House narrowly passes Obamacare replacement

[SueEllenRules!]

House Narrowly Passes Obamacare Replacement

• With just two votes to spare, House Republicans on Thursday fulfilled a longtime campaign promise by passing legislation that would overhaul the 2010 Affordable Care Act. However, the measure is unlikely to get through the Senate without significant changes.
• The 217-213 vote caps weeks of intense party negotiations that produced a compromise amenable to just enough conservatives and moderates to send the bill to the Senate. Twenty Republicans, mostly from the moderate Tuesday Group, joined all Democrats in opposing the measure over concerns about millions of Americans losing their health insurance.
• “This bill delivers onto promises that we have made to the American people,” Speaker Paul Ryan (R-Wis.) said on the House floor shortly before the vote. “A lot of us have been waiting seven years to cast this vote. Many of us are here because we pledged to cast this very vote, to repeal and replace Obamacare.”
• The legislation’s successful House passage amounts to a comeback victory for President Donald Trump and Ryan, who weeks ago was forced to pull a previous version of the bill to avoid a humiliating defeat on the House floor.
• Despite this week’s breakthrough, House members know their bill will be changed in the Senate, a chamber more bent toward compromise, and where Republicans can’t afford to lose more than two GOP votes to ensure passage.
• “I told everybody over here, whatever we’re sending over there is not written in stone,” Rep. Tom Cole (R-Okla.) told reporters Thursday before the vote. “So that should both reassure you and scare you.”
• Republicans reached a deal on Wednesday that paved the way for Thursday’s vote. The short turnaround, which allowed lawmakers to send the bill to the Senate before the start of a week-long House recess, did not provide sufficient time for the nonpartisan Congressional Budget Office to analyze the legislation’s potential impact on the federal budget and on health care for millions of Americans.
• The bill would repeal significant parts of the ACA, including its individual and employer mandates. It would also change how the federal government finances its share of Medicaid and give states the option to apply for exemptions from certain consumer protections under the 2010 health law.
• The House Freedom Caucus endorsed the measure after it was revised to allow states to opt out of some federal insurance regulations, which conservatives say would lower average premiums. Meanwhile, to bring some moderates on board, the bill now includes $8 billion in extra help for people with pre-existing conditions who could face higher costs in states with certain waivers.
• Rep. Daniel Webster (R-Fla.), who had opposed the legislation before Thursday morning, voted in favor of the revised measure, saying he was swayed in part because he views Thursday’s House action as a preliminary vote.
• “There’s plenty of votes between now and the end,” he said. “There’s all kinds of ways to block it in the future if it doesn’t work out.”
• Sen. John Thune (R-S.D.), a member of Senate Republican leadership team, is already working on an amendment related to the legislation’s tax credits, and Sen. Lindsey Graham (R-S.C.) warned on Twitter before the House vote that the bill “should be viewed with caution.”
• Health insurers, who face a June deadline to submit their rates for 2018 health plans, have been putting pressure on senators for more clarity. Sen. Chuck Grassley (R-Iowa) said he met with insurers on Thursday.
• “I told them there’s no assurance I can give you, from a substance standpoint or a process standpoint, of when that’s gonna happen because there’s been so little discussion of it” in the Senate, Grassley said on Instagram.
• The treatment of Medicaid, which prompted some House Republicans to vote against the bill, is likely to be be a major issue in the Senate, with GOP Sens. Shelley Moore Capito (W.Va.), Cory Gardner (Colo.), Lisa Murkowski (Alaska) and Rob Portman (Ohio) all raising concerns.
• House Minority Leader Nancy Pelosi (D-Calif.), who served as speaker and shepherded the Affordable Care Act through Congress, said the fact that Republicans are relying on the Senate to make changes will not matter when Democrats take their case to the American people in the coming elections.

https://apple.news/AmmXhnjlJMZ2tJhixjI1fPw

 

[SueEllenRules!]

3 winners and 3 losers from the Republican vote to replace Obamacare
House Republicans have passed the American Health Care Act, a bill that would greatly reduce funding for Obamacare’s coverage programs, leaving millions fewer people with health insurance.

• The bill would dramatically remake the American health care system, changing who can afford coverage in the individual market — and who will be left uninsured. It also revealed new fault lines in the Republican Congress, showing who had the power to shift the bill’s priorities and who yielded little influence.
• If the bill makes it through the Senate and becomes law, Republicans will have achieved a campaign promise they’ve been making for the past seven years. Millions of Americans will lose health insurance altogether, according to CBO estimates based on an earlier version of the bill. Taxes will drop for the wealthiest Americans. And for those still buying individual plans, the American health insurance system will prioritize the needs of young and healthy people more, and sicker people less.
• Here are the winners and losers from this stage of the fight.

Winner: People who are young, healthy, and high-income

• If you earn a good salary, are young and healthy, and want to buy a cheaper, skimpier insurance plan, the American Health Care Act could be pretty good for you. It would give Americans who earn upward of $100,000 tax credits to help purchase insurance. Right now, Obamacare’s tax credits are only available to individuals who earn less than $64,000.
• The Republican bill makes it easier for insurers to charge lower prices to young people, too. Right now, insurance plans are required to only charge the oldest enrollees three times as much as the youngest enrollees. AHCA would change that rule to allow insurers to charge the oldest enrollees five times as much. This would raise premiums on the elderly but lower them for young Americans. Christine Eibner, a researcher at the RAND Corporation, estimates that this particular policy would lower annual premiums for a 24-year-old from $2,800 to $2,100
• AHCA would let states apply for waivers so that insurers in those states could charge people with preexisting conditions higher premiums. For healthy people without preexisting conditions, this would be a benefit: They would no longer have to pay more so that the insurance company could cover the high medical bills of other enrollees. Instead, the Republican bill would move the individual market closer to the one that we had before Obamacare, where health insurance premiums were meant to reflect how much an individual’s own coverage is expected to cost.
• If you’re someone who uses little health care, that could be a good deal. If you’re someone who is expected to have high bills, however…

