Myths & facts re: Obamacare

1-5-17 NPR

1) CLAIM: Obamacare suffers from “massive premium increases”

FACT CHECK: True in some cases, but it’s also relative. Obamacare is also actually cheaper on average than the typical employer-provided plan.
A study by the Urban Institute last year found that even without the subsidy, insurance policies sold on the exchanges cost about 10 percent less than the typical employer-provided plan. Exchange policies might seem more expensive, because part of the cost of workplace plans is typically paid by employers, and thus largely invisible to the employee.

2) CLAIM: “You’re stuck with one option” under Obamacare

FACT CHECK: Not true for the majority, but it has increasingly become the case.
Obamacare insurance exchanges have grown less competitive, as some insurance companies have lost money and left the market. One in five customers on the exchanges had just one insurance company to choose from this year (up from 2 percent in 2016). Nearly 6 in 10 customers have a choice of three or more companies. The lack of competition, which can lead to higher prices, tends to be worse in rural areas and the South.
Insurance companies have struggled, in part, because fewer young, healthy people have signed up for coverage than forecast. Backers of the Affordable Care Act say that could be remedied with more generous subsidies to encourage sign-ups or bigger penalties for those who fail to enroll. Obama also renewed the idea of a public insurance option to supplement private offerings.

3) CLAIM: “The health care system has been ruined, dismantled under Obamacare”
FACT CHECK: Prices were going up at faster rates before Obamacare.
Most Americans under age 65 still get health insurance through an employer, although the percentage has been slowly dropping. The cost of employer-provided coverage has gone up since passage of the ACA. But the annual price hikes were considerably larger in the decade before the law was passed. Some of the savings from slower premium growth have been offset by higher deductibles.

4) CLAIM: ACA repeal would “rip health care away from millions”

FACT CHECK: True, if Republicans don’t protect them or replace ACA with something that provides coverage.
The Affordable Care Act has expanded health care coverage to some 20 million Americans through a combination of subsidized individual policies, expanded Medicaid, and allowing young adults to stay on their parents’ plans. The uninsured rate has fallen to an all-time low of around 10 percent. Coverage would be higher still if 19 states had not refused to expand Medicaid.
Republicans have promised an orderly transition as they work toward a replacement for Obamacare, and it’s possible the effective date for any repeal could be delayed for a number of years. Insurance companies, however, may be reluctant to participate once it’s clear Obamacare’s individual market is being phased out.

5) CLAIM: Rural hospitals are going to suffer

FACT CHECK: True, if repealed outright, but it’s also because of the way the ACA was structured in the first place.
The concern for hospitals reflects a trade-off when the ACA was passed seven years ago. The government scaled back what it pays hospitals for treating Medicare patients and the indigent, with the expectation that would be offset by payments from millions of newly insured.
Hospitals worry that if repeal of the law cuts insurance coverage, but doesn’t restore other payments, they could be left with a mountain of unpaid bills. The American Hospital Association and the Federation of American Hospitals urged Congress and the incoming Trump administration to either protect insurance coverage or replace the hospital payments.

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Planned parenthood under attack again

1-5-17 CNN

House Speaker Paul Ryan announced Thursday that Republicans will move to strip all federal funding for Planned Parenthood as part of the process they are using early this year to dismantle Obamacare.

The decision to add the controversial Planned Parenthood language, which is opposed by most Democrats, could have a major impact on getting the Affordable Care Act repeal legislation through the Senate because supporters need the backing of at least 50 of their 52 members and two pro-choice senators, Susan Collins of Maine and Lisa Murkowski of Alaska, won’t commit to approving the bill with the Planned Parenthood provision in it.

The vast majority of federal money that Planned Parenthood does receive funds preventive health care, birth control, pregnancy tests, and other women’s health care services. Democrats also point out that much of the money the group received is through the Medicaid program, which reimburses health care clinics that provide care to those covered by the federal program.

