Category Archives: Heller

Heller at the President’s Right: Lunch Time At The White House

Nothing like watching Senator Dean Heller (R-NV) sitting next to POTUS, smiling and applauding as the remarks from the President replicate every standard talking point made by every Republican since the passage of the Affordable Care Act.  Including such wonderful clichés as:

You’ll pay lower premiums (Oh, such lower premiums you won’t believe) — Any fool can sell low premium policies, the ones with high deductibles and co-pays, limited benefits, and caps.  Worse still, these junk policies will be sold across state lines so that consumer standards and protections of the worst level of protection will be the standard.

The states will have control over Medicaid (smaller units will be better for individual needs)  Nothing like blowing a big wide ‘beautiful’ hole in the Nevada budget!  Cutting $770B from Medicaid will have effects far beyond Nevada’s capacity to support its elderly, its children, its rural health care facilities, its support for low income working families.  That was the point of Medicaid — expenses far beyond the capacity of individual states could be shared nationwide, allowing medical care and services for the greatest good for the greatest number.

Some counties only have one insurance corporation offering policies in the individual market.  Did the president recall that before the ACA there were some counties that had no insurance corporations offering policies in the individual market.  There’s a solution to this problem — one the president didn’t mention — establish a public option.

Then there flowed the usual barrel of platitudes and campaign rhetoric, freedom and flexibility, low cost with high coverage,  everyone can get better insurance, reduce burdensome taxation, burdensome regulation….

And there was Senator Dean Heller, smiling as though siding with the president isn’t going to be a major political problem for him in the 2018 campaign season.  It makes a person wonder.

Senator Heller can be reached at 202-224-6244, 775-686-5770; 702-388-6605

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Embattled Bill Entangled Senator

While the Russians are in, or not in, meetings which are, or aren’t important, and which do or don’t offer trade-craft dangles — there’s a Senate version of the health insurance bill as egregious as its predecessors.  The hold music of the morning on Senator Dean Heller’s DC office phone is a static infused version of The Battle Hymn of the Republic while a person waits for an opportunity for leave a message for the Senator urging opposition to the health care insurance bill.

There’s a reason no one likes this bill — it puts insurance corporations back into the bifurcated market  with high premiums for those older and lower premiums (with higher co-payment and deductible out of pocket expenses) for younger, or less affluent, customers.  It puts state budgets at extreme risk. It slashes Medicaid funding (in conjunction with the proposed budget), thus placing services for children and the elderly in peril.

Senator Heller is described as being wedged into a hard place — between the desires of the hard right (and perhaps the bounteous coffers of Sheldon Adelson) and the hopes of his constituents and the Governor who want reasonable access to affordable health care insurance.

“Heller, in other words, has backed himself into a corner. Either he honors the concerns he raised just a few weeks ago, or reverses course and completes a very public betrayal – the year before his re-election campaign.” [NBC]

It’s time to offer Senator Heller a way out of this box — encouraging his continued opposition to the health insurance bill — call 202-224-6244; or 702-388-6605; or 775-686-5770.

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Filed under Health Care, health insurance, Heller, Politics

ICYMI: In Case You Missed It, Instant Summer Reading Recommendations

The Nevada Independent has several excellent articles about the health insurance ‘reform’ battle in the state,  I’d recommend starting with ‘Senator Cortez-Masto’s denunciation of the Senate health bill,” and move on to ‘Dispatches from Washington.’

The Reno Gazette Journal reports (video) on Rep. Jacky Rosen’s (D-NV3) decision to run for Senator Dean Heller’s seat.

Please note TPM’s report from the conference of Secretaries of State concerning election data security.  If this conclusion doesn’t disturb us, it should:

“But both Republican and Democratic Secretaries of State, who are responsible for carrying out elections in many states, said they have been frustrated in recent months by a lack of information from federal intelligence officials on allegations of Russian meddling with the vote. They say that despite the best efforts by federal officials, it may be too late in to make substantive changes.”

Interestingly enough, vote suppression advocate Chris Kobach was a no-show at the meeting.  Perhaps this is because some election experts have identified major flaws in Kobach’s “election integrity” plans.