Loser: people are older, sick, and low-income

• For low-income people who get their coverage through either Medicaid or the individual marketplace, though, the AHCA will likely change things for the worse.
• The bill would end the Medicaid expansion in 2020, a program that millions of Americans who earn less than 138 percent of the poverty line (about $15,000 for an individual) currently rely on. The end result would be that people eventually get moved into the individual market, where they would have to pay for private insurance coverage. They would get some help from AHCA’s tax credits, but likely not enough to afford to purchase a plan — keep in mind, these are people who are only earning $15,000 or less per year.
• People already in the marketplace would see significant change, too. Right now, Obamacare’s tax credits are based on income, with those who earn less getting more help. Under Obamacare, people who earn less than 200 percent of the poverty line (about $24,120 for an individual or $49,200 for a family of four) get the most generous help, enough money so that a midlevel plan would cost no more than 6.4 percent of their income.
• Under AHCA, which doesn’t base tax credits on income alone, those people would get substantially less help. The Congressional Budget Office estimates that the average 40-year-old who earns $26,500 would see her tax credit fall from $4,800 to $3,650 under AHCA.
• For an older Obamacare enrollee, the problem would be even more acute, because insurers would be allowed to charge the oldest enrollees five times as much as the youngest enrollees. This would have the result of raising premiums for Obamacare enrollees in their 60s.
• CBO estimates that a 64-year-old earning $26,500 would see their annual tax credit decline from $13,600 to $4,900. The amount they pay out of pocket for their premiums, meanwhile, would go up from $1,700 in annual premiums under current law to $14,600 under AHCA. Right now, with the tax credit, that person spends very little of her own money on a premium. Under the new bill, she’d spend nearly half her annual income on health insurance.

Winner: the Freedom Caucus

• The Freedom Caucus went into the Obamacare repeal fight with two non-negotiable demands. First, they wanted a bill that got rid of Obamacare’s requirement that sick and healthy people be charged the same premiums. Second, they wanted to end Obamacare’s essential health benefit mandate, which requires insurers to cover 10 types of medical care including hospital trips, maternity care, and mental health services.
• This was a huge ask. These are two of the most popular parts of the Affordable Care Act. American voters really like Obamacare’s ban on preexisting conditions; a recent Washington Post poll found that 70 percent want that part of the law to stay.
• But the Freedom Caucus ultimately got its way, as the Republicans added an amendment that would allow states to waive out of these two provisions. This group of legislators moved the Republican replacement plan sharply to the right, and showed that they could sway the caucus toward a more conservative health care plan.

Loser: the Tuesday Group and moderate Republicans

• The Tuesday Group, a loose affiliation of moderate Republicans, had the exact opposite experience in the health care debate. These moderates opposed the first version of AHCA because they felt it didn’t do enough to protect the Americans who rely on the health care law’s programs.
• The Freedom Caucus then added a series of changes that made the bill more conservative, the ones described earlier. They let states waive out of the preexisting condition ban and cover fewer benefits.
• Moderates, somewhat amazingly, signed onto these changes while getting incredibly little in return. Rep. Fred Upton of Michigan secured an additional $8 billion in funding to help cover people with preexisting conditions. He admitted that he didn’t know whether this would be enough to actually make sure those people receive quality health care.
• The moderates went from opposing the more moderate version of AHCA to supporting the more conservative one — which doesn’t speak especially well to their leverage and muscle on Capitol Hill.

Winner: very rich Americans

• The AHCA would amount to a huge tax cut for the wealthiest Americans by rolling back key taxes included in Obamacare. One analysis of an earlier version of the bill estimated that it contains $600 billion in tax cuts that would save the wealthiest 0.1 percent of Americans, on average, $200,000 each.
• The single biggest tax cut included in the bill is the repeal of the 3.8 percent tax the Affordable Care Act applied to capital gains, dividend, and interest income for families with $250,000 or more in income ($125,000 for singles).
• Repealing that tax is a change that, by definition, only helps affluent Americans. If you’re part of a married couple and, like the vast majority of Americans, make less than $250,000 a year, or earn more than that but have little investment income, it doesn’t affect you at all.

Loser: the Senate

• The Senate has had the luxury so far of sitting on the sidelines of the health care debate and waiting to see what bill the House passes. Now, the ball is in their court — and they don’t sound entirely excited to receive it.
• AHCA is an unpopular bill. Different polls find that somewhere between 17 percent and 37 percent of Americans approve of the Republican plan, and now it’s being dropped squarely in the laps of senators.
• Senators presumably don’t want to be the road block to Obamacare repeal — a goal of the Republican party for years now — but also have major concerns about AHCA. Many of them worry about the bill’s deep cuts to Medicaid and changes to private insurance. Now they’ll have to hash out the issues on their own.
• A few senators have suggested they will even draft their own competing bill — which will be just as challenging of an effort in the Senate as it has been in the House this year.

Winner: Donald Trump

• Trump has spent months now campaigning on his promise to “repeal and replace Obamacare. He has promised, repeatedly, that a plan would be coming soon and Republicans would get it done.
• In getting the American Health Care Act through the House, he finally gets to claim progress on that goal. He has a clear political victory he can point at, in a presidency where very little policy has been made.

Loser: Donald Trump

• Trump has repeatedly promised a health care bill that will “cover everyone” and take care of people with preexisting conditions.
• The bill that just passed the House is decidedly not that bill. The things Trump says are currently in the bill — protections for everyone with preexisting conditions, for example — are not in the American Health Care Act. The most recent CBO estimate says that 24 million fewer Americans would have coverage under AHCA. Clearly, not everyone is covered.
• Trump has repeated these claims this week and he may well keep repeating these claims about AHCA in the future too. But eventually, if he signs this bill into law, the way AHCA actually works will become clear to the Americans who lose insurance and the Americans with preexisting conditions who suddenly have to pay more for coverage. That will be a rude awakening for the voters who have, for years now, been promised the exact opposite.

https://apple.news/Ai5fxhgBBRPeyVTOW_wc4vA

 

[Snarky Oracle!]

If it manages to pass the Senate, and they're predicting it won't, it would be nice if only people who voted for Trump would lose their coverage. Maybe they could volunteer it, throwing themselves on the altar for their gaseous leader.

 

[SueEllenRules!]

Trump’s health care victory could be a Pyrrhic one
With the passage of the American Health Care Act through the House, President Donald Trump has succeeded in reviving a tremendously unpopular bill that could place his House majority in serious peril.

