Irregular commentary on whatever's on my mind -- politics, sports, current events, and life in general. After twenty years of writing business and community newsletters, fifteen years of fantasy baseball newsletters, and two years of email "columns", this is, I suppose, the inevitable result: the awful conceit that someone might actually care to read what I have to say. Posts may be added often, rarely, or never again. As always, my mood and motivation are unpredictable.
Regarding healthcare, the Affordable Care Act is the law of the land. It's not fake news. The ACA is popular. You're not. Yet you're cheer-leading for the ACA's failure and threatening to sabotage it. Your behavior is petulant, childishly vengeful, and flat-out wrong. You're nothing but a kindergarten tyrant.
Cost-sharing reductions (CSR's) are not bailouts. They're part of the ACA law and a necessary mechanism in the big picture. So stop your hissy-fits and your bullying bullshit and pay the damn CSR's!
Then instruct Congress to work together in a bipartisan manner to stabilize premiums, strengthen the marketplace, and preserve the ACA. Voila!
If there's a glimmer of intelligence under that ludicrous hair-do of yours, you'll try to be constructive, and not just a bitter demolition man.
I've written to Sen. Rob Portman (R-Ohio) so often over the years, his staff has subscribed me to his weekly constituent newsletter, "Rob's Rundown." Receiving these regular doses of self-congratulatory disinformation is a privilege I never asked for. In fact, I've tried to unsubscribe, but the crap keeps running downhill into my email inbox no matter what.
The most recent bit of smug spin came on Saturday, where I learned from his staff that "Last week, his focus was on healthcare, where his goal is create a more workable system that lowers the cost of coverage and provides access to quality care, while protecting the most vulnerable in our society."
If those are really Robbie's goals, he has a funny way of showing it.
He voted yes to proceed with House's godawful AHCA, voted yes on the Senate's equally awful BCRA, and voted yes on the Senate's last-minute, half-baked skinny repeal. All three votes failed, but all three times, Rob was in favor of a destructive travesty which would have achieved precisely none of his "goals."
Robbie is a hypocritical fraud with zero credibility remaining.
The lovely Mrs. Gammons woke me at 6:00 this morning to report that the "skinny repeal" had failed in the Senate. For now, Buster breathes a sigh of relief. I'm grateful for the "no" votes of Senators Collins, Murkowski, and, in a surprisingly non-d'bag moment, John McCain. I have nothing but scorn for my own weak-kneed, lily-livered, spineless nancy-boy Senator, Robbie Portman.
McCain was a real surprise. Do you suppose he returned from the cancer ward to the Senate and voted "yes" on the motion to proceed, just so he could vote "no" on the ill-conceived repeal bill? Is he really that much of a sly fox, is he that calculating, or did he want to come back to D.C. just to give the finger to Trump? Don't know, don't care. Whatever his motivation, he did the right thing. Obamacare lives!
My heartfelt thanks go to all those good people who took time to write, call, or email their Senators to oppose the GOP's vile repeal attempt. I truly appreciate it. Sometimes, little actions really do help.
"Almost everything you do may seem insignificant, but it is most important that you do it." -- Mahatma Gandhi
Let me get this straight, Rob -- Now you're saying you'll vote for a repeal only if you can be sure it will never become law? You would actually consider voting in favor of a terrible "whatever" repeal bill, if you can make the House promise to NOT pass it, so you could then go into conference with the House's Freedom Caucus Teabag idiots in hopes of creating a "better" bill? Are you insane?
It's clear you dim bulbs don't have, and never have had, the slightest clue about how to make anything better for healthcare. All you care about is a "win," no matter the consequences for millions of Americans. It's deplorable.
I don't know if he's doing the fandango, but here is the new White House Communications Director "reporting directly to Trump."
Anthony Scaramucci is a combative, oily, vulgar, moussed-up, mobbed-up, deal-making money man. He's the stereotypical New York asshole we've all grown to hate. Naturally, he's Trump's kind of guy. The Mooch spends all day lying for a living, and lavishing undeserved praise on the Orange Shit-Gibbon. He's Trump's Mini-Me.
