Nel's New Day

January 14, 2017

GOP Health Care Plan: Take from the Poor, Give to the Rich

Filed under: Health Care — trp2011 @ 10:17 PM
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Without a replacement plan for the Affordable Care Act (ACA), 24 million people who gained health insurance under the law may lose it. Donald Trump (DT) has promised that no one will lose any health insurance, but GOP members of the Congress aren’t backing up his guarantee.

While the Republicans plan to take health care from the poor, they give tax cuts to the rich. The top 1 percent of earners would get an average tax cut of $33,000 if the ACA is repealed, and those in the top 0.1 percent would get an average cut of $197,000. Repealing ACA’s taxes removes the 0.9 percent Medicare payroll surtax on wages above $200,000 ($150 billion) and the 3.8 percent surtax on investment income above the same threshold ($250 billion). That $800 billion increase in the deficit is about half the loss.

Another quarter of the revenue loss comes from repealing various fees on insurance companies, medical device companies, and drug manufacturers. About $450 billion of the $1.10 trillion of costs in repealing the ACA’s Medicare comes from reversing Medicare Advantage cuts. Another $500 billion would come from ending reductions in the growth of provider payments in fee-for-service Medicare. This is just for future cuts. If past cuts are reversed, about $200 billion to $250 billion more would be lost. In addition, Paul Ryan is struggling to pay for his planned $6 trillion tax cut for the wealthy.

Major losers from an ACA repeal are small business owners. With self-employed people, they represent 50 percent out of ACA customers.

While the GOP wants to repeal the ACA within a month, DT said at a news conference Wednesday in New York City that a plan to replace the Affordable Care Act would wait until after Secretary of Health and Human Services nominee Rep. Tom Price of Georgia wins confirmation.

But the chairman of a key committee involved in both repeal-replace and confirming Price said his confirmation may not take place until around the President’s Day recess in February. Sen. Lamar Alexander (R-TN) also doesn’t want to make decisions until he consults with governors who will be in town around Presidents’ Day. Several GOP governors are joining Democrats to oppose the repeal.

health-chart

As Republicans blithely refer to Obamacare repeal, they probably don’t know how many people are covered by the ACA. The above chart shows the health status of people in the U.S. a year ago. Since then, Medicaid has increased from 71 million to about 74.4 million, largely from Louisiana expanding the program.

  • Green sections covering 46 percent of the nation are for government employees, including the military.
  • Orange sections are for Medicare—also threatened—plus Medicaid Advantage and Disability (under 65 years old).
  • Burgundy sections are NON-ACA Medicaid: Adults, Children and CHIP.
  • Blue sections are the greatest areas impacted by the ACA: Medicaid/CHIP expansion, the subsidized individual market exchange enrollees, and BHP enrollees in New York & Minnesota.
  • Yellow sections are the unsubsidized individual market. These people are enrolled in the ACA exchange but paying full price and off-exchange.
  • Gray/silver section is miscellaneous: the Indian Health Service, Student plans, NY’s ‘Child Health Plus’ program, etc.
  • Red sections are those still uninsured, down to about  27 million people. It includes people ineligible for either Medicaid or the exchange in 19 GOP states and undocumented immigrants. Others earn too much for ACA subsidies or cannot get them because of their employers.

In December House Speaker Paul Ryan (R-WI) said, “We will give everyone access to affordable health-care coverage.” He added that pre-existing conditions are “a very important feature of any health-care system.” DT’s counselor Kellyanne Conway promised that DT will keep the pre-existing conditions. That, of course, was before the GOP senators voted against it along with other health care provisions to help people. Ryan also promised that the GOP will ensure that “no one is worse off.”

At his press conference this week, DT described his replacement model:

“They can say what they want, they can guide you anyway they wanna guide you. In some cases, they guide you incorrectly. In most cases, you realize what’s happened, it’s imploding as we sit.”

He also made the promise that “we’re going to have a health care that is far less expensive and far better.” He didn’t answer the question about whether everyone covered now will continue to have coverage.

In a letter to the Oregonian (January 14, 2017), Terry Weiss of Philomath superbly explained the idiocy of the proposed health care repeal:

“If a little old lady in Oregon can figure this out, why can’t someone in Washington? Medicare, Medicaid, and Obamacare account for thousands of jobs and billions of dollars to healthcare providers and suppliers. If any or all are removed, many thousands of living wage jobs will be lost and millions of dollars in income will vanish. Tax losses will be huge to federal and state budgets. If you can’t wrap your mind around the human aspect—letting people die or go untreated for illnesses and injuries—surely the enormous negative effect on the economy should make you pause.

“Spend billions of dollars dismantling a functional and economical system with only three percent overhead to administer Medicaid and medicare. Then spend more billions putting together another system that is untested and unknown and will take place to put in place. This is efficient government spending?

“I can’t figure out why the first order of business for this Congress and president is to tank the economy and take aay living-wage jobs. The opposite of the promises made by one and all. I known campaign promises tend to be less than truthful, but this is unbelievable. Where are the political commentators, representatives of the medical industrial complex, DEOs, and decent human beings?”

As another “little old lady” in Oregon, I worry about the IQ and common sense of the people who are leading our government. For example, Rep. Bill Huizenga (R-MI) suggested that people shouldn’t go to the doctor immediately with an illness or injury. He proudly cited his own experience by making his son wait a day to go to the emergency room for an arm injury. He saved money, but the arm was broken. According to Huizenga, that’s the reason that people shouldn’t get money for health care. Without necessary insurance, they could just wait until the next day—or perhaps longer.

This level of stupidity is not new. Former House Majority Leader dick Armey (R-TX), leader and instigator of the Tea Party, said, “The largest empirical problem we have in health care today is too many people are too over-insured.” That was when almost 40 million people lacked health insurance.

People who complain about the high cost of insurance refuse to accept the fact that the private market is driving up costs. Medicare, a government program, saw its costs rise by an average of 1.4 percent from 2010 to 2015, less than half the cost increase for private insurers even after the ACA forced them to charge less for “administrative costs.” As the above letter stated, these costs are three percent while the ACA allows private insurers to spend up to 20 percent–and that’s less than in the past.

A year ago Paul Ryan signed legislation to repeal the ACA and cut off federal funding to Planned Parenthood. The bill didn’t succeed, but Ryan and his colleagues had a good time taking away health care for 24 million people. Chip Somodevilla/Getty Images [visual]

WASHINGTON, DC - JANUARY 07:  Speaker of the House Paul Ryan (R-WI) (3rd L) shares a laugh with Republican members of Congress after signing legislation to repeal the Affordable Care Act, also known as Obamacare, and to cut off federal funding of Planned Parenthood during an enrollment ceremony in the Rayburn Room at the U.S. Capitol January 7, 2016 in Washington, DC. President Barack Obama has promised to veto the bill.  (Photo by Chip Somodevilla/Getty Images) *** BESTPIX ***

Obamacare has been a success: fewer people are uninsured; hospitals’ uncompensated care costs have fallen by over 50 percent;  overall national health spending as a share of GDP has dropped faster than predicted; the growth in spending on health needs has slowed to one-third of the average in the early 2000s; the increase in premiums is only 60 percent of the average during the ten years before the ACA; and “Obamacare” is more popular. Even little old ladies know that.

January 13, 2017

So How’s That Obamacare Repeal Going?

Why did people hate the Affordable Care Act, a law that helped people have better health care and live longer? Conservative leadership fed lies to their constituents—like this one from House Speaker Paul Ryan (R-WI) at a town-hall event this week–because they feared a Democratic plan would be popular. Ryan’s mistake was taking a question from a man who owns a small business in a red state, worked for the Reagan and Bush campaigns, and opposed the ACA. That was before the ACA saved his life after his life-threatening cancer was treated, thanks to “Obamacare.” Jeff Jeans said, “I want to thank President Obama from the bottom of my heart because I would be dead if it weren’t for him.”

Ryan’s response? The flat-out lie that the ACA is a “death spiral” because people won’t buy insurance when it gets too expensive.  If Ryan were right, enrollment numbers would be dropping. But instead they’re skyrocketing. The proportion of young adults is steady, proving that the mix of people enrolling this year is less likely to be sicker and more expensive. And this is happening despite the uncertainty about the future of health care for the people in the United States, thanks to the unhealthy obsession in the GOP Congress about a repeal.  Lies are failing with the public, however, because 75 percent object to repealing if there isn’t even a replacement.

Today, the U.S. House began their process of destroying health care for the millions and millions of people in the United States. A vote of 227-198 with only nine GOP defectors approved the budget resolution that the Senate passed in the dark of night earlier this week. The bill doesn’t specifically address the ACA, but the passed “budget reconciliation” is needed to kill off the ACA because of the danger from a Senate filibuster.

Rep. Charlie Dent (R-PA) warned that their action could send insurance markets into a collapse. Rep. Justin Amash (R-MI) tweeted, “Most massive budget in U.S. history passed 227-198. It adds more than $9 TRILLION to the debt over the next decade.” House Majority Whip Steve Scalise (R-LA) argued that the House had to pass the bill because they had campaigned on it.

