CBO Numbers Says GOP Health Plan Benefits Young, Healthy…Not Seniors

Published in the Woonsocket Call on May 28, 2017

Weeks ago, the Trump Administration and GOP House leadership mended fences with GOP moderates and conservatives to hammer out a new version of the introduced legislation, the American Health Care Act (AHCA) of 2017 and replace the Affordable Care Act, called Obamacare Care. The GOP health care proposal with its last-minute changes passed on May 4 by a razor-thin vote of 217-213, a slim margin of four votes. All 193 Democrats opposed passage, along with 20 Republican lawmakers.

With passage, AHCA moved to the Senate for deliberation. Senators considered the House passed health care bill “Dead on Arrival.” But, Senate Majority Leader Mitch McConnell (R-Ky.) quickly appointed 13 Republican Senators to hammer out their chamber’s health care bill. Political observers doubt whether McConnell has enough votes to pass legislation this year.

Democratic lawmakers and critics of the House’s passed AHCA legislative proposal expressed outrage that House Speaker Paul Ryan (R-WI) called for a vote, not even waiting for the nonpartisan Congressional Budget Office (CBO) to provide an updated financial analysis of the new version of AHCA. The CBO’s cost analysis of the original bill, pulled moments before a scheduled vote on March 24, 2017, found that the GOP health care bill estimated that if passed 24 million or more Americans could be uninsured by 2026.

Now the long-awaited CBO new numbers are finally in for the House GOP passed health care bill.

According to the CBO analysis released on May 24, 2017, 23 million people will lose health insurance in the next decade under the House GOP’s recently passed health care proposal. The CBO analysis concludes that the AHCA benefits the young and healthy at the expense of older and sicker Americans. The report indicates that “near seniors” (aged 50-64) will be hit particularly hard by the GOP healthcare bill. Specifically, net insurance premium costs for low-income seniors would rise by 700 to 847 percent over the next 10 years under House-passed bill. A 64-year-old with an income of $26,500 per year who paid $1,700 annually for an Obamacare policy would now pay a whopping $13,600 under the Republican plan.

Aging Groups Rally Against Flawed GOP Fix to Nation’s Health Coverage

Aging advocates says that CBO’s analysis of the newer version of AHCA again brings to the forefront the flaws of the GOP’s health care coverage fix.

In a statement, AARP Executive Vice President Nancy LeaMond says the new CBO analysis serves as another example that the House legislation would make harmful changes to the nation’s current health care system. The bill would also hurt older Americans by decreasing the solvency of Medicare, hiking costs for those who can least afford them, eroding seniors’ ability to live independently, and giving tax breaks to big drug companies and health insurance companies, she said.

“AARP reiterates our strong opposition to the harmful bill passed by the House and calls on the Senate to take action by starting a bill from scratch. The CBO analysis found that premiums would go up to unaffordable levels by inflicting an Age Tax and removing current protections for people with common conditions including diabetes and weight gain. Putting a greater financial burden on older Americans is not the way to solve the problems in our health care system,” says LeaMond.

“The CBO report was no surprise to those of us who are looking out for the best interests of older Americans. The GOP leadership was so focused on passing repeal and replace legislation that they failed their due diligence by ignoring an ominous flaw: their bill will drive up seniors’ out-of-pocket costs by repealing subsidies that help defray the cost of premiums,” says Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare in a statement.

The report also confirms that the House bill will only compound the problems faced by near seniors with pre-existing conditions. While an amendment by Rep. Fred Upton (R-MI) adds $8 billion over five years to fund high-risk pools for patients with pre-existing conditions, that will not be nearly enough to offset the extra costs to seniors, warns Richtman.

According to CBO, “People who are less healthy (including those with pre-existing or newly acquired medical conditions) would ultimately be unable to purchase comprehensive non-group health insurance at premiums comparable to those under current law, if they could purchase it at all.”