Montana Senator Steve Daines (R) will today introduce an amendment calling for the United States to adopt a Medicare-for-all, single-payer system.
Of course, as a rock-ribbed, freedom-loving, tax-hating wing-nut conservative, Daines is vehemently opposed to any such plan, and he knows it won't pass, but he's putting forth his amendment as a ploy to get those shameful Democrats on record as supporting the monstrous sort of humane, efficient, less costly, non-profit system used by the rest of the civilized world.
Dear readers, I need your help. Indeed, I'm begging for it.
In February, I was gobsmacked at the age of 62 by an out-of-nowhere diagnosis of Stage 4 lung and bone cancer. I had extensive surgery, a two-night hospital stay, and two weeks of radiation. My ongoing treatment is a very expensive targeted therapy daily oral drug, plus CT scans, bloodwork and a very expensive injection every eight weeks. This regimen will continue indefinitely, i.e. forever.
This sort of treatment is prohibitively expensive without good health insurance. And I'm fortunate to have good coverage via the ACA/Obamacare. I'm even more fortunate because, as a self-employed person, I've never had such quality coverage before and the ACA's premium subsidies make my plan truly affordable. My out-of-pocket costs are finally in line with those of good employer-provided plans with employer-subsidized premiums. Without the ACA, I could never afford the sort of individual health insurance which is currently keeping me alive.
I've been covered by the ACA/Obamacare since open enrollment started in 2013. Approximately 20 million people picked up coverage via the ACA, most of whom wouldn't be insured without it. Our nation's uninsured rate is at an all-time low. And Republicans would like to blow it all up and take it all away from us.
The GOP's efforts to destroy Obamacare have unprecedented opposition from physicians, hospital groups, healthcare advocates, insurers, and 87% of the American public. The various Republican "ideas" are opposed by the American Medical Assoc., the American Hospital Assoc., America's Health Insurance Plans, the Blue Cross-Blue Shield Assoc., AARP, and the American Academy of Actuaries, to name but a few.
Republican plans will raise costs dramatically on the sick and the old, and will deny coverage to somewhere between 16 million (the so-called "skinny" repeal) and 32 million (repeal only) Americans currently covered by health insurance.
The GOP doesn't give a shit about healthcare policy. Most of them know nothing about insurance. Their obsession -- all they care about -- is destroying the signature legislative accomplishment of President Obama.
Their cruelty and immorality is staggering, as they ignore all public outcry and demands to keep Obamacare and flush Trumpcare like the turd that it is. Since the House rolled out its hideous initial version back in March, I've been on pins and needles. And I've been active, attending an occasional protest and calling, writing, or emailing just about every day.
Now I'm tired, sad, frustrated, disgusted, and probably a bit depressed. The zombie of GOP healthcare destruction just won't die. Mitch senselessly wants to pass something, and quickly, and Trumpistopheles has said he'll sign anything.
We must keep fighting this abomination, and not just for my sake. Many lives are at stake. This is not about politics, it's about human decency and morality. I have relatives and friends with autistic children. I know people with physical disabilities and mental disorders. They all need lots of expensive care, and will for the rest of their lives. Think about those folks, and all those like them. They'll get hurt if the GOP succeeds with their craven scheme.
I'm not giving up, but I need your help. Please help me! If you're in Ohio, please commit to calling or emailing Senator Portman at least once a day from now on. Two or three times a day is better. Tell him that 87% of Americans oppose Trumpcare, he must therefore reject any version of Trumpcare, and must NOT repeal Obamacare.
Here is Portman's email link: https://www.portman.senate.gov/public/index.cfm/contact-form
His D.C. office phone number is 202-224-3353.
If you're not in Ohio, please call or email your Republican senator every day with the same message.
This is what can happen when you speak without any preparation or notes.
