Category Archives: medical news

Trump doing all he can to destroy ACA

The Affordable Care Act isn’t dying on its own. Donald J. Trump just cannot stand the thought of the ACA surviving, so he’s taking measures to kill it.

Congress has failed to repeal the ACA and replace it with an abomination called Trumpcare. So what does the president decide to do? He plans now to eliminate the cost-sharing reduction subsidies that have helped low-income Americans afford the health care the ACA is intended to provide them.

That’s right. The CSR is slated to be toast. The president is intent on wiping the ACA off the books. No matter what it takes or who it hurts. He’s going to hurt a lot of Americans by eliminating the CSR provision. reports: The White House announced late Thursday that the administration would stop the payments. The move comes as the Trump administration is also cutting funding for Obamacare outreach and pursuing new regulations to blow holes in the law, changes that collectively threaten a program through which millions of Americans purchase insurance.

I get what’s happening. The president is taking some executive action to do what couldn’t be done legislatively. The irony is that Trump and other Republicans were so damn critical of President Barack Obama for exercising his constitutional authority time and again on issues of the day.

CSR helps provide insurance

The subsidy is intended to provide a cushion for Americans seeking insurance under the ACA. I have some knowledge of this, as my wife applied for health insurance under the health care law, and was able to purchase it with the CSR allowance. She’s now on Medicare — as am I.

The president is now intent on denying that benefit to millions of Americans. He said the ACA was “dying.” Medical analysts have disagreed with that assessment. So the president has decided to pull the trigger himself.


GOP needs to learn how to govern

It’s over. For now. Maybe it’ll be back. Maybe not.

Senate Republicans — along with their colleagues in the U.S. House of Representatives — had signed in blood (proverbially) their vow to repeal the Affordable Care Act, which they referred to colloquially and derisively as Obamacare.

They failed. Again. For the umpteenth time. The ACA remains the law of the land for the foreseeable future if not longer.

This begs the question for me: Can the Republicans ever govern?

The GOP face-planted on ACA repeal when three senators said “no” to the bill called Graham-Cassidy, named after GOP Sens. Lindsey Graham and Bill Cassidy. The senators who stuck the shiv into this effort were John McCain, Rand Paul and Susan Collins. They’ve all been in the Senate for a while and were part of the Republican pledge to rid the nation of President Barack Obama’s signature domestic legislation.

This cluster-fudge reminds me a bit of how an earlier Republican insurgency, led by former House Speaker Newt Gingrich, stormed Capitol Hill in 1994. They took command of Congress and then had to learn quickly how to govern. They stumbled, bumbled and fumbled their way while battling a Democrat in the White House, President Bill Clinton.

But they managed, eventually, to find their way out of the darkness. The difference between then and now is that the the earlier GOP congressional leadership team worked with a president who knew how to govern, how to compromise, how to cajole the opposition when he needed to do it.

The Republican Party now controls Congress and the White House. Therein we have the difference between then and now.

Republicans fought tooth-and-nail with President Barack Obama over repealing the ACA. They never crafted an acceptable alternative. Obama and his Democratic allies in Congress fought them off. Obama then left office in January. Donald Trump said he wanted a bill on his desk when he stepped into the Oval Office. He didn’t find one.

How come? The GOP was too fixated on the “repeal” part of the strategy and not nearly enough on the “replace” part of it. As for the president, he was clueless during the campaign about what it took to assemble a legislative alternative to the ACA — and is just as clueless at this very moment about how to negotiate with disparate members of his party’s congressional caucus to find a solution.

I keep circling back to the notion that the presidency requires knowledge of the complex and sometimes arcane system of governing the United States of America.

Donald Trump doesn’t know it and his ignorance of the details of his office has revealed that the political party to which he ostensibly is a member has yet to find its governing legs.

Buh-bye, latest GOP effort to kill the ACA

Well, here’s where we stand with the persistent Republican effort to repeal the Affordable Care Act.

It’s a goner. Kaput. Finished. Party’s over, man.

U.S. Sen. Susan Collins, R-Maine, today announced she won’t vote for the latest Senate GOP-engineered effort to repeal the ACA and replace it with an abomination that we’ll call Trumpcare.

You know what interests me about this latest death knell being run over the GOP’s ACA repeal effort: The three senators who’ve announced their opposition to it have done so for wildly varying reasons.