Republicans cut independent ethics office power

1-2-17 New York Times 

House Republicans, defying their top leaders, voted Monday to significantly curtail the power of an independent ethics office set up in 2008 in the aftermath of corruption scandals that sent three members of Congress to jail.

The move to weaken the Office of Congressional Ethics was not public until late Monday, when Representative Robert Goodlatte, Republican of Virginia and chairman of the House Judiciary Committee, announced that the House Republican Conference had approved the change with no advance public notice or debate.

In its place, a new Office of Congressional Complaint Review would be set up within the House Ethics Committee, which before the creation of the Office of Congressional Ethics had been accused of ignoring credible allegations of wrongdoing by lawmakers.

1-4-17 update. Paul Ryan was opposed to this. Trump also expressed his opinion against it. Obviously Dems hated it too. Yesterday Republicans backed down on this.

Reconciliation as tool to gut Obamacare

1-4-17 New York Times 

Republicans hope to repeal major parts of the Affordable Care Act using an expedited procedure known as budget reconciliation.

The process begins with a budget blueprint, a resolution that guides Congress but is not presented to the president for a signature or veto. It recommends federal revenue, deficit, debt and spending levels in areas like defense, energy, education and health care.

The resolution may direct one or more committees to develop legislation to achieve specified budgetary results. By adopting these proposals, Congress can change existing laws so that actual revenue and spending are brought into line with — reconciled with — policies in the budget resolution.
Q. How has reconciliation been used?
A. Since 1980, Congress has completed action on 24 budget reconciliation bills. Twenty became law. Four were vetoed.
The Omnibus Budget Reconciliation Act of 1981 was a vehicle for much of the “Reagan revolution.” It squeezed savings out of Social Security, Medicare, Medicaid, food stamps, the school lunch program, farm subsidies, student loans, welfare and jobless benefits, among many other programs.
In 1996, Congress reversed six decades of social welfare policy, eliminating the individual entitlement to cash assistance for the nation’s poorest children and giving each state a lump sum of federal money with vast discretion over its use. Those changes were made in a reconciliation bill, pushed by Republicans but signed by President Bill Clinton.
Congress reduced deficits with another reconciliation bill, the Balanced Budget Act of 1997. That law also created the Children’s Health Insurance Program, primarily for uninsured children in low-income families. On the same day in 1997, Mr. Clinton signed a separate reconciliation bill that cut taxes.

The Bush tax cuts were adopted in reconciliation bills signed by President George W. Bush in 2001 and 2003.

On several occasions, Congress has increased assistance to low-income working families by increasing the earned-income tax credit in reconciliation bills.
Congress also made changes to the Affordable Care Act in a reconciliation bill passed immediately after President Obama signed the health care overhaul in 2010. Later, when Republicans controlled both houses of Congress, they passed a reconciliation bill to eviscerate the Affordable Care Act, but Mr. Obama vetoed the bill in January 2016.
Q. What does this mean for the Affordable Care Act?

A. Republicans hope to use the fast-track procedure of budget reconciliation to repeal or nullify provisions of the law that affect spending and taxes. They could, for example, eliminate penalties imposed on people who go without insurance and on larger employers who do not offer coverage to employees.
They could use a reconciliation bill to eliminate tens of billions of dollars provided each year to states that have expanded eligibility for Medicaid. And they could use it to repeal subsidies for private health insurance coverage obtained through the public marketplaces known as exchanges.
Republicans could also repeal a number of taxes and fees imposed on certain high-income people and on health insurers and manufacturers of brand-name prescription drugs and medical devices: tax increases that help offset the cost of the insurance coverage expansions.
Those provisions were all rolled back in the reconciliation bill Mr. Obama vetoed last January. That bill did not touch insurance market standards established in the Affordable Care Act, which do not directly cost the government money or raise taxes. The standards stipulate, for example, that insurers cannot deny coverage or charge higher premiums because of a person’s pre-existing conditions. Insurers must allow parents to keep children on their policies until the age of 26, and they cannot charge women higher rates than men, as they often did in the past.
Such provisions are politically popular, but it is not clear how they could remain in force without the coverage expansions that help insurers afford such regulations. Without an effective requirement for people to carry insurance, and without subsidies, supporters of the health law say many healthy people would go without coverage, knowing they could obtain it if they became ill and needed it.