Yesterday, Trumpenstein addressed the National Boy Scout Jamboree in West Virginia. And he delivered one the most inarticulate, incoherent, rambling, sneering, inappropriate hot messes of narcissistic verbal diarrhea ever heard anywhere. They say the man doesn't drink, but I'm not so sure.
Straight from the horse's ass, I mean mouth, here's some of what he had to say to the Boy Scouts (mind you, the Boy Scouts!):
Tonight we put aside the fake news and all of that.
Who the hell wants to speak about politics in front of the Boy Scouts?
Washington, it's not a good place. We ought to change it from the word "swamp" to the word "cesspool" or maybe the word "sewer."
[HHS Secretary] Tom Price is here. He better get the votes [to repeal Obamacare]. Otherwise, I'll say, "Tom, you're fired!"
The fake media will say, "President Trump spoke before a small group of Boy Scouts." Fake media. Fake news.
William Levitt sold his company for a tremendous amount of money. And he went out and bought a yacht and he had a very interesting life.
In the end, he failed badly, lost all his money, went personally bankrupt. And I saw him at a cocktail party. And it was sad because all the hottest people in New York were at this party.
You remember that incredible night with the maps?
We won and won.
The polls, that's also fake news. They're fake polls.
Merry Christmas. You're going to be saying, "Merry Christmas" again, folks.
By the way, do you see the billions and billions and billions of additional money that we're putting back into our military?
Everywhere it sails, that great Scout's name will be feared!
The great Andy Borowitz of The New Yorker could not remain silent.
Girl Scouts Obtain Restraining Order Against Trump
WASHINGTON (The Borowitz Report) -- In an extraordinary rebuke of the President of the United States, the Girls Scouts of the U.S.A. have obtained a restraining order against Donald J. Trump.
The order, which was granted Monday night, prevents Trump from coming withing three hundred feet of any gathering of the Girl Scouts organization.
Carol Foyler, a Girls Scouts spokesperson, said that while the G.S.U.S.A. sought the restraining order "out of an abundance of caution," the girls themselves were "in no way, shape, or form" afraid of President Trump.
"They're prepared to deal with bobcats and bears," she said. "They can handle a malignant narcissist."
Trump wasted little time responding to the Girl Scouts action, lashing out at the organization in an early-morning tweet storm.
"Failing Girls Scouts bad (or sick) guys," Trump wrote. "Mints, cookies terrible. Sad!"
My email to Rob Portman in advance of today's Senate vote on some version of the undead TrumpCare monster.
Subject: Vote NO today on motion to proceed on healthcare
It's me again, Rob, your 62 year-old constituent with Stage 4 cancer being kept alive by Obamacare.
I'm tremendously disturbed to hear you say that whichever slap-dash version of ACA destruction Mitch puts forward today "doesn't matter" to you. Are you nuts? Of course it matters, because they're all awful, rotten, and opposed by the overwhelming majority of Americans. But this doesn't matter to you and you'd like to debate any of those horrible options anyway? Why? There's nothing to debate. They all suck and are undeserving of consideration.
What you should do is focus on the healthcare system already in place, and work to strengthen and improve it.
I'm also tremendously disturbed that you lack the spine to come out publicly and say so.
Be a man today, and do what's right. Vote NO on any motion to proceed! _____________________________________
In a desperate D.C. speech today, Donny Distemper was in snarling attack-dog mode, bashing Obamacare and trying to threaten/shame/arm-twist Republican Senators into voting tomorrow on a motion to proceed with . . . something, not sure what exactly, but something. Standing in front of a group of "victims" (victims!), Putin's Puppet railed ridiculously against the ACA, calling it "death," a "government takeover of healthcare," and a "nightmare." He said "Obamacare has wreaked havoc for the past 17 years," (or seven, whatever) and he urged his reluctant GOP troops to "keep their promise" (to destroy the best healthcare America has ever known).
Blow it out your ass, Donnie! Republican Senators aren't even sure what they'll be voting on tomorrow. A motion to proceed . . . with what? With McCain unavailable, Mitch has no margin of error. Looks like Trumpcare will remain, for now, a dead duck.