The Senate vote allowed non-binding amendments showing the chamber’s position. These are positions that the GOP Senate oppose:

Protect people with pre-existing conditions: 52 million people in the U.S.—25 percent of non-elderly people—have pre-existing conditions. Before ACA, they were frequently denied any coverage. Only two Republicans voted in support of keeping these conditions in a health care plan.

Let young adults stay on their parents’ plan: Over six million young people 26 years old and younger have gained health insurance since this plan went into effect in 2010. Surveys show 85-percent approval of this provision. Again only two Republicans support this condition.

Maintain access to contraceptive coverage: The ACA has caused spending on contraceptive health care to drop 20 percent. Only two Republicans vote in favor of this amendment.

Ensure Medicaid expansion stays in place: 11 million low-income people benefited from this provision in 2015, and thousands of jobs were created for direct care workers.  Republicans unanimously defeated this amendment.

Protect children on Medicaid or CHIP: GOP Senators blocked this amendment.

Protect veterans’ health care: Republicans blocked an amendment to make it harder to restrict veterans’ access to VA health care.

Republicans demonstrated that they oppose insurance that requires pre-existing conditions, puts children up through age 26 on the parents’ policy, provides free contraceptive care, helps low-income people and children, and protects veterans. These are the leaders who want to take people’s health care: Vice President-elect Mike Pence with Senate Majority Leader Mitch McConnell and Sen. John Barrasso (AP Photo/Cliff Owen).

health-care-killers

The public opposition to ACA repeal began when more and more people understood that the congressional goal was to take away health care without any new plan. Sen Bob Corker warned that repeal without replacement would be “not very appealing.” Even ultra-conservative Sen. Ron Johnson (R-WI) asked for a replacement “game plan.” Passing the repeal/replacement also requires 60 votes in the Senate because of the filibuster.

The derailing of the grand repeal plan began just four days after the GOP Congress took over the country. That’s when Republicans determined that the GOP project to Make America Sick Again would cost more than four times than the extremely expensive Iraq War while it kills millions of private sector jobs. Republicans had a solution: hide the cost of their repeal. Page 25 of the new rules package passed by GOP House members stated that the Congressional Budget Office (CBO) should estimate the cost over $5 trillion—except Obamacare. Unfortunately, that plan didn’t work either: the word got out that what the GOP calls an “appropriate” level of public debt is actually an unnecessary anti-job debt spike.

Add to that problem Ryan’s decision to defund Planned Parenthood through a bill to repeal Obamacare, and the bill riled more conservatives. Two moderate female GOP senators opposed this suggestion, and the program is highly popular throughout the nation.

Some of the most conservative senators—Rand Paul (R-KY), Bob Corker (R-TN), and Tom Cotton (R-AR) for example—are reluctant to vote for the repeal because of the increasing deficit. Paul wants an immediate repeal but isn’t happy about the $10 trillion dollars added to the deficit. Even ultra-conservative Sen. Lamar Alexander (R-TN), chairman of the Health Committee, declared that it’s not smart to repeal without a replacement.  Sens. Susan Collins (R-ME) and John McCain (R-AZ) don’t like Repeal without Replace. Six dubious senators will put the 48 Democrats opposing the repeal to a majority of the chamber. Lisa Murkowski (R-AK) might join them because she, like Collins, doesn’t like the idea of defunding Planned Parenthood.

The repeal is rapidly coming to a head because GOP leadership wants to force the development of legislation by January 27. Wanting to postpone the deadline until March 3 are at least five GOP senators: Bill Cassidy (LA ), Susan Collins (ME), Bob Corker (TN), Lisa Murkowski (AK), and Rob Portman (OH).

Congressional Republicans are also facing opposition from GOP governors. John Kasich (OH) and Rick Snyder (MI) have already complained about the loss of Medicaid. Kasich said the hospitals need Medicaid that “has worked very well in this state.” He said that the program covers 700,000 of his residents; Snyder agreed when talking about his 642,000 people in Michigan. Other GOP governors opposing the repeal thus far are Charlie Baker (MA),  Asa Hutchinson (AR), and Brian Sandoval (NV).

Kasich eloquently expressed his concern:

“Let’s just say they just got rid of it, didn’t replace it with anything.” What happens to the 700,000 people [in Ohio]? What happens to drug treatment? What happens to mental health counseling? What happens to these people who have very high cholesterol and are victims from a heart attack? What happens to them?”

The GOP desire to balance the federal budget occurs only with Democratic presidents. Republican legislators showed no longing for “fiscal responsibility” during the Reagan/Bush years. Under Clinton, their need for zero deficit returned, but unfortunately for them, Clinton showed a surplus by the end of his two terms. In the two following Bush/Cheney terms, Republicans asserted that “deficits don’t matter.” They ran up trillions of costs for two wars, two tax-cut packages, Medicare expansion, and the Wall Street bailout.

During the two terms of Democratic President Obama, conservatives screamed about the ballooning deficit set in place by his predecessor. The GOP even lowered the credit rating of the United States and then closed down the country because of their demand for a balanced budget. With a prospective GOP president, the majority of GOP Congressional legislators started to repeal a law vastly increasing the deficit, a law that keeps people alive. Their plans would put the public debt to at least $29.1 trillion by 2016, according to the budget resolution they passed.

People are already losing jobs because of the GOP’s declaration that they will “repeal Obamacare.” The loss of health care for millions of people is already sending shock waves throughout the $3 trillion-a-year health system. Hospitals estimate that the repeal will cost them $165 billion within five years and trigger “an unprecedented public health crisis” if sick people can’t get care. The Advisory Board Company, providing services to health care firms, has already laid off 200 people partly because hospitals vastly decreased spending after the election.

With much lower health coverage, hospitals and health providers could find themselves on the hook for up to $1.1 trillion for uncompensated care in the next decade, causing the collapse of finances in hospitals serving needy populations. Their only solution would be to curtail services and reduce workforce, impacting health care access even for the insured. Illinois alone would suffer a loss of 95,000 jobs and $13.1 billion. Forty percent of the state’s hospitals are already in the red or close to it.

The question is whether the GOP can get over its gridlock and lack of bipartisanship to pass a “repeal and replace” law. I wouldn’t bet on it.

December 8, 2016

FDA’s Losses

I’m addicted to The Rachel Maddow Show, as anyone who knows me can tell you. She’s one of the very few bright lights since November 9, 2016. Last night she had a particularly spectacular segment on Donald Trump’s (DT) proposal for the head of the Food and Drug Administration. As we’ve watch the attempted destruction of the United States through DT’s nominees, this one—hard as it may be to believe—seems to stand out.

The transition team is considering Jim O’Neill, a managing director for Silicon Valley billionaire Peter Thiel’s Capital Management. Thiel himself is an interesting figure who believes that the United States was destroyed in the 1920s when women got the vote. Last summer he was the first openly LGBT person to speak at the GOP convention and endorsed the platform that opposes hate-crime laws, HIV funding, and appropriate bathroom use by transgender people, calling it a “distraction.” At the same time, he supports laws to deny services to LGBT people.

Thiel pays students to drop out of college and sponsored Hulk Hogan’s lawsuit against the Gawker that outed Thiel almost ten years ago. The lawsuit was an objection to the “damaging way of getting attention by bullying people even when there was no connection with the public interest”—odd when one considers that this is DT’s MO. The co-founder of PayPal donated $1.25 million to DT’s campaign and was appointed to the highly homophobic transition team where he worked with Ken Blackwell who compares homosexuals to arsonists.

But I digress. Back to Jim O’Neill. As a board member of the Thiel-backed Seasteading Institute, he supports creating mini-cities at the bottom of the ocean to save the world from the devastating place that the United States has become. In a 30-minute speech, O’Neill said, “We can all wish that existing governments will somehow stumble into freedom, but if we want to achieve freedom, seasteads are by far the best prospect.” The video of this speech has magically disappeared from the Seasteading website since he was considered for the FDA position but is still available here. Thiel’s reason for Seasteading is to avoid taxes because he could use the “cities” to morph offshore companies into offshore countries with no responsibility or accountability to any government.

With no medical or scientific background, O’Neill thinks that drugs don’t need to be independently tested before they go on the market. Two years ago, he announced that his idea to reform the FDA was “approving drugs after their sponsors have demonstrated safety—and let people start using them, at their own risk, but not much risk of safety. Let’s prove efficacy after they’ve been legalized.” When he was in George W. Bush’s Health and Human Services Department, he opposed the regulation of companies that perform laboratory-developed drug tests with algorithms. Another of O’Neill’s beliefs is that anti-aging medication will reverse aging and that people can live forever.

