Senate Republicans Pushing to Vote on Latest Health Care Proposal

Published in the Woonsocket Call on September 24, 2017

With the September 30 expiration of its special Senate budget reconciliations status that allows the chamber to repeal and replace Obamacare with just a simple majority, Senate Republicains are rushing to bring their latest health care fix up for vote by the end of next week. The GOP’s last attempt failed by a razor thin margin.

Critics charge that the Senate Republicans push to quickly vote on their latest health care bill, crafted by Republican Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, comes before the issuance of a complete analysis of the Congressional Budget Office (CB)) that would detail the legislative proposal would impact coverage nationwide.

AARP, the National Committee to Preserve Social Security and health care provider groups say that Graham-Cassidy’s fix to put the brakes to rising health care costs will increase premium and out-of-pocket costs for millions. They say that the nonpartisan CBO would give the details to its negative impact.

Even Gov. Chris Christie came out opposing the GOP health care over haul bill that Senate Republicans are pushing. “I can’t support a bill that takes $3.9 billion away from the people of the state of New Jersey,” said the New Jersey Governor, reported last Wednesday by the Trentonian News. Democratic Colorado Gov. John Hickenlooper and Gov. Republican Governor John Kasich, of Ohio, held a bipartisan news conference this week calling for a bipartisan approach to reforming health care.

Talk Show Host Jimmy Kimmel also came out swinging against the Graham-Cassidy proposal, calling Sen. Cassidy, a co-sponsor of the bill, a liar. Earlier this year the Republican Senator had appeared on his show and after hearing that Kimmel had an infant son with a heart condition, he assure Kimmel that any GOP proposal would protect those with pre-existing conditions. It does not, at least to Kimmel’s satisfaction.

For days, aging and provider groups and even Democrats on cable shows expressed concern that the Graham-Cassidy Bill would allow states to permit insurance companies to charge people with preexisting conditions (an estimated 25 million Americans age 50 to 64) just because they have cancer, diabetes, high blood pressure, asthma, etc.

Age Tax Hits Seniors Right in their Wallets

On September 20, 2017, AARP writer Dena Bunis, charges in a blog posting, “Latest Senate Health Care Bill Revives Age Tax for Older Americans,” the GOP’s latest effort to repeal President Obama’s landmark Affordable Care Act (ACA), imposes an “age tax” on older Americans by eliminating premium tax credits and cost sharing payments that helped low-income persons afford deductibles and copayments for medical services.

The Graham-Cassidy bill would also allow states to get federal waivers for insurers to charge older Americans more so as to lower the cost for younger policyholders. The ACA limits the expense for older policyholders at three times the amount younger ones pay, says Bunis.

To illustrate the “age tax” Bunis, citing an AARP analysis, notes, that for a 60-year-old earning $25,000 a year, premiums and out-of-pocket costs could increase by as much as $16,174 a year. If that 60-year-old lives in a state that allows insurers to charge older individuals dramatically higher premiums, he or she would face an additional $4,124 increase in premiums,” she says.

The Graham-Cassidy bill takes away the premium tax credits that help older adults pay for their health care coverage, notes Bunis. . “About 6 million 50- to 64-year-olds buy their health coverage in the individual market, and about half of those individuals receive tax credits to help pay their premiums, she says, citing an analysis by the AARP Public Policy Institute.

The Graham-Cassidy bill would also eliminate vital cost-sharing payments that help low-income persons — especially those over age 50 — afford deductibles and copayments for medical services, too, adds Bunis, noting that “about 58 percent of adults enrolled in ACA marketplace plans get cost-sharing assistance, and 35 percent of those individuals are between 50 and 64 years old.”

Bunis notes that the latest Senate health care proposal would shift federal funds to the state through block grants that would allow each state to develop their own specific health care coverage initiatives to reduce costs. But, she says that Medicaid per capita cap or block grants funding proposals, “fundamentally change the Medicaid program [covering 17.4 million older Americans and people with disabilities], which has been a safety net for millions of poor Americans and people with disabilities.