Hi Rob. It’s me
again, your 62 year-old constituent with Stage 4 cancer being kept alive by
Please ignore the threats from the lunatic in the Oval
Office. Today he said the GOP made “a
solemn vow” to repeal and replace the ACA.
It was not a vow; it was a stupid, silly campaign slogan, nothing more. He also says that any Republican Senators who
vote against the awful, rotten BCRA Senate bill are “telling America you are
fine with Obamacare.”
I’m fine with Obamacare, Rob. So are the majority of Americans. It’s not a “nightmare,” it’s not “death,” and
there are no “victims.” But there will
be plenty of real victims if you vote to proceed with Mitch’s abomination.
Vote NO on any motion to proceed! Vote NO on the BCRA!
Vote NO on any repeal & replace scheme! Keep Obamacare and work to strengthen and
preserve it. I’ll be watching very
During Trump's remarks, I did notice one unmistakable victim of the Obamacare nightmare. Just look at what the government takeover of healthcare has done to this woman's eyebrows! Poor thing -- that's just tragic!
As I mentioned, I've sent my weak-kneed Senator a pro-ACA email every day ever since this TrumpCare crap started. Demonstrating just how much he cares about this issue, and how closely he follows the concerns of his constituents, I received this email response from him this morning:
"Dear Buster, Thank you for contacting me to express your views on the Over-the-Counter Hearing Aid Act of 2017. It is good to hear from you. As you know, nearly 48 million Americans suffer from various forms of hearing impediments. . . . "
And apparently Robbie is among those 48 million! I sent him a hundred messages on the importance of Obamacare, and he never responded once. Not once!
"Fuck Obamacare. Let's talk about hearing aids."
But he does "respond" to something that never occurred. I never, ever contacted him on the Over-the-Counter Hearing Aid Act. Don't know what it is, and don't care.
This one will be of interest mainly to Ohio readers.
About a month ago, I had a post which discussed Ohio Issue 2, a.k.a. the Drug Price Relief Act, a citizen initiative which will appear on the November ballot. Issue 2 would prohibit the state from paying more for any prescription drug than the lowest price paid for the same drug by the VA. Ohio pays for drugs for approximately 4 million Medicaid recipients and state employees.
In that post, http://bustergammons.blogspot.com/2017/06/big-money-battle-over-ohios-drug-price.html , I said I'd be inclined to vote for Issue 2 because of scare-tactic advertising by its deep-pocket opponents in the drug industry. That well-financed opposition has some heavy hitters, including the Pharmaceutical Research & Manufacturers of America (PhRMA), the huge drug-maker lobby. Also opposed to Issue 2 are the predictably conservative Ohio Chamber of Commerce, various local Chambers, drug and medical trade associations, and the Buckeye Institute -- a far right-wing advocacy group, part of a network of of state pressure groups aligned with ALEC, the corporate-funded operation churning out business-wish-list legislation for state and local lawmakers.
In that June post, I held out the possibility that I could be persuaded to change my mind. Dale Butland, spokesperson for the anti-Issue 2 group Ohioans Against the Deceptive Rx Ballot Issue, contacted me and offered to take me up on it. He sent me a link to a radio interview and to his group's website. We exchanged phone numbers and I promised to call, but I haven't. Mr. Butland is a well-known Democrat, and the former press secretary and chief of staff for the late Senators Howard Metzenbaum and John Glenn. He's also the former spokesman for Innovation Ohio. I have great respect for him. (If you're reading, Dale, sorry to wimp out on the call-back. I did listen to the radio show and perused the websites of both sides.) Here are the links to both sites:
This morning I read the one-sided Columbus Dispatch editorial opposing Issue 2 and urging a no vote. It could have been written by Ohioans Against the Deceptive Rx Ballot Issue. Maybe it was. It was filled with all the same FUD-inducing words: might, could, unpredictable, potentially, unknown, higher costs, deceptive with little explanation of why and how.After reading the other available info and today's editorial, I am convinced that voting for Issue 2 is the right thing to do. I don't normally disagree with Mr. Butland, so call this the exception that proves the rule.