The FDA has control over regulations for food, drugs, medical devices, dietary supplements, cosmetics, and tobacco—much of the consumption in the U.S. O’Neill claims that the lack of a free market in health care causes negative health consequences that would not occur in a free market. At the same time DT is attacking the free market system. Republicans decry DT’s interference that brought $7 million to Indiana’s Carrier as “crony capitalism” as well as his pride in dropping stock prices for Boeing with one tweet. DT also claims that he will “bring down drug prices,” against causing drops in pharmaceutical stocks.

O’Neill has also said that organ donors should be allowed to be paid. “There are plenty of healthy spare kidneys walking around, unused,” he said in a speech at a 2009 Seasteading conference.

This week, Congress readied the weakening of the FDA for DT by passing the 21st Century Cures Act. On the surface—and from the mainstream media—the public may believe that it should embrace the bill. To do so would ignore the ability of ineffective or dangerous medicines to easily reach people without reining in drug prices. Passing the bill, however, was a given because it funds Vice-President Joe Biden’s “Cancer Moonshot” initiative which covers all the rank stench of its other effects.

Some of the bill’s promises are already in existence, for example a six to ten month turnaround for evaluations of almost all new drug applications. There is also no evidence that current requirements cause higher drug prices. These are some of the negative provisions:

  • The funding for such programs such as addressing the opioid addition is not guaranteed for next year or after that.
  • The promised “patient-focused” drug development merely means that a brief statement about this experience will be made public.
  • Earlier provisions helping the public have disappeared from the final bill: (1) requiring third parties to certify the safety of medical devices after modification by companies; and (2) granting permission for shorter or smaller clinical trials for medical devices.
  • A provision allowing the FDA to use “real world evidence” for drug testing relies on the Secretary’s discretion. (Consider O’Neill’s “discretion” as Secretary of the FDA.)
  • The act eliminates “informed consent” when “the proposed clinical testing poses no more than minimal risk to the human subject and includes appropriate safeguards to protect the rights, safety, and welfare of the human subject.” The FDA gets to decide “minimal risk.”
  • Stem-cell therapies are slightly expedited through cutting back testing and permitting these in the marketplace before they have been proved effective and safe. This provision benefits wealthy Texan Ed Bosarge, who runs a stem-cell firm, gave $3 million to GOP Mitch McConnell’s super PAC, the Senate Leadership Fund and donated another $4.7 million to other GOP super PACs since Citizen United.
  • The bonus for the pharmaceutical company is their new ability to promote “off-label” uses of drugs, widely expanding their markets and avoiding the requirement of FDA approval for new indications.
  • The act cuts $3.5 billion, or about 30%, from Obamacare’s Prevention and Public Health Fund, which fosters work to prevent Alzheimer’s disease, hospital-acquired infections and other conditions.

Promoters of the act complained that the FDA acted as a bottleneck for drug companies, but the agency usually acts as a rubber stamp for them: it approved 89 percent of last year’s applications for new drug uses. Lessened scrutiny is demonstrated by such events as the need to pull Merck’s Vioxx, a painkiller and arthritis drug the FDA approved in 1999, five years later because it raised the risk of heart attacks. By then, 88,000 people in the U.S. suffered from heart attacks, and 38,000 of these people died.

Essure, a device implanted in women’s fallopian tubes as an alternative to permanent surgical sterilization and marketed by Bayer, received expedited approval in 2002 based on “two nonrandomized, nonblinded, prospective studies that lacked a [control] group and enrolled a total of 926 women.” Since then, research shows serious potential side effects and concerns that it is not safer than tubal ligations as well as appearing less effective in preventing pregnancy. Essure is still on the market but is required to have health risks warnings on the label.

Winners of the bill are the drug companies, medical device manufacturers, the National Institutes of Health, and Joe Biden. Losers are the FDA, aging and deteriorating labs, randomized clinical trials, customer advocacy groups, and regenerative medicine that would expand treatments for stroke victims and people suffering from Alzheimer’s, Parkinson’s and diabetes. The final draft does not permit new regenerative medicine products to skip the Phase 3 trials.

About 1,455 lobbyists on behalf of over 400 companies and other organizations at a cost of $500,000 succeeded in pushing through the legislature. It offers “something for everyone,” funding important projects while adding danger and unnecessary expenditures that benefit drug companies. If O’Neill is nominated and confirmed as the FDA Secretary, he will create more danger for people in the United States.

The bill passed the House in 392-to-26 with my representative, Kurt Schrader, in the majority and preening about his “success.” The Senate supported it in a 94-5 vote, and I’m proud of both my Oregon senators who voted in the minority, agreeing with Sen. Elizabeth Warren (D-MA) who said that she knows “the difference between compromise and extortion.” She called the NIH funding a fig leaf, “and most of that fig leaf isn’t even real. Most of the money won’t really be there unless future Congresses pass future bills in future years to spend those dollars.” Warren knows that most of her Democratic colleagues were bought off with false promises.

August 12, 2016

Equal Pay for Women’s Soccer Team; ACA Makes People Healthier

The U.S. Women’s National Soccer Team has won three World Cup titles and four Olympic gold medals, but they are still get paid just 72 percent per game as the U.S. men’s team—that didn’t even qualify for the current Olympics. The women’s team generated almost $20 million more in revenue than the men’s team, and their World Cup final last year was the most watched soccer game in history. Liza Bayless wrote:

“The US women’s national team collectively earned $2 million for their 2015 World Cup win. The US men’s national team — who has not made it past the quarterfinals of a World Cup in more than eight decades, and has never won — earned $9 million for their loss in the round of 16 at the 2014 Men’s World Cup in Brazil. Germany, the winning team, collected $35 million….

“The women’s team brought in more revenue in the 2016 fiscal year (granted, a World Cup year) and is also projected to outperform the men in revenue and profit in 2017, when neither team is playing a World Cup. US Soccer expects they will bring in almost twice as much as the men–$17.6 million versus $9 million. And yet the federation pays its female players $1,350 for winning an exhibition match while the men receive up to $17,625 for doing the same. For a loss, men receive $5,000. Women receive nothing. For making the World Cup roster, a male player makes $68,750 while a woman makes $15,000.

“The women do receive a base salary of $72,000 for playing on the national team and some benefits that the men do not. However, if both teams were to win all 20 exhibition games–the matches they play outside of tournaments–in a year, a female player would be paid $99,000 total (including base salary) while a male player would be paid $263,320. Additionally, sponsors compensate men hundreds of dollars more per game appearance.”

If you think that the women deserve equal pay for their winning as the men do for their losing, please sign this petition.

_____________________________________________________________________________________

While Republican candidates march around claiming that they will do away with the Affordable Care Act, ACA has provided health insurance to about 20 million people and made people healthier.

  • People are less likely to have medical debt or postpone care because of care.
  • People are more likely to have a regular doctor and get preventative health services.
  • Low-income people in Arkansas and Kentucky, which expanded Medicaid insurance to everyone below a certain income threshold, are healthier than peers in Texas, which did not expand.

These are the findings from a study during the last two years. A 2015 survey found that the people in Arkansas and Kentucky, states with Medicaid expansion, are almost five percent more likely than peers in Texas, a state without Medicaid expansion, to say they are in excellent health, a bigger difference than the 2014 survey. Another study in Oregon tracked people for two years who received Medicaid insurance and those who remained uninsured. People with insurance were much more likely to be in good or excellent health as well as more financially secure. The most recent state to expand its health care program, Louisiana, became the 31st in the nation.

Trump - New Yorker - leftTrump Watch: Two covers reflect Trump’s downward trajectory since the GOP convention only three weeks ago. The New Yorker shows rain falling on Trump to indicate the increasing disaster of his campaign. Time is considering Trump as “person of the year,” defined as a person, group, idea or object that “for better or for worse…has done the most to influence the events of the year.”

 

Trump - Time cover

 

Message to Republicans and Bernie supporters who plan to vote for Trump: The risk of having Donald Trump for president is far worse than Hillary Clinton’s nominating liberals to the Supreme Court. That message comes from conservative legal scholars. They claim that Trump is totally unfit to deal with “foreign affairs and domestic crises”—much of a president’s job—and that it’s doubtful that he’ll keep his word about his justice nominees.

According to Ilya Somin, Trump’s picks could undermine the constitution and turn the country into “a big-government xenophobic party hostile to civil liberties and opposed to most constitutional constraints on government power–much like the far-right nationalist parties of Western Europe, whose platforms are very similar to his.”

Republicans who defiantly defended Donald Trump’s statement that President Obama is the “founder of ISIS” found themselves thrown under the bus after Trump said that he was just joking—two days after he repeated the statement over and over. It the same thing that he says after many of  his statements bringing negative publicity–yelling at a baby to leave his rally, calling violence on Hillary Clinton and her supporters, etc.

Trump may have listened to Clinton’s criticism that his entire economic team is male; he has added nine names to the group, eight of them female. Still no people of color, however. And still as conservative.

People who listen to Trump touting his program for child care need to realize that this is only for guests at his resorts. Although he said that he provides on-site child-care service for employees, called Trump Kids, no one can find evidence of such programs. Yet this service, also called Trumpeteers, caters to his hotel and gold club patrons.