Seniors who rely on Medicaid will suffer under the GOP’s passed health care bill, said Richtman, noting that the CBO report calculates that the AHCA slashes Medicaid spending by $834 billion. Medicaid currently helps pay for long term care for millions of seniors nationwide.

The CBO estimates that some 14 million Medicaid recipients would lose coverage under the AHCA – or not be able to attain it in the first place – within the next 10 years. In fact, more than half of the increase in uninsured Americans under the AHCA would come from this vulnerable population. In addition, changes to the ACA’s individual market reforms will increase the number of uninsured Americans age 50 to 64 from just over 10 percent under current law to nearly 30 percent, says Richtman.

Richtman charges that the GOP healthcare bill also weakens Medicare by repealing a tax on high wage earners, which would decrease the solvency of the Medicare Part A Trust Fund by three years. Accelerating the exhaustion of the Part A trust fund would likely lead to cuts in Medicare, including privatizing the program, that would be detrimental to current and future beneficiaries.

“The amended American Health Care Act is an assault on the health care of all seniors,” says Richtman. “We can only hope that the Senate will take the CBO’s new figures into consideration – and reverse the provisions that are so demonstrably harmful to our nation’s seniors.”

GOP Defends its Health Care Coverage Fix

As expected, with the release of CBO’s new numbers, the GOP moved quickly to dispute the federal agency’s findings. Republican National Committee Chairwoman Ronna McDaniel stated “The CBO has a history of being way off in their predictions, often giving a different forecast from actual reality.”

Even former House Speaker Newt Gingrich (R-GA) got into the verbal fray, blasting the new CBO analysis on FOX Business’ Lou Dobbs Tonight, calling for “the abolishment of the federal agency.” Gingrich called CBO “a dishonest bureaucratic organization,” suggesting that money might be saved by hiring “outside professional firms, get three to five major scores on bills.”

The Battle on Health Care Reform Moves to the Upper Chamber

On May 22, 2017, more than 75 national organizations recently sent a letter to Senate Majority Leader Mitch McConnell and Ranking Minority Leader Chuck Schumer, calling on the Senators to reject AHCA and to engage in “a transparent, bipartisan dialogue on needed reforms to enhance health care access and affordability.” The correspondence gave notice that these organizations strongly opposed provisions in the AHCA that undermined Medicare’s financing and risk access to essential care for Medicare and Medicaid recipients.

The correspondence cosigners noted that Obamacare imposed a small tax increase on the highest earners that helped” put Medicare on stronger financial footing. The GOP health care bill’s repeal of this tax would result in lost revenues, causing the Medicare Hospital Insurance (Part A) Trust Fund to become insolvent two years earlier than anticipated. The correspondence also expresses alarm that Congress would knowingly vote to undercut the Trust Fund.

The correspondence also charges that the GOP’s AHCA advances devastating Medicaid cuts—per-capita caps—that threaten access to needed care for the 11 million people with Medicare who also depend on Medicaid. One in five people with Medicare rely on Medicaid to cover vital long-term home care and nursing home services, to help afford their Medicare premiums and cost-sharing, and more.

“Federal cuts to Medicaid…would drive states to make hard choices, likely leading states to scale back benefits, impose waiting lists, implement unaffordable financial obligations, or otherwise restrict access to services,” says the correspondence.

Joe Baker, president of the Medicare Rights Center, said, “A Medicaid cut is a Medicare cut. One in five people with Medicare rely on Medicaid to access home and community-based services and nursing home care that they would otherwise go without. Medicaid is also the lifeline that helps millions of older adults and people with disabilities afford their Medicare premiums and cost-sharing. Per-capita caps are not a viable path forward to support our aging nation; the Senate must start from scratch.”

Adds, Kevin Prindiville, executive director of Justice in Aging. “The AHCA risks the health and financial security of millions of older adults in our families and communities. Slashing the program’s funding by over $800 billion eliminates Medicaid’s 50-year guarantee that older adults can count on Medicaid when they need it the most. We call on the Senate to protect seniors and Medicaid.”

