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Tag Archives: AHCA

Don’t count on Senators like Roy Blunt to do the right thing about healthcare

06 Saturday May 2017

Posted by willykay in Uncategorized

≈ 2 Comments

Tags

ACA, AHCA, Obamacare, Repeal and Replace, Roy Blunt, Trumpcare, U.S. Senate

Lots of progressive commentators are consoling themselves for last week’s congressional healthcare disaster by telling us that the Trumpcare abomination won’t fly in the Senate where GOP “moderate” senators will prevail. Or whatever. It is true that the GOP-majority Senate has, as an entity, turned up its collective nose when confronted with the stench of the House bill and has committed to producing its very own version of Trumpcare (a.k.a. Dump & Dupe). In order to keep the Dump & Dupe momentum going , House Speaker Mitch McConnell (R-Ky) sicced a working group on the topic right away.

But before we get too optimistic about the final Senate product, consider that Missouri Republican Senator Roy Blunt is part of the working group. This is the same Roy Blunt who was charged in 2009 to come up with the Republican alternative to Obamacare. Remember that plan? I bet you don’t. The four page document Blunt produced was that bad. As a Kansas City Star editorial pointed out, it was short on details and long on opinion-based talking points. Nor had Blunt bothered bothered to suss out the costs of his proposals and the number of uninsured Americans it would cover. It was a sort of abbreviated GOP la-la land fantasy.

Details aren’t important to folks like Blunt whose only language is right-wing power – let the real-world consequences be damned. And he’s what passes for a Republican moderate these days. He’s already signaled that he was fine with many of the provisions of the earlier, terrible iterations of Trumpcare, asserting that ““the nucleus of the plan is clearly there.” The only part of the earlier bills he objected to was the fact “it may not be a plan that gets a majority of votes and lets us move on.”

Nor is Roy Blunt a lone ranger in the Senate. Still feeling optimistic about the Senate’s take on Dump & Dupe?

When Blunt offered his four-page outline back in 2009, the House Speaker, Rep. John Boehner (R-OH), averred that “we have to be careful not to impede what works in the current system,” adding that “we take the current health care system and make it better for all Americans.” If it strikes you that this might be a good idea today – take what works in Obamacare – which is a lot – and make it better, perhaps you should phone old Roy and let him know that this is what you’d like to see come out of the Senate. Republicans can always save face by calling it Trumpcare.

Of course, that particular course of action would require that Blunt and his Senate GOP cronies actually cared about their constituents.

So maybe you should also let Senator Blunt know that you’ll remember whose fault it is if he helps  Freedom yodelers like Ann Wagner do our healthcare in. He won’t be up for election for several years, but it isn’t only elephants who don’t forget.

“Freedom” Ann Wagner Style

06 Saturday May 2017

Posted by willykay in Uncategorized

≈ 4 Comments

Tags

AHCA, Ann Wagner, missouri, Obamacaare, Trumpcare

Well, they did it. The Republican members of the U.S. House of Representatives put Obamacare on the butcher’s block and started blindly hacking. The bloody mess that they’re now serving up would deny healthcare to millions of Americans, but, hey, at least, Big Orange got his ego stoked with a big “win.”

One of the prime ego stokers was Rep. Ann Wagner (R-2) who celebrated – perhaps at Big Orange’s Rose Garden beer-bust victory lap? – by screaming the word “freedom,” which she identified as “the line of the day, out of Braveheart.” As you will note if you check out the video, Riverfront Times‘ s Paul Friswold aptly captured Wagner’s tone, declaring that “she preened and cooed,” and seemed “positively giddy with anticipation at ripping healthcare away from millions of American citizens.”

Tasteless, yes. But it also suggests that Wagner’s conception of freedom is very special. Enumerating some of the actual provisions of Trumpcare 3.0 (which I base on Paul Waldman’s thorough summary, quoting directly at times) gives us the following anatomy of Braveheart Annie’s idea of healthcare freedom:

