century.”
As the House plan appeared on life support, Republican leaders, backed by the White House, fanned out Tuesday with a full-throated defense ahead of a planned House vote next week.
Price and Vice President Mike Pence met behind closed doors with Senate Republicans at their weekly lunch, joined by the chairmen of the House committees who drafted the GOP bill. House Speaker Paul D. Ryan (R-Wis.) spoke by phone later in the day with President Trump.
Leaders balked at a report from the nonpartisan Congressional Budget Office that 24 million more Americans would be left uninsured under the GOP plan — wiping out the health coverage gains under the Affordable Care Act, also known as Obamacare.
Republicans contend that their plan would ultimately lower costs and give Americans more choices, and they complained that deductibles were so high under Obamacare policies that it put access to healthcare out of reach.
“Democrats were concerned about coverage. They’re patting themselves on the back for giving you coverage, but you still couldn’t afford to go to the doctor,” Mick Mulvaney, the administration’s Office of Management and Budget director, said on CNN. “That’s what we are trying to fix.”
The CBO report, however, predicted that while insurance premiums would eventually come down, deductibles under the GOP plan would be higher for many consumers.
Even as some moderate Republicans bolted after the CBO report, pressure mounted from conservative lawmakers and outside groups for a complete repeal of the Affordable Care Act. They want to reduce coverage requirements and more quickly end Obamacare’s expansion of Medicaid for low-income Americans in some states.
“We’re making real good progress with the White House and leadership, and I’m optimistic we’ll see some good results in less than a week,” said Rep. Mark Meadows (R-N.C.), the chairman of the conservative House Freedom Caucus, which is set for a meeting at the White House this week.
Republicans weren’t always at odds with a government role in expanding the nation’s healthcare system. Some voted for President Lyndon B. Johnson’s push to create the Medicare program for seniors.
President Nixon once considered an even more expansive healthcare system, and President George W. Bush launched a new entitlement, the Medicare prescription drug Part D program, which continues today.
But President Reagan famously campaigned against Medicare, deriding it as socialism. And some conservative groups abandoned Bush over the new prescription drug benefit.
Sen. Bill Cassidy (R-La.), a physician who is a leader in his party on health policy, is working to amend the House bill to ensure that millions of Americans — particularly older, low-income adults — don’t lose coverage.
He rejected the premise that Republicans are not as versed in health policy as their Democratic colleagues and noted that not every lawmaker can be an expert on every issue.
“Republicans did Medicare Part D, which is pretty significant, and they certainly collaborated with CHIP,” he said, referring to the Children’s Health Insurance Program.
“My golly, if I’ve been living healthcare for 30 years I’d hope I’d know a little bit,” he added, referring to his work as a doctor. “Someone else knows far more about real estate.”
The challenge now for Republicans is trying to remain the party of small government while also becoming the party that preserves a healthcare entitlement program that a growing number of Americans say they want to keep.
lisa.mascaro@latimes.com
Twitter: @LisaMascaro
Mar 15, 2017 13:19:16 #
Mar 15, 2017 13:20:29 #
The challenge now for Republicans is trying to remain the party of small government while also becoming the party that preserves a healthcare entitlement program that a growing number of Americans say they want to keep.
Mar 15, 2017 13:23:00 #
Not feeling good about GOP plan
A new poll finds that most Americans are skeptical about the Republican proposal to replace Obamacare.
By Noam N. Levey
WASHINGTON — Americans are deeply skeptical about the current House Republican plan to replace the Affordable Care Act, and few think it will bring down costs or expand coverage, a new nationwide survey finds.
In fact, nearly half the country thinks the GOP plan will increase the number of uninsured and raise prices for consumers who have to buy coverage on their own, according to the poll from the nonprofit Kaiser Family Foundation .
“What people really want out of their healthcare system is lower costs,” said Mollyann Brodie, who oversees polling for the foundation. “This is a warning sign that the public’s early impression of this is that it is more likely to raise costs.”
The poll, which follows release of the Republican legislation last week, may signal more challenges for the GOP, which is struggling to develop a replacement for the 2010 healthcare law, often called Obamacare.
This week, an independent analysis by the Congressional Budget Office estimated the GOP legislation would double the number of Americans without health coverage over the next decade, increasing the ranks of the uninsured by 24 million.
At the same time, the budget office calculated health insurance would become increasingly difficult for lower-income and older Americans to afford.
The CBO report has further complicated Republican efforts to quickly pass the House legislation and send a bill to President Trump, which GOP leaders had said they wanted to do by next month.
Over the next decade, the House Republican plan would roll back nearly $1 trillion in federal aid to states to provide health coverage to poor people through Medicaid.
The legislation would also loosen regulation of health insurers and restructure a system of insurance subsidies in the current law that help low- and moderate-income Americans who don’t get health benefits through an employer.
The House legislation has drawn strong criticism from major physician and hospital groups and leading organizations representing patients, who warn that it would undermine key protections, particularly for sick Americans.
Republican leaders argue their bill would strip away unnecessary mandates and regulations and make insurance more affordable to consumers.
“They’re going to be able to buy a coverage policy that they want for themselves and for their family,” Health and Human Services Secretary Tom Price told reporters outside the White House on Monday.
The new Kaiser poll suggests few Americans share such a rosy view.
Just 23% of those surveyed said they believed the House bill would “decrease costs for people who buy their own insurance.”
And though Republican respondents were most sanguine about the legislation, only 46% said they believed the House bill would reduce costs. By comparison, 47% said the bill would either raise costs or not change them.
Americans had a similarly dim view about what the Republican plan would mean for consumers’ deductibles, which are already a major barrier for many patients.
Forty-one percent of respondents said they believed the GOP legislation would lead to insurance plans with higher deductibles, compared with just 25% who said it would lead to lower deductibles.
GOP politicians have hammered the current law for making consumers buy health plans with what critics say are unaffordable deductibles. But the CBO analysis of the House plan predicts that deductibles will probably be even higher under the Republican bill.
One highly unpopular part of the GOP bill is a provision to cut federal Medicaid funding for Planned Parenthood, a longtime goal of conservative Republicans.
Three in four Americans believe that funding should continue, the Kaiser poll found. (Federal law currently bans federal funding for abortion services, but does reimburse Planned Parenthood for numerous other medical services, including providing family planning.)
Even a majority of Republican men — 55% — believe Planned Parenthood should continue to receive federal Medicaid payments, the survey shows.
Overall, the current healthcare law remains a deeply partisan issue, with a large majority of Republicans viewing it unfavorably and a large majority of Democrats viewing it favorably.
But overall support for the law remains at its highest level in years in the Kaiser survey, mirroring the findings of many polls since Republicans began their repeal push.
Forty-nine percent of Americans held a favorable view of the law in the latest poll, compared with 44% who have an unfavorable view.