Collins opposes the bill because it cuts too much money from state Medicaid assistance programs for Americans who cannot afford health insurance. Sen. John McCain of Arizona hates the partisan process that brought this bill forward; he wants Democrats to be involved in this effort. Sen. Rand Paul of Kentucky doesn’t like the block grant provision, which he says simply renders the replacement as an “Obamacare light” version of the ACA.

There might be more Republicans who’ll abandon this effort. Sen. Lisa Murkowski of Alaska has strong reservations. So does Sen. Ted Cruz of Texas, who contends that his buddy Sen. Mike Lee of Utah also might vote “no.”

That all might be a moot point. Sen. Orrin Hatch, R-Utah, said today he doubts the bill will get to a vote. Senate Republican leaders have conceded likely defeat.

The Senate GOP has until Saturday to repeal the ACA with a mere 50-vote (plus one) majority; after that the rule shifts back to the Senate’s 60-vote supermajority rule.

What now?

Hey, here’s an idea: How about sitting down with congressional Democrats to work out ways to repair the ACA? Are congressional Republicans so hell bent on removing President Barack Obama’s signature legislative achievement from the books that they simply won’t look for common ground with their Democratic “friends”?

Premiums are too high. Health insurance isn’t as “affordable” as it was advertised. Surely there are ways to tinker, tweak and fine-tune the legislation to make it better. Aren’t there?

We aren’t re-inventing the wheel here, folks. Members of Congress did that very thing more than 50 years when they approved Medicare legislation. It wasn’t perfect, either, but they sought — and found — common ground to improve it to older Americans’ satisfaction.

That, I submit, is a sure-fire formula for furthering the cause of good-government legislation.

Is the party over for ACA repeal? Let’s hope so

On the day earlier this summer when he voted “no” on a plan to repeal the Affordable Care Act, U.S. Sen. John McCain, R-Ariz., made an impassioned plea for the body where he has served for three decades to return to “regular order.”

Meaning that both parties, Democrats and Republicans, need to work for common ground, to seek compromise, to actually get things done for the good of the citizens they all serve.

The Vietnam War hero’s plea fell on deaf ears. Senate Republicans decided — against logic and good judgment — to proceed yet again with a GOP-only repeal of the ACA.

Sen. McCain has stuck the shiv into the GOP’s efforts by announcing he plans to vote “no” once again on this ACA repeal effort. It likely blows the effort to smithereens. Sen. Rand Paul, R-Ky., will vote against it because it doesn’t go far enough in getting rid of the vestiges of the ACA; Sen. Susan Collins, R-Maine, is a likely “no” vote, as is Sen. Lisa Murkowski, R-Alaska.

Senate Republicans — who have hardly any room for defections given their slim Senate majority — face a Sept. 30 deadline to get this deal done with a 50-vote plus one (Vice President Mike Pence) majority; after that, Senate rules return to a 60-vote supermajority requirement.

So, what about that “regular order” thing that McCain sought earlier this year?

The ACA isn’t perfect. It likely isn’t even a good piece of legislation. Barack Obama’s signature bill needs work. It needs to be amended, nipped and tucked. To do that, though, requires that “regular order” that McCain wants to see restored. That would mean bipartisan cooperation, the search for commonality.

That’s how legislation gets done.

President Lyndon Johnson knew how to legislate. He employed his overpowering persuasive skills to bring Republicans along. President Richard Nixon was no slouch, either, at working with Democrats. Nor were Presidents Ford, Reagan, Bush 41, Clinton or Bush 43.

President Obama needed to work better at developing that skill. Then again, the Republican intransigence was too big a hurdle for him to overcome.

Sen. McCain has called repeatedly for a return to the old way of legislating. His decision today only drives home that call even more deeply.

The question now becomes: Is anyone in a leadership position going to heed those calls ever again on Capitol Hill?

ACA repeal foes keep adding up

For those who might be keeping score on the Who Hates the ACA Repeal Bill the Most list, I’ll offer a quick review.

The list of medical and related professional organizations that oppose the Republicans’ plan to repeal the Affordable Care Act and replace it with God-knows-what is growing.

They include the American Medical Association, the insurance industry, the assorted medical specialist groups within the AMA umbrella, every single state Medicaid agency (yes, all 50 of them oppose the GOP repeal/replace option), political think tanks covering virtually the entire political spectrum.

Who favors the bill about to be decided next week in a U.S. Senate vote? As near as I can tell, the list comprises just two key groups: the Republican Senate caucus and the president of the United States, Donald John Trump Sr.