• He has also ensured that health care — a bad issue for him — will continue to dominate headlines for months as the fight over the GOP bill moves on to the Senate.
• And he has succeeded in increasing what may be the biggest risk of all for himself and his party — that this extremely controversial bill will in the end actually become law and strip tens of millions of Americans of their health coverage while making a mockery of Trump’s own campaign promises.
• It is clear, then, that while this vote was indeed a “win” for Trump in the short term, it could entail some very serious political consequences for him and for the GOP in the long run.
• Press coverage of House Republicans’ withdrawal of the American Health Care Act back in March portrayed it as a humiliating defeat for Trump. And though he had at first signaled that he wanted to leave health reform behind and move on to other issues, he is a man who hates losing. So he had his aides and House leaders work to revive the bill, and now it has cleared the House of Representatives, giving him the short-term victory he so craved.
• And there are some real benefits to Trump from today’s vote. With his first 100 days widely viewed as disappointing and ineffective, he has won some headlines about a victory. He’s managed to pass his first big bill through a chamber of Congress. And he’s kept the GOP legislative agenda of Obamacare repeal and a big permanent tax cut alive for now.
• But the policy, politics, and process of the American Health Care Act have been handled so abysmally by Republicans that even this success seems to create more and more problems for them down the road. As I’ve been writing, by not managing to put together a better and more popular bill, Trump has ended up in a no-win situation on health reform, where both passage and failure cause him immense difficulties.

The unpopular AHCA imperils Republicans’ House majority

• According to the most recent Congressional Budget Office estimates — Republicans didn’t bother to wait for a score of their latest revisions — the GOP health bill is projected to result in 24 million people losing insurance by 2026. It slashes $880 billion from Medicaid. And it has particularly devastating effects on older, poorer Americans who had to buy insurance on the individual marketplaces — CBO projected a 64-year-old making $26,500 would see her premiums rise by 750 percent. Most major health care industry and patients groups have condemned the bill, and polls showed it to be incredibly unpopular.
• Regardless of what happens next, Trump has now yoked 217 House Republicans — all but 21 of them — to this bill, and put them on record supporting it. And that could have very serious electoral consequences.
• A paper by a group of political scientists (Brendan Nyhan, Eric McGhee, John Sides, Seth Masket, and Steven Greene) found that House Democrats who voted for President Obama’s health reform bill in 2010 ended up with a midterm election vote share on average 5.8 points lower than similar Democrats who opposed the bill. Without this drag on Obamacare supporters, the authors calculated, Democrats would have been favored to hold on to the House. Instead, of course, they lost it in 2010, and have never reclaimed it since.
• Holding on to control of the House is obviously important in helping a president get his legislative priorities into law. But its importance doesn’t stop there. Whichever party controls the House sets the chamber’s investigatory agenda and has subpoena power through control of various committees.
• If the president’s allies control Congress, he’s generally shielded from the worst of troublesome congressional investigations. But if his opponents do, they can make a whole lot of trouble for the administration depending on what they find. For instance, Hillary Clinton’s use of a private email address and server for her State Department work was in fact unearthed by a congressional Republican–led committee investigating the Benghazi attacks. If Republicans had not retaken the House, the email scandal may never have become public, and Clinton could well be president today.
• There are a whole host of ethics concerns already related to Trump, his businesses, and his children, and how all those intermingle with government activity. Republican-led congressional committees have so far been uninterested in digging too deep into all that, but you can rest assured that Democrat-led committees would be very interested indeed. And there are a bunch of other matters that could be investigated too, not least Russia-related scandals.
• All that, of course, remains hypothetical and in the future, but by forcing so many House Republicans in districts Clinton won or narrowly lost to go on record backing such an unpopular measure here, Trump likely has significantly helped Democrats’ chances of retaking the House.

The health care issue will now dominate Washington’s agenda for the foreseeable future

• American voters have relatively short memories. Congressional Republicans were blamed for the tremendously unpopular two-week government shutdown of fall 2013, and it seemed they had greatly damaged their chances for the 2014 midterms. But they realized they were fighting a losing battle and smartly gave up, letting the government reopen and not waging that fight again. A year passed, other issues rose to the top of the agenda, Republicans had a chance to improve their popularity, and they won landslide midterm gains.
• Some use this example to argue that the government shutdown wasn’t as bad for the GOP as it seemed, but that’s not my takeaway. Republicans’ key choice in my view was to abandon that strategy. If they had continued to keep the government shut down or waged future shutdown fights throughout 2014, things could have turned out very differently. But they smartly didn’t.
• Now, President Trump has never been particularly comfortable discussing health care policy, and when the AHCA was pulled back in March, he at first seemed positively eager to move on to tax cuts, an issue that had the potential to be more popular and politically beneficial to him. In the end, however, he decided he didn’t want to move on after all, and resurrected the health bill.
• So regardless of what happens next in the Senate, the consequence here is that health reform will continue to dominate headlines about the administration and Congress for the foreseeable future.
• This means that yet again, Trump has passed up an opportunity to prioritize an issue that is actually popular — something like jobs or infrastructure, or even a tax cut bill — and could conceivably help turn around his dismal approval ratings. And of course, if the bill is signed into law, he will in some senses never be able to escape the health care issue, as his administration will be held responsible for implementing it.

The biggest risk of all for Trump and Republicans is that the health bill might actually become law

• Now that the health bill has cleared the House, there are essentially three ways things could play out now:

1. The bill just dies in the Senate, with the chamber failing to pass anything and effectively ending discussion of the matter.
2. The Senate dramatically overhauls the health bill, but the House can’t accept the changes that have been made, and the bill dies due to the failure of the two chambers to agree.
3. The bill actually passes the Senate, the House and Senate come to an agreement, and the bill becomes law with President Trump’s signature.