For the people who believe that Trump will stop outsourcing, here’s a list of countries where Trump product are manufactured: furniture – Turkey; shirts – Bangladesh and other Asian countries; vodka – Netherlands; suits – Mexico; tie clips – china; barware – Slovenia; glass and building materials – China; elevator parts – Japan; shampoo – Hong Kong; beach furniture – China; artificial turf – United Kingdom; marble – Italy; pens – Norway; slippers and cutlery – China. Trump could make all these things in the U.S., as this website shows. Yet Trump swore he would never eat Oreo cookies again after Nabisco moved to Mexico and said, “Our people should have more pride in buying made in the USA.”

Repeating his accusation that he might lose Pennsylvania because the voting is rigged, Trump told his audience that the people need to “go down to certain areas … and make sure other people don’t come in and vote five times.” Donald Trump declared today that there’s only one way he could lose the state of Pennsylvania: if he’s cheated out of it. At this time, Clinton is ahead of Trump in Pennsylvania polls by ten points.

A team at the conservative Washington Post will publish Trump Revealed: An American Journey of Ambition, Ego, Money, and Power on August 23. Amazon is offering pre-orders, and it’s sure to instantly hit the best-seller list! An excerpt is available on-line for impatient readers.

What makes Trump the angriest? The media repeating his words. His description for journalists doing their job makes them “the lowest form of life.” He said, “I tell you, the lowest.”They are the lowest form of humanity.”

March 31, 2016

“Small Government” in Kentucky, Alabama

bevins hammerWhen GOP Matt Bevin ran for Kentucky’s governor, he promised to save the people by doing away from the dreaded “Obamacare” in the state. Republicans elected him, and he kept his promise. Under the former governor, the state’s health care, KYNECT, was a model for the country in its coverage for over 500,000 people.

Here is what happened with the Tea Party’s new state computer system:

  • Benefind—Bevin’s new system to replace KYNECT for—has shut people out of their online accounts or entirely eliminated their health coverage with no warning and no explanation.
  • Children have been cut off from Medicaid coverage.
  • People who visit overcrowded state offices where they are forced to wait hours—sometimes an entire day—to see anyone. Or they are forced to come back the next day after the computers crash.
  • The helpline is available only from 8:00 am to 3:00 pm, limiting access for people who work those hours.
  • The recorded message sends people to a website which has many glitches, is hard to use, and provides no help for people without computers or Internet access.
  • People looking for help in public benefits now are forced to wait hours or days as they repeatedly call the helpline that gives them only a recorded message before hanging up.
  • People who can’t get coverage are cutting back on their medications and ending up in the hospitals’ emergency rooms multiple times.
  • Over 500 workers statewide trained to help people sign up for health coverage cannot access Benefind and thus cannot help people to apply for coverage or fix problems with their coverage.
  • People who formerly provided proof of citizenship can no longer get health coverage until they resubmit the documentation.

Bevin’s answer? On YouTube, he says, “I’m aware of and sensitive to your frustrations.”

Republicans who say that big government doesn’t work may be right—when they’re trying to operate it.

[Personal comment: Today I spent over two hours on the telephone with insurance companies and pharmacies on behalf of my partner. One of her medications cannot be generic; therefore she needs prior approval from her insurance company to pay for the brand medication. She has prior approval, but the insurance company will not send her anything in writing to prove it. Even after that, the cost of the medication with differs from $87 to $1500 for a ninety-day supply—with insurance.

I called three pharmacies multiple times to find the prices. All of them started out by stating that they couldn’t do that without the prescription although one of them said on the opening telephone message that it would give the prices of medications for Medicare. The cheapest pharmacy, gave three different prices on three different calls, but refused to give any written verification. It will take faxes for the prescription but won’t send a fax to request the prescription from the pharmacy that holds the prescription. That pharmacy will fax the prescription on but only after it is asked. Another prescription will require a doctor’s visit.

I’m retired—sort of—and have the time to make the calls during the daytime when these places are open. I’m also determined and willing to take on the problems of these calls. After a drastic increase in my blood pressure over the two hours, I can’t imagine the pain that people in Kentucky are now enduring—just because the GOP doesn’t like “big government” and probably people. Then there’s the issue of a different in almost $6,000 for a prescription from a local pharmacy and the “mail-in” part of a huge insurance company. These problems are something that could be changed by single-payer or universal health care, but it might violate our freedom. Big business loves our freedom because it gives them trillions of dollars.]

Did I mention that Republicans hate “big government”? Here’s a fine example of how they legislate it. Mississippi just passed the “Religious Liberty Accommodations Act,” yet to be signed by GOP Gov. Phil Bryant, allowing discrimination against sex by anyone except a male/female couple after marriage. According to the language, an unmarried couple having sex in their personal bedroom is breaking the law if signed by Bryant.

In another Southern state, the big story out of Alabama less than two weeks ago showed GOP Alabama Gov. Robert Bentley governing the state by giving an 80 percent increase in salary to four cabinet members, an extra $73,405 each, after signing a bill banning all cities from raising the minimum wage—the federally mandated $7.25 an hour. These salary increases were the biggest, but dozens of other people—cabinet and staff members—also got sizeable raises.

Last August Bentley defunded Planned Parenthood in the state before a federal judge overturned his move. Taxpayers had to pay for the legal fees. Last December Bentley diverted funding from the 2010 BP oil spill recovery effort to renovate a second Governor’s mansion on the Gulf Coast. In January he took 45,000 people off food stamps if they weren’t supporting minor children. Each of these people had received only $194 a month.

bentleyThis month, however, things got very bad for Robert Bentley after it was revealed that he is having phone sex—and maybe more—with his top aide, Rebecah Mason, on “burner” phones bought at Best Buy. (To find details, just Google the situation.) Rumors have been swirling about his infidelities for quite a while, but they became much more open after his wife of 50 years filed for divorce. He first denied the accusations, despite the tapes played on the media, and then asked for forgiveness. Just for his infidelity and not for refusing poor women health care, causing people to go hungry, appropriating funds for his own personal use, and trying to block LGBT rights in the name of “family values.” Bentley supporters complain that the emphasis in the country shouldn’t be on sex—no problem as long as conservative laws don’t prioritize sex in their “big government” prohibitions.

Although some lawmakers talk about impeaching Bentley, he says he won’t quit. His former Baptist pastor talked about “church discipline” and said that Bentley is no longer a member of the Tuscaloosa congregation where he was once a deacon. The subject of Bentley’s desire has resigned, wanting to spend more time at home with her family, but her husband, state director of the state faith-based initiative office, remains at his job.

Mason’s company was paid over $328,000 during the past three years, more than his cabinet members before their 80 percent raise. She may have been received much more than this. Although Mason served as Bentley’s top aide, she didn’t have to file financial disclosure forms because she wasn’t designated as a state employee.

Alabama has trouble with politicians: a former governor is in prison for corruption, and the speaker of the State House of Representatives is to stand trial this year on 23 felony charges of ethics violations.

Bentley is using his position to investigate two men for blogging about his alleged affair with political adviser Rebekah Mason. He ordered the National Crime Information Center (NCIC) and the Law Enforcement Tactical System (LETS) to find incriminating evidence against attorney Donald V. Watkins, and Legal Schnauzer blogger, Roger Shuler. Some people question whether Bentley broke any laws in his love fest, but Watkins claims investigations will find “wire and mail fraud, money laundering, conspiracy, and racketeering violations under federal law, among other charges …[in circumventing] public oversight, transparency and competitive bid laws by channeling millions of public dollars into entities like the Workforce Councils of Alabama and others legitimate agencies and then directing the recipient agency to execute vendor contracts with certain special friends and supporters.”

The U.S. House Freedom Caucus, each making an annual salary of $174,000, is working toward “small government”by not going to work. Despite Senate Majority Leader Mitch McConnell (R-KY)’s claim that the entire last year of the presidential term is a “lame-duck session,” the HFC understands that this time is only the approximately 75 days between the general election and the new president’s inauguration. Members hope to not go into session for this time, causing only 17 days in session after July 15 and  zero days after September 30. They have to wait until April 12 to do this because they aren’t in session.

Conservative House members have already killed the budget and the appropriations process for the year, and the government can’t operate after September 30 without a continuing resolution to maintain last year’s spending levels. HFC board member Mick Mulvaney (R-SC) described the lame-duck session as “a bunch of people who have already either quit, retired or been fired by their constituents decide they still want to vote on major stuff.” He admitted that quitting work that early this year wouldn’t look good for the legislators. He also said, “When you’re one of the people who tends to think most of what we do here is screwed up in the first place, then the less we do, maybe the better.”

That’s life in the world of conservatives who want “small government.”