  • Freedom from healthcare for everyday Americans:
    • Frees upwards of 24 million from their insurance coverage:
    • Frees states from the Medicaid expansion that covered a considerable portion of those 24 million Americans if their legislators are, like those in Missouri, inclined to say that only rich folks folks deserve healthcare.
    • Frees states from a big portion of their federal Medicaid funding by cutting $880 billion dollars from the program over 10 years.
    • Frees states to kick “otherwise eligible” people off Medicaid once federal funding becomes block-grants – which are likely to diminish over time.
    • Frees middle income people from the ACA subsidies, “replacing them with far more meager tax credits pegged not to people’s income but to their age. Poorer people would get less than they do now, while richer people would get more.”
  • Freedom for insurance companies to run wild:
    • Frees insurance companies from constraints that kept them from charging older people as much as five times more than they charge younger people for insurance.
    • Frees insurance companies to impose yearly and lifetime caps on what they will pay to cover illnesses – a provision that could also affect those who get their insurance through their employers.
    • Frees insurance companies – in states that seek waivers – from requirements that they offer plans that cover essential benefits guaranteed under Obamacare, things like “such as emergency services, hospitalization, mental health care, preventive care, maternity care, and substance abuse treatment.”
    • Frees insurance companies from having to give coverage to those with preexisting conditions and will allow them to charge them dramatically more if they do offer such coverage. It establishes expensive and inefficient “high-risk” pools for those with preexisting conditions while failing to offer adequate funding to cover the number of people who suffer from chronic illnesses.
    • Frees insurance companies to set higher deductibles for patients.
    • Frees insurance companies to reinstate medical underwriting so that when “you apply for insurance you’ll have to document every condition or ailment you’ve ever had,”  which in turn allows the insurers to identify your preexisting conditions and either deny coverage or charge you a fortune.
  • Freedom for rich people to sock it away:
    • Frees families making more that $250,000 a year from paying billions of dollars in taxes.

So much freedom. This version of Trumpcare isn’t too likely to survive the Senate. But we better never forget that Rep. Wagner tried to give us freedom Donald Trump style. Someone, somewhere (I can’t recall where) called her freedom scream her “let them eat cake moment.” Me, personally, I think of the Howard Dean scream – if her opponents don’t play this nasty little performance over and over again in TV ads next year, they’re fools.

Maybe Trumpcare might just help free Ann Wagner too. Free her from her current job, that is.

Rep. Vicky Hartzler (r): Who’s that yonder, dressed in black?

04 Thursday May 2017

Posted by Michael Bersin in social media

≈ 2 Comments

Tags

4th Congressional District, ACA, AHCA, missouri, social media, Trumpcare, Twitter, VickyHartzler

….Who’s that yonder, dressed in black? 
Must be the hypocrites a-turnin’ back

Oh won’t you sit down? 
Lord, I can’t sit down….

The right wingnut majority in the U.S. House of Representatives voted to gut health care for millions of Americans by implementing Trumpcare. Among them was Representative Vicky Hartzler (r).

Representative Vicky Hartzler (r) [2016 file photo].

From Representative Vicky Hartzler (r) this afternoon, via Twitter:

Rep. Vicky Hartzler‏ @RepHartzler
#AHCA is the first step towards building a fair system that empowers Americans, not the government, to make their own health care decisions.
[….]
1:24 PM – 4 May 2017

So very proud, isn’t she?

Some of the responses:

I called your office this morning. Your assistant asked what my concern was. I asked that you consider a “No” vote. She hung up on me.

How is that any way to treat your constituents. You know, the people you work for and are supposed to represent?

Taking away healthcare from 24 million Americans & putting the powerful interest groups in charge is nothing to celebrate. VOTE YOU OUT!

It’s official. You’re basically a murderer.

but House voted to be exempt from this? hypocrites.this is supposed to be good for American citizens but it isn’t good enough for Congress?!

Wow! After bragging that you pray for #MO4, you vote to remove healthcare for your constituents.
Very Christlike. #ACA

Liar…polish up that resume. When your base (boomers & seniors) see what you have done to their HC you are done.

No, it’s the first step toward the unnecessary harm to, and death of, millions of Americans. I hope you’re happy. #votethemout #Trumpcare

With respect, how exactly do you reconcile taking part in the National Day of Prayer with passing a bill that punishes the sick and poor?

And yet you are exempted? Why is that fair?

Ya right the rich keep getting richer

It’s the first step to tons of people losing insurance. Going to give money to your opponent right now.

Why wasn’t there 3 days of public debate on this bill? What are you hiding?

Very disappointed in you…but not surprised in the least. Can’t wait for 2018!!

I will remember your vote today. I will never support you running for any office. I will ask Camden Co voters to do the same.

It is a sad day for your constituents. The ones you are supposed to be representing not the DC establishment. 2018 cannot come soon enough.

Great job! Voted for a bill that is bad for your constituents and they don’t want. Guess you don’t want to keep your job.

Looking forward to doing everything I possibly can to ensure you don’t get reelected. Shame on you.

Why not wait until the CBO released its score first? Maybe those howls against ACA weren’t really about process after all.

Hypocrisy from right wingnut republicans? Say it ain’t so…

You’re disgusting. I guess you’re only pro-life when it comes to the unborn. Once they’re out in the world, you stop caring about them.

I have no words to express the depths of my anger and disgust with you. I can only hope the fools who voted for you will finally wake up.

Explain this to constituents in a town hall.

That ain’t gonna happen anytime soon.

You just threw my son to the wolves for having been born with congenital heart disease, in order to give the rich tax cuts. You disgust me.

what good is decision making when those of us with pre-existing conditions’ can’t afford any of the options?

“You are killing me”

A cursory glance at the preexisting conditions that are not covered under the AHCA suggests you might not understand the meaning of “fair.”

