Tag Archives for Obamacare

House GOP Leadership Puts its Health Care Proposal on Fast-Track

Published in Woonsocket Call on March 12, 2017

After years of calling for the dismantling of Obama’s signature health care law, the 2010 Affordable Care Act (ACA), dubbed Obamacare, an emboldened GOP controlling both the White House and two chambers of Congress, began legislative efforts to substantially change the way the federal government subsidizes health coverage for millions of Americans and puts the brakes on Medicaid expansion that extended coverage to millions more.

On March 6, House Speaker Paul Ryan (R-Wis), with the blessing of President Donald Trump, began his legislative efforts to enact the House GOP’s 123 page health care proposal, the new American Health Care Act (AHCA). Democratic lawmakers and aging groups charge that the AHCA lacks a fiscal estimate from the bipartisan Congressional Budget Office as to how many people will lose their health insurance coverage as a result of the bill or how much it will cost.”

According to rating agency S&P Global Ratings, between 6 million and 10 million people could lose health insurance coverage if the GOP’s health care proposal to “repeal and replace” Obamacare passes. Specifically, there would be a decline in enrollment in the individual health insurance plan market of between 2 million and 4 million people. There would also be a decline of between 4 million and 6 million people in the nation’s Medicaid system after 2020 to 2024, says the recently released analysis.

GOP Health Proposal on Fast-Track

Just hours after AHCA was introduced early in the week, the House Energy and Commerce Committee and Ways and Means Committee began holding markups on their specific portions of the GOP’s health care proposal. After deliberating for almost 18 hours the Ways and Means approved its portion by a vote of 23-16, along party lines. After a marathon 27-hour markup session, the AHCA proposal was approved by the second House panel, Energy and Commerce Committee, by voted 31 to 23, by party line, too. Next week, the House Budget and Rules committees is expected to take up the GOP health care proposal, with a full House floor scheduled for the week of March 20. It has been reported that Ryan hopes to have a bill to President Trump for signature before April recess.

“Obamacare is rapidly collapsing. Skyrocketing premiums, soaring deductibles, and dwindling choices are not what the people were promised seven years ago. It’s time to turn a page and rescue our health care system from this disastrous law,” said House Speaker Ryan in a statement released when AHCA was thrown into the legislative hopper.

Ryan asserted that the GOP health care proposal would “drive down costs, encourage competition, and give every American access to quality, affordable health insurance. It protects young adults, patients with pre-existing conditions, and provides a stable transition so that no one has the rug pulled out from under them.”

The GOP health care proposal would keep two of the most popular provisions of Obama’s ACA, specifically providing health care coverage to people with pre-existing conditions (though insurers would be allowed to charge higher premiums to individuals with lapsed health care coverage) and allowing children to stay on their parents’ health plans until the age of 26.

But, the GOP’s efforts to repeal and replace Obama Care has brought aging groups together to put the brakes on House passage.

Aging Groups Come Out Swinging

Seniors’ advocates object to the ACHA’s impact on federal programs that provide both healthcare and long-term care to retirees. The bill rescinds an 0.9% tax on upper income earners’ wages, which had been used to extend the solvency of Medicare until 2028. Removing the tax decreases Medicare’s solvency by four years, which could lead to benefit cuts down the road. Advocates also decry the age-rating provisions in the repeal bill, which would allow insurers to charge older Americans up to five times as much for premiums as younger enrollees pay. The $4,000 tax credits for near seniors (aged 50-64) which replace Obamacare subsidies won’t make a dent in the premiums that this age group will pay under the GOP plan. Older Americans who can’t afford insurance will then arrive at the threshold of Medicare less healthy, putting additional strain on the system.

“This legislation is a triple whammy for seniors. It’s bad for Medicare beneficiaries, bad for near seniors, and bad for the Medicare program,” says Max Richtman, President and CEO of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare.”

Richmond is especially alarmed that the AHCA also makes radical changes to the Medicaid program. The bill cuts $370 billion from Medicaid over 10 years by imposing “per capita caps,” meaning that states will get a fixed federal payment per beneficiary instead of the guaranteed match they now receive. Those fixed payments will not be able to keep pace with rising healthcare costs, leaving the states with significant shortfalls. “Millions of seniors rely on Medicaid for skilled nursing care, both in the home and at community-based facilities. The cut in federal payments will compel states to remove seniors from Medicaid rolls or radically reduce benefits, forcing them and their families into poverty.”

Following the release of the GOP’s AHCA, the Washington, D.C.-based AARP, the nation’s largest advocacy group representing over 37 million members, came out swinging. The GOP legislative proposal would weaken Medicare, leaving the door open to a voucher program that shifts costs and risks to seniors, warned AARP Executive Vice President Nancy LeaMond in a statement.