January 21, 2016

Flint’s Poisoned Water Problems Not Disappearing

In the wake of his PR disaster—and the Flint residents’ water disaster—Michigan Gov. Rick Snyder released 249 emails to show that he was not to blame. Heavy redactions in the emails don’t hide the administration’s dismissive and belittling attitude toward people concerned about health issues from the brackish water coming into their homes. After traces of “coliform and fecal coliform bacterium” appeared in the city’s water plant, officials just added chlorine to the water. An email from Snyder’s Chief of Staff shows how the administration refused to take responsibility:

 “I can’t figure out why the state is responsible except that [State Treasurer] Dillon did make the ultimate decision so we’re not able to avoid the subject.”

The emails accused residents of using their children’s health as a “political football” and refused action after a hospital and a university stopped using Flint water because it was corroding their metal instruments.  An email stated that Flint residents were only concerned about the aesthetics of the water, “taste, smell and color being among the top complaints.”

According to Snyder, the released emails represent all the Flint-related correspondence in 2014 and 2015. Missing are the ones from 2013 which began the debacle through key decisions. Aides have been non-committal when asked about release of these emails. Snyder has been “invited” to appear in front of the House Committee on Oversight and Government Reform on February 3, 2016 regarding the poisoned water that government has provided Flint residents. He has not been “called” to appear because only Republicans can do this.

The EPA may also be asked to appear at a congressional hearing.

A few missing pieces from yesterday’s blog on the Flint water travesty:

In December 2011, Snyder appointed Michael Brown as emergency manager of Flint to replace elected Flint officials and act unilaterally as an extension of state executive power. Brown was George W. Bush’s head of FEMA during the 2005 Hurricane Katrina. He sent untrained rescue workers to the disaster area while telling fire and rescue departments not to send trucks or emergency workers without a direct appeal from state or local governments. Three days after the disaster, he told the media that he was not aware that the New Orleans Convention Center housed thousands of evacuees who lacked food and water and blamed those stuck in the city of not choosing to leave the city, despite the lack of transportation. Brown quit the FEMA job days after the hurricane. Later he declared that President Obama wanted the Deepwater Horizon oil spill so that he could “pander to the environmentalists.” Brown lasted in Flint for only nine months.

In March 2013, State treasury and Department of Environmental Quality officials ignored external reports showing that changing the water to the Flint River would not save money Three months later Flint’s emergency manager abandoned Detroit water.

In August 2014, Flint River water violated National Primary Drinking Water Regulations twice with more violations in September and December of that year. Last September, the Michigan Department of Health and Human Services claimed that spikes in illnesses from lead were “seasonal and not related to the water supply.”

The first cases of Legionnaires’ disease in Flint in five years appeared two months after the water source was changed. After a year with 47 cases and five deaths, Snyder declared that the epidemic was over, but the numbers doubled in the next months. The incidence of this waterborne bacterial infection that can be deadly for between 5 to 30 percent of those who contract it is nine times greater in Flint than the national average. Doctors had predicted the onslaught of the disease because of iron caused by corrosion. No one will ever know the source of the Legionnaires’ disease because Michigan failed to take the appropriate cultures. The disease could return with warm weather because the state has not done any testing.

EPA Region 5 Administrator Susan Hedman, the director overseeing a region including Flint, resigned after it was discovered that she told the former Flint mayor that a report from one of its own scientists be concealed until it was vetted and revised.

The EPA has announced an emergency order requiring that the state and city “take a series of immediate steps to address the drinking water contamination in Flint.” It said the city and state’s response to the crisis has been “inadequate to protect public health.” The EPA will take over lead sampling because of repeated delays and a lack of transparency in the water crisis continue to pose “an imminent and substantial” danger to residents. Months after the EPA required corrosion controls be added to Flint’s water system and the water source be shifted back to Lake Huron water from the Flint River, “underlying problems” and “fundamental deficiencies” remain. The state has one day to comply with the order.

Michigan is also ordered to create a public website for all reports and sampling results, and the state is to inventory all homes in Flint with lead service lines. The EPA told Flint and Michigan to establish an independent advisory panel on drinking water issues and required that the city must show “technical, managerial, and financial capacity” before moving to a new Lake Huron water system.

At the U.S. Conference of Mayors, President Obama announced that the federal government will send at least $80 million next week, some of it to be used to rebuild water lines and other city infrastructure. The funding comes from a federal revolving loan fund that provides low-cost loans to eligible entities, including municipalities for water infrastructure projects. Replacing lead service lines and making other infrastructure repairs could cost as much as $1.5 billion.

The EPA, which could also be called to appear at a congressional hearing said to be set for early next month, also requested that its Inspector General evaluate Region 5’s supervision program for public water systems, a move U.S. Sen. Gary Peters, D-Mich., applauded as a way to “better understand how EPA could have helped prevent Flint’s water crisis and what they can do to keep this situation from ever happening again.”

Last September, a Flint lawmaker asked Michigan’s attorney general, Bill Shuette, to investigate the Flint water situation. Schuette, a Republican thought to be considering a gubernatorial run, refused. In December, his staffer said that an investigation was not necessary. Five months after building negative publicity about Flint water, Shuette said he would launch an investigation the day after Snyder asked the president to declare a federal emergency in Flint.

In the weeks after Schuette refused to investigate, national media attention on Flint increased, and on Jan. 14, Republican Governor Rick Snyder asked President Barack Obama to declare a federal emergency. The next day, Schuette had changed his tune. He said that he would launch an investigation “without fear or favor.” He office is already defending state officials in a lawsuit generated by protesting Flint residents alleging that officials ignored evidence of the toxic water.

Under state law, the AG has to represent emergency managers when they are sued, but the entity that the manager runs has to pay for the legal costs. Thus the same person who investigates the water poisoning also protect the officials who did it while the people bringing the law suit must pay for the defense’s legal costs. Schuette has not said whether he will bring in outside counsel.

Gov. Snyder was an accountant with no elected office experience before he took over a state with a population of almost 10 million people. Before the Flint water crisis, he had contemplated a run for president. Snyder is a prime example of what happens when the private sector attempts to take over government functions.

After almost two years of Flint water’s fiasco, the state Department of Environmental Quality Director Keith Creagh said that “we should have been more aggressive. He blames two top officials in the Office of Drinking Water and Municipal Assistance for the misinterpretation of the federal Lead and Copper Rule, but both officials still have state jobs. They just been reassigned to keep away from the Flint water issues. No one has been fired over the catastrophe.

flint safe to washTen days ago, Rick Snyder told the media that the Flint water is so safe that he would let his grandkids bathe in it. It’s a safe assertion because he doesn’t have grandchildren. This poster on the right has been removed from the government website.

This is Republican leadership at its “finest.”

After I wrote the above, I went into the kitchen and ran the water a few seconds, grateful that I don’t live in a state with governor-appointed emergency managers instead of elected officials.

 

January 20, 2016

Michigan Governor Poisons Flint Residents, Wants Federal Money

“If the kids in a rich suburb of Detroit had been drinking contaminated water, we would have done something about it.” That was Hillary Clinton’s comment about the poisoned water in Flint (MI) thanks to the man assigned by Gov. Rick Snyder to run the city.

The horror in Flint started six years ago when businessman Rick Snyder was elected governor because he claimed to create jobs and run the government like a business—similar to what Donald Trump promises in his current presidential campaign.

The purpose of business is to make money for the owners and cut costs by eliminating jobs; the purpose of government in a democracy is to make people’s lives better, not to profit off them. Business and government require different skills and philosophies, and Snyder is an example of this difference. When he was on the board of the computer company Gateway, it went from 21,000 U.S. workers to 7,400 in about a decade. Gateway no longer exists.

Under Snyder, GOP legislators passed a law allowing the government to replace elected officials with an “emergency manager” picked by the governor. The manager makes all the decisions—just like in a business. The law was repealed by referendum in 2012 but replaced with a new law in a GOP-controlled legislative session that prevented it from being subject to a voter referendum.

The first time that Snyder used his dictatorial powers was in Benton Harbor where a park had been deeded to the city in 1917 “in perpetuity.” The new emergency manager in 2011 took over part of waterfront park for a luxury golf resort, with the help of a development group. It’s board included the sponsor of the new law. That success of stripping elected officials of any powers for the benefit of private business moved on to Detroit, Flint, Highland Park, and other Michigan municipalities.

Michigan residents couldn’t successfully protest the new dictator approach in its state, and the rest of the United States pretty much ignored the problem until MSNBC’s Rachel Maddow began to show the way that the new “business-like” system allowed massive amounts of lead in the city water that Flint residents pay to receive.

flint-waterFlint’s problem started almost two years ago when its manager “saved” $8.5 million over five years by switching the water source from Detroit through a pipeline to drawing water from the polluted Flint River. The acidic water that leaches lead and other metals from pipes could have been chemically treated to control corrosion, but the manager chose not to spend the $100 a day for that safety.

For 18 months people complained about the taste and smell of the brown water piped into their homes while they got rashes and their hair fell out from showering in it. As any good businessman, the manager denied any problems and said that the water was fine.

