Posts tagged with "Obamacare"

Never mind: Trump reverses himself on Obamacare replacement vote

April 4, 2019

President Donald Trump now claims he never wanted Congress to “repeal and replace” Obamacare ahead of the 2020 elections, even though he unexpectedly revived the issue and pushed for swift action over the course of the past week, The Hill reports.

“I was never planning a vote prior to the 2020 Election on the wonderful HealthCare package that some very talented people are now developing for me & the Republican Party. It will be on full display during the Election as a much better & less expensive alternative to ObamaCare,” he tweeted.

The president denied that pressure from Senate Majority Leader Mitch McConnell (R-Kentucky) led him to change his plans, even though he announced his decision after speaking with the top GOP senator on Monday.

“I never asked Mitch McConnell for a vote before the Election as has been incorrectly reported (as usual) in the @nytimes, but only after the Election when we take back the House etc. Republicans will always support pre-existing conditions!” Trump wrote.

However, The Hill reported that, on Monday, April 1, McConnell told the president that he would not bow to White House demands to revisit healthcare so soon, and that the Senate will not be moving comprehensive health care legislation before the 2020 election, despite the president asking Senate Republicans to do that in a meeting last week.

McConnell said he made clear to the president that Senate Republicans will work on bills to keep down the cost of health care, but that they will not work on a comprehensive package to replace the Affordable Care Act.

Following that conversation—and his own about-face in tweets on the issue—President Trump predicted that healthcare “will be a great campaign issue” for Republicans.

I wanted to delay it myself. I want to put it after the election because we don’t have the House,” the president told reporters in the Oval Office.

Research contact: @thehill

Democrats: Trump’s move to terminate Obamacare gives us a gift ahead of 2020

March 28, 2019

In a move that has appalled his own advisers, and alarmed the G.O.P. as a whole, President Donald Trump on March 27 began a legal effort to “essentially terminate” the entire Affordable Care Act ―including its heretofore sacrosanct pre-existing conditions protections.

About half of Americans—133 million—have a health issue that qualifies as a pre-existing condition. Under the ACA, also known as Obamacare, insurers have been banned from denying coverage for (or from charging more for plans that cover) pre-existing conditions.

And American voters have made it clear that they like it that way. According to a poll by the Kaiser Family Foundation just before the midterm elections last November, fully 58% of Americans said they were “very concerned” that Republicans would remove this safeguard—and expose them either to higher costs or no coverage at all.

In fact, at that time, healthcare was top-of-mind for U.S. voters—and indications are that it continues to be.

According to a report by the Huffington Post,  Democrats are saying that the president’s extreme position on the ACA will matter far more to voters in 2020 than anything coming out of Special Counsel Robert Mueller’s investigation into the 2016 presidential election.

And while Republicans have said for years that the ACA should be “repealed and replaced,” they are not so sure that the issue should be revisited at this time.

It comes down to this: On March 25, the Department of Justice asked federal courts to throw out all of Obamacare, not just one part of it, as it had done previously. If the U.S. 5th Circuit Court of Appeals, which is weighing the lawsuit, agrees with the government, the matter will almost certainly go before the Supreme Court, which has already turned away two major challenges to the 2010 healthcare law, the Huffington Post notes. With two new Trump-picked justices on the high court, however, there is no telling whether the law would survive a third.

“This move by the Trump administration to take away health care will prove far more detrimental to the administration and the Republican Party than any gains they might have made by the issuance” of Attorney General William Barr’s letter summarizing the findings of Mueller’s investigation, Senate Minority Leader Chuck Schumer (D-New York.) said on March 26.

 “They are literally teeing this up as an issue for Democrats for the next year and a half. They’re not even making a laughable attempt to save the most popular parts of the Affordable Care Act,” Senator Chris Murphy (D-Connecticut) told reporters on Tuesday.

Vulnerable Republican senators up for re-election in 2020, whose seats Democrats need to win in order to take back control of the Senate, are likely to face additional attacks over healthcare following the Trump administration’s new stance on the lawsuit. But GOP leaders say they have confidence in their members to fend off attacks over Obamacare going into the 2020 election.

