Shifting Dollars From Poor to Rich Is a Key Part of the Senate Health Bill

(THIS ARTICLE IS COURTESY OF THE NEW YORK TIMES)

The Affordable Care Act gave health insurance to millions of Americans by shifting resources from the wealthy to the poor and by moving oversight from states to the federal government. The Senate bill introduced Thursday pushes back forcefully on both dimensions.

The bill is aligned with long-held Republican values, advancing states’ rights and paring back growing entitlement programs, while freeing individuals from requirements that they have insurance and emphasizing personal responsibility. Obamacare raised taxes on high earners and the health care industry, and essentially redistributed that income — in the form of health insurance or insurance subsidies — to many of the groups that have fared poorly over the last few decades.

The draft Senate bill, called the Better Care Reconciliation Act, would jettison those taxes while reducing federal funding for the care of low-income Americans. The bill’s largest benefits go to the wealthiest Americans, who have the most comfortable health care arrangements, and its biggest losses fall to poorer Americans who rely on government support. The bill preserves many of the structures of Obamacare, but rejects several of its central goals.

Like a House version of the legislation, the bill would fundamentally change the structure of Medicaid, which provides health insurance to 74 million disabled or poor Americans, including nearly 40 percent of all children. Instead of open-ended payments, the federal government would give states a maximum payment for nearly every individual enrolled in the program. The Senate version of the bill would increase that allotment every year by a formula that is expected to grow substantially more slowly than the average increase in medical costs.

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Avik Roy, the president of the Foundation for Research on Equal Opportunity, and a conservative health care analyst, cheered the bill on Twitter, saying, “If it passes, it’ll be the greatest policy achievement by a G.O.P. Congress in my lifetime.” The bill, he explained in an email, provides a mechanism for poor Americans to move from Medicaid coverage into the private market, a goal he has long championed as a way of equalizing insurance coverage across income groups.

States would continue to receive extra funding for Obamacare’s expansion of Medicaid to more poor adults, but only temporarily. After several years, states wishing to cover that population would be expected to pay a much greater share of the bill, even as they adjust to leaner federal funding for other Medicaid beneficiaries — disabled children, nursing home residents — who are more vulnerable.

Mitch McConnell, the Senate majority leader, in the Capitol on Thursday.CreditSaul Loeb/Agence France-Presse — Getty Images

High-income earners would get substantial tax cuts on payroll and investment income. Subsidies for those low-income Americans who buy their own insurance would decline compared with current law. Low-income Americans who currently buy their own insurance would also lose federal help in paying their deductibles and co-payments.

The bill does offer insurance subsidies to poor Americans who live in states that don’t offer them Medicaid coverage, a group without good insurance options under Obamacare. But the high-deductible plans that would become the norm might continue to leave care out of their financial reach even if they do buy insurance.

The battle over resources played into the public debate. Mitch McConnell, the Senate majority leader, said the bill was needed to “bring help to the families who have been struggling with Obamacare.” In a Facebook post, President Barack Obama, without mentioning the taxes that made his program possible, condemned the Senate bill as “a massive transfer of wealth from middle-class and poor families to the richest people in America.”

In another expression of Republican principles, the bill would make it much easier for states to set their own rules for insurance regulation, a return to the norm before Obamacare.

Where Senators Stand on the Health Care Bill

Senate Republican leaders unveiled their health care bill on Thursday.

Under the bill, states would be able to apply for waivers that would let them eliminate consumer protection regulations, like rules that require all health plans to cover a basic package of benefits or that prevent insurance plans from limiting how much care they will cover in a given year.

States could get rid of the online marketplaces that help consumers compare similar health plans, and make a variety of other changes to the health insurance system. The standards for approval are quite permissive. Not every state would choose to eliminate such rules, of course. But several might.

“You can eliminate all those financial protections,” said Nicholas Bagley, a law professor at the University of Michigan. “That would be huge.”

Americans with pre-existing conditions would continue to enjoy protection from discrimination: In contrast with the House health bill, insurers would not be allowed to charge higher prices to customers with a history of illness, even in states that wish to loosen insurance regulations.