I plan to do everything I can to see her voted out of office and back to obscurity where she belongs.

You are a coward and a liar

You kno nothing about insurance. insurance companies make all decisions, they always have! You just gave them control over life & death.

I am 100% disgusted and ashamed that my representative would vote in favor of this horrendous bill. I AM AGAINST AHCA!

No it’s he 1st step towards millions losing healthcare and dying. If it’s so great why did Congress exempt themselves? #VickiHartless

How can you be so blind and deluded, @RepHartzler? This ridiculous move will crush Americans and lead to many deaths. But you don’t care.

thanks for taking away my healthcare. You are the best.

Uh, right wingnut republicans don’t get sarcasm.

This tweet proves how clueless you are.

How DARE you take away people’s health care & force huge premium increases?!?!? You aren’t listening to your constituents!

SHAME

2018 can’t come soon enough.

Congrats. I have depression and autism, two things that knock me off of getting coverage. Thank you for making me scared to get medical help

You sold your soul to the devil for greed. Your constituents wanted better care, not more expensive plans that cover less.

I don’t feel “empowered” as your constituent when you fail to address our concerns. I dare you to hold a town hall. I dare you. #NoAHCA

Please post when your next town hall is going to take place. Thank you.

Why can’t the people you represent have the same health care benefits of Congress? #youfail

@RepHartzler is super pro life! Unless you have a pre existing condition…or you’re poor…or you’re a refugee…

In fact, if you’re not a wealthy, white, christian could you just go ahead and die so Vicky doesn’t have to be bothered? Time=money, folks.

Hold a town hall, let’s see if you can look your constituents in the eye while you tell them their lives weren’t worth fighting for.

cool story, so when will you be holding a town hall? And where should I donate against you? Thanks

Your lies are unbecoming Miss Vickie. 24 million will lose what little they have and the republicans are celebrating ‘cuz they got rich!

When and where will you be having a town hall? I want to see you lie in person! Coward.

The reviews are in.

Predicting the future: After the Trumpcare 3.0 vote

03 Wednesday May 2017

Posted by willykay in Uncategorized

≈ Leave a comment

Tags

ACA, AHCA, Ann Wagner, Billy Long, Jason Smith, Obamacare, Roy Blunt, Sam Graves, Trumpcare, Vicky Hartzler

There are rumors that the 3rd iteration of the Obamcare repeal and replace bill, GOP Dump& Dupe, will be voted on this week – perhaps tonight, and – brace yourselves – this totally terrible, cruel bill might pass the House and be sent to the Senate. It’s likely that it won’t pass in the Senate, at least not in its current incoherent form, but, who knows? As Steven Benen observes, lots of us cheered when Big Orange got the GOP presidential nomination – no one thought such a clown could ever in a million years win the general election.

But console yourselves. There are some existential bedrocks you will always be able to count on:

After she votes for the revised bill – and she’s not currently counted among the holdouts – those of us who subscribe to Rep. Ann Wagner’s (R-2) email newsletter will get a gushing account of how she battled to save us from that bad, old Obamacare. And she won’t even ask for thanks – she just wants us to stop phoning her about the damn thing, please, and, for god sakes, quit asking her to come to an in-person town hall and actually listen to random concerns of the hoi polloi. Mama did what she had to do to save us from ourselves and no matter how many time we’ve asked her to leave Obamacare alone, she knows that we really don’t mean that at all. After all, St. Louisians stop her in the grocery all the time to tell her to keep on keeping on. At whatever she keeps on at. Working to help bankers, I think.

GOP Senator Roy Blunt will hem and haw in order to persuade us he isn’t as dumb as the rest of his party, but he won’t even require that push comes to shove to make him go along with GOP leadership when/if the bill comes to the Senate – when the inevitable fallout begins, though, he’ll remind you about the hemming and hawing.

Rep. Billy Long (R-7) will carry on about how he held out until he got a dinky little pittance as a down-payment for ineffective high risk pools (along with a in-person goosing from the Big Guy in the White House). He’ll try to persuade you (using standard talking points developed by somebody else ) that this particular thirty pieces of silver makes up for voting to take away protections from folks with preexisting conditions. Nobody but the terminally stupid will be fooled. Oh wait, those are the people who vote for Republicans like Billy Long.

And Vicky Hartzler (R-4) will let us know that Jesus told her to vote for Trumpcare 3.0. She’ll do it indirectly, as befits a congresswoman who has to pretend to serve the heathens too. She runs with Jesus after all and Obamacare was just full of provisions that were hurtful to the Christian Taliban members who worry that they’ll go to hell if they contribute to a common insurance pool that also funds contraception for those who don’t share their beliefs.

Sam Graves (R-6) and Jason Smith (R-8 ) will vote as expected. And if they say anything about it all, they’ll do it in the usual way which consists of whispering over in the corners with safely like-minded supporters. Nobody else actually knows who they are, so no big deal.

