Home Daily News Clips Thursday News: Trumpcare Going to Be Ugly, Nasty, Mean; “Georgia, Healthcare, and...

Thursday News: Trumpcare Going to Be Ugly, Nasty, Mean; “Georgia, Healthcare, and All The Other Bad Things”; “Pipeline Fighters Take a Stand in Virginia Vote”


by Lowell

Here are a few national and Virginia news headlines, political and otherwise, for Thursday, June 22.

  • Quizzical

    I have a Groundhog Day feeling about Trumpcare, in that we are revisiting policy debates that we have already had over and over, and should be resolved by now. For instance, there now seems to be an implicit idea out there that if 20 million or more people lose their subsidized health insurance and if Medicaid eligibility is drastically cut back, there’s going to be a big savings that will lead to lower health insurance premiums.

    But I thought the foundation of both the Massachusetts health care system (Romneycare) and the ACA that having a huge number of uninsured was bad both from a health care delivery standpoint but also because it was more expensive. That is, someone who is uninsured still is entitled to be treated in the emergency rooms of publicly funded hospitals. That’s the most expensive way to deliver health care, and it leads to worse outcomes because the uninsured people put off going to the ER until they are very sick. So by doing that, you lose the benefits of preventative care that heads off health problems before they get really bad and really expensive to treat.

    There is no such thing as a free ER visit, so the hospitals providing that care get paid either through some sort of taxpayer subsidy or by upping the charges for all patients of the hospital so that those with health insurance subsidize the treatment of the uninsured. That is why health insurance premiums were increasing at an unsustainable rate before the ACA was passed.

    Simple logic tells us that if the AHCA features a huge reduction in Medicaid eligibility and a huge reduction in subsidies for health insurance for people who can’t otherwise afford insurance, then the costs for health care for all of those folks are going to be passed to the public hospitals, and the hospitals are going to pass the increased costs on, one way or another. Otherwise, the hospital goes out of business and shuts down.

    I keep reading that the clever Republicans are going to delay the implementation of the AHCA until after 2020, but as we saw with the ACA, when the law changes the hospital systems and the other health care providers start adapting immediately. They are not going to wait until 2020 to start making big changes in their operations.

    • Quizzical

      And there is more. Although at the time it was passed, the Obama administration didn’t tout the fact that the ACA was in part a jobs bill, years later it was disclosed that they were looking at it that way. It seems self-evident that if Congress prunes back the ACA, the unintended consequence is that they will cause the loss of jobs in the health care sector. To put it another way, if Congress and Trump take money out of the health care system, there are going to be layoffs at hospitals, clinics, doctors offices, and health insurance companies. How many jobs will be lost? I don’t know, but I’m sure the job losses will be many times more than all the job gains that Trump thinks he can get in coal and oil.

      Another thing is there is an under appreciated benefit to having health insurance or being on Medicaid, apart from access to preventative care and protection from huge expenses due to illness. The under appreciated benefit is that the insurer or the government negotiates with the heath care providers on the charges for medical services, supplies and drugs. No insurance, and you pay the full retail charge — which is grossly inflated to try to cover the costs of care for the uninsured. They will charge you the full rates and then sue to collect if you don’t pay and you have any assets. Don’t think for a moment that they won’t — hospitals get judgments for unpaid medical bills every day.

      For those in your twenties and in good health, that’s something to remember before you spurn health insurance coverage. Without insurance, you are playing health care roulette and if you lose the gamble, you could be wiped out. There is an article about that which should be required reading — Biitter Pill, Why Medical Bills Are Killing Us, by Steven Brill.

  • Barack Obama:

    Our politics are divided. They have been for a long time. And while I know that division makes it difficult to listen to Americans with whom we disagree, that’s what we need to do today.

    I recognize that repealing and replacing the Affordable Care Act has become a core tenet of the Republican Party. Still, I hope that our Senators, many of whom I know well, step back and measure what’s really at stake, and consider that the rationale for action, on health care or any other issue, must be something more than simply undoing something that Democrats did.

    We didn’t fight for the Affordable Care Act for more than a year in the public square for any personal or political gain – we fought for it because we knew it would save lives, prevent financial misery, and ultimately set this country we love on a better, healthier course.

    Nor did we fight for it alone. Thousands upon thousands of Americans, including Republicans, threw themselves into that collective effort, not for political reasons, but for intensely personal ones – a sick child, a parent lost to cancer, the memory of medical bills that threatened to derail their dreams.

    And you made a difference. For the first time, more than ninety percent of Americans know the security of health insurance. Health care costs, while still rising, have been rising at the slowest pace in fifty years. Women can’t be charged more for their insurance, young adults can stay on their parents’ plan until they turn 26, contraceptive care and preventive care are now free. Paying more, or being denied insurance altogether due to a preexisting condition – we made that a thing of the past.

