Tag Archives: health

Trump Throws Ryan Under the Bus in the Classiest Way Possible

by WalkerMcCranie Posted on March 26, 2017

Mother Jones

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On Friday—that’s 24 hours ago for those of you with short memories—President Trump insisted that he had no hard feelings toward Paul Ryan. Ryan had worked hard on the health care bill, and it was just bad luck that it failed. In fact, it was really the fault of the Democrats, who hadn’t provided a single vote. Not one!

However, experienced Trump watchers noticed a brief aside: he mentioned that there were a few things he would have done differently—but he wasn’t going to talk about that. This is Trump code for “I’m not to blame and I won’t be able to bottle up my whining for long. I definitely will talk about these things eventually.”

So how long would Trump be able to hold his tongue? A few days? A whole week? Nope. About 18 hours, it turned out:

And here’s what Jeanine Pirro said a few hours after that on her Fox News program:

What a guy. Within 24 hours Trump is sticking a shiv in Paul Ryan’s back without even a pretense of keeping it private. He doesn’t have the guts to tell Ryan to his face, so instead he uses a TV show to pass along the message.

The real message, of course, is that no one should ever work with Trump. He’ll throw you under the bus at the first hint that he needs someone to take the blame for something that went awry. And maybe Ryan should take him up on this. When John Boehner retired and Kevin McCarthy flamed out, Republicans were literally left with no plausible candidates for Speaker who were acceptable to all factions of the party. Ryan was the only one who came close, so if he quits the GOP is in for some real chaos. That’s just what they need as they try to get a budget in place and start work on a hugely complex tax cut for the rich.

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Trump Throws Ryan Under the Bus in the Classiest Way Possible

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Kansas Republicans Just Defied Donald Trump and Voted to Expand Medicaid

by SallyLandon Posted on March 24, 2017

Mother Jones

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On the same day the House was supposed to pass a bill dismantling Medicaid, Kansas Republicans took a big step toward expanding the program in their state.

In a voice vote Thursday morning, a committee in the Kansas Senate approved legislation that would enable the state to take advantage of an Obamacare provision offering Medicaid health insurance coverage to a wider group of poor people. The federal government would provide the vast majority of the funding.

Many deep-red states like Kansas have rejected Medicaid expansion based largely on their ideological objections to Obamacare. But as I reported earlier this week, a new bloc of moderate Republicans in the state—back by the health care industry and business community—have teamed up with Democrats to push Medicaid expansion. They point out that the state has given up, to date, nearly $2 billion in federal funds that could have helped both improve the health of the state’s low-income communities while also boosting its economy.

The Kansas House overwhelming passed Medicaid expansion earlier this year. The full state Senate is expected to vote on the issue Monday, according to KCUR. But they would likely need to cobble together a veto-proof majority, since Gov. Sam Brownback (R) has vocally opposed to adopting the program. In fact, Brownback released a letter Thursday, signed with seven other Republican governors, asking Congress to pass the repeal of Obamacare, which would eventually end funding for new sign-ups in the Medicaid expansion and would prevent states such as Kansas signing up in the meantime.

It’s unclear if Congress will heed Brownback’s request. The GOP’s bill to repeal and replace Obamacare was supposed to get a vote in the full House sometime Thursday, but with both conservatives and moderate Republicans balking, the vote was delayed. The Trump administration set a deadline for a Friday vote, saying the White House would otherwise abandon the effort. Congress is currently debating the measure, but vote counts from various news outlets suggest Republicans currently lack enough votes to pass the bill.

Read more about the fight for Medicaid expansion in Kansas here.

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Kansas Republicans Just Defied Donald Trump and Voted to Expand Medicaid

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Conservatives Demand End to Pre-Existing Conditions Ban

by VilmaHerrmann Posted on March 23, 2017

Mother Jones

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I guess I was wrong last night. The New York Times says President Trump has caved in to demands to repeal the minimum set of required benefits for health care insurance:

President Trump agreed to the demands of conservative House Republicans to remove federal requirements that health insurance plans provide a basic set of benefits like maternity care, emergency services, mental health and wellness visits as he struggles to round up enough votes to pass a broad health care overhaul.

But the Washington Post reports that this still wasn’t enough:

Conservative House Republicans rebuffed an offer by President Trump on Thursday to strip a key set of mandates from the nation’s current health-care law, raising doubts about whether House Speaker Paul D. Ryan (R-Wis.) has the votes to pass the bill.

