2017-JUL-28: Reuters/Ipsos poll shows public wants Congress to end health care reform efforts:
The reform efforts essentially collapsed by JUL-28.
A poll showed that almost two in three U.S. adults wants Congress to stop its reform efforts, and retain Obamacare, either "entirely as is" or after reforming "problem areas." The survey involved "... more than 1,130 Americans, including 381 Republicans and 475 Democrats." This is a significant increase from a poll in 2017-JAN where just over a half of U.S. adults agreed with that action. Those in favor of retaining Obamacare included about 90% of Democrats and 30% of Republicans.
Kyle Stewart, writing for Roll Call, said:
"The poll also showed an increase in support for specific components of the Affordable Care Act. Seventy-seven percent of Americans favor expanding Medicaid to low-income families, up from 66 percent in April 2012. And 43 percent said they support requiring U.S. residents to own health insurance, an increase from 36 percent in 2012, ..."
"Blame for the health care reform failure was shared, according to survey respondents. Twenty percent said Senate Republicans were 'most responsible,' while 13 percent said President Donald J. Trump, and 11 percent said Republican Senator John McCain of Arizona. The remaining 56 percent was divided between Senate Democrats, Republican Senate Majority Leader Mitch McConnell of Kentucky, and Republican Senators Susan Collins of Maine and Lisa Murkowski of Alaska." 2
2017-JUL-29: President Trump raised the stakes by threatening to attack the health insurance provided to members of Congress, their families, and low-income Americans:
Although there was a consensus in Congress that healthcare reform was "dead in the water," President Trump decided to "flog the dead horse" with a bit of blackmail. (Please pardon the scrambled metaphors.)
President Trump tweeted:
"If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!"
The "bailouts for insurance companies" appears to refer to government payments to insurance companies to partly pay for the health insurance of low income Americans. The "bailouts for Representatives and Senators" reduce the cost of the superb, gold-plated, insurance plans enjoyed by members of Congress and their families.
Jenny Beth Martin of the Tea Party Patriots had issued a statement on the previous day saying:
"To unite congressional Republicans, President Donald Trump should take action to end the congressional exemption from ObamaCare. It is apparent that since Members of Congress, their families and staff do not have to live under the law they passed for every other American, they lack the incentive to take the action they were elected to take. Ending Congress’s special exemption from ObamaCare will motivate Republicans to finally keep their promise — if not for principle, at least to improve their own insurance predicament." 3
The votes in favor of the bill fell short again. The bill, like so many before it, died.
2017-SEP-13: Graham-Cassidy bill: Republicans try, still again, to repeal and replace Obamacare
A new bill was introduced by Senator Lindsey Graham (R-SC) and Bill Cassidy (R-LA). This is a last-ditch effort that is under a very tight time constraint. It was almost certain to fail.
There are 100 Senators: two from each state. Normally, a bill in the Senate requires 60 votes in favor in order to pass. That is well beyond the number that has been achieved by any of the recent Republican-sponsored healthcare bills. All 49 Democratic and Independent members of the Senate will probably vote against it. So far, there have always been a few Republican Senators that refuse vote for the bills because they harm so many fellow Americans. A "reconciliation" process in the Senate means that this bill requires only 50 votes in favor to pass. The Senate's parliamentarian has ruled that the process will expire when the fiscal year ends on SEP-30. 60 positive votes will be required after that date - an impossible hurdle for any of the recent healthcare bills.
As introduced, the Graham-Cassidy bill would:
Repeal individual mandates;
Repeal employer mandates;
End the Medicaid expansion;
Allow states to permit insurance companies to increase premiums for people with pre-existing conditions;
Allow states to permit insurance companies to apply maximum lifetime quotas; and
Defund Planned Parenthood's cancer screening, contraceptive education, and similar preventative programs. (The federal government never has funded Planned Parenthood abortions). 4
The bill is being sold on the basis that it would transform the existing system into "block grants" given to each state. What is not being emphasized is that the grants would be significantly less than states receive under the current system. An independent group, the Center on Budget and Policy Priorities, has analyzed the bill and concludes that the transfer from the federal government to the states would be reduced by $239 billion dollars over the first decade. A second factor that is not emphasized is that the block grants would be eliminated after ten years. A third factor is that the bill would create a "per capita cap" on Medicaid that would place a maximum amount that each person could receive. That would reduce federal support for healthcare by another $179 billion over the first decade. 5
Georges Benjamin, executive director of the American Public Health Association, was not impressed by the bill. He said:
"The Graham-Cassidy plan would take health insurance coverage away from millions of people, eliminate critical public health funding, devastate the Medicaid program, increase out-of-pocket costs, and weaken or eliminate protections for people living with pre-existing conditions." 6
Alison Kodjak, writing for National Public Radio, said:
"Graham-Cassidy essentially deconstructs all of the major programs created by the Affordable Care Act [a.k.a. ACA, Obamacare], gathers up the money and hands it over to states to run their own health care programs.
It gets rid of both the subsidies that help people buy individual health insurance policies and the reimbursements to insurance companies for offering price breaks on co payments and deductibles to the lowest-income customers.
