Tag Archives for Medicaid

GOP Health Care Proposal Pulled at Last Moment

Published in Woonsocket Call on March 26, 2017

Days ago, unified Democratic lawmakers combined with a deep philosophical wedge between the conservative House Freedom Caucus and moderate Republicans over policy details of the American Health Care Act (AHCA), forced the Trump Administration and House Speaker Paul Ryan to pull the AHCA proposal minutes from a floor vote to steer it away from a humiliating legislative defeat last Friday. Interestingly, the seventh anniversary of President Barack Obama signing the Affordable Care Act (ACA), his signature health care law, took place one day before the House vote.

A day before Friday’s scheduled vote to dismantle and repeal Obama’s ACA, President Donald Trump taking a high-risk negotiation tactic straight out of his bestselling book, “The Art of the Deal,” gave a late-Thursday night ultimatum to the House GOP lawmakers. Trump told to them to vote up or down on AHCA or he would be prepared to move on to other legislative agenda items.

As to Trump’s ultimatum to GOP House lawmakers, CNN Presidency Historian Timothy Naftali noted on CNN Newsroom with Fredricka Whitfield, “He played chicken and he blinked.”

House GOP Making Legislative Sausage

In a report issued on March 13, the Congressional Budget Office (CBO), detailed the drastic impact of the initial AHCA legislative proposal. CBO, a federal agency that provides budget and economic information to Congress, found that AHCA would result in 24 million losing health insurance coverage by 2026, Medicaid would be cut by $880 billion over the next ten years, and premiums and out-of-pocket costs would skyrocket increase, particularly for older adults and individuals with lower incomes.

Earlier this week, on Monday, Ryan and his House GOP Leadership team made eight amendments to AHCA to pull in skeptical GOP moderate and conservative lawmakers, including the controversial speeding up tax cuts while whittling down the Medicaid program. Later, on March 23, CBO confirmed that these amendments would lead to essentially the same level of coverage losses, about 24 million people and cost increases for individuals and would yield $187 billion less in savings than the original GOP health care proposal.

Meanwhile, on Wednesday, Senator Wyden and Congressman Pallone revealed that the Center for Medicare & Medicaid Services’ independent Actuary “estimated that the repeal of the tax on prescription medications, known as the ‘pharma fee,’ beginning January 1, 2017 would increase Medicare Part B premiums by $8.7 billion through fiscal year 2027.” noted the Center for Medicare Advocacy.

On Thursday, three more amendments were offered to sway GOP House critics. One would strip the requirement that insurance companies cover essential health benefits (EHB). This amendment would effectively eliminate annual out-of-pocket caps, reinstate annual and lifetime coverage limits, and gut protections for pre-existing conditions. Another would delay – but not remove – the Medicare payroll tax cut that will undermine Medicare’s financing and its future stability.

After the defeat of AHCA, Trump blamed the Democrats for the House GOP’s failure to pass its health care proposal to scrap Obamacare. “The Democrats were not going to give us a single vote,” he said, warning that “Obamacare will explode” forcing the opposition party back to the negotiation table to craft a better health care law.

House Speaker Ryan also noted that “We are going to be living with Obamacare for the foreseeable future.”

“We just really did not get a consensus today,” say Ryan. “That’s why I thought the wise thing to do was not proceed with a vote but to pull the bill. When asked if he was going to try “to prop it up, Ryan responded by saying “it is so fundamentally flawed, I don’t know that that is possible.”

Sighs of Relief from Aging Groups, Democrats

“The American Health Care Act is not American in spirit or health care in substance. In fact, it’s a tax cut bill for the wealthy, not a health care bill for the people. It will make America sicker. Congress should reject this charade and this disaster of a bill today,” states Judith Stein, Executive Director of the Center for Medicare Advocacy.

“The House Congressional leadership was destined to lose on their disastrous American Health Care Act, which would have effectively repealed Obamacare and hurt seniors, including beneficiaries of Medicare and Medicaid. It doesn’t matter whether they pulled or failed to pass the bill,” says Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare in a statement. “It needed to go down and we thank the millions of National Committee members and supporters – and those of other senior advocacy organizations – whose protests were loud, numerous, and furious.”

