It’s really hard to be a Democrat these days. Yes, at the moment, we have a slim majority in the House of Representatives and the slenderest of margins in the Senate. Joe Biden is our president. All of this contributes to why it is especially important now for Senators Joe Manchin and Kyrsten Sinema to join their fellow Democrats and support the Build Back Better Act.

Everything comes with difficulty for Democrats. It’s not like with the Republicans where there is a myriad of ways to say no, to obstruct, to negate, to undermine. Democrats have to deal with a real diversity of opinions within their ranks and focus on constructing policy rather than destructing programs.

In 2009-10, Democrats had a slim workable majority in Congress and were able to pass the Affordable Care Act. It was a significant step forward, but because of literally no help from Republicans and some dissension within their ranks, it was a watered-down version of the bill that President Barack Obama wanted. It did not include the public option which would have given citizens the right to choose a government-sponsored health care program that would have been more affordable than others because unlike private plans, it did not involve make a profit for the insurer. Despite the absence of the public option, the ACA was the biggest new federal program passed since Lyndon Johnson’s Great Society.

Right now, there is an opportunity for Democrats to once again pass major legislation. They have done so with the COVID-related American Rescue Plan and then the Infrastructure Investment and Jobs Act. But there is a third piece of legislation that will really strengthen the social and economic safety net that was created in President Franklin Roosevelt’s New Deal and then the Great Society. It is the Build Back Better Act.

This omnibus bill is a remarkable proposal that provides comprehensive benefits for everyone from infants to the very elderly. Once again, it appears that there will be no help in the Senate in passing the bill. And, if history serves us right, next year’s mid-term elections will see one or both houses of Congress revert to the Republicans. That will put an end to any meaningful social, economic and human rights legislation that Joe Biden wants to pass.

This is why now is not the time for Joe Manchin and Kyrsten Sinema to not jack around Biden, Congressional Democrats and the American people. We have a window of opportunity that is almost certain to shut after next year’s elections. Currently, Joe Biden, Chuck Schumer, Nancy Pelosi and others can go to Manchin and Sinema and ask them to support the Build Back Better Act. Manchin in particular has shown a willingness to meet, even at inconvenient hours. He hears, though we don’t know how well he listens. But this is the time for him to accept the wins that he has already accomplished (including reduction of the bill by more than a trillion dollars). He could still qualify to be TIME Magazine’s Person of the Year because he has perhaps had more influence of the US, if not the world, than any other person. TIME awards the honor whether the change effected by the recipient is positive or negative.

After the 2022 mid-terms, Democrats will likely be in the minority. Any talks between Biden and Congressional leaders with Manchin or Sinema will be meaningless. As the political pendulum has swung in recent years, there may not be another opportunity for a decade or more.

So, Joe and Kyrsten, whether your really are Democrats or not, now is the time to at least pretend to be one and help the party in this infrequent window of opportunity. Tomorrow’s next chance is far too far off.

The post Another reason why Manchin and Sinema should vote like Dems, at least for now appeared first on Occasional Planet.

Elizabeth Warren has proposed a student loan forgiveness program that would cancel up to $50K in student loan debt. Warren says that her plan would totally eliminate student loan debt for 75% of Americans who have that debt and would at least reach 95% of Americans with some debt (there’s even a nifty calculator). Kamala Harris has a student loan forgiveness proposal that would forgive up to $20K in student debt if you received a Pell Grant and start as well as operate a business successfully for 3 years. The business would have to be in an income-disadvantaged neighborhood. Bernie Sanders also has a student loan forgiveness proposal; he wants to forgive all of it. That’s it. There are no formulas, no missives full of technocratic language, and no barrier to entry other than having accumulated student loan debt. To quote democratic strategist James Carville “the less you say, the more you heard”. Simplicity matters, and the broadest policies with the easiest to understand messages typically beat out complexity no matter how much wonkish nerds at think-tanks spend on market testing for whatever candidate they’re writing policy for.

“Build the Wall” was and continues to be more effective at energizing voters than “comprehensive immigration reform.” In 2008, “Universal Coverage” had a much better ring to it than “replacing the tax exemption with a tax credit to be applied to a health savings account.” There’s a separate argument that can be made about messaging and how that can matter when campaigning. As we’ve seen, voters don’t always care too much what actual legislation looks like as long as they can identify it with the campaign message. This would in part explain why Trump voters are satisfied with current policy on immigration despite there being no new wall construction.

However, there are relevant considerations that are obviously more important than messaging such as whether something is good policy. Unequivocally, universal programs are better than means tested programs and that’s why Democrats need to run on them and then fight for them once in government. Whether it’s Medicare-for-All vs. “Medicare-for-All-Who-Want-It” or forgiving all student debt as opposed to forgiving most of it, there are at least 3 reasons why (especially in this campaign) universal programs are better.