It rolls back the Obamacare Medicaid expansion that was adopted by 31 states and Washington, D.C., and it eliminates the Basic Health Program that was created under the ACA and implemented in New York and Minnesota." 6
Unfortunately, the tight time schedule will not permit sufficient time for the Congressional Budget Office to evaluate the Graham-Cassidy bill and generate their assessment of the bill's impact on people. Thus the Senators will be voting on the bill blind, without knowing exactly to what degree the public would be hurt. One can probably assume that this bill, like previous Republican bills, would cause the premature and preventable deaths of hundreds of thousands of additional Americans over its first decade.
Meanwhile, Senator Bernie Sanders, (I-VT) has introduced a bill to establish a federal government-run health insurance system. It would resemble Medicare and would be similar to the single-payer plans that are in place in most of the world's developed countries. Everyone would be covered. These plans are heavily favored by the public in these countries where they have been implemented, including Canada, the UK, Australia, New Zealand, etc. Their per-capita cost is much less than the present or proposed U.S. system. However, the bill is also probably going to fail, largely because Republicans view it as a socialist scheme. 7
2017-SEP-20: Former President Barack Obama responds to the Graham-Cassidy proposed healthcare bill:
"... what’s needed today [is] the engagement of everyone who wants to see a better future for our children.
Those of you who live in countries that already have universal healthcare are trying to figure out what’s the controversy here. I am too. ..."
The [ACA] legislation that we passed was full of things that still needed to be fixed. It wasn’t perfect. But it was better, and so when I see people trying to undo that hard-won progress for the 50th or 60th time, with bills that would raise costs or reduce coverage, or roll back protections for older Americans, or people with pre-existing conditions, the cancer survivor, the expecting mom or the child with autism, or asthma, for whom coverage once again would be almost unobtainable, it is aggravating.
And all this being done without any demonstrable economic or actuarial or plain common sense rationale. It frustrates.
It’s certainly frustrating to have to mobilize every few months to keep our leaders from inflicting real human suffering on our constituents.
But typically that’s how progress is won, and how progress is maintained on every issue. We have to stand up for each other, recognize that progress is never inevitable." 8
The ONION chimes in:
"The ONION" is a satirical web site that bills itself as: "America's finest news source'" They published an article on healthcare titled: "GOP Leaders Confident They’ll Have Cruelty Necessary To Pass Healthcare Bill." It says:
"Increasingly optimistic that the callousness they required would be locked down by the September 30 deadline, GOP leaders were confident Wednesday that they will have the cruelty necessary to pass their new healthcare bill. 'While we were nearly there on our previous attempts, with this go-around we’re all but certain we have the savagery we need for this measure to move forward,' said bill coauthor Sen. Lindsey Graham (R-SC), adding that the utter contempt for the lives of middle class and poor Americans appeared to be 'falling into place nicely.' 'I’m not saying that lining up the wanton disregard for human suffering will be easy, but I’m more and more persuaded that it will be there when this bill ultimately comes to the floor.' At press time, Graham was meeting with several key undecideds, confident they just needed a bit more coaxing before fully pledging their inhumanity." 10
Webmaster's comment [bias alert]:
Needless to say, the ONION's quotations are totally false and imaginary.
As the Republican Senators approval of the bill, they are in effect signing the death warrants of hundreds of thousands of fellow Americans. One wonders just what thoughts go through their minds as the ink is drying.
Total lack of empathy towards the disadvantaged, and a total lack of knowledge of The Golden Rule appear to be two requirements for some Senators to hold office.
2017-SEP-22: Opposition to the bill:
Senator John McCain (R-AZ) issued a statement saying that he could not:
"... in good conscience [support the bill.] ... I believe we could do better working together, Republicans and Democrats, and have not yet really tried. Nor could I support it without knowing how much it will cost, how it will affect insurance premiums, and how many people will be helped or hurt by it. ..."
"We should not be content to pass health care legislation on a party-line basis, as Democrats did when they rammed Obamacare through Congress in 2009. If we do so, our success could be as short-lived as theirs when the political winds shift, as they regularly do."
[A bill of this magnitude] requires a bipartisan approach."
Senator Rand Paul, (R-KY) has said that he would not vote for the bill because it left too much of the Affordable Care Act in place.
Senator Susan Collins, (R, ME) said that she was "leaning against" the bill.
With three Republican Senators and probably all of the Democratic Senators voting against the bill, it is heading towards failure.
Senator Chuck Schumer (D, NY) said:
"John McCain shows the same courage in Congress that he showed when he was a naval aviator. I have assured Senator McCain that as soon as repeal is off the table, we Democrats are intent on resuming the bipartisan process." 11
Carl Hulse, writing for the New York Times, suggests that Campaign fund-raising for Republicans is drying up, because the Republican majority is unable to repeal the Affordable Care Act and pass other bills. Senator Cory Gardner (R-CO) indicates that:
"Donors are furious. We haven’t kept our promise." 12
Senator Charles E. Grassley (R-IA) referring to the Republicans' commitment to replace and repeal the Affordable Care Act said:
"Republicans campaigned on this so often that we have a responsibility to carry out what you said in the campaign. That’s pretty much as much of a reason [to pass the bill] as the substance of the bill."
Republican fund raising during March reached about $7 million; July and August fund raising was only $2 million per month. 12