By contrast, the Huffington Post reports, G.O.P. senators facing tough re-election fights in 2020 said they support popular elements of the Affordable Care Act even as they continue to maintain that the law should be repealed ― a delicate rhetorical balancing act that failed to save many GOP members of Congress in the 2018 midterm election.

“I support coverage for pre-existing provisions, and Congress should act to make sure that happens. I think what we need to do is make sure we have affordable health care,” Senator Cory Gardner (R-Colorado), who is facing a tough campaign, told reporters.

Only Senator Susan Collins (R-Maine), who voted against repealing Obamacare in 2017, criticized the decision to argue in court that the entire law should be struck down as unconstitutional.

“It is highly unusual for the [Department of Justice] not to defend duly enacted laws, which the Affordable Care Act certainly was. This decision to even go more broadly in failing to defend the law is very disappointing,” Collins said.

Research contact: @HuffPost

Mitch McConnell: GOP intends to gut Social Security, Medicare, and Medicaid after midterms

October 26, 2018

It’s the talk of the Beltway, according to the Los Angeles Times: Did Senator Mitch McConnell (R-Kentucky) just admit that the GOP intends to dismantle Social Security, Medicare, and Medicaid after the midterm elections?

The scuttlebutt started, the Times reported on October 19, after the Senate majority leader gave an interview to Bloomberg  on October 16, in which he singled out “entitlements”—that’s political code for Social Security, Medicare, and Medicaid—as “the real drivers of the debt” and called for them to be adjusted “to the demographics of the future.”

To make it short and sweet, McConnell intends to cut benefits.

Indeed, Bloomberg said, the Senate Majority Leader blamed rising federal deficits and debt on “a bipartisan unwillingness to contain spending on Medicare, Medicaid, and Social Security.”

What’s more, although Republican legislators spent most of last winter trying to gut the Affordable Care Act, McConnell also telegraphed a plan to try again to repeal healthcare coverage after the midterm elections.

That’s despite indications that the ACA is becoming more popular with the public, not less, and voters’ concerns about preserving its protections for those with preexisting conditions may be driving them to the polls — and not to vote Republican. A poll released on October 18 by the Henry J. Kaiser Family Foundation, found that fully 71% of U.S. voters say healthcare is the most important issue driving them to the polls in the midterm elections.

In an October 17 interview with Reuters, McConnell commented that the GOP’s failure to repeal the ACA was “the one disappointment of this Congress from a Republican point of view.”  He said Republicans could try again to repeal Obamacare if they win enough seats in U.S. elections next month.

The CBO projects the current fiscal year deficit at $973 billion, and says it expects annual deficits to exceed $1 trillion into the next decade. The CBO attributed much of the deficit to “recently enacted legislative changes. … In particular, provisions of the 2017 tax act.”

The Congressional Budget office sees things differently. The CBO projects the current fiscal year deficit at $973 billion, and says it expects annual deficits to exceed $1 trillion into the next decade. The CBO attributed much of the deficit to “recently enacted legislative changes. … In particular, provisions of the 2017 tax act.”

Research contact: @hitzikm

As GOP moves to cut coverage of pre-existing conditions, its candidates say the opposite

October 25, 2018

Republicans candidates are feverishly back-pedaling on their plundering of Obamacare—and are regretting filing lawsuits to relieve insurers of their responsibility to cover pre-existing conditions, according to a report by Rachel Maddow of MSNBC on October 23.

A poll released on October 18 by the Henry J. Kaiser Family Foundation, found that fully 71% of U.S. voters say healthcare is the most important issue driving them to the polls in the midterm elections. That’s good for Democrats who are running, but bad for the GOP, Maddow said.

But that’s not stopping Republican candidates—and the president—from misrepresenting their true positions, the cable news anchor said.

In fact, Maddow identified five candidates who, she said, are lying about their overall support for healthcare—and their antipathy toward coverage of pre-existing conditions.

Among those whom Maddow said had voted against the Affordable Care Act, but who now say they support it are Representative Martha McSally (R-2nd District-Arizona); Senator Ted Cruz (R-Texas); Senator Dean Heller (R-Nevada); Representative Dana Rohrabacher (R-48th District-California); and Representative Kevin Cramer (R-North Dakota).