“No one knew’ that health care could be so complicated. Hopefully, he has learned a lesson… that health legislation is built on a complex foundation that considers the real human needs – and costs – of changes to the system. A common refrain from Donald Trump during the campaign was, ‘What do you have to lose by electing me?’ Now we know what’s at stake: affordable health care for older Americans, Medicare, and Medicaid,” says Richtman.

“The leadership’s decision to withdraw the bill from consideration proves that the voices of Americans are very powerful. This harmful legislation would have added an Age Tax on older Americans and put vulnerable populations at risk,” says AARP Executive Vice President Nancy LeaMond, in a statement.

LeaMond calls on Congress to focus on the issues important to older Americans and their families, including: protecting and improving Medicare’s benefits and financing; providing access to affordable quality coverage; preventing insurers from engaging in discriminatory practices; lowering prescription drug costs; providing new incentives to expand home and community based services; and strengthening efforts to fight fraud, waste, and abuse.

Adds, Justice in Aging Executive Director, Kevin Prindiville, “Congress tried to rush this disastrous bill through Congress without regard for the health and safety of older Americans and their families, and such a bill cannot and should not be revived. Older adults and their families rely on Medicaid and Medicare and these programs must be protected.”

Compromise might well be the way to make sound changes to the nation’s health care law, says Rep. David N. Cicilline (D-RI), who serves as House Democratic Policy and Communications Committee. “The Affordable Care Act is a good law, and Republicans and Democrats should be working together to make it even better. If Republicans ever decide to come to the table, we should work together to increase competition, expand coverage, and bring down premiums. That’s a decision that Republicans have to make – whether to work with Democrats or continue down the path they’re on,” he says.

Rep. James Langevin (D-RI) also stresses the importance of reaching over the aisle to create a better health care law and getting away from partisan bickering. “It’s time for Republicans to move on from their misguided crusade to dismantle the ACA. The health care law has brought insurance coverage to millions of Americans. Its consumer protections, premium assistance, essential health benefits, and countless other provisions that were at risk of elimination have improved our nation’s health and saved lives. We must work together in a bipartisan manner to strengthen and improve the ACA, not risk the health and wellbeing of everyday Americans for an empty, partisan victory,” he says.

Cicilline: Let’s Bring Back the House Permanent Select Committee on Aging

Published in the Woonsocket Call on March 5, 2017

Twenty-three years after the House eliminated the House Permanent Select Committee on Aging, Rep. David N. Cicilline (D-RI) introduced a House resolution days ago to reestablish the House select committee, once charged with investigating and putting a spotlight on aging policy, spurring legislation and other actions. During the last Congressional session, Cicilline, attracting 63 cosigners (no Republicans) out of 435 lawmakers, threw his simple resolution into the House legislative hopper only to see no action taken.

During the 115th Congress, on March 1, 2016, Cicilline introduced House Resolution 16, which would bring back the House Permanent Select Committee on Aging. Its charge would be to conduct a continuing comprehensive studies on specific aging policy to identify issues, problems and trends. Like the former House Select Committee, its work would not be limited by narrow jurisdictional boundaries of the standing committees but broadly at the targeted aging issue.

According to Cicilline, all standing and select committees of the House (except Appropriations) are authorized by a simple House resolution, detailing purpose, defining membership and any other issue that needs to be addressed, and funding is then provided through appropriations.

House Aging Panel to Play Important Role in Today’s Congress

It is extremely obvious to Cicilline and his 24 Democratic cosigners that included Rep. James R. Langevin (D-RI), about the important role the House Permanent Select Committee on Aging would play in today’s Congress. In explaining why he introduced the simple resolution, Cicilline tells this writer that, “Our nation’s seniors deserve dedicated attention by lawmakers to consider the legislative priorities that affect them, including Social Security and Medicare, the rising cost of prescription drugs, poverty, housing issues, long-term care, and other important issues.”