1. Universal Programs are More Resistant to Attack from Opposing Interests
   1. Nine states have approved work requirements for Medicaid, and each would have implemented those requirements if not for federal judges blocking implementation. [The Trump Administration is appealing those decisions]. As of 2017, fifteen states have passed legislation to drug test recipients of SNAP or other public assistance programs. Obamacare has been undermined by the failure of 14 states, including 2 of the 3 largest states in the union, have refused to expand Medicaid and have denied millions of people access to healthcare coverage. Meanwhile Medicare benefits have only expanded since its creation in 1965 and has continued to enjoy broad support from voters from both parties. The difference is obvious, Medicare eventually covers everyone while the other programs have formulas for determining coverage and harsh cut-offs. It is easier to oppose a program when it will never benefit you and it’s harder for monied corporate interests to fund opposition to programs that help everyone. That is why privatization of Social Security and Medicare will never become a mainstream right-wing talking point and also serves an effective scare tactic from democratic politicians.
2. Universal Programs Always Help Who They’re Meant To
   1. Hillary Clinton, Pete Buttigieg, and other liberals have made the argument that “we shouldn’t be paying for billionaires’ kids to go to college.” The implication being that public money would be used on the super wealthy to pay for things that they themselves can already afford. That falls apart rather quickly when you go policy by policy. Students take out loans because they can’t afford the cost of school, children of wealthy families are not taking out student loans because they are from wealthy families who can afford tuition and therefore universal student debt forgiveness wouldn’t apply to them in the first place because they have no student debt. The same is true of universal free-public college, most wealthy families send their children to elite private universities and would still pay tuition. When it comes to Medicare-for-All, an argument has been made that we would create a dual-system where the rich are able to afford a higher standard of care under private insurance while the masses must use a public system. That analysis misses two things; we already have the dual-system where wealthy people receive better healthcare and at least in our new paradigm, everyone has healthcare where currently that is not the case. What is most important is that in a universal system, there is no chance that those who need help won’t receive it. Even the best means-tested programs still create incentives for people to work less or stay unmarried or be generally unproductive because without public subsidies they would not be able to afford to live.
3. Politics is About Negotiating, If You Don’t Start High Then You’ve Lost
   1. As anyone who has ever bought a car or home or any product where there isn’t a fixed price knows, you don’t offer the price you’re willing to settle for. If you start with where you’re willing to settle, then you’ll either end up paying more or not buying anything at all because you have to convince the seller that they also received a fair deal. The same is true in politics, we have a bicameral legislature and it will be necessary to deal with conservatives elements in both parties (especially in the Senate) in order to pass any legislation. For Medicare-for-All to be accomplished in the next 4 years a number of extraordinary events would need to happen. Democrats would need to win the Presidency, hold the House, win the Senate, whip every Democratic vote, abolish the filibuster, and appoint a Supreme Court justice to ensure that the law can survive court challenges. That all probably won’t happen, but we can still make sure that we get the best healthcare legislation possible. We may very well end up with Beto’s “Medicare-for-America” or Buttigieg’s “Medicare-for-All-Who-Want-It” or Biden’s “ACA 2.0”. These plans would cover millions more people and make our healthcare system better, but these are plans that we should settle for. We will all be better off if we end up in the middle of Medicare-for-All and our current ineffective system. I don’t know that the same will be true if we’re in the middle of ACA 2.0 and the ACA. By promoting universal programs, we are shifting the Overton window and what is possible in regard to policy which will make it easier to eventually achieve those big progressive ideas.

This country needs big structural change and piecemeal reforms or tinkering around the edges will not make life meaningfully better for most people. Government ought to be viewed as a tool to make people’s lives better and we should not be afraid of unleashing its power to combat the inherent problems present in our political economic system.

It’s time for Democrats to put down the calculators, delete the Brookings Institute from their Rolodex, and embrace big ideas.

The post Embrace Universality, Reject Means Testing appeared first on Occasional Planet.

Regardless of party affiliation or which party’s candidates voters cast their ballots for on November 6, the big winners in the midterm elections are all Americans with pre-existing medical conditions.

That’s because as of January 3, 2019, when the 116^th Congress convenes, Republican-led efforts to repeal the Affordable Care Act will be blocked by a Democratic majority in the House. For at least the next two years, Americans can sleep more soundly and stop worrying about being denied healthcare insurance coverage because of a pre-existing condition, or being charged more for coverage because of one or more pre-existing conditions, or discovering that their insurance denies coverage for services or treatments associated with a pre-existing condition.