In particular, Senator Ted Cruz once spoke for more than 21 hours about his opposition to Obamacare, including a dramatic reading of the Dr. Seuss classic “Green Eggs and Ham” on the Senate floor, The Washington Post reminded readers on October 25. The speech was styled as a filibuster, but was not actually one — no vote was being delayed; Cruz was just making a memorable stink about how much he did not like Obamacare.

President Donald Trump also is prevaricating about his true position: “Republicans will always protect people with pre-existing conditions,” Trump said at a rally on October 23 in support of Senator Dean Heller in Nevada.

However, Maddow’s Producer Steve Benen wrote on her blog on October 24, “In reality, Republicans continue to fight to gut the ACA’s protections for Americans with pre-existing conditions, and a total number of zero Democratic officials “have been talking about” scaling back the existing Obamacare safeguards”(although the GOP claims they are).

“This is not a fight in which a complex truth lurks in some gray area in between partisan talking points. Republicans have not only fought for years to strip Americans with pre-existing conditions of their protections; they’re also–right now – trying to get the courts to gut these protections, too,” Benen wrote.

He noted, “If the midterm elections are going to be about which party is sincere about championing protections for those with pre-existing conditions, Republicans are likely to have a rough year.”

Research contact: @stevebenen

Obama urges Americans to vote Democratic, whether candidates are charismatic or not

July 2, 2018

Speaking at a Democratic National Committee fundraiser on June 28 in Beverly Hills, California—the first of three at which he has committed to appear—former President Barack Obama said that, although the political situation is dire, the party should not resort to magical thinking about a hero such as himself coming back to save the day.

He warned of a country and a world on the brink — “you are right to be concerned,” he told the crowd — but said they’d flub their chance to change that if they kept pining for a savior, according to a report by Politico.

Instead, he focused on getting out the vote for the midterm elections in support of Democrat candidates—charismatic or not.

Do not wait for the perfect message, don’t wait to feel a tingle in your spine because you’re expecting politicians to be so inspiring and poetic and moving that somehow, ‘OK, I’ll get off my couch after all and go spend the 15-20 minutes it takes for me to vote,’” Obama said in his first public comments in months, Politico noted, adding, “because that’s part of what happened in the last election. I heard that too much.”

He pointed out that “[The Republicans] don’t worry about inspiration. They worry about winning the seat and they are very systematic about work—not just at the presidential level, but at the congressional and state legislative levels.”

As usual, Obama refrained from referring to President Donald Trump by name in public, but he spoke at length about the problems he perceives in the current administration — and why he thinks Democrats would be foolish to assume that they have mounted the opposition to beat him just because they’ve been doing well in winning recent elections.

“Fear is powerful,” Obama said, referring to the POTUS’s tactics to undermine the American ethos. “Telling people that somebody’s out to get you, or somebody took your job, or somebody has it out for you, or is going to change you, or your community, or your way of life — that’s an old story and it has shown itself to be powerful in societies all around the world. It is a deliberate, systematic effort to tap into that part of our brain that carries fear in it.”

The former president did not get into specifics about immigration, the Supreme Court vacancy, world trade, or foreign affairs. His only direct comments on current events were about the newspaper office shooting in Maryland earlier Thursday; which he said left him heartbroken but hopeful that people would see this one as the turning point to take action on gun laws, Politico reported.

Instead, he talked mostly in general terms about how the Republicans and Democrats tell “different stories.”

“There’s a fundamental contrast of how we view the world,” Obama said. “We are seeing the consequences of when one vision is realized, or in charge.”

A new national message will come, Obama argued, as the 2020 field of presidential candidates emerges. The people who are looking for one now are being ridiculous, he said, but if they needed something to hold them over, he said his own old slogan still works.

 “All these people [who] are out here kvetching and wringing their hands and stressed and anxious and constantly watching cable TV and howling at the moon, ‘What are we going to do?,’ their hair’s falling out, they can’t sleep,” Obama said. “The majority of the American people prefer a story of hope. A majority of the American people prefer a country that comes together rather than being divided. The majority of the country doesn’t want to see a dog-eat-dog world where everybody is angry all the time.”