Not until Flint pediatrician Dr. Mona Hanna-Attisha compared blood test results for 1,746 Flint children before and after the change in water was any whiff of concern evidenced. Even then, Michigan politicians called her an “irresponsible researcher” who caused “near hysteria.” Not until a September 2015 study from Virginia Tech’s Marc Edwards did city officials admit there was something wrong with the water and told people not to drink it.

The manager did try to minimize the problem by testing water in a way designed to minimize lead readings by flushing the water several minutes before taking a sample and using very low flow rates. Edwards, however, found readings as high as 13,000 ppb (parts per billion of lead); 5,000 ppb is considered to be “toxic waste.” The EPA set 15 ppb has a point where steps should be taken to reduce the level although levels as low as 5 ppb can be concerning. A few miles away, Troy (MI)’s lead in the water measures 1.1 ppb.  [Pipes from a Flint water study]

flint-water-study-photos

Everyone suffers for exposure to lead, but children are particularly susceptible. Symptoms:

  • Abdominal pain
  • Constipation
  • Fatigue
  • Headaches
  • Irritability
  • Loss of appetite
  • Memory loss
  • Pain and tingling in hands and/or feet
  • Weakness

Exposure while a woman is pregnant damages the nervous system of the developing fetus. It can also cause miscarriage, stillbirths, and infertility in both men and women. Children suffer from lasting neurological and behavioral damage, intellectual disabilities, serious difficulty controlling impulses, retaining information, and learning in school. It is difficult or impossible for them to later have thought-intensive jobs. Lead keeps the body from absorbing nutrients for cell development and the growth of strong teeth and bones. The Natural Resources Defense Council’s (NRDC) stated:

“The lead builds up in soft tissue — kidneys, bone marrow, liver, and brain — as well as bones and teeth. … Some scientists believe that low-level chronic lead exposure in childhood can alter secretion of the human growth hormone, stunting growth and promoting obesity.”

People in Flint started in April 2014 to persuade the city to take action about the poisonous water. In May 2014, the city learned that trihalomethanes ( TTHMs) were above levels allowed in the Clean Water Act but didn’t tell residents for another eight months and didn’t change to safe water. In October 2014, GM noticed that the water was corroding engines and started trucking in water from outside the city. While Flint continued to deny any problems with the water, the governor’s office secretly ordered that Flint be supplied filters. The discrepancies between reports of toxicity in the water from the Michigan Department of Environmental Quality and the city of Flint during last year indicate a cover-up by the governor’s appointed manager.

Snyder’s business-like approach became such a PR disaster that he started reluctantly thinking about a solution. Although he switched back to Detroit water last October, the damage to the pipes was most likely done by then. Snyder waited until Jan. 5, 2016 to declare a state of emergency and another week to mobilize the National Guard to distribute bottled water and water filters–starting with seven guardspersons—one per 14,285.7 people.

Finally Snyder asked President Obama to declare a federal emergency. Through FEMA, taxpayers will pay up to $5 million for water, filters and cartridges and other items, but Snyder has been refused an additional $96 million because the Flint water crisis is not a natural disaster. Snyder, his emergency manager, and the GOP legislators who voted for a dictatorship caused the entire calamity, and Snyder finally admitted that he knew about the problems with water for several months, perhaps as much as a year.

Yet in his State of the State speech this week, Snyder blamed the problem on “entrenched bureaucrats.” He also said, “Government failed you at the federal, state and local level.” The problems came entirely from a state decision to create a legislatively created dictatorship in Flint. Michigan residents elected their representatives who allow travesties such as the poisoning of water in one of its cities.

As if the lead in the water wasn’t enough, an outbreak of Legionnaire’s disease in Flint, seemingly a consequence of Flint’s water, has hit 87 people. Ten of these people are dead. Yet Flint is still charging customers for the poisoned water and sending shut-off notices threatening to cut off their water if they don’t pay for it.

In a peculiar coincidence, the office of the public works director who resigned last November during the developing crisis was broken into in late December. No one knows what was taken, and surveillance videos didn’t show anyone breaking into the office.

Distressed by Clinton’s call to do something about Flint’s water, Snyder tweeted, “Political statements and finger pointing from political candidates only distract from solving the Flint water crisis.” He forgets that the problem was caused by politics and that without the growing transparency surrounding the “Flint water crisis,” people would still be receiving the brown, nasty water.

Asked about the problem in Flint,” GOP presidential candidate Marco Rubio hemmed and hawed before he talked about not having an opinion because he hadn’t been briefed on it. At the same time, federal GOP legislators voted to overturn provisions of the Clean Water Act—the same provisions that they voted to repeal last June.

As President Obama said about Flint while he was visiting Michigan, “It is a reminder of why you can’t shortchange basic services that we provide to our people and that we together provide as a government to make sure that public health and safety is preserved.” Flint is also a reminder of why people can’t run government like a business.

Reversing the damage to the pipes will cost $1.5 billion. Reversing the brain damage and other health issues is impossible.

Heckofajob, Snyder. And same to all your cohorts.

Snyder has moved Darnell Farley, the emergency manager who switched Flint’s water from the Detroit system to the Flint River, to the new emergency manager of Detroit’s public schools. Here are a few photos of the Detroit schools. (More disgusting ones here.) We’ll see what Farley makes of this.

flint stairway

flint urinals

August 11, 2015

‘Obamacare’ Good for the Country

Another federal ruling has come down on the Affordable Care Act, and we can only hope that this one is the last. After the Supreme Court once again decided in favor of the ACA, the entire Circuit Court of Appeals for D.C. refused to rehear Sissel v. Department of Health and Human Services. Over a year ago, a three-judge panel had turned down a lawsuit that attempt to strike down the ACA based on a procedural issue that the law should have originated in the House rather than the Senate. Judge Brett Kavanaugh disagreed. That loss led Sissel to ask for the entire court to hear the case. He lost in a unanimous decision.

The D.C. circuit court is split between seven Democrat-appointed judges and four of the most conservative judges nominated by Republican presidents. Sissel might have expected to get a ruling in his favor at least from the conservative judges because the release of a decision took a long time. Instead, the lengthy time before a ruling came from a disagreement about why the court wouldn’t hear the case. Judges disagreed only on academic grounds.

It is unlikely that the Supreme Court will take up Sissel’s case, and the conservative nature of the judges ruling in favor of the ACA may discourage other people from going to court. For example, Judge Janice Rogers Brown, who ruled against Sissel, called the New Deal a “socialist revolution” and claimed that Social Security is a kind of intergenerational cannibalism because of all the “free stuff” that “the political system will permit [Social Security recipients] to extract.”

As time goes one, the ACA continues to get stronger.

A Forbes report by Bruce Japsen, who has covered healthcare and healthcare policies for over 20 years, indicates that unpaid hospital bills drastically declined, both in number and cost, after ACA went completely into effect. Steve Filton, CEO of Universal Health Services (UHS), said that uncompensated care in the company’s hospitals has been on the decline for six quarters. The company’s cost for “doubtful accounts” declined some 17 percent over the first six months of 2015, compared to the same time period in 2014. In 2015, UHS acute care hospitals have seen a “decrease in the aggregate of charity care, uninsured discounts and provision of doubtful accounts as a percentage of gross charges.”

Filton reported something that is obvious to everyone except Republicans. Of the six states with UHC acute care hospitals, two of them—California and Nevada—show a greater participation in Medicaid expansion. The other four states are Florida, Oklahoma, South Carolina, and Texas. A bonus of the ACA is that healthcare stocks are going up, with a surge after the Supreme Court issued its positive ruling in June.

Florida, one of the states that refused Medicaid expansion, denies health insurance to almost one million working poor people. Senate Republicans were in favor of accepting the expansion because the funding would come from the federal government, but Gov. Rick Scott persuaded the House to vote against the working poor. Legislators do understand, however, how important health insurance is: they also voted to keep their own low-cost health insurance. Almost 30,000 state workers, including Scott and Attorney General Pam Bondi (who sued the government over the Affordable Care Act), each pay just $8.34 a month for individual coverage or $30 a month for family coverage. Members of the House, Senate and rank-and-file state employees pay $50 a month for themselves or $180 for family coverage. Their insurance rates are frozen through 2016.

Another Forbes report shows that the ACA has added almost one million jobs in health-related fields through June 2014. The first of over 67 attempts to repeal ACA was called “Repealing the Job-Killing Health Care Law Act.”

A new report in The Journal of the American Medical Association shows that the ACA is a great success especially for minorities previously without healthcare. Over the first two enrollment periods, 10.2 million Americans have received private coverage through Obamacare, and another 12.2 million have been covered by Medicaid and the Children’s Health Program. Costs for Medicaid have dramatically dropped, and the program is fully funded for the next thirty years.

Six measures were used in the survey: self-reported rates of being uninsured, no personal physician, difficult access to medications, inability to afford needed care, overall health status, and health-related activity limitations. Five of these measures improved after people were able to purchase insurance on ACA exchanges; only days limited by poor health didn’t improve.

