A morally bankrupt political party hellbent on denying medical care to millions of Americans

The Trump administration has expanded its sabotage efforts of “Obamacare” into a full-scale undermining of the American healthcare system. Under Trump, Obamacare outreach groups face budget cuts as high as 98%:

The Trump administration has informed government-funded Obamacare outreach groups of deep impending budget cuts next year, with some nonprofits having budgets slashed by as much as 98 percent.

The Health and Human Services Department announced August 31 that it would cut funding for the health law’s in-person assistance program by 41 percent. Late Wednesday night, the administration sent each group its individual budget. It shows widespread variation in how big those funding cuts will be.

Last year’s budget for the navigator program ran out on September 1. This year’s grants were released just before midnight on September 13, meaning that the outreach groups went two weeks with no funding at all. This led to some groups laying off workers or shutting down operations entirely.

Last week the Congressional Budget Office (CBO) issued a new report showing that Trump is making Obamacare premiums more expensive:

The Trump administration’s management of Obamacare is causing higher premiums and lower enrollment in the individual market, a new report from the Congressional Budget Office finds.

The nonpartisan office estimates that average premiums in the health law marketplaces will be 15 percent higher next year “largely because of short-term market uncertainty — in particular, insurers’ uncertainty about whether federal funding for certain subsidies that are currently available will continue to be provided.”

The CBO also estimates that there will be less competition in the marketplaces next year, which it also attributes to the uncertain federal environment surrounding the health law’s future.

The subsidies the CBO refers to are the Affordable Care Act’s cost-sharing reduction subsidies, which cover copays and deductibles for low-income health care enrollees. The Trump administration has not said whether it will continue to pay these subsidies next year, causing many insurance plans to raise their premiums to prevent any possible shortfall in revenue.

The CBO also points to “announced reductions in federal advertising, outreach, and other enrollment efforts” as additional factors that will make Obamacare sign-ups smaller next year than they otherwise would have been.

President Trump has often described the Affordable Care Act as “imploding on its own.” The CBO report suggests this isn’t the case at all; rather, the Trump administration is making specific policy decisions that are leading to an individual market that will be less functional, with fewer people signed up and higher premiums for those who do enroll.

As of Tuesday, the bipartisan effort to stabilize the “Obamacare” marketplace by coming up with a bipartisan agreeement on cost sharing reductions (CSRs) to health insuers is over. GOP leadership shut down the bipartisan effort to leave only one option available to GOP members, the zombie “Trumpcare” bill from Sens. Graham and Cassidy. Senators scrap bipartisan effort to stabilize Obamacare markets, saying no deal was possible:

Sen. Lamar Alexander pulled the plug Tuesday on his push for a bipartisan bill to stabilize the individual health insurance market, saying he and a key Democrat had been unable to reach a deal that could pass.

Alexander, a Tennessee Republican, said he and Democratic Sen. Patty Murray of Washington “had hoped to agree early this week on a limited, bipartisan plan to stabilize 2018 premiums in the individual health insurance market that we could take to Senate leaders by the end of the month.”

“During the last month, we have worked hard and in good faith, but have not found the necessary consensus among Republicans and Democrats to put a bill in the Senate leaders’ hands that could be enacted,” said Alexander, chairman of the Senate Health, Education, Labor and Pensions Committee.

Murray placed the blame squarely on Republican leaders.

“We identified significant common ground and I made some tough concessions to move in Chairman Alexander’s direction when it comes to giving states more flexibility,” said Murray, the committee’s top Democrat. “I am disappointed that Republican leaders have decided to freeze this bipartisan approach and are trying to jam through a partisan Trumpcare bill, but I am confident that we can reach a deal if we keep working together — and I am committed to getting that done.”

Andrew Prokop at Vox.com explains The bait and switch at the heart of the new Obamacare repeal bill:

As Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA) try to wrangle Senate votes for their Obamacare repeal bill before September 30, they’re relying on one argument most of all: Their bill, they say, will give much more flexibility to individual states to figure out how to make health care work.

Cassidy and Graham like to emphasize that their bill would roll back Obamacare’s spending and regulations and would instead simply send states money in a block grant. States, they say, would be free to figure out how to use that block grant money however they see fit — they’d be able to experiment with their own approaches. Even moderate Republicans are likely tempted by an argument like that.

