Category Archives: Healthcare

House votes on GOP ‘tax cuts for corporations and Plutocrats’ bill today

The House is scheduled to vote on the GOP “tax cuts for corporations and Plutocrats” bill today. House Is Poised to Pass Tax Bill in Major Step Toward Overhaul:

The House tax bill, which passed in the Ways and Means Committee last week, would cut taxes more than $1.4 trillion over 10 years. It cuts the corporate tax rate to 20 percent from 35 percent, collapses the tax brackets to four from seven, switches the United States to an international tax system that is more in line with the rest of the world and scales back many popular deductions, including one for state and local taxes paid.

The House bill appeared on track for passage on Thursday, despite some Republican opposition. If all House members vote and every Democrat opposes the bill, Republican leaders can afford to lose no more than 22 of their members for it to pass.

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The House is expected to begin floor debate at 9 a.m. on Thursday for about two hours. Mr. Trump is expected to make a visit to the Capitol to speak to the Republican conference around 11:30 a.m., according to a congressional aide. A vote is then expected to take place in the early afternoon.

The House GOP tax bill does not include the repeal of the “Obamacare” individual mandate that is in the Senate bill to help ensure passage in the House. This is all just a ruse. There is an explicit understanding that if the Senate can pass its version of the tax bill with repeal of the Obamacare individual mandate, the House will follow suit. Paul Ryan: Senate will have to take lead on scrapping Obamacare individual mandate in the tax bill:

In an interview on CNBC’s “Squawk Box,” House Speaker Paul Ryan suggested that his members could get behind eliminating Obamacare’s individual mandate as part of a tax reform bill. However, he said the House will not do so in the bill it hopes to pass Thursday. Instead, it will wait to address it in a conference committee with the Senate, he said.

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Ryan did not outright say the House would back such a measure, but he noted that his members have voted to repeal the mandate in the past.

“We’ve had the House votes to do that. We passed our repeal of the individual mandate back in May,” the Wisconsin Republican said. “But we never had the votes in the Senate. So what we didn’t want to do is make tax reform harder than it already is.”

“But it really is whether or not the Senate has the votes for this or not. So, we’re seeing what the Senate can do. If the Senate can get it through committee, if they can get it through the floor, then we’ll meet them in conference and we’ll assess at that time,” Ryan added.

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Action Alert: Time to kill the evil GOP bastards’ ‘tax cuts for corporations and Putocrats’ bill

Senate Finance Committee Chairman Orrin Hatch released the revisions to the Senate tax plan Tuesday night. The new version sunsets most of the individual tax provisions after 2025, but makes the lower corporate tax rate permanent. Senate GOP changes tax bill to add Obamacare mandate repeal, make individual income cuts expire:

Senate Republicans announced that the individual tax cuts in the plan would be made temporary, expiring at the end of 2025 to comply with Senate rules limiting the impact of legislation on the long-term deficit [by making the individual income tax cuts temporary, Senate leaders are seeking to ensure that the bill does not violate the chamber’s Byrd Rule that prohibits legislation passed with fewer than 60 votes from raising the deficit after 10 years]. A corporate tax cut, reducing the rate from 35 to 20 percent, would be left permanent.

Oh, and it also repeals the Affordable Care Act’s individual mandate.

This would result in 13 million fewer people having health insurance, according to projections from the nonpartisan Congressional Budget Office.

The CBO has also projected that repealing the individual mandate would drive up insurance premiums for many Americans by roughly 10 percent.

As Axios.com says:

Remember “skinny repeal”? The repeal bill that all but three Senate Republicans voted for on the express condition that it not become law? Because, as Sen. Lindsey Graham put it, “the skinny bill as policy is a disaster”? The policy is basically the same this time around.

  • “Skinny repeal” would have done more than just end the individual mandate, but that was its biggest change, and the one that made it a “disaster” for insurance markets. Any vehicle that repeals the individual mandate, without a replacement, will cause premiums to rise and leave millions more Americans uninsured.
  • That said, none of the three senators who killed skinny repeal — Susan Collins, John McCain or Lisa Murkowski — has said repealing the individual mandate would be a deal-breaker for their tax votes.