….Rep. Justin Amash (R-Mich.), asked whether the White House had made its final negotiating offer, said that if that’s the case, “They’re not going to pass the bill.”…As of mid-afternoon Thursday, 37 House Republicans — mainly Freedom Caucus members — had announced their opposition to the bill, known as the American Health Care Act.

So what do conservatives want? Here’s the Post again:

Conservative lawmakers have asked to eliminate much of Obamacare’s Title I, which….bars companies from setting insurance rates based on a person’s sex, medical condition, genetic condition or other factors.

In other words, insurers could charge you more if you have a pre-existing condition. That would effectively kill off the Obamacare provision that requires insurers to cover everyone who applies. They’d simply price policies out of reach for people with expensive pre-existing conditions and that would be that.

Would this pass muster with the Senate parliamentarian, who has to agree that repealing Title 1 “directly affects” the budget? I doubt it. Would Mike Pence go ahead and overrule her? Maybe. Is this whole thing a debacle beyond imagining? Oh yes.

POSTSCRIPT: It’s worth pointing out that if Republicans go down this road, they’ve essentially killed the filibuster completely. Basically, they would have set a precedent that anything can be added to a reconciliation bill—which can’t be filibustered—and the vice president will overrule the parliamentarian and declare that it’s OK. At that point, the Senate can include reconciliation instructions for just about anything in its annual budget resolution. As long as the president and vice president are from the same party, they can then pass anything they want with 51 votes.

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Conservatives Demand End to Pre-Existing Conditions Ban

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What’s Missing From This Photo of Politicians Deciding the Future of Women’s Health?

by CPMCamille Posted on March 23, 2017

Mother Jones

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President Donald Trump met with the arch-conservative House Freedom Caucus at the White House Thursday to try to hammer out a deal on Obamacare repeal. A major question in the final negotiations? Whether or not maternity care and mammograms should be considered “essential” treatments covered by all health insurance policies under the Republican proposal. (“I wouldn’t want to lose my mammograms,” quipped Sen. Pat Roberts (R-Kan.), who supports scrapping the requirement. He apologized.)

The White House happily snapped a photo of the gathering that will go a long way toward deciding the future of women’s health in America, and EMIILY’s List, the group that works to elect pro-choice Democratic women to Congress, also blasted out a photo of the event to reporters. Notice anything?

Here’s another angle:

Update: Washington Democratic Sen. Patty Murray has weighed in:

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What’s Missing From This Photo of Politicians Deciding the Future of Women’s Health?

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Republicans Now Considering How to Make a Bad Health Care Plan Into a Complete Wreck

by Martha8879 Posted on March 23, 2017

Mother Jones

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Our acronym for the day is EHB, which stands for Essential Health Benefits. These are things which every health care plan is required to cover, and Obamacare spells out ten of them:

  1. Doctor visits
  2. Emergency room visits
  3. Hospital visits
  4. Prescription drugs
  5. Pediatric care
  6. Lab services
  7. Preventive care
  8. Maternity care
  9. Mental health care
  10. Rehabilitation services

The Republican health care bill is still having trouble getting enough votes to pass, so Paul Ryan is thinking about placating conservatives by repealing all of these EHBs. This means that a health insurer could literally sell you a policy that didn’t cover doctor visits, hospital visits, ER visits, your children’s health care, or prescription drugs—and still be perfectly legal. Here’s a rough estimate of how much we spend nationally on each of these categories of EHB:

There are many problems with repealing Obamacare’s minimum required benefits, but I’d like to list just three:

Oh come on. This is ridiculous.

Even if the current version of AHCA doesn’t cause a death spiral, it sure would if EHBs got repealed. Insurers would assume that anyone who asks for a policy that covers one of these (former) EHBs is pretty sure they’re going to need it. Naturally they’d price their policies accordingly: Worthless policies would get really cheap, but comprehensive policies would get astronomically expensive. Virtually no one would be able to afford them.

There’s a good chance that repealing the EHBs would not only produce crappier insurance policies, but would also cost the government more money. Think about it. Every year AHCA provides you a tax credit for health insurance. You might as well use it, right? So insurers would all compete to offer policies that cover almost nothing but cost exactly $2,000 or $3,000 or $4,000. Everybody would sign up for one, because it’s free so they might as well. So instead of, say, 10 million people using the tax credits, 30 million would. These policies wouldn’t do squat, but Uncle Sam has to pay for them anyway—and now he’s got to pay for three times as many of them.