The arguments against Issue 2 are these, with counterpoints in red:
It doesn't cover all Ohioans, only Medicaid recipients and state employees. So what? It covers 4 million Ohioans.
The Medicaid drug prices for Ohio are already discounted 23%, which is almost the same as the VA's standard 24% discount. So there's no real benefit. But there's no harm either. And importantly, if there's no benefit, no real price reduction, why is PhRMA spending a fortune to fight so hard against it?
The VA negotiates discounts deeper than the required 24%. Those lower prices aren't published, and are subject to frequent change. Opponents say this means Ohio can't find out the real VA price, which would make Issue 2 "functionally impossible to comply with." Huh? You're saying the VA would just refuse to divulge its discounted price info if required by law to do so? Why would they do that?
The claim of $400 million annually in drug cost savings is exaggerated. Maybe, but opponents don't claim it won't save money, only that it mightnot, due to uncertainty. And the drug makers are obviously not losing money at VA prices.
Opponents paint a picture of a zero-sum game, where drug makers always maintain a steady margin, no matter what. They claim that if Issue 2 forces a price cut here, drug companies will retaliate by jacking up their prices over there, meaning higher prices to the VA or across-the-board to all of us. So we better let drug makers keep having it their way, or else they might/could/maybe would fuck us even worse.Do you believe the pharmaceutical industry would take petty vengeance on Ohio for insisting on somewhat larger discounts for Medicaid recipients? Do think the drug makers would find it wise to very publicly adopt the full-greed, screw-you posture of Mylan EpiPen or "Pharma Bro" Martin Shkreli? Or might they more reasonably decide the mandated pricing isn't so bad after all, since they'd still be holding sufficient profit margins?
The anti-Issue 2 side is engaging in the sort of speculation, fear-mongering and negative ad messaging typically found in conservative political campaigning. I understand that Issue 2 comes without guarantees, but for all their scare tactics about higher costs and what might happen or could happen, Issue 2 could just as easily trigger overall drug price reductions for Ohioans not directly involved with the state. Whatever its consequences if passed, Issue 2 surely won't bring the apocalypse threatened by its opponents.
I also think its useful to consider the big-money interests fighting so hard and spending so freely to defeat Issue 2. I cannot recall the PhRMA lobby, the Chamber of Commerce, the Buckeye Institute, or ALEC demonstrating a history of being consumer-friendly, and I seriously doubt these leopards have suddenly changed their spots. Facing such opposition, Issue 2 faces a difficult uphill battle.
Issue 2 is supported and primarily funded by the AIDS Healthcare Foundation (AHF), a California non-profit.
Hi Rob. It's me again, your 62-year-old constituent with Stage 4 cancer being kept alive by Obamacare.
It should be abundantly clear to you that while the GOP's constant refrain of "repeal and replace" may have once had some value as a campaign slogan, it was always a stupid "promise" and is utterly useless in its practical application. Tens of millions of Americans losing healthcare, discriminatory price hikes on the sick and elderly, huge tax breaks for the insurance, pharma, and medical device industries? C'mon. There is no political capital to be gained by passing any version of the BCRA. There is only political suicide. You'll just wind up looking like a bunch of ignorant, cruel jerks.
You owe absolutely nothing to that crazy asshole in the Oval Office. Forget him, and remember what your colleague Shelley Moore Capito said -- you didn't come here to hurt people. The ACA and its Medicaid expansion doesn't hurt people, it helps people. The ACA is established law, it's good law, it's popular law, and you'll have hell to pay if you take it away.
So don't. Forget repeal and replace. Keep the ACA and do everything you can to strengthen and improve it by stabilizing its pricing and participation.
