“BBBA” — A Message from House Democrats

Rep. Cheri Bustos delivering the message from House Democrats regarding the GOP’s American Health Care Act, the AHCA, which should more aptly be titled the “BBBA,” the Big Breaks for Billionaires Act. They hear us and they’re ready to stand up for the values that unite us and fight to get real results for hardworking families.

AMA Physicians Reject House ACA Replacement Bill

Andrew W. Gurman, MD Andrew W. Gurman, MD
President
American Medical Association
@AndyGurmanMD

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

Letter re: the AHCA being driven through the US House

#TrumpedUpCare Losers: Those Using Long-Term Care Under Medicaid

Rep. Joe Kennedy III speaking at 4:15AM this morning on the impact of the Republican’s #TrumpedUpCare bill on those who receive Medicaid benefits for #LongTermCare ….so much for Republicans NOT picking “winners and losers” … about 6.9 MILLION seniors across America who could find themselves turfed out of care when there’s no way to pay the bill for their care.

HR7 now heading to the Senate

hr7-01

This week House passed HR7 to permanently authorize the Hyde Amendment. The final vote was 238-183, largely along party lines. See how your representative voted:

  • NV-CD1, Dina Titus ………………………………. NAY
  • NV-CD2, Mark Amodei …………………………… AYE
  • NV-CD3, Jacky Rosen ……………………………. NAY
  • NV-CD4, Ruben Kihuen ………………………….. NAY

Heard of the Hyde Amendment? It prohibits the use of federal funds for abortion or health plans that cover abortion, except in the cases of rape, incest, or when the life of the mother is in danger. Currently, it’s not a permanent law but rather a “rider” that’s been included in annual appropriations bills since 1976. This version, however, takes Hyde one step further by prohibiting “employer plans” from being able to carry coverage for abortions, because employers receive a tax break for the healthcare plans they offer to their employees.

What happens now?  HR7 heads to the Senate. Let Senator Heller and Senator Cortez Masto know what you think!

The Irony of Ironies via Republican Poison Pills

H.R. 2577 is a conglomeration of a number of bills (Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2017) that  the Senate needs to take action on failed a super-majority vote (60 votes) for cloture (the ability to be considered and voted for/against on the Senate floor).  One version of that bill was passed by the House and a different version of that/those bills passed the Senate.  Thus, it’s now gone to conference committee to work out the wrinkles between the two versions.

This conference agreement now includes the Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2017, the Zika Response and Preparedness Appropriations Act, 2016, the Zika Vector Control Act, and an unacceptable ‘division’ on funds to be rescinded from programs the Republicans don’t particularly like.  That’s what came to the floor for a cloture vote, and it failed miserably — 52-48.

Really, Senator McConnell?  It’s too difficult for the general public to understand?  I don’t think so.

It’s one thing for Republicans to short-change President Obama’s funding request.  It’s another thing to start attaching ‘poison pills’ to the proposed legislation that limit or outright prohibit women’s choices.  When you introduce a funding proposal that limits the distribution of contraceptives and that prevents family planning organizations like Planned Parenthood from participating in the effort to help women in Zika-affected areas delay pregnancy, from a disease that not just contracted from a mosquito bite, but from sexual activity with an infected male partner, did you really think that Senate Democrats would just roll over and vote for that?

When you start gutting provisions of the Federal Water Pollution Control Act, did you honestly believe that Democrats would just roll over and just vote for that?

SEC. 2. MOSQUITO CONTROL WAIVER.
Notwithstanding section 402 of the Federal Water Pollution Control Act (33 U.S.C. 1342), during the 180 day period following the date of enactment of this Act the Administrator of the United States Environmental Protection Agency (or a State, in the case of a permit program approved under subsection (b)) shall not require a permit for a discharge from the application by an entity authorized under State or local law, such as a vector control district, of a pesticide in compliance with all relevant requirements of the Federal Insecticide, Fungicide, and Rodenticide Act (7 U.S.C. 136 et seq.) to control mosquitos or mosquito larvae for the prevention or control of the Zika virus.

When you start stripping funding for the Patient Protection and Affordable Care Act (Obamacare), did you really expect Democrats to just roll over, see the light and vote your way?  Or, when you decide to fund your bill by stripping balances  from the Departments of Labor, Health and Human Services, and Education, did you really expect Democrats to go “oh yeah, that’s a great idea” and vote in favor of your bill?  Or better yet, given that we already know that you stripped a bunch of funding from the State Department for Embassy security that might have made the outcome in Benghazi drastically different, did you really expect the Senate Democrats to let you strip even more funding for the State Department and other Foreign Operations?

Are you nuts?  They certainly weren’t and neither am I.  It took me hours to sort through all the links on Congress.gov, but here’s what I found:

DIVISION D–RESCISSIONS OF FUNDS

Sec. 101.
(a) $543,000,000 of the unobligated amounts made available under section 1323(c)(1) of the Patient Protection and Affordable Care Act (42 U.S.C. 18043(c)(1)) is rescinded immediately upon enactment of this Act.

Sec. 1323. Community health insurance option. Requires the Secretary to offer a Community Health Insurance Option as a qualified health plan through Exchanges. Allows States to enact a law to opt out of offering the option. Requires the option to cover only essential health benefits; States may require additional benefits, but must defray their cost. Requires the Secretary to set geographically adjusted premium rates that cover expected costs. Requires the Secretary to negotiate provider reimbursement rates, but they must not be higher than average rates paid by private qualified health plans. Subjects the option to State and Federal solvency standards and to State consumer protection laws. Establishes a Start-Up Fund to provide loans for initial operations, to be repaid with interest within 10 years. Authorizes the Secretary to contract with nonprofits for the administration of the option.

(b) $100,000,000 of the unobligated balances available in the Nonrecurring expenses fund established in section 223 of division G of Public Law 110-161 (42 U.S.C. 3514a) from any fiscal year is rescinded immediately upon enactment of this Act.

DIVISION G–DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2008
Title I–Department of Labor
Title II–Department of Health and Human Services
Title III–Department of Education
Title IV–Related Agencies
Title V–General Provisions
Title VI–National Commission on Children and Disasters

(c) $107,000,000 of the unobligated balances of appropriations made available under the heading Bilateral Economic Assistance, Funds Appropriated to the President, Economic Support Fund in title IX of the Department of State, Foreign Operations, and Related Programs Appropriations Act, 2015 (division J of Public Law 113-235) is rescinded immediately upon enactment of this Act: Provided, That such amounts are designated by the Congress as an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985.

Personally, I side with Senate Minority Leader Harry Reid who declared, “It is unbelievable that somebody would have the audacity to come to the floor and say it’s Democrats’ fault. A significant amount of American women, especially young women, go to Planned Parenthood, and the Republicans want to say, ‘you can’t do that.’” Why indeed would Democrats not just prohibit Planned Parenthood from providing any services, but gut the EPA’s ability to assure clean water and harm HHS’s ability to manage health insurance options for not just Puerto Ricans, but millions of American families across our nation?  Apparently Sen. McConnell completely missed the irony of claiming to improve women’s health by prohibiting and defunding health opportunities for women altogether.


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