Unfortunately, the news media and party pundits continue to waste valuable reporting time on which party was the biggest winner – Democrats for taking back the House or Republicans for holding on to the majority in the Senate. As the pundits continue to push the winner/loser line and who is up and who is down in the polls, they’re giving scant air time to the most important story that touches the lives of all Americans—affordable and dependable access to healthcare.

Democrats, in particular, are missing the opportunity to trumpet what might be the most consequential result of the midterm elections and drive home the message that Democrats have just won a victory that protects all Americans and their families. Incredibly, Democrats once again are failing to craft a unified message that reminds voters that Democrats belong to the party that conceived of and committed itself for more than eighty years to compassionate, life-saving, and family-affirming programs like Social Security, Medicare, Medicaid, and the Affordable Care Act.

A new message for Democrats

Democrats, if you’re paying attention, here’s my suggestion for the most important message to drive home from now until 2020:

America, because of our steadfast commitment to your health and well-being, you can stop worrying about being denied health coverage if

• You are one of the 82 million Americans with a pre-existing condition with employer-based coverage.
• You are one of the 50 to 130 million, or 19 to 50 percent of non-elderly Americans, with some type of pre-existing condition.
• You are one of the 44 million Americans with high blood pressure or high cholesterol.
• You are one of the 34 million individuals suffering from asthma or chronic lung disease.
• You are in the group of the 34 million people who have osteoarthritis and other joint disorders.
• You are a parent with a child who is suffering from a childhood illness, because 1 in 4 children might have been denied coverage if the protections of the Affordable Care Act had been eliminated.

And what are those pre-existing conditions? The list is long and encompasses most of the most common ailments. According to the nonprofit Kaiser Family Foundation, here are just some of the pre-existing conditions that insurers used to routinely deny coverage for prior to enactment in 2014 of the Affordable Care Act:

• HIV/AIDS
• Lupus
• Alcohol abuse/drug abuse with recent treatment
• Mental disorders
• Alzheimer’s/dementia
• Multiple sclerosis
• Rheumatoid arthritis, fibromyalgia, and other inflammatory joint disease
• Muscular dystrophy
• Cancer within some period of time (e.g. 10 years)
• Severe obesity
• Cerebral palsy
• Organ transplant
• Congestive heart failure
• Paraplegia
• Coronary artery/heart disease, bypass surgery
• Paralysis
• Chrohn’s disease/ulcerative colitis
• Parkinson’s disease
• Chronic obstructive pulmonary disease/emphysema
• Pending surgery or hospitalization
• Diabetes mellitus
• Penumocystic pneumonia
• Epilepsy
• Pregnancy or expectant parent
• Hemophilia
• Sleep apnea
• Hepatitis C
• Stroke
• Kidney disease, renal failure
• Transsexualism

The post Big winners in 2018 midterms? Every American with a pre-existing condition appeared first on Occasional Planet.

In a dramatic break from a long-standing norm of defending federal laws, Attorney General Jeff Session has announced that the Department of Justice will not defend the Affordable Care Act in a lawsuit filed in Texas by 20 Republican-governed states. The lawsuit seeks to declare all of ACA [aka “Obamacare”] unconstitutional and, therefore, invalid. In other words, the Trump administration is attempting to do in the courts what Republicans in Congress failed to do in 2017.

The decision was approved by [if not ordered by] Donald Trump, said Sessions, in the opening paragraphs of a three-page letter he sent to the court. [For what it’s worth—meaning not much—Trump is on the record as promising to protect coverage for pre-existing health conditions—one of the most popular aspects of the ACA. If the court invalidates the ACA, with Trump’s support, those protections would be gone. An estimated 130 million adults under the age of 65 in the U.S. have a pre-existing health condition.]

The Washington Post calls the lawsuit and the Department of Justice’s position in favor of it…

…a bold swipe at the ACA, a Republican whipping post since its 2010 passage…[the lawsuit] does not immediately affect any of its provision. But it puts the law on far more wobbly legal footing in the case, which is being heard by a GOP-appointed judge who has in other recent cases ruled against more minor aspects

In a telling twist, three career DOJ lawyers quit shortly before Sessions submitted his brief. According to AP, they were replaced with political appointees.

Defense of the law now falls to Attorneys General from 16 other states. In a press release issued yesterday upon the filing of the states’ brief in opposition, Attorney General Xavier Becerra of California said of the lawsuit,

The lawsuit initiated by Texas is dangerous and reckless and would destroy the ACA as we know it. It would leave millions of Americans without access to affordable, quality healthcare. It is irresponsible and puts politics ahead of working families. We won’t sit back as Texas and others try yet again to dismantle our healthcare system. Our coalition of states and partners across the country will fight any effort to strip families of their health insurance.”