• If scenario 1 or 2 happens, we’ll essentially return to where things were in March when the AHCA failed in the House, only after several more weeks or months of Trump’s crucial first year have been invested into this.
• The truly interesting and dangerous outcome for the GOP, though, is scenario 3: The bill becomes law (without being rewritten from scratch by the Senate into something that bears zero resemblance to what it is now, which could be the GOP’s only way out of this mess).
• Because Republicans from Trump on down have been engaged in a remarkably brazen campaign of lies and deceit to sell this bill. They have repeatedly promised it will give Americans more choice and lower premiums and deductibles. Trump has promised to cover everyone, even those who can’t afford it. House Majority Leader Kevin McCarthy promised just this morning that no one would have their Medicaid taken away via the GOP bill.
• All of these are flat-out lies. As mentioned, according to the CBO, the bill would cause tens of millions to lose coverage, slash hundreds of millions of dollars from Medicaid, and send premiums skyrocketing for older and poorer Americans (including many Trump voters). And if it were actually implemented, people would of course notice this.
• “No legislation enacted in recent decades cut low-income programs this much — or even comes close,” Robert Greenstein, the founder and president of the Center on Budget and Policy Priorities, recently told my colleague Dylan Matthews. The amount of damage this would do to so many Americans’ benefits and pocketbooks could well be unprecedented in US politics. By reviving this bill, then, Republicans are very much playing with fire, and putting millions of Americans’ — and their own political futures — at risk of getting burned.

https://apple.news/A_YNYdVaWR7q8zFG7SPon9A

 

[Gabriel Maxwell]

For all the hyperventilating over ISIS and sanctimonious outrage over alien criminals from sanctuary cities, the party of evil sure don't seem to mind mass murdering many more Americans than the former two could ever accomplish combined.

Then again, there's that Rose Garden celebration. Who throws a shindig at half time? Perhaps they don't ultimately care if their awful bill fails at the Senate as they'd get the best of both worlds:

a) claim in 2018 they kept the campaign promise (but it was those few Senate Republicans' fault it didn't get done), and
b) not suffer the rage of people losing their coverage.

Possibly the best way out after painting themselves into a corner yapping about repealing Obamacare for 7 years and then displaying utter incompetence in recent weeks despite all the power they amassed.

Meanwhile, a couple of a**holes great each other with the international sign for "We did it!"

 

[Snarky Oracle!]

 

[SueEllenRules!]

How Republicans from Clinton-won districts voted on health care

(CNN) -- Fourteen of the most vulnerable House Republicans -- those from congressional districts Democrat Hillary Clinton won in 2016 -- voted Thursday to back the Republican health care bill. It's a decision Democrats hope to hang over their heads for the next 19 months.

Clinton won 23 congressional districts in 2016 that are now represented by Republicans. Only nine of those members decided to buck their party and vote against the American Health Care Act, the Republican-backed repeal of President Barack Obama's signature health care achievement.

By backing the bill, the 14 vulnerable Republicans are all but guaranteeing they will hear about their vote on television, from opponents and at town halls throughout the 2018 cycle. And after the Republican plan passed the House, the Democratic Congressional Campaign Committee pledged to hold this vote to the members.

"Make no mistake about it: every single House Republican bears the responsibility for this heartless legislation, and the passage of this bill will haunt them through Election Day," Ben Ray Luján, the committee chairman, said in a statement.

Minority Leader Nancy Pelosi made this case bluntly on the House floor Thursday.

"You have every provision of this bill tattooed on your forehead," she said to Republicans. "You will glow in the dark with this one, you will glow in the dark."

Republicans made similar promises in 2009 after the House and Senate backed Obamacare -- they proved to be correct. Democrats lost the House in 2010 during a wave election for Republicans. They also lost the Senate to Republicans in 2014.

House Speaker Paul Ryan nodded to this fact during his speech on the floor before the vote.

"A lot of us have been waiting seven years to cast that vote," he said. "Many of us are here because we pledged to cast this very vote."

But those Republicans tasked with protecting these vulnerable members have argued that they have all been tested in tough districts and that they understand their areas better than most.

Some of the Republicans from Clinton districts who voted for the health care repeal bill stood by the vote afterward by physically standing behind the president as he touted the incremental win.

Two vulnerable Republicans from southern California -- Rep. Darrell Issa and Rep. Mimi Walters -- stood near Trump as he touted the victory.

The DCCC announced after the vote on Thursday that they were starting a digital ad campaign against Issa, Walters and 28 other Republicans.

14 Republican "yes" votes from Clinton-won districts:

• John Culberson (TX-7)
• Carlos Curbelo (FL-26)
• Jeff Denham (CA-10)
• Darrell Issa (CA-49)
• Steve Knight (CA-25)
• Martha McSally (AZ-2)
• Erik Paulsen (MN-7)
• Dana Rohrabacher (CA-48)
• Peter Roskam (IL-6)
• Ed Royce (CA-39)
• Pete Sessions (TX-32)
• David Valdadao (CA-21)
• Mimi Walters (CA-45)
• Kevin Yoder (KS-3)

9 Republican "no" votes from Clinton-won districts:

• Mike Coffman (CO-6)
• Barbara Comstock (VA-10)
• Ryan Costello (PA-6)
• Will Hurd (TX-23)
• John Katko (NY-24)
• Leonard Lance (NJ-7)
• Pat Meehan (PA-7)
• Dave Reichert (WA-8)
• Ileana Ros-Lehtinen (FL-27)

http://www.cnn.com/2017/05/04/polit...ublicans-hillary-clinton-districts/index.html

 

[SueEllenRules!]

House Passage of Trumpcare Should Mean Heavy Republican Defeats At The Polls Next Year