“Simply put, this legislation is not a health care bill,” says Judith Stein, executive director of the Center for Medicare Advocacy. “A health care bill would strengthen coverage and delivery programs. AHCA gratuitously weakens Medicare, decimates Medicaid, and guts insurance for 24 million people. We urge the Senate to reject this charade and develop a real health care bill that improves coverage and enhances the Affordable Care Act.”

Rhode Islanders Give Tips to Graduates

Published in the Woonsocket Call on May 14, 2017

During the month of May, commencement speakers will be addressing the graduating Class of 2017 at Colleges, Universities and higher learning institutions in Rhode Island and throughout the nation. Robed graduating seniors will listen attentively to these 10 minute speeches usually given by very well-known lawmakers, judges, television personalities and business CEOs who offer tips on how the graduate can live a successful and fulfilling life. The graduate can only hope that this advice that might just propel them into a more rewarding personal and professional life.

Traditionally this notable, successful, and stimulating figure, is oftentimes well-known in the community. Larger institutions may choose speakers of national or international renown, but sometimes this recognition comes at a great cost, commanding high speaking fees. Locally, Brown University, unique among Ivy League institutions, features graduating seniors, rather than outside dignitaries, as their commencement speakers.

So, I suggest to Presidents of Colleges and Universities, with your tight operating budgets, you can save a little money by not bringing in high-paid commencement speakers with another alternative. As can be seen below, there are many potential candidates in Rhode Island communities that fly below the selection committee’s radar screen and can give college graduates very sound strategies for success gleaned from their everyday life experiences. The messages gleaned from average every day Rhode Islanders will most surely give a road maps on how the graduating senior can reach their potential in a very challenging world.

Eric J. Auger, 48, Pawtucket, Co-Founder/Creative Director for TEN21 Productions. “Having been an active artist and exhibiting my work since the age of 4, I can look back at 44 years of trials and errors that have influenced me to become the artist that I am today. My advice to anyone starting out is to follow your intuition and embrace all the success and failures that it may bring you. Living through and learning from these experiences is what opens your eyes to your true potential.”

Michael Bilow, Providence, Writer at Motif Magazine, “Only you are the ultimate judge of what you want. Take advice from people who want to help you, but don’t worry about pleasing them. Money is important to have enough to be independent, but not as an end in itself. Never take a job or a romantic partner just because others expect it of you. Be nice, but not too nice. Don’t lie to yourself. Worry less. You have a right to be happy.”

Natelie Carter, 73, Cumberland, Director of Operations for Blackstone Valley Tourism Council.
“One of the oldest pieces of wisdom ever dispensed is one that has guided my life “Know Thyself.” It still directs my life that has been filled with remarkable events and few regrets. However, there is the wisdom of Edna St. Vincent Millay to learn from “I am glad that I paid so little attention to good advice; had I abided by it I might have been saved from some of my most valuable mistakes.”

Greg Gerritt, 63, Providence, Head of Research for ProsperityForRI.com. “Climate Change is the existential crisis of our time. Be ready to resist the oligarchy when they seek to prevent protest and work to protect their fortunes. Be ready to resist the oligarchy when they crank up the false news and the war machine. If you shut down the war machine and truly stop climate change your lives will be better. If you do not, get ready for a hot and violent planet and community.”

Maureen O’Gorman, Warwick, Adult Correctional Institute GED Teacher. “Meredith Grey, fictional philosophizing doctor said: “The story of our evolution is the story of what we leave behind.” Human tails no longer exist and the appendix isn’t functional. Every choice we make comes at the cost of choices we didn’t make. Reinventing ourselves can’t happen without discarding something behind as we move forward. Honor the past, but do not live in it.”

Nora Hall, 72, North Kingston, freelance writer. “Empathy may be the most important life skill you can develop. It enables you to “put yourself in another’s shoes” and makes you a great leader.”

