Tag Archives for ACA

Aging Groups: House GOP Tax Rewrite a Turkey

Published in the Woonsocket Call on November 19, 2017

Thanksgiving approaches the GOP-Controlled House has passed H.R. 1, “Tax Cuts and Jobs Act,” its tax reform legislation, on November 16, by a partisan vote of 227 to 206, with 13 Republicans siding with the Democrats. The House tax bill would dramatically reduce corporate and individual income taxes and would increase the deficit by $ 1.7 trillion over 10 years — — possibly offset by $ $338 billion saved by repealing the Affordable Care Act’s (ACA) individual mandate.

On Thursday, after four days of debate, members of the Senate Finance Committee voted 14 to 12 along party lines to approve their version of the tax package. Now the full Senate is expected to consider the bill after Thanksgiving hoping to quickly get it to President Donald Trump’s desk for his signature.

Medicare and ACA Takes a Hit

Matt Shepard, of the Center for Medicare Advocacy, warns that the GOP’s attempt to overhaul to nation’s tax code is an immediate threat to the Medicare program and healthcare coverage to millions of Americans covered by ACA.

According to Shepard, the nonpartisan Congressional Budget Office projects that the huge cost for the Republican tax plan would result in immediate, automatic and ongoing cuss to Medicare — $25 billion in 2018 alone.

After the GOP’s failed attempts to repeal the ACA, the Senate now uses a provision in its tax rewrite plan to finally repeal the ACA’s individual mandate to purchase insurance coverage in order to help pay for tax cuts, he says. If the GOP tax reform legislation becomes law, 13 million more people will be without health coverage and increasing premiums will disproportionately affect people age 50 who are not yet eligible for Medicare.

“These new dangers are on top of an already bad bill. Congress is engaged in a rushed effort to push through a massive tax cut for corporations and the wealthy, presenting a clear and present danger to health coverage, other vital programs, and families throughout the nation,” says Shepard.

“After adding $1.5 trillion to the federal debt, policymakers will use the higher debt – created by the tax cuts – to argue that deep cuts to Medicare, Medicaid, Social Security, and other bedrock programs are necessary,” predicts Shepard.

Responding to the House passage of its tax reform bill, just days ago, in a statement AARP Executive Vice President and Chief Advocacy & Engagement Officer Nancy LeaMond expressed disappointment in passage, warning that the legislation is harmful to millions of Americans age 65 and over.

Older Tax Payers Get Financial Hit with GOP Tax Code Fix

“AARP estimates H.R. 1 will raise taxes on 1.2 million seniors next year alone. Millions more older Americans will see tax increases in the future, or at best, no tax relief at all,” says LeaMond.

As Congress continues its debate to hammer out tax reform, LeaMond calls on lawmakers to retain the medical expense deduction at the 7.5% income threshold for older tax filers. “Nearly three-quarters of tax filers who claim the medical expense deduction are age 50 or older and live with a chronic health condition or illness. Seventy percent of filers who claim this deduction have income below $75,000.,” she says, urging that Congress also retain the standard deduction for older taxpayers, which helps reduce tax liability and can help seniors avoid a tax increase.

AARP also urges Congress to assist working family caregivers in a new tax code that creates a new, non-refundable tax credit to offset the often high out-of-pocket costs associated with caring for a loved one.

Finally, LeaMond calls on Congress to reject adding a provision in the tax bill that will lead to higher premium costs in the individual insurance market, as well as 13 million Americans losing their health coverage, including 2 million Americans who would lose employer-sponsored coverage.

In a statement, Max Richtman, President and CEO, National Committee to Preserve Social Security and Medicare, calls the House passed tax rewrite, “Robin Hood-in-Reverse tax legislation.” Now, the House Republicans have sent out a “crystal-clear message “that the elderly, disabled, poor, and working class are no longer part of the GOP’s vision for America,” he says.

Blooming Deficit Might Trigger Raid Social Security

“This craven giveaway to the wealthy and big corporations at the expense of everyone else flies in the face of public opinion, basic decency, and good old common sense, says Richtman, “By ballooning the deficit, Republicans have teed up a raid on Social Security, Medicare, and Medicaid to make up the difference,” he warns.

“The repeal of the medical expense deduction will punish seniors paying out of pocket for treatment of chronic and serious diseases – or long-term care., says Richtman.

