ObamaCare

Cartoon of the day

Published by Anonymous (not verified) on Sun, 24/09/2017 - 10:16am in

Cartoon of the day

Published by Anonymous (not verified) on Sat, 23/09/2017 - 11:00pm in

Last-Ditch Effort By Republicans to Replace ACA: What You Need to Know

Published by Anonymous (not verified) on Thu, 21/09/2017 - 5:51am in

This post originally appeared at Kaiser Health News.

Republican efforts in Congress to “repeal and replace” the federal Affordable Care Act are back from the dead. Again.

While the chances for this last-ditch measure appear iffy, many GOP senators are rallying around a proposal by Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA), along with Sens. Dean Heller (R-NV) and Ron Johnson (R-WI)

They are racing the clock to round up the needed 50 votes — and there are 52 Senate Republicans.


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Mary Mayhew, commissioner of Maine's Dept. of Health & Human Services (left) and Gov. Paul LePage answer questions during a news conference to announce changes to the MaineCare system in Augusta, Maine, on Dec. 6, 2011. (Photo by Joe Phelan/Portland Press Herald via Getty Images)

The War on Medicaid Is Moving to the States

BY Greg Kaufmann | September 5, 2017

An earlier attempt to replace the ACA this summer fell just one vote short when Sens. Susan Collins (R-ME), Lisa Murkowski (R-AK) and John McCain (R-AZ) voted against it. The latest push is setting off a massive guessing game on Capitol Hill about where the GOP can pick up the needed vote.

After Sept. 30, the end of the current fiscal year, Republicans would need 60 votes ­— which means eight Democrats — to pass any such legislation because special budget rules allowing approval with a simple majority will expire.

Unlike previous GOP repeal-and-replace packages that passed the House and nearly passed the Senate, the Graham-Cassidy proposal would leave in place most of the ACA taxes that generated funding to expand coverage for millions of Americans. The plan would simply give those funds as lump sums to each state. States could do almost whatever they please with them. And the Congressional Budget Office has yet to weigh in on the potential impact of the bill, although earlier estimates of similar provisions suggest premiums would go up and coverage down.

“If you believe repealing and replacing Obamacare is a good idea, this is your best and only chance to make it happen, because everything else has failed,” said Graham in unveiling the bill last week.

Here are five things to know about the latest GOP bill:

1. It would repeal most of the structure of the ACA.


RELATED: Health & Science


A July 2017 protest against the Republican health care bill in Milwaukee, Wisconsin. (Joe Brusky/Flickr cc 2.0)

Doctors Are Warming Up to Single-Payer Health Care

BY Rachel Bluth | August 22, 2017

The Graham-Cassidy proposal would eliminate the federal insurance exchange, healthcare.gov, along with the subsidies and tax credits that help people with low and moderate incomes — and small businesses — pay for health insurance and associated health costs. It would eliminate penalties for individuals who fail to obtain health insurance and employers who fail to provide it.

It would eliminate the tax on medical devices. 

2. It would eliminate many of the popular insurance protections, including those for people with pre-existing conditions, in the health law.

Under the proposal, states could “waive” rules in the law requiring insurers to provide a list of specific “essential health benefits” and mandating that premiums be the same for people regardless of their health status. That would once again expose people with pre-existing health conditions to unaffordable or unavailable coverage. Republicans have consistently said they wanted to maintain these protections, which polls have shown to be popular among voters.

3. It would fundamentally restructure the Medicaid program.

Medicaid, the joint-federal health program for low-income people, currently covers more than 70 million Americans. The Graham-Cassidy proposal would end the program’s expansion under the ACA and cap funding overall, and it would redistribute the funds that had provided coverage for millions of new Medicaid enrollees. It seeks to equalize payments among states. States that did not expand Medicaid and were getting fewer federal dollars for the program would receive more money and states that did expand would see large cuts, according to the bill’s own sponsors. For example, Oklahoma would see an 88 percent increase from 2020 to 2026, while Massachusetts would see a 10 percent cut.

The proposal would also bar Planned Parenthood from getting any Medicaid funding for family planning and other reproductive health services for one year, the maximum allowed under budget rules governing this bill. 

4. It’s getting mixed reviews from the states.

Sponsors of the proposal hoped for significant support from the nation’s governors as a way to help push the bill through. But, so far, the governors who are publicly supporting the measure, including Scott Walker (R-WI) and Doug Ducey (R-AZ), are being offset by opponents including Chris Sununu (R-NH), John Kasich (R-OH) and Bill Walker (I-AK).