Receiving Medicaid eligibility for coverage and services would leave fewer doctors and other providers willing to take Medicaid patients or provide needed care because reimbursement is too low.

Block grants, mandated by the Graham-Cassidy bill, would only last through 2026, offering no replacement health care plan, says Bunis. “Over 20 years, Graham-Cassidy would slash Medicaid funding by $1.2 trillion to $3.2 trillion, turning control of the program to the states and shifting costs over time to states and Medicaid enrollees,” she says.

“Americans have a right to know how this bill would impact them. Regretfully, the Majority Leadership is rushing the Senate to blindly consider Graham-Cassidy without fully vetting this proposal in committee hearings and mark-up, where amendments could be considered, and without a full Congressional Budget Office (CBO) score. CBO previously estimated that repeal-without-replace would cause 32 million people to lose health coverage,” said Max Richtman, President and Chief Executive Officer of the National Committee to Preserve Social Security and Medicare (NCPSSM), in a statement to Senate Finance. The Senate panel is scheduled to hold a hearing on the Graham-Cassidy bill next week.

“Senate consideration of any bill that would change the accessibility and affordability of essential health care for millions of Americans without a complete CBO analysis and committee debate would be the height of legislative malpractice,” says Richtman.

NCPSSM calls the latest GOP Senate Health care proposal “deeply flawed” and suggests that it be referred to the Senate Committee on Health, Education, Labor and Pensions where Chairman Lamar Alexander and Ranking Member Patty Murray are attempting to hammer out a bipartisan solution to strengthen the ACA’s individual health insurance market reforms.

A Final Take

A press time, Republican Sens. Ron Paul (Kentucky) and John McCain (Arizona) give thumbs down to the Graham-Cassidy bill with the Portland Press Herald reporting that Sen. Susan Collins of Maine, saying “I’m leaning against the bill.” Fifty Republican Senators must give their thumbs up, with Vice President Mike Pence casting the tie-breaking vote, to get a simple majority for passage. Now, the votes are just not there for passage.

But, one long-time Republican Senator speaks honestly on the record why President Donald Trump his fellow Senate caucus members are pushing so hard for passage of the latest Senate health care proposal. “You know, I could maybe give you 10 reasons why this bill shouldn’t be considered,” Iowa Republican Senator Chuck Grassley. “But Republicans campaigned on this so often that you have a responsibility to carry out what you said in the campaign. That’s pretty much as much of a reason as the substance of the bill.”

Sadly, if true the Republican-controlled Congress has put millions of Americans at risk of losing their health care coverage and at risk for the sake of a political promise. Our lawmakers must become statesmen and vote on legislative proposals because it is the right thing to do, not politicians who vote by party-line.

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Three GOP Senators Derail ‘Skinny’ Repeal Maneuvers

Published in the Woonsocket Call on July 30, 2017

After seven years of vowing to repeal and replace President Obama’s Affordable Care Act, nicknamed Obamacare, Congressional GOP efforts went down in flames on Friday when Sens. John McCain, of Arizona, Susan Collins of Maine, and Lisa Murkowski, of Alaska, voted nay in supporting the Senate Republican’s “skinny” repeal bill.

Sen. McCain, giving his no vote with a thumb down gesture, left Republican Senators gasping and Democratic Senators clapping. The 80-year old Arizona Senator, recently diagnosed with an aggressive brain cancer, had flown back to vote. The Senator’s vote was considered the decisive vote to derail the GOP’s long-time efforts to repeal and replace Obamacare.

Senate Republicans Begin Efforts to Repeal Obamacare

On July 25, GOP leadership began its efforts to begin debate on the Senate health care bill to repeal AHA. On that Tuesday afternoon, the Senate passed a “motion to proceed” vote by 51-50, the deciding vote being cast by Vice President Mike Pence. The votes outcome allowed the upper chamber to begin debate on the Senate Republican’s Obamacare repeal-and-replace proposal. Sens. Collins and Murkowski had opposed this motion, but McCain, returning to Washington, D.C. after being diagnosed with brain cancer, voted yes to proceed with the debate.