With Senate Republicans gearing up their efforts to pass their version of the House’s “Tax Cuts and Jobs Act,” Richtman calls on Senators “to show courage and to do what House Republicans refused to [do]: stop the tax juggernaut before it does irreparable harm to our nation.”

If the GOP tax reform legislation is passed by Congress and signed into law by President Trump, we will quickly find out by Christmas if it a financial gift to America’s middle class or a lump of coal in their stockings. Aging groups already know this answer.

Senate Health Bill Vote Expected Next Week

Published in Woonsocket Call on June 25, 2017

The long-awaited Senate health bill text crafted by a group of 13 GOP senators (all male) appointed by Senate Majority Leader Mitch McConnell of Kentucky to replace and repeal President Obama’s Affordable Care Act of 2017 (ACA), popularly, called Obamacare, was unveiled days ago. Republican lawmakers have worked for over seven years to dismantle the Democratic president’s landmark health care law. Supporters say that ACA brought health care coverage to an estimated 20 million Americans, covered between marketplace, Medicaid expansion, young adults staying on their parent’s plan, and other coverage provisions. Critics charge that Obamacare imposed too many costs to business owners.

Minority Leader Chuck Schumer and Senate Democrats lashed out at GOP Senate leadership charging that the Senate health bill, titled “Better Care Reconciliation Act of 2017,” was written behind closed doors without a single committee hearing being held or draft bill text being circulated to the public. Some Republican senators also expressed frustration for not seeing the details of the GOP bill before its release on June 22, 2017.

Like Senate Democrats, Health and Human Secretary Tom Price was left in the dark, too. At a Senate hearing before the release of the Senate bill the Trump Administration’s top health official stated that he had not seen any legislative language.

Senate Health Bill “Meaner” than House Version

Despite President Trump’s campaign pledge not to touch popular entitlement programs, like Medicare and Medicaid, he strongly endorsed the House Republican passed health bill, the American Health Care Act of 2017 (AHCA). At the eleventh hour, Trump twisted the arms of reluctant GOOP House members to gain their support of the controversial health care bill. Celebrating the passage of AHCA at the White House Rose garden, the president told the attending Republican lawmakers and guests that the GOP health bill was a “great plan,” adding that it was “very, very, incredibly well-crafted.” It was reported weeks later, after a closed-door luncheon with 15 Republican Senators, Trump had called AHCA “mean” and urged the attending Senators make their legislative proposal “more generous.”

With the release of the Senate health bill, Senate Minority Leader Schumer called the bill “meaner” than the House passed version, stressing its negative impact was far worse than AHCA. Trump called the House health bill “mean.” Schumer views the Senate’s version “meaner.”

GOP Senate leadership is pressing for a floor vote before the upcoming July 4th Congressional recess. To meet this deadline, this vote must take place by the end of next week, either Thursday or Friday, after 20 hours of debate. Early next week the Congressional Budget Office will release its score, detailing cost and coverage impact, on the Senate health bill. Moderate Republican senators might just be influenced not to vote for the bill if reduces health coverage for millions of Americans.

It usually takes 60 votes to pass a bill in the Senate. But, GOP Senate leadership is using a technical parliamentary procedure, referred to as reconciliation, to allow the Senate health bill to pass with only 50 votes, including the Vice President as a tiebreaker.

At press time, there are four conservative senators (Rand Paul of Kentucky, Ted Cruz of Texas, Mike Lee of Utah and Ron Johnson of Wisconsin) and one moderate senator (Dean Heller of Nevada)., who have publicly expressed their opposition to the Senate health bill. With all Democratic and Independent senators in their caucus opposing passage of the bill, GOP Senate leadership can only afford the defection of two Republican senators if they want their bill to pass.

Meanwhile, a 100-year old organization, Planned Parenthood, is gearing up to fight a provision of the Senate health bill that would cut $555 million in funding. Two moderate GOP Senators, Susan Collins of Maine and Lisa Murkowski of Alaska, are on the fence voting for the bill if cuts are made to Planned Parenthood.

Aging Groups See Writing on Wall if Senate Passes Health Bill

The released 142-page GOP Senate health bill, written hastily behind closed doors, will overhaul the nation’s health care system, impacting on one-sixth of the nation’s economy. Dozens of aging, health care and medical groups, including AARP, National Committee to Preserve Social Security and Medicare (NCPSSM), the American Medical Association, and the American Hospital Association, are voicing their strong opposition to the GOP Senate’s health care fix.