• Passage of the House Republican health care bill, coming on the House floor on May 4, will be touted by President Trump and his party as a great victory. And, it certainly changes the atmospherics from the previous period when the similar health care bill was pulled from the House floor schedule as it faced certain defeat.
• But, viewed objectively, the bill’s passage is not a wonderful victory for the party, in terms of its electoral attractiveness. The bill roils the waters on key health care issues so much that it will cause a thronging to the polls in 2018 by angry and, frankly, legitimately scared voters.
• Take what the “new” May version does that differs from the earlier version. By a major weakening of insurance protection, the “new” May version won over the ultra-conservatives of the House Freedom Caucus who would not vote for the earlier version because they felt it did too much for the public.
• Namely, one of the pillars of the Affordable Care Act was always the protection for people with pre-existing conditions. The Act meant that such people could change or get a new insurer, without being denied insurance or charged more because of their pre-existing conditions. Insurers could no longer refuse coverage to, or overcharge, people who had a heart attack or cancer. This gave comfort to the tens of millions of families who would otherwise live in fear of being denied insurance coverage when they most need it.
• Initially, the early version of “Trumpcare” preserved the protection for pre-existing conditions. The proponents of that version knew how unpopular it would be to pull that protection out.
• But in the recent round of intra-party bargaining, the ultra-conservatives won out. Individual states can opt out of protection for pre-existing conditions. This will allow insurers in red states to profit more, and perhaps to charge a little less, because they will not cover the more expensive insureds – those with pre-existing conditions. Insurance will be more profitable for insurers, and perhaps a little less expensive to those who can get it, in the reddest of states for sure – the old Confederacy from the Carolinas to Texas. But Republicans hold a majority of state governments, so quite a few states may opt out.
• Trump and his party will keep insisting that they give protection in this bill for pre-existing conditions. But, there is only a fig leaf. States that opt out will have “high risk pools” Those who have had a heart attack or cancer and cannot get regular insurance can get it by joining with others like them in the “high risk pools.” The Republicans even kicked in some extra money for these pools, the so-called “eight billion dollars.”
• “High risk pools” are a non-starter. They concentrate all the most expensive patients in one pool. That means their premiums are inevitably much higher than the premiums for regular insurance. The high premiums, in turn, drive out anyone capable of getting any other insurance, further concentrating the most expensive patients. “High risk pools” violate the elementary principles of insurance. They mean that in opt-out states, there will no longer be coverage for those with pre-existing conditions unless they are affluent enough – and able to go without the rest of what they need to buy – to pay top dollar.
• So when does this piece turn to payback? At next year’s election, this bill will wake up the threatened middle class voters across the country. It may be argued that only in a limited number of districts will Republican moderate Congressmen face retribution from their swing-district constituents. After all, the country is gerrymandered to the point that there are not that many vulnerable Republican Congressmen. And some of them will say they voted against the bill.
• However, in the Senate, there is a different story. Over 20 of the 33 Senators up for election next year are Democrats. Democrats may worry if they can hold those seats. The answer is that the House bill is so threatening, so frightening, that angry voters will flock to the polls to vote in those races, too.
• Let’s hope so.

https://www.google.com/amp/s/www.fo...epublican-defeats-at-the-polls-next-year/amp/

 

[SueEllenRules!]

Warren Buffett Says Trump's Obamacare Repeal Bill Is 'Huge Tax Cut For Guys Like Me'
Berkshire Hathaway Inc. Chairman Warren Buffett took on the Republican Obamacare repeal bill that was passed by the House this week and called it “a huge tax cut” for the rich.

• The billionaire investor was speaking at Berkshire Hathaway’s annual shareholders' meeting in Omaha, Nebraska, which is attended every year by tens of thousands of investors and is referred to as the “Woodstock of capitalism.”
• “Medical costs are the tapeworm of American economic competitiveness,” Buffett said, as reported by the New York Times. “That is a problem this society is having trouble with and is going to have more trouble with.”
• The world’s second richest man – according to Forbes’ 2017 ranking – explained how healthcare costs were a bigger problem for American businesses than high taxes. While most developed countries publicly finance their healthcare spending, U.S.-based employers provide health insurance coverage for almost half of the population, often at high rates. Buffett added that the costs “will go up a lot more.”
• Buffett said if the bill pushed by President Donald Trump was in effect last year, his federal income taxes would have gone down by 17 percent.
• “So it is a huge tax cut for guys like me,” Buffett was reported saying by Reuters. “And when there's a tax cut, either the deficit goes up or they get the taxes from somebody else.”
• Trump’s proposed tax plan is expected to cut corporate tax to 15 percent – “to the benefit of shareholders” as Buffett put it – and the new Republican healthcare bill would also repeal most of the taxes that paid for the Obamacare, or as it is formally known, the Affordable Care Act.
• The GOP bill, however, has an uphill task ahead of it as it faces the Senate. Critics of the bill have said it will take away the healthcare benefits of millions of people and allow the rich to get tax breaks, just as mentioned by Buffett.
• “Donald Trump and Republicans just celebrated voting to let thousands of Americans die so that billionaires get tax breaks,” Trump critic and Vermont Sen. Bernie Sanders tweeted after the bill was passed in the House with a 217-213 vote. “Think about that.”
• Another Democratic senator who has been a vocal critic of the new bill said it would just make the rich wealthier while taking away basic healthcare from those in need.
• “Trumpcare isn’t a health care bill. A bill that destroys health care for millions to shovel cash to the rich isn’t a health care bill. #AHCA” Sen. Elizabeth Warren tweeted.
• Buffett is a Democrat who is said to be close to former President Barack Obama. He supported Democratic candidate Hillary Clinton during the 2016 election and has asked Trump to release his tax returns in the past.
• Buffett was joined by his longtime business partner, Charles Munger, who said both political parties – Republicans and Democrats – were facing great difficulty in thinking rationally about the issue at hand because they “hate each other so much.”

https://apple.news/AZMGFIge9P9yCL1uN6qt9mg

 

[SueEllenRules!]

GOP congressman: Republicans were 'irresponsible' to celebrate AHCA passage at White House
Wisconsin Rep. Mike Gallagher said Monday that his fellow Republicans were "irresponsible" for celebrating the House's passage of the American Health Care Act at the White House.

• "The Democrats were singing on the House floor, singing on the House floor after the vote," the GOP congressman said on "The Jerry Bader Show," a local Wisconsin radio program. "They were celebrating the vote going forward because they feel like it allowed them to get an electoral advantage and, honestly, the Republicans who went to celebrate at the White House — I disagree with that approach."
• He went on to ask, "What are we celebrating? We haven't passed a bill into law. The Senate's gonna re-write this thing. I've never seen the Packers pop the champagne at halftime. I just think that's irresponsible. And so I just would urge both sides to just lay down the traditional kind of political weapons if we can because this is a really complex topic and we need serious people working together to fix it."
• Gallagher, who voted for the bill, was referring his House colleagues' trip to the White House Rose Garden last week to tout their bill to replace Obamacare and to Democrats singing, "Na na na, hey hey hey, goodbye" to taunt Republicans on the House floor.
• In the interview, Gallagher also criticized President Donald Trump for saying to Australian Prime Minister Malcolm Turnbull that Australia, which has a universal health care system, has "better health care than we do."
• "Listen, if the President is going back and forth on what direction he wants Congress to go, that does create a problem, quite honestly," he said. "Because our system has evolved in such a way where presidential leadership is often the only thing that is able to resolve very difficult legislative issues. Now, I don't think it should have evolved that way. I think we have ceded far too much authority to the President but that's where we are."
• He later added of Republican senators, "I think for one, they're taking a look at the House bill and they're seeing where they can fix it and improve and so I'm not sure how much the President's statements are impacting that process. I would be surprised if they're impacting them at all. But it's not helpful to suggest, you know, that we wanna get a single payer system."

https://apple.news/ANWI-Jw-SR-6zxD8E3n1r5g

 

[darkshadows38]

i have no idea if trump care or whatever it's called is a good thing or not, but is the next president going to name it after himself or herself if we have a woman who actually isn't evil run next election.