But It’s good to know that you can rely on Republicans to be Republicans. Isn’t it?

*Third sentence of 2nd paragraph edited slightly for clarity (5-3-1, 9:51 pm)

Billy Long wants to toss a dime to the dying

03 Wednesday May 2017

Posted by willykay in Uncategorized

≈ 1 Comment

Tags

ACA, AHCA, Billy Long, missouri, Obamacare, preexisting conditions

You may remember that a few days ago we were all sure that hell was finally freezing over. The event that occasioned this apocalyptic premonition was the fact that Rep. Billy Long (R-7) let us know that he wouldn’t support the latest iteration of the Republican Dump & Dupe Obamacare “repeal and replace” bill because it made no provision for those of us with preexisting conditions. This is the same high-living Billy Long who voted to cut SNAP food stamp benefits while claiming that folks in his district – where over 40,000 folks get food stamps – wanted more cuts. He’s not a really compassionate guy so the concern for those with preexisting conditions was a little unexpected.

I can only surmise that ol’ Billy has been hearing from plenty of riled-up constituents who will be hurt if Obamacare preexisting conditions provisions are eradicated. Without the protections written into Obamacare, the chronically ill can be denied health care insurance outright, or, when insurance companies are willing to write us a policy, they will be free to bankrupt us. The extremist Republican determination to return us to the pre-Obamacare status quo has rightly energized citizens who realize that Dump & Dupe will most likely mean we’ll be able to “choose” to die years earlier than we would have under Obamacare.

But never fear, like tigers, Republicans can’t really change their stripes. Billy thinks he has found a way to flim-flam those angry sick people who don’t want to die and still give his buddy, Donald Trump, the healthcare win he is demanding – regardless of the consequences for everyday Americans. An amendment that would allow states to do away with preexisting conditions protections will remain. But Congress will throw an extra $8 billion – over five years – into “high-risk pools” that, in theory, could be used to ameliorate the expense of the much higher premiums those of us with pre-existing conditions will have to cope with after the Obamacare repeal.

This is like throwing a dime at one of several men starving on the street and continuing on your merry way convinced that you have dealt with the problem of hunger in your community. As WaPos Paul Waldman notes, it “a laughably small amount of money compared with what would be required to insure this population” which consists of one out of every four non-elderly Americans; nor is it necessarily a continuing funding stream. According to Jean Hall, a physician and researcher at the University of Kansas Medical Center, underfunding is just one of the problems with the proposal to relegate patients with preexisting conditions to high-risk pools:

Recent proposals to replace ACA reforms with high-risk pools focus on using state-based programs, but historical experience with 35 state-based high-risk pools and more recent experience with the national Pre-Existing Condition Insurance Plan (PCIP) illustrate the problems with this approach. Even though state-based high-risk pools charged premiums of up to 250 percent of those charged to healthy beneficiaries in the individual insurance market, premium revenues paid just 53 percent, on average, of program costs. In addition to these high premiums, enrollees in state-based high-risk pools faced annual deductibles as high as $25,000 and annual coverage limits as low as $75,000.1 Past research indicated that high costs and limited benefits associated with high-risk pool coverage resulted in delayed or forgone care and adverse outcomes for enrollees. Many also accrued medical debt despite having insurance.2

For these reasons, use of high-risk pools in lieu of marketplace and Medicaid expansion coverage would result in greater state and federal costs, fewer people with preexisting conditions able to obtain coverage, and coverage that fails to meet the often greater needs of people with chronic conditions. Affording coverage would be particularly difficult for people with incomes below 400 percent of the federal poverty level, who accounted for 80 percent of the uninsured population with preexisting conditions prior to implementation of the AC

Even if Billy is able to placate his constituents in the short term, he’s not likely to get off scot-free. As Waldman observes, the fallout from Dupe & Dump will be severe:

The news media will be filled with horror stories of people who lost their coverage, and in some cases their lives, because of what Republicans did. If the bill passes, it will result in an outpouring of rage, particularly on the left but among all kinds of voters, that will vastly increase the chances of a Democratic wave in 2018 and even 2020.

Of course, there might be an upside. Come 2018, we may finally get rid of politicians like Billy Long.

*Edited slightly for accuracy (5/3/17, 3:58 pm)

This is what Democracy looks like – Harrisonville, Missouri – March 22, 2017

23 Thursday Mar 2017

Posted by Michael Bersin in Uncategorized

≈ 3 Comments

Tags

4th Congressional District, ACA, AHCA, Harrisonville, Indivisible KC, missouri, Obamacare, repeal, Vicky Hartzler

Wednesday at noon nine individuals, residents of the 4th Congressional District, came to Representative Vicky Hartzler’s Harrisonville, Missouri field office to express their concerns with the republican attempt to repeal the ACA (“Obamacare”) and “replace” it with Trumpcare. Adam Timmerman, a Field Representative for Representative Hartzler (r), opened up the office to hear their concerns. He listened intently, took notes, and, like all of the constituents in attendance, was unfailingly polite throughout the hour long exchange.