It’s anyone’s guess as to whether this latest assault will be approved by a judge. Some legal scholars have called the arguments “ludicrous.” [Also ludicrous would be any attempt by me—a non-lawyer—to explain why they describe it that way. For an actual explanation, please check out this link. ]

So, the fight to preserve a good idea—ACA—that is very popular and has benefited millions of Americans—is not over. In their vindictive battle against all things Obama, Republicans are using every ploy they can conceive of to take away access to health care from the 11.2 million people who have enrolled for 2018.  [That  figure was slightly lower than in 2017, but it was seen by ACA advocates as “robust,” because so many people signed up, despite the Trump administration doing everything it could depress enrollment by making it more difficult.]

Unfortunately, this assault is too easily buried under the daily deluge of shiny- object distractions flashed by the Trump Administration, and by the tsunami of revelations about corruption that dominate the daily news cycle. We need to stay vigilant.

The post The latest assault on ACA [Obamacare]: DOJ won’t defend it in court appeared first on Occasional Planet.

The House has passed a tax bill that is disproportionately kind to the wealthy; the Senate is about to do the same and then Donald Trump can flash that Cheshire grin again as he signs a document that may sound good to his base, but in reality will not be.

Besides stacking the deck in favor of the likes of himself, the bill also gives him and other Republicans a long-awaited victory in dissembling the Affordable Care Act. The individual mandate for health care coverage will essentially be gutted because penalties for non-compliance are eliminated. This means that thirteen million fewer individuals will have health care coverage and premiums will go up for those who still have coverage.

Regrettably, the underlying theme to Republican policies is meanness. Parenthetically, it might be noted that a recent CNN poll shows that Republican Senator is 20% more popular among Democrats than members of his own party (68% – 48%). If only McCain would show the party the same respect that they show to him.

The recent literal train wreck in Washington State gave Trump another opportunity to call next for a robust infrastructure bill. Of course, this comes as his budget cuts infrastructure spending by $55 billion, including a considerable amount for Amtrak. None of this stops Trump from calling for massive upgrades to our roads, bridges, airports, rail system – just about everything except cyber security. Democrats have talked about a real infrastructure bill that would cost on the order of a trillion dollars. That’s a lot of money, but it be fresh money going into circulation and the multiplier effect of contractors and workers receiving it would mean that each dollar would turn over in the economy up to four times in a year. Much of that would come back in the way of tax revenue.

Trump has also spoken about a trillion dollars for infrastructure, but up to eighty percent of it would be smoke and mirrors. That’s because it would not be actual federal spending. Instead, it would be up to $800 billion in tax breaks to contractors and real estate owners such as himself to “stimulate” infrastructure growth.

This one has difficulty passing the giggle test, because tax breaks for the wealthy do what they are called, they give more money to the wealthy. Without macro plans from the government to fund necessary projects, there will be negligible improvement to the infrastructure. What should be a major public program to improve the lives of the American people is just a further transference of public money into the coffers of the wealthy.

The mysteries of the Republican brain continue to be at the center of dysfunctional policies. There seems to be a lack of empathy, and policy-makers do not mind constructing programs that harm the most vulnerable (one of the seven forbidden words) among us. But even more odd is how the economically deprived in the Republican base have difficulty seeing who is oppressing them. They may scapegoat that it is “liberal values” and a lack of respect for their hard work (not everyone in any “class” is really a hard worker). It’s true that liberal programs have not always been a panacea for those who are designed to help, but the progressive perspective is to try to help and learn from mistakes. Many Republicans are happy to oppress their base if it means more money for the wealthy. That’s the tax bill and a likely infrastructure bill to come.

Democrats must put all the pressure they can on Trump so he seriously negotiates with “Chuck and Nancy” so that something can be salvaged. But that might be expecting too much of a man constructed like Trump.

The post Next: Republican Meanness in an Infrastructure Bill appeared first on Occasional Planet.

Donald Trump’s recent statements and tweets have created confusion and chaos in the health insurance market, just as open enrollment for ACA/Obamacare is about to begin, on November 1. He’s making it sound like he has killed Obamacare for good. He’s saying things like “Obamacare is dead. It’s over. You might as well not even mention it. There is no Obamacare.” But that is not true.

You can get health insurance for 2018 on the ACA/Obamacare exchanges. The program is still alive. The exchanges are still alive. You can still get health insurance with subsidized premiums. Trump would love for you to be confused and to just not even try. That would depress enrollment and help him sink the program that he hates—not because he understands its purpose, its workings, or how it affects individual people and the overall economy, but simply because it bears the name “Obama.”