Here’s the catch: The bill doesn’t just move around Obamacare’s spending. It severely cuts federal spending on health care overall — both for Obamacare and for traditional Medicaid. And since covering people costs money, the result will inevitably be that millions of people will lose coverage.

The Graham-Cassidy bill is essentially a Trojan horse for these dramatic cuts on health spending that Republican leaders have been pushing all along. Three features of the bill in particular make this clear:

1) The bill dramatically cuts and restructures traditional Medicaid. Like previous Obamacare repeal bills Republicans have put forward, Graham-Cassidy goes far beyond just rolling back Obamacare, to instead restructure the finances of the Medicaid program as a whole.

It does this by converting Medicaid to a “per capita cap” system, in which the federal government would no longer commit to open-ended funding to help states afford enrollees’ health bills. Instead of matching the money states spend on Medicaid enrollees, the federal government would provide a set amount of money to states to spend on recipients.

Using numbers from previous Congressional Budget Office scores, the Center on Budget and Policy Priorities estimates that this proposal would cut about $175 billion from traditional Medicaid between 2020 and 2026. Experts argue that per capita caps also give states incentives to kick more expensive patients off Medicaid or roll back coverage.

2) In turning Obamacare’s spending into a block grant, Cassidy and Graham aren’t just redistributing it — they’re reducing it: In theory, it would be possible to restructure Obamacare’s existing spending into block grants for states — and even to distribute it differently among states — without cutting spending overall.

But that’s not what Graham-Cassidy does. Per CBPP’s analysis, the way the bill’s block grant formula is designed, it would dole out “$239 billion less between 2020 and 2026 than projected federal spending for the Medicaid expansion and marketplace subsidies under current law.”

Cassidy has tried to dismiss the CBPP numbers as coming from a liberal think tank. But since the CBO hasn’t released its analysis yet — and won’t have time to before Senate Republicans’ September 30 deadline — these are the outside numbers we have to work with.

3) The new block grant ends entirely after 2026, and there is nothing to replace it afterward. Yes, the vaunted block grants that Graham and Cassidy say will give states such flexibility have a built-in expiration date. They have claimed that this is because of the Senate’s budget reconciliation rules, though it’s not clear how or whether that’s true.

The practical effect, though, would be to set up a major fight several years down the road about whether these block grants should be continued at all, or whether they should be reduced even further. And since the default outcome if no action is taken is for the block grants to vanish, conservatives who want even deeper spending cuts will have the advantage in this showdown.

We can see the CBPP’s estimated impact of these three provisions together in the below chart:

CBPP Chart

From 2020 to 2026, there will be cuts from the transformation of Obamacare funding into a smaller block grant (in dark red) and the restructuring of traditional Medicaid (in pale red). Then in 2027, the block grants disappear entirely, meaning enormous cuts unless Congress manages to agree on a deal to continue them.

So the argument about giving states “flexibility” leaves out a whole lot. Less money would be available to states overall in those newly flexible block grants, and on top of that, traditional Medicaid would be cut — which clearly points toward millions losing coverage overall. And that’s even before the whole system is set to fall off a cliff in 2027.

With all this in mind, Graham-Cassidy looks a whole lot like all the previous GOP Obamacare repeal bills this year. At its core, it’s basically another way to cut hundreds of billions in federal health spending and toss millions off coverage.

Finally, the Graham-Cassidy zombie “Trumpcare” bill violates the “Jimmy Kimmel Test,” or more accurately, the “Bill Cassidy Test” that Sen. Cassidy previously agreed to with late night host Jimmy Kimmel when discussing the emergency care needed to save the life of his newborn son earlier this year. Jimmy Kimmel: new Obamacare repeal bill flunks the Jimmy Kimmel Test:

Jimmy Kimmel became an unlikely figure in the Republican health care debate a few months ago when he reached an accord of sorts with Sen. Bill Cassidy (R-LA), setting standards that any bill to repeal and replace Obamacare should meet.

On Tuesday, Kimmel slammed Cassidy, the author of the GOP’s last-ditch plan to overhaul US health care, for failing to meet those standards in his own legislation.

Watch the video.

Screen Shot 2017-09-20 at 5.55.02 AM

“This guy, Bill Cassidy, just lied right to my face,” Kimmel said in his opening monologue, which was posted online shortly before his show aired.