Why now? The savings. Repealing the mandate would save the government roughly $340 billion over a decade, and Republicans need that money to help offset the lost revenues from $1.5 trillion in tax cuts.

  • As CBO reminded lawmakers yesterday, if the tax bill does end up adding $1.5 trillion to the deficit, automatic cuts would kick in — including $25 billion from Medicare. Some Republicans have also said they won’t vote for a tax bill that adds to the deficit, making the search for spending cuts especially important.

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Action Alert: Sabotage of ‘Obamacare’ is back on the agenda in GOP tax cut bill

Tea-Publicans have a math problem with their tax cut bill to avoid the Senate cloture rule of 60 votes to close debate on their tax cut bill, so now the repeal of  the “Obamacare” individual mandate is back on the table to raise the revenue necessary to comply with the “Byrd Rule” in the Senate.

In short, Tea-Publicans are going to sabotage “Obamacare” in order to give tax cuts to corporations and Plutocrats.

Phil Mattingly at CNN explains in brief, Tax reform state of play: Republicans’ math problem:

House Republicans have a math problem, according to a separate JCT analysis circulated to members Tuesday night.

Due to changes made to the proposal in committee, most notably a significant change in a 20% excise tax for multinational companies, the bill is now about $74 billion over the $1.5 trillion target for deficits the committee is supposed to hit. And aides acknowledge more changes are coming that will likely add more to that.

So what do they do? Well, they need revenue.

Where can they find it? There’s a reason the repeal of Obamacare’s individual mandate hasn’t been taken off the table yet. As I’ve noted many times, House GOP leaders do not want to bring this into play and Senate Republicans are very unlikely to include it at any point, sources tell me.

Tara Golsham at Vox.com adds further, The Republican tax reform bill will live and die by this obscure Senate rule:

Republicans have a math problem.

The tax reform bill they are pushing through the Senate will live and die by a complicated rule — known as the “Byrd Rule,” a condition of the “budget reconciliation” process that allows Republicans to pass legislation with only 51 votes in the Senate. Because of how they set it up, Republicans’ tax bill can only increase the deficit by $1.5 trillion in the first 10 years, with no increase outside that window.

But as it stands, neither the House tax bill nor the Senate’s passes this test.

The Congressional Budget Office estimates the House bill will increase the deficit by $1.7 trillion, and the initial analyses of the Senate bill show it is on track to increase the deficit outside the 10-year window — the plan’s largest impact on the deficit is by $216.7 billion in 2027.

Maneuvering around Senate rules is not new to congressional Republicans, who recently tried, and failed, to pass Obamacare repeal through budget reconciliation. They said tax reform would be easier.

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It will all come down to what the Senate parliamentarian will permit. There’s no question that Republicans are desperately in search of budget gimmicks and rosy economic projections to make it all work — the question is if it will.

Which brings us to today.  Trump Again Wades Into Tax Debate, Suggesting Repeal of Obamacare Mandate:

As Republican lawmakers worked on Monday toward a delicate compromise on a $1.5 trillion tax cut, President Trump threw himself back into the discussion, suggesting that Republicans could reduce taxes even further by repealing the Affordable Care Act’s individual mandate that most people have health insurance.

After a long day of meetings in the Philippines, Mr. Trump took to Twitter to congratulate House and Senate Republicans for making progress on tax cut legislation during his 12-day trip through Asia. Then he pressed them to change course.

“Now, how about ending the unfair & highly unpopular Indiv Mandate in OCare & reducing taxes even further?” Mr. Trump said, referring to the health law’s mandate that most people have coverage or pay a penalty. “Cut top rate to 35% w/all of the rest going to middle income cuts?”

Mr. Trump’s latest suggestions came hours before the Senate Finance Committee met to begin its formal “markup” of the tax bill, a process that includes debate about the legislation and the consideration of amendments.

The Septuagenarian Ninja Turtle, Senate Majority Leader Mitch McConnell, will agree to an amendment to the tax bill from Senator Aqua Buddha, Rand Paul, fresh off having his ribs broken after a neighbor tackled him in a bizarre incident. Senate GOP to add repeal of Obamacare insurance mandate into tax bill:

Senate Republican leaders are changing their tax bill to include a repeal of a key plank of the Affordable Care Act, a major alteration as they now try to accomplish two of their top domestic priorities in a single piece of legislation.

