Playing Doctor with Americans’ Lives

3Doctors400Republicans, in both the House and the Senate, are currently colluding to gut Healthcare Reform and deny actual healthcare to millions of women across our nation using a process called Reconciliation.  Reconciliation is an expedited budgetary process that offers some procedural advantages: it needs only the support of a simple majority in the Senate, and cannot be filibustered. The bill they intend pass via reconciliation is HR3762, inappropriately named, “Restoring Americans’ Healthcare Freedom Reconciliation Act” … it should be named “Butchering All Hope of Being Able to Afford Effective Healthcare Act.”

This reconciliation bill includes language to repeal key parts of Obamacare: the individual mandate, the employer mandate, the medical device tax and the ‘Cadillac tax.’ There are press posts saying that it will also end the Independent Payment Advisory Board (IPAB), but I can’t find such a provision in the bill.In addition, it would defund Planned Parenthood for one year

Defunding Planned Parenthood for a Year—

Here’s the section which specifically codifies the vilification of Planned Parenthood as a “Prohibited Entity” that just happens to provide “essential” healthcare for millions of women across our nation:

SEC. 202. FEDERAL PAYMENT TO STATES.
(a) In General.—Notwithstanding section 504(a), 1902(a)(23), 2002, 2005(a)(4), 2102(a)(7), or 2105(a)(1) of the Social Security Act (42 U.S.C. 704(a), 1396b(a)(23), 1397a, 1397d(a)(4), 1397bb(a)(2), 1397ee(a)(1)), or the terms of any Medicaid waiver in effect on the date of enactment of this Act that is approved under section 1115 or 1915 of the Social Security Act (42 U.S.C. 1315, 1396n), for the 1-year period beginning on the date of the enactment of this Act no Federal funds may be made available to a State for payments to a prohibited entity, whether made directly to the prohibited entity or through a managed care organization under contract with the State.

(b) Definition Of Prohibited Entity.—In this section, the term “prohibited entity” means an entity, including its affiliates, subsidiaries, successors, and clinics—

(1) that, as of the date of enactment of this Act—

(A) is an organization described in section 501(c)(3) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code;

(B) is an essential community provider described in section 156.235 of title 45, Code of Federal Regulations, that is primarily engaged in family planning services, reproductive health, and related medical care; and

(C) provides for abortions, other than an abortion—

(i) if the pregnancy is the result of an act of rape or incest; or

(ii) in the case where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself; and

(2) for which the total amount of Federal and State expenditures under the Medicaid program under title XIX of the Social Security Act in fiscal year 2014 made directly to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity, or made to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity as part of a nationwide health care provider network, exceeded $350,000,000.

[Emphasis mine]

Please note that the provisions to completely eliminate any funds for Planned Parenthood were proposed and recommended by the Ways and Means Committee currently led by Rep. Paul Ryan, that same Paul Ryan who will is expected to be elected as Speaker of the House next Wednesday — that is, unless the right wing extremists of the Republican Freedom Caucus renege and cast their votes for their beloved Rep. Daniel Webster instead.

Repealing the Individual and Employer Mandates —

Repealing individual mandate provisions are likely to increase, rather than decrease, the number of U.S. residents without health coverage, thus eliminating the progress that has been made in holding people responsible for their healthcare.  If the CBO forecasts are correct, the H.R. 3762 mandate repeal provisions could increase the number of uninsured U.S. residents by 55 percent to 65 percent. But, that’s okay with Republicans because for each person who doesn’t buy health insurance, the government doesn’t have to shell out $760-$815.  But they took it one step further.  To help their corporate benefactors, they also plan on repealing the mandates on employers to provide medical coverage.  Thus, ordinary Americans seeking to access affordable healthcare coverage for themselves and their families are going to rapidly find themselves up the proverbial creak, with no paddle, a leaky boat and no pail with which to bail out their boat.

The house voted on passage of HR3762 on Friday.  The vote was 240-189 with 5 Democrats not voting.  One Democrat (Peterson) voted for passage and ALL THREE of Nevada’s Congressional Republicans voted ‘AYE’ for passage! The bill is now off to the Senate, where it can be considered without a 60-vote cloture requirement (assuming the package passes muster with the Senate “Byrd Rule.”).

The Byrd Rule is a Senate rule that amends the Congressional Budget Act of 1974 to allow Senators, during the Reconciliation Process, to block a piece of legislation if it purports significantly to increase the federal deficit beyond a ten-year term or is otherwise an “extraneous matter” as set forth in the Budget Act.  It is named after West Virginia Senator Robert Byrd.

The Congressional Budget Office (CBO) assessed the effects of HR3762 on long-term deficits and direct spending as follows:

  • Including macroeconomic feedback, CBO and JCT estimate that enacting the legislation would increase net direct spending as well as on-budget deficits by more than $5 billion in one or more of the four consecutive 10-year periods beginning in 2026.
  • Excluding macroeconomic feedback, CBO and JCT estimate that enacting the legislation would not increase net direct spending by more than $5 billion in either of the first two consecutive 10-year periods beginning in 2026; however, the agencies are not able to determine whether enacting the legislation would increase net direct spending by more than $5 billion in the third or fourth 10-year period.
  • Excluding macroeconomic feedback, CBO and JCT estimate that enacting the legislation would increase on-budget deficits by more than $5 billion in one or more of the four consecutive 10-year periods beginning in 2026.

