opioid epidemic

House approves massive spending bill, moves to Senate to avert a government shutdown (Updated)

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The U.S. House of Representatives on a vote of 256-167 (proceeding under the TARGET Act) has approved a $1.3 trillion spending bill to avert a government shutdown and to fund federal agencies through Sept. 30, sending the measure over to the Senate ahead of a midnight Friday deadline.

Arizona Delegation: YES McSally, O’Halleran, Sinema; NO Biggs, Gallego, Gosar, Grijalva, Schweikert.

The Senate is expected to vote late on Thursday or Friday, before current government funding expires at midnight on Friday. There could still be another brief Aqua Buddha shutdown from Senator Rand Paul (R-KY) desperately seeking attention.

You can read the massive 2,232-page, $1.3 trillion spending bill to search for what is hidden in it.

Here are a few highlights of what is (and is not) in the spending bill compiled from several sources including the Washington Post, Politico, and Vox.com.

OVERALL SPENDING

Defense spending generally favored by Republicans is set to rise $80 billion over previously authorized budget sequester levels, including a 2.4 percent pay raise for military personnel and $144 billion for Pentagon hardware.

Domestic spending generally favored by Democrats is set to rise by $63 billion over previously authorized budget sequester levels, including increases in funding for infrastructure, medical research, veterans programs and efforts to combat the opioid epidemic. Civilian federal employees get a 1.9 percent pay raise.

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#AZLeg Passes Landmark, Bipartisan Opioid Bill

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There were a lot of conversations going on in advance of the Arizona Opioid Epidemic Act.

January 25, 2018 was one of the most dramatic days at the Arizona Legislature, since I was elected.

Not only did we have ~75 Luchadores visiting their Legislators and five extremely aggressive anti-immigrant, pro-Trump protesters heckling them, we also had the big vote on the Arizona Opioid Epidemic Act (SB1001).

We have been working on SB1001/HB2001 for weeks. Unlike much of what we do in the Arizona Legislature, the Arizona Opioid Epidemic Act was a truly bipartisan effort. The governor even gave the Democrats the bill language in advance and asked for our input. The Republicans included us in the bill development process because they needed our votes and because didn’t want us to blow it up on the floor with our speechifying, as we did with the stingy TANF and teacher raises in 2017.

As someone who worked in public health and nicotine addiction treatment for years, I was proud to serve on the Democratic Caucus team that reviewed the bill and offered suggestions for revision. It was very heartening that they included several Democratic ideas in this bill. Four of my suggestions were included: offering treatment instead of jail during an overdose situation, AKA the 911 Good Samaritan bill (HB2101), which has been proposed by Democrats for four years in a row; providing funds to counties for life-saving NARCAN kits (HB2201); providing a non-commercial treatment referral service; and offering treatment in a brief intervention after an overdose scare (when your doctor says, “You didn’t die this time. Maybe you should quit!”). The Democrats also suggested including the Angel Initiative (where addicts can drop off their drugs and ask for treatment, without fear of arrest) and $10 million for drug addiction treatment services for people not on AHCCCS (Medicaid) or private insurance.

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Questions for Martha McSally re: health care

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Below is some recent reporting on health care to help you formulate your questions for Rep. Martha McSally for her “chicken bunker” tele-town hall tonight.

The largest health insurance companies in the United States reaped historically large profits in the first quarter of this year, despite all the noise you hear surrounding the Affordable Care Act’s individual marketplaces. Profits are booming at health insurance companies:

Aetna, Anthem, Cigna, Humana and UnitedHealth Group — the big five for-profit insurers — cumulatively collected $4.5 billion in net earnings in the first three months of 2017. That was by far the biggest first-quarter haul for the group since the ACA exchanges went live in 2014. Other major insurers, such as the Blue Cross and Blue Shield company Health Care Service Corp., also are improving their ACA operations.

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Aetna lost money only because it had to pay Humana a $1 billion break-up fee after their merger failed; otherwise it would have been in the black. Some other things to keep in mind:

  • The ACA exchanges represent a small amount of the insurance market, and most of the for-profit carriers have bailed on those plans.
  • Employer-based coverage is a profit center, but insurers continue to invest more in Medicare Advantage and Medicaid.
  • Congress suspended the ACA’s health insurance industry fee for 2017, which is creating a temporary windfall.
  • The first quarter of the year is usually good for health insurers. Deductibles are reset, leaving people on the hook for a lot of their out-of-pocket medical expenses. The fourth quarter usually is the worst, since people often reach their deductibles by the end of the year.

Uncertainty over the future of health care for millions of Americans grew deeper Monday after the administration and House Republicans asked an appeals court for a 90-day extension in a case that involves federal payments to reduce deductibles and copayments for people with modest incomes who buy their own policies. Insurers seek stability as Trump delays health care decision:

The fate of $7 billion in “cost-sharing subsidies” remains under a cloud as insurers finalize their premium requests for next year.

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