And this list keeps growing as next week’s Senate vote approaches.

The Washington, DC-based AARP, representing a whopping 38 million members, vows to hold GOP Senators accountable for a bill that hurts older Americans. The nonprofit group charges that “the legislation imposes an “Age Tax” on older adults – increasing health care premiums and reducing tax credits [that made insurance more affordable under Obamacare], makes cuts to both Medicaid funding, and yet gives billions of dollars in take breaks to drug and insurance companies.”

“AARP is also deeply concerned that the Senate bill cuts Medicaid funding that would strip health coverage from millions of low-income and vulnerable Americans who depend on the coverage, including 17 million poor seniors and children and adults with disabilities. The proposed Medicaid cuts would leave millions, including our most vulnerable seniors, at risk of losing the care they need and erode seniors’ ability to live in their homes and communities,” says
AARP Executive Vice President Nancy LeaMond, in a statement.

“The Senate bill also cuts funding for Medicare which weakens the programs ability to pay benefits and leaves the door wide open to benefit cuts and Medicare vouchers. AARP has long opposed proposals that cut benefits or weaken Medicare, adds LeaMond.

LeaMond says, “As we did with all 435 Members of the House of Representatives, AARP will also hold all 100 Senators accountable for their votes on this harmful health care bill. Our members care deeply about their health care and have told us repeatedly that they want to know where their elected officials stand. We strongly urge the Senate to reject this bill.”

Another Washington-DC based organization, the National Committee to Preserve Social Security and Medicare, an advocacy group whose mission is to protect Social Security and Medicare, issued a stinging statement criticizing the Senate health bill.

“The Senate’s version of AHCA is an exercise in political expediency that does nothing to safeguard access to quality healthcare for older Americans. President Trump rightly called the House-passed bill ‘mean’ and lacking ‘heart.’ Unfortunately, the Senate bill is only marginally less mean in some ways, and even more heartless in others, says Max Richtman, President & CEO of the National Committee to Preserve Social Security and Medicare.

Adds, Richtman, “The Senate health bill is “a lose-lose for seniors and the American people. The biggest loss is that the AHCA ends the Medicaid program as we know it. Astoundingly, the Senate bill makes even deeper cuts to Medicaid than the House did. This is devastating news for today’s and tomorrow’s seniors suffering from Alzheimer’s, cancer, the after-effects of stroke and other serious conditions who depend on Medicaid to pay for long-term care. Millions will lose Medicaid coverage over the next ten years.”

“Despite some tweaks to premium subsidies, the Senate legislation will make healthcare unaffordable for many near seniors aged 50-64. The legislation allows insurers to charge older Americans five times as much as younger adults. Though the Senate bill nominally protects people with pre-existing conditions, the waiver of essential benefits means older patients with pre-existing conditions like diabetes, cancer, and heart disease will pay sky-high premiums [making these premiums unaffordable to most]. Finally, the bill weakens Medicare by reducing the solvency of the Part A Trust fund,” notes Richtman.

Looking at a Crystal Ball

Darrell M. West, vice president and director of Governance Studies at the Washington, D.C.-based the Brookings Institution, says that the Senate health bill does not fix the issues critics had with the House version. “It moves Medicaid from an entitlement to a discretionary program. It uses a longer phase-in period than the House, but imposes deeper cuts on the program. This is very problematic from the standpoint of poor and disabled people who need help,” says West.

According to West, Republican Senators from more moderate states already have said they will not support the current version. There also are conservative Senators who feel the bill does not go far enough in repealing Obamacare. If those positions hold up, it doesn’t look like the bill will pass.

West warns those who oppose the passage of the Senate health bill to not underestimate Senate Majority Leader Mitch McConnell. “He is willing to negotiate with individual Senators to get their votes so it is premature to call the bill dead. McConnell knows the Senate well and understands what compromises need to be made to get to 50 votes,” notes West.

If Senate Republicans pass their health care bill next week, I predict they might just find out that they have “awakened a sleeping giant,” the Democrats. When the dust settles after the 2018 mid-term elections we will find this out.