The poll was conducted March 6-12 among a nationally representative random sample of 1,206 adults. The margin of sampling error is plus or minus 3 percentage points for the full sample.
noam.levey@latimes.com
A new poll finds that most Americans are skeptical about the Republican proposal to replace Obamacare.
By Noam N. Levey
WASHINGTON — Americans are deeply skeptical about the current House Republican plan to replace the Affordable Care Act, and few think it will bring down costs or expand coverage, a new nationwide survey finds.
In fact, nearly half the country thinks the GOP plan will increase the number of uninsured and raise prices for consumers who have to buy coverage on their own, according to the poll from the nonprofit Kaiser Family Foundation .
“What people really want out of their healthcare system is lower costs,” said Mollyann Brodie, who oversees polling for the foundation. “This is a warning sign that the public’s early impression of this is that it is more likely to raise costs.”
The poll, which follows release of the Republican legislation last week, may signal more challenges for the GOP, which is struggling to develop a replacement for the 2010 healthcare law, often called Obamacare.
This week, an independent analysis by the Congressional Budget Office estimated the GOP legislation would double the number of Americans without health coverage over the next decade, increasing the ranks of the uninsured by 24 million.
At the same time, the budget office calculated health insurance would become increasingly difficult for lower-income and older Americans to afford.
The CBO report has further complicated Republican efforts to quickly pass the House legislation and send a bill to President Trump, which GOP leaders had said they wanted to do by next month.
Over the next decade, the House Republican plan would roll back nearly $1 trillion in federal aid to states to provide health coverage to poor people through Medicaid.
The legislation would also loosen regulation of health insurers and restructure a system of insurance subsidies in the current law that help low- and moderate-income Americans who don’t get health benefits through an employer.
The House legislation has drawn strong criticism from major physician and hospital groups and leading organizations representing patients, who warn that it would undermine key protections, particularly for sick Americans.
Republican leaders argue their bill would strip away unnecessary mandates and regulations and make insurance more affordable to consumers.
“They’re going to be able to buy a coverage policy that they want for themselves and for their family,” Health and Human Services Secretary Tom Price told reporters outside the White House on Monday.
The new Kaiser poll suggests few Americans share such a rosy view.
Just 23% of those surveyed said they believed the House bill would “decrease costs for people who buy their own insurance.”
And though Republican respondents were most sanguine about the legislation, only 46% said they believed the House bill would reduce costs. By comparison, 47% said the bill would either raise costs or not change them.
Americans had a similarly dim view about what the Republican plan would mean for consumers’ deductibles, which are already a major barrier for many patients.
Forty-one percent of respondents said they believed the GOP legislation would lead to insurance plans with higher deductibles, compared with just 25% who said it would lead to lower deductibles.
GOP politicians have hammered the current law for making consumers buy health plans with what critics say are unaffordable deductibles. But the CBO analysis of the House plan predicts that deductibles will probably be even higher under the Republican bill.
One highly unpopular part of the GOP bill is a provision to cut federal Medicaid funding for Planned Parenthood, a longtime goal of conservative Republicans.
Three in four Americans believe that funding should continue, the Kaiser poll found. (Federal law currently bans federal funding for abortion services, but does reimburse Planned Parenthood for numerous other medical services, including providing family planning.)
Even a majority of Republican men — 55% — believe Planned Parenthood should continue to receive federal Medicaid payments, the survey shows.
Overall, the current healthcare law remains a deeply partisan issue, with a large majority of Republicans viewing it unfavorably and a large majority of Democrats viewing it favorably.
But overall support for the law remains at its highest level in years in the Kaiser survey, mirroring the findings of many polls since Republicans began their repeal push.
Forty-nine percent of Americans held a favorable view of the law in the latest poll, compared with 44% who have an unfavorable view.
The poll was conducted March 6-12 among a nationally representative random sample of 1,206 adults. The margin of sampling error is plus or minus 3 percentage points for the full sample.
noam.levey@latimes.com
Mar 15, 2017 13:24:49 #
All the ACA attacks apply to Trumpcare
By Neera Tanden
T he nonpartisan Congressional Budget Office on Monday released its analysis of the House GOP’s plan to repeal and replace the Affordable Care Act. The result is about as damning as it gets. According to the CBO, 24 million people will lose health insurance over the next decade under the Republican bill, including 14 million in the next year alone.
I served on President Obama’s healthcare reform team and worked on the Hill to get the legislation passed. It was apparent to me then that many of the Republicans’ criticisms of the ACA were wrong, and yet they now apply to the House GOP bill that Speaker Paul Ryan introduced last week.
Since the ACA was passed by the Senate in 2009, the GOP has been attacking it for delivering unaffordable healthcare. Costs were too high, they said. But according to analysis by my colleague Topher Spiro and other healthcare experts, the GOP bill would raise annual healthcare costs for the average enrollee by $1,542, and those costs would continue to increase each year. Older individuals would be hit even harder, with those between the ages of 55 and 64 paying $5,269 more per year on average.
Further analysis by the Los Angeles Times paints an especially dark picture for supporters of President Trump. Of the 70 counties that would suffer the biggest losses under the plan, 68 supported Trump. In fact, 14 of the 15 states most affected by this bill voted for Trump, with states such as North Carolina, Alaska, Oklahoma and Nebraska bearing the heaviest burden.
The GOP campaigned on high ACA costs but then created a bill that raises, not decreases, those costs for families. As millions of Trump supporters lose the healthcare coverage they need, wealthy Americans such as Trump can expect a windfall. People making more than $1 million a year would see their taxes cut by $144 billion over the next decade, and wealthy health insurance CEOs would see their incomes skyrocket .
Eight years ago, the GOP decried the creation of a partisan Democratic bill. But today, only Republicans support the Ryan plan. Doctors, nurses, hospitals and most insurers oppose this bill. No Democrats were even consulted on the legislation.
Eight years ago, Republicans accused Democrats of ramming through the ACA, even though we spent more than a year holding hundreds of meetings, roundtable discussions and public hearings with experts and stakeholders throughout the healthcare industry. Obama gave a nearly hourlong speech to Congress, laying out his vision and inviting further discussion from both sides of the aisle. Senate Democrats accepted more than 160 Republican amendments to the healthcare bill. And House Democrats held multiple public hearings before and after introducing their legislation in June 2009, allowing relevant committees time to discuss the bill and make amendments long before holding the final House vote four months later.
Now House Republicans want to bypass that crucial process in order to rush their bill through in the next week or so — no hearings with experts, no bipartisan summits, no testimony from the Health and Human Services secretary.
Trump and Republican leaders have tried to assure their anxious rank-and-file members that they will be able to move on to other issues if they simply deal with healthcare quickly. But as someone who was intimately involved in the crafting, passage and defense of the ACA, I know Republicans are fooling themselves.
For starters, Ryan is asking his members to vote for a bill that is not likely to get enough support to pass the Senate. And even if it does, repealing and replacing the ACA isn’t the end of the process — it’s the beginning of a long and ugly drama that will engulf their party for years to come.