Everett Hoag, 63, North Providence, President of Fountain Street Creative. “Advice to new artists – Believe in yourself and your work. Explore as many forms as you can. Discover art comes from inside and as long as you have the skills, true art will emerge. Keep creating and create what is true to you, never stop or be discouraged by what others say… Designers — we make the world more beautiful. More functional. Safer. More special. The more of ‘you’ that goes into your work, the more original it becomes; there’s something magical about that.”

John Kevorkian, 63, East Greenwich, Management Psychologist/Business Coach. “Over the years, I’ve noticed that so much of success comes from simply showing up. Be aware, get involved, get engaged with what is important to you. Be there and be! Be truly interested in understanding the other’s viewpoint and situation. Ask questions and listen to learn what you don’t know and then you will be well prepared to confidently voice opinions and be helpful. Be a catalyst. It is easier to make things happen if you don’t care who gets the credit.”

Larry Monastesse, 65, Pawtucket, Director of Administration, Coastline Employee Assistant Program (EAP). “Passion and Education is the Key. Mistakes happen- learn from them but do not quit. Keep your goals front and center. Have the courage to follow you heart, it is the true measure of your success. Time is limited, share with family and friends. They will be with you on your lifelong journey. Make time for yourself and give back to society in some form that you are comfortable with and enjoy. Do dream and enjoy the ride.”

Steven R. Porter, 52, Glocester, A college diploma is treated like the end of an educational learning journey, but truthfully, it’s just the start. Those who will be the most successful in life never stop reading, studying or acquiring new skills. The world is a rapidly changing place, and higher education does a good job of preparing you for what the world was like, not what the world is going to be. Stay positive and aggressive.

Debra Rossetti, over 50, Central Falls, Staff Developer/Literacy, New York City Department of Education. “You can and will make a difference in our society and world, This day is a special and important milestone in your life. You have accomplished much to be standing where you are now, but your journey has just begun. You have much more to do and challenges to bear in your years ahead. Transform yourself in to the person you aspire to be, be ready for change, think forward and move forward. Continue to educate yourself. Life is a journey with lessons to learn at every corner. Take advantage of opportunities to grow your mind and pursue your dreams. Believe in yourself, believe in others, always be humble and kind.”

Randy Sacilotto, 55, Cumberland, Navigant Credit Unions, Vice President, Community Development. “My mom told me to remember to love people and use things, never the other way around. This may seem pretty simple and logical. Yet there are times we may want to do the reverse. Remember that it is by genuine caring interaction with another human soul that we learn and laugh and grow. And nothing you will own will ever visit you when you’re sick, hold you when you’re sad, or celebrate your accomplishments.”

Susan Sweet, 75, Rumford, former state employee. “Make your own trail and avoid the well-worn path. Find interests and passions and live them. Create purpose in your life. Do something good, something useful in your life. Contribute to the happiness and well-being of other beings. Let Death be your advisor.”

Patricia Zacks, 63, Pawtucket, Owner of Camera Werks: Never be afraid of trying new things. Hardships and setbacks are part of life, but it is how we deal with them that can make all the difference. Obstacles may be opportunities in disguise, and change oftentimes leads to new roads, exciting journeys and a time of self discovery. Follow your bliss.

GOP Health Care Reform Moves to Senate

Published in Woonsocket Call on May 7, 2017

House Speaker Paul Ryan’s words are now coming back to haunt him and GOP leadership that rammed American Health Care Act (AHCA), without procedural safeguards, through the House chamber days ago. “I don’t think we should pass bills that we haven’t read that we don’t know what they cost,” said Ryan in a 2009 interview on MSNBC when Congress was debating President Obama’s 1990-page Affordable Care Act (ACA), or Obamacare.

Last month, the Trump Administration efforts to repeal and replace Obamacare, with the American Health Care Act (AHCA) went down in flames when so many GOP moderates and conservative House lawmakers opposed the bill that the leadership didn’t dare bring it up for a vote. Successful negotiations of the GOP factions crafted a new version that passed last Thursday by a razor-thin vote of 217-213, a slim margin of four votes. All 193 Democrats opposed passage, along with 20 Republican lawmakers. With House passage, the bill moves to the Senate for deliberation.