The former president characterized the Republican effort to torpedo Obamacare as an opportunity for Democrats.

“Reality has an interesting way of coming up and biting you, and the other side has been peddling a lot of stuff that is so patently untrue that you can get away with it for a while, but at a certain point, you confront reality,” he said. “The Democrats’ job is not to exaggerate; the Democrats’ job is not to simply mimic the tactics of the other side. All we have to do is work hard on behalf of that truth. And if we do, we’ll get better outcomes.”

Research contact: @IsaacDovere

Trump administration to dismantle Affordable Care Act after midterms

June 11, 2018

One of the great advantages of Obamacare was that it enabled Americans with “pre-existing medical conditions”—from diabetes, to heart failure to cancer—to get coverage from insurance providers. Now, Politico reports, the Trump administration “is urging a federal court to dismantle” this provision—but to wait until after the midterm elections this year.

What’s more, the administration would like to see the very basis of the Affordable Care Act—the mandate for every U.S. citizen to get coverage—taken out of the bill as soon as December.

Both moves come in response to a lawsuit from conservative states seeking to entirely invalidate the act. Indeed, On June 7, the Justice Department told a judge in Texas who will rule on the case that Congress’ decision to repeal the penalty for failing to buy health insurance renders unconstitutional other Obamacare language banning insurers from charging people more or denying them coverage based on a pre-existing condition.

According to the Politico story, the Texas-led lawsuit— filed last February—claims that the recent elimination of Obamacare’s individual mandate penalty means that the whole healthcare law should now be ruled invalid. The mandate penalty was wiped out, effective as of 2019, as part of the GOP tax law passed late last year.

The administration’s evening filing says it agrees with states bringing the suit that the individual mandate is unconstitutional, as are two of the law’s major insurance provisions meant to protect people with expensive medical conditions. With the filing, the Trump administration is asking the courts to wipe out protections that many congressional Republicans were wary of eliminating in their failed efforts to repeal Obamacare.

And they are right to worry: Findings of a Monmouth University poll, released in March, show that 51% of Americans  would prefer to keep the Affordable Care Act and work to improve it, with another 7% saying that they want to keep the ACA entirely intact. Just four out of ten U.S. voters wants to see the act repealed, either with a replacement put in place (31%) or without one (8%).

The poll established that a majority support Obamacare, regardless of whether they get their coverage through an employer (57%), through a privately purchased plan (55%) or through publicly funded coverage (63%).

Attorney General Jeff Sessions, in a letter to House Speaker Paul Ryan, acknowledged that the executive branch typically defends existing federal law, but he said this was a “rare case where the proper course” is to forgo defense of the individual mandate.

The administration’s decision means that a group of 15 Democratic states led by California will be largely responsible for defending  Obamacare against its latest legal threat, Politico said.

Research contact: pdmurray@monmouth.edu

Medicaid expansion linked to better, more timely surgical care

February 16, 2018

The  Affordable Care Act’s Medicaid expansion has been linked to better access to surgery—and higher-quality surgical care, at that—according to findings of a study  of 300,000 patients nationwide by Harvard T.H. Chan School of Public Health released online in the January 24 edition of JAMA Surgery.

“What was most striking was that we saw significant improvements in the treatment of surgical conditions fairly quickly, less than two years after states expanded Medicaid coverage,” said lead author Andrew Loehrer, who conducted the study as a research fellow at Harvard Chan School.

Previous studies have examined the impact of the expansion of Medicaid by the ACA (also known as Obamacare) on a range of outcomes in medical areas such as  primary care, prescription medication use, and self-reported health— generally finding favorable results. But this is the first study showing similar benefits for serious conditions requiring surgery.

The researchers looked at five years’ worth of data from patients across 42 U.S. states who were admitted to hospitals for one of five common surgical conditions: appendicitis, cholecystitis, diverticulitis, peripheral artery disease (PAD), or aortic aneurysm. They analyzed trends in insurance coverage, timeliness of surgical care, and care outcomes—both before the ACA’s Medicaid expansion (2010-13) and after (2014-15)—comparing 27 states that chose to expand their Medicaid programs with 15 that chose not to expand.