 

[SueEllenRules!]

The 13 Senators Working On The Health Care Bill Are All Men

• According to a report first shared by Bloomberg, the 13 senators working on the American Health Care Act (AHCA) are all men. The chamber version of the bill is supposed to contain legislative revisions in order to pass the Senate, and at this moment, there is not a single woman in the list of the senators who are working to tweak the bill.
• The Senate version of the AHCA is expected to address growing concerns about the House bill. Many fear the House's version would affect the health insurance coverage of over 24 million Americans, and they are also concerned about the move to defund Planned Parenthood — a critical source of reproductive health care for millions of women and men in the United States.
• If the House bill passes as is, health care experts expect that the loss of health care coverage would be primarily due to the egregious uptick in premiums, the slashing of some $880 billion from Medicaid, and the possibility of insurers denying coverage for people with "pre-existing conditions."
• Among the 52 Republicans in the Senate, only five are women. Two of them are at odds with the health care bill: Susan Collins of Maine and Lisa Murkowski of Alaska. Apart from those two are Deb Fischer of Nebraska, Shelley Moore Capito of West Virginia, and Joni Ernst of Iowa.
• All of the Republican women — including Collins and Murkowski, who have previously voiced disagreement with defunding Planned Parenthood — are completely absent from the 13 all-male Republican list of senators.
• Although ABC News reported that Collins voiced optimism for the health care bill sitting in the Senate — claiming to treat it with a "new, fresh approach" — her absence, along with the four other female Republican senators, from the list should be a concern for everyone for a simple reason: zero women on a panel of 13 men essentially means there is no actual person with an immediate understanding of female health on that board.
• According to a report first shared by Bloomberg, the 13 senators working on the American Health Care Act (AHCA) are all men. The chamber version of the bill is supposed to contain legislative revisions in order to pass the Senate, and at this moment, there is not a single woman in the list of the senators who are working to tweak the bill.
• The Senate version of the AHCA is expected to address growing concerns about the House bill. Many fear the House's version would affect the health insurance coverage of over 24 million Americans, and they are also concerned about the move to defund Planned Parenthood — a critical source of reproductive health care for millions of women and men in the United States.
• If the House bill passes as is, health care experts expect that the loss of health care coverage would be primarily due to the egregious uptick in premiums, the slashing of some $880 billion from Medicaid, and the possibility of insurers denying coverage for people with "pre-existing conditions."
• Among the 52 Republicans in the Senate, only five are women. Two of them are at odds with the health care bill: Susan Collins of Maine and Lisa Murkowski of Alaska. Apart from those two are Deb Fischer of Nebraska, Shelley Moore Capito of West Virginia, and Joni Ernst of Iowa.
• All of the Republican women — including Collins and Murkowski, who have previously voiced disagreement with defunding Planned Parenthood — are completely absent from the 13 all-male Republican list of senators.
• Although ABC News reported that Collins voiced optimism for the health care bill sitting in the Senate — claiming to treat it with a "new, fresh approach" — her absence, along with the four other female Republican senators, from the list should be a concern for everyone for a simple reason: zero women on a panel of 13 men essentially means there is no actual person with an immediate understanding of female health on that board.
• Without women on that list, it is hard to believe that any male Republican on the panel meant to work on the bill is remotely aware of the vulnerability a woman faces in her life when it comes to her health. By potentially placing sexual assault survivors at risk, targeting abortion coverage, and jeopardizing birth control, the bill necessitates a gender-balanced review in order to have any chance at being fair to women.
• It is even harder to believe that this list of 13 Republican men understands how potentially eliminating maternity care from health care could endanger the lives of millions of expecting mothers in America. Not only that but the bill's requisite to treat particular issues as "pre-existing conditions" disproportionately harms women.
• With no woman in that sea of testosterone, it is unlikely that the Senate version of the American Health Care Act will be any different than its House edition.

https://www.bustle.com/p/the-13-senators-working-on-the-health-care-bill-are-all-men-56291

 

[SueEllenRules!]

23 million more uninsured under House Obamacare repeal, CBO says
Roughly 23 million more people would be uninsured over a decade if the House-passed Obamacare repeal bill becomes law, according to a highly anticipated CBO analysis that could complicate Senate Republicans' hopes of getting their own bill through the upper chamber.

• The nonpartisan scorekeeping office also forecasts the House plan would cut the deficit by $119 billion over a decade, primarily because of its cuts to Medicaid and private insurance subsidies.
• House Republicans approved the bill in April without waiting for the CBO score.

23 million more uninsured under House Obamacare repeal, CBO says - POLITICO
https://apple.news/A838brIzlSGamZ4LlGfxceQ

 

[SueEllenRules!]

The Congressional Budget Office just handed Democrats a gift for the 2018 campaign
The long-awaited Congressional Budget Office analysis of the American Health Care Act is out and the news isn't terribly good for Republicans hoping to avoid major electoral losses in 2018.