Before the House vote on the GOP health bill there were no legislative hearings held to debate its merits and its full text was posted on the Web less than 24 hours before the vote. Ryan did not even wait for the nonpartisan Congressional Budget Office (CBO) to provide an updated financial analysis of AHCA. The CBO’s analysis of the original bill, pulled moments before a scheduled vote on March 24, 2017, found that the GOP health care proposal estimated that if passed 24 million or more Americans could be uninsured by 2026.

Opposition Mounting to GOP Health Care Proposal

With the passage of AHCA, Democratic Policy and Communication Committee Co-Chair David N. Cicilline (D-RI) issued the following statement, saying “This is the cruelest and most immoral thing I’ve seen the Republican Party do to the American people. They just passed a bill that they know will result in the deaths of thousands of working people each year. I don’t know how they sleep at night.”

“All you need to know about this bill is that Republicans tried to exempt themselves from coverage [of the GOP health care proposal]] before they got caught. That’s because they know it’s a raw deal,” says Senator Sheldon Whitehouse. This legislation sets us on a path to the bad old days when insurance companies could refuse coverage to those with preexisting conditions and deny people health benefits that should be in every plan – like ‎maternity and mental health care, he says.

Whitehouse warns that AHCA’s passage will leave millions of Americans without access to affordable health insurance. “Rhode Islanders rely on the Affordable Care Act and it’s working here. If they want to improve it, that’s one thing, but this House bill will hurt Rhode Islanders,

Within hours of the House vote on AHCA, a joint statement was issued by six prestigious national medical organizations (American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Congress of Obstetricians and Gynecologists, American Psychiatric Association American and the American Osteopathic Association), representing over 560,000 physicians and medical students, denouncing the GOP health bill. Dozens of other state and national health care organizations, including the American Medical Association, American Nurses Association and American Hospital Association (and this number grows daily) also gave a thumb down on the Republican health bill that is considered “unworkable and flawed.”

Aging advocacy groups came out swinging, too.

AARP, representing 38 million members and considered to be one of the nation’s most powerful aging lobbying groups, plans to hold GOP House lawmakers accounting for their support of AHCA while gearing up to oppose the Republican health care proposal in the Senate.

In a statement, AARP Executive Vice President Nancy LeaMond reiterated AARP’s opposition to the GOP health bill passed in the U.S. House of Representatives, calling it “flawed” and warning that the legislative proposal “would harm American families who count on access to affordable health care.”

LeaMond says, “the bill will put an Age Tax on us as we age, harming millions of American families with health insurance, forcing many to lose coverage or pay thousands of dollars more for health care. In addition, the bill now puts at risk the 25 million older adults with pre-existing conditions, such as cancer and diabetes, who would likely find health care unaffordable or unavailable to them.”

According to LeaMond, AARP will continue its opposition of AHCA as it moves for Senate consideration because it “includes an Age Tax on older Americans, eliminates critical protections for those with pre-existing conditions, puts coverage at risk for millions, cuts the life of Medicare, erodes seniors’ ability to live independently, and gives sweetheart deals to big drug and insurance companies while doing nothing to lower the cost of prescriptions.

LeaMond warns, “We promised to hold members of Congress accountable for their vote on this bill. True to our promise, AARP is now letting its 38 million members know how their elected Representative voted on this health bill in The Bulletin, a print publication that goes to all of our members, as well as through emails, social media, and other communications.”

Medicaid Takes a Major Blow

“The bill threatens the very heart of the Medicaid program, taking away the guarantee that Medicaid will be there when seniors need it most. By slashing Medicaid funding by over $800 billion, the AHCA will place tremendous strain on state budget, says Kevin Prindiville, Executive Director of Justice in Aging, a nonprofit advocacy group for low-income seniors. “States will be forced to cut services, restrict eligibility, and reduce benefits for seniors, children, people with disabilities, and low-income older adults, he says.