Hardly news, but he just keeps getting crazier. Nothing is ever his fault, it's a witch hunt and everybody's out to get him, and it's all "very unfair to the president."
Lying Attorney General Jeff Sessions should not have recused himself. "Extremely unfair."
Special Investigator Robert Mueller has "many conflicts of interest." (Donnie ought to know all about conflicts of interest.)
So does Deputy A.G. Rod Rosenstein, who's from "Baltimore, where there are very few Republicans."
At the G-20, Donnie and Vladi merely exchanged "pleasantries" and "talked about adoption. It was very interesting."
French President Emmanuel Macron "loves holding my hand."
"Enemies of mine are saying [my speech in Poland] was the greatest speech ever made on foreign soil by a president."
"Napoleon didn't go to Russia that night because he had extracurricular activities, and they froze to death. Same thing happened to Hitler. He was all set to walk in, but it went and dropped to 35 below. But the Russians have great fighters in the cold. I mean, they've won five wars where the armies that went against them froze to death. . . . So, we're having a good time!" (Huh?)
Speaking about health insurance: "So pre-exisitng conditions are a tough deal. Because you are basically saying from the moment the insurance, you're 21 years old, you start working and you're paying $12 a year for insurance, and by the time you're 70, you get a nice plan." (Huh? And WTF?? That's not how insurance works.)
"For the time in office, five months and a couple weeks, I think I've done more than anyone else."
Current events, history, insurance, etc. -- no one knows less but says more crap than Lord Tiny Hands, King of Bullshit. His every word is a lie.
For more of his ignorant, delusional ramblings, click the link.
"Repeal and replace!" Since 2009, that's been the GOP's rallying cry in the Congress. They actually believe their slogan is a viable policy, and most of them believe it's what got them elected. But the majority of Americans approve of Obamacare, and overwhelming majorities prefer it to any replacement alternative the Republicans have come up with.
Orange John Boehner tried and failed to pass a repeal bill about a million times. After an initial fail, on his second try Paulie Smallnuts Ryan -- or as Steve Bannon calls him, that "limp-dicked mofo" -- passed a repeal bill in his GOP House which then failed to pass the GOP-controlled Senate. Mitch McConnell whipped up a quickie Senate version which also failed to pass in his own Senate. Then the Kentucky Tortoise went for a long-shot repeal-only abomination which failed immediately! Didn't even last a day. Hilarious incompetence! And well-deserved failure. The repeal zombie may finally be dead.
After all this Republican failure, Donnie Distemper accepted no responsibility and blamed it all on the obstructionist Democrats -- "We're not going to own it. I'm not going to own it. Republicans aren't going to own it." -- and proclaimed he'd just "let Obamacare fail" and would then expect Democrats to come crawling, begging him for help.
Good luck with that skeevy plan, Don. The "failing Obamacare" narrative is dubious, and if you believe the American public will idly stand by as you sabotage the ACA, you're even dumber than you look.
Hi Rob. It's me again, your 62-year-old constituent with Stage 4 cancer being kept alive by Obamacare.
"Phew! That was a close one!"
I'm sure you're breathing a big sigh of relief this morning. When your GOP colleagues, Mike Lee and Jerry Moran, announced their opposition to a motion to proceed on the Senate healthcare bill, they did you a big favor -- they let you avoid your responsibility to make a decision and publicly announce your own position. Lucky you, eh? You probably should buy Mike and Jerry a nice dinner.
But now your feckless Senate leader Mitch McConnell says he wants to punt. He proposes you pass a complete repeal of the ACA now, but with a two-year delay before repeal would take effect. In other words, kill it now and worry about it later. (Or, in personal terms for me, I can live another two years, but after that, good luck.) WTF???
You couldn't possibly dream up a more cynical, contemptuous, immoral idea. You think you had a shit storm with your previous plans? Just try to make this lead balloon fly.
You can't escape your duty. Once again, Robbie, it's going to fall to you and other so-called "moderates" to do the right thing and save the Senate from itself. Repealing the ACA remains a horrible and unpopular idea. Be a man, stand up today and publicly renounce Mitch's disgusting "repeal now, worry later" scheme. Vote NO!