On Tuesday 10 governors — five Democrats, four Republicans and Walker — sent a letter to Senate leaders urging them to pursue a more bipartisan approach. “Only open, bipartisan approaches can achieve true, lasting reforms,” said the letter.

Bill sponsor Cassidy was even taken to task publicly by his own state’s health secretary. Dr. Rebekah Gee, who was appointed by Louisiana’s Democratic governor, wrote that the bill “uniquely and disproportionately hurts Louisiana due to our recent [Medicaid] expansion and high burden of extreme poverty.”

5. The measure would come to the Senate floor with the most truncated process imaginable.

The Senate is working on its Republican-only plans under a process called “budget reconciliation,” which limits floor debate to 20 hours and prohibits a filibuster. In fact, all the time for floor debate was used up in July, when Republicans failed to advance any of several proposed overhaul plans. Senate Majority Leader Mitch McConnell (R-KY) could bring the bill back up anytime, but senators would immediately proceed to votes. Specifically, the next order of business would be a process called “vote-a-rama,” where votes on the bill and amendments can continue, in theory, as long as senators can stay awake to call for them.

Several senators, most notably John McCain, who cast the deciding vote to stop the process in July, have called for “regular order,” in which the bill would first be considered in the relevant committee before coming to the floor. The Senate Finance Committee, which Democrats used to write most of the ACA, has scheduled a hearing for next week. But there is not enough time for full committee consideration and a vote before the end of next week.

Meanwhile, the Congressional Budget Office said in a statement Tuesday that it could come up with an analysis by next week that would determine whether the proposal meets the requirements to be considered under the reconciliation process. But it said that more complicated questions like how many people would lose insurance under the proposal or what would happen to insurance premiums could not be answered “for at least several weeks.”

That has outraged Democrats, who are united in opposition to the measure.

“I don’t know how any senator could go home to their constituents and explain why they voted for a major bill with major consequences to so many of their people without having specific answers about how it would impact their state,” said Senate Minority Leader Chuck Schumer (D-NY) on the Senate floor Tuesday.

 
Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

The post Last-Ditch Effort By Republicans to Replace ACA: What You Need to Know appeared first on BillMoyers.com.

DNC Chair Perez blasts Trump for breaking government promises to American Indians

Published by Anonymous (not verified) on Fri, 11/08/2017 - 4:44am in

Since long before the founding of the Republic, the settler populations from the Puritans onward did their best to wipe out the indigenous peoples of what is now the United States. By Meteor Blades  The vast majority of American Indians—likely in their millions—were killed by European-brought diseases. But public policy, spoken and written, was predicated on extermination, sometimes […]

The post DNC Chair Perez blasts Trump for breaking government promises to American Indians appeared first on Red, Green, and Blue.


What’s Next for Obamacare? An Urgent Prognosis

Published by Anonymous (not verified) on Thu, 10/08/2017 - 5:44am in

On Friday, July 21, as our senators were getting their first look at a bill that would have put at least 22 million Americans back into the ranks of the uninsured, hundreds of people were waiting patiently — and had been since well before dawn — at the gates of a county fairgrounds in the mountains of southwest Virginia.

Many of them had traveled from hundreds of miles away and had slept in their cars and trucks, hoping to be among the first admitted when the fairground gates opened at 5 a.m. All had them had fallen through the cracks of a dysfunctional system that Obamacare at best applied a Band-Aid to, bringing many people into coverage but leaving many others out and doing little to control health care costs.

Most of the people at the fairgrounds were uninsured but many others actually had insurance. But their policies — including some bought through an Obamacare exchange — either had such high deductibles they still couldn’t afford to go to the doctor, or they didn’t cover what most of them needed, dental and vision care in particular.


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"The problem is the fact that health care in the United States is a for-profit industry, like petroleum speculation or automobile manufacture," writes William Rivers Pitt. (Photo by Hamza Butt/ flickr CC 2.0)

A Lesson From My Hospital Bed: For-Profit Health Care Is a Merciless Sham

BY William Rivers Pitt | June 23, 2017

By Sunday afternoon, the third and final day of this annual pop-up clinic, organized by the Remote Area Medical Volunteer Corps (RAM), doctors, nurses and dentists had treated more than 2,000 patients — not in private examining rooms but under tents and in the barns and animal stalls scattered throughout the Wise County, Virginia, fairgrounds, just as they’ve done over a long weekend in July for 18 years.