• According to the CBO, the AHCA will ensure 23 million fewer people than Obamacare by 2026. That's broadly consistent with the 24 million number the earlier health care legislation pushed by Republicans — but never voted on — produced.
• In a bit of good news for Republicans, the AHCA is expected to reduce the deficit by $119 billion, less than the $151 billion estimated in the original bill but still a significant chunk of change.
• The details of the CBO report — unstable markets! rising premiums! — will be debated endlessly in Washington and in health care circles around the country.
• But, it's important to remember that the average person has NO idea what the CBO is or does or what its "scoring" means. The public pays only passing attention to these sorts of things that so captivate political Washington. What the average person does care about is bottom lines. And, on that front, Republicans look likely to lose.
• There are two big bottom line numbers in this CBO report: 23 million and $119 billion. The question is which matters more: The delta between how many people Obamacare is covering and how many Trumpcare is projected to cover OR the money the country is saving on the debt.
• One of these things is an esoteric number. The other is a real-world one. And the latter beats out the former every single time in campaigns.
• Consider that for the average person our national deficit is a very, very hard concept to grasp. Sure, we owe lots of money. And, sure, owing that money — particularly to China! — is a bad thing. But, the size of the deficit is not something that has a day in, day out impact on most peoples' lives. In fact, I'd be willing to wager a large sum of money that the vast majority of people in the country don't think about the federal deficit more than once a year — if that.
• Health care — particularly access to it — is something that touches large swaths of the country on a weekly or monthly — if not daily — basis. It's something that every single person in the country has experience — and often frustration — with. The idea that 23 million people who would have health care if President Trump and Congressional Republicans do nothing will lose it under Trumpcare is going to be an extremely difficult case to make.
• Add to that the fact that House Republicans passed the bill without even knowing how much it would cost or how many people it would leave uninsured makes it all the worse politically speaking.
• Imagine this ad running against an endangered House Republican who voted for the AHCA: "Congressman X voted for Donald Trump's health care plan before he even knew what the bill would do. Now, a non-partisan budgeting agency say the legislation will eliminate health care options for 23 million people."
• Pretty damning, right?
• Republicans can — and already are — pushing back against the CBO. "The CBO has a long track record of being way, way off in its modeling, with predictions often differing drastically from what actually happens," Republican National Committee spokesman Mike Reed said in an email sent to reporters shortly after the CBO release. The problem is that the numbers are the numbers. Not everyone likes the CBO, but they are the gold standard when it comes to analyzing costs and impacts of legislation.
• And remember that, in politics, the shortest and most succinct argument almost always wins. The Democratic argument goes like this: "The AHCA will leave 23 million more people uninsured." The Republican argument? "Well, that number is produced by a group known for not being totally accurate in its predictions and plus we are going to reduce the deficit by some too!"
• It's not even close. That's a loser for Republicans. And a massive gift for Democrats looking to take back the House — and hold their ground in the Senate — next November.

The Congressional Budget Office just handed Democrats a gift for the 2018 campaign - CNN
https://apple.news/AcLzNyNw4Rs-d8fjIxyJUFg

 

[SueEllenRules!]

The GOP Health Bill Is As Unpopular As Ever
Americans care more about health care than any other issue, including the economy and Trump's relationship with Russia.

• The Republican bill to repeal Obamacare remains as unpopular as ever, a new survey finds.
• Just under one-third of the public favored the American Health Care Act after it passed the House in early May ― and that may have been a ceiling. A new HuffPost/YouGov poll shows 26 percent of the public supporting the bill, and 44 percent opposing it. A significant portion, 31 percent, remains undecided. The poll was taken before the Congressional Budget Office released its new estimate of the bill’s impact on Wednesday afternoon.
• Americans are split on the value of the current health care law, according to the poll, with 41 percent in favor and 42 percent opposed. (Other recent surveys have found somewhat higher support.) But by a nearly 2 to 1 margin, 42 percent to 23 percent, they say they expect that the GOP alternative would be a change for the worse, not the better.
• Just 12 percent of Americans expect the GOP’s bill to affect them positively if it passes, while 31 percent say it would leave them personally worse off. The majority, 57 percent, say they wouldn’t be affected or that they’re not sure what the effects would be.
• Sixty-two percent of Trump voters say they support the AHCA ― that number is up from March but down from the 75 percent who favored it earlier this month. Just 3 percent of Clinton voters support the bill, which represents little change from past surveys.
• As in previous polls, staunch opposition to the bill far outweighs any fervent support. Just 6 percent of people strongly favor the bill, while more than five times as many, 32 percent, strongly oppose it.
• One reason that uncertainty about the bill remains as high as it’s ever been: The AHCA has struggled to stay in the news amid a rapid-fire accumulation of other political stories, including controversies over the Trump administration’s relationship with Russia. While 83 percent of people say they’ve heard at least something about the new bill, just about one-third say they’ve heard a lot about it recently.
• And although Americans are both unenthused about the AHCA and bothered by some of the most recent Russia stories, there are signs that the former is currently the more politically damaging issue. For one thing, Trump’s supporters have rallied to his side around the Russia revelations in a way they haven’t with the health bill.
• For another, people simply seem to care a lot more about their own health care. Asked to pick the two issues most important to them, 47 percent of Americans named health care, outranking every single other issue listed. The economy ranked second, at 38 percent. Immigration came in at 20 percent. Just 12 percent chose Trump’s relationship with Russia as one of the issues most important to them.
• The HuffPost/YouGov poll consisted of 1,000 completed interviews conducted May 22-23 among U.S. adults, using a sample selected from YouGov’s opt-in online panel to match the demographics and other characteristics of the adult U.S. population.

The GOP Health Bill Is As Unpopular As Ever - HuffPost
https://apple.news/Aota-HEdQQcSt2ss-rXaQ1g

 

[SueEllenRules!]

Health Care Bill Impact on Premiums, Uninsured, Pre-existing Conditions
The GOP health care bill would insure 23 million fewer people than current law after a decade, while potentially impacting many with pre-existing conditions, according to the nonpartisan Congressional Budget Office.

• WASHINGTON — The GOP health care bill would insure 23 million fewer people than current law after a decade, while potentially impacting many with pre-existing conditions, according to the nonpartisan Congressional Budget Office.
• The bill would spend $1.1 trillion less on health care and use the savings primarily to finance large tax cuts for high-income earners and medical companies.
• While some Americans would see lower premiums, CBO concluded that many people with pre-existing conditions would no longer be able to afford insurance and that many who received coverage would pay thousands of dollars more in out-of-pocket expenses.
• The findings in the analysis of the bill that passed the House stand in stark contrast to President Donald Trump’s promise to provide “insurance for everybody” that would cover pre-existing conditions, lower deductibles and shield Medicaid from cuts.
• The House voted on the American Health Care Act earlier this month without waiting for the CBO to weigh in, an unusual move that had the potential to derail the bill entirely if the score failed to meet certain procedural requirements.
• While the topline numbers were little changed from a previous version of the bill that was withdrawn from consideration, which the CBO found in March would insure 24 million fewer people and save $150 billion, the report found that the latest changes to Obamacare regulations would make insurance unattainable for many sick people and raise costs for others.