But patients with serious illnesses may still face skimpier, less useful coverage. States may waive benefit requirements and allow insurers to charge customers more. Someone seriously ill who buys a plan that does not cover prescription drugs, for example, may not find it very valuable.

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A protester being removed from outside the office of Mitch McConnell on Thursday.CreditSaul Loeb/Agence France-Presse — Getty Images

There are features that would tend to drive down the sticker price of insurance, a crucial concern of many Republican lawmakers, who have criticized high prices under Obamacare. Plans that cover fewer benefits and come with higher deductibles would cost less than more comprehensive coverage.

But because federal subsidies would also decline, only a fraction of people buying their own insurance would enjoy the benefits of lower prices. Many middle-income Americans would be expected to pay a larger share of their income to purchase health insurance that covers a smaller share of their care.

The bill also includes substantial funds to help protect insurers from losses caused by unusually expensive patients, a measure designed to lure into the market those insurance carriers that have grown skittish by losses in the early years of Obamacare. But it removes a policy dear to the insurance industry — if no one else. Without an individual mandate with penalties for Americans who remain uninsured, healthier customers may choose to opt out of the market until they need medical care, increasing costs for those who stay in.

The reforms are unlikely to drive down out-of-pocket spending, another perennial complaint of the bill’s authors, and a central critique by President Trump of the current system. He often likes to say that Obamacare plans come with deductibles so high that they are unusable. Subsidies under the bill would help middle-income consumers buy insurance that pays 58 percent of the average patient’s medical costs, down from 70 percent under Obamacare; it would also remove a different type of subsidy designed to lower deductibles further for Americans earning less than around $30,000 a year.

Out-of-pocket spending is the top concern of most voters. The insurance they would buy under the bill might seem cheap at first, but it wouldn’t be if they ended up paying more in deductibles.

Mr. McConnell was constrained by political considerations and the peculiar rules of the legislative mechanism that he chose to avoid a Democratic filibuster. Despite those limits, he managed to produce a bill that reflects some bedrock conservative values. But the bill also shows some jagged seams. It may not fix many of Obamacare’s problems — high premiums, high deductibles, declining competition — that he has railed against in promoting the new bill’s passage.

The U.S. Constitution Says All Are Created Equal, GOP House And Senate Say Hell No

 

Once again the GOP federal Congress and Senate show their disdain (the feeling that someone or something is unworthy of one’s consideration or respect; contempt) for the poor and the working class American people. The GOP in their healthcare bill they are pushing down the throats of the American people show how much they despise at least the bottom 90% (incomes) of the people. I live in Kentucky so Senator Mitch McConnell is one of my two Senators so I am hoping that the next time he comes up for reelection that the people of this State vote this horses behind out of office. I am a registered voting Independent, I personally can’t stand either the Republican or the Democratic Party leaderships as in my opinion neither have any interest in being honest with the American people.

 

Even though this next ‘idea’ is not one I invented I have felt this way for many years concerning health care in America. There is only one health plan that should be allowed here in our Country and that is: every single person in America should have exactly the same insurance as the Congressmen, Congresswomen, the U.S. Senators and the President have, exactly the same as theirs. They are supposed to be the servants but they have illegally made themselves into our slave masters. I do not know anything about what their plans are, I do not know if they have to pay anything out of their own pockets for the monthly costs or if they have deductibles but shouldn’t ‘We The People’ be allowed to have at least as good of healthcare as ‘our servants’? For these people to be bringing ‘other’ healthcare bills to the ‘floor’ for a vote is pure and total hypocrisy! Okay, these are just my thoughts on this issue, what are your thoughts on this issue?

U.S. Senate Votes Near Unanimously (98-2) For Russia, Iran Sanctions

(THIS ARTICLE IS COURTESY OF REUTERS)

U.S. Senate votes near unanimously for Russia, Iran sanctions

By Patricia Zengerle | WASHINGTON

The U.S. Senate voted nearly unanimously on Thursday for legislation to impose new sanctions on Russia and force President Donald Trump to get Congress’ approval before easing any existing sanctions on Russia.