They are intent on tossing millions of Americans off the list of the insured; they want to all but eliminate Medicaid subsidies for those Americans who rely on them to afford health insurance … and some other things, too.

To what end? They want, according to U.S. Sen. Chuck Grassley, the Iowa Republican and a key Senate heavyweight, to fulfill a campaign promise. Grassley said recently he could think of “10 reasons” why the Senate shouldn’t even consider this legislation, but they’re pushing ahead because of pressure from the Trump base of supporters who want to get rid of anything with Barack Obama’s name on it.

So, who do these folks represent? The various and sundry — and powerful — interest groups that oppose repealing/replacing the ACA, not to mention the vast majority of the American public? Or do they represent only the shrinking minority of voters within their own party?

I don’t need to remind these folks — but I will anyway — that they govern a nation comprising millions of Americans who would prefer the federal government to amend and repair the ACA to make it better. There is no compelling need to toss the entire legislation into the crapper.

Grassley tells ‘truth’ about ACA repeal effort

U.S. Sen. Chuck Grassley, R-Iowa, said this about Republican efforts to repeal the Affordable Care Act.

“You know, I could maybe give you 10 reasons why this bill shouldn’t be considered … 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.”

Well now …

The GOP rush to repeal and replace the ACA is meant to fulfill a campaign pledge. Does it not matter, then, what the Republican bill does? Or who it harms? Or whether it’s an actual improvement over the ACA?

The Senate Republican caucus is up against the wall on this one. It has until Sept. 30 to get this bill approved with just 50 Senate votes; a tie would bring in Vice President Mike Pence to cast the deciding vote. After that date, Senate rules roll back to a 60-vote supermajority requirement, which the Republicans don’t have.

I’m going to give Sen. Grassley kudos for candor, though. There’s been so little of it as it relates to this discussion. It’s rare to hear a leading U.S. lawmaker speak the truth about political motives.

Not that it makes it any better …

Who needs that CBO ‘score’ on health care bill, right, GOP?

The Republican rush to repeal the Affordable Care Act might proceed without a key element that GOP congressmen and women would need to make this critical judgment.

The Congressional Budget Office won’t be able to provide its full analysis of the impact the replacement legislation will have on the future of Americans’ health care insurance.

You see, Congress is facing a Sept. 30 deadline to get this deal done with a simple majority of 50 Senate votes. After that date, the rule rolls back to a 60-vote supermajority requirement. So, there you have it: Senate Republicans don’t want to wait for a “score” that they usually rely on to help them decide matters of this importance.

As Politico reports: The Congressional Budget Office will only have a bare-bones assessment of the latest GOP bill ready before Sept. 30, the deadline for Senate Republicans to pass health care legislation on a party-line vote.

Is it any wonder, then, that some Senate Republican leaders — such as John McCain of Arizona — are critical of the process that is rushing this vote forward?

Read the Politico story here.

The ACA is Barack Obama’s signature domestic legislative achievement. Republicans want to wipe it out, toss it aside. They aren’t interested in repairing it, improving it, making it work better for Americans.

In normal times, the complete CBO analysis was thought to be the standard for lawmakers to follow. The CBO is known to be a completely non-partisan, unbiased source to determine the financial impact of legislation. Its previous analyses of efforts to repeal and replace the ACA have told us that 20 million Americans would lose health insurance under terms of the replacement legislation. Are ACA repeal/replace proponents afraid of what the CBO is going to tell us about what they’ve got in mind this time around?

This latest health care insurance bill comes from Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana. Sen. Rand Paul of Kentucky already opposes it. Sen. Susan Collins of Maine is teetering against it. Sen. Lisa Murkowski of Alaska is said to be leaning toward a “no” vote. McCain already is on record opposing this fast-track process.

Is this what we’re getting? Half-baked decision-making based on matters that have little to do with the facts?

GOP launches ACA repeal 2.0

For the ever-lovin’ life of me I cannot grasp this notion that congressional Republicans keep insisting on repealing the Affordable Care Act.

They don’t want to fix what’s wrong with it. They want it gone. They want it tossed, ground up, thrown onto the trash heap. Why? I only can gather it’s because it has the name “Barack Obama” on it.

The GOP-run U.S. Senate is scrambling now to get a second run at tossing the ACA out. They’re trying to round up enough votes to approve repeal with a simple majority; after Sept. 30, according to a Senate rule, they’ll need 60 votes to do the job.