“Indivisible” – Harrisonville, Missouri – March 22, 2017.

“Trump care makes me sick” – Harrisonville, Missouri – March 22, 2017.

“Christian Warrior” – Harrisonville, Missouri – March 22, 2017.

Adam Timmerman, Field Representative for Representative Vicky Hartzler (r).

“…I would like my story to be heard, too. And there’s just so much uncertainty about this act, about how it’s going to affect people. Who’s going to lose insurance? And, and, all I ever hear is it will be their choice. But it’s not always a choice. It’s whether you choose to eat, you choose to pay rent, you choose to pay your mortgage, or you choose to have insurance. And I know many people disagree with me, but I agree that health care should be a right, it should be a right by our government…”

“…I think she [Representative Hartzler] is not listening to her people in her district. I think when we get on the phone, um, that is not a good test of the members of her district at all. Town meetings is a good test for that. You can’t get on the phone and take five different people to talk and get a feel of the thousands of people she represents. And she is our voice, she’s not big business or insurance’s voice. Or the party line voice. She is not. We should be able to connect with her and talk with her and give her our worries and concerns and on our issues in this district…”

One of the constituents was concerned with the “facts” presented by Representative Hartzler (r) on a recent district telephone conference call with constituents:

“…if she [Representative Hartzler] truly wants to serve her constituents I think she needs to gain access to these things [facts], which is about a fifteen minute Internet search, actually. I’d be happy to send her those links as well as articles from numerous medical journals that have come out in support of ACA. And then she would have the information she needs to vote, to make a knowledgeable vote, for those individuals that she serves…”

“…Missouri did not expand Medicaid. And, on top of that if Trumpcare does get passed almost an additional forty thousand people in her district alone will not have any health insurance. Now that comes back to when, you know, they wait ’til they’re deathly ill or really, really sick, they go to the emergency room. They can’t pay that bill. So, who does?…”

Eight of the nine individuals present supported continuation and improvement of the ACA (“Obamacare”) and opposed its repeal and the implementation of Trumpcare. With one individual, an apparent libertarian, it was difficult to tell what he thought.

Welcome to Missouri’s 4th Congressional District.

Successful Medicaid innovation in Missouri may die thanks to AHCA

20 Monday Mar 2017

Posted by willykay in Uncategorized

≈ 2 Comments

Tags

2703 Grant Program, ACA, AHCA, Community Health Homes, health care, Medicaid, Mental health care, missouri, Obamacare, SB28, Tom Price, Trumpcare

The Missouri Medicaid environment:

Missouri’s GOP legislature has been adamant that they will never take up the Obamacare offer to provide health care coverage for poor Missourians by expanding Medicaid coverage. In fact, they’re trying to jump the gun on Trumpcare’s not-so-stealthy attack on Medicaid with SB28, which  would request “a global waiver from HHS to transform the state’s Medicaid into a block grant program, which would be federally capped and adjusted for inflation, state gross domestic product, population growth and other factors.” This move would , according to health care advocacy groups, “cut necessary funding for healthcare services for Missouri’s most vulnerable citizens.”

The Good News

Given this anti-Medicaid predisposition in the state, it’s all the more surprising to learn that, thanks to Democratic former governor Jay Nixon, Missouri took aggressive advantage of the provision in the Affordable Care Act (ACA) (a.k.a. Obamacare), the 2703 grant program, that allocated funds so that 25 Missouri community medical centers could experiment with providing a wide range of coordinated – mental, physical, dental and counseling – services in a community “health home” environment. The results in Missouri have been wildly successful:

According to a review by the Missouri Department of Mental Health, the results of the 2703 grant program in that state have been impressive. The more than 23,000 Missourians who have received care under the health home initiative met or exceeded six of nine benchmark goals for disease management after the ACA-supported expansion. For patients with diabetes alone (America’s most costly disease, at approximately $332 billion a year), the number with controlled blood glucose levels rose from 18 percent to 61 percent. The percentage of patients with hypertension and cardiovascular disease who controlled their blood pressure went from 24 to 67 percent, and their good cholesterol levels soared from 21 to 56 percent. On the cost side, hospitalizations and emergency room visits for this group dropped 14 percent and 19 percent respectively. This saved the state $31 million just in the first year of the program, and the savings have continued, according to Natalie Fornelli, manager of integrated care at Missouri’s Division of Behavioral Health. In 2015, Missouri’s health home program won the American Psychiatric Association’s Gold Achievement Award for community health services. The program is now considered a national model.