This is all pretty straightforward stuff, and it’s hard to believe that Ryan would go down this catastrophic road. Enough’s enough. If I had to guess—and we might well know the answer before I wake up on Thursday—I’d say that Ryan tries to buy off the conservatives by taking maternity benefits off the EHB list and leaving everything else alone. After all, it’s maternity care that really seems to be a burr in the ass of the Freedom Caucus folks.

Why? Because they’re knuckle-draggers. It’s hard to put it any other way. They figure that being pregnant is solely a woman’s responsibility and there’s no reason men should have to help pay for it. Really. I’m not joking. What can you even say to people so terminally dimwitted?

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Republicans Now Considering How to Make a Bad Health Care Plan Into a Complete Wreck

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To reduce obesity and depression, we need more nature in our lives.

by AveryGrafton Posted on March 22, 2017

U.S. cities are packed with about 5 million medium-sized buildings — schools, churches, community centers, apartment buildings. Most use way more energy than they should. Many also have poor airflow and dirty, out-of-date heating and electrical systems. Those conditions contribute to high inner-city asthma rates and other health concerns.

“These buildings are actually making children sick,” says Donnel Baird, who grew up in such a place. His parents, immigrants from Guyana, raised their kids in a one-bedroom Brooklyn apartment, relying on a cooking stove for heat. Baird eventually moved to the South and then attended Duke University, before returning to New York as a community organizer in 2008.

In 2013, Baird launched BlocPower, which provides engineering and financial know-how to retrofit city buildings. The technical part is cool: Engineers survey structures with sensors and smartphone apps, figuring out the best ways to reduce energy use, like replacing oil boilers with solar hot water. But the financing is critical; BlocPower builds the case for each project and connects owners with lenders. It has already retrofitted more than 500 buildings in New York and is expanding into Chicago, Philadelphia, and Atlanta.

“The biggest way for us to reduce carbon emissions right now,” Baird says, “is efficiency.”

Meet all the fixers on this year’s Grist 50.

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To reduce obesity and depression, we need more nature in our lives.

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GOP Health Care Bill Is Worse Than Just Repealing Obamacare Completely

by LeticiaRentoul Posted on March 21, 2017

Mother Jones

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Over at The Upshot, Margot Sanger-Katz catches something that any of us might have noticed if we’d had keen enough eyes. The CBO famously projected that the Republican health care bill would result in 24 million people losing health insurance:

But one piece of context has gone little noticed: The Republican bill would actually result in more people being uninsured than if Obamacare were simply repealed. Getting rid of the major coverage provisions and regulations of Obamacare would cost 23 million Americans their health insurance, according to another recent C.B.O. report. In other words, 1 million more Americans would have health insurance with a clean repeal than with the Republican replacement plan, according to C.B.O. estimates.

Here’s what the CBO said in its January report. If only the individual mandate, the subsidies, and the Medicaid expansion are repealed, 32 million people will lose insurance by 2026. If, in addition, community rating, minimum coverage requirements, and the preexisting conditions ban are repealed—in other words, if essentially all of Obamacare is repealed and nothing put in its place—23 million people will lose insurance by 2026.

As it happens, the current Republican bill is similar to Option 1, which means the GOP is making progress. Under their old bill 32 million people would be kicked off the insurance rolls, while the new bill only kicks off 24 million. However, they could do even better by just repealing everything, full stop.

Now, it so happens that they can’t do that. Democrats can filibuster all the additional stuff in Option 2. Nevertheless, Sanger-Katz is right: it’s pretty remarkable that the Republican bill actually does more damage than repealing Obamacare and simply doing nothing at all. Not just any party can pull off something like that.

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GOP Health Care Bill Is Worse Than Just Repealing Obamacare Completely

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Burning coal for electricity continues its steep slide into history.

by BetseyH277 Posted on March 21, 2017

U.S. cities are packed with about 5 million medium-sized buildings — schools, churches, community centers, apartment buildings. Most use way more energy than they should. Many also have poor airflow and dirty, out-of-date heating and electrical systems. Those conditions contribute to high inner-city asthma rates and other health concerns.

“These buildings are actually making children sick,” says Donnel Baird, who grew up in such a place. His parents, immigrants from Guyana, raised their kids in a one-bedroom Brooklyn apartment, relying on a cooking stove for heat. Baird eventually moved to the South and then attended Duke University, before returning to New York as a community organizer in 2008.