GOP party leaders said Tuesday they would now attach a provision to their tax bill that would repeal the Affordable Care Act’s individual mandate, a part of the health care law that creates penalties for Americans who don’t have health insurance.

“We’re optimistic that inserting the individual mandate repeal would be helpful,” Senate Majority Leader Mitch McConnell (R-Ky.) said Tuesday after meeting with party members during a closed-door lunch.

Republicans had up until Tuesday resisted making the change, worried that injecting health care politics would imperil the tax bill. But many of their members have supported adding the repeal, which President Trump has suggested repeatedly.

Repealing the health care provision would free up more than $300 billion in government funding over the next decade, but it would also eventually lead to 13 million fewer people having health insurance, according to projections from the Congressional Budget Office.

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[T]he change could unnerve less conservative Republican senators, who voted against previous Senate efforts to repeal large parts of the Affordable Care Act, also known as Obamacare.

In addition to repealing the individual mandate, the updated tax bill could also likely include a new bipartisan health care agreement recently reached by Sens. Lamar Alexander (R-Tenn) and Patty Murray (D-Wash), according to Republican Sens. Bob Corker (R-Tenn) and Susan Collins (R-Maine).

That Murray-Alexander agreement would fund federal subsidies used to help lower-income Americans afford their health care.

The push for the change came after repeated demands from Trump, Sen. Rand Paul (R-Ky) and Sen. Tom Cotton (R-Ark).

Earlier Tuesday, Paul said he would introduce an amendment to the tax bill that would repeal the individual mandate and use the savings to lower taxes for middle class families. The tax bills in the House and Senate would lower taxes for many Americans, but nonpartisan analysts have concluded millions would pay higher taxes, particularly if they lived in states such as New York, New Jersey, and California.

But he might not need to propose an amendment not that GOP leaders have largely agreed to make the change. The bill could not be amended during debate this week in the Senate Finance Committee.

Trump has called for the adding a repeal of the individual mandate into the tax cut bill, though he has said the savings should go toward lowering the top tax rate for the wealthiest Americans.

Republicans spent much of the first eight months of 2011 trying to repeal or roll back the Affordable Care Act, President Obama’s signature legislative achievement. But they were repeatedly stymied by GOP defections in the Senate, with a handful of Republicans saying they wanted the changes to be either more sweeping or done in a bipartisan way.

Republicans control just 52 votes of the 100-seat Senate, and so the defection of three members would imperil any changes to the bill. They are trying to pass the tax cut bill through a process known as reconciliation, which means they only need a majority of support to pass the bill.

House GOP leaders have said they would explore whether to include a repeal of the individual mandate in their version of the tax cut bill, but they have so far not made that change. They are hoping to vote on their version of the measure as soon as Thursday.

The House and Senate must pass matching versions of the tax cut bill in order for Trump to be able to sign them into law.

So, sabotaging “Obamacare” and taking health care away from 13 million Americans is how the GOP will pay for its tax cuts for corporations and Plutocrats.

This is only one means the Senate can use to get around its “Byrd Rule.” Tara Golsham continues:

It will all come down to what the Senate parliamentarian will permit. There’s no question that Republicans are desperately in search of budget gimmicks and rosy economic projections to make it all work — the question is if it will.

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Republicans have tied their hands: They have passed a budget that allows them to increase the deficit by $1.5 trillion in the first 10 years, but they want to pursue massive tax cuts that appear to increase the deficit outside that 10-year window.

House Republicans are expected to vote on their tax bill this week, as the Senate is marking up its version — both would have to see substantial changes to pass the Byrd test.

The ways Republicans are trying to get around the Byrd question

Already Republicans are using gimmicks to get around this, the major one being passing what appears to a sweeping tax cut that will sunset after 10 years. This is what former President George W. Bush did with his tax cuts under budget reconciliation in 2001, essentially getting around the deficit restriction by making the tax cuts temporary. This House included some of this, sunsetting the $300 family credit after five years. The Senate could do the same.

