The US House, as authorized by the president, released the controversial memo by Rep. David Nunes (R-CA) today despite protests from our nation’s intelligence services claiming that omissions of fact render it as nothing but partisan propaganda. Nunes, the supposed author of the document, has NOT read the underlying investigative documents upon which he claims his memo is based. Sadly, Speaker Ryan, second in line to the presidency, believes it’s appropriate to promote Nunes’ propaganda to “the base.” The Democratic rebuttal may or may not be released dependent of the whims of the man occupying the oval office and whether he thinks it appropriate for the American People to have that information.
|Andrew W. Gurman, MD
American Medical Association
The American Health Care Act (AHCA), released by Congress this week, is intended to repeal and replace the Affordable Care Act (ACA). But as introduced, it does not align with the health reform objectives that the AMA set forth in January to protect patients. While the ACA is imperfect, the current version of the AHCA is not legislation we can support.
The replacement bill, as written, would reverse the coverage gains achieved under the ACA, causing many Americans to lose the health care coverage they have come to depend upon.
In a letter sent today to leaders of the House committees that will mark up the AHCA, AMA CEO and Executive Vice President James L. Madara, MD, wrote that the proposed changes to Medicaid would limit states’ ability to respond to changes in service demands and threaten coverage for people with low incomes. Dr. Madara also noted that the proposed changes in tax credits and subsidies to help patients purchase private health insurance coverage are expected to result in fewer Americans with insurance coverage.
It is unclear the exact impact this bill will have on the number of insured Americans, and review by the nonpartisan Congressional Budget Office is still pending. The ratings and analytics firm S&P Global Ratings has already estimated that as many as 10 million Americans could lose coverage if this bill becomes law, saying that between 2 million and 4 million people could lose the insurance they purchased in the individual health exchanges under the ACA, and between 4 million and 6 million could lose their coverage under Medicaid.
That just won’t do.
We all know that our health system is highly complex, but our core commitment to the patients most in need should be straightforward. As the AMA has previously stated, members of Congress must keep top of mind the potentially life-altering impact their policy decisions will have.
We physicians often see patients at their most vulnerable, from the first time they set eyes on a newborn child to the last time they squeeze a dying loved one’s hand. We don’t want to see any of our patients, now insured, exposed to the financial and medical uncertainties that would come with losing that coverage.
That is, above all, why physicians must be involved in this debate.
Editor’s note: In the coming weeks, a series of AMA Wire® articles will explore policies that form the basis of the AMA’s advocacy on health reform. Read parts one (“Protecting insurance gains is priority No. 1”) and two (“No going back on key market protections”).
Reprinted with permission and as Published by the American Medical Association on AMA Wire at: https://wire.ama-assn.org/ama-news/physicians-reject-house-aca-replacement-bill
On Thursday, Rep. Sean Patrick Maloney [D-NY] offered an amendment to the military construction and veterans affairs spending bill that would prohibit discrimination against LGBT individuals in hiring and employment activities. It was very similar to an amendment that was offered last year by Rep. Scott Peters [D-CA] which upheld President Obama’s 2014 executive order banning federal contractors from making hiring decisions that discriminate based on sexual orientation or gender identity. 60 Republicans voted forRep Peters’ bill which was adopted 241-184 [HR2577, Roll Call 326, 6-9-15]. However, Rep. Maloney’s amendment by a single vote, 212-213 [HR 4974, Roll Call 226, 5-19-16], after seven Republicans switched their votes at the last minute.
Rep. Mark Amodei [NV2] and Rep. Cresant Hardy [NV4] voted against passage of BOTH amendments (last year’s and this year’s). It should, therefore, be noted that BOTH are in favor of allowing discrimination to take place.