"Essential Health Benefits"

• The effect would be most concentrated in states that chose to opt out of Obamacare’s “essential health benefits,” which requires insurers to cover categories like hospitalization or prescription drugs, and in states that waived Obamacare’s guarantee that insurers charge people the same premium regardless of pre-existing conditions.
• These waivers formed the core of a deal with the House Freedom Caucus that secured enough conservative votes to pass the bill. The CBO predicted about 1/6th of the population would live in states that waived both provisions.
• In particular, the report predicted that “spending on maternity care and mental health and substance abuse services could increase by thousands of dollars in a given year” per enrollee as insurers would sell plans on the individual market that did not cover these previously required benefits.
• In addition, insurers would be able to impose annual and lifetime limits, a practice banned by the Affordable Care Act, on benefits on longer considered essential by states. This limits could potentially return even for large employer-based plans, which the CBO noted can base their benefits package on any state's regulations.
• The CBO’s findings ran directly counter to claims by Republican leaders that their bill would provide adequate — even superior — protection for people with pre-existing conditions. Far from it, the study predicted insurance markets would become “unstable” in waiver states as people with pre-existing conditions faced higher and higher premiums that many would be unable to afford.
• Mindful of these concerns, Rep. Fred Upton (R-MI) brought moderate Republicans on board with the AHCA by negotiating an $8 billion deal to fund high risk pools for sicker consumers to buy insurance. But the CBO found the money “would not be sufficient to substantially reduce the large increases in premiums” for the affected people, a conclusion that outside health policy experts have echoed as well.

Impact on the young, old

• As was the case with the original bill, premiums would increase dramatically for older low-income Americans, especially those in areas — often rural — that have higher medical costs. The average 64-year-old making $26,500 would pay between $13,600 and $16,100 in premiums per year versus just $1,700 under current law, which provides more generous subsidies and further limits the amount insurers can charge based on age.
• For some younger and higher-income customers, the bill would lower premiums. In states that waived Obamacare regulations on essential health benefits and made moderate changes — about one-third of the population, by CBO’s estimate — average premiums would be 20% lower in a decade compared to current law but for plans that cover fewer expenses.
• A 21-year-old making $68,200 a year, for example, would be among of the biggest winners: Their average premiums would drop from $5,100 to between $1,250 and $1,750 depending on their state's regulations.
• In states that waived EHB’s and protections for pre-existing conditions, premiums would be lower for some healthy people but “a few million” consumers would purchase plans that were so skimpy as to “not cover major medical risks” and thus not be considered insurance.
• As was the case with the previous bill, CBO estimated that the bill would cut Medicaid spending by over $800 billion, leaving program with 14 million fewer people enrolled after a decade.
• The money saved by slashing Medicaid and reducing subsidies for people to purchase private insurance would largely go to repealing Obamacare's taxes on high-income earners and medical companies, which would cost $664 billion over 10 years. The bill would also reduce revenues by another $210 billion by repealing penalties for individuals who choose not to purchase insurance — the so-called individual mandate — and for employers who don't provide coverage.
• The Senate is already working on its own health care bill, but is taking a slower approach and has yet to release details on a framework. There’s still a possibility that major provisions of the House bill, especially the changes to regulations negotiated by the House Freedom Caucus, will have to be removed to comply with procedural rules.
• But the CBO score is sure to fuel a fresh round of attacks from Democrats and health advocacy groups, both of which have sharply criticized the Republican efforts. Polling has shown public opinion souring on the bill: A Monmouth University survey released Wednesday found just 32% of respondents approved of the AHCA versus 55% who disapproved.

Health Care Bill Impact on Premiums, Uninsured, Pre-existing Conditions - NBC News
https://apple.news/AH_1Yk2NSRmWmQt1JdQuX8w

 

[SueEllenRules!]

GOP senators expect health care vote soon — even if they can't get to 51
Several members of the Senate Republican leadership said Monday they expect there will be a vote on a health care bill, even if the tense negotiations underway now to find consensus in the Republican conference are unsuccessful and leaders are unable to forge an agreement that can pass.

• Sen. John Thune of South Dakota said it is important they try to pass a bill in the next few weeks even if the vote fails.
• "I still think in the end there is a huge reason why we have to get to 50 on this," said Thune, the third-ranking GOP leader. "Obviously, we're going to have a vote on this one way or the other. But if we don't pass something and we go into '18, you know, it's on us to try to get this fixed."
• Sen. Roy Blunt of Missouri, another GOP leader, was asked about recent downbeat assessments from other Republican senators — like Richard Burr of North Carolina, who said he didn't think a deal could be reached this year.
• "I think the leader is still optimistic about it and we'll see where it goes here in the next few days," Blunt said, referring to Senate Majority Leader Mitch McConnell, who is leading the talks.
• Asked if this is "crunch time," Blunt said yes.
• "I don't think this gets better over time, so my personal view is that we've got between now and the Fourth of July to decide whether the votes are there or not and hope they are," he added.
• A defeat could be embarrassing to Republicans, who have long pushed the repeal and replacement of Obamacare. But having a vote — even if it fails — could provide some closure on the issue and allow the GOP-controlled Congress to move onto other issues like government spending, the debt ceiling and more.
• Sen. John Cornyn, the chamber's No. 2 Republican, also told reporters Monday his caucus is reaching a time to "make decisions."
• "I know there's been a lot of work done at the staff level but I think we're getting to the point where ... we need to make decisions and I think we're ready to land this airplane. It's been in the air for seven years and it's time to come in for a landing — hopefully a soft landing," the Texas senator said.
• Asked about Burr's grim assessment Friday, Cornyn said: "Suffice it to say, I'm a little more optimistic."

GOP senators expect health care vote soon -- even if they can't get to 51 - CNN
https://apple.news/Alyva1cA2QVG4jabGZ-3ojQ