Back in May, Kimmel interviewed Cassidy about the GOP’s health care plans after the late-night host had been outspoken about his newborn son’s open-heart surgery. He and Cassidy discussed what became called the “Jimmy Kimmel test.” Cassidy has used that term repeatedly throughout the past few months of the health care debate.

Kimmel defined it like this: “No family should be denied medical care, emergency or otherwise, because they can’t afford it.”

The host ticked through related requirements that he said Cassidy had set for his own health care plan:

  • Provide health coverage for everyone
  • Prevent discrimination against people with preexisting conditions
  • Lower premiums for middle-class Americans
  • Prohibit lifetime caps on insurance benefits

“The new bill does none of those things,” Kimmel said on Tuesday night. “Not only did Bill Cassidy fail the Jimmy Kimmel test, he failed the Bill Cassidy test.”

“He wasn’t very honest,” the host said to open his monologue. “It seemed like he was being honest. He got a lot of credit and attention for coming off like a rare reasonable voice in the Republican Party when it came to health care.”

The bill produced by Cassidy and Sen. Lindsey Graham (R-SC), which Republican leaders are trying to build support for and put on the Senate floor next week, is widely expected to result in fewer people having health coverage. Insurers would also be permitted, if individual states choose to allow it, to charge people higher premiums based on their medical history, as Vox’s Sarah Kliff reported.

The net effect on premiums is not expected to be known before the Senate would vote, because the nonpartisan Congressional Budget Office said it would not have enough time to fully analyze the bill. But some people could see higher premiums, if prices based on health status are once again allowed.

Finally, by allowing states to waive Obamacare’s rules for which essential health benefits insurance plans must cover, annual or lifetime limits could be reintroduced for services that states decide are not mandatory

“With this [bill], your child with a preexisting condition will get the care he needs, if and only if his father is Jimmy Kimmel,” Kimmel said Tuesday. “Otherwise you might be screwed.”

Asked for a response to Kimmel’s comments, Cassidy focused on the looming September 30 deadline for Senate Republicans to pass a health care bill.

“We have a September 30 deadline on our promise. Let’s finish the job,” he said in a statement provided by his office.

That’s right, we have to blow up one-fifth of the U.S. economy and deny health care to millions of Americans for Tea-Publican politicians to “keep our promise” to repeal Obamacare to our GOP crazy base primary voters who may vote us out of office. This is ideology, not sound public policy. And it is political cowardice in the face of a small minority of voters.

Do all you can to persuade your senators to vote against this GOP attempt to undermine the American health care system and to deny health care to millions of Americans.

Then vote every one of these morally bankrupt evil GOP bastards up and down the ballot out of office next year.

19 responses to “A morally bankrupt political party hellbent on denying medical care to millions of Americans

  1. Trump praises health care system in non-existent African country
    09/21/17
    By Steve Benen

    Donald Trump attended a United Nations luncheon with African leaders yesterday…

    “We cannot have prosperity if we’re not healthy,” the American president said. “We will continue our partnership on critical health initiatives. Uganda has made incredible strides in the battle against HIV/AIDS. In Guinea and Nigeria, you fought a horrifying Ebola outbreak. Nambia’s health system is increasingly self-sufficient.”

    That, of course, struck many as odd, since there is no such country as Nambia…

    http://www.msnbc.com/rachel-maddow-show/trump-praises-health-care-system-non-existent-african-country

    • “That, of course, struck many as odd, since there is no such country as Nambia…”

      And that is a very tiny nit to pick with his speech. NAMIBIA and it’s health care care system have made remarkable strides in recent years as the Country spent more of it’s wealth on healthcare. It has been in the news recently. Since NAMIBIA is one of the wealthiest counries in Africa, it makes sense it should be in the vanguard of improving healthcare in a continent not noted for such progress.

      For the author of your article to make something big of the missing “I” in NAMIBIA (NAMBIA versus NAMIBIA) shows the extremely low level that the media sinks to in order to criticize Trump. It is like the “potato versus potatoe” kerfufle with Dan Quayle a few years back. Extremely petty…

      • Yes, Steve, the author admitted it was a “forgivable” mistake although some might argue that a so called “president” of the US should be well versed in what countries are in Africa when he speaks to the African leaders at the UN. Wouldn’t that be amazing? A president who didn’t embarrass his country multiple times per day?