So, do not be confused. Do not give up. Trump is doing everything he can to make you think that you can’t get health insurance for next year. And he’s not just talking: He has taken administrative action to make it harder for you to enroll. But you definitely can still enroll and get health coverage for 2018.

He has shortened the enrollment period from the customary three months to only six weeks. [Enrollment opens on Wednesday, November 1, 2017. It ends on December 15, 2017.] Pay attention to those dates. Don’t wake up on January 2 and say, “Gee, I should get healthcare insurance now. Oh, oops, I missed the deadline.” Trump would love for that to happen. Don’t let him fool you.

He has reduced—by 91 percent– the amount of money that will be spent on advertising the open enrollment period. So, you won’t be hearing as much about it, seeing as many ads, or getting much snail mail, email or social media contact about open enrollment. But you can still get health insurance for 2018 through the ACA.

He has reduced—by 41 percent overall—the amount of money that the government will pay to the non-government organizations who are most likely to reach out to people eligible for ACA/Obamacare enrollment — especially low-income people. Some of these groups have had their ACA/Obamacare outreach budgets slashed by as much as 90 percent. So you won’t be hearing as much from community organizations who used to remind you about open enrollment. But you can still get health insurance for 2018 through the ACA.

This vast reduction in funds has reduced the number of navigators who answer the ACA/Obamacare phones and help you work through the enrollment documents. You’re going to have to wait longer to connect with a navigator, and the person you talk with may not be as knowledgeable as those who had the job in previous years. But you can still get health insurance for 2018 through the ACA.

The big news last week was that Trump announced that he would immediately stop supporting the cost-sharing subsidies [CSR’s] that reimburse insurers for reducing deductibles and co-pays for lower income Obamacare enrollees. Until then, the administration had been paying these subsidies on a month-to-month basis.

But this huge act of Trumpian sabotage does not let insurer off the hook entirely. “Insurers must continue providing these cost-sharing discounts—even though they won’t be paid for them,” notes CNN. “That’s because the subsidies are required by the Affordable Care Act.”

So, if you qualify for premium subsidies—which are separate and unaffected by the CSR payments—you won’t have to pay much more, although you may need to switch plans to keep your rates steady. But you can still get health insurance for 2018 through ACA/Obamacare.

Trump’s moves will undoubtedly result in rate increases next year. So, your ACA/Obamacare insurance plan could cost more. But you can still get health insurance for 2018 through ACA/Obamacare, despite what Donald Trump would like you to think. ACA/Obamacare is not dead. If this is the year when you have decided to sign up,or if you need to look into a new plan, you should definitely explore your options at healthcare.gov.

The post Can you still get health insurance for 2018 via ACA/Obamacare? Yes, you can appeared first on Occasional Planet.

This year’s open enrollment period for ACA/Obamacare is from November 1, 2017 to December 15, 2017. That is a mere six weeks, compared to the three-month enrollment period available in all previous ACA years. Anyone — in any state — needing to sign up for ACA/Obamacare for 2018 needs to pay attention to the deadline. The Trump administration has:

• Cut the enrollment period in half
• Slashed advertising and outreach by 90%
• Chopped by 41% the dollars allocated to non-governmental groups who reach out to likely ACA enrollees
• Severely cut the number of ACA navigators available to help people enroll
• Is shutting down healthcare.gov “for maintenance” for 12 hours during all but one Sunday in the upcoming open enrollment season. Kaiser Health News reports that not only will the shutdowns occur from 12 a.m. to 12 p.m. ET every Sunday except December 10, but the Department of Health and Human Services will also shut down healthcare.gov overnight on the first day of open enrollment, November 1.

There’s only one way to describe these tactics: sabotage.

Having failed to kill ACA/Obamacare legislatively [more than 50 times], the Trump administration has embarked on a cynical scheme to undermine the program by making it harder to enroll. It’s a nasty plan that is gratuitously mean and vengeful. It in no way reflects what people actually want: A Pew Research poll shows that favorable views of ACA/Obamacare hit a new high in 2017. [It’s telling, isn’t it, that, essentially, all it took for ACA/Obamacare to reach its highest approval rating was for Barack Obama to leave office.]

People want ACA/Obamacare to stay. People who don’t get health insurance through their employers want it through the ACA’s state exchanges. And even the 56% of Americans who get their health insurance via work—want the provisions enacted in the Affordable Care Act [coverage for pre-existing conditions, essential health benefits, no lifetime limits, kids on the plan until age 26, etc.] Whether they admit it or not. Whether or not they realize that the Affordable Care Act [ACA] IS Obamacare. Even if they live in Mitch McConnell-land [Kentucky], where Obama-hating state legislators renamed ACA “Kynect Care” just so that people getting desirable Obamacare benefits would think that they were getting something else. [In 2016, Kentucky Governor Matt Bevin killed Kynect Care, not because it wasn’t working, but because it was working too well. Kentuckians now get their health insurance via healthcare.gov.]

