Tag Archives: ACA repeal

Things That Go Bump In The Night and Things That Are Making More Noise Than Sense

Another week of the Trumpster Fire, another week of news from a fire hose, and another week during which we, as news consumers, are required to filter wheat from chaff, and the relevant from the nearly irrelevant.  What things bumping in the night should be attended to? Which can be set off to the side and safely ignored for the moment.

Bumps With More Noise Than Significance

Preliminary public polling results.  The Press/Media is enamored of the latest rendition of The Great Blue Wave.  This is one of the least informative ways of filling one’s air-time.  First, national preference polling is interesting, but all elections are local.  While some members of the punditry are beginning to mouth the words “vote suppression,” and “gerrymandering,” not enough information and analysis has been shared about the effects of these GOP efforts to maintain control of the Congress, and of state elections. Secondly,  there are no national elections for Congressional seats — to state the perfectly obvious.  Those elections will be determined by candidate recruitment and quality, personnel and monetary resources, and campaign competence.  None of these, with the possible exception of shared mailing lists and big donors (monetary resources) is national in scope.  Third, some campaigns will be assisted by the efforts of third party groups. For example, are Union members out canvassing? Are students out doing registration drives?  Are small groups of activists providing services like rides to the polls? The extent and nature of these ancillary groups and their activities will have an impact, we just don’t know the extent to date.  None of this will be “news” to anyone who’s been paying attention to American civic life for the last few decades.

Just because it’s on the news doesn’t necessarily mean it’s important.  The occupant of the Oval Office and some members of the media are still playing the DC parlor game, “Who is Anonymous?” Or anonomus or anamonomous or whatever.  I’m still working on why this might be important.  For my money we still have staff in the executive branch who are willing to explode the national debt in service to tax cuts for the top 0.01% of American income earners, at ease with putting 12,000 children in “detention” facilities for an indefinite period, and quite pleased to allow health insurance companies to charge people with pre-existing medical conditions more for their premiums.  That these people will occasionally arise on their hind legs and proclaim the Great One has gone too far doesn’t impress me.  What would impress me?

How about more attention paid to this nugget:

“Besides family, one of the only people Trump continues to trust is Stephen Miller. “The op-ed has validated Miller’s view, which was also Steve Bannon’s, that there’s an ‘administrative state’ out to get Trump,” a Republican close to the White House said. “There is a coup, and it’s not slow-rolling or concealed,” Bannon told me. “Trump believes there’s a coup,” a person familiar with his thinking said.”

And thus our Oval Office Occupant (Or Triple Zero if spelled 0val 0ffice 0ccupant) is more heavily reliant on a blatantly racist, far right wing conspiracy fabulist, who stokes the Occupant’s most divisive tendencies?  This seems to call for more analysis, and yet the punditry still grasps the Who-Done-It? segment, or pontificates upon the “effect” of the infamous Op-Ed on the President’s “mind set.”  Clue number one a White Nationalist was influencing the 000 might have been the initial Muslim ban?  More clues — no DACA agreement  by Congressional Democrats was ever going to be satisfactory — no one ‘would care’ that there might be children separated from their parents at the southern border — it’s considered acceptable to move funds from FEMA and the Coast Guard to pay for more ICE detention facilities —  it’s supposed to be all right for asylum seeking families to be kept in these detention facilities indefinitely?

Things Not Making So Much Noise But Nevertheless Important

Health care and health insurance.  There is nothing the GOP would enjoy so much as repealing the last semi-colon and comma of the Affordable Care Act.  We’ve heard the “more competition” argument currently coming from the House Speaker before.  It doesn’t make any more sense now than it did then.  Health insurance is not a product analogous to purchasing a motor vehicle or any other consumer product.  One doesn’t choose to get hit by a bus, or hit with a cancer diagnosis, or hit with a complicated pregnancy — or even an uncomplicated one for that matter.