In a move that could complicate U.S. President Donald Trump’s desire for warmer relations with Moscow, the Senate backed the measure by 98-2. Republican Senator Rand Paul and Bernie Sanders, an independent who caucuses with the Democrats, were the only two “no” votes.

The measure is intended to punish Russia for meddling in the 2016 U.S. election, its annexation of Ukraine’s Crimea region and support for Syria’s government in the six-year-long civil war.

If passed in the House of Representatives and signed into law by Trump, it would put into law sanctions previously established via former President Barack Obama’s executive orders, including some on Russian energy projects. The legislation also allows new sanctions on Russian mining, metals, shipping and railways and targets Russians guilty of conducting cyber attacks or supplying weapons to Syria’s government.

“The legislation sends a very, very strong signal to Russia, the nefarious activities they’ve been involved in,” Senator Bob Corker, the Republican chairman of the Senate Foreign Relations Committee, said as lawmakers debated the measure.

If the measure became law, it could complicate relations with some countries in Europe. Germany and Austria said the new punitive measures could expose European companies involved in projects in Russia to fines.

The legislation sets up a review process that would require Trump to get Congress’ approval before taking any action to ease, suspend or lift any sanctions on Russia.

National flags of Russia and the U.S. fly at Vnukovo International Airport in Moscow, Russia April 11, 2017.REUTERS/Maxim Shemetov
Trump was especially effusive about Russian president Vladimir Putin during the 2016 U.S. election campaign, though his openness to closer ties to Moscow has tempered somewhat, with his administration on the defensive over investigations into Russian meddling in the election.

Putin dismissed the proposed sanctions, saying they reflected an internal political struggle in the United States, and that Washington’s policy of imposing sanctions on Moscow had always been to try to contain Russia.

The bill also includes new sanctions on Iran over its ballistic missile program and other activities not related to the international nuclear agreement reached with the United States and other world powers.

UNCERTAIN PATH IN HOUSE

To become law, the legislation must pass the House of Representatives and be signed by Trump. House aides said they expected the chamber would begin to debate the measure in coming weeks.

However, they could not predict if it would come up for a final vote before lawmakers leave Washington at the end of July for their summer recess.

Senior aides told Reuters they expected some sanctions package would eventually pass, but they expected the measure would be changed in the House. The Trump administration has pushed back against the bill, and his fellow Republicans hold a commanding 238- to 193-seat majority in the chamber.

Secretary of State Rex Tillerson questioned the legislation on Wednesday, urging Congress to ensure that any sanctions package “allows the president to have the flexibility to adjust sanctions to meet the needs of what is always an evolving diplomatic situation.”

Previously, U.S. energy sanctions had only targeted Russia’s future high-tech energy projects, such as drilling for oil in the Arctic, fracking and offshore drilling. They blocked U.S. companies such as Exxon Mobil, where Tillerson was chairman, from investing in such projects.

The new bill would slap sanctions on companies in other countries looking to invest in those projects in the absence of U.S. companies, a practice known as backfilling.

Also included for the first time are discretionary measures the Trump administration could impose on investments by companies in Western countries on Russia energy export pipelines to Europe.

The Senate also voted overwhelmingly on Thursday to add provisions to the bill allowing the U.S. space agency NASA to continue using Russian-made rocket engines and the 100 senators voted unanimously for an amendment reaffirming the U.S. commitment to the NATO alliance.

(Additional reporting by Tim Gardner; Editing by Yara Bayoumy and Tom Brown)

The Senate Parliamentarian Warns Republicans That Their Healthcare Bill Can’t Pass

(THIS ARTICLE IS COURTESY OF THE HILL NEWSPAPER)

The Senate parliamentarian has warned Republicans that a key provision in their healthcare reform bill related to abortion is unlikely to be allowed, raising a serious threat to the legislation.