    We did these things together. So many of you made that change possible.

    At the same time, I was careful to say again and again that while the Affordable Care Act represented a significant step forward for America, it was not perfect, nor could it be the end of our efforts – and that if Republicans could put together a plan that is demonstrably better than the improvements we made to our health care system, that covers as many people at less cost, I would gladly and publicly support it.

    That remains true. So I still hope that there are enough Republicans in Congress who remember that public service is not about sport or notching a political win, that there’s a reason we all chose to serve in the first place, and that hopefully, it’s to make people’s lives better, not worse.

    But right now, after eight years, the legislation rushed through the House and the Senate without public hearings or debate would do the opposite. It would raise costs, reduce coverage, roll back protections, and ruin Medicaid as we know it. That’s not my opinion, but rather the conclusion of all objective analyses, from the nonpartisan Congressional Budget Office, which found that 23 million Americans would lose insurance, to America’s doctors, nurses, and hospitals on the front lines of our health care system.

    The Senate bill, unveiled today, is not a health care bill. It’s a massive transfer of wealth from middle-class and poor families to the richest people in America. It hands enormous tax cuts to the rich and to the drug and insurance industries, paid for by cutting health care for everybody else. Those with private insurance will experience higher premiums and higher deductibles, with lower tax credits to help working families cover the costs, even as their plans might no longer cover pregnancy, mental health care, or expensive prescriptions. Discrimination based on pre-existing conditions could become the norm again. Millions of families will lose coverage entirely.

    Simply put, if there’s a chance you might get sick, get old, or start a family – this bill will do you harm. And small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, cannot change the fundamental meanness at the core of this legislation.

    I hope our Senators ask themselves – what will happen to the Americans grappling with opioid addiction who suddenly lose their coverage? What will happen to pregnant mothers, children with disabilities, poor adults and seniors who need long-term care once they can no longer count on Medicaid? What will happen if you have a medical emergency when insurance companies are once again allowed to exclude the benefits you need, send you unlimited bills, or set unaffordable deductibles? What impossible choices will working parents be forced to make if their child’s cancer treatment costs them more than their life savings?

    To put the American people through that pain – while giving billionaires and corporations a massive tax cut in return – that’s tough to fathom. But it’s what’s at stake right now. So it remains my fervent hope that we step back and try to deliver on what the American people need.

    That might take some time and compromise between Democrats and Republicans. But I believe that’s what people want to see. I believe it would demonstrate the kind of leadership that appeals to Americans across party lines. And I believe that it’s possible – if you are willing to make a difference again. If you’re willing to call your members of Congress. If you are willing to visit their offices. If you are willing to speak out, let them and the country know, in very real terms, what this means for you and your family.

    After all, this debate has always been about something bigger than politics. It’s about the character of our country – who we are, and who we aspire to be. And that’s always worth fighting for.

  • Robert Reich:

    The Senate version of the repeal (and “replacement”) of the Affordable Care Act — which Mitch McConnell is now sharing with Senate Republicans — eliminates just about all of its extra taxes on the rich by deeply cutting Medicaid and reducing subsidies to the poor. But McConnell figures he can keep moderate Republicans in the fold (he needs almost all their votes) by delaying these provisions and allowing states to reduce insurance coverage.

    The plan:

    1. Basically retains Obamacare’s insurance subsidies. But starting in 2020 this assistance wouldn’t be available for most of the working-class who now receive them, nor for anyone ineligible for Medicaid. See #2.
    2. Cuts Medicaid more deeply than the House version by giving states an amount per person that grows more slowly than the growth in healthcare costs. This provision won’t kick in for 7 years, well past senators’ next reelection battles.
    3. Ends the Affordable Care Act’s Medicaid expansion in 5 years — gradually reducing the extra federal payments starting in 2021.
    4. Continues to protect patients with preexisting conditions, but allows states to reduce insurance coverage to everyone, including people with preexisting conditions.

    In other words, all cuts are made through the back door of delays and state waivers. It only looks like a kinder, gentler version of the House repeal of the Affordable Care Act — but 7 to 10 years from now its result would be even crueler.

  • VA GOP Chair John Whit-less all in on trashing US health care, depriving 10s of millions of coverage

    Anyone remotely familiar with health insurance knows just how badly broken Obamacare is. In Virginia, premiums have gone up 77 percent since 2013. Virginians are far too often forced to purchase ‘insurance’ with sky high deductibles, narrow networks, and unaffordable rates. Like the House bill before it, today’s Senate bill moves us closer to fixing this untenable situation.

    States need flexibility to reform and rebuild Medicaid and other Federally-backed programs in ways that meet the needs of their populations, and the Senate bill gets us closer to that goal. Republicans are committed to ensuring that Virginians have health care, not just health insurance. The Senate bill moves us closer to that goal.