“As you know, the House Permanent Select Committee on Aging was active in the House of Representatives between 1974 and 1993 with the purpose of “advising Congress and the American people on how to meet the challenge of growing old in America,” noted Cicilline, who represents the state’s First Congressional District. “ The select committee did not have legislative authority, but conducted investigations, held hearings, and issued reports to inform Congress on issues related to aging,” he said.

Cicilline says, “The reestablishment of this Select Committee would emphasize Congress’ commitment to our current and future seniors and would allow us to focus our energy to ensure that they are able to live with dignity and enjoy a high quality of life,”

A newly operational House Permanent Select Committee on Aging would be charged with conducting ongoing comprehensive studies to examine the myriad of problems that older Americans face, taking a look at income maintenance, poverty and welfare, housing, health (including medical research), employment, education, recreation, and long-term care.

The newly established House Select Committee would also study ways that would encourage the development of public and private sector programs and policies that would keep older Americans active in their community. Finally, hearings would generate federal policies to encourage coordination of both governmental and private sector programs designed to deal with problems of aging. House Lawmakers and staff on this Select Committee would also review any policy recommendations made by the President or by the White House Conference on Aging that impact the nation’s older population.’

Hammering the Nail in the Casket

Claude Pepper’s death in 1989, who had served as a former Chairman of the House Permanent Select Committee on Aging, might have been an omen to aging groups of the bleak future of the House Aging panel. In 1993, Congress moved to tighten its belt to match President Clinton’s White House staff cuts. Democratic House leadership’s efforts to streamline its operations by slashing $1.5 million from its budget jurisdictions over aging policy would lead to its elimination in that year.

If alive in 1993, Rep. Pepper (D-Florida), serving as the House Permanent Select Committee on Aging, its chair for six years and considered by many to be the nation’s most visible Congressional advocate for the nation’s seniors, would have fought tooth and nail to save his beloved Select Committee.
House lawmakers who opposed the elimination of this Select Committee warned that standing committee staff did not have the time nor resources to thoroughly investigate aging policy but this select committee did. Even with these arguments and the intense lobbying of aging groups, including AARP, National Council on Aging, National Council of Senior Citizens, and Older Woman’s League, the House Permanent Select Committee on Aging could not be saved. No vote was scheduled to continue its existence on March 31, 1993 when its authorization automatically expired.

The former House Permanent Select Committee on Aging did have an impact on crafting national aging policy. In 1993, with the demise of this select committee staff, writer Rebecca H. Patterson reported on March 31, 1993 in the St. Petersburg Times that Staff Director Brian Lutz said that during its 18 years, the House Aging panel “has been responsible for about 1,000 hearings and reports.”

Throughout its existence, the House Permanent Select Committee on Aging prodded Congress to abolish forced retirement, reform nursing home operations and reduce abuse against patients, to increase home care benefits, cover breast screening for older women, combat elder abuse, improve elderly housing as well as establish research and care centers for Alzheimer’s Disease.

Support from the Trenches

It’s about time that Congress brings back the House Permanent Select Committee on Aging, say long time aging advocates.

As a former Staff Director of the Senate Select Special Committee on Aging, Max Richtman, CEO and President of the Washington-DC based National Committee to Preserve Social Security and Medicare, says bringing back the House Permanent Select Committee on Aging is “long overdue.” The House Aging panel will once again provide serious oversight and lay the ground work for House legislative proposals impacting Social Security, Medicare and Medicaid, he says.

According to Richtman, the Rhode Island Congressman is highly regarded by House Democratic lawmakers and was recently appointed to a Democratic leadership position,” he says. “America’s seniors have been looking for “a champion in the mold of the late Rep. Claude Pepper for a very long time, he says, noting that Cicilline “may well be just the person to fill his shoes.”

Fernando Torres-Gil, M.S.W., Ph.D., Director of the Center for Policy Research on Aging at the UCLA Luskin School of Public Affairs, says “The U.S. House Select Committee on Aging was a leading voice for older persons and an aging society and with illustrious champions for the elderly. Claude Pepper and Edward Roybal were examples of congressional leadership on protecting Social Security and enhancing nursing home protections.” As a former staff director of this select committee during the l980s, Torres-Gil remembered how important it was to have this committee “gerontologize” Congressional lawmakers. “It became in its time the largest committee in the Congress with members on both sides of the aisle vying to be appointed to this committee,” he said.