As the infighting spills into public view, the media will feast on every twist and turn. Republicans will no longer be able to shift the blame. No Barack Obama in the White House, no lack of control in Congress.
And when disaster inevitably strikes and people start losing coverage, do congressional Republicans think Trump will defend them? Or will there be a 3 a.m. tweetstorm with their names on it?
As we approach the seventh anniversary of the ACA’s passage, the GOP’s replacement plan is shaping up to be a policy and political disaster. It breaks Trump’s promises to keep everyone covered and to not cut Medicaid; it pits House and Senate Republicans against each other; and it sends premiums up for voters in both parties, especially Trump’s supporters.
The comedian Michelle Wolf recently joked on Twitter , “In the time it took [Republicans] to come up with a replacement plan for Obamacare, [they] could have become a doctor.” It certainly would’ve been a better investment for them, their voters and the entire country.
Neera Tanden is the president and
CEO of the Center for American
Progress. She served as a healthcare policy advisor at the Department of Health and Human Services during the Obama administration.
By Neera Tanden
T he nonpartisan Congressional Budget Office on Monday released its analysis of the House GOP’s plan to repeal and replace the Affordable Care Act. The result is about as damning as it gets. According to the CBO, 24 million people will lose health insurance over the next decade under the Republican bill, including 14 million in the next year alone.
I served on President Obama’s healthcare reform team and worked on the Hill to get the legislation passed. It was apparent to me then that many of the Republicans’ criticisms of the ACA were wrong, and yet they now apply to the House GOP bill that Speaker Paul Ryan introduced last week.
Since the ACA was passed by the Senate in 2009, the GOP has been attacking it for delivering unaffordable healthcare. Costs were too high, they said. But according to analysis by my colleague Topher Spiro and other healthcare experts, the GOP bill would raise annual healthcare costs for the average enrollee by $1,542, and those costs would continue to increase each year. Older individuals would be hit even harder, with those between the ages of 55 and 64 paying $5,269 more per year on average.
Further analysis by the Los Angeles Times paints an especially dark picture for supporters of President Trump. Of the 70 counties that would suffer the biggest losses under the plan, 68 supported Trump. In fact, 14 of the 15 states most affected by this bill voted for Trump, with states such as North Carolina, Alaska, Oklahoma and Nebraska bearing the heaviest burden.
The GOP campaigned on high ACA costs but then created a bill that raises, not decreases, those costs for families. As millions of Trump supporters lose the healthcare coverage they need, wealthy Americans such as Trump can expect a windfall. People making more than $1 million a year would see their taxes cut by $144 billion over the next decade, and wealthy health insurance CEOs would see their incomes skyrocket .
Eight years ago, the GOP decried the creation of a partisan Democratic bill. But today, only Republicans support the Ryan plan. Doctors, nurses, hospitals and most insurers oppose this bill. No Democrats were even consulted on the legislation.
Eight years ago, Republicans accused Democrats of ramming through the ACA, even though we spent more than a year holding hundreds of meetings, roundtable discussions and public hearings with experts and stakeholders throughout the healthcare industry. Obama gave a nearly hourlong speech to Congress, laying out his vision and inviting further discussion from both sides of the aisle. Senate Democrats accepted more than 160 Republican amendments to the healthcare bill. And House Democrats held multiple public hearings before and after introducing their legislation in June 2009, allowing relevant committees time to discuss the bill and make amendments long before holding the final House vote four months later.
Now House Republicans want to bypass that crucial process in order to rush their bill through in the next week or so — no hearings with experts, no bipartisan summits, no testimony from the Health and Human Services secretary.
Trump and Republican leaders have tried to assure their anxious rank-and-file members that they will be able to move on to other issues if they simply deal with healthcare quickly. But as someone who was intimately involved in the crafting, passage and defense of the ACA, I know Republicans are fooling themselves.
For starters, Ryan is asking his members to vote for a bill that is not likely to get enough support to pass the Senate. And even if it does, repealing and replacing the ACA isn’t the end of the process — it’s the beginning of a long and ugly drama that will engulf their party for years to come.
As the infighting spills into public view, the media will feast on every twist and turn. Republicans will no longer be able to shift the blame. No Barack Obama in the White House, no lack of control in Congress.
And when disaster inevitably strikes and people start losing coverage, do congressional Republicans think Trump will defend them? Or will there be a 3 a.m. tweetstorm with their names on it?
As we approach the seventh anniversary of the ACA’s passage, the GOP’s replacement plan is shaping up to be a policy and political disaster. It breaks Trump’s promises to keep everyone covered and to not cut Medicaid; it pits House and Senate Republicans against each other; and it sends premiums up for voters in both parties, especially Trump’s supporters.
The comedian Michelle Wolf recently joked on Twitter , “In the time it took [Republicans] to come up with a replacement plan for Obamacare, [they] could have become a doctor.” It certainly would’ve been a better investment for them, their voters and the entire country.
Neera Tanden is the president and
CEO of the Center for American
Progress. She served as a healthcare policy advisor at the Department of Health and Human Services during the Obama administration.
Mar 15, 2017 13:26:15 #
The opioid epidemic is about to get worse
Trump promised repeatedly that he would expand addiction treatment, but his party is going in the opposite direction.
DOYLE McMANUS
A drug epidemic is ravaging the United States, and it’s getting worse, not better. More than 52,000 Americans died from drug overdoses in 2015, more than died from automobile accidents or firearms. That’s far more than died from overdoses in any year during the crack epidemic of the 1980s.
Most of those deaths were from opioids – prescription painkillers, heroin and fentanyl, a dangerous synthetic drug.
In Maryland, where I live, opioid deaths jumped 62% in the first three quarters of 2016; Gov. Larry Hogan, a moderate Republican, declared a state of emergency and asked the federal government for help.
But you wouldn’t know that from the American Health Care Act of 2017, the House Republican proposal to repeal Obamacare and replace it with a smaller, cheaper health insurance program.
Not only does the bill offer no solutions for the drug crisis; it would make the problem worse by making dramatic cuts in Medicaid, the healthcare program that covers low-income people.
Under Obamacare, Medicaid was enlarged to allow people with incomes up to about $16,400 (for a single person) to enroll – at least in the 31 states that agreed to the expansion.
The House bill would roll back that expansion, mainly by capping federal payments to state Medicaid programs. In total, it would cut Medicaid funding by an estimated 25%, or $880 billion over 10 years – the largest cost saving in the bill.
The bill also includes a provision allowing states to drop mental health and addition services from their Medicaid plans. (Obamacare required those services to be included.)
Health economists worry that once federal subsidies are capped, states may find themselves choosing whose Medicaid to fund: mothers and children, elderly nursing home residents, or drug users.
“They can continue to take on those responsibilities and pay for it out of their own budgets, or, if they are under pressure, they have to scale back,” said Richard G. Frank of Harvard Medical School. “Historically, states have been loath to cover substance abuse treatment.”