And, now we get to “muddle time” during which the current administration tries to muddy the waters about the  other election problem — Russian interference.  Spokespersons and advocates are on the air-waves saying that “Gee, it’s not 17 intelligence agencies, it’s actually just a handful of people who reached the conclusion that the Russians meddled,”  which is one tactic to discredit the reports that are unequivocal in their assessment that, yes, the Russians interfered.   Following this comes the Gee Whiz moment in which the apologist who says that “we’ve not actually seen the evidence of this.”  A statement such as this is simply a variation on the previous talking point:  We’ve investigated this enough, there’s nothing there, move along please.

Speaking of elections, please take a look at the bill introduced by Rep. Mark Amodei (R-NV2) HR 2101, the Prior Approval Reform Act:  To amend the Federal Election Campaign Act of 1971 to expand the ability of trade associations to solicit contributions from the stockholders and executive or administrative personnel of their member corporations, and for other purposes.  The effective date, January 1, 2018, would allow more “corporate” money in politics just in time for 2018 campaign season.   The Associated General Contractors would be pleased to see this enacted. [pdf]  Those disturbed by the dark, and darker money, flowing into our campaigns should track this bill.

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Filed under Amodei, Health Care, health insurance, Heller, Nevada politics, Politics, Vote Suppression, Voting

Health, Wealth, and Senator Heller: Recommended Reading

Health care continues as a high priority item for Nevadans, and Greg Sargent’s article for the Washington Post points out how the “GOP Stunt Backfired…and why,” is highly recommended for pulling the tarpaulin off the GOP obfuscation concerning the Affordable Care Act.  The New York Times reports on the impact of the health insurance battle on other elements of the GOP agenda.  Ian Millhiser warns us that if we stop paying attention, the GOP wins.  Meanwhile,…

Senator Dean Heller continues to spout the party lines (the part under the tarp) while ostensibly opposing the repeal bill:

“Under the ACA, premiums have increased 7 times faster than wages, and federal regulations under the law’s employer mandate have cut workers’ hours, wages, or both.”

Nothing like tossing one’s apples and oranges together and expecting to get grape juice.  Some significant elements are missing from this pithy bit of prose.  First, premiums have increased, but not at an equal pace in all states. Secondly, the rate of premium increases have slowed during the implementation of the ACA.  Third, wages have been stagnant during the past decade, but that has little to do with the enactment of health care insurance reform — in fact, lower wage working Americans were included in the Medicaid expansion– the very program the GOP wants to slash in order to provide tax cuts to wealthy Americans.

Senator Heller believes that re-importation of prescription drugs and allowing insurance purchases across state lines are part of the solution.  Notice that he’s not in favor of so much competition as to allow Medicare to negotiate drug prices in the manner allowed to the Veterans Administration.  Also notice that he’s not mentioning that some states have rather more lax requirements for the sale of comprehensive health insurance than others.  The “across state lines,” or “portability argument” sounds good until we recall that states build in consumer protections into their regulatory frameworks.  If we could be guaranteed that portability would be a function of the most rigorous consumer protections there’s something to be discussed herein; if not, it’s simply a formula for a race to the bottom.

This is no time to remove our attention to the decimation of health insurance affordability —

Senator Heller can be reached in Las Vegas at 702-388-6605; Reno at 775-686-5770; and DC at 202-224-6244.

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Filed under Health Care, health insurance, Heller, nevada health, Nevada politics, Politics

What Nevada Loses under Trump-Doesn’t-Care

Here’s what Nevada loses under the egregious Trumpcare Bill:

(1)  138,100 citizens in Nevada will lose their health insurance coverage.

(2) 81,000 Nevadans will lose their Medicaid coverage.

(3) 439,000 Nevadans with pre-existing conditions will be put at risk.

(4) The bill cuts funding for care for 125,056 Nevadans with disabilities.

(5) It would raise the average health insurance premium for Nevadans by $677 in 2018.

(6) $288 million in new costs will be added to Nevadans in order to keep their Medicaid expansion.

Not a very good deal for the Silver State!

