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U.S. Healthcare


2017-SEP:
One Last Try to repeal Obamacare Fails

Part 19

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pills and thermometer 1

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This topic is continued here from the previous page

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2017-SEP: Medical associations oppose the Graham-Cassidy healthcare bill:

A partial list of national medical associations that are opposed to the bill are:

It appears that there are no U.S. national medical associations in the U.S. who actually support the bill. As U.S. News and World Report stated:
"The nation's doctors, hospitals and health insurance plans are unified in their opposition to the latest Republican bill to dismantle Barack Obama's Affordable Care Act." 4

However, two politically motivated anti-abortion groups do support the bill, presumably because it contains a clause that would defund Planned Parenthood (PP). That would not remove abortion funding by the federal government to PP because none exists. It would only remove funding for contraceptive education, cancer and STD screening tests, etc:

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Brief excerpts from the reasons given by a few of the medical associations who oppose the bill:

  • Sixteen groups made a joint statement in opposition to the bill: the ALS Association, American Cancer Society Cancer Action Network, American Diabetes Association, American Heart Association, American Lung Association, Arthritis Foundation, Cystic Fibrosis Foundation, Family Voices, Juvenile Diabetes Research Foundation, Lutheran Services in America, March of Dimes, National Health Council, National Multiple Sclerosis Society, National Organization for Rare Diseases, Volunteers of America, and WomenHeart:

    "This bill would limit funding for the Medicaid program, roll back important essential health benefit protections, and potentially open the door to annual and lifetime caps on coverage, endangering access to critical care for millions of Americans. Our organizations urge senators to oppose this legislation."

  • The joint Alzheimer’s Association and Alzheimer’s Impact Movement statement said:

    "More than 5 million Americans are currently living with Alzheimer’s, a progressive and fatal brain disease, and another 15 million are providing care. ... Medicaid is the only public program that covers these long-term nursing home stays. Medicaid also covers home and community-based services which are critical for people with dementia, particularly in the early and middle stages of the disease. The proposed changes to Medicaid outlined in the Graham-Cassidy Amendment could have a drastic impact on this vulnerable population given that more than 1 in 4 seniors with Alzheimer's and other dementias are currently on Medicaid."

  • The American Cancer Society statement said:

    "Our analysis indicates the bill could allow insurers to:

    • Charge cancer patients and survivors far higher rates to make coverage unaffordable;
    • Eliminate coverage for cancer care in their health plans;
    • Re-institute arbitrary caps on annual and lifetime coverage.
  • The CEO and Executive Vice President James L. Madara of the American Medical Association wrote:
  • "Similar to proposals that were considered in the Senate in July, we believe the Graham-Cassidy Amendment would result in millions of Americans losing their health insurance coverage, destabilize health insurance markets, and decrease access to affordable coverage and care. We sincerely urge the Senate to take short-term measures to stabilize the health insurance market by continuing to fund cost sharing reduction payments."

  • The American Nurses Association said:

    "The Senate’s new plan to repeal the Affordable Care Act will cause chaos for states subsidizing coverage -- and ultimately rip away healthcare from patients."

    Their web site has a form to fill out. It will arrange for a call from the Nurses Association which will connect you directly with your senators.

  • Sr. Carol Keehan, President and CEO of the Catholic Health Association asked people to phone their senators and tell them to:
    • "Vote 'NO' on the Graham-Cassidy legislation ... which eliminates Medicaid expansion coverage, premium tax credits, and cost-sharing reduction subsidies and replaces them with state block grants.

    • Oppose the complete restructuring and deep funding reductions to the Medicaid program in the bill [which the bill would cause by] -- capping & cutting federal Medicaid funding, through both per capita caps and block grants, [which] fundamentally undermines the health care safety net and our ability to serve beneficiaries.

    • ... enact bipartisan legislation to stabilize the individual insurance market. ..."

She notes that:

    • "The new block grant funding is estimated to be $239 billion less over ten years than that provided under the current law, resulting in large cuts for many states. ..."

    • "In addition, funding cuts and structural changes to the traditional Medicaid program would inflict permanent and far-reaching damage on communities and lead to coverage losses for millions of our nation’s most vulnerable populations. Caps and block grants simply shift the cost burden onto local and state governments, individual beneficiaries and health providers. States will be unable to make up for the estimated $175 billion in Medicaid cuts over 10 years."

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2017-SEP-25: Senator Susan Collins announces her firm opposition to the bill:

Her main concerns were the drastic cuts to Medicaid and the limits to protection of persons with pre-existing medical conditions.

With Senators John McCain (R-AZ), Rand Paul (R-KY), Susan Collins (R-ME) ready to vote against the bill, and Ted Cruz (R-TX) asking for changes before he would vote for the bill, its probability of passage appeared to be remote.

Thomas Kapland and Robert Pear of the New York Times wrote that Senator Collins' decision:

"... effectively dooms what had been a long-shot effort by Republicans in the Senate to make one more attempt at repealing the health law after failing in dramatic fashion in July.

For seven years, Republicans have said they would repeal President Barack Obama’s signature domestic achievement and replace it with a new health care system more palatable to conservatives. But they were never able to formulate a replacement that was both politically and substantively viable."

After the inauguration of President Trump, the Senate Republicans hoped to pass a number of laws, overturning many of the changes implemented by the Obama administration. But after almost eight months, even while holding control of the Presidency, Senate, and House, their accomplishments have been essentially zero. 3

There does not appear to be any wording for a healthcare law that would obtain the support of a majority of Senators at this time.