The parliamentarian, Elizabeth MacDonough, has flagged language that would bar people from using new refundable tax credits for private insurance plans that cover abortion, according to Senate sources.

If Republicans are forced to strip the so-called Hyde language from the legislation, which essentially bars federal funds from being used to pay for abortions unless to save the life of a mother or in cases of rape and incest, it may doom the bill.

MacDonough declined to comment for this article.

Unless a workaround can be found, conservative senators and groups that advocate against abortion rights are likely to oppose the legislation.

Republicans control 52 seats in the Senate; they can afford only two defections and still pass the bill, assuming Democrats are united against it. Vice President would break a 50-50 tie.

Normally controversial legislation requires 60 votes to pass the Senate, but Republicans hope to pass the ObamaCare repeal-and-replace bill with a simple majority vote under a special budgetary process known as reconciliation.

The catch is that the legislation must pass a six-part test known as the Byrd Rule, and it’s up to the parliamentarian to advise whether legislative provisions meet its requirements.

The toughest requirement states that a provision cannot produce changes in government outlays or revenues that are merely incidental to the non-budgetary components of the provision.

In other words, a provision passed under reconciliation cannot be primarily oriented toward making policy change instead of impacting the budget. Arguably, attaching Hyde language to the refundable tax credits is designed more to shape abortion policy than affect how much money is spent to subsidize healthcare coverage.

 

The abortion language that conservatives want in the healthcare bill may run afoul of a precedent set in 1995, when then-Senate Parliamentarian Robert Dove ruled that an abortion provision affecting a state block grant program failed to meet reconciliation requirements, according to a source briefed on internal Senate discussions.

One GOP source identified the parliamentarian’s objection to the Hyde language along with Republican infighting over how to cap ObamaCare’s Medicaid expansion as two of the biggest obstacles to passing a bill.

A Republican senator confirmed that negotiators have wrestled with the procedural obstacle facing the anti-abortion language.

“That has come up and there well could be a challenge,” the lawmaker said.

The lawmaker, however, said that the problem is surmountable, arguing “there are ways around it.”

One possibility would be to change the form of assistance to low-income people by changing it from a refundable tax credit to a subsidy filtered through an already existing government program that restricts abortion services, such as the Federal Employee Health Benefits program or Medicaid.

A second Republican senator said discussions on the topic are ongoing.

GOP negotiators picked up the pace of their discussions with the parliamentarian after the Congressional Budget Office released an updated score for the House-passed bill in late May.

President Trump is pushing the Senate to pass its version of the legislation by July 4.

If GOP leaders are forced to strip the Hyde language from the healthcare bill and cannot find an alternative way to seal off insurance tax credits or subsidies from abortion services, they would lose the support of anti-abortion rights groups, a devastating blow.

“We’ve made it clear in a lot of conversations and some letters that any GOP replacement plan has to be consistent with the principles of the Hyde Amendment,” said David Christensen, vice president of government affairs at Family Research Council, a conservative group that promotes Christian values.

“Abortion is not healthcare and the government should not be subsidizing elective abortion,” he added.

Christensen predicted that activists would be up in arms if abortion services aren’t barred under the bill.

“If the Byrd Rule were to be an obstacle to ensuring the GOP replacement plan in the Senate does not subsidize abortion, that’s something that would be a serious problem for us and the pro-life community,” he said.

Republican senators who are thought to be safe votes to support the GOP leadership’s ObamaCare repeal and replace plan may suddenly shift to undecided or opposed.

“Would that be a deal killer? I’d have to think about it. I’m inclined to think it would [be],” said Sen. Jim Inhofe (R-Okla.).

Senate Finance Committee Chairman Orrin Hatch (R-Utah), who has jurisdiction over the tax credits in the healthcare bill, acknowledged it could be tough to pass the bill without the anti-abortion language.

“I think a lot of people do think that’s essential,” he said.