I’ve often referred to the 50 miles of highway between my hometown of Kingsport, Tennessee, and Wise, Virginia, as my road to Damascus. I learned about the massive clinic 10 years ago while visiting relatives. I went there out of curiosity. I left shaken and changed. I knew that some of the people in those long lines could have been people I grew up with. I knew I could have been one of them if I hadn’t had more than a few lucky breaks along the way.

I also realized that, as a health insurance executive, I was at least partly responsible for that scene. My job then was to help perpetuate a system that was very profitable for the insurance industry and other special interests, even if the consequence was a rapidly growing number of Americans without health insurance or any other means to pay for the care they needed. A few months later I quit my job and became a vocal advocate for reform.

Yes, Obamacare has brought more people into coverage, but 30 million of us still lack health insurance, and at least that many more are underinsured because of the insurance industry’s years-long strategy — which was actually abetted by the Affordable Care Act — to move all of us, regardless of our income, into high-deductible plans.

I went back to Wise County last month thinking the crowd might be smaller than it was 10 years ago. If anything, the need has only increased. Yes, Obamacare has brought more people into coverage, but 30 million of us still lack health insurance, and at least that many more are underinsured because of the insurance industry’s years-long strategy — which was actually abetted by the Affordable Care Act — to move all of us, regardless of our income, into high-deductible plans.

Some Republican criticisms of Obamacare are valid, although none of what they’ve proposed so far would address them. Obamacare hasn’t done much to slow the increase in the prices of everything from prescription drugs to a stay in the hospital, and premiums continue to go up for those of us who have coverage.

And there is little hope that the law can get us much closer to universal coverage. In fact, a recent Gallup poll found that the percentage of Americans without health insurance is on the rise again. In the second quarter of 2017, 11.7 percent of Americans were uninsured, compared to 10.9 percent at the end of 2016. That means an additional 2 million people are once again uninsured.

Meanwhile, as growing numbers of Americans are enrolled in high-deductible plans, more of us are skipping visits to the doctor and not getting our prescriptions filled. The Commonwealth Fund, which keeps track of changes in the number of underinsured Americans, says 31 million of us were underinsured in 2014 as insurers and employers continued to push more of us into high-deductible plans. The number of underinsured people in such plans has more than tripled since 2003. The Commonwealth Fund says more than half of the underinsured have problems paying medical bills or are paying off medical debt over time.

It’s little wonder then why many people who line up for RAM’s clinics have insurance, but insurance that increasingly is of little value to them.

So where do we go from here? Although members of the far-right Freedom Caucus say they’ll keep trying to repeal Obamacare, there now is much talk in Washington about a bipartisan effort to “fix” the law. And it is in urgent need of attention.

Even the best run Obamacare exchanges are reporting that premiums will take a big hike again next year. Republicans, of course, are partly to blame. In 2015, Sen. Marco Rubio of Florida quietly inserted language into a big spending bill that halted payments from a fund set up to help stabilize the individual insurance market. That’s the reason many of the small co-op insurance companies failed and several big insurers stopped selling policies on the exchanges.

More recently, President Trump has tweet threatened to “let Obamacare implode.” He could make it happen by cutting off payments that reduce out-of-pocket expense for low-income Obamacare customers. Because that money flows through insurance companies, their anxious executives, knowing Trump could follow through just to see what happens, have decided to increase premiums more than they otherwise would on policies they sell on the Obamacare exchanges next year.

The California exchange, the biggest and arguably one of the best-run in the country, announced recently that rates will go up an average of 12.5 percent for California residents in 2018, in large part because of uncertainty as to what Trump and the Republicans will — or won’t — do.

The other, more significant reason premiums continue to increase year after year, often by double digits, is because of a fact insurance industry flacks like I used to be have successfully obscured for decades: private health insurers cannot control medical costs. Not only that, they have incentives not to even try very hard.

The Affordable Care Act forced insurers to be somewhat more consumer-friendly, but for the most part they are doing business just as they were before, shifting more and more of the cost of care from them to us. The industry’s successful PR campaigns over many years have obscured what in reality is classic market failure.