GOP Health Care Reform Moves to Senate

Published in Woonsocket Call on May 7, 2017

House Speaker Paul Ryan’s words are now coming back to haunt him and GOP leadership that rammed American Health Care Act (AHCA), without procedural safeguards, through the House chamber days ago. “I don’t think we should pass bills that we haven’t read that we don’t know what they cost,” said Ryan in a 2009 interview on MSNBC when Congress was debating President Obama’s 1990-page Affordable Care Act (ACA), or Obamacare.

Last month, the Trump Administration efforts to repeal and replace Obamacare, with the American Health Care Act (AHCA) went down in flames when so many GOP moderates and conservative House lawmakers opposed the bill that the leadership didn’t dare bring it up for a vote. Successful negotiations of the GOP factions crafted a new version that passed last Thursday by a razor-thin vote of 217-213, a slim margin of four votes. All 193 Democrats opposed passage, along with 20 Republican lawmakers. With House passage, the bill moves to the Senate for deliberation.

Before the House vote on the GOP health bill there were no legislative hearings held to debate its merits and its full text was posted on the Web less than 24 hours before the vote. Ryan did not even wait for the nonpartisan Congressional Budget Office (CBO) to provide an updated financial analysis of AHCA. The CBO’s analysis of the original bill, pulled moments before a scheduled vote on March 24, 2017, found that the GOP health care proposal estimated that if passed 24 million or more Americans could be uninsured by 2026.

Opposition Mounting to GOP Health Care Proposal

With the passage of AHCA, Democratic Policy and Communication Committee Co-Chair David N. Cicilline (D-RI) issued the following statement, saying “This is the cruelest and most immoral thing I’ve seen the Republican Party do to the American people. They just passed a bill that they know will result in the deaths of thousands of working people each year. I don’t know how they sleep at night.”

“All you need to know about this bill is that Republicans tried to exempt themselves from coverage [of the GOP health care proposal]] before they got caught. That’s because they know it’s a raw deal,” says Senator Sheldon Whitehouse. This legislation sets us on a path to the bad old days when insurance companies could refuse coverage to those with preexisting conditions and deny people health benefits that should be in every plan – like ‎maternity and mental health care, he says.

Whitehouse warns that AHCA’s passage will leave millions of Americans without access to affordable health insurance. “Rhode Islanders rely on the Affordable Care Act and it’s working here. If they want to improve it, that’s one thing, but this House bill will hurt Rhode Islanders,

Within hours of the House vote on AHCA, a joint statement was issued by six prestigious national medical organizations (American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Congress of Obstetricians and Gynecologists, American Psychiatric Association American and the American Osteopathic Association), representing over 560,000 physicians and medical students, denouncing the GOP health bill. Dozens of other state and national health care organizations, including the American Medical Association, American Nurses Association and American Hospital Association (and this number grows daily) also gave a thumb down on the Republican health bill that is considered “unworkable and flawed.”

Aging advocacy groups came out swinging, too.

AARP, representing 38 million members and considered to be one of the nation’s most powerful aging lobbying groups, plans to hold GOP House lawmakers accounting for their support of AHCA while gearing up to oppose the Republican health care proposal in the Senate.

In a statement, AARP Executive Vice President Nancy LeaMond reiterated AARP’s opposition to the GOP health bill passed in the U.S. House of Representatives, calling it “flawed” and warning that the legislative proposal “would harm American families who count on access to affordable health care.”

LeaMond says, “the bill will put an Age Tax on us as we age, harming millions of American families with health insurance, forcing many to lose coverage or pay thousands of dollars more for health care. In addition, the bill now puts at risk the 25 million older adults with pre-existing conditions, such as cancer and diabetes, who would likely find health care unaffordable or unavailable to them.”

According to LeaMond, AARP will continue its opposition of AHCA as it moves for Senate consideration because it “includes an Age Tax on older Americans, eliminates critical protections for those with pre-existing conditions, puts coverage at risk for millions, cuts the life of Medicare, erodes seniors’ ability to live independently, and gives sweetheart deals to big drug and insurance companies while doing nothing to lower the cost of prescriptions.

LeaMond warns, “We promised to hold members of Congress accountable for their vote on this bill. True to our promise, AARP is now letting its 38 million members know how their elected Representative voted on this health bill in The Bulletin, a print publication that goes to all of our members, as well as through emails, social media, and other communications.”