The Bad News:

Under Trumpcare, the funding that supports these programs is likely to disappear:

At the national level, the fate of the 2703 program is also in doubt. It’s possible that, as Republican lawmakers in Washington and the Trump administration wrestle with the complexities of repealing and replacing Obamacare, they’ll conclude that failing to continue the 2703 grants will likely cost more in tax dollars than it saves, even as it would deprive hundreds of thousands of poor, mentally ill Americans the coordinated treatment that can save their lives. But, as Sidney Watson, a professor at the Saint Louis University School of Law and an expert on health care access for the poor, observes, Trump’s new Health and Human Services secretary, Tom Price, “has expressed a lot of skepticism about the Medicare and Medicaid demonstration centers.”

Tom Price? Skepticism? No kidding. They guy believes in freedom. Freedom to die, that is. As Politico notes, Price’s “vision for health reform hinges on eliminating much of the federal government’s role in favor of a free-market framework built on privatization, state flexibility and changes to the tax code.” He’s a member of the Association of American Physicians and Surgeons, a far right fringe medical group that declares Medicare “evil” and “immoral.” You can bet that they and their most prominent member, Tom Price, don’t think much of Medicaid either. The better a federal health program does, the more these fools believe it saps our moral fiber, inculcates dependency and undermines physician freedom – the  whole right wing drill, in other words..

Those of you who are calling your representatives and senators and begging them to save our health care, forget about the truly awful AHCA and maybe just fix Obamacare’s relatively minor problems, might also want to bring up the 2703 program and its proven success here in Missouri. Surely the Republicans can’t be so stupid that they’ll argue with success.  Or, on second thought, maybe they will.There is that whole Dump and Dupe AHCA effort. If that isn’t arguing with success – Obamacare increased the ranks of the insured by 20 million, after all – then I don’t know what is.

Trumpcare may prove there really is a sucker born every minute

13 Monday Mar 2017

Posted by willykay in Uncategorized

≈ Leave a comment

Tags

AHCA, American Health Care Act, Donald Trump, health care, health insurance, Trumpcare

I took the graphic below from Talking Points Memo where it is put forward with the following warning: “Please don’t share this image far and wide because then people would know all of President Trump’s broken promises about health insurance for millions of people.” I’m assuming that this is a tongue-in-cheek invitation to share the image far and wide, so I’m taking advantage of TPM’s work to make the point about how dim-witted our truth-challenged President thinks his supporters are. And, sadly, he may be right

What Trump promised:

Trumplies.jpg

What Trumpcare delivers:

  1. Current estimates are that 10-15 million people will lose healthcare if Trumpcare is passed in its present  form – which is why Republicans are trying to rush it through Congress before the Congressional Budget Office delivers the official score.*
  2. According to the Kaiser Foundation, Trumpcare would give those in the individual market on average $1,700 less help with premiums in 2020, compared to the ACA’s premium tax credits.
  3. The Center for Budget and Policy Priorities (CBPP) notes that this this projected loss would vary by state – from a high of over $10,000 in Alaska to about $49 in Indiana. In Missouri, tax credits would decrease assistance to consumers by $2,312 a year.
  4. Hardest hit would be older and lower-income consumers.
  5. Low-income consumers would also lose help with deductibles and other out-of-pocket costs.
  6. The CBPP also notes that because the tax credits that are proposed to take the place of Obamacare subsidies are so demonstrably insufficient, they would help destabilize the individual market and possibly destroy it completely – so no insurance for folks not insured by employers, Medicare and the scanty Medicaid that will remain after Trumpcare reins in the expansion.
  7. The consumers who will be hit the largest are by-and-large an important part of Trump’s die-hard supporters. Greg Sargent pulled the following statistics about where the Trumpcare impact would land hardest out of a chart published in the New York Times:
    • Those who stand to lose more than $7,500 in subsidies went for Trump by 58-39.
    • Those who stand to lose between $5,000 and $7,500 went for Trump by 60-35.
    • Those who stand to lose between $2,500 and $5,000 went for Trump by 49-45.
    • Those who stand to lose between $1,000 and $2,500 went for Trump by 46-46.
  8. By cutting the tax on those making more than $200,000, which was used to shore up Medicare, Trumpcare will deplete Medicare resources much sooner than would have otherwise been the case.

And this is only a partial catalogue of the potential problems with this dismally amateurish  effort at healthcare policy.

So what does Trump – the man who gave us the “bigly health insurance promises” enumerated above – have to say about this plan? He thinks it’s “wonderful.”

Holy Sweet Jesus! This man is our president. For the next four years. Unless he screws up with the corruption and foreign influence scandals to the point that even the GOP congress has to hit the impeachment button. And given how compliant they currently are, that would have to be a whole crap load of corruption.

UPDATE:  CBO scoring just released today. lt’s really bad. How bad? Here’s a summary of the numbers from  the Washington Post. GOPers reacting with dum-dum denial or slick misdirection – saying things like Trumpcare will increase “access” to healthcare. You can do you know what with “access” to health care coverage I can’t afford to purchase – I need to be covered so I can get “access” to medical care.