As drug companies, hospitals and other providers raise their prices, insurers simply raise premiums to more than offset the increases. Because most of us (and our employers) have no choice but to do business with private insurers, if we want coverage, we pay what they demand. That means ever-increasing premium revenue for insurers, which fuels their ever-increasing profits. The Affordable Care Act forced insurers to be somewhat more consumer-friendly, but for the most part they are doing business just as they were before, shifting more and more of the cost of care from them to us. The industry’s successful PR campaigns over many years have obscured what in reality is classic market failure.

The talk of a possible bipartisan effort to address some of Obamacare’s shortcomings is coming from the so-called Problem Solvers Caucus, a group of 40 or so members of Congress with roughly equal numbers of Republicans and Democrats. GOP members of the caucus have floated a handful of ideas they believe will stabilize the Obamacare markets they helped destabilize in the first place, but they also want to reward some of the special interests that write big campaign checks.

In addition to setting up a “stabilization fund” to help states reduce premiums for people with preexisting conditions, they would repeal the 2.3 percent Obamacare tax on medical devices that under the law helps pay for the expansion of coverage. They also would exempt businesses with 500 workers or fewer from having to provide coverage to employees and their dependents. Under Obamacare, employers with at least 50 workers must offer coverage.

I would put at about zero the chances of this caucus coming up with legislation that would pass either the House or Senate. Many Republicans appear to have grown weary of dealing with health care because — who knew? — it’s hard. Just last week week, GOP Sen. Chuck Grassley of Iowa, a member of the all-important Finance Committee, said the Senate has given up on repeal and replace and is moving on to tax reform.

The more Americans learned about what the Republicans’ repeal bills would have done — and what they would have taken away from millions of us — the more they opposed them. Even Fox News reported that only 27 percent of voters favored the Senate bill. By the time senators voted on the bill, other polls showed far less support. As for the repeal bill the House passed in May, an NBC/Wall Street Journal poll found that only 16 percent of Americans liked it.


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Felue Chang (right), who obtained health insurance through the Affordable Care Act, receives a checkup from Dr. Peria Del Pino-White at the South Broward Community Health Services clinic on April 15, 2014 in Hollywood, Florida. (Photo by Joe Raedle/Getty Images)

Repeal Obamacare? GOP Should Be Careful What They Wish For

BY Wendell Potter | December 7, 2016

The debate on the GOP bills had the unintended consequence, at least for Republican leaders, of rekindling interest in a Canadian-style single-payer health care system. Recent polls have shown a resurgence in support for single-payer health care, with a majority of Democrats and a significant minority of Republicans now favoring it. We’ve seen similar poll numbers in the past, but what is different this time is that business leaders, including some famous Republican business leaders, are waking up to the fact that private insurers not only are unnecessary and unhelpful, they are part of the problem. And they’re speaking up.

Warren Buffett told Berkshire Hathaway’s shareholders in May that medical costs are “the tapeworm of American economic competitiveness.” The company’s vice chairman, Republican Charlie Munger, went on to suggest that the US should adopt a single-payer system to replace “the Rube Goldberg system that arose by accident.”

Buffett and Munger are not the only voices in the business community fed up with the current system. The ultimate goal of a recently formed group called Business Leaders Transforming Healthcare is a single-payer system. It already has more than 200 members.

Longtime single-payer advocate Bernie Sanders says he will introduce a new bill next month to create a “Medicare-for-all” system in the US. To drum up support, he is planning a six-figure digital ad buy with money from his 2018 re-election campaign.

Although any single-payer plan would require new tax revenue, Sanders and many others, including many health policy experts and economists, have long contended that a single-payer system would eliminate much of the waste in our current system and that most Americans would pay less for government-provided coverage than they pay private insurance companies now.

But as long as Republicans control Congress and Trump sits in the White House, don’t expect Sanders’ bill to be enacted. And even if Democrats retake Washington, enacting single-payer health care at the federal level will not be an easy lift because many Democrats get as many campaign contributions from health care special interests as Republicans do.

That’s why many advocates believe the best route to single-payer is through the states. They note that Canada’s system got its start in Regina, Saskatchewan, not Ottawa.  

If single-payer has a chance of succeeding at any level, advocates, this time including motivated business executives, will have to work more strategically and have far more resources than they’ve had in the past to counter what will be a massive campaign of deceptive ads and PR tactics financed by the special interests with the most to lose.