A Medicaid cut that large, Baltimore health commissioner Leana Wen told me, “could cost the lives of thousands of people. It’s medically irresponsible. And it’s fiscally irresponsible; it will create costs down the road.”
Already, Dr. Wen noted, only about 1 in 10 drug abusers get addiction treatment.
“That’s a statistic we would not find acceptable for any other disease,” she said. “We wouldn’t accept it if we were providing insulin to 1 in 10 diabetics, or making chemotherapy available to only 1 in 10 cancer patients.”
Wen works for a Democratic mayor in a Democratic city. But there are Republicans who agree – especially governors in the states that expanded Medicaid and now rely on the program for addiction treatment.
“Don’t kill Medicaid expansion,” Ohio Gov. John Kasich pleaded this week on NBC’s “Meet the Press.” His state had more opioid deaths than any other in 2015; an estimated 151,000 Ohioans are getting drug or mental health treatment under Medicaid.
“If you’re drug addicted, if you’re mentally ill, you have to consistently see the doctor. From what I see in this House bill, the resources are not there,” Kasich said. “It’s not that we love Obamacare. It means don’t throw the baby out with the bathwater.”
Sen. Rob Portman, an Ohio Republican, won reelection last year partly because of his dogged work to increase federal spending on the drug epidemic. Last week, Portman signed a letter demanding that states be given time for an orderly transition to a new system – at least until 2020, hopefully longer.
But House conservatives want to cut Medicaid funds even faster than the bill proposes.
It’s a classic conflict between Republican pragmatists and hard-liners – and the man in the middle is President Trump.
During the campaign, Trump criticized the Obama administration for failing to stop the drug epidemic, and promised that he would fix it. At a rally in New Hampshire, Trump promised “a plan to end the opioid epidemic,” and released a statement saying he would incentivize state and local governments to mandate drug treatment. And in his formal speech to Congress last month, Trump renewed the pledge. “We will expand treatment for those who have become so badly addicted,” he said, without offering any details.
But the House bill goes in the opposite direction; it would cut drug treatment, not expand it. Of all Trump’s promises, this might be the cruelest to break. Has he noticed?
doyle.mcmanus@latimes.com
Twitter: @DoyleMcManus
Trump promised repeatedly that he would expand addiction treatment, but his party is going in the opposite direction.
DOYLE McMANUS
A drug epidemic is ravaging the United States, and it’s getting worse, not better. More than 52,000 Americans died from drug overdoses in 2015, more than died from automobile accidents or firearms. That’s far more than died from overdoses in any year during the crack epidemic of the 1980s.
Most of those deaths were from opioids – prescription painkillers, heroin and fentanyl, a dangerous synthetic drug.
In Maryland, where I live, opioid deaths jumped 62% in the first three quarters of 2016; Gov. Larry Hogan, a moderate Republican, declared a state of emergency and asked the federal government for help.
But you wouldn’t know that from the American Health Care Act of 2017, the House Republican proposal to repeal Obamacare and replace it with a smaller, cheaper health insurance program.
Not only does the bill offer no solutions for the drug crisis; it would make the problem worse by making dramatic cuts in Medicaid, the healthcare program that covers low-income people.
Under Obamacare, Medicaid was enlarged to allow people with incomes up to about $16,400 (for a single person) to enroll – at least in the 31 states that agreed to the expansion.
The House bill would roll back that expansion, mainly by capping federal payments to state Medicaid programs. In total, it would cut Medicaid funding by an estimated 25%, or $880 billion over 10 years – the largest cost saving in the bill.
The bill also includes a provision allowing states to drop mental health and addition services from their Medicaid plans. (Obamacare required those services to be included.)
Health economists worry that once federal subsidies are capped, states may find themselves choosing whose Medicaid to fund: mothers and children, elderly nursing home residents, or drug users.
“They can continue to take on those responsibilities and pay for it out of their own budgets, or, if they are under pressure, they have to scale back,” said Richard G. Frank of Harvard Medical School. “Historically, states have been loath to cover substance abuse treatment.”
A Medicaid cut that large, Baltimore health commissioner Leana Wen told me, “could cost the lives of thousands of people. It’s medically irresponsible. And it’s fiscally irresponsible; it will create costs down the road.”
Already, Dr. Wen noted, only about 1 in 10 drug abusers get addiction treatment.
“That’s a statistic we would not find acceptable for any other disease,” she said. “We wouldn’t accept it if we were providing insulin to 1 in 10 diabetics, or making chemotherapy available to only 1 in 10 cancer patients.”
Wen works for a Democratic mayor in a Democratic city. But there are Republicans who agree – especially governors in the states that expanded Medicaid and now rely on the program for addiction treatment.
“Don’t kill Medicaid expansion,” Ohio Gov. John Kasich pleaded this week on NBC’s “Meet the Press.” His state had more opioid deaths than any other in 2015; an estimated 151,000 Ohioans are getting drug or mental health treatment under Medicaid.
“If you’re drug addicted, if you’re mentally ill, you have to consistently see the doctor. From what I see in this House bill, the resources are not there,” Kasich said. “It’s not that we love Obamacare. It means don’t throw the baby out with the bathwater.”
Sen. Rob Portman, an Ohio Republican, won reelection last year partly because of his dogged work to increase federal spending on the drug epidemic. Last week, Portman signed a letter demanding that states be given time for an orderly transition to a new system – at least until 2020, hopefully longer.
But House conservatives want to cut Medicaid funds even faster than the bill proposes.
It’s a classic conflict between Republican pragmatists and hard-liners – and the man in the middle is President Trump.
During the campaign, Trump criticized the Obama administration for failing to stop the drug epidemic, and promised that he would fix it. At a rally in New Hampshire, Trump promised “a plan to end the opioid epidemic,” and released a statement saying he would incentivize state and local governments to mandate drug treatment. And in his formal speech to Congress last month, Trump renewed the pledge. “We will expand treatment for those who have become so badly addicted,” he said, without offering any details.
But the House bill goes in the opposite direction; it would cut drug treatment, not expand it. Of all Trump’s promises, this might be the cruelest to break. Has he noticed?
doyle.mcmanus@latimes.com
Twitter: @DoyleMcManus
Mar 15, 2017 13:28:26 #
Defiant even in the eye of a Twitterstorm
STEVE LOPEZ
Has it been two months already?
Time flies when you’re on the road to becoming great again.
President Trump’s repeated promise of cheaper and better healthcare for everyone isn’t looking so hot at the moment for 24 million people or so. Investigations into votes by 5 million immigrants in this country illegally, and the phone-tapping of candidate Trump by President Obama, seem to be stalled. My mail is more racist and vulgar than ever, and the country remains split in two, with fear on one side and loathing on the other.
And we have at least three years and 10 months of greatness still to come. That means we’re likely to have thousands more broadsides from Torrance’s Tweeting Ted — Democratic Rep. Ted Lieu — who has been trying his best to outpace the Tweeter of the Free World on social media.