The White House established its sham "Election Integrity Commission" to "prove" the lie that Hillary received 5 million illegal votes and therefore DT really did win the popular vote. The Integrity Commission, led by infamous Kansas vote suppressor Kris Kobach, immediately asked every state to provide personal information on all of its registered voters, including addresses, Social Security numbers, party affiliation, and voting history. Most states immediately told Kobach to stuff it up his ass and snap it off.
Many thousands of citizens chimed in as well, expressing their anger and disgust about such invasions of privacy in emails sent to the Integrity Commission. Demonstrating just how much integrity it really has, the Commission released 112 pages of these emails, with the senders' personal information there for all to see -- names, addresses, email addresses, phone numbers, and places of employment.
To secure votes for his latest version of TrumpCare, which is opposed by the medical/hospital industry and by 85% of the American people, here's Mitch's slimy sales pitch: _______________________________________________
By Steve Benen, on the MaddowBlog
The Washington Postreports today, however, that Senate Majority Leader Mitch McConnell (R-KY) has an argument intended to reassure his members concerned about Medicaid’s future.
Here’s what McConnell has told several hesitant senators, including Sen. Rob Portman (R-OH) and Sen. Shelley Moore Capito (R-WV):
The bill’s deepest Medicaid cuts are far into the future, and they’ll never go into effect anyway.
“He’s trying to sell the pragmatists like Portman, like Capito, on the idea the CPI-U* cut will never happen,” a GOP lobbyist and former Hill staffer told me.
(*Based on the Consumer Price Index-Urban, the bill calls for a 26% cut in Medicaid spending in 2026.)
In other words, the current iteration of the Republican health care legislation will include brutal cuts to Medicaid, but the GOP’s less conservative senators can vote for it anyway, confident in the idea that, in the future, policymakers will intervene to make sure this policy isn’t actually implemented.
Take a moment to consider just how cynical this is. Senators are supposed to vote, on purpose, for legislation they know would do real harm to their constituents, based on assurances from Mitch McConnell that someone, at some point, in some way, will clean up the mess they voted for.
Of course, this would occur long after they'd been re-elected.
This isn’t how responsible legislating in a mature democracy is supposed to work.
In addition to this truly ridiculous approach to policymaking on a life-or-death issue, members tempted to go along with such a gambit might want to consider how they’ll answer voters’ questions on this.
Republican lawmakers might find it difficult to tell the people they represent, “Sure, I voted against your interests, but only because I received assurances that the policies I approved won’t actually be implemented.”
Hi Rob. It's me once again, your 62-year-old constituent with Stage 4 cancer being kept alive by Obamacare.
The BCRA Version 2 released today is still cruel and repugnant. It's still a huge tax cut for Big Pharma and Big Insurance. It still guts Medicaid, taxes older Americans, doesn’t cover essential health benefits like maternity care, will cause out-of-pocket costs to skyrocket, defunds Planned Parenthood, and contains a perverted concept of “choice” -- quarantining sick people into high risk pools while further stripping away coverage for people with pre-existing conditions.
It adds more money for opioid treatment. Nice, but don't let yourself be bought for one small benefit in an ocean of detriment. Don't be a sell-out!
It's me again, Rob, with ideas on how to preserve, stabilize and strengthen the Affordable Care Act. This is a long one, so I know neither you nor your staff will read it, but you really should.
Despite Secretary Tom Price's ignorant rhetoric, the Dept. of Health & Human Services confirmed last week that the ACA is "working as intended." This was followed on Monday by a new analysis of the first quarter 2017 ACA results from the non-profit Kaiser Family Foundation, which found that "Insurer financial data suggest stabilizing individual health insurance markets," and "We find no evidence of the individual market collapsing."