        And your favorite president, the one you adore, the one you can’t stop apologizing for, went on to say:

        “Africa has tremendous business potential. I have so many friends going to your countries, trying to get rich. I congratulate you. They’re spending a lot of money.”

        Yes, what a great joke. Apparently no one laughed. Memories of white men plundering Africa are just, well, too recent.

        Trump is accustomed to performing at Klan rallies for fans like you, but you know what? The UN isn’t a Klan rally.

        • “And your favorite president, the one you adore, the one you can’t stop apologizing for…”

          Now come on, Liza, I have mentioned many times that I am not a died in the wool, “hold on with my fingertips” supporter of Trump. I like some things he has done, and I have disliked some things he has done. I have criticized Trump on these pages before.

          My issue in defending him is that so many people hate him to an irrational degree, and want him to fail so badly they will hurt the Nation to do it. That is not healthy. Just as I did with President Obama, I think it is in the best interests of the Nation to at least give Trump a fair chance and not try to nitpick every little thing he does. Many people I know wanted to pillory Obama and I objected to that. I believe that once a President is elected, they should be given reasonable support and an opportunity to present their goals and then decide whether to support them or not, based upon their ideas, not their personality. I think it is a healthy and very acceptable thing to oppose a President on principles and opposition to what they want to do. But opposing a President because you hate them for defeating your candidate, or because they have a crappy personality, or because you envy his wealth, or similar reason is not a healthy thing.

          “Trump is accustomed to performing at Klan rallies for fans like you…”

          Now you are just being gratuitously mean.

          “The UN isn’t a Klan rally.”

          Nor did Trump’s speech indicate it was. He was straight forward, spoke plainly, and told the UN what he genuinely thought. I thought he should not have used the “Rocketman” in reference to Kim Jung Un, but that was the only thing I saw that should not have been in speech.

          “Wouldn’t that be amazing? A president who didn’t embarrass his country multiple times per day?”

          I understand Trump gets under the skin of leftists, but he does not “embarrass [the] country multiple times per day”. You think he embarasses all of us because you tend avoid or to ignore contrary points of view and you spend your time largely in echo chambers. Bob Lord mentioned to you the other day that he doesn’t want Blog for Arizona to become an echo chamber for good reason. Listening only to people that agree with you and not hearing counter-arguments with an open mind can create a warped view of the real world. You hate Trump with a raw virulence that sometimes borders on the hysterical and that certainly distorts your view of what he says and does.

          I don’t think Trump will ever be the best President we have had, or run even close to that standard. But I also don’t think he will prove to be the worst, either. He has some good ideas and he has some terrible ideas, but he IS the President and I will support him when I think he is correct, and I will take him to task when I think he is wrong.

      • It is interesting, and so typical, that you seem to have overlooked Trump saying, “We cannot have prosperity if we’re not healthy,” and going on to praise “Nambia’s health system”.

        Trump knows zero, zip, nada about the healthcare system of any country, real or fictitious, including his own. He is blathering what was written for him to say and he is totally clueless which is why he makes mistakes. That’s what is on display here, nothing new.

        As you were.

        • “It is interesting, and so typical, that you seem to have overlooked Trump saying, “We cannot have prosperity if we’re not healthy,” and going on to praise “Nambia’s health system”.”

          I didn’t overlook that. In fact, that was the central idea in my first response to you. Remember? Nit picking a missing “i”? Given that this is what I wrote about, I am not sure what this blurb is supposed to mean.

          “Trump knows zero, zip, nada about the healthcare system of any country, real or fictitious, including his own.”

          You say that with such conviction and fervor, a reader could believe that you have special insider knowledge about Trump and what he knows. Trump is not as stupid as you like to think he is. He was at the top of his classes in school, nearly always held leadership positions, and has had a very successful career that made him a billionaire. Whether you approve or not, those are significant accomplishments. I suspect you would agree id it wasn’t Trump being judged.

          ” He is blathering what was written for him to say…”

          Yes, he undoubtedly was. Just as every President before him has done. Even Obama used speech writers, you know? Hiring good speech writers is always a high priority for Presidents.

  2. September 20, 2017 – 12:34 PM EDT
    Blue Cross warns GOP repeal bill ‘undermines’ pre-existing condition rules

    The Blue Cross Blue Shield Association warned against a new GOP ObamaCare bill on Wednesday, saying it would “undermine” protections for pre-existing conditions.