I’m not surprised by Lieu’s resistance. In January, after attending the Trump inauguration, I roamed the halls of Congress and talked to Southern California Reps. Tony Cardenas, Adam Schiff and Lieu, all of whom said being in the minority party didn’t mean they had to wear muzzles for four years. All three have been outspoken critics in the early going.
On that visit, I noticed that Lieu had taped a sign to his door.
“Alternative Fact Free Zone.”
It was a reference to the administration’s extraterrestrial claim that attendance at Trump’s inauguration was vastly larger than reported by the lying media.
Since then, Lieu has called Trump guru and alt-media mogul Steve Bannon “Dr. Evil.” He has demanded that U.S. Atty. Gen. Jeff Sessions resign for false statements made during his confirmation hearing. He co-introduced a measure that could force a House vote on demanding documents related to Sessions and Trump campaign contacts with Russian officials.
And when the new chief of environmental protection said carbon dioxide is not a primary contributor to global warming, Lieu couldn’t help himself.
“Scott Pruitt is Making America Unscientific Again,” he tweeted.
In short, the second-term congressman from Torrance — a colonel in the U.S. Air Force Reserves and a former military prosecutor — has been like a puppy with a chew toy.
“It is NOT okay that @realDonaldTrump routinely lies and lives in a universe of #alternativefacts,” he tweeted Feb. 8.
On Feb. 21, he tapped out another scolding:
“Lyin’ @realDonaldTrump has made 132 false or misleading claims as @POTUS.”
@tedlieu often tweets in the style and language of Trump, with capital letters, exclamation points and parentheses.
“More evidence #Trumpcare is a disaster,” said one Lieu tweet. “American Medical Association calls it critically flawed. Sad (or sick) bill!”
Trump was missing in action after the release of the GOP health reform plan, which hits many of his core supporters over the head with a mallet, judging by the analysis of the Congressional Budget Office. Just a couple of weeks ago Trump was popping off about how the bill was going to be “fantastic.” He also said, after beating up on Obamacare for months, “Nobody knew healthcare could be so complicated.”
I thought he wrote “The Art of the Deal” and knew how to make things happen. What next? Is Trump going to discover car manufacturing has been automated, coal is yesterday’s power source and the math is tricky on tax cuts for everyone along with massive increases in military spending?
Obamacare wasn’t perfect, Lieu said, and it could have used some tweaks. But he called the GOP proposal a calamity that would slash Medicaid and threaten Medicare, among other problems.
The AARP said the bill would hike costs “for those who can least afford them, eroding seniors’ ability to live independently, and giving tax breaks to big drug companies and health insurance companies.”
My tweet to Trump was, “Will new health care plan offer coverage for having your foot removed from your mouth?”
Lieu was more direct:
“Dear lyin’ @realDonaldTrump: The disaster known as #TrumpCare cuts both #Medicare and #medicaid. Did you read the bill?”
Lieu’s social media commentary took a dark turn this week in response to comments about American culture and identity by Iowa Rep. Steve King, a Trump cheerleader who sounds a lot like Steve Bannon. We need a more homogeneous U.S., said King, who praised a Dutch politician who has spoken out against Muslim immigration to Europe.
“Dear @steveKingIA: You know what makes America great?” Lieu tweeted. “You get to make obscene comments and I get to call you a stark, raving racist.”
Lieu’s family moved to the U.S. from Taiwan when he was 3. His parents worked at flea markets before starting their own gift store, and Lieu went to Stanford and earned degrees in political science and computer science before getting his law degree at Georgetown University.
He took particular umbrage at King’s contention on CNN Monday that immigration poses a threat because “you cannot rebuild your civilization with somebody else’s babies. You’ve got to keep your birth rate up, and that you need to teach your children your values.”
On Twitter, Lieu posted a photo of his two smiling boys, 13 and 11, along with another note to King.
“Dear Representative Steve King: These are my two babies.”
Trump’s spokesman said Tuesday the president does not share King’s views. Lieu told me he feels an obligation to speak out against King, Bannon, Trump or anyone else who trades in divisiveness or dishonesty.
“I will not cede public discourse to anyone,” he said.
I asked if he thought California could be punished by Trump or Congress for bold, blue resistance by him and other Californians.
Lieu said no, because when it comes to federal funding formulas, there’s not a great deal of discretion. But for him, that’s beside the point, anyway.
“Michelle Obama had that beautiful line, ‘When they go low, we go high,’ ” Lieu said. “I thought about it a lot. But I also thought, ‘We lost the election.’ My view now is that when they go low, we fight back.”
steve.lopez@latimes.com
Twitter: @LATstevelopez
STEVE LOPEZ
Has it been two months already?
Time flies when you’re on the road to becoming great again.
President Trump’s repeated promise of cheaper and better healthcare for everyone isn’t looking so hot at the moment for 24 million people or so. Investigations into votes by 5 million immigrants in this country illegally, and the phone-tapping of candidate Trump by President Obama, seem to be stalled. My mail is more racist and vulgar than ever, and the country remains split in two, with fear on one side and loathing on the other.
And we have at least three years and 10 months of greatness still to come. That means we’re likely to have thousands more broadsides from Torrance’s Tweeting Ted — Democratic Rep. Ted Lieu — who has been trying his best to outpace the Tweeter of the Free World on social media.
I’m not surprised by Lieu’s resistance. In January, after attending the Trump inauguration, I roamed the halls of Congress and talked to Southern California Reps. Tony Cardenas, Adam Schiff and Lieu, all of whom said being in the minority party didn’t mean they had to wear muzzles for four years. All three have been outspoken critics in the early going.
On that visit, I noticed that Lieu had taped a sign to his door.
“Alternative Fact Free Zone.”
It was a reference to the administration’s extraterrestrial claim that attendance at Trump’s inauguration was vastly larger than reported by the lying media.
Since then, Lieu has called Trump guru and alt-media mogul Steve Bannon “Dr. Evil.” He has demanded that U.S. Atty. Gen. Jeff Sessions resign for false statements made during his confirmation hearing. He co-introduced a measure that could force a House vote on demanding documents related to Sessions and Trump campaign contacts with Russian officials.
And when the new chief of environmental protection said carbon dioxide is not a primary contributor to global warming, Lieu couldn’t help himself.
“Scott Pruitt is Making America Unscientific Again,” he tweeted.
In short, the second-term congressman from Torrance — a colonel in the U.S. Air Force Reserves and a former military prosecutor — has been like a puppy with a chew toy.
“It is NOT okay that @realDonaldTrump routinely lies and lives in a universe of #alternativefacts,” he tweeted Feb. 8.
On Feb. 21, he tapped out another scolding:
“Lyin’ @realDonaldTrump has made 132 false or misleading claims as @POTUS.”