Making enrollment more difficult is a Republican dirty trick.

Potentially hundreds of thousands of people could wake up in January—having waited until close to the longer deadline they thought was in effect—to find that they’ve missed their chance to get health insurance through the Affordable Care Act. Thousands more, encountering long waits on the phone, a shut-down healthcare.gov on the Sunday they chose to do their enrollment, or being assisted by less experienced, less informed navigators, may just give up out of frustration. And that’s exactly what the Trump administration and its Congressional-Republican enablers are hoping will happen. They want enrollment to be a hassle. They want people to miss the deadline. They are eager for people to quit the enrollment process because it’s slow and frustrating. Their goal is to shrink enrollment and thereby initiate the long-hoped for Obamacare death spiral, in which the program self-destructs.

These tactics dovetail beautifully with what many Republican legislators want — while obviating the need for them to actually vote on repeal. Newly resigned Director of Health and Human Services Tom Price, who is most certainly one of the plotters behind this Obamacare-sinking plan, can now just sit back and watch his hoped-for disaster unfold, while not having to take responsibility for it. It’s a perfect storm, if you are a soulless Republican meanie who enjoys full health insurance coverage paid for by the government.

It is hard to imagine a more perverse strategy.

We don’t want repeal/replace. We like the provisions of ACA/Obamacare. People have called, written, facebooked, texted, IM’d, sat-in, demonstrated, marched, protested, pleaded, and campaigned—again and again—to prevent the derailment of a program—imperfect as it may be in some of its provisions—that has made healthcare insurance possible for tens of millions who didn’t have it before, and that has dramatically improved coverage for people already insured through their employers. These are the people Congressional representatives and Senators are supposed to be representing. Instead, they are ignoring the human needs in their districts, elevating their own political needs, and kowtowing to financial blackmail by their fat-cat campaign donors.

This is sick.

Please remind everyone you know that ACA enrollment is different this year. The clock is ticking. Those of us who have health insurance cannot be complacent. If Republicans succeed in undermining ACA/Obamacare with this irresponsible, immature, immoral trickery, we will all suffer.

The post Signing up for ACA Obamacare? Republican sabotage makes it harder to enroll appeared first on Occasional Planet.

How does the Graham-Cassidy “repeal and replace” bill compare to current law [aka Obamacare, ACA]? Roll Call has done the hard work of creating an easy-to-visualize chart to help us see the differences. [Spoiler alert: Graham-Cassidy is the most drastic version of “repeal and replace” yet.] Here’s the infographic. View it and weep. Send it to your Senator and Congressional representative, who most likely have no idea because they haven’t bothered to read or analyze the bill and/or are lying about what they do know. [And call, text, fax, and/or email your Senators, or sit-in, lie-in, or scream, kick and protest. This bill must not pass.] Note, too, that virtually the entire health-care world opposes this bill. [To see comments by the major healthcare organizations, click here.]

Graham-Cassidy vs. House-passed AHCA, vs. existing ACA requirements

The post Infographic: How Graham-Cassidy stacks up, in one chart appeared first on Occasional Planet.

We can see it now, the smiling faces of more than forty Democrats and Republicans in the House of Representatives who are working on fashioning a compromise for health care after the apparent defeat of “Repeal and Replace.”

I wish that I did not think that terms like compromise and bi-partisan mean capitulation for the Democrats. However, recent history shows that this is almost a certainty. A fundamental difference between today’s Democrats and Republicans is that the Republicans never lose sight of their locked-in ideological positions. When it comes to health care policy, almost all Republicans march lock-step to the mantra of repeal and replace the Affordable Care Act. The meanness that undergirds the policy positions of so many of their members is reflected by their efforts to cut coverage, raise costs and disenfranchise the poor.

Democrats seem to be happy just to be able to talk with Republicans. Other than Bernie Sanders, we hardly hear any Democrats clearly state that they support a system of Medicare-for-All. This should not be an outlandish position; it is completely consistent with the policies of the New Deal and Great Society. Medicare-for-All is a system that is based on compassion. It is a commitment to preserve and expand the social safety net for those among us who need it most.

The new bi-partisan group in the House that is promoting health care compromise is called the Problem Solvers caucus. Sounds like a good idea, but what exactly is it that they want to do?

The four items that they have identified as part of their agenda may sound reasonable on the surface. However, it’s important to keep in mind that these suggestions are all based on preserving and protecting employer-based health insurance and ensuring the financial well-being of insurance companies.