The study concluded:

“As states continue to debate whether to expand Medicaid under the ACA, these results add to the growing body of research indicating that such expansions are associated with significant benefits for low-income populations.”

An ACA provision mandating that insurers must pay 80 percent of the premiums on health care saved individuals or their employers $5 billion in rebates or premium adjustments for 2011 and 2012. Unlike dire predictions, few—if any—insurers went out of business.

Despite the overwhelmingly positive news about the ACA, the GOP continues to waste its time trying to repeal the law—the last time at the end of July. Majority Leader Mitch McConnell says that he is prepared to hold another vote “to bring an end to the nightmare of Obamacare.” This is a dream that patients, investors, and healthcare companies want to preserve.

In mid-June, the nonpartisan Congressional Budget Office reported that a ACA repeal would “probably increase budget deficits with or without considering the effects of macroeconomic feedback.” The deficit could increase up to $353 billion over a decade. The repeal would also add 19 million people to those uninsured by 2016 and grow by several million in the following years.

Media and candidates are constantly criticizing Donald Trump for not having specifics in carrying out his ideas, but Republicans have the same problem with healthcare reform. After five years of claiming that they will have a plan, it still doesn’t exist. At this time, their only plan is to add billions to the deficit while denying health care to millions of people.

Each state is allowed to set the income level at which people can no longer get Medicaid. In Texas, for example, a family of four must make less than 20 percent of the poverty level to qualify. That’s $4,531 in total annual income. If the family makes $4,532, then they can’t get Medicaid. In Alabama, the cutoff is $4,293. In a Catch-22 a family of four that makes over one-fourth the poverty level in Texas can’t get subsidies for health insurance until it hits 100 percent of the poverty level–$18,128 a year. In addition, childless adults cannot get any Medicaid in all the 19 states without expansion except for Wisconsin.

Two years after ACA became the law of the land, only one state has a rate of uninsured citizens over 20 percent—Texas with 21 percent of its residents lacking health insurance. Before ACA, 14 states were 20 percent or above. California halved its uninsured rate, and both Arkansas and Kentucky dropped their rates from 20 percent to 9 percent in these two years. The national average went from 20 percent uninsured to 13.2 percent with the highest rates for states with Republican governors. New England has insured 95 percent of its population; Rhode Island has only 2.7 percent uninsured.

As of now, 31 states have accepted the Medicaid expansion and its accompanying federal funding, an increase from 26 states a year ago. Time is gradually changing perspectives as more people demand health care and people continue to die without health insurance. In the same year, approval of the ACA has gone up 10 points while disapproval has gone down 12 points. The 47-percent approval is almost triple the 17-percent approval rate of Congress.

approval

During the first GOP presidential candidate debate, Ohio Gov. John Kasich said that the state’s Medicaid expansion cut down the prison population. He said, “Eighty percent of the people in our prisons have addictions or problems,” Kasich added. “We now treat them in the prisons, release them in the community and the recidivism rate is 10 percent….” The average rate in the United State is 52 percent. Ohio is one of 31 states saving money and keeping people alive with Medicaid expansion.

June 27, 2015

Subsidies for Healthcare–For Now

The day before the Supreme Court made marriage equality the law of the land, it kept the healthcare subsidies for low-income people in King v. Burwell. Thanks to a 6-3 decision, over 6 million people are able to keep their health insurance because the Supremes didn’t allow four words to restrict subsidies to only the states with their own healthcare exchanges. For the second time in three years, conservatives hate Chief Justice John Roberts for retaining the law that expanded health care to an additional 16.4 million people although Justice Anthony Kennedy also voted with the more progressive block of four justices. Roberts wrote, “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them.”

Hospital operators and insurers largely supported the court’s decision to keep the subsidies that remain in the 34 states using the federal exchange as well as the other states that have either their own exchanges or a combination. The lawsuit was financed by a conservative group, Competitive Enterprise Institute, that found four unlikely plaintiffs who are eligible for subsidies but just don’t like the law. GOP members of the House have voted over 50 times to repeal the law and plan to continue the repeals in lieu of passing laws that would help people.

The court’s decision made the law more secure than if the conservatives had not brought the lawsuit because it holds that the subsidies are a permanent part of the ACA that can be changed only by Congress. Before the ruling, a president might have blocked the ACA by executive action; now changes must be made by a majority vote in the House and a 60-vote margin in the Senate.

Two years ago, Scalia used the term “legalistic argle-bargle” for the court’s rationale in keeping the ACA. In this dissent, he maintained that Roberts’ reasoning was an act of “interpretive jiggery-pokery.” A great irony is that dissenters Scalia, Clarence Thomas, and Samuel Alito declared that the ACA intended subsidies for all eligible consumers regardless of state or federal exchanges three years ago in NIFB v. Sebelius. This year the three of them moved 180 degrees away from their earlier position in opposing the ACA.

The conservative viciousness toward the ruling, although not surprising, was still disgusting. Fox host Andrea Tantaros called the “judiciary, John Roberts included, is now just the water boy for the welfare state.” Breitbart editor Ben Shapiro drew his comparison from the erotic novel/movie Fifty Shades of Grey when he tweeted, “The Roberts Court took the ACA to its Red Room of Pain and then alternatively tortured it and made love to it until it complied.” On Glenn Beck’s The Blaze, Wayne Allyn Root wrote that Roberts’ decision shows that he is being blackmailed by the Obama administration.

GOP presidential candidate Sen. Ted Cruz (R-TX) called the Supreme Court decisions to give health care to low-income people and legalize marriage equality as “some of the darkest 24 hours in our nation’s history.” To him, it’s much worse than the Civil War, two world wars, the attacks on the World Trade Center—I could go on and on.

Rep. Brian Babin (R-TX) believes he has found a way to punish the Supreme Court justices for its decision: he has introduced the “SCOTUScare Act,” requiring “the Supreme Court and all of its employees to sign up for Obamacare.” As many other people—including conservative members of Congress—fail to understand, no one “signs up” for the ACA. The law simply protects people from some unreasonable provisions of insurance companies—lifetime caps, denial because of pre-existing conditions, and skyrocketing premiums not used for medical needs.

Former Texas governor and GOP presidential candidate Rick Perry is a classic example of the GOP approach toward health care for low-income people. Called out for having the largest number of uninsured people in his state—one out of five Texans without health insurance—he said, “We make access the real issue.” Texan uninsured are four times less likely to have regular health care and more likely to die of health-related problems. Insurance would improve their overall health by 7 to 8 percent.

“Texas has been criticized for having a large number of uninsured,” Perry said. “But that’s what Texans wanted.” By not expanding Medicaid, 1.5 million Texans, with a median income of $833, are denied health care. In that state, non-disabled parents must earn less than $,500 for a family of four to gain the existing Medicaid. Texas has lost about $10 billion a year for the expanded program with Texas paying only seven percent of the cost, but Perry said that even $1 in the name of “Obamacare” was a dollar too much.

Many GOP members in Congress know that the King ruling saved them from disaster because they had no plans if they had won. Rep. Paul Ryan (R-WI) smiled at the ruling, and a GOP congressional member said “that fight could have killed us.” The candidates now  focus on electing a GOP president to get Congress closer to repealing Obamacare. They talk about putting the patient back in charge of their health care—all patients, that is, except women.

Candidates may wish to use caution, however, in using anti-healthcare for their platforms. In April, an Associated Press-GfK poll showed that 56 percent of the people wanted a ruling in favor of subsidies in contrast to the 39 percent opposition. Another 51 percent wanted Congress to subsidize premiums in all states. In CBS News/New York Times polling, 47 percent of people approve of ACA, the highest percentage thus far and more than the 44 percent who oppose the ACA.

A question is why so many people are opposed to the ACA when so few people are actually affected by it. The relentless pounding from conservatives against the law is a big reason, but even more, people blame the ACA for any problem in the health care system. Too few doctors? Rising costs of premiums and health care? Deductibles too high? It must be Obamacare. Premiums go up every year, but the cost has increased less since the law went into effect. Out-of-pocket costs are going up faster than wages, but that didn’t start with the law. Higher deductibles began before the law. Most people don’t remember the problems before the ACA’s protections went into effect, and the conservatives work every day to erase their memories.

uninsured

The SCOTUS ruling helped over 6 million people, but it didn’t do anything for the 4.3 million people prohibited from getting coverage in the 22 states that refuse to expand Medicaid. Ten of these states are former Confederate states, and most are former slaveholding states. About 61 percent of the people in the Medicaid gap live in Florida, Texas, Georgia, and North Carolina. In the states with expanded Medicaid, early detection and treatment of chronic diseases such as diabetes saves money from more advanced costs. Hospitals in states with expanded Medicaid save money by reduced uncompensated costs of treating the uninsured. Baton Rouge General Medical Center Mid Center (Louisiana) recently had to close its emergency room. It’s also notable that many GOP presidential candidates come from states that reject healthcare for low-income people.