Atlantic Hurricane Season Begins: NOAA And FEMA Have No Leaders/Directors

(THIS ARTICLE IS COURTESY OF CNN)

Hurricane season began on June 1, and according to the National Oceanic and Atmospheric Administration, the season will be a busy one, with an above-average range of 5-9 hurricanes likely in the Atlantic.

The United States could be especially vulnerable to hurricane landfalls this year, observers say, but not because of the enhanced activity that is expected.

NOAA is forecasting an above-average hurricane season in 2017.

The two agencies that protect the country’s coast lines and its residents, NOAA and the Federal Emergency Management Agency (FEMA) are still without leaders — positions that must be appointed by President Donald Trump and confirmed by the Senate.
“That should scare the hell out of everybody,” retired US Lt. Gen. Russel Honoré told CNN. “These positions help save lives.”
Honoré knows all too well the value that leadership plays during a crisis, as he commanded Joint Task Force Katrina. He coordinated military relief efforts in the aftermath of Hurricane Katrina.

Lt. Gen. Russel L. Honoré talks to his soldiers at Camp Shelby, Mississippi, on September 8, 2005.

Despite concerns, FEMA and NOAA say they are prepared for the hurricane season and the aftermath of any storms that make landfall and cause damage.
NOAA runs the National Hurricane Center (NHC), the agency that tracks and forecasts tropical storms and hurricanes, providing five-day forecasts to allow government officials plenty of time to make preparations and organize evacuations.
Not only is NOAA lacking a leader, but the NHC is also without a director after Rick Knabb stepped down earlier this year after leading the center for five years. The director briefs government leaders as well as the American public directly on the forecast for impending storms.
Also under NOAA is the National Weather Service, which is tasked with issuing life-saving warnings for impeding threats from land-falling storms such as strong winds, flooding rainfall and damaging storm surge.
While also key in the preparations, FEMA’s role really kicks in once the storm hits and a disaster has been declared, as FEMA coordinates the government-wide relief efforts.
According to FEMA’s website, “it is designed to bring an orderly and systemic means of federal natural disaster assistance for state and local governments in carrying out their responsibilities to aid citizens.”
But according to Honoré, things could be anything but orderly. “These operations will not function as they should with temporary people doing the jobs.”
“Just look back to Hurricane Katrina to see how important leadership was. If someone is slow in making decisions it can be costly — imagine having no one at all,” Honoré said, referring to the criticism and eventual resignation of then-FEMA director Mike Brown over the bungled response after Katrina hit.
Trump did appoint former Alabama Emergency Management Agency Director Brock Long in late April to lead FEMA, but as of this week, the selection has yet to be confirmed by the Senate.
Despite the vacancy, FEMA director of public affairs William Booher believes the agency will be able to serve its mission.
“Throughout the transition to the new administration, FEMA has ensured that career civilian staff are in place in key positions throughout the agency, allowing them to continue, uninterrupted, to perform their core mission responsibilities — preparing for, responding to, recovering from, and mitigating all hazards, Booher told CNN.
Booher stated that the agency is “looking forward to working with the Senate on the confirmation process and a successful vote” for Brock Long.
A NOAA spokesman told CNN the National Hurricane Center’s acting director, Ed Rappaport, is an experienced leader with 30 years at the center.
“NOAA is fully prepared for the hurricane season and is even launching new and improved products and services this year,” said Chris Vaccaro. “Under our acting administrator, NOAA will continue to provide the American public with science and services important for public safety, the nation’s natural resources, and the economy.”
Trump has yet to appoint someone to the NOAA position.
While the heads of NOAA and FEMA are not the only vacant positions in the US government waiting on appointments, the prospect of a busy hurricane season make them two of the most important.
“We’ve already lost six months of preparation,” Honoré pleaded. “The government has been preaching to people to prepare themselves for hurricanes, but they haven’t done their part to prepare by picking someone to lead.”

Iran And Saudi Arabia Fight Proxy War In Yemen: Yemen People Pay The Biggest Price

(THIS ARTICLE IS COURTESY OF CNN)

US: No ‘blank check’ for Saudi Arabia in Yemen

U.S. weapons for Saudi atrocities?