“Before people even reach retirement age, big insurance companies would be allowed to charge them an age tax that adds up to thousands of dollars more per year. Older Americans need affordable health care services and prescriptions. This plan goes in the opposite direction, increasing insurance premiums for older Americans and not doing anything to lower drug costs, noted LeaMond.

LeaMond charged, “On top of the hefty premium increase for consumers, big drug companies and other special interests get a sweetheart deal. “Finally, Medicaid cuts could impact people of all ages and put at risk the health of 17.4 million children and adults with disabilities and seniors by eliminating much needed services that allow individuals to live independently in their homes and communities.”

“Although no one believes the current health care system is perfect, this harmful legislation would make health care less secure and less affordable,” says LeaMond, noting that her nonprofit aging group will work with either political party to hammer out a health plan that “puts Americans’ health care first, not the special interests.”

Adds Judith Stein, executive director of the Center for Medicare Advocacy in a statement, “the proposed AHCA would also gut key financing mechanisms of the Affordable Care Act that would amount to tax cuts for the wealthy – by some estimates, by hundreds of billions of dollars. Regrettably, these tax cuts include provisions that would jeopardize Medicare’s financial stability. “We fear such cuts will lead to renewed calls to ‘save’ Medicare by privatizing it for future generations,” says Stein.

According to the Center for Medicare Advocacy’s statement, the proposed GOP legislative proposal would dismantle key structural supports of ACA, including eliminating the employer coverage mandate and the individual mandate to obtain health coverage, and instead would impose a 30 percent penalty for lapses in coverage. Instead of the ACA’s subsidies that make health coverage more affordable for millions, the new legislation would offer age-based tax credits ranging from about $2,000 to $4,000 – likely insufficient to pay for meaningful insurance coverage.

The Medicare Advocacy Group also warns that older Americans needing health insurance coverage before becoming Medicare eligible would also be hit hard by the proposed AHCA. The ACA’s protection of older adults that prevents insurance companies from charging no more than three times the premium amount charged of younger individuals (a 3:1 ratio) would be replaced by a higher 5:1 ratio – this dramatically increasing the premium amount insurance companies can charge older adults. Critics call this change an “age tax.”

Finally, the Republican’s AHCA would also phase out ACA’s expansion of Medicaid starting in 2020, structurally reforming virtually the entire Medicaid program (including Medicaid expansion). These changes would have a devastating impact on providing health care by capping federal Medicaid payments to each state to a limited, preset amount per person (often referred to as a “Per Capita Cap”).

Could Political Backlash Happen with Passage of AHCA?

Last Thursday, Ryan, with sleeves rolled up, urged GOP lawmakers to back AHCA, promising tweaks to address Republican conservatives’ concerns. At the 23 minute news conference, Ryan said: “This is the closest we’ve been to repealing and replacing Obamacare and it’s the closest we will ever get to repealing and replacing Obamacare.” It is either voting for the House bill, or let ACA survive, he said.

President Trump also chimed in to the AHCA debate, too, by calling for the controversial health care proposal’s enactment in an afternoon tweet. “Despite what you hear in the press, health care is coming along great. We are talking to many groups and it will end in a beautiful picture!,” he tweeted.

As the Congressional April recess approaches opposition to AHCA is building as physician, nurse and hospital groups warn that the legislative proposal’s enactment will take health care coverage away from millions of Americans. While Democratic and progressive organizations oppose ACA’s passage, too, a growing number of GOP lawmakers and conservative groups, from the Cato Institute, Americans for Prosperity and Tea Party Patriots, are expressing their concerns.

Days ago, Andrev Ostrovskv, chief medical officer for Medicaid at the Baltimore, Maryland-based Centers for Medicare and Medicaid based, risking the wrath of Trump’s political appointees in his federal agency, tweeted his displeasure and opposition. “Despite political messaging from others at HHS [Health and Human Services], I align with the experts from @aafp @AmerAcadPeds @AmerMedicalAssn in opposition to #AHCA,” he tweeted. Dr. Ostrovskv’s agency oversees the administering of Obamacare.

Even if the GOP House Leadership are able to address conservative lawmaker concerns, one being AHCA does not require an earlier halt to Medicaid expansion enrollment, the GOP’s health care proposal appears to have a rocky road to travel in the upper chamber. Senate. Republications, having just a 52-48 slim majority, can only lose two votes.

Says Senator Tom Cotton (R-Arkansas) in a tweet to House GOP Leadership: “ House health-care bill can’t pass Senate w/o major changes. To my friends in House: pause, start over. Get it right, don’t get it fast.”