Call. Call. Call Senator Dean Heller.  702-388-6605    775-686-5770    202-224-6244

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Filed under health, health insurance, Heller, Medicaid, nevada health, Nevada politics, Politics

48 Hours: The Health Care Bill

If a person hasn’t found the reason to call Senator Heller’s office and advise him to vote NO on the Republican version of a health care bill, consider the following:

(1)  One in three residents of skilled nursing facilities in Nevada are supported by Medicaid. Now, apply a simple calculator test — if a person was born in 1946 (the beginning of the Baby Boom) he or she will hit 80 in 2026.  In short, the Baby Boomers will be in the age range to need such care just as the major cuts to Medicaid kicks in.  About 65,000,000 children were born in this country between 1945 and 1961.  Cuts to the Medicaid program in this context is essentially create a crisis which we could easily have avoided.

(2) The Republicans are fond of focusing on “premium increases.”  That’s only a part of the story.  Anyone can devise insurance policies with low premiums — raise the deductibles, cut the coverage, increase co-pays,  insert lifetime benefit limits, and Voila! lower premiums.   The problems begin when a person tries to use the insurance — the reason the person bought the policy in the first place — “We’re so sorry, but this policy doesn’t cover immunizations. Or, mammograms, or prostate cancer screening, or the expenses related to the birth of your first child…”

(3) Speaking of lower premiums,  if a person has insurance from an employer then there should be no surprise when the coverage decreases compliments of the waivers included in the Senate bill — “We’re sorry, but we no longer cover wellness screenings for men and women, maternity care, or other elements that used to be included as Essential Benefits.” If a person thought that employer sponsored policies were “safe” from “reforms,” please think again.

(4) This isn’t a health care bill, it’s a tax cut bill.  Those whose income is in the top 0.1% level would receive a lovely $250,000 tax savings gift in 2026. Those earning more than $875,000 (top 1%) would get tax savings of $45,500.  [CNN]  All this at the expense of working Americans.

(5) The buzz word “patient centered” is nonsense.  At bottom, it’s a euphemistic way of saying “You are On Your Own.” A person can “choose” to buy what he or she can afford — and for lower income Americans this means lower coverage and higher out of pocket expenses.  The problem with applying classic market principles to health care is that much of what is covered isn’t a matter of Choice.  No one chooses to be in a traffic accident, any more than a person chooses to get cancer or have a heart attack.   The Republican argument seems to boil down to “live a perfect life and make excellent choices” and you are ‘worthy’ of having insurance.  This argument only works IF a person has no familial risk factors, IF a person isn’t exposed to other people (who might have an infectious disease), and IF a person can afford to build a residence in which there are no places to fall and no way to have an accident with a garage door.  In short, it’s fantasy land.

The next few hours are crucial — that’s right — HOURS. Please call Senator Heller’s office at 702-388-6605;  or 775-686-5770; or 202-224-6244.  Your health care services are at stake.

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Filed under Health Care, health insurance, Heller, nevada health, Nevada politics, Politics

Caring for Grandma on the I-80 Corridor

Republican “reforms” of Medicaid, which seem to be composed of stalling funding until the program can be gutted in 2025, could easily have a negative impact on those families trying to find skilled nursing care for elderly relatives along the I-80 corridor in northern Nevada.  As noted in the previous post, health care facilities in northern Nevada have service areas of miles and miles of miles and miles.  The euphemistic term “remote rural” is especially pertinent in this instance.  These may be the “cow counties” but they do include a significant number of individuals over the age of 65.

By The Numbers 

Pershing County (Lovelock) has a total population of 6,560 of which 14.8% are over 65, and 11.1% of those are disabled individuals under the age of 65.  Humboldt County (Winnemucca) population of 16,842 includes 11.9% over 65 and 8.3% under 65 disabled. Lander County (Battle Mountain) has 5,702 people, of whom 13% are over 65 and 6.5% are disabled.  Eureka County (Eureka) is a small entity with 1,917 people of whom 12.9% are over 65, and 6.6% are disabled.  More populous Elko County (Elko) with 52,168 people has an over 65 population of 10.0% and 8.4% disabled individuals.  Churchill County (Fallon) has a population of 24,198 of whom 18.7% are over 65 and 6.5% are disabled.

