Medicaid

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

by

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.

Read more

(Update) Action Alert: you have until September 30 to kill this zombie ‘Trumpcare’ bill

by

Yesterday I posted an Action Alert: you have until September 30 to kill this zombie ‘Trumpcare’ bill.

Steve Benen doubles down on this action alert today. Senate Dems issue a ‘red alert’ on Republican repeal efforts:

Senate Minority Leader Chuck Schumer (D-N.Y.) issued a “red alert” to health care advocates late Friday, and we’ve seen similar sentiments from Sens. Cory Booker (D-N.J.), Elizabeth Warren (D-Mass.), Kirsten Gillibrand‏ (D-N.Y.), and Al Franken (D-Minn.). Sen. Chris Murphy (D-Conn.) told health care proponents, “Drop what you are doing to start calling, start showing up, start descending on DC.” Sen. Bernie Sanders (I-Vt.) has been focused on his single-payer proposal, but he added yesterday, “Our immediate concern is to beat back yet another disastrous Republican proposal to throw millions of people off health insurance.”

Among opinion leaders, progressive voices like the Washington Post’s E.J. Dionne and the New York Times’ Paul Krugman both devoted their columns today to warning the public that the threat to the existing health care system is quite real.

Dylan Scott at Vox.com reports that Governor Doug Ducey, the ice cream man hired by Koch industries to run their Southwest subsidiary formerly known as the state of Arizona, has announced his support for the zombie “Trumpcare” bill — before he has any idea of what its effects are — potentially giving cover to Senator John McCain to once again demonstrate that he is not a man of principles — “regular order! “– but a partisan political hack. John McCain might have just received permission to vote for Obamacare repeal:

The Senate’s longshot Obamacare repeal bill gained more momentum Monday after receiving a big endorsement: Republican Arizona Gov. Doug Ducey.

The governor’s position matters because Sen. John McCain (R-AZ) has said his governor’s support was necessary for the senator to back the plan, which would bring it one vote closer to the magical number of 50.

Ducey said that he would support the bill from Sens. Bill Cassidy (R-LA) and Lindsey Graham (R-SC), which would turn much of Obamacare’s funding into block grants for states with few strings attached. The bill would also place a federal spending cap on Medicaid, which is jointly funded by the states and feds, for the first time. That has caused many governors, who administer Medicaid, to balk.

Read more

Arizona Supreme Court to hear appeal of Gov. Jan Brewer’s Medicaid expansion plan

by

Earlier this year, the Arizona Court of Appeals affirmed the Maricopa County Superior Court decision upholding former governor Jan Brewer’s Medicaid (AHCCCS) expansion plan in 2013. AZ Court of Appeals upholds Medicaid (AHCCCS) expansion plan.

The “Kochtopus” Death Star, the Goldwater Institute, which is litigating the case on behalf of our lawless Tea-Publican legislators who are parties to this lawsuit, of course appealed the decision to the Arizona Supreme Court. Jan Brewer’s Medicaid (AHCCCS) expansion plan goes to Arizona Supreme Court.

The Arizona Supreme Court has now said it will hear the appeal. The Arizona Capitol Times (subscription required) reports, AZ Supreme Court to decide on Medicaid tax:

The state’s high court agreed Tuesday to decide whether a levy that funds Arizona’s expanded Medicaid program was illegally enacted.

Without comment, the justices said they want to give foes of the levy — current and former state lawmakers — a chance to make the case that it really is a tax.

What the court decides will be significant, as it takes a two-thirds vote of both the House and Senate to raise taxes [the “Two-Thirds for Taxes” Amendment, Prop. 108 (1992)]. . And since the measure did not get that margin, a finding that the levy actually is a tax would mean the Arizona Health Care Cost Containment System, the state’s Medicaid program, could no longer collect it.

More significant, without the approximately $265 million being collected each year, the state could no longer afford to provide care to about 400,000 Arizonans who were added to the plan as a result of the 2013 action.

Tuesday’s action does not mean the justices have already reached a conclusion. But just the decision to review lower court ruling upholding the legality of the levy places it in potential jeopardy.

Read more

Contradictions and confusion over fate of ‘Obamacare’

by

Recent reporting on the fate of “Obamacare” has been both contradictory and confusing to anyone trying to follow the machinations of Congress and the Trump White House.

Tom Price at the Department of Health and Human Services (DHS), a Teabagger opponent of “Obamacare,” continues his efforts to sabotage “Obamacare.” The Same Agency That Runs Obamacare Is Using Taxpayer Money to Undermine It:

The Trump administration said on Thursday that it would slash spending on advertising and promotion for the Affordable Care Act, but it has already been waging a multipronged campaign against it.

* * *

[T]he Department of Health and Human Services — an agency with a legal responsibility to administer the law — has used taxpayer dollars to oppose it.

Legal experts say that while it is common for a new administration to reinterpret an existing law, it is unusual to take steps to undermine it. Here are three ways the health department has campaigned against Obamacare. [Quick Summary]

1. REDIRECTING PROMOTIONAL FUNDING

Instead of using its outreach budget to promote the Affordable Care Act, the department made videos critical of the law.

2. ATTACKING THE LAW

The department targeted the Affordable Care Act with a marketing campaign as Republicans in Congress tried to repeal the legislation.

3. DELETING INFORMATION ONLINE

The department removed useful guidance for consumers about the Affordable Care Act from its website.

Read more

CBO: Trump sabotage of ‘Obamacare’ would send premiums and the deficit skyward

by

The Trump administration is going to have to file a status report in House v. Price regarding its position on the continuation of cost-sharing subsidies to insurance companies under “Obamacare.”

On August 1, the D.C. Circuit Court of Appeals granted the motion for leave to intervene filed by several state attorneys general and the District of Columbia. As part of that order, the Court ordered “the case shall continue to be held in abeyance. Appellee, appellants, and intervenors are directed to file status reports at 90-day intervals.” A status report was due on or about August 22 after a continuation in May.

[T]his bizarre lawsuit could still blow up the ACA insurance markets:

A pending court case, House v. Price (née House v. Burwell — and so much turns on the name change), has given the administration a bomb it could use to blow up insurance markets across the country. At stake is the legality of the payments the federal government makes to insurance companies to help cover the medical expenses of low-income people.

If Obama’s appeal continues, then the payments continue. But if President Trump or Attorney General Jeff Sessions were to decide not to continue the appeal, that’s a game changer.

By moving to defuse House v. Price, the Trump administration could signal that it means to make the best of Obamacare. At the same time, however, the case may represent the last best chance to rip the statute up from the roots. Skittish insurers are watching closely to see what the administration will do. Time is short: Insurers will have to decide very soon whether they want to participate on Obamacare’s exchanges in 2018.

Without the subsidies, insurance markets could quickly unravel. Even more insurers could withdraw from the public marketplaces where more than 10 million Americans obtained coverage last year.

Read more