So we can dispense with the fiction that Obamacare is "failing" and "in a death spiral." It's not. But, operating effectively as a large group insurance system, it could be further stabilized and strengthened by encouraging increased participation from insurers and enrollees. Here's how:
1. Continue to fully fund the ACA's cost-sharing subsidies. These are not premium subsidies. Instead, they subsidize out-of-pocket costs of deductibles and co-pays for certain low-income insureds. Insurance companies cover these costs up front and are reimbursed by the federal government. Reimbursement is now in doubt due to a GOP lawsuit alleging the ACA doesn't have funding authority for such payments. The case is in limbo while you R's screw around with TrumpCare. But some insurance carriers have withdrawn from the ACA exchanges as Trump threatens to renege on these cost-sharing payments in 2018.
2. Continue to enforce the ACA's individual mandate and penalties for non-compliance. Although Trump threatened to waive the requirement, the IRS continues to issue and collect penalties from taxpayers who refused to buy health insurance. That's good. But your GOP bills would eliminate penalties on both individuals and employers of 50 or more. That would be bad -- a participation disincentive that would allow the number of enrollees in the group to shrink. Our largest group plans are Social Security and Medicare, and they're mandatory. Virtually all working people must participate and pay into them. Our approach with the ACA must be the same -- everyone benefits when the group is as large as possible. The "choice" argument made by some conservatives is bogus. So is the idea of high-risk pools to isolate those with expensive treatment needs. Think "big group!" Spread the risks over large numbers.
3. Remember the "A" stands for affordable. Maintain the ACA's premium subsidies at the current level using the existing income-based calculations. In fact, to increase the group size for the benefit of all, consider making the premium and cost-sharing subsidies more generous, not less. This would entice more people to enroll and stay enrolled, which would in turn encourage more insurance carriers to participate. Maintain the ACA's Medicaid expansion. Slashing the Medicaid rolls is unconscionable. Keep thinking "big group!" Young or old, rich or poor, healthy or sick, this is just a numbers game. Everybody into the pool!
4. Remember the "C" stands for care. So keep the ACA's benchmark actuarial value and essential benefits. Your plan to reduce the ACA's "silver" plan benchmark from 70% AV (insurance paying 70% of covered services) to 58% is a deception and bad health insurance policy. So is eliminating the ACA's required "essential medical benefits." Such tactics are included in the Senate bill so the GOP may give the illusion they've "lowered" premium costs, when all you really did was greatly reduce coverage. Giving me less covered care, then crowing about how you've saved me money is no care at all -- it's a crock!
5. Reinstate the recently-expired risk adjustment, reinsurance and risk corridor programs which helped stabilize premiums. Make them a permanent part of the ACA. Such programs are a great help to insurance companies in maintaining steady, affordable premiums.
6. Make a government-run public option plan available on the federal and state exchanges, at least in areas where only one or two carriers now participate. Ideally, a public option should be a part of the exchanges in every state coast to coast. It would improve competition and offer us a genuine choice. (Insurance companies hate this idea, but remember you work for us, not them.) A simple and easy starting point would be to lower the Medicare eligibility age from 65 to, say, 50, and offer that option on the health insurance exchanges.
7. If necessary, use government controls to stabilize participation and pricing on the exchanges.
Require two or three insurance companies to participate on each state's exchange. Hand-pick those companies if necessary.
Based on income tax returns, automatically enroll certain low-income individuals in an affordable exchange plan if they don't choose one on their own. Medicare does this, and it guarantees a certain level of participants.
Require everyone purchasing individual health insurance to do so on the exchanges. Washington D.C. does this with their health insurance exchange, and it seems to work pretty well. Again, keep thinking "big group!"
Institute government price controls on premiums as a last resort. We've used price controls during WW II, the Korean war, and in the early 1970's. It's a strong step, but it can be effective.
Focus your efforts on these critical health care ideas to stabilize and improve the ACA, and forget that cobbled-together piece of crap that Mitch released today. Leave well enough alone. The TrumpCare/BCRA Version 2 is still a loser. Vote NO!
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