Another 36 million people earn too much for Medicaid eligibility and can’t afford health insurance. The solution for this would have been the single-payer system that the Republicans proposed over two decades ago but refused under President Obama because they didn’t want to make him look successful.

Satirist Andy Borowitz wrote a column four years ago, entitled, “Republicans: Trillions Could Be Cut from Budget if We Eliminate Empathy – Humanity Also on Chopping Block.” The problem with satire is that it is sometimes true. Borowitz has brilliantly described the GOP position of 2015. He attributed this statement to then Rep. Eric Cantor (R-VA), who lost his position to another legislator with even less humanity, but the problem remains:

“Once congressional Republicans eliminate such empathy-laden budget items as lunches for poor children, medicine for the indigent and oxygen for seniors, … we can move from cutting empathy to cutting humanity.”

“With humanity removed from the budget, he said, ‘That’s where the real savings come in.’

“By eliminating the food, medicine and oxygen necessary to sustain human life, ‘We will reduce the single biggest drain on the U.S. economy: people.’”

In a supreme touch of irony, Chief Justice John Roberts held up the marriage laws of Kalahari Bushmen, the Han Chinese, the Carthaginians, and the Aztecs as examples of “a social institution that has formed the basis of human society for millennia.” The Bushmen are Botswana’s poorest citizens, the Chinese are hated by most conservatives, the Aztecs believed in human sacrifice, and the Carthaginians followed a polytheistic religion—possibly with infant sacrifices.

With these societies used as models for the conservatives, the GOP has truly lost its humanity.

March 23, 2015

Happy Birthday, ‘Obamacare’

Today is the Affordable Care Act’s fifth birthday. For five years, most of the GOP legislators have been making predictions about the law’s leading the entire country to wrack and ruin. The following dozen failed predictions show how all these people have been wrong:

happy birthday Failed Prediction #1 – Americans won’t enroll in the ACA: The demand was so great that the website sometimes crashed from the heavy usage. About 8 million people signed up for private insurance coverage in 2014, and the number rose to 11.4 million in 2015. While it was hard to sign up for health care on the exchanges last year, it was harder to be uninsured or underinsured.

Failed Prediction #2 – The ACA won’t meet its enrollment goals: In its first two years, enrollment totals exceeded preliminary projections.

Failed Prediction #3 – Insurers will want no part of the ACA system: Many insurers see the ACA as a major growth opportunity that lets them expand in the individual market.

Failed Prediction #4 – The ACA will cause the economy to suffer and kill jobs: In one press conference, House Speaker John Boehner (R-OH) used the phrase “job-killing” an average of every two minutes while talking about the ACA. Yet the U.S. has had 59 consecutive months of job growth since October 2010, the longest stretch of time in history.  National data also shows no indication of employers hiring people under 30 hours a week to avoid the ACA insurance mandate. The average length of the work-week, which dropped during the recession, recently matched pre-2010 levels. Using interviews with major U.S. employers, Bloomberg found that the law “is putting such a small dent in the profits of U.S. companies that many refer to its impact as “not material” or “not significant.” It decided that “the biggest entitlement legislation in a generation is causing barely a ripple in corporate America.”

Failed Prediction #5 – People who enrolled wouldn’t pay their premiums: Again the GOP was wrong. Five months into last year, over 91% of the 8 million consumers who enrolled through an ACA exchange marketplace paid their premiums.

Failed Prediction #6: People would see exorbitant premiums: Those who qualify for tax credits through the insurance exchange pay an average of $82 per month for premiums—one-fourth of the expenditure without financial help. More people who changed from individual insurance to exchanges have lower premiums.

Failed Prediction #7 – Premiums will shoot up next year: State-by-state information shows that more insurers coming to the market are pressuring prices to go down. In 2015, premiums for the ACA’s mid-level plans rose by an average of 2 percent. In 48 major cities, prices for these benchmark plans actually fell by 0.2 percent, compared to the 10-percent increases before the ACA.

Failed Prediction #8 – The ACA helps only those with coverage: Republicans are wrong.

Failed Prediction #9 – The ACA will lead to a “net loss” on overall coverage: Boehner argued that fewer people had health insurance after the health law’s insurance expansion than prior to it, but the uninsured rate has dropped by one-fourth. In Minnesota it’s gone down by 40 percent, and in some cities the number will shrink by 60 percent in cities with expanded Medicaid. People who would not get subsidies still got the same insurance plans by going to an insurance broker. Boehner also ignored the expansion of 9.1 million enrollees on Medicaid.

Failed Prediction #10 – The ACA will lead to higher deficits and a weaker fiscal footing for the nation: The GOP, the party that actually raises the deficit, told the country that “Obamacare” would “bankrupt” the country. In April 2014, the Congressional Budget Office reduced its budget forecast by $100 billion, less than it expected to spend during the first projection in January 2010. The CBO reduced its 10-year estimate of ACA cost by 20 percent and its Medicaid costs attributable to the law by 8 percent, partly because people with health insurance no longer rely on the emergency room for health care.

Failed Prediction #11 – Americans will end up hating the coverage they receive through the ACA: A new Gallup poll shows that 71 percent find their coverage through exchanges to be good or excellent, and another 19 percent said the coverage was fair. Only 9 percent gave it a poor rating.

Failed Prediction #12 – “Obamacare” will mostly sign up people who already have insurance:  A Kaiser Family Foundation survey finds that 57 percent of enrollees previously lacked insurance.

More failed projections: there is no “death spiral,” or “death panels,” or “rate shock.” Not one prediction has lived up to scrutiny. And not one prominent Republican is willing to admit the failed predictions or even explanations for these mistakes and misjudgments. Instead, they’re still busy trying to repeal the law.

Facts will not change the minds of many in opposition, as Jonathan Chait pointed out:

“Suppose you strongly objected to the idea that your city should own a bunch of buildings where people can go borrow books for free. (Some people do!) If you couldn’t persuade a majority of fellow citizens of your conceptual objections to libraries, you might try arguing that the library scheme was doomed to collapse in cost overruns, or that nobody would ever use them, or that shelves of heavy books would be routinely toppling over and killing small children. But the fact is that running buildings where people can check out books, and running exchanges where people can purchase basic health insurance packages, are both things that governments can do.”

One GOP complaint is that “Obamacare” helps only the poor. It is true that the poorest people get free Medicaid, and those up to an income of $94,000 a year for a family of four can get tax credits. People who receive insurance from their employees are having their coverage paid by “other people’s money.”

Employer-sponsored insurance get tax deductions, giving the largest benefits to those who earn the most money as compared to the ACA which gives the most to those who earn the least. For example, newly-announced presidential candidate Sen. Ted Cruz’s (R-TX) premiums, up to $40,000 for the year for his family, were paid by his wife’s employer, Goldman Sachs. Cruz will be shopping for health insurance because his wife has taken an unpaid leave while he runs for president.

Sen. John Barrasso (R-WY) may have summarized the GOP complaints with this comment on the floor of the Senate: “It’s time for the White House to stop celebrating [the ACA] and start thinking about the people.” Huh?

What’s ahead for the Affordable Care Act?  After voting dozens of time to repeal the ACA, the GOP is trying to pass a budget that would double the uninsured rate and eliminate $1 trillion in tax revenue that pays for the law. Republicans have no plan to help the millions of families losing affordable medical care if they succeed. Rep. Paul Ryan (R-WI) has only one suggestion: he urged state lawmakers to stop state insurance exchanges if the Supreme Court rules that this as a requirement for the ACA. That’s what he told state legislators last week during a conference call organized by the conservative think tank Foundation for Government Accountability.

If the Supreme Court were to rule for mandated state exchanges, subsidies in the mostly blue states would continue while millions of consumers in GOP-run states would go without. Michigan and Ohio are intending to set up the exchanges that Ryan warns against because no one should do what the White House wants, even if it puts constituents in jeopardy.

Missouri is a prime example of problems with GOP legislators. GOP legislators have threatened to filibuster any Medicaid expansion bill and Bob Onder, a new state senator, has proposed a bill to keep an insurance company from selling policies in the state if it accepts federal subsidies sold on the federal health exchange. The state refuses to accept billions of federal dollars to offer Medicaid coverage to approximately 300,000 uninsured residents. Onder said, “To expand Medicaid would only put further stress on a system that’s already strained,” Onder said. A single mother with two children must make less than $3,700 to get Medicaid, and rural hospitals are facing either huge cutbacks or closure because the state refuses Medicaid expansion.

aca cowThe GOP-led legislature, however, has passed a bill to insure cows in the state. It would subsidize up to 70 percent of farmers’ premium payments for dairy insurance. The House passed it by 110 to 49, and the Senate did better at 31-2. Rep. Jeremy LaFaver (D-MO) called it the “Affordable Cow Act” because insurance subsidies for cows are fine but “not for people.”

Maybe some day, Republicans will figure out that “Obamacare” should be called “GOP Cares.”

Republican_Obamacare

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