In 2013, Baird launched BlocPower, which provides engineering and financial know-how to retrofit city buildings. The technical part is cool: Engineers survey structures with sensors and smartphone apps, figuring out the best ways to reduce energy use, like replacing oil boilers with solar hot water. But the financing is critical; BlocPower builds the case for each project and connects owners with lenders. It has already retrofitted more than 500 buildings in New York and is expanding into Chicago, Philadelphia, and Atlanta.

“The biggest way for us to reduce carbon emissions right now,” Baird says, “is efficiency.”

Meet all the fixers on this year’s Grist 50.

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Burning coal for electricity continues its steep slide into history.

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There Is No Pivot. There Will Never Be a Pivot.

by MazieCarmona Posted on March 19, 2017

Mother Jones

Another week, another pivot gone awry:

For Mr. Trump, this was supposed to be a week of pivoting and message discipline. The president read from a script during public appearances and posted on Twitter less often. He invited lawmakers from both parties to the White House for strategy sessions on the health measure. He scheduled policy speeches, like one near Detroit, where he announced that he was halting fuel economy standards imposed by Mr. Obama.

….But by Friday, as Mr. Trump worked to call attention to his powers of persuasion in securing commitments from a dozen wavering Republicans to back the health measure, the White House was left frantically trying to explain why Mr. Spicer had repeated allegations that the Government Communications Headquarters, the British spy agency, had helped to eavesdrop on the president during the campaign.

There’s a piece of me that hardly blames reporters for replaying the “pivot” narrative over and over. Let’s face it: It defies human understanding that an easily bored 8-year-old has been elected president of the United States. But he has—and every week he promises to be good. Maybe he even tries. Who knows?

For something like 50 or 60 consecutive weeks, the Trump entourage has been insisting that the boss is going to pivot and start being presidential real soon now. How long before everyone understands it’s not going to happen?

We have 3.8 years of this acting out left. It’s time for everyone to give up on the fantasy that Trump is going to turn into an adult someday.

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There Is No Pivot. There Will Never Be a Pivot.

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Here’s Why CBO Projects 10% Lower Premiums Under the Republican Health Care Bill

by NataliaHudgins Posted on March 18, 2017

Mother Jones

One of the surprising things about the CBO score of AHCA, the Republican health care bill, is their conclusion that premiums will fall starting in 2020. By 2026, average premiums will be 10 percent lower than they would be under Obamacare. But why? Here’s CBO:

First, the mix of people enrolled in coverage obtained in the nongroup market is anticipated to be younger, on average, than the mix under current law. Second, premiums, on average, are estimated to fall because of the elimination of actuarial value requirements, which would result in plans that cover a lower share of health care costs, on average.

….By 2026, CBO and JCT project, premiums in the nongroup market would be 20 percent to 25 percent lower for a 21-year-old and 8 percent to 10 percent lower for a 40-year-old—but 20 percent to 25 percent higher for a 64-year-old.

Hmmm. Let’s translate this into English. First, CBO assumes that premiums will go up for old people, forcing many of them to drop out of the market. Since old people have expensive premiums, fewer old people means the average for the remaining pool will be lower.1 Second, AHCA policies will cover far less of your medical expenses, so naturally they’ll be cheaper.

The chart below shows how this “reduces” average premiums. If you use CBO’s projections and do a little arithmetic assuming a modestly younger pool, you get the average premium estimate for the overall pool shown on the left. AHCA is cheaper than Obamacare.

But the current age breakdown in the Obamacare insurance pool is 28 percent young, 38 percent middle-aged, and 26 percent old. What if you assume that stays the same? You get the premium estimates in the middle.

Finally, what if you assume that AHCA paid for 87 percent of your medical bills, just like Obamacare? Then you get the premium estimate on the right.

In other words, if you compare apples to apples, AHCA produces far higher overall premiums than Obamacare.2

Note that CBO didn’t do anything wrong here. They simply did their projections based on a (correct) assumption that AHCA would be too expensive for many old people and would produce crappier policies that had higher deductibles and paid far less of your medical bills. The “average” premium is lower, but obviously not in a way that helps anybody in real life.3

1Think about it this way. If a high school sends all its A students to a magnet school across town, the school’s average GPA will go down. This is despite the fact that nobody’s grades have actually changed.

2This is a fairly extreme example because the actuarial value changes a lot (87 percent vs. 65 percent) for the cheaper policies preferred by low-income folks. CBO has a second example that uses a middle-class worker, and it produces similar but less dramatic results.

3Hardly anybody, that is. If you’re young and don’t get any medical care, then the lower premiums really do help you.

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Here’s Why CBO Projects 10% Lower Premiums Under the Republican Health Care Bill

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