Twitter impact

12-10-16 NPR

In October 2015, then-18-year-old Lauren Batchelder asked Trump a question at a political forum in New Hampshire. “So, maybe I’m wrong, maybe you can prove me wrong, but I don’t think you’re a friend to women,” she said. Trump defended himself, and Batchelder took the mic again, asking if she’d get equal pay and access to abortion with Trump as president. Trump answered: “You’re going to make the same if you do as good of a job, and I happen to be pro-life, okay?”

Batchelder thought that was the end of it, but when she woke up the next day, she realized that the current president-elect had sent out a series of tweets about her. “The arrogant young woman who questioned me in such a nasty fashion at No Labels yesterday was a Jeb staffer!” he tweeted. (Batchelder is not, and has never been, a staffer for Jeb Bush, though she did volunteer for his campaign.) His followers replied with screenshots of Batchelder and posted her phone number and other personal information online.

Within hours, her phone began to ring, and her email inbox and Facebook account filled with threatening messages. “I didn’t really know what anyone was going to do,” Batchelder, now 19, told the Washington Post. “He was only going to tweet about it and that was it, but I didn’t really know what his supporters were going to do, and that to me was the scariest part.”

She said the abuse has continued, prompting one Trump supporter to send her a Facebook message five days before the election that read, “Wishing I could f—ing punch you in the face. id then proceed to stomp your head on the curb and urinate in your bloodied mouth and i know where you live, so watch your f—ing back punk.”
Batchelder’s case illustrates what happens when Trump, who has more than 17 million Twitter followers, goes after a private citizen online. And far from showing restraint as his following has grown, Trump has continued the pattern. On Wednesday he attacked Chuck Jones, a union leader, who wrote in the Washington Post Thursday that his office is now receiving threats, too.

Dept of Energy Worried

12-10-16 NPR 

Among his campaign promises, President-elect Donald Trump vowed to increase domestic energy production and roll back President Obama’s efforts to combat climate change. A lengthy questionnaire recently sent to the Department of Energy suggests that effort may dig deep.

Among the transition’s inquiries, NPR’s Jennifer Ludden reports:
“It wants to know who at the Department of Energy attended domestic and international climate talks. It wants emails about those conferences. It also asks about money spent on loan-guarantee programs for renewable energy. … The Trump team questionnaire also asks about the Energy Department’s role in the Iran nuclear deal, which Trump has called ‘stupid.’ And it asks for the 20 highest paid employees at the department’s national laboratories.”
The Washington Post notes a recent history of clashes between Republican administrations and federal environmental scientists:

“In [Ronald] Reagan’s first term, Anne Gorsuch was appointed to head the Environmental Protection Agency amid a major push for regulatory rollback. But after Gorsuch resigned amid controversy in 1983, Congress opened investigations into supposed “hit lists” at the agency used to track the views of members of scientific advisory boards, according to contemporary news reports.
“During the George W. Bush administration, there were complaints that scientific documents had been edited to raise doubts about the science of climate change and that researchers had been prevented from speaking openly to the media and sharing their expertise.”

Russia did interfere

12-10-16 NPR

“Intelligence agencies have identified individuals with connections to the Russian government who provided WikiLeaks with thousands of hacked emails from the Democratic National Committee and others, including Hillary Clinton’s campaign chairman, according to U.S. officials,” the Post reports. “Those officials described the individuals as actors known to the intelligence community and part of a wider Russian operation to boost Trump and hurt Clinton’s chances.”