@tedlieu often tweets in the style and language of Trump, with capital letters, exclamation points and parentheses.
“More evidence #Trumpcare is a disaster,” said one Lieu tweet. “American Medical Association calls it critically flawed. Sad (or sick) bill!”
Trump was missing in action after the release of the GOP health reform plan, which hits many of his core supporters over the head with a mallet, judging by the analysis of the Congressional Budget Office. Just a couple of weeks ago Trump was popping off about how the bill was going to be “fantastic.” He also said, after beating up on Obamacare for months, “Nobody knew healthcare could be so complicated.”
I thought he wrote “The Art of the Deal” and knew how to make things happen. What next? Is Trump going to discover car manufacturing has been automated, coal is yesterday’s power source and the math is tricky on tax cuts for everyone along with massive increases in military spending?
Obamacare wasn’t perfect, Lieu said, and it could have used some tweaks. But he called the GOP proposal a calamity that would slash Medicaid and threaten Medicare, among other problems.
The AARP said the bill would hike costs “for those who can least afford them, eroding seniors’ ability to live independently, and giving tax breaks to big drug companies and health insurance companies.”
My tweet to Trump was, “Will new health care plan offer coverage for having your foot removed from your mouth?”
Lieu was more direct:
“Dear lyin’ @realDonaldTrump: The disaster known as #TrumpCare cuts both #Medicare and #medicaid. Did you read the bill?”
Lieu’s social media commentary took a dark turn this week in response to comments about American culture and identity by Iowa Rep. Steve King, a Trump cheerleader who sounds a lot like Steve Bannon. We need a more homogeneous U.S., said King, who praised a Dutch politician who has spoken out against Muslim immigration to Europe.
“Dear @steveKingIA: You know what makes America great?” Lieu tweeted. “You get to make obscene comments and I get to call you a stark, raving racist.”
Lieu’s family moved to the U.S. from Taiwan when he was 3. His parents worked at flea markets before starting their own gift store, and Lieu went to Stanford and earned degrees in political science and computer science before getting his law degree at Georgetown University.
He took particular umbrage at King’s contention on CNN Monday that immigration poses a threat because “you cannot rebuild your civilization with somebody else’s babies. You’ve got to keep your birth rate up, and that you need to teach your children your values.”
On Twitter, Lieu posted a photo of his two smiling boys, 13 and 11, along with another note to King.
“Dear Representative Steve King: These are my two babies.”
Trump’s spokesman said Tuesday the president does not share King’s views. Lieu told me he feels an obligation to speak out against King, Bannon, Trump or anyone else who trades in divisiveness or dishonesty.
“I will not cede public discourse to anyone,” he said.
I asked if he thought California could be punished by Trump or Congress for bold, blue resistance by him and other Californians.
Lieu said no, because when it comes to federal funding formulas, there’s not a great deal of discretion. But for him, that’s beside the point, anyway.
“Michelle Obama had that beautiful line, ‘When they go low, we go high,’ ” Lieu said. “I thought about it a lot. But I also thought, ‘We lost the election.’ My view now is that when they go low, we fight back.”
steve.lopez@latimes.com
Twitter: @LATstevelopez
Mar 15, 2017 13:32:14 #
7 more ways the GOP is offering a bad Rx
MICHAEL HILTZIK
The headline findings in the Congressional Budget Office’s analysis of the Obamacare repeal bill produced by House Republicans are brutal enough: 24 million Americans losing their health coverage, healthcare costs soaring for many millions more, and the evisceration of Medicaid, all while handing the richest Americans a handsome tax cut.
But in its fine print, the CBO report identified at least seven other ways the GOP proposal would damage the U.S. healthcare system. Some would have effects reaching far beyond the middle- and low-income buyers of insurance on the individual market who are the Affordable Care Act’s chief beneficiaries.
1. Shopping for health insurance will become tremendously more complicated. The Affordable Care Act standardized individual policies into four tiers based on “actuarial value” — the percentage of medical care costs covered by the insurer, ranging from bronze (60% actuarial value), silver (70%), gold (80%) and platinum (90%). This simplification allows buyers to compare plans on price alone, since within each tier every plan must offer roughly the same coverage. Insurers are required to offer at least one silver and one gold plan to participate in the individual marketplaces.
The rules didn’t entirely eliminate the complexity of shopping, since insurers can meet their actuarial value requirements by adjusting premiums or deductibles, or both. But they helped. The Republicans’ American Health Care Act repeals the actuarial value requirement. “Under the legislation, plans would be harder to compare, making shopping for a plan on the basis of price more difficult,” the CBO concluded.
2. Individual insurance plans will tend to offer skimpier benefits. By repealing the actuarial value rules, the GOP proposal removes the lower boundary of plan quality, at least to an extent.
Because the measure leaves in place the ACA’s mandate that all plans offer a roster of minimum essential benefits, including maternity, hospital coverage and mental health services, the CBO feels that insurers will be hard-pressed to offer plans with actuarial values below 60%. But it expects health plans to drift down toward the lowest possible value. Such plans would attract younger, healthier buyers because of their lower costs. But insurers would tend to avoid offering high actuarial value plans “out of a fear of attracting a greater proportion of less healthy enrollees.”
David Anderson of Duke believes that insurers could probably fashion plans with actuarial values as low as 55%; lower-value plans will effectively become the standard. “It will be very hard for people to buy a non-bronze plan because insurers won’t offer them except at exorbitant prices,” he writes. The bottom line: a drift toward lower-quality health insurance.
3. Out-of-pocket costs will be much higher. With low premiums becoming the key lure for buyers, insurers will tend to raise deductibles and co-pays. These consequently will “tend to be higher than those anticipated under current law” (that is, Obamacare), the CBO forecasts.
Another blow will be the GOP plan’s repeal of Obamacare’s cost-sharing subsidies, starting in 2020, which go to especially low-income households. About 57% of all buyers on the individual market receive those subsidies, so the repeal of this provision will hit about 5 million Americans hard.
4. Employer-sponsored insurance might start to disappear. The CBO projected that the passage of the ACA would trigger a decline in employer-sponsored insurance, which covers about half of all Americans . That didn’t happen to the extent the CBO expected, but it calculates now that the GOP proposal might do the job. That’s because the GOP bill repeals the penalties for individuals and companies above a certain size that don’t carry coverage.
The analysis projects that because of these reduced incentives, 2 million Americans would lose or drop out of employer-sponsored coverage by 2020, and 7 million by 2026. The CBO notes further that, since the GOP proposal provides premium subsidies to Americans with higher incomes than are eligible under Obamacare, some better-paid employees might forgo their employer plans and buy coverage on the individual market. Two countervailing factors exist, however: Although subsidies would be available to higher-income workers, on the whole they’d be skimpier than the ACA’s; and the quality of insurance outside the employer-based market might be lower than what’s available on the job.
5. A key program promoting public health will be axed. The GOP plan kills the Prevention and Public Health Fund as of 2019, saving $9 billion. The loss to public health will be incalculable.