Medicaid Takes a Major Blow

“The bill threatens the very heart of the Medicaid program, taking away the guarantee that Medicaid will be there when seniors need it most. By slashing Medicaid funding by over $800 billion, the AHCA will place tremendous strain on state budget, says Kevin Prindiville, Executive Director of Justice in Aging, a nonprofit advocacy group for low-income seniors. “States will be forced to cut services, restrict eligibility, and reduce benefits for seniors, children, people with disabilities, and low-income older adults, he says.

“Congress is forcing families to pay more out-of-pocket when grandparents and other loved ones need nursing home care or home care. Two-thirds of all Medicaid spending for older adults pays for long-term services and supports. The AHCA puts this vital care for seniors in jeopardy,” says Prindiville. “By passing the ACHA, the House chose to cut taxes for the wealthy and pharmaceutical companies while harming Medicare beneficiaries by increasing Part B premiums and reducing the life of the Medicare Trust Fund, he says.

Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare calls the AHCA vote “appalling” for retirees and views the “raid of Medicare, cuts to Medicaid among the most problematic parts of the AHCA.”

“Despite the bill’s name, risking the health of our nation’s most vulnerable citizens to give the wealthy an $ 600 billion tax cut is tremendously uncaring — and does not reflect real American values,” says Richtman. In modifying the original AHCA bill to give reluctant Republicans political cover, the House leadership made a bad piece of legislation even worse,” he says.

No Protection for Pre-existing Conditions

“Recent amendments to this cruel, ill-advised bill could put coverage for older Americans with pre-existing conditions like cancer and diabetes out of reach. The $8 billion (over 5 years) added to the legislation at the last minute to defray the cost of higher premiums is woefully inadequate. It’s a thin veil that covers a head of snakes,” notes Richtman

“Equally inadequate are the meager tax credits that the GOP bill offers older Americans to buy insurance. A $4,000 annual tax credit doesn’t come to close to covering premiums for seniors ages 60-64, meaning millions of older Americans will lose coverage altogether,” says Richtman.

According to Richtman, AHCA slashes nearly $1 trillion from the Medicaid by converting the social health care program into a block grant program or imposing per capita caps. “This would make it harder for impoverished seniors to access long term skilled nursing care and community or home care. Overall, the Congressional Budget Office estimates that 14 million people will be kicked off the Medicaid rolls in the next 10 years if this bill becomes law,” he says.

Richtman observes that the enactment of AHCA would reduce Medicare’s solvency by repealing Obamacare’s 0.9 percent payroll tax on wages above $200,000. This could lead to cuts in Medicare, including privatizing the program — harming current and future beneficiaries, he says.

“Under the GOP bill, insurers can charge older enrollees five times more than younger ones. The Congressional Budget Office predicts that by 2026 this provision will substantially raise premiums for older people by as much as 25 percent,” notes Richtman.

Senate Becomes New AHCA Battle Ground

After the politically decisive House vote to pass AHCA, President Donald Trump and House GOP lawmakers celebrated their major political victory at the White House Rose Garden claiming that they had fulfilled a promise made 7 years ago to repeal and replace Obamacare. But this celebration was short lived. Like House Democratic lawmakers, Democratic and Republican Senators began voicing their skepticism and strong opposition to the House’s passed health bill. Holding a slim 52-to-48 advantage in the upper chamber, GOP Senate Leadership must craft a bill that can win the support of at least 50 of their caucus members.

Washington insiders are now reporting that the House’s unpopular AHCA is “Dead on Arrival” in the Senate. Senate Republicans say they will not vote on the House passed bill and the upper chamber is expected to move slowly in crafting its health bill, starting from scratch. Many GOP Senators opposed AHCA, especially those who want to protect their constituents with pre-existing conditions and others who represent states that have expanded their Medicaid program under Obamacare.

A group of 13 Republican Senators (all men) have begun the process of hammering out their own health bill. Senate rules do not allow a review of the legislation or the determination of the rules of the debate until the CBO provides its official fiscal impact estimate. Because of this the health policy debate may not begin until summer.

Hopefully, Senate Majority Leader Mitch McConnell, a Republican from Kentucky, and his partisan working group will reach across the aisle to Democratic Senators to assist in crafting a bipartisan solution. Won’t that be refreshing.