Citing anonymous officials briefed on the issue, the Post says the CIA shared its findings with senators in a closed-door briefing last week, saying it was now “quite clear” that Russia’s goal was to tip the presidency in Trump’s favor:
” ‘It is the assessment of the intelligence community that Russia’s goal here was to favor one candidate over the other, to help Trump get elected,’ said a senior U.S. official briefed on an intelligence presentation made to U.S. senators. ‘That’s the consensus view.’ ”
On Friday evening, the Trump transition team fired back with a statement dismissing the report of the agency’s conclusion.

“These are the same people that said Saddam Hussein had weapons of mass destruction,” the statement said. “The election ended a long time ago in one of the biggest Electoral College victories in history. It’s now time to move on and ‘Make America Great Again.’ ”
Puke.

Cohn, Economic Policy Advisor

12-9-16 New York Times 

The longtime second-in-command at Goldman Sachs, Gary D. Cohn, is expected to be named director of the National Economic Council, which oversees economic policy in the White House.

The role was established by President Bill Clinton and given to Goldman’s co-chairman at the time, Robert E. Rubin. Mr. Rubin’s co-chairman, Stephen Friedman, later held the position under President George W. Bush.

This time, however, the selection of a Goldman insider is at odds with statements made by Mr. Trump during the presidential campaign. He repeatedly attacked the financial elite — and Goldman Sachs in particular.
In a commercial that ran in the closing days of the campaign, Mr. Trump warned about a “a global power structure that is responsible for the economic decisions that have robbed our working class, stripped our country of its wealth and put that money into the pockets of a handful of large corporations and political entities.” The face of Goldman’s chief executive, Lloyd C. Blankfein — Mr. Cohn’s longtime friend and collaborator — was among the images that flashed ominously on the screen.

And Mr. Trump criticized both Hillary Clinton and a primary opponent, Senator Ted Cruz, Republican of Texas, over their ties to the investment bank. “I know the guys at Goldman Sachs,” Mr. Trump said at one primary debate. “They have total, total control” over Mr. Cruz, he said. “Just like they have total control over Hillary Clinton.”
Since his election, however, Mr. Trump has stocked his future cabinet with a number of Goldman alumni, including Mr. Mnuchin, a hedge fund manager and a former Goldman trader, and Stephen K. Bannon, a former Goldman banker who is now Mr. Trump’s chief strategist.
Unlike those two, Mr. Cohn is a longtime top Goldman executive who was helping to guide the firm before and during the financial crisis.
In Mr. Cohn, Mr. Trump is not only turning to yet another Goldman hand — and a registered Democrat — but he is also choosing a financier whose thinking about the economy has stood in contrast to the president-elect’s more nationalistic views.

While Mr. Trump has criticized companies that have moved their work force overseas, Mr. Cohn has been candid about Goldman’s international outlook: “We have a globalized work force, so when I need to go out and hire the incremental worker, I go out and look around the world and see where that incremental worker is available.”

Mr. Cohn, though, has agreed with Mr. Trump about the need to lighten the regulations that have been imposed on banks like Goldman since the financial crisis.

Russia risk?

12-9-16 NPR 

In what could mark an escalation of tensions with the West, commercial satellite images suggest that Russia is moving a new generation of nuclear-capable missiles into Eastern Europe.

If Russia has decided to permanently position Iskander in Kaliningrad, “It may be in response to a number of things,” says retired Brig. Gen. Peter Zwack, who served as defense attaché to Russia from 2012 to 2014.

The U.S. has recently deployed a missile defense system in Romania and is building a second base in Poland. U.S. and European officials say those sites are to defend against potential ballistic launches from Iran, but Zwack says that Russia views them as provocations. The new Polish missile defense site would be within range of the Iskander, adds Lewis.
But Zwack says it’s important not to overreact. Russia already has nuclear-capable systems based in Kaliningrad, including SS-21 ballistic missiles. The new Iskanders will “freak the local neighbors,” he says, but they “will not change any strategic equation, because if they go into tactical mode, it’s the end of the world anyway.”