After the elimination of the House Permanent Select Committee on Aging in 1993, a brief effort was undertaken by Rep. Nancy Pelosi (D-California) when she became House Speaker to bring back the Aging panel but this attempt was not successful. It’s time for Pelosi and her Democratic lawmakers to make a full court press to make it happen in 2017.

Cicilline’s legislative efforts to resurrect the House Permanent Select Committee on Aging is in the hands of GOP House Speaker Paul Ryan who controls the chamber. The Washington, DC-based Leadership Council of Aging Organizations, a coalition of 72 national nonprofit aging advocacy groups, could play a key role in advocating for and supporting the Resolution that would establish, once again, a House Select Committee focused on the issues of aging in America.

Can nation survive Trump and GOP’s control of Capitol Hill?

Published in the Pawtucket TImes on January 9, 2017

Almost two months ago when GOP presidential candidate Donald Trump trounced his Democratic challenger Hillary Clinton and his party took control of both chamber of Congress. Trump’s surprising victory stunned both voters and political commentators and pundits covering the heated presidential race. According to a Nov. 16, 2016 Gallup Poll, 80 percent of Trump’s voters are “excited,” while 76 percent of Clinton’s voters say they are “afraid.” A large majority of the respondents (75 percent) shared one reaction: “surprise.”

Days after the tumultuous election, Darrell M. West, vice president and director of Governance Studies at the Washington, D.C.-based the Brookings Institution, penned his thoughts about how president-elect Trump might govern the divided nation. His posting, “Four Scenarios for a Trump Presidency,” can be found on the Brooking’s FixGov blog, written on Nov. 14, 2016.

Speculating on Trump’s White House Governance

In his 1,286-word blog, West, an American author, political scientist, pollical commentator who formerly taught Political Science at Brown University for 26 years, says that Trump might choose to govern as a traditional Republican endorsing tax cuts, deregulation and repealing Obamacare. Like other GOP politicians he would call for reinstituting law and order, fighting ISIS and other extremist militant groups and controlling illegal immigration from coming into this country. “These typical GOP positions might resolve his philosophical differences on “entitlement reform and free trade,” says West, an author or co-author of 22 books.

Trump just might even turn over the reins of the presidency to Vice President Mike Pence, House Speaker Paul Ryan and Chief of Staff Reince Priebus, says West, these individuals “becoming the de facto prime minister.”

According to West, like president-elect Trump did during the presidential campaign, he might take on the role of a “popular rogue.” A “populist Trump could break conventional political rules and “attack the political establishment to represent the little guy,” notes West’s blog posting.

West also suggests that Trump might ultimately fail as president. After all, he lost the popular vote by 2 percentage points — or nearly three million votes — and alienated women, millennials, minorities and immigrants with his insulting comments. Scandals and disclosures about his personal behavior and continuing concerns about serious financial conflicts of interest could derail his “honeymoon” phase at the beginning of his presidential term and negatively impact his popularity ratings, he says.

West also speculates in his blog that policy backlashes due to millions losing health care coverage by his push to repeal Obamacare, privatizing Medicare or gutting Social Security, a slow-down in the economy or even Trump’s continued liking of Russian President Vladimir Putin, might make him a one-term president, like President Jimmy Carter.

Finally, public outcry and violent protest may turn Trump into an authoritarian leader. If this happens West expresses concerns smear campaigns(waged by White House Strategist Steve Bannon), the use of federal agencies to “attack adversaries” and the use of local police to “crack down” on protestors. “Firing top intelligence officials would suggest that Trump wants compliant people who will do his bidding against foreign and domestic adversaries,” he says.

Big Changes with the GOP in Charge

“It is a scary time in American politics,” says West, who expects to see big changes on Capitol Hill in 2017. The Brookings political pundit predicts that a Trump White House with a GOP controlled Congress will tackle large tax cuts, corporate tax reform, repealing Obamacare (but not having anything to replace it with), and reversing the Dodd Frank financial regulation bill. With the Republicans controlling both chambers of Congress he does not expect gridlock during the first six months of the 115th Congress.