    “The bill contains provisions that would allow states to waive key consumer protections, as well as undermine safeguards for those with pre-existing medical conditions,” the association said in a statement.

    The bill would allow states to repeal ObamaCare rules that prevent people with pre-existing conditions from being charged higher premiums.

    http://thehill.com/policy/healthcare/351549-blue-cross-warns-gop-repeal-bill-undermines-pre-existing-condition-rules?amp

  3. CNN‏Verified account @CNN 19h19 hours ago

    Former Pres. Obama on health care: “When I see people trying to undo that hard-won progress, for the 50th or 60th time … it is aggravating.”

    • For Sure Not Tom

      Rick “No Condoms for You” Santorum ran around reminding the GOP that they’re going to lose a lot of the base if they don’t do as promised, overturn the very successful ACA.

      It’s a political move that will cost people their homes and lives, including a lot of the base as it turns out.

      But the base is just happy that someone is throwing out all the stuff that black man and his family left in the White House.

  4. Trump’s recent tweets on Zombiecare. (Trolling again so y’all don’t have to).

    Donald J. Trump‏Verified account @realDonaldTrump 2h2 hours ago

    Senator (Doctor) Bill Cassidy is a class act who really cares about people and their Health(care), he doesn’t lie-just wants to help people!

    Donald J. Trump‏Verified account @realDonaldTrump 4h4 hours ago

    I would not sign Graham-Cassidy if it did not include coverage of pre-existing conditions. It does! A great Bill. Repeal & Replace.

    Donald J. Trump‏Verified account @realDonaldTrump 14h14 hours ago

    I hope Republican Senators will vote for Graham-Cassidy and fulfill their promise to Repeal & Replace ObamaCare. Money direct to States!

    Donald J. Trump‏Verified account @realDonaldTrump 15h15 hours ago

    Rand Paul is a friend of mine but he is such a negative force when it comes to fixing healthcare. Graham-Cassidy Bill is GREAT! Ends Ocare!

  5. Ducey SUPPORTS this shitcare bill, even though AZ will get $11 BILLION less in federal dollars for healthcare now…and in 2026, when those block grants run out, we will get $133 BILLION less. A HUGE cut for Arizona’s citizens!! But he’s all for it! Wonder why? Oh…I see. Once a Koch whore, always a Koch whore.

    https://amp.theguardian.com/us-news/2017/jun/26/koch-network-piggy-banks-closed-republicans-healthcare-tax-reform

    • Yep! Our “esteemed” governor is a world class Koch-Sucker and proud of it!

      • For Sure Not Tom

        Don’t get me started on the Koch’s. My fingers are still tired from my last hysterical rant.

        • “My fingers are still tired from my last hysterical rant.”

          And what a thorough, vigorous and enthusiastic rant it was, Tom! I could tell your heart and mind were really into it! ;o)

  6. They’re especially hellbent (and bound) to kill the ACA since their patronos, the Brothers Koch (who incidentally own our “esteemed” governor) have made it clear that no repeal & no tax cuts for them mean no more money.

    https://www.theguardian.com/us-news/2017/jun/26/koch-network-piggy-banks-closed-republicans-healthcare-tax-reform

    • “…the Brothers Koch…have made it clear that no repeal & no tax cuts for them mean no more money.”

      When did they make this clear, Wileybud? I can’t find a source where they said that. That is a rather stark pronouncement and I am pretty certain it wold be reported somewhere, wouldn’t it?

      • Click on the link Steve.

        • For Sure Not Tom

        • “Click on the link Steve.”

          I did read it, Wileybud. No where in it does it say that the Koch Brothers told anyone that. The article did say that many donors are telling Congressmen that there will be no more money until progress is made, but other than the opening sentence that makes the statement the Koch Brothers are doing it, there is nothing else in the article to back it up.

          The truth is that I don’t really care if the Koch Brothers are threatening the GOP or not. I think it is quite reasonable to demand some performance from people you support before handing over more millions of dollars to them if they are not going to live up to their committments. I was simply curious about the Koch Brothers because they are usually (and it would appear still are) not so public about what they want and do to get it. It would have been interesting to see a case where they were actually so outspoken. That’s all.