Senators began a 20- hour period of debate, considering various amendments to the House version of the health care bill. By a vote of 43 to 57, the Senate rejected one version that included Sen. Ted Cruz’s (R-TX) controversial amendment that would have allowed those with pre-existing conditions to be separated into plans with much higher premiums. The Senate also rejected, by a vote of 45 to 55, another version that would have repealed the ACA with no replacement but with a two-year delay, giving GOP senators more time to create their replacement.

Late Thursday evening, GOP Senate leadership finally unveil its expected “skinny” repeal bill, formally called the Health Care Freedom Act, that would repeal ACA’s individual and employer mandates, temporarily repeal the medical device tax, and give states more flexibility to allow insurance that doesn’t comply with Obamacare regulations.

CBO’s analysis of the “skinny” repeal bill, estimated that 15 million more people would be uninsured next year than under Obamacare, with 16 million more in 2026, and that premiums would increase 20 percent next year, compared to current law.

Earlier that day, Sen. McCain and Republican Senators Lindsey Graham of South Carolina and Ron Johnson of Wisconsin, held a news conference threatening to oppose the “skinny” repeal bill if the House Speaker did not offer sound guarantees that the House would enter negotiations after the Senate passed it. They feared that the House would end up passing “the skinny bill” rather than a more comprehensive bill hammered out in conference committee.

Ryan’s carefully crafted statement to the concerned Senators that the House would be willing to go to a conference committee did not include a specific guarantee that the House would not vote on the Senate’s proposal. Both Graham and Johnson went on to vote for the legislation. But, after his surprising vote it seems that McCain still had his concerns.

Before the Senate vote, President Trump even tweeted his displeasure of Murkowski’s opposition, her no vote against debating Obamacare repeal, says the Alaska Dispatch News. The state’s daily newspaper reported that Interior Secretary Ryan Zinke called the state’s Senators, Murkowski and Dan Sullivan, to inform them that Murkowski’s vote would “put Alaska’s future with the administration in jeopardy.”

After Zinke’s call, “Murkowski, who chairs the Senate and Natural Resources Committee, sent a message back to the Interior Secretary and Trump. Overseeing the agencies confirmation process, a committee hearing on nominations to the Interior and Energy departments, was “postponed indefinitely” with no reason given, stated the Alaska Dispatch News.

Finally, early Friday, by a vote of 49-51, Senate Republicans failed to repeal Obamacare with three Republican senators — McCain, Collins and Murkowski – joining 48 Democrats to vote against the “skinny” repeal bill. Sen. McCain’s reputation as a political maverick was evident when he voted against GOP Senate leadership. But, this vote will be considered his political legacy.

A Sigh of Relief

Reacting to the defeat of the Senate’s ‘skinny’ repeal bill, AARP Executive Vice President Nancy LeaMond, in a statement, called the vote “a victory for Americans age 50-plus.”

“The ‘skinny’ bill the Senate defeated would have dramatically increased health care costs, caused millions to lose their health coverage, and destabilized the insurance market,” says LeaMond.” She also thanked Senators Collins, McCain, and Murkowski, Senate Democrats and Independents who “called, emailed, rallied and wrote to object to this seriously flawed bill.”

Max Richtman, President and CEO of the National Committee to Preserve Social Security, in a statement stated, “Senators Susan Collins, Lisa Murkowski and John McCain were under extreme pressure from the White House and their colleagues to vote with the party instead of voting for the American people. It’s important to applaud them for stopping this train wreck of a healthcare bill. We have to wonder, however, why other Senators were willing to put their constituents at risk by cutting off their healthcare coverage.”

“We urge the majority party to put raw politics aside and work with Democrats to improve the Affordable Care Act in a way that benefits millions of American families in both blue states and red states. Let’s move forward, not back,” said Richtman.

A Bipartisan Approach

President Trump and Congress must finally listen to listen to their constituents to create policies to bring health care coverage to those in need. It is time to put politics aside and work in a bipartisan manner to hammer out a viable solution to provide affordable health care insurance to millions of Americans without coverage. McCain, Collins, and Murkowski, did just that when they resisted their party’s pressure to vote their own personal conscience not party line. They believed that the bill they voted against would do more harm than good.