Trumpcare is bad but Trump hopes you won’t notice how bad it is if he talks about Obamacare instead

10 Friday Mar 2017

Posted by willykay in Uncategorized

≈ 2 Comments

Tags

ACA, AHCA, Donald Trump, healthcare, Obamacare, Trumpcare

I got the missive below in my email yesterday – Donald Trump’s first effort to come out swinging in favor of Paul Ryan’s Dump and Dupe Obamacare replacement. Notice that the staffers doing the President’s thinking White House’s healthcare PR outreach don’t have much to say about Trumpcare (a.k.a. Ryancare, the American Health Care Act or the AHCA) – which is understandable since the only parties that don’t hold Trumpcare in contempt are the bill’s two sponsors and Paul Ryan – and evidently Donald Trump who tweeted that it’s “wonderful” regardless of the fact that it violates every promise he made to his supporters about replacing Obamacare with something better.

So what do you do when you haven’t really got anything nice to say about the program you’re offering as a replacement for Obamacare? Why you keep on trashing Obamacare. You blast out emails like the one below – which I have presented below in sections annotated with italicized interpositions pointing out the more obvious lies and half-truths:

It’s been seven years since Obamacare was passed, and now, more than ever, we are seeing the harmful effects of this disastrous law.

Obamacare (ACA) insured 20 million previously uninsured people through Medicaid expansion and in the private individual health care market through the exchanges. It enacted a tax on those earning over $200,000/yr that shored up the Medicare system, extending its life by four years at this point – a gain that will be lost if the ACA is repealed in favor of the AHCA which eliminates that high-income tax. Some harmful effects!

Obamacare has led to higher costs and fewer health insurance options for millions of hard-working Americans. Independent analysis found 41 states faced higher average healthcare deductibles last year, with 17 states facing double-digit rate increases. Nearly one in five Americans have only one insurer offering Obamacare exchange plans.

In just the past year, Obamacare premiums have increased by 25 percent on the typical plan and coverage choices have dropped by 28 percent as insurers have left the market.

Obamacare did not negatively affect costs for those who receive insurance through their employers; in fact, it slowed the increasing price trajectory in the pre-Obamacare insurance industry. Premiums were rising by an average of 10% a year before Obamacare – and those who had serious illnesses could be charged considerably more – a practice that Obamacare ended. While premiums for those on the exchanges did increase considerably in 2017, the increase was offset by increased subsidies based on income – and consumers were able to use the exchanges to find competitive alternative insurers.

Things are only getting worse. This past year, nearly 20 million American citizens opted not to get healthcare insurance, with 6.5 million paying the penalty and millions more asking for a hardship exemption from the penalty.

Over 48 million people were uninsured before the major provisions of Obamacare took effect. Those with preexisting conditions can get affordable insurance and don’t face lifetime caps thanks to Obamacare. Seems like things have gotten better, not worse.

A higher penalty for refusing to buy insurance, along with more generous subsidies would have brought more younger, healthier people into the exchanges, which would, in turn, have incentivized more insurers to remain in the exchange. Republicans, however, refused to consider fixing these obvious problems. Congress could still decide to fix Obamacare instead of replacing it with the vastly inferior AHCA – a much worse system that will cost more and provide less – or nothing in many cases. But, given the GOP adherence to ideology over pragmatic policy, it’s not likely that a Republican-dominated congress would ever act to make the system better instead of worse

Americans were promised that Obamacare would bring down healthcare costs — that promise was broken. Americans were promised they could keep their healthcare plans under Obamacare – that promise was broken. Americans were promised that Obamacare would not raise taxes on the middle-class – that promise was broken.
The American people want change and President Donald J. Trump promised to repeal and replace this disaster. That is exactly what the President is working with Congress to achieve. Step up and support the repeal and replacement of Obamacare.

Obamacare did slow the growth of healthcare costs as we noted above. Its subsidies made insurance affordable for many in the individual market. Politifact rated the claim that Obamacare raised taxes on the middle class “mostly false,” noting that a few minor associated taxes, like those on tanning salons, might affect the middle class.

Obamacare had problems to be sure – but in most instances they could easily be fixed if Republican in congress were willing to work in good faith with Democrats to insure the program’s success.

So what about Trumpcare? Estimates are that it could leave more than 15,000 people who are currently insured under Obamacare without coverage, cause premiums to raise for even those in the employer-based market, and perhaps ultimately destroy the entire individual market. Pretty clear why the White House doesn’t want to talk about Trumpcare, but prefers to resort to the type of lies about Obamacare they’ve been peddling for the past seven years. Nancy LeTourneau best describes what we get in Trump’s surrender to the Republican ideology that he has ipso facto endorsed – despite his earlier promises to do the opposite:

This embrace of ideology over competence is exactly how we’ve arrived at a post-truth era. An abandonment of facts/data coupled with emotional appeals (often based on lies) have been the tools used to promote ideology. The Republican Party remains devoid of any principles based on the pragmatism of what works. It is possible that, in their zeal, they will be able to destroy Obamacare and maybe even pass their massive tax cuts for the most wealthy among us — all while ignoring the facts about what a disaster those policies will be.