West predicts that, in the long-run, many of the GOP president and Republican Congressional leadership policy initiatives will be problematic. “They are governing as if they have a clear mandate even though they lost the popular vote, he says.

West, like some political observers, expects many of the GOP’s conservative policy proposals to hurt the people who voted for Trump. The tax cuts go disproportionately to the top one percent and proposed changes in Medicare and Medicaid will limit medical care, he said.

“In a couple of years, the economy probably will be much weaker than it is today, which will undermine the very rationale of Trump’s candidacy,” says West, noting that if this happens the newly-elected president could have a 30 percent job approval rating by 2018. “Of course, that is when he really will become dangerous! The risk is he may try things to improve his poll numbers, such as identifying scapegoats or confronting adversaries,” warns West.

“GOP Congressional leaders have plans to privatize Medicare and block grant Medicaid to the states. This will impose limitations on medical care and make it more difficulty for needy people to get the help they need,” adds West, who also sees Republicans moving to reduce home care and medical assistance to America’s elderly.

West sees the “GOP legislative initiatives as being very contentious politically, and will reinforce perceptions of the GOP as cold and heartless [to Americans].”

“Democrats will not be able to pass legislation. Their main power will be trying to block things they don’t like or stop nominations at confirmation hearings that they find problematic,” says West, noting that they will be put in a defensive posture. “They will seek to protect certain gains made during the Obama administration.

West believes that Trump’s fix for the economy will not work. “In the longer-run, there is a risk that inflation will go up. Interest rates already have risen in anticipation of this,” he says.

“The market is expecting Trump to spend a lot of money and not be able to corral spending by the same amount. That will increase deficits and drive up inflation. It will be hard to blame this on Democrats since there has been low inflation for years now. It will be pretty obvious that GOP policies are responsible for the rate increases,” West adds.

Democrats Mobilize, Video Sends Message to Congress

As president-elect Trump’s inauguration approaches, President Obama traveled to Capitol Hill last week to urge Congressional Democrats to block the GOP president and the Republican Congressional leadership’s efforts to dismantle Obamacare, the outgoing president’s signature healthcare reform law and to fight their legislative policy initiatives. Behind closed doors Obama urged Democratic lawmakers to not “rescue” the Republicans by passing replacement measures. He suggested calling the GOP’s new plan, “Trumpcare,” to ensure that they are held responsible for any disruptions in health coverage. At press time there seems to be no GOP health care plan to consider.

After Obama’s meeting Democrats lawmakers have begun using the phrase, “Make America Sick Again,” tying into Trump’s wildly recognized campaign slogan, “Make American Great Again.”

Hollywood is moving to block Trump’s policy initiatives. Almost a week ago documentarian Liz Garbus unveiled her one minute and 49 second video (#StandUpForUS), released by Humanity for Progress, to urge Congress to block any legislative initiatives pushed by Trump and his GOP allies that attack groups he marginalized during last year’s presidential campaign. Celebrities and activists lined up to participate in this video. They included Rosie Perez, Keegan-Michael Key, Tavi Gevinson, Lea Delaria, Sally Field, Steve Buscemi, Zoe Kazan, Jeffrey Wright and Janet Mock, among others.

“The majority of Americans, regardless of who they voted for, did not vote for racism, for sexism, or for xenophobia … and yet Donald Trump won,” notes the video. At the end of the video, viewers are asked to email the video to members of Congress, as well as to sign a petition on http://www.MoveOn.org, to resist Trump and the GOP agenda,

Stay Tuned

The aftermath of the 2017 presidential election has politically split our nation. Although Trump won the Electoral College, Clinton, the former secretary of state, pulled in over 64 million votes. Even without a clear legislative mandate President-elect Trump and Republican Congressional leadership are moving at a quick pace to make major policy and systemic changes during the first 100 days of the 115th Congress. Democrats are now forced to play the loyal opposition for the next four years and fight against GOP policies rammed through the legislative process. Will GOP legislative fixes push American in the right direction? Or will the nation survive these changes? Stay tuned.