For the sake of this analysis, let’s assume that the families would like to find skilled nursing facilities for their elderly relatives closer to home than securing similar residences in the Reno/Sparks/Carson City area.  That means finding skilled nursing facilities in the towns listed above.  Elko County has such a unit with room for 110 residents, Fallon has a facility with a capacity for 74 residents.  Lander and Eureka counties are served by a facility in Battle Mountain with a capacity of 18.  Pershing county has one facility with a capacity of 25 residents, and Winnemucca has a skilled nursing facility for up to 26 residents. [Links]  We’re speaking in numbers at present, but it’s important to remember that those numbers are specifically associated with real people, and very real families who are seeking affordable quality care for those individuals.

The cost of skilled nursing care will vary with the level and type of medical or rehabilitative services required, however we can generally assume that the monthly price tag for SNF care in Nevada is about $8,213.  Drilling down a bit deeper, the reported minimum cost per month for Skilled Nursing Care in a semi-private room is about $3,346; the median is $7,128; the maximum is $8,425.  Private rooms come at a minimum of $4,106, a median cost of $8,213, and a maximum cost of $15,452.  [SNF]  At this point another reminder is appropriate — these aren’t price tags, the numbers represent what a family might have to pay for care specific to the needs of their elderly relatives.

And now we return to the numbers.  In the State of Nevada 1 out of every 7 persons over the age of 65 is covered by Medicaid. Medicaid covers 3 out of every 5 nursing home residents. [KFF]  Consider for just a moment what would happen to the fiscal solvency of the residential facilities listed above in the rural counties if Medicaid is cut, then “reformed” into block grants (which can be further cut by Congressional action) and finally all but reformed out of existence by Republican representatives.

Mythology

Let’s work on some of the elements of Republican mythology commonly associated with their efforts to slash the Medicaid program.

(1) It was only originally intended to cover the “really poor.” Republicans have an interesting way of defining “poverty.”  Several reports of recent memory decry the fact that people on various welfare programs have CARS (to get to work) and REFRIGERATORS (which come with most furnished apartments.)  Left to their own devices it’s easy to imagine that unless a person is naked, living rough in the bush, and starved into semi-consciousness the individual wouldn’t qualify as “poor” by some Republican standards.  That said, Medicaid isn’t really a welfare program — it’s essentially a health insurance program.  One way to extend this health insurance coverage was to apply income eligibility standards for publicly subsidized health insurance — for the low income families, for the aged and for the disabled.

(2) The states can do better because they are closer to the problems.   There’s a reason we have a federal system — there are some tasks which the states are not capable of adequately addressing.  Providing health insurance coverage for millions of Americans working at low wage jobs, who have disabled family members, who have aging family members, and have children in need of health care services is one of those objectives best addressed by federal resources.  Imagine if someone said the states can best determine what security is best for them?  Should we block grant the Defense Department budget, send it to the states and let them decide how to fund the elements of their National Guard?  This sounds ridiculous, and doesn’t the Constitution require government prioritization of our mutual defense? Yes, and it also provides that our government provide for our “general welfare.”

(3) We’re really not cutting anything.  No? When the inflation rate for the medical sector exceeds that of the other sectors of the economy, and budgeting or funding proposals don’t meet or exceed that inflation rate the end result is a cut.  It’s not mathematics, it’s just old fashioned arithmetic.  There’s also something disingenuous about continually clamoring for tax cuts (especially at the state level) and then offering that the states should pick up more of “their share” of program expenses.  Finally, it’s always easier to cut funds from “block grants” than it is from specific program budgets.  Yes, the Republicans intend to cut Medicaid; if it’s done slowly or quickly is beside the point — at some date the result will be the same.   Program cuts will affect those real people in those real skilled nursing facilities, both the staff providing the services and the residents who depend on them.

Senator Dean Heller should be aware of these issues, and if he isn’t perhaps he should receive some phone calls this week.  702-388-6605;  775-686-5770; 202-224-6244.

*And we still haven’t discussed the benefits of Medicaid supported home health care programs!

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Filed under Health Care, health insurance, Heller, Medicaid, nevada health, Nevada politics, Politics