U.S. weapons for Saudi atrocities? 04:52

Story highlights

  • Saudi-led airstrikes hit a funeral home in the Yemeni capital
  • At least 155 people killed, health ministry officials say

(CNN)The White House on Saturday condemned a Saudi-led coalition airstrike on a wake in Yemen that local health officials said killed at least 155 people.

“US security cooperation with Saudi Arabia is not a blank check,” US National Security Council Spokesman Ned Price said in a statement.
“Even as we assist Saudi Arabia regarding the defense of their territorial integrity, we have and will continue to express our serious concerns about the conflict in Yemen and how it has been waged.”

US 'not afraid' to raise Yemen concerns with Saudis

 US ‘not afraid’ to raise Yemen concerns with Saudis 02:00
Price added that the US would reevaluate its support for the coalition in its fight to prevent Houthi rebelsallied with Iran and forces loyal to Yemen’s deposed President Ali Abdullah Saleh from taking power.
“In light of this and other recent incidents, we have initiated an immediate review of our already significantly reduced support to the Saudi-led coalition and are prepared to adjust our support so as to better align with US principles, values and interests, including achieving an immediate and durable end to Yemen’s tragic conflict,” he said.
Earlier Saturday, the Saudi-led coalition denied accusations that it was responsible for the attack.
It later said it will “immediately investigate” reports that its warplanes were responsible for the airstrikes, according to the official Saudi Press Agency.

Yemen: A 'poor country's' forgotten war

 Yemen: A ‘poor country’s’ forgotten war 05:00
“The coalition confirms that its troops have clear instructions not to target populated areas and to avoid civilians,” SPA added.

‘Too heavy a price’

Witnesses of Saturday’s airstrike in Sanaa reported multiple civilian casualties at the wake, where hundreds of people had gathered to mourn the death of rebel-appointed Interior Minister Jalal al Rowaishan’s father.
In addition to the reported deaths, hundreds of attendees were also wounded in the strike, local health officials said.
At least 20 people lost limbs, according to medical staff at the German Hospital in Sanaa.

Saudi Arabia now spends more than Russia on defense

 Saudi Arabia now spends more than Russia on defense 01:20
Robert Mardini, regional director for the International Committee of the Red Cross, condemned what he called an “outrageous loss of civilian life.”
“Civilians in Yemen have already paid far too heavy a price these past 18 months,” he said in a statement.

Escalating crisis

The Saudi-led coalition, involving several Arab countries, began a military campaign in Yemen in March 2015 after Houthis — a minority Shia group supported by Iran — drove out the US-backed government, led by President Abdu Rabbu Mansour Hadi, and took over Sanaa.
The crisis quickly escalated into a multisided war, which allowed al Qaeda and ISIS — other enemies of the Houthis — to grow stronger amid the chaos.
Since peace talks in Kuwait failed in August, the coalition has intensified airstrikes, despite vocal criticism from rights groups that the bombardments have been indiscriminate and could constitute war crimes. The attacks have often hit civilian targets with devastating results.
The US has come under increasing pressure to stop selling arms to Saudi Arabia.
The US Senate last month rejected a bipartisan proposal to block a pending $1.15 billion United States arms sale to Riyadh.

Yemen: A 'poor country's' forgotten war

 Yemen: A ‘poor country’s’ forgotten war 05:00
Critics of the military deal, which was approved by the Obama administration, complained it could further drag the US into the war in Yemen and contribute to the worsening humanitarian crisis there.
Civilian casualties are only part of the crisis. Yemen’s UNICEF office has reported that nearly 10,000 children younger than 5 died from preventable diseases there during the past year.
Some 1.5 million children are currently malnourished in Yemen, and 370,000 of them suffer from severe acute malnutrition, according to the charity.
Yemen’s economic infrastructure has also been ravaged by war.
At least 430 factories and companies were destroyed by coalition airstrikes since the start of the conflict, according to Ahmed Bahri, political chief of the Sanaa-based Haq Party.