There are already rumors of a temporary and permanent split in tax reform proposals among Republican members. The question is whose tax cuts are permanent and whose are temporary. Sen. Orrin Hatch (R-UT), who chairs the Senate Finance Committee, said his committee has “every intention of making the business reforms permanent” at the start of the bill’s markup — meaning it might be the individual tax cuts that will sunset, instead of the corporate rate.

One way this happens, floated by Zach Moller, a senior policy analyst for the Committee for a Responsible Federal Budget, is what he calls the “Title Gambit.” Republicans could split up their tax bill into three separate titles: One would be a temporary Republican-led effort that would pursue aggressive tax cuts; a second would be permanent and comply with Senate rules; and the third would be a permanent bipartisan proposal needing 60 votes that would likely find consensus around issues like the child tax credit or doubling the standard deduction. By going this route, Republicans would be able to split the impact of the deficit between budget reconciliation bills and regular order.

But again, it comes down to whether the parliamentarian will go for these separate titles, which are usually separated by committee involvement.

Some analysts have also floated the nuclear option, in which the presiding officer of the Senate — Vice President Mike Pence — just overrules the Senate parliamentarian. McConnell did not allow for this in the health care debate, but some have theorized there is more pressure for him to go to extreme lengths this time.

Either way, Republicans are relying on projections of increased economic growth from tax cuts to offset the revenue losses from those cuts, known as “dynamic scoring,” to sell their tax bill.

The Senate Budget Committee could also use a different, more ideologically conservative score of their tax plan instead of the CBO’s evaluation, like the Tax Foundation’s score or the Treasury Department’s.

But currently, even under the rosiest of projections, economic growth alone doesn’t seem to be enough to offset the full losses from the deepest cuts Republicans have proposed. The conservative Tax Foundation found the House tax bill would still increase the deficit by $500 billion, and projections from the University of Pennsylvania’s Wharton School showed that by 2040, the debt would increase by $6.4 trillion to $6.9 trillion.

The tax cuts aren’t paying for themselves. And there’s still skepticism whether the Senate parliamentarian will accept those growth numbers.

Call your senators and demand that they reject destroying America’s health care system and taking away health care from 13 million Americans just so President Trump and Tea-Publicans can declare a “win,” his only legislative victory, by giving tax cuts to corporations and Plutocrats while also increasing taxes on th middle class.

Neither of Arizona’s senators have any concerns about reelection at this point. They are free to vote their conscience. They should do what is right for their constituents and America, not what is demanded by party loyalty.

UPDATE: Industry groups representing doctors, hospitals and insurance companies wrote to Congress on Tuesday to express their opposition to repealing Obamacare’s individual mandate. Medical Groups To Congress: Don’t Nuke The Individual Mandate:

In a letter, America’s Health Insurance Plans, the American Academy of Family Physicians, the American Hospital Association, the American Medical Association, the Blue Cross Blue Shield Association and the Federation of American Hospitals said that eliminating the mandate “likely will result in a significant increase in premiums, which would in turn substantially increase the number of uninsured Americans.”

“Experts agree that in order to have a health insurance system in which anyone can obtain coverage regardless of their health status, there must be incentives for everyone to enroll in and maintain coverage throughout the year,” the groups wrote in their statement.

They added: “Repealing the individual mandate without a workable alternative will reduce enrollment, further destabilizing an already fragile individual and small group health insurance market on which more than 10 million Americans rely.”

Last week, the Congressional Budget Office and the Joint Committee on Taxation estimated that repealing Obamacare’s individual mandate would increase the number of uninsured people by 13 million by 2027.

GOP tax bill is a vehicle to sabotage ‘Obamacare’

Neil Young once did a live album entitled “Rust Never Sleeps.” Well, neither do evil GOP bastards. Even in defeat, they are constantly plotting and scheming their next move to impose their evil plans on America. They are unrelenting. This is why, “Eternal vigilance is the price of liberty.”

The latest example of this: Trump personally pushing GOP leaders to use tax bill to undermine Obamacare:

[GOP] leaders took a preliminary step to study Trump’s proposal to include language in the tax bill that would scrap the Affordable Care Act’s individual mandate, a change nonpartisan analysts say would save the government more than $400 billion over a decade but would also leave 15 million more Americans without health insurance.