That campaign will be waged not just by insurance companies but also by drug and medical device makers, pharmacy benefit managers and organizations like the American Hospital Association and the American Medical Association. The symbiotic relationship between private insurers and health care providers has proven to be exceedingly profitable for all of them, and they will spend whatever they think it will take to keep our expensive and dysfunctional Rube Goldberg of a system in place. Even if it means growing numbers of Americans being treated in barns and animal stalls.

The post What’s Next for Obamacare? An Urgent Prognosis appeared first on BillMoyers.com.

Why Down Under Comes Out on Top in Health Care

Published by Anonymous (not verified) on Wed, 09/08/2017 - 3:21am in

When I arrived in New York as a young journalist from Sydney, Australia in 2003, not even the dazzle of the big city could conceal the extent of my surprise over three conditions of American society.

One, the racism that still played out; a dark underbelly of a nation painted on the resigned faces on the 4 subway as I traveled home to Crown Heights every day. Two, the air of individualism you could smell on the streets. Yes, there were the Wall Street financiers, but it was everywhere — in the delis, on the bikes of restaurant delivery boys peddling furiously into the night. It seemed to whisper, “Hey girl, you might make it if you try hard enough, but you’re on your own now, good luck!”

There’s good reason why American politicians are gushing over health care down under. Bernie Sanders was back at it again on the Senate floor last week, and even Donald Trump has praised Australia’s health care system this year. Here’s why.

— Christine Kearney

And then finally, there was the American health system. If the first two issues were steeped in American history, health care seemed different. To the outsider, it was nearly unfathomable why the most prosperous nation on earth had not fixed a decades-old problem, that was only becoming a costlier and increasing burden as each year passed.

We had all heard about it. Horror stories spread back home of Australians who had forgotten to take out travel insurance in the US only to end up with six-figure hospital bills. But it was different when right before my eyes — back then some 45 million people carrying the burden of being uninsured. (Little did I know I would soon join them.)

Despite coverage of 2003’s Medicare Prescription Drug, Improvement and Modernization Act, when I quizzed American journalists why there were not more stories, why there didn’t seem any sense of urgency to overall change, I would often be met with a small shrug, and resignation that all those stories had been done before. Change had failed. It wasn’t a scoop.

If that was the sense among some journalists, I still wondered why the public wasn’t more restless. I had to conclude many everyday Americans were simply clueless about how other countries worked.

But now, they’re beginning to know. A couple weeks ago, Americans heard Bernie Sanders gush how Australia’s universal health care is wildly more efficient and effective than America’s. Sanders told the Senate floor: “Not only does Australia guarantee universal health care, spend less on health care per capita, and pay less than we do for many health services, they have better health outcomes.”

Sanders was capitalizing on Donald Trump admitting back in May to a visiting Australian Prime Minister Malcolm Turnbull, “you have better health care than we do.” Yet analysts say the now defeated “skinny repeal” of Obamacare Trump backed would have made the US system less like Australia’s, not more. And Democrats have rightly pointed out the Australian system includes a publicly funded Medicare system far more comprehensive than America’s that covers all ages.

This isn’t refutable. Study after study ranks America way down and Australia among the best overall health care in developed nations. Just two weeks ago, a new study by a team of American researchers found the United States spends far more on health care than other high-income countries, with spending levels rising continuously over the past three decades.

A recent study by the Commonwealth Fund think tank compared the quality of health care systems of 11 high income countries based on 72 indicators, ranking Australia’s mixed public-private system among the top three overall, along with the UK and The Netherlands. It also ranked highest on Administrative Efficiency and Health Care Outcomes.

Despite the praise, Australia’s health care system still depends on a mixed market structure (like the US), using both public and private sectors to provide funds to deliver health care. And it’s not without its failings, including sliding down the world rankings on equity, with people in rural and poorer areas less able to access quality health care, and in general out-of-pocket costs for everyone continuing to increase.

The federal government funds Medicare, a universal public health insurance program providing free or subsidized access to care for Australian citizens…Private health insurance (PHI) is readily available and offers more choice of providers, faster access for nonemergency services, and rebates for selected services.

— The Commonwealth Fund

But that is little consolation for the US, which ranked last overall, last in access, equity and health care outcomes, and next to last in administrative efficiency, as reported by patients and providers. Only in care process did it perform better, ranking fifth.

The authors concluded: “Despite spending nearly twice as much as several other countries, the country’s performance is lacklustre.”

That America’s health care system overspends isn’t exactly news to Americans.

But the tendency to reject change isn’t just politics, say analysts, it’s also human nature, whether in Australia or America.