And because enacting the legislation would affect direct spending and revenues, ‘pay-as-you-go procedures‘ apply.

The President is then expected to veto, setting up the need for a veto-override vote in Congress.  In a statement promising Obama’s veto, the White House said the GOP measure “would take away critical benefits and health care coverage from hard-working middle-class families.”

However, a conservative revolt could derail the bill’s progress, as some conservative groups are opposing because the bill leaves some parts of ObamaCare intact


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Per the Tea Party: “The Ryan Budget is a Good Start”

Version 2 of Representative Ryan’s “Path to Prosperity” (in reality, a path to Poverty for many), is due out today.  Believing that the attacks against last year’s Path have failed, they’ve decided to double-down and go after the prize of privatization of Medicare and Social Security in this year’s budget as well. In his op-ed about the impending release of his budget, Rep. Ryan stated

“Like last year, our budget delivers real spending discipline. It does this not through indiscriminate cuts that endanger our military, but by ending the epidemic of crony politics and government overreach that has weakened confidence in the nation’s institutions and its economy. And it strengthens the safety net by returning power to the states, which are in the best position to tailor assistance to their specific populations.  

Our budget’s Medicare reforms make no changes for those in or near retirement. For those who will retire a decade from now, our plan provides guaranteed coverage options financed by a premium-support payment. And this year, our budget adds even more choices for seniors, including a traditional fee-for-service Medicare option.

We also introduce a competitive-bidding process to determine the growth of government’s financial contribution to Medicare. Forcing health plans to compete against each other is the best way to achieve high-quality coverage at the lowest cost, and implementing these reforms in Medicare can have the effect of lowering health-care costs for everyone. This is the key to increasing access and affordability while preventing government debt from threatening the health security of seniors and the economic security of all Americans.”

Ryan’s new version of the “Plan” is purported to include a Ryan-Wyden “bipartisan plan” to strengthen medicare and expand health care choices for all.  That’s pure bull-puckey if you ask me.  They may be wrapping it up in prettier packaging, but it’s still a plan to privatize Medicare by gifting it to the Insurance industry and providing vouchers to seniors that will have ever-declining values.  Now if you ask me … that promotes health care rationing as aging seniors would no longer be able to afford effective health care.

The “Plan”  continues to promote no changes for those in or near retirement. Americans currently over the age of 55 would see no changes to the structure of their benefits, although they would be “free to opt into a private plan” once the new Medicare Exchange was established in 2022.  That’s the point at which Medicare would begin offering seniors a choice among Medicare-approved private plans competing alongside a traditional Medicare plan on a Medicare Exchange.

All of us have paid in throughout our working careers, both poor and rich.  Many of us have planned for retirement based on certain assumptions … well I guess Ryan’s plan is reminding us about that old adage about “ass u me.”  Supposedly, the “Plan” would provide more help for those who “need” it and less help for those who don’t.  Personally, I want to see just exactly how Mr. Ryan proposes to define those who “don’t.”

Ryan’s “Plan” would purportedly repeal or defund the Independent Payment Advisory Board which was created by the Patient Protection and Affordable Care Act (“Obamacare”).  This is the board that is supposed to analyze the effectiveness of health care practices and make recommendations to Congress for improvements in Medicare.  The GOP would have you believe that the IPAB is nothing more than a “death panel.”  They’re wrong, this panel assures you are receiving effective care, not just the cheapest service they can provide.  It’s mandate is to assure that ineffective practices and medications are set aside and more effective treatments are used instead.  By eliminating this board and relying on Insurance companies to dictate what type of treatment or medication they’re willing to fund, seniors will get less effective health care.  Thus, the Ryan Plan promotes insurance company death panel strategies.

We know what the President has proposed.  Ryan’s budget is expected out at 10AM this morning. Like version 1, it’s been reported that it won’t increase any revenues and proposes further tax cuts for individuals as well as corporations, taking the tax code down to two rates: 15% and 25%. But this far, he’s not indicated any income levels associated with those rates.

Ryan claims his new budget is “revenue neutral” as he’s proposing to close a few loopholes, but he has yet to identify which loopholes and who would be affected.  You can expect to see extremely low spending on education, infrastructure, and research.  I certainly hope that seriously deficient bridge you drive across each day to get to your workplace doesn’t decide to fall into the river or some abyss anytime soon, because the GOP doesn’t understand the need for maintenance and replacement.

I look forward to being able to peruse the numbers, specifically military spending which consumes a huge portion of the federal budget.  Purportedly, he’s treated that as a seriously sacred cow and has not cut a single penny.  I want to see if that’s true, or worse, if he’s actually proposing to increase spending for weapons and war as he did in version 1.

Regardless, Ryan’s approach won’t be balancing the budget or closing the deficit anytime soon.