Consumer protection.  While the great fire hose emits its inundation of noise about all things Trumpian, consumer protections enacted to prevent yet another Wall Street melt down are under attack.  The student loan market is being “deregulated.”  Not a good thing.  The smaller issues involved in the Dodd Frank Act have been resolved with some bipartisan legislation, but the administration wants to go further — and the assortment of Goldman Sachs alums in the administration are being ever so helpful in this regard.  Left unchecked we’re going to see another round of de-regulation, which didn’t work out so well for us the last time.  Caveat Emptor American consumer — be careful before voting for any candidate who vows to cut red tape and diminish the “burdens” of regulations — like those preventing the next melt down in the Wall Street Casino.

It’s the Stupid Economy.   Yes. Wall Street has been doing quite nicely thank you very much. I maintain my position that the worst business news is readily available on most broadcast networks.  If a person believes that the DJIA represents the state of the American economy then they’re in for more surprises like the ones which emerged in 2007-08.   Information like real median household income trends is available from FRED, but before we get too excited note median household income numbers may be obscuring other figures like wages adjusted for inflation for full time employees.   Further, what’s being added in to the mix as “income?”  All income includes everything from unemployment benefits to returns on investments.  It’s those returns on investments that have made some very nice progress over the last ten years…wages maybe not so much.  We’re on our own to dive more deeply into the wage issues and income distribution data.  There’s some good news, some bad news, and some news to think about like the 16 straight quarters we’ve had of increasing domestic household debt.  So, it’s time for the question:  Are we seeing candidates for Congress who acknowledge the need for common sense controls on Wall Street casino operations? Who are aware and concerned for wage and salary workers and their economic security?  Are we getting more noise from the highly generalized pie in the sky theoretical visionaries who want us to believe that those with great wealth are going to buy all the homes, cars, washing machines, shoes, movie tickets, and restaurant meals necessary to keep the US economy rolling on?

I could use a little more light on these subjects, and perhaps a bit less bump in the night stuff about a “crisis on the border” (manufactured by the current administration) or “The Press Is Out To Get Me,” from Orange Blossom.   And, I’m looking for Congressional and Senate Candidates who will speak to me about how to fix problems, rather than shout at me about how to fix the blame for them.  I’d like for political discourse to make more sense than noise.

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Filed under anti-immigration, banking, Economy, financial regulation, Health Care, health insurance, Heller, Nevada politics, Politics

It’s Official: GOP Hates Women — Scamcare Edition

In case there’s anyone left who thinks the Republican Party is representing the needs of women in this country, the contradiction is right in front of us in the form of the Graham-Cassidy+Heller (tagging along) bill.

Amy Friedrich-Karnik, senior federal policy adviser at the Center for Reproductive Rights, pointed to a statistic from progressive think tank the Century Foundation that estimates 13 million women will lose access to maternity care services if the ACA is repealed. Friedrich-Karnik explained that the bill also blocks Medicaid patients from using Planned Parenthood, which bars access to essential preventative care like birth control, cancer screenings, and STD testing and treatment. “It also slashes Medicaid overall and into the future, and so really impacting particularly low-income women and women of color who rely on Medicaid broadly for their health care,” she said. According to the Kaiser Health Network, Medicaid pays for nearly half of all births in America and covers family planning services for 13.5 million women. [Jez]

Not only is the bill a golf ball shot to the back of the head for Nevada women, it could cost the state some $250 million in funding:

Specifically, the proposal would eliminate the marketplace subsidies and federal dollars that states that chose to opt-in to Medicaid expansion under the ACA, like Nevada, currently receive, replacing them with block grants to be doled out to states, which would be left with the responsibility of deciding how to spend that money. It also converts almost the entire Medicaid program to a per capita cap, under which the federal government would set a limit on how much it reimburses states per enrollee, and allows states to waiver certain provisions from the ACA that require insurance companies to cover certain services and bars them from placing annual or lifetime caps on coverage. [NVInd]

Got that? Nevada gets a per capita cap, AND insurance corporations could refuse to cover pre-existing conditions, maternity care, family planning, women’s health care services, AND the corporations could revert to that wonderful old scam — the lifetime limit on coverage.  This isn’t as bad as the former “skinny” bill — it’s worse.

Senator Heller might have wanted to give this version some thought before he inked his name on the paperwork to co-sponsor the bill, but he didn’t.