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A small group of activists rally against the GOP health care plan outside of the Metropolitan Republican Club, in New York City on July 5, 2017.. Republicans in the Senate will resume work on the bill next week when Congress returns to Washington after a holiday recess. (Photo by Drew Angerer/Getty Images)

The Battles Ahead: Meet the Biggest Opponents of Single-Payer

BY Michael Corcoran | July 7, 2017

“There’s the human tendency to get used to the benefits you have, or the system you have,” says Australian-American relations expert, Associate Professor Brendon O’Connor of the Sydney-based think tank The US Studies Centre.

Another underlying reason Americans might have difficulty changing their thinking on health care could be buried in the second of my initial observations in New York — the overall effects of such a free-market leader, he noted. Not least the view that Australians see health care as a right, while in America’s that’s still debatable.

O’Conner believes that is why in America “you have some of the world’s best health care, and you also have some of the biggest gaps in coverage.”

“It goes to a little bit to the heart of America as a more free-market, laissez faire, more capitalist society,” he said. “The idea of a government providing a one-stop shop for health care like the United Kingdom, or even like ours, I would argue is an anathema to American values and traditions.”

Still, while for now a Republican-controlled Congress is hardly going to push for an increase in the government’s role, O’Conner believes “something is sort of changing” and any new president and new Congress might give hope to more universal health care.

“People realize it’s a very expensive system, it doesn’t cover as many people or [offer] benefits like other systems in the western word, so a little bit of comparative analysis rightly leads American politicians and a lot of policymakers to think, ‘Hang on, this system isn’t all its cracked up to be and it’s got a lot of faults.’”

In the meantime, while America’s health care system remains broken, it still plays an important role in Australian politics.

“The American model is presented as bit of monster, politically, in campaigns,” said O’Conner. “It’s one of those good examples of America being a kind of dystopia or disfunction that Australians want to avoid. It’s been a pretty regular trope of the Labor Party to say, ‘Look, we don’t want to go to that American model.’”

The post Why Down Under Comes Out on Top in Health Care appeared first on BillMoyers.com.

Cartoon of the day

Published by Anonymous (not verified) on Tue, 08/08/2017 - 9:00pm in

God-Damn-You-All-to-Hell_1000_590_500

Special mention

198617_600  jdz170730c_590_378

Tagged: Brazil, cartoon, corruption, Obamacare, Temer, Trump, United States

People, Not Politicians, Beat Health Care Repeal

Published by Anonymous (not verified) on Thu, 03/08/2017 - 4:00am in

This post first appeared at OurFuture.org.

In Friday’s early morning hours, news outlets had their spotlights trained on Sen. John McCain (R-AZ), casting him as the decisive player in the latest health repeal drama.

When McCain walked to the front of the room, flagged the clerk, and gave a thumbs down, reporters immediately dashed out of the gallery to pound out stories about the “maverick” move.

It was a dramatic moment, in a dramatic week, in a dramatic presidency. It’s the kind of political theater that sells newspapers and keeps 24-hour cable pundits in business.

 
The Real Story

But the most important parts of the story have little to do with the dramatic gestures of the senior senator from Arizona, who largely objected to the bill for procedural reasons, rather than the fact that it would kick tens of millions of people off health care to give tax cuts to billionaires. And despite their more-principled opposition, the real story isn’t really about Sen. Susan Collins (R-ME) and Sen. Lisa Murkowski (R-AK), either.


RELATED: Activism


Mari Cordes and Rights and Democracy colleagues leaving for their delegation to D.C. (Photo courtesy Rights and Democracy)

Now That Skinny Repeal Is Squashed, What’s Next for Health Care?

BY Sarah Jaffe | August 1, 2017

No. It’s that people from all walks of life, in small towns and big cities, in red districts and blue, have waged a historic effort. We’ve stood up for ourselves and for our families, friends and neighbors who would be impacted by health care repeal.

We’ve stood side-by-side to say that we should be a country that cares for one another, not one where we take health care from seniors, push the disabled into dilapidated institutions or let the poor die in the richest country on earth.

Republicans have waged a seven-year battle to repeal the Affordable Care Act. Since August of 2009, they’ve used the law to stir their base into a frenzy. No wonder that since the election they’ve made it the centerpiece of their legislative agenda, going so far as to promise to repeal it on day one.