The fund is a linchpin of the budget of the Centers for Disease Control and Prevention, accounting for 12% of the CDC’s spending . It pays for the CDC’s vaccine program, for instance.
“Losing this funding would cripple CDC’s ability to detect, prevent, and respond to vaccine-preventable respiratory and related infectious disease threats including pandemic influenza,” the agency says. Through the CDC, the fund also provides all 50 states with money to address public health crises; pays for childhood lead poisoning prevention programs nationwide; and helps health departments coast to coast to battle healthcare-related infections.
For some reason, Republicans have had the knives out for the Prevention and Public Health Fund for years. In 2010, a Senate Republican aide was quoted dismissing it as “a slush fund for jungle gyms.”
In fact, as health economist Harold Pollack observed at the time, the fund “serves critical, but often politically marginal constituencies.”
6. Patients of Planned Parenthood clinics would be cast adrift. The GOP proposal would cut all federal funding for Planned Parenthood for a year following its enactment, though it seems likely that the cutoff would be renewed year by year as long as the Republicans hold the House, Senate and White House.
The victims of this provision would be almost entirely low-income residents of areas already starved of clinics and doctors, especially rural areas. The CBO expects that about 15% of those residents would lose access to healthcare.
Since the services most affected would be those that “help women avert pregnancies,” the CBO paints this provision as the essence of cutting off one’s nose to spite one’s face. Births among the target population would rise by “several thousand.” That would increase costs for Medicaid, which pays for about 45% of all births. Moreover, some of the newborn children would themselves be eligible for Medicaid. The program would face $77 million in increased costs over 10 years, the CBO estimates. Since the GOP is also aiming to cut Medicaid funding, many of those mothers and children would lose access to healthcare entirely.
7. The continuous coverage rule would drive 2 million people out of the market and make the overall insurance pool sicker. One of the GOP plan’s most perverse provisions is the “continuous coverage” rule, which penalizes those who allow their insurance to lapse for more than 63 days during a year. They’re hit with a 30% surcharge for up to a year, once they do sign up.
The rule is ostensibly designed to encourage everyone to carry coverage, but would have the opposite effect, encouraging healthy Americans to put off buying insurance until they fall ill. The CBO estimates that 2 million fewer people would buy insurance each year; judging that the 30% penalty is manageable, they’d choose to roll the dice.
In sum, then, the GOP’s American Health Care Act would not only roll back all the gains in insurance coverage notched by the ACA over the last four years, but would make millions of Americans poorer and sicker. It’s not a return to the health insurance landscape that existed before the ACA’s enactment in 2010, but a voyage into an immeasurably more dismal, and unhealthier, world.
Follow @hiltzikm on Twitter, see facebook.com/hiltzik or email michael.hiltzik
@latimes.com.
MICHAEL HILTZIK
The headline findings in the Congressional Budget Office’s analysis of the Obamacare repeal bill produced by House Republicans are brutal enough: 24 million Americans losing their health coverage, healthcare costs soaring for many millions more, and the evisceration of Medicaid, all while handing the richest Americans a handsome tax cut.
But in its fine print, the CBO report identified at least seven other ways the GOP proposal would damage the U.S. healthcare system. Some would have effects reaching far beyond the middle- and low-income buyers of insurance on the individual market who are the Affordable Care Act’s chief beneficiaries.
1. Shopping for health insurance will become tremendously more complicated. The Affordable Care Act standardized individual policies into four tiers based on “actuarial value” — the percentage of medical care costs covered by the insurer, ranging from bronze (60% actuarial value), silver (70%), gold (80%) and platinum (90%). This simplification allows buyers to compare plans on price alone, since within each tier every plan must offer roughly the same coverage. Insurers are required to offer at least one silver and one gold plan to participate in the individual marketplaces.
The rules didn’t entirely eliminate the complexity of shopping, since insurers can meet their actuarial value requirements by adjusting premiums or deductibles, or both. But they helped. The Republicans’ American Health Care Act repeals the actuarial value requirement. “Under the legislation, plans would be harder to compare, making shopping for a plan on the basis of price more difficult,” the CBO concluded.
2. Individual insurance plans will tend to offer skimpier benefits. By repealing the actuarial value rules, the GOP proposal removes the lower boundary of plan quality, at least to an extent.
Because the measure leaves in place the ACA’s mandate that all plans offer a roster of minimum essential benefits, including maternity, hospital coverage and mental health services, the CBO feels that insurers will be hard-pressed to offer plans with actuarial values below 60%. But it expects health plans to drift down toward the lowest possible value. Such plans would attract younger, healthier buyers because of their lower costs. But insurers would tend to avoid offering high actuarial value plans “out of a fear of attracting a greater proportion of less healthy enrollees.”
David Anderson of Duke believes that insurers could probably fashion plans with actuarial values as low as 55%; lower-value plans will effectively become the standard. “It will be very hard for people to buy a non-bronze plan because insurers won’t offer them except at exorbitant prices,” he writes. The bottom line: a drift toward lower-quality health insurance.
3. Out-of-pocket costs will be much higher. With low premiums becoming the key lure for buyers, insurers will tend to raise deductibles and co-pays. These consequently will “tend to be higher than those anticipated under current law” (that is, Obamacare), the CBO forecasts.
Another blow will be the GOP plan’s repeal of Obamacare’s cost-sharing subsidies, starting in 2020, which go to especially low-income households. About 57% of all buyers on the individual market receive those subsidies, so the repeal of this provision will hit about 5 million Americans hard.
4. Employer-sponsored insurance might start to disappear. The CBO projected that the passage of the ACA would trigger a decline in employer-sponsored insurance, which covers about half of all Americans . That didn’t happen to the extent the CBO expected, but it calculates now that the GOP proposal might do the job. That’s because the GOP bill repeals the penalties for individuals and companies above a certain size that don’t carry coverage.
The analysis projects that because of these reduced incentives, 2 million Americans would lose or drop out of employer-sponsored coverage by 2020, and 7 million by 2026. The CBO notes further that, since the GOP proposal provides premium subsidies to Americans with higher incomes than are eligible under Obamacare, some better-paid employees might forgo their employer plans and buy coverage on the individual market. Two countervailing factors exist, however: Although subsidies would be available to higher-income workers, on the whole they’d be skimpier than the ACA’s; and the quality of insurance outside the employer-based market might be lower than what’s available on the job.
5. A key program promoting public health will be axed. The GOP plan kills the Prevention and Public Health Fund as of 2019, saving $9 billion. The loss to public health will be incalculable.
The fund is a linchpin of the budget of the Centers for Disease Control and Prevention, accounting for 12% of the CDC’s spending . It pays for the CDC’s vaccine program, for instance.