Although the identities of the seven vote-switchers were not publicly recorded on the House floor, here’s the names of those Reps who switched there votes and deserve your shaming:
- Rep. Darrell Issa [R-CA]
- Rep. Jeff Denham [R-CA]
- Rep. David Valadao [R-CA]
- Rep. Mimi Walters [R-CA]
- Rep. Greg Walden [R-OR]
- Rep. David Young [R-IA]
- Rep. Bruce Poliquin [R-ME]
“House Republicans are so committed to discriminating against LGBT Americans, that they broke regular order to force their members to reverse their votes and support Republicans’ bigotry,” Minority Leader Nancy Pelosi [D-CA] said in a statement.
On the other side, Speaker Ryan had this to say: “This is federalism. The states should do this. The federal government shouldn’t stick its nose in this business.” UH … Hello? This had to do with FEDERAL contracts for which States hold NO responsibility for issuance, nor for enforcement.
Here are the names of 30 Republicans who voted for the Peters amendment but against the Maloney amendment:
The House GOP-dominated Budget Committee held 9 hour markup, with several lawmakers going hoarse and one losing her voice. Democrats offered up 29 amendments, involving immigration reform, prescription drug prices, and equal pay. Every amendment failed, including one proposed by Rep. Debbie Dingell [D, MI-12] that would have designated $457.5M in emergency funding for Flint and required Michigan to match the federal funds. The budget advanced 20-16, with Democrats voting against and all but one Republican voting for the measure. Here’s their summary:
Balances the Budget
- Balances the budget within 10 years – without raising taxes – and puts the country on a path to paying off the national debt
- This budget achieves $7 trillion in deficit reduction over ten years through a combination of $6.5 trillion in savings coupled with economic growth
- Savings are higher than any previous House Budget Committee proposal and discretionary spending is below 2008 levels
- Requires consideration of legislation this year to achieve at least $30 billion in automatic spending reductions and reforms over the near term
- Advances budget process reforms to promote fiscal discipline, and calls for a vote on a Balanced Budget Amendment this year
Strengthens Our National Defense
- Provides for greater security at home and strength abroad at funding levels above the president’s budget and with increased resources for training, equipment and compensation
- Supports the bipartisan prohibition on closing the Guantanamo Bay detention facility and transfer of detainees to American soil
- Identifies vulnerabilities in our nation’s refugee program and calls for oversight and rigorous screening
- Calls for an improved and accountable Department of Veterans Affairs that can better deliver services and benefits to our veterans
Empowers Our Citizens & Communities
- Promotes job creation and a healthier economy by calling for a fairer, simpler tax code, regulatory reform, expanded energy production, and a more efficient, effective and accountable government
- Repeals all of Obamacare (Patient Protection and Affordable Care Act)
- Endorses patient-centered health care solutions that improve access to quality, affordable care (but does absolutely nothing to assure access to insurance nor does it rein in health care costs)
- Saves, strengthens, and secures Medicare for current and future retirees (read the Q&A carefully as to HOW they intend to do that)
- Empowers states and local communities with the flexibility to innovate and make improvements to Medicaid, nutrition assistance, education and other programs
- Strengthens the Disability Insurance program by putting an end to the “double-dipping” loophole that currently allows individuals to receive both unemployment insurance and disability insurance simultaneously
- Puts an end to corporate welfare and dismantles the Department of Commerce [that would mean they intend to help balance the budget by issuing pink slips to 43,000+ employees and ending measuring services like: Bureau of Economic Analysis (BEA), Bureau of Industry and Security (BIS), U.S. Census Bureau (Census), Economic Development Admin (EDA), Economics and Statistics Admin (ESA), International Trade Admin (ITA), Minority Business Development Agency (MBDA), Natl Institute of Standards and Technology (NIST), Natl Oceanic and Atmospheric Administration (NOAA), Natl Technical Information Service (NTIS), Operation Natl Telecom & Information Admin (NTIA), and United States Patent and Trademark Office (USPTO).
- Read the Plan
- Summary & Key Facts
- Charts & Graphs
- Frequently Asked Questions (Make sure you read the Q&A regarding “full” repeal of the Affordable Care Act, AND the dance they do to explain how their “voucher” approach to Medicare isn’t really a “voucher” program for their apparent privatization of our trust fund contributions)
- Legislative Text
- Adopted Amendments
- Summary Tables