 
Millions Speak Out

But in the last six months, millions of people have showed up at marches and rallies, spoken out at town halls, put their electeds on speed dial, and bird-dogged them from fundraiser-to-fundraiser. We’ve derailed the Republican agenda again. And again. And again.

We’ve derailed the Republican agenda again. And again. And again.

While some of this activity has been spontaneous, spurred by righteous indignation at legislation that puts tax cuts for billionaires above health care for families, it is also a testament to grass roots organizing.

Many of the same organizations that have been working to reform the health care system for decades, and that worked tirelessly to pass the Affordable Care Act, have played a crucial role in training and mobilizing everyday people.

This includes groups like People’s Action and more than 20 of our state-based organizations, but also dozens of groups cooperating under the banner of Health Care for America Now, labor unions such as SEIU, and digital advocacy organizations like MoveOn.

A crucial feature of groundswell we’ve seen since the election, the so-called “Resistance” movement, is that it’s been a big-tent movement to derail the Republicans’ ability to govern on a broad array of issues — not just health care.

Quickly puncturing the idea that the Republicans’ sweeping victories in a deeply flawed electoral system was accompanied by any kind of popular mandate, it knocked the wind out of some very puffed up sails.

But in December, just weeks after the election, organizers put in place an infrastructure to channel energy from the grass roots into confronting what we knew would be the Republicans’ chief legislative priority.

The fundamentals of our strategy have been deceptively simple: delay and divide.

 
Why We Fight

We didn’t know if we could defeat the repeal effort — indeed, we still don’t know if we ultimately will — but we are certain that if we slow it down we can work to prevent disastrous policy proposals and delegitimize the Republican Party’s ideas.


RELATED: health care


We also knew that right-wing polarization over the last decade has created deep divisions within their party. Our goal has been to peel off ideologically moderate or electorally vulnerable Republicans, knowing that the far-right will also peel off votes from the other direction. This strategy has enabled us to fracture the Republican’s governing coalition in both the House and the Senate.

Our organizations have worked night and day with hundreds of thousands of politically engaged people to generate a huge volume of activity aimed at realizing this strategy.

People’s Action and our state-based member organizations alone have organized more than 638 rallies, 105 lobby meetings in congressional offices, and hundreds of thousands of phone calls, letters, and petition signatures. And we represent just one part of this broader movement to save our health care.

 
Tactics That Win

In addition to the sheer volume of our activity, we engaged in four key tactics. First, we engaged Republican governors in states that had the most to lose from the repeal effort, urging them to speak out against it.

Second, we worked directly with rural voters around issues that matter most in their communities. Third, we focused not only on pre-existing conditions and raising premiums, but also on Medicaid, a program that serves more than 70 million people.

Most importantly, we worked day in and day out with families who have benefited from the Affordable Care Act and have the most to lose from repeal, elevating their stories. This was crucial to putting the narrative about health care back on track.

After all, health care should be about helping real people thrive, not about line items on a budget or mitigating liability to bolster profits. By sharing those stories, we recentered the debate around making sure our health care system works for the people who rely on it: us.

 
Working Together

By working together, our movement has fundamentally redefined the terms of the health care debate and reshaped the political terrain on which Republicans are trying to legislate. What happened Friday night, happened because of us — the people — not the politicians huddled in the dead of night to decide just how many people in this country should lose their health care.

This fight isn’t over, by a long shot. Already over the weekend, Trump took to twitter to bully more members of his own party and threaten to sink the health care exchanges. Sen. Lindsey Graham is testing support for a new repeal bill. And Republicans are gearing up for major fights on the budget and taxes that could gut Medicaid, privatize Medicare, and give away billions of dollars in tax cuts to drug and insurance corporations and the ultra-wealthy.

But today, we fight with new confidence. When we stand together, when we fight smart, we can win. The Republicans have shown us that they have no ideas of their own for how to reform health care. But we do. The path forward is to take health care out of the market and make it available to every person in this country as a human right.

 
Now’s The Time

Now is the time to put forward bold solutions that drive in that direction. Democrats should put forward legislation that lowers the Medicare age, expands Medicaid, creates a public option in every state, and requires the government negotiate lower prescription drug prices with drug corporations.

They should shorten the length of prescription drug patents and allow people to import prescription drugs from abroad. And any legislative agenda or party platform with a chance of leading Democrats to victory should include Medicare-for-all.

We’ve spent the last six months fighting against a president and a party that are bound and determined to attack our communities at every turn. Now is the time to fight for the world we need.