“Losing this funding would cripple CDC’s ability to detect, prevent, and respond to vaccine-preventable respiratory and related infectious disease threats including pandemic influenza,” the agency says. Through the CDC, the fund also provides all 50 states with money to address public health crises; pays for childhood lead poisoning prevention programs nationwide; and helps health departments coast to coast to battle healthcare-related infections.
For some reason, Republicans have had the knives out for the Prevention and Public Health Fund for years. In 2010, a Senate Republican aide was quoted dismissing it as “a slush fund for jungle gyms.”
In fact, as health economist Harold Pollack observed at the time, the fund “serves critical, but often politically marginal constituencies.”
6. Patients of Planned Parenthood clinics would be cast adrift. The GOP proposal would cut all federal funding for Planned Parenthood for a year following its enactment, though it seems likely that the cutoff would be renewed year by year as long as the Republicans hold the House, Senate and White House.
The victims of this provision would be almost entirely low-income residents of areas already starved of clinics and doctors, especially rural areas. The CBO expects that about 15% of those residents would lose access to healthcare.
Since the services most affected would be those that “help women avert pregnancies,” the CBO paints this provision as the essence of cutting off one’s nose to spite one’s face. Births among the target population would rise by “several thousand.” That would increase costs for Medicaid, which pays for about 45% of all births. Moreover, some of the newborn children would themselves be eligible for Medicaid. The program would face $77 million in increased costs over 10 years, the CBO estimates. Since the GOP is also aiming to cut Medicaid funding, many of those mothers and children would lose access to healthcare entirely.
7. The continuous coverage rule would drive 2 million people out of the market and make the overall insurance pool sicker. One of the GOP plan’s most perverse provisions is the “continuous coverage” rule, which penalizes those who allow their insurance to lapse for more than 63 days during a year. They’re hit with a 30% surcharge for up to a year, once they do sign up.
The rule is ostensibly designed to encourage everyone to carry coverage, but would have the opposite effect, encouraging healthy Americans to put off buying insurance until they fall ill. The CBO estimates that 2 million fewer people would buy insurance each year; judging that the 30% penalty is manageable, they’d choose to roll the dice.
In sum, then, the GOP’s American Health Care Act would not only roll back all the gains in insurance coverage notched by the ACA over the last four years, but would make millions of Americans poorer and sicker. It’s not a return to the health insurance landscape that existed before the ACA’s enactment in 2010, but a voyage into an immeasurably more dismal, and unhealthier, world.
Follow @hiltzikm on Twitter, see facebook.com/hiltzik or email michael.hiltzik
@latimes.com.
Mar 15, 2017 13:34:06 #
Premium hikes seen in GOP plan
By Melody Petersen
Health insurance premiums would leap substantially for many Californians, especially lower-income people living in high-cost cities, under the House Republican plan to replace Obamacare, according to an analysis released Tuesday.
Californians purchasing insurance through the state’s Obamacare program known as Covered California received $4.2 billion in subsidies in 2016 to help them buy coverage.
By 2020, the average subsidy would be only 60% of what is provided under the current law if the Republican plan becomes law, according to a preliminary analysis by officials at the state insurance exchange.
The decline would especially hurt those living in San Francisco and other cities in Northern California, where healthcare is more expensive, according to the report.
For example, in Los Angeles, a 62-year-old earning $30,000 a year would see her net premium increase from $207 a month under the current law to $275 a month under the proposed law. If that person lived in San Francisco, however, the monthly premium would leap threefold, from $209 to $668.
Peter Lee, executive director of Covered California, said healthcare costs 30% to 40% more in Northern California compared with the southern half of the state, where there is more competition between doctors, hospitals and clinics.
The current law known as the Affordable Care Act helps people cover those more expensive premiums by giving them bigger subsidies. About 12% of families signing up for insurance on the state exchange now receive more than $10,000 in subsidies, the analysis found. That would change under the proposed law, which would provide subsidies based primarily on a person’s age.
melody.petersen@latimes.com
By Melody Petersen
Health insurance premiums would leap substantially for many Californians, especially lower-income people living in high-cost cities, under the House Republican plan to replace Obamacare, according to an analysis released Tuesday.
Californians purchasing insurance through the state’s Obamacare program known as Covered California received $4.2 billion in subsidies in 2016 to help them buy coverage.
By 2020, the average subsidy would be only 60% of what is provided under the current law if the Republican plan becomes law, according to a preliminary analysis by officials at the state insurance exchange.
The decline would especially hurt those living in San Francisco and other cities in Northern California, where healthcare is more expensive, according to the report.
For example, in Los Angeles, a 62-year-old earning $30,000 a year would see her net premium increase from $207 a month under the current law to $275 a month under the proposed law. If that person lived in San Francisco, however, the monthly premium would leap threefold, from $209 to $668.
Peter Lee, executive director of Covered California, said healthcare costs 30% to 40% more in Northern California compared with the southern half of the state, where there is more competition between doctors, hospitals and clinics.
The current law known as the Affordable Care Act helps people cover those more expensive premiums by giving them bigger subsidies. About 12% of families signing up for insurance on the state exchange now receive more than $10,000 in subsidies, the analysis found. That would change under the proposed law, which would provide subsidies based primarily on a person’s age.
melody.petersen@latimes.com
Mar 15, 2017 15:49:11 #
eagleye13 wrote:
so woodssprite;
This is your savior?
Why do you side with a Billionaire elitist like George "Giorgi" Soros?
10 Things You Didn't Know About "Giorgi" George Soros
https://youtu.be/tfBHYxEojZk
SOROS ROTHSCHILD RACE WAR PROPAGANDA EXPOSED
https://youtu.be/lhqqz3QFQKE
George Soros: Evil Puppet Master Exposed
https://youtu.be/1eRFTHD2CTg
This is your savior?
Why do you side with a Billionaire elitist like George "Giorgi" Soros?
10 Things You Didn't Know About "Giorgi" George Soros
https://youtu.be/tfBHYxEojZk
SOROS ROTHSCHILD RACE WAR PROPAGANDA EXPOSED
https://youtu.be/lhqqz3QFQKE
George Soros: Evil Puppet Master Exposed
https://youtu.be/1eRFTHD2CTg
I "side" with no one. Just refuse to bash someone I know so little about. The man has his good points. I'm not willing to condemn him without knowing more about the situation.
Mar 15, 2017 16:50:35 #
woodssprite 17 wrote:
I "side" with no one. Just refuse to bash someone I know so little about. The man has his good points. I'm not willing to condemn him without knowing more about the situation.
George Soros - The Zionist Puppet Master Who Considers Himself GOD EXPOSED
https://youtu.be/3VxwjOvtM0A
Everything George Soros Doesn't Want You To Know
https://youtu.be/JmMw9aMXmMY
Published on Nov 15, 2016
Soros formula to destroy America followed by Obama, Hillary, clergy, educators, congressman, judges, professors & on and on. Knowledge is power. Calling for the arrest of George Soros a treasonous terrorist for high crimes and misdemeanors. Please speak out with me and make our voices heard.
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