Obamacare can be reworked to become more cost effective and to provide more health insurance to those in need of coverage. A recently released USA Today/Suffolk University poll at the end of June says that “just 12 percent of Americans support the Senate Republican health care plan. But, “a 53 percent majority say Congress should either leave the law known as Obamacare alone or work to fix its problems while keeping its framework intact.”

The majority of America says keep Obamacare, but make it better. Hopefully, lawmakers will listen.

Search on for GOP Senators to Protect Medicare

Published in Woonsocket Call on January 29, 2017

Since President Donald Trump took the oath of office on January 20, he is making good on some of his hundreds of campaign promises. During his first week in office Trump signed three executive orders declaring new government policies and eight presidential memoranda detailing the priorities of his new administration.

But, for aging groups, with Trumps arrival in Washington, D.C, the skirmish officially begins to protect Medicare in this new session of Congress.

With Trump and Congressional Republican Leadership on record for their support of repealing the 2010 Affordable Care Act, popularly known as Obamacare, President and CEO Max Richtman, of the National Committee to Preserve Social Security and Medicare (NCPSSM), clearly sees the writing on the wall. If successful, Richtman warns that GOP legislative actions will severely damage Medicare impacting 57 million seniors and disabled adults who rely on the program for their health care.

Building A Firewall Against Privatizing Medicare

With the GOP holding a slim majority of the U.S. Senate seats, 52 to the Democrats 48 seats, Richtman sees swaying Republican Senators away from their party’s position on privatizing Medicare to protect the federal health care program.

On January 24, 2017, Richtman urged Senator John McCain (R-AZ), Senator Susan Collins (R-ME), Senator Charles Grassley (R-IA), and Senator Lamar Alexander (R-TN) to be the Senate’s “firewall against Medicare cuts.” His correspondence asked them to vote against proposals to privatize Medicare, raise the Medicare eligibility age from 65 to 67, and repeal provisions in the Affordable Care Act (ACA), President Barack Obama’s landmark health care law, that provided additional benefits to beneficiaries.

Richtman reminded the GOP Senators that the Affordable Care Act (ACA) improved Medicare benefits and extended the solvency of the Part A Hospital Insurance Trust Fund by more than a decade. ACA’s closing of the prescription drug donut hole has put money into the pockets of Medicare beneficiaries. The health care law also added coverage of an annual wellness visit and eliminated copays for preventive services like cancer screenings, he said.

“I am also troubled by “premium support” [GOP] proposals to privatize Medicare,” says Richtman. According the aging advocate who was a former staff director of the U.S. Senate Special Committee on Aging and a 16-year veteran of Capitol Hill, under previous privatization plans, beneficiaries would not enroll in the current program; rather, they would receive a capped payment or voucher to be used to purchase private health insurance or traditional Medicare. Private plans would have to provide benefits that are at least actuarially equivalent to the benefit package provided by fee-for-service Medicare, but they could manipulate their plans to attract the youngest and healthiest seniors. This would leave traditional Medicare with older and sicker beneficiaries whose higher health costs would lead to higher premiums that they and others may be unable or unwilling to afford, reducing the fee for service risk pool even further resulting in a death spiral for traditional Medicare.

GOP Medicare Fix Financially Hurts Beneficiaries

Richtman also told the GOP Senators that NCPSSM opposed the raising of the Medicare eligibility age from age 65 to 67 because the proposal would increase costs for millions of older Americans. Absent the guarantees in the existing ACA, such as requiring insurance companies to cover people with pre-existing medical conditions and limiting age rating, millions of seniors 65 and 66 without Medicare would find private insurance unaffordable. Raising the eligibility age would also increase average costs for Medicare as younger, healthier seniors are eliminated from the risk pool and costs are spread across an older, less-healthy population, he says.