With the popularity of Obamacare the GOP’s death wish to repeal and replace the law may well be hazardous to the Republican Party’s political health. We’ll find out for sure in the mid-term elections.

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.

Republicans Begin a Legislative Assault on Social Security

Published in Woonsocket Call on December 11, 2016

With the dust just settling after last month’s heated presidential 2016 election, the GOP took over the White House and maintained control of both chambers of Congress. With almost 40 days left before Obama leaves office, an emboldened GOP calls for the repeal of Obmacare and the privatization of Medicare. That said, fixing Social Security is now on their short list of domestic policies to address.

Last Thursday, the long-anticipated political skirmish over how to reform and ensure the fiscal solvency of Social Security began with Ways and Means Social Security Subcommittee Chairman Sam Johnson (TX-03) introducing legislation to drastically overhaul the nation’s most popular social insurance program.

In the Eyes of the Beholder

“For years I’ve talked about the need to fix Social Security so that our children and grandchildren can count on it to be there for them just like it’s there for today’s seniors and individuals with disabilities,” Johnson said in his statement introducing H.R. 6439, the Social Security Reform Act of 2016. “My commonsense plan is the start of a fact-based conversation about how we do just that. I urge my colleagues to also put pen to paper and offer their ideas about how they would save Social Security for generations to come,” he said.

Johnson’s legislative proposal seeks to overhaul the nation’s Social Security program by increasing the retirement age from 67 to 69, this change impacting people born in 1968 who will begin retiring in the mid-2030s. The basic Social Security benefit formula would also become less generous for beneficiaries… except for the poorest beneficiaries. The annual cost-of-living adjustment (COLA), using a Chained-Weighted CPI, would put the brakes on generous COLA increases. COLA’s would be cut for those earning over $85,000.

Circling the Wagons to Protect Social Security

Democratic Leader Nancy Pelosi came out swing in a statement after Johnson’s threw his bill into the legislative hopper, charging that it would “inflict deep cuts in Social Security benefits.”

“Apparently nothing upsets House Republicans like the idea of hard-working people getting to enjoy a secure and dignified retirement. While Speaker Ryan sharpens his knives for Medicare, Chairman Johnson’s bill is an alarming sign that Republicans are greedily eying devastating cuts to Americans’ Social Security benefits as well,” Pelosi said.

She warned, “Although current retirees and those close to retirement will receive their Social Security benefits, changes are looming with a Trump administration and a Republican-controlled Congress. For younger generations all benefit cut options are expected to be put on the table.”

Rhode Island Congressman David Cicilline calls Johnson’s legislative proposal a “travesty,” warning that it would “destroy Social Security as we know it by slashing the critical benefits that millions of seniors rely on to live their retirement years with dignity.”

According to Cicilline, the last time Republicans tried to eliminate Social Security during the Administration of President George W. Bush, the American people were outraged and rejected it.”

Max Richtman, President and CEO of the Washington-based National Committee to Preserve Social Security and Medicare views Johnson’s Social Security fix legislation introduced as the 114th Congress is wrapping up, “the first salvo in the ‘War on the Working Class.’”

Rep. Johnson will no doubt re-introduce his bill in the next Congress, he predicts.

According to Richtman, Johnson’s legislative proposal cuts Social Security benefits by one third while raising the retirement age from 67 to 69. It seeks to control costs by changing the benefit-computation formula in a way that cuts benefit amounts. Finally, it cuts COLAs, too.

Richtman charges that this Social Security reform proposal would “irreparably harm the nearly 60 million Americans who currently depend on Social Security as well as future beneficiaries.”

“President-elect Trump will have a veto pen. Now is the time for Mr. Trump to re-affirm his campaign promise “not to touch” Social Security and Medicare. So far, he has been uncharacteristically silent on this vital issue. I promise that we will hold him accountable,” says Richtman.

“No one voted for massive cuts to Social Security, nor to end the program as we know it,” says Nancy Altman, founding co-director of Social Security Works, in a response to Johnson’s legislative proposal to radically change Social Security. “The Johnson plan would gradually but inexorably turn Social Security from a program that replaces wages to one that produces essentially one flat benefit, independent of how much a worker contributed,” she says.

“With Republicans in full control of the federal government, these cuts have a real chance of being passed into law. Trump needs to immediately reassure the American people that he will keep his campaign promise and veto this awful bill. He should tweet that immediately,” adds Altman.

The presidential debates and the platforms of the GOP and Democratic party reveal a stark difference as how to each party will fix the ailing Social Security program. Now is not the time to put Social Security on the chopping block. Congress must come together to hammer out bipartisan approaches to ensure the fiscal solvency for the next 100 years. .