The Senate fell a vote short of the majority it needed earlier this summer. ACA repeal was thought to be a goner. It’s back.

What does the new bill look like? I understand it looks a lot like the old one. It diminishes Medicaid benefits for low-income Americans; it gets rid of the cost reduction subsidy that the ACA provides for those who seek health insurance under the government plan.

Sen. John McCain, R-Ariz., who cast the deciding vote that killed the Senate effort before the August recess, called for a return to “regular order.” He wants Republicans to work with Democrats; he wants bipartisan cooperation, if not buy-in.

He’s preaching to no one within his Republican Senate caucus.

Senate Republicans are intent on doing precisely what they accused Senate Democrats of doing in 2010 when the ACA was approved and signed into law by President Obama. They’re going to shove it down the other party’s throats and make Americans like what they’re doing … no matter what.

I remain baffled by the idea that they cannot find a way to fix the ACA. Indeed, the former president offered to work with Republicans if they could find a solution. They stiffed him.

They could do the same thing now, with a Republican in the White House.

Indeed, it now appears that Donald Trump is showing some sign that he’s beginning to learn one of the lessons of governing in Washington, D.C.: Legislating is a team sport that works best when both political parties are sitting at the same table.

ACA is actually doing what it’s supposed to do

Let’s talk about health insurance, OK?

The highly partisan agency, the U.S. Census Bureau, has come up with some data that illustrate the difficulty the Republicans in Congress — and the pseudo-Republican in the White House — have had difficulty in repealing the Affordable Care Act.

The Census Bureau reports that the rolls of uninsured Americans has continued to decline since the enactment of the ACA. It’s now down to 8.8 percent this past year, down 0.3 percent from 2015.

Prior to implementation of the ACA, the uninsured rate stood at 13.3 percent, according to the Census Bureau.

Oh, by the way, I’m joking about the Census Bureau being full of partisan hacks.

The news isn’t all good for the ACA. A Gallup Poll indicates an increase in uninsured Americans stemming largely from the uncertainty over the ACA’s future.

Mend it, don’t end it.

I remain committed to the notion, though, that the ACA can be fine-tuned, improved, tweaked and tinkered with. It need not be scrapped, tossed onto the scrap heap, which is what congressional Republicans and Donald J. Trump want to do.

Need I remind readers of this blog that Medicare’s enactment in 1965 was followed by the a round of tinkering? President Lyndon Johnson managed to persuade his fellow Democrats and his many Republican allies on Capitol Hill to improve the landmark health insurance program. The program works well for elderly Americans.

Why in the name of compromise and cooperation can’t we find that formula today? What is stopping congressional Republicans who control Capitol Hill from working hand-in-glove with Democrats to improve the ACA? President Barack Obama implored both sides on Capitol Hill to improve it if they were so inclined; he said he was all in on any effort to make the ACA work better for more Americans.

Republicans were having none of it. “We gotta repeal it!” they bellowed. Well, they had their chance after Trump got elected president. The president failed to deliver the goods. GOP leaders in Congress failed as well. The ACA remains the law. It figures to stay that way for the foreseeable future — if not longer.

Republicans say they intend to keep yapping about repealing the ACA and replacing it with something else. The voices are growing a bit more muted in sticking to that mantra.

That’s fine with me. Repeal isn’t the only answer. Surely there’s a way to make the ACA work for even more Americans.

CBO weighs in again: not good for ACA repeal

That doggone Congressional Budget Office has done it again.

It has released a report that suggests an attempt to repeal the Affordable Care Act — even through a back-door process — is doomed to cost Americans more than many of them can afford.

The CBO reports that Donald Trump’s threat to repeal the “cost-sharing” payments to Americans seeking health insurance under the ACA is going to cause premiums to skyrocket. Such a repeal also would balloon the deficit by $194 billion over the next decade.

The president has made the threat as a way to get congressional Democrats to bargain with Republicans after the GOP repeal/replace effort failed in the U.S. Senate.

The payments provide Americans a way to afford health insurance. They subsidize insurance companies as well, giving them a chance to provide coverage to Americans who otherwise could not afford it.

As I’ve noted already, my wife and I have benefited directly from the payments provided under the ACA and I am appalled that the president would threaten to cut them off, to use them as a bargaining tool — or, if you’ll accept this description, as a political football.

I’m glad the CBO has lined up on the side of Americans — such as yours truly — who want the president and Congress to improve the ACA, not repeal it.