The article in The New York Times gathered 784 comments over night. Reader Jim Dickinson posted the following remark:

"So once again Senate Republicans appear destined to walk blindly into a wall, fall on their faces, and accidentally do the right thing. I find it amazing that only three among them seem to care at all about the health and welfare of the people who elected them. Even with a majority in both houses of Congress Republicans are unable to faithfully represent their constituent's best interests.

How pathetic, sad and depressing it is to be a citizen of the US in the age of Trump." 3

By late 2017-SEP, only a small handful of Republican Senators --  John McCain, Susan Collins, Lisa Murkowski, and Rand Paul -- were concerned about their constituents' loss of health care and premature death if the bill were passed. They had indicated that they would vote against the bill, thus making its passage impossible.

President Trump tweeted on the morning of SEP-27 that Republicans actually had the votes needed to pass the bill, except that one supporter was in the hospital and thus was unable to vote.  Matthew Yglesias, updating an article at Vox, responded:

"In reality, there is no hospitalized senator. But Trump has constructed for himself an alternative version of reality in which not only is there a hospitalized senator but the budget reconciliation instructions which expire tomorrow somehow return early next year, meaning that when the fake senator’s hospitalization ends they’ll be able to come back and pass the bill." 5

Also on SEP-27, Senate majority leader Mitch McConnell (R-KY) confirmed that there would be no vote on the Graham-Cassidy bill. It is now dead in the water. 5

Perry Bacon Jr, writing for Fivethirtyeight.com summarized the problems with all of the 2017 attempts to modify health care:

"Graham-Cassidy failed for the same reasons the various other Obamacare repeals have: It was too conservative for senators like Maine’s Susan Collins, insufficiently conservative for people like Kentucky’s Rand Paul and written in too much of a slapdash, partisan way for people like Arizona’s John McCain." 6

A preliminary assessment of the Graham-Cassidy bill by the Congressional Budget Office indicates that if the bill were passed into law:

  • Millions more people would lose their insurance, but an accurate number is unknown at this time.

  • Expenditures under Medicaid would be reduced by about $100 billion a year during the first decade.

  • Total federal expenditure on health care would be reduced by about 13.3 billion a year during the first decade.

  • Preserving the current regulations on insurance markets while reducing the funding that helps people pay for it would lead to an "unsustainable spiral." 6

  • In addition, the reduction in expenditures on health care by the federal government would have enabled a reduction in the income tax rate for the very rich. This, in turn, would keep campaign money flowing to individuals members of Congress from he rich.

As this report is being updated, it is October-01. The reconciliation process has ended. Any future attempts to revise the Affordable Care Act will require 60 votes in the Senate -- an impossible hurdle to overcome with the current makeup of the Senate.

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2017-OCT-12 to 16: President Trump attacks "Obamacare," and issues a false claim about it:

On OCT-12, he announced that subsidies for low income Obamacare users will be terminated. Senator Susan Collins (R-ME) said that this would threaten:

"... the ability of vulnerable peoplle to receive health care."

President Trump claimed that the Affordable Care Act (ACA) no longer exists. Addressing a meeting of his Cabinet, he claimed:

"Obamacare is finished. It’s dead. It’s gone. You shouldn’t even mention it. It’s gone. There is no such thing as Obamacare anymore."

In reality, Obamacare is still the law of the land. A sign-up period will run from 2017-NOV-01 to DEC-15 in most states. 7

Sadly, many uninsured people will probably interpret President Trump's statement literally, will not bother to try to enroll in Obamacare, and remain uninsured and vulnerable to untreated illness and death.

Jonathan Cohn, writing for Huffington Post, said:

"A critical mass of insurers has remained in the [ACA] program because, as of this year, their financials were finally improving and they could see the makings of the stable, profitable market that the law’s architects always envisioned. But that future was dependent on an administration that wanted the program to succeed. The Trump administration feels differently, and insurers will be thinking about that, hard, in the spring when they make their decisions about whether to stay in the program for 2019 and beyond. ..." 8

Trump has also reduced the ACA's advertising budget and the length of the signup interval, with the apparent intent of making the death of the ACA a self-fulfilling prophecy.

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More developments are probable.

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References used:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

  1. Image © Natalia Nazarenko Vladimirovna. Downloaded from Dreamstime Stock Photos, ID 2839729
  2. , "Here’s a list of medical groups opposing the Cassidy-Graham health-care bill," The Washington Post, 2017-SEP-22, at: https://www.washingtonpost.com/
  3. Thomas Kapland & Robert Pear, "Health Bill Appears Dead as Pivotal G.O.P. Senator Declares Opposition," 2017-SEP-25, The New York Times, at: https://www.nytimes.com
  4. "The Latest: Health Care Groups Oppose GOP Bill," U.S. News and World Report, 2017-SEP-23, at: https://www.usnews.com/
  5.  Matthew Yglesias, "Trump keeps saying Graham-Cassidy failed because a senator’s in the hospital," Vox, 2017-SEP-28, at: https://www.vox.com/
  6. Perry Bacon Jr, "What Went Down In The Debate Over Graham-Cassidy," FiveThirtyEight, 2017-SEP-25, at: http://fivethirtyeight.com/
  7. Igor Bobic, "Trump Says There's 'No Such Thing As Obamacare Anymore' One Month Before Enrollment Starts," Huffington Post, 2017-OCT-16, at: https://www.huffingtonpost.com/
  8. Jonathan Cohn, "Trump’s Latest Health Care Move Will Cause Pain, But Not For The Poor," Huffington Post, 2017-OCT-16, at: https://www.huffingtonpost.com/

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Copyright © 2017 by Ontario Consultants on Religious Tolerance
Originally posted on: 2017-SEP-24
Latest update: 2017-OCT-17
Author: B.A. Robinson
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