Richtman urged the GOP Senators to oppose efforts underway in the 115th Congress to block grant Medicaid, cap Medicaid payments on a per-beneficiary basis (per capita caps) and/or repeal the ACA’s Medicaid expansion. He noted that these policy changes would “financially hurt states and lead to states cutting services, quality and eligibility for the most vulnerable of our senior population.”

Many seniors would not be able to absorb the loss of coverage and increase in their costs that would occur if these proposals became law. In fact, half of all Medicare beneficiaries in 2014 had incomes below $24,150 and Medicare households spent over two times more than the average American household on out-of-pocket health care costs,” he says.

“If Senate Democrats stand strong, we only need a handful of Republicans to protect the commitment to Medicare,” says Richtman. “We hope Senators McCain, Collins, Grassley, and Alexander to do the right thing for seniors in their states – and across America.”

Richtman correspondence to the four GOP Senators is part of NCPSSM’s pro-active legislative strategy to protect the existing Medicare program. The letters sent quantify the economic impact that proposed Medicare cuts would have on seniors in the four GOP Senators’ states: Arizona (with 1.3 million beneficiaries), Maine (306,000 beneficiaries), Iowa (nearly 572,000 beneficiaries), and Tennessee (1.2 million beneficiaries).

“We know that these four Republican Senators have the wisdom and judgment to protect seniors in their states from legislation that would impose painful Medicare cuts,” says Richtman. “It’s time to slam the brakes on any attempts to pass harmful legislation.”

Senate Democrats Attempt to Block HHS Nomination

Two days before Trump was sworn in as president, the Senate Health, Education, Labor and Pensions (HELP) Committee held confirmation hearing on Rep. Tom Price, (R-Ga), Trump’s nominee to oversee the Department of Health and Human Services, the federal agency that oversees the Medicare program. In confirmed, he is expected to play a key role in the GOP’s efforts to privatize Medicare.

No formal vote was taken at the HELP Committee hearing but the Congressman is scheduled to testify a week later at the Senate Finance Committee, which will vote on his nomination.

During the four-hour heated confirmation hearing, held in 430 Dirksen Senate Office Building, HHS nominee Price dodged questions lobbed by Democrats about the Trump Administrations position on the future of Medicare. They also zeroed in on his personal financial investments in health care companies, calling them conflicts of interest which the denied.

Price, an orthopedic surgeon and a six term congressman, considered to be one of the most vocal critics of Obamacare on Capitol Hill, is expected play a key role in the GOP’s efforts to repeal and replace the Affordable Care Act.

Rhode Island Sen. Sheldon Whitehouse, sitting on the HELP Committee, gave this take on Price after the first of two confirmation hearings: “Price hasn’t been able to win Democratic support for any of his health care legislation [in the House] and today confirmed that he and his allies have no plan that can win support from across the aisle or the millions of Americans who would be affected by tearing down the Affordable Care Act. He conceded that he should not stop Americans under twenty-six from staying on their parents’ insurance, re-open the dreaded prescription drug doughnut hole for seniors, deny coverage to those with pre-existing conditions, and reinstate lifetime limits on care. But he has no plan to make that happen.”

Adds Whitehouse, “Price also failed to reassure the Rhode Islanders I serve who rely on Medicare for their care. He has fought to voucherize the program, which would gradually unload costs onto seniors while eroding their benefits. He needed to tell the American people they could depend on him to faithfully administer Medicare and keep the sacred promise we’ve made to our seniors of a dignified retirement with access to good health care. He did not.”

“Congress must protect Social Security and Medicare, but many Republicans see the latest election results as an opportunity to hollow out these vital programs. President Trump’s pick to oversee Medicare has long championed efforts to privatize Medicare, which I strongly oppose. Cutting benefits and privatizing these programs could hurt millions of Americans and harm our economy,” said Sen. Jack Reed, noting that these programs reduce poverty and improve public health in ways that benefit all Americans.

As NCPSSM’s Richtman continues his effort to sway GOP Senators, rallying the troops at the state-level may well be the path to blocking GOP attempts to privatize Medicare. Voters in states with Republican Senators must send this message to their elected official, “don’t touch my Medicare.” Let the movement to strengthen Medicare in these states begin today.