The post People, Not Politicians, Beat Health Care Repeal appeared first on BillMoyers.com.

Trump’s Big Loss

Published by Anonymous (not verified) on Thu, 03/08/2017 - 1:00am in

This post first appeared at Robert Reich’s blog.

The demise of the Republican effort to repeal the Affordable Care Act is hardly the end of the story. Donald Trump will not let this loss stand.

Since its inception in 2010, Republicans made the Affordable Care Act into a symbol of Obama-Clinton overreach — part of a supposed plot by liberal elites to expand government, burden the white working class, and transfer benefits to poor blacks and Latinos.

Ever the political opportunist, Trump poured his own poisonous salt into this conjured-up wound.

Ever the political opportunist, Trump poured his own poisonous salt into this conjured-up wound. Although he never really understood the Affordable Care Act, Trump used it to prey upon resentments of class, race, ethnicity and religiosity that propelled him into the White House.

Repealing “Obamacare” has remained one of Trump’s central rallying cries to his increasingly angry base.

“The question for every senator, Democrat or Republican, is whether they will side with Obamacare’s architects, which have been so destructive to our country, or with its forgotten victims,” Trump said last Monday, adding that any senator who failed to vote against it “is telling America that you are fine with the Obamacare nightmare.”

Now, having lost that fight, Trump will try to subvert the act by delaying funding so some insurers won’t have time to participate, not enforcing the individual mandate so funding will be inadequate, not informing those who are eligible about when to sign up and how to do so, and looking the other way when states don’t comply.

But that’s not all. Trump doesn’t want his base to perceive him as a loser.

So be prepared for scorched-earth politics from the Oval Office, including more savage verbal attacks on Barack Obama and Hillary Clinton, more baseless charges of voter fraud in the 2016 election, more specific threats to fire special counsel Robert Mueller, and further escalation of the culture wars.

Most Americans won’t be swayed by these pyrotechnics because they’ve become inured to our unhinged president.

But that’s not the point. The rantings are intended to shore up Trump’s “base” – the third of the country that continues to support him, who still believe they’re “victims” of Obamacare, who are willing to believe Trump himself is the victim of a liberal conspiracy to unseat him.

Trump wants his base to become increasingly angry and politically mobilized so they’ll continue to exert an outsized influence on the Republican Party.

There is a deeper danger here. As Harvard political scientist Archon Fung has argued, stable democracies require that citizens be committed to the rule of law even if they fail to achieve their preferred policies.

Settling our differences through ballots and agreed-upon processes rather than through force is what separates democracy from authoritarianism.

Donald Trump has never been committed to the rule of law. For him, it’s all about winning.

But Donald Trump has never been committed to the rule of law. For him, it’s all about winning. If he can’t win through established democratic processes, he’ll mobilize his base to change them.

Trump is already demanding that Mitch McConnell and Senate Republicans obliterate the filibuster, thereby allowing anything to be passed with a bare majority.

On Saturday he tweeted “Republican Senate must get rid of 60 vote NOW!” adding that the filibuster “allows 8 Dems to control country” and “Republicans in the Senate will NEVER win if they don’t go to a 51 vote majority NOW. They look like fools and are just wasting time.”

What’s particularly worrisome about Trump’s attack on the processes of our democracy is that the assault comes at a time when the percentage of Americans who regard the other party as a fundamental threat is growing.

In 2014 — even before Trump’s incendiary presidential campaign — 35 percent of Republicans saw the Democratic Party as a “threat to the nation’s well being” and 27 percent of Democrats regarded Republicans the same way, according to the Pew Research Center.

Those percentages are undoubtedly higher today. If Trump has his way, they’ll be higher still.

Anyone who regards the other party as a threat to the nation’s well being is less apt to accept outcomes in which the other is perceived to prevail — whether it’s a decision not to repeal the Affordable Care Act, or a special counsel’s conclusion that Trump did in fact collude with Russians, or even the outcome of the next presidential election.

As a practical matter, when large numbers of citizens aren’t willing to accept such outcomes, we’re no longer part of the same democracy.

I fear this is where Trump intends to take his followers, along with as much of the Republican Party as he can: Toward a rejection of political outcomes they regard as illegitimate and therefore a rejection of democracy as we know it.

That way, Trump will always win.

The post Trump’s Big Loss appeared first on BillMoyers.com.

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