The study found that Medicaid expansion was associated with:

  • A 7.5-percentage-point decrease in the probability of patients being uninsured;
  • An 8.6-percentage-point increased probability of patients having Medicaid;
  • A 1.8-percentage-point increase in the probability of patients seeking care earlier, before their surgical conditions became complicated; and
  • A 2.6-percentage-point increase in patients’ probability of receiving optimal care

They speculated that the ACA’s Medicaid expansion led patients with surgical conditions to seek treatment before complications set in. Being treated for these conditions earlier makes it more likely that they will have better health outcomes, the authors said.

“The fate of the ACA and Medicaid remain … a key policy debate,” said senior author Benjamin Sommers, associate professor of Health Policy and Economics at Harvard Chan School. “As policymakers continue to discuss major changes to the ACA, and the Trump administration advances reforms that could lead to fewer people covered by Medicaid, our findings provide important new evidence that Medicaid expansion is improving the quality of care for serious conditions affecting tens of thousands of Americans every year.”

Research contact: mhdwyer@hsph.harvard.edu

9 million enroll in Obamacare

December 26, 2017

In the 39 state exchanges in which residents are able to take advantage of the federal HealthCare.gov website to enroll in Obamacare—more formally known as the Affordable Care Act Program—8.8 million Americans signed up for insurance for 2018, the Centers for Medicare and Medicaid Services announced on December 21.

The six-week open enrollment period in those 39 states, plus the state-run exchanges in Idaho and Vermont, ended December 15—but 10 more states, as well as the District of Columbia, enforce later deadlines and people in many states can still enroll through federal exchanges under special circumstances.

Total nationwide enrollment will be considerably higher than 8.8 million when the other states ― which include California and New York ― tally their results, the Huffington Post reported.

About 18 million Americans in all used the Healthcare.gov website  between November 1 and December 15. Among Spanish speakers, 680,000 used CuidadDeSalud.gov and 470,000 spoke with a representative by telephone. Nearly 2 million Americans “window-shopped,” but did not buy on the site.

In the last week of open enrollment, over 4.1 million people selected plans using the HealthCare.gov platform or were automatically re-enrolled in a plan. The total, CMS.gov said, likely will be at least slightly higher than 8.8 million, because the agency is still processing some applications.

The 8.8 million is down about 4% percent from the 9.2 million people who had signed up by the end of the campaign last year, which was down from the 9.6 million who had done so the year before. New customers made up 2.4 million of that total—down from the almost 3 million new enrollees who signed up for 2017 plans.

Lower enrollment overall remains likely because the vast majority of states use the federal system. That isn’t a good thing, the Huffington Post said, noting, “It means fewer Americans who don’t get health coverage from their employers or a government program like Medicaid or Medicare will be covered next year.”

Having more Americans uninsured apparently will make the POTUS happy: Indeed, President Trump openly rooted for Obamacare to “fail” and bragged that he would allow the plan to “implode.”

In support of his intentions to bring down Obamacare, the administration made the enrollment period only half as long this year as it had been; slashed the advertising budget by 90% and cut funding for enrollment counselors by 40% overall.

As the Huffington Post reported, Trump repeatedly made public statements suggesting he wouldn’t fully enforce the individual mandate—making insurance companies nervous that fewer healthy people would enroll this year. Many insurers increased premiums more than originally planned because of that.

And in what President Trump viewed as a “win,” the administration managed to undo the individual mandate after 2019 as part of his unpopular tax bill, passed by both houses of Congress this past week and signed by the president.

Finally, Trump also plans to relax regulations of short-term insurance policies. They are now available for a maximum of three months, but the POTUS is bent on increasing them to a full year. Because these plans screen customers for pre-existing conditions ― which insurers selling exchange policies are forbidden to do ― they could lure healthy people away from the Obamacare market, further increasing costs for the sick people who would remain and weakening the exchanges.

What happens during 2019 enrollment period will be anybody’s guess. However, Democrats are aiming for the midterm elections to shore up the plan.

Research contact: @JeffYoung