“Congress is forcing families to pay more out-of-pocket when grandparents and other loved ones need nursing home care or home care. Two-thirds of all Medicaid spending for older adults pays for long-term services and supports. The AHCA puts this vital care for seniors in jeopardy,” says Prindiville. “By passing the ACHA, the House chose to cut taxes for the wealthy and pharmaceutical companies while harming Medicare beneficiaries by increasing Part B premiums and reducing the life of the Medicare Trust Fund, he says.

Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare calls the AHCA vote “appalling” for retirees and views the “raid of Medicare, cuts to Medicaid among the most problematic parts of the AHCA.”

“Despite the bill’s name, risking the health of our nation’s most vulnerable citizens to give the wealthy an $ 600 billion tax cut is tremendously uncaring — and does not reflect real American values,” says Richtman. In modifying the original AHCA bill to give reluctant Republicans political cover, the House leadership made a bad piece of legislation even worse,” he says.

No Protection for Pre-existing Conditions

“Recent amendments to this cruel, ill-advised bill could put coverage for older Americans with pre-existing conditions like cancer and diabetes out of reach. The $8 billion (over 5 years) added to the legislation at the last minute to defray the cost of higher premiums is woefully inadequate. It’s a thin veil that covers a head of snakes,” notes Richtman

“Equally inadequate are the meager tax credits that the GOP bill offers older Americans to buy insurance. A $4,000 annual tax credit doesn’t come to close to covering premiums for seniors ages 60-64, meaning millions of older Americans will lose coverage altogether,” says Richtman.

According to Richtman, AHCA slashes nearly $1 trillion from the Medicaid by converting the social health care program into a block grant program or imposing per capita caps. “This would make it harder for impoverished seniors to access long term skilled nursing care and community or home care. Overall, the Congressional Budget Office estimates that 14 million people will be kicked off the Medicaid rolls in the next 10 years if this bill becomes law,” he says.

Richtman observes that the enactment of AHCA would reduce Medicare’s solvency by repealing Obamacare’s 0.9 percent payroll tax on wages above $200,000. This could lead to cuts in Medicare, including privatizing the program — harming current and future beneficiaries, he says.

“Under the GOP bill, insurers can charge older enrollees five times more than younger ones. The Congressional Budget Office predicts that by 2026 this provision will substantially raise premiums for older people by as much as 25 percent,” notes Richtman.

Senate Becomes New AHCA Battle Ground

After the politically decisive House vote to pass AHCA, President Donald Trump and House GOP lawmakers celebrated their major political victory at the White House Rose Garden claiming that they had fulfilled a promise made 7 years ago to repeal and replace Obamacare. But this celebration was short lived. Like House Democratic lawmakers, Democratic and Republican Senators began voicing their skepticism and strong opposition to the House’s passed health bill. Holding a slim 52-to-48 advantage in the upper chamber, GOP Senate Leadership must craft a bill that can win the support of at least 50 of their caucus members.

Washington insiders are now reporting that the House’s unpopular AHCA is “Dead on Arrival” in the Senate. Senate Republicans say they will not vote on the House passed bill and the upper chamber is expected to move slowly in crafting its health bill, starting from scratch. Many GOP Senators opposed AHCA, especially those who want to protect their constituents with pre-existing conditions and others who represent states that have expanded their Medicaid program under Obamacare.

A group of 13 Republican Senators (all men) have begun the process of hammering out their own health bill. Senate rules do not allow a review of the legislation or the determination of the rules of the debate until the CBO provides its official fiscal impact estimate. Because of this the health policy debate may not begin until summer.

Hopefully, Senate Majority Leader Mitch McConnell, a Republican from Kentucky, and his partisan working group will reach across the aisle to Democratic Senators to assist in crafting a bipartisan solution. Won’t that be refreshing.