*Formatting revised for readability, text with links to White House Web Page eliminated)  (3/11/2017; 11:31)

Roy Blunt will work to pass GOP Dump and Dupe healthcare plan

07 Tuesday Mar 2017

Posted by willykay in Uncategorized

≈ 1 Comment

Tags

ACA, ACA Replacement, AHCA, missouri, Obamacare, Roy Blunt

Yesterday Republicans finally released their plan to dump Obamacare while duping Americans about how badly it’s going to hurt. And how badly will it hurt? Paul Waldman offers a quick summary of the most salient parts of this mess – in short, it will cut benefits for older and poorer people, cost them more, undermine the insurance market, undo Medicaid expansion, cut Planned Parenthood funding and drain Medicare sooner – but, hey, it will also give a big tax cut to the wealthy so it’s all good right?

And then there’s the question of its cost relative to the number of people it will deprive of insurance. A question that we can’t answer because Paul Ryan is intent on getting it out of committee and up for a vote before the Congressoinal Budget Office (CBO) has a chance to score it. It’s that bad.

Paul Krugman explains just how bad the GOP Dump and Dupe plan really is:

For the GOP proposal basically accepts the logic of Obamacare. It retains insurer regulation to prevent exclusion of people with preexisting conditions. It imposes a penalty on those who don’t buy insurance while healthy. And it offers tax credits to help people buy insurance. Conservatives calling the plan Obamacare 2.0 definitely have a point.

But a better designation would be Obamacare 0.5, because it’s really about replacing relatively solid pillars with half-measures, severely and probably fatally weakening the whole structure.

First, the individual mandate – already too weak, so that too many healthy people opt out – is replaced by a penalty imposed if and only if the uninsured decide to enter the market later. This wouldn’t do much.

Second, the ACA subsidies, which are linked both to income and to the cost of insurance, are replaced by flat tax credits which would be worth much less to lower-income Americans, the very people most likely to need help buying insurance.

Taken together, these moves would almost surely lead to a death spiral. …

Nothing here that’s too surprising. The GOP boxed itself into a corner, braying continuously about the horror that was Obamacare – which, in fact, incorporated many ideas devised by conservative thinkers at the Heritage Institute Foundation. Obamacare pumped all the workable ideas out  of the conservative idea well. Which why the repeal part of replace and repeal hasn’t gotten much attention from Republicans apart from bland assurances that all will be well. Of course, now that they have to come up with something, they don’t want to be left with the mess repeal and replace will inevitably create, so they’re twisting and turning and hoping to placate their base with dump and dupe.

Lots of observers think that this particular iteration of dump and dupe will die in the Senate if it even makes it that far – the super rightwing House Freedom Caucus rather emphatically doesn’t buy into the replace/dupe part of the exercise – they want straight out repeal or nothing. That assessment has been cautiously echoed by Missouri’s always cautious Roy Blunt, a junior member of the Senate leadership group:

“Well, I haven’t had time to look at it in great depth yet, so we’ll see,” Blunt said of the plan on KMBZ local radio Tuesday. “What I don’t like is it may not be a plan that gets a majority votes and let’s us move on. Because, we can’t stay where we are with the plan we’ve got now.”

Blunt said any final plan would need to be negotiated.

“I think the nucleus of the plan is clearly there and the President says it’s negotiable and so do House members,” he said. “So, I’ll be interested to be a part of that negotiation as we work toward a majority in the House and Senate that puts a bill on the President’s desk.”

There are two things we can unpack from this statement that tells us a lot about Roy Blunt:

1. Blunt’s priority is, as usual, the political ramifications – he doesn’t really care too much about the bill itself. He just wants to get something done so that he and his fellow corporate shills can get back to doing their real work serving the interests of the folks who write the campaign checks. He knows, though, that Republicans need to check this rather tiresome box off – the GOP’ has demonized Obamacare and promised to repeal it for so long that they have to deliver something or eat some very public crow.

2. Blunt tells us that he believes that “the nucleus of the plan is clearly there” and we can’t stay “where we are with the plan we’ve got now.” But if Obamacare is really so bad, why preserve its structure, the nucleus, I presume, while making it less effective and hurting thousands of his constituents in the process? Could it be that he just doesn’t care what it does or doesn’t do for Missourians?

Roy wants to be part of the process, the “negotiation,” going forward. And that fact should scare us. We know who Blunt is in congress to serve. And it isn’t those folks who finally got insurance under Obamacare. If the new dump and dupe plan is bad, its next iterations will probably be even worse, and we’ll have Roy Blunt and his cronies to thank for it.

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