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Undermining the Affordable Care Act through a tax overhaul, meanwhile, would probably draw the same type of opposition that earlier efforts did in the Senate, dooming several such attempts to repeal what some call Obamacare earlier this year. Many in Congress say such an effort would destroy Republicans’ chance of passing major legislation this year.

Still, under heavy pressure from Trump, House Ways and Means Committee Chairman Kevin Brady (R-Tex.) said he would ask the Congressional Budget Office to assess the implications of repealing the individual mandate as part of the tax overhaul, the first step toward including the proposal in the bill.

“The president feels very strongly about including this at some step before the final process,” Brady said at a Friday event hosted by Politico. “He’s told me that twice by phone and once in person.”

Brady also suggested he was unlikely to ultimately adopt the change Trump had personally pushed him to make, noting the possibility such a change would sink the bill’s hopes in the Senate.

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Fate of Arizona’s Medicaid expansion now in the hands of the AZ Supreme Court

The Arizona Supreme Court on Thursday heard oral arguments on Republican lawmakers’ challenge of a hospital assessment that funds the state’s Medicaid expansion. Fate of GOP’s challenge to Medicaid expansion now in hands of the Arizona Supreme Court:

An attorney for three dozen current and former lawmakers argued that the hospital assessment is a tax that requires a two-thirds legislative majority to enact. The assessment was narrowly approved by the Legislature in 2013.

The lawsuit was rejected by a Maricopa County Superior Court judge in 2015, and the Arizona Court of Appeals upheld that decision in March.

The appellate court in its opinion (.pdf) said the law imposed an assessment that is exempt from the requirement that any act by lawmakers increasing state revenues, such a tax hike, must get a two-thirds vote in the Legislature [the “Two-Thirds for Taxes” amendment, Prop. 108 (1992)].

The “Kochtopus” Death Star, the Goldwater Institute attorney representing the lawmakers, pressed ahead with an argument before the seven-member Arizona Supreme Court that the assessment is a tax that required the vote of a two-thirds majority of the Legislature under Proposition 108, which was passed by voters in 1992.

“It is clear under Proposition 108, a supermajority is needed for the Legislature to authorize what they did here,” said Christina Sandefur, a Goldwater Institute attorney who represented the lawmakers. “That is what the voters wanted. They wanted the supermajority to apply any time the Legislature acts to raise revenue.”

Timothy Berg, an attorney representing Arizona and the state’s Medicaid program, said the voter-approved initiative included an exception that allows fees and assessments imposed by state agencies.

Berg argued that voters passed Proposition 108 with the intent of limiting the Legislature’s ability to raise taxes with a simple majority, not restrict fee increases that are a routine part of state government.

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Healthcare Forum: We Want to Hear Your Stories

 

Banner University Medical Center

High-tech medical care at Banner University Medical Center

For the past 30 years, my career has focused on health promotion, disease prevention, behavioral research, and communications. I have seen, photographed, and written about the good, the bad and the ugly parts of our country’s healthcare “system”.

I saw the rise of HMOs (health maintenance organizations) in the 1980s. I cheered the Clintons for at least trying to fix the overly complicated mess in the early 1990s. I saw costs going up every year and service going down. I saw a health insurance system that was creaking under the weight of its own complexity, while big insurance and big pharma collected huge profits. As managing editor of the American Journal of Medicine, I stood proudly by the Editor-in-Chief when he and the Editorial Board called for Medicare for All on multiple occasions.

Along the way, I have heard stories about huge medical bills, uncompensated hospital care, outrageously expensive drugs, limited or delayed access to medical care, premature death and disease, medical bankruptcy, and the medical consequences of poverty.

Now, as a member of the Arizona House and the ranking Democrat on the Health Committee, I want to hear your stories.

Do you have concerns about the future of the Affordable Care Act, Medicare, Medicaid and Kids Care? Is the cost of medical care or prescription drugs a worry for your family? How would dramatic cuts to these programs impact you? Come to the 200 Stories: Tucson Healthcare Forum on Oct 29.

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