For health care to work in a society, two, and only two, vital moving parts must be of central concern. The first is the people – citizens seeking preventive and curative health care. The second is the providers – doctors, nurses, hospitals, clinics, etc.

Insurance companies only muddy the waters. They position themselves between the demand for health care (people) and the supply of health care (the providers). Insurance companies exist because of the naïve belief that they provide competition in health care which results in better service at lower cost. What they in fact do is design policies to maximize their profits while elevating premiums and reducing services. They continue to exist because they lobby well, particularly among Republicans, but also many Democrats, as witnessed by the key role of insurance companies in the Affordable Care Act.

As reported by New York Magazine, here are their four suggestions from the Problem Solvers caucus, and reasons why these suggestions provide band-aids at the expense of necessary reform:

The bipartisan working group also wants to change Obamacare’s employer mandate so that it applies only to companies with more than 500 workers. Currently companies with at least 50 workers can be hit with a tax penalty if they don’t provide coverage to their workers.

Problem: Millions of American workers are employed by companies with fewer than 500 workers. If those companies do not provide coverage, then the workers are left in the individual market with no group bargaining power. With Medicare for All, everyone would be on an even plain. Also, perpetuating employer based health insurance (a) raises costs for American businesses, and (b) keeps parasitic insurance companies in business.

The group also wants to create a federal stability fund — dollar amount unspecified — that states can tap to reduce premiums and other costs for people with extremely expensive medical needs. Both the Senate and House repeal packages contained similar pots of money.

Problem: why should states have anything to do with health care? As witnessed by so many states opting out of Medicaid expansion, as provided in the Affordable Care Act, empowering states with health care responsibility puts an irresponsible guardian in charge of citizens’ rights to health care. Also, states, particularly in the South, have shown much less regard for human rights than the federal government.

The bipartisan proposal also calls for scrapping Obamacare’s medical-device tax, an idea that has received bipartisan support in the past.

Problem: Let’s keep in mind that with Medicare-for-All, the program could largely be funded by an expanded payroll tax for the wealthy. There would not be a need for nickel and dime taxes.

Finally, the working group is seeking greater flexibility for state innovation. Obamacare already allows state to seek waivers from coverage rules, but the lawmakers want additional guidance on how states can take advantage of them.

Problem: As we previously said, empowering states disempowers individuals. State innovation is code language for states to engage in races to the bottom. The losers are those who most need the safety nets.

Currently, we are a long way from legislating Medicare-for-All. It’s also possible that there will be a temporary hibernation of the Republican calls to Repeal and Replace the Affordable Care Act.

So, it makes sense to look for compromise. The ideas that the Problem Solvers Caucus is suggesting may in fact help ameliorate current conditions in the health care market. To the extent that it is possible, fixes should be made.

But Democrats should not lose sight of the knowledge that the concept of a health care market is a construct of parasitic business interests at the expense of consumers and health care providers.

Before Democrats engage in “problem solving,” it would be best for them to clarify what they really want and ensure that their final goals will not be jeopardized by dancing with the Republicans.

The post Dems – Beware of sleepwalking into compromise appeared first on Occasional Planet.

Recently, Senator John McCain of Arizona was diagnosed with a very aggressive form of brain cancer. John McCain served his country first as a soldier, who was unbroken as a prisoner of war under the Vietcong for 7 long years. And now for the last 35 years, McCain has served his country as a member of the House, a United States Senator. Cancer is a horrible disease that I wouldn’t wish on anyone, I know McCain will face the challenges of this illness with courage as every afflicted person does, and I wish him the best.

But John McCain is a hypocrite, and how dare he pontificate about the lack of leadership and the rise of partisanship in Washington. McCain, perhaps more than any other Republican, is directly responsible for legitimizing the brand of politics that would eventually pave the way for the Tea Party & Donald Trump.

There was a time when the GOP could be separated into two camps. There were Republicans, whether they be conservative like Reagan or liberal like Rockefeller. It was accepted that these people had beliefs that were rooted in small government and the free market. Right or wrong on policy, almost always wrong, one knew that these people were rational actors who could govern. Then there was the crazy caucus, comprised of your right-wing reactionaries, your racists, your Christian fundamentalists, and assorted invalids. These were your Jesse Helms, Pat Buchanans, and Pat Roberts. These people might win a primary or two, win a senate race in a conservative state, or even find themselves in the cabinet. But these people had no credibility, the Republican party was not their party, and no matter how the base was changing, Republicans made an effort not to give those people platforms unless absolutely necessary (like 1992, when Bush Sr. allowed Pat Buchanan to speak at the RNC and he declared a “culture war”).