It’s understandable that Nevadans are tiring of calling, writing, and sign making, but if Republicans are nothing else they are persistent.  They’re counting on public apathy, ignorance, and fatigue.  Not this time. Not on American health care. Not on our watch.

Senator Heller’s Washington DC office number is 202-224-6244.  Calls are tallied, and at some point the number of calls opposing this iteration of scam-care needs to impinge on the amount of money Republicans are counting on from the Koch Brothers and other right wing radicals.

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Filed under Health Care, health insurance, Heller, Medicaid, 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

To Our GOP Friends Who Don’t Seem To Have A Clue How Insurance Works

We might go for the Ryan budget bill in regard health insurance directly, but others have already noted that either (a) he doesn’t have a clue how insurance works, or (b) he’s trying to pull a fast one on the American public.  At any  rate, the phase I of the ACA repeal is essentially a gigantic giveaway to health insurance and pharmaceutical corporations, a tax boon to those in the upper 0.1% income bracket, and a dismantling of the Medicaid program. The contents of Phase II have been tipped.  It’s on the Speaker’s website, but requires a bit of unpacking:

“Administration actions, notably by HHS Secretary Price, to stabilize the health insurance market, increase choices, and lower costs…”

Translation: The content of health insurance policies, currently listed as “essential provisions” for all policies, is under a head on assault.

If a corporation is going to offer a comprehensive health insurance policy for sale to customers, it must include “ambulatory care for patients in a hospital or not,” “emergency services,” “hospitalization,” “pregnancy, maternity, and newborn care,” “mental health and substance abuse treatment,” “prescription drugs,” “rehabilitation,” “laboratory services,” “preventive and wellness care,” “pediatric care including vision and oral care,” and “birth control and breastfeeding coverage.”

Now, just guess what parts of this coverage the GOP finds objectionable?  If you guessed anything having to do with WOMEN give yourself the prize of the day.

Why, the guys grouse, do I have to have a policy covering maternity and neo-natal care, birth control prescriptions, and pediatric care?  It’s because of how insurance works.

Aside from the obvious part wherein it requires both men and women to create a ‘maternity situation,’ the whole idea of insurance is encapsulated in the word POOL.

“When you buy insurance, you join many others who pay money to an insurance company.  The insurance company uses the money collected to pay claims that are submitted by those who have purchased insurance.  The money is “pooled” and losses and expenses are shared.  An important aspect is the members of a pool share similar risk characteristics.” [HIW]

In the case of health insurance, the “shared characteristic” of note is that everyone who buys a policy is a human being, who at some point will need health care.  The more people (policies) in the pool the wider the risk can be shared. And, that’s the point of insurance — spreading the risk among as many policy holders as possible.

Creating ‘cafeteria’ policies might be profitable for the insurance corporations, but it doesn’t make health care affordable for most people.  If we carve out special coverage for maternity care and remove this from the larger pool (which includes men) all this serves to do is to increase costs for those remaining in a smaller pool.  Similarly, if prostate cancer screening and treatment is carved out from comprehensive coverage, this serves to increase costs as the overall pool is diminished.

Got it? If not, think of your auto insurance.  10 people buy GenZ Insurance, 9 of them never file a claim, 1 does. The costs related to the one claim are shared among those who bought into the pool and paid premiums to maintain their insurance.  We require all automobile owners in this state to have at least minimal insurance. In Nevada, this means you have to have a policy covering $15,000 for bodily injury or death in an accident for one person, $30,000 for bodily injury or death of two persons in an accident, and $10,000 to cover property damage. Thus, all Nevada drivers must have at least minimal participation in the auto insurance pool. Again, the larger the pool the greater sharing of risk, the entire point of having insurance.

Back to health insurance, if we thought Phase I is a disaster, Phase II should be even worse. Phase III is the ‘portability canard.”  Has it occurred to anyone in the GOP hierarchy that nothing that really prevents insurance corporations from selling their policies across state lines — IF they agree to accept the standards set by state insurance commissions for the protection of their consumers.  More on this later — if necessary.

 

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Filed under Economy, Health Care, health insurance, Insurance, Politics