But in 2008, when John McCain won the Republican nomination and was tasked with picking a running mate, he unleashed Pandora’s box. I don’t buy that McCain was forced into making the decision that he did, or that there were no alternatives. If John McCain was determined to have a woman on the ticket, he could’ve picked Lisa Murkowski (also from Alaska) or Olympia Snowe. If he was determined to pick a woman with governing experience, he could’ve picked former New Jersey Governor Christine Todd Whitman. But no, John McCain picked Sarah Palin.

Every time McCain talks about the need for responsible leadership, remember he thought Sarah Palin was the best qualified person to succeed him should he be unable to serve as President.

Every time the media plays that clip of McCain defending Obama against rumors that he was secretly a Muslim, remember Sarah Palin was the one saying “Obama was palling around with terrorists” and “he doesn’t see America like you and I see America”.

Every time McCain wants to bemoan the rising partisanship, remember it was his running mate who would call Obama a socialist and decry the impending collapse of America.

Every time McCain expresses concern about Trump, remember Sarah Palin rallied her base, the base that exists solely because of John McCain, behind Donald Trump during the GOP Primaries.

Because John McCain allowed Sarah Palin to be introduced to a general election audience, it made Michelle Bachmann, Rick Perry, Rick Santorum, and Herman Cain seem palatable four years later. These were people from the crazy caucus. Mitt Romney, an occasionally reasonable person (who turned out to be right about Russia) was even forced to adopt some of the more inflammatory rhetoric from the crazy caucus just to solidify his base.  Romney was even forced to whore himself out for the endorsement of a tiny-fingered vulgarian who also happened to be a failed steak salesman (more on him later). That was only necessary for Romney because for years that person had been the leading voice behind the racist lie that Obama wasn’t born in the United States.

It was to be expected that after eight years of leadership by people like Allen West, Steve King, and Louie Gohmert, that the crazy caucus would become a dominating force in the GOP. Because of Palin, Ted Nugent, Kid Rock, and Alex Jones are relevant political figures. Let’s be clear, an environment where Donald Trump could become the nominee would not have existed had it not been for Sarah Palin paving the way for this new wave of idiocy. She laid the cornerstone, took the slings and arrows, and blew the dog whistle louder than George Wallace, so that one day someone of her ilk might be considered Presidential. Ted Cruz and Marco Rubio were once considered the reasonable Republicans in 2016….Ted Cruz actually believes that George Soros is conspiring with the UN to eliminate private property so he can build golf courses, and Marco Rubio calls the West Bank “Judea and Samaria” because he subscribes to Christian apocalypse theory. These were the reasonable people, and together with Trump they won 81% of GOP primary voters.

Sarah Palin emboldened the crazy caucus, and John McCain emboldened Sarah Palin. These people and their racism were dormant for decades, and McCain’s choices have brought them to the forefront of our politics with consequences that will be seen for a generation.

Even if you could excuse McCain for his choice of Sarah Palin, and the residual effects nearly a decade later, there’s still the matter of McCain’s voting record. John McCain is as Republican as any member of congress, he may talk a big game, but he’s voted with his party nearly 90% of the time since he’s been in the Senate.

Every time we talk about all the sacrifices John McCain made for this country, remember he’s been more than willing to sacrifice the lives of a lot of other people’s children by sending them to war.

Every time McCain talks about defeating ISIS and responsible foreign policy, remember he voted for the Iraq War, which directly resulted in the creation of ISIS, and his signing of the Iran letter in a desperate attempt to undercut the nuclear deal.

Every time McCain talks about compassion, remember he’s been trying to privatize Social Security and the social safety net for years.

Every time McCain talks about the struggles he’s had with his health, remember the vote he cast to proceed with debate on a bill that would deprive at least 22 million people of their healthcare. What even allowed him to even get his diagnosis in time was pre-screening, which is encouraged under Obamacare, which he wants to repeal.

Every time McCain talks about normalcy, remember the day he returned to the senate to be the deciding vote to proceed on debating a bill that nobody read or understands what they’re debating.

Every time McCain criticizes Trumps rhetoric about immigrants and walls, remember McCain ran ads saying “complete the danged fence!”

Every time there’s a new revelation about Russia and McCain feigns concern, remember McCain endorsed Trump for months and still endorses the Trump agenda even if he doesn’t approve of the man.

That speech he gave in front of the senate Tuesday, was worse than just political theater, it was delusion disguised as hypocrisy wrapped in a platitude. It was a man, who lived the life of Chamberlain and thinks he’ll be remembered as Churchill. McCain could use what might be his final months to redeem himself, actually be the man behind the words, and be the principled person we all want him to be. But he won’t, because that’s not John McCain, and it never will be.

He’s a hero because he pretends to be a maverick? I like people who are actually mavericks.

The post John McCain, please spare us appeared first on Occasional Planet.