On March 24, the Congressional Budget Office, or CBO, published data that surprised even the staunchest advocates for health care reform: New estimates show that total federal spending in fiscal year 2016 for major health care programs will be lower than was projected back in January 2009. Why is this shocking? The January 2009 projections did not include the Affordable Care Act, or ACA, which was not signed into law until March 2010. This means that federal health programs are covering more people while spending less money.
Though the ACA coverage expansion added new costs, total spending for federal health programs is still less than what the CBO projected in January 2009 because of huge savings from Medicare. In fact, the CBO’s projections for FY 2016 Medicare spending have fallen $107 billion since January 2009. A portion of the Medicare savings can be unambiguously attributed to the ACA.
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).
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)
After the 62nd vote to repeal “Obamacare” (the Patient Protection and Affordable Care Act) which has now been upheld by the Supreme Court TWICE, the Republiban members of Congress finally managed to pass HR 3762. Inaptly named, the bill that would have done the exact opposite of its title: “Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015.” Restoring “Americans'” freedom? Nope! More like restoring the freedom for Insurance Corporations to give Americans the short shrift related to any hope of accessing healthcare insurance and thus health care itself.
And just so you know, each and every Nevada Republican in the House of Representatives, Rep. Mark Amodei (CD2), Rep. Joe Heck (CD3), and Rep. Cresant Hardy (CD4) voted FOR passage of HR 3762 (as well as a large number of previous bills) which would not just repeal the Affordable Care Act for millions of Americans who can barely afford health insurance as it is, but would have also revoked any and all funding received by Planned Parenthood by folks who not only can’t afford health insurance, but can’t afford health care either. Senator Dean Heller also voted FOR passage(repeal) in the Senate in December preceding the vote in the House.
Today, at the stroke of his pen, President Obama showed us exactly HOW important it is that we have a Democratic President in the oval office as he promptly and unceremoniously vetoed their wasted efforts. Here’s his message back to Congress:
TO THE HOUSE OF REPRESENTATIVES:
I am returning herewith without my approval H.R. 3762, which provides for reconciliation pursuant to section 2002 of the concurrent resolution on the budget for fiscal year 2016, herein referred to as the Reconciliation Act. This legislation would not only repeal parts of the Affordable Care Act, but would reverse the significant progress we have made in improving health care in America. The Affordable Care Act includes a set of fairer rules and stronger consumer protections that have made health care coverage more affordable, more attainable, and more patient centered. And it is working. About 17.6 million Americans have gained health care coverage as the law’s coverage provisions have taken effect. The Nation’s uninsured rate now stands at its lowest level ever, and demand for Marketplace coverage during December 2015 was at an all-time high. Health care costs are lower than expected when the law was passed, and health care quality is higher — with improvements in patient safety saving an estimated 87,000 lives. Health care has changed for the better, setting this country on a smarter, stronger course.
The Reconciliation Act would reverse that course. The Congressional Budget Office estimates that the legislation would increase the number of uninsured Americans by 22 million after 2017. The Council of Economic Advisers estimates that this reduction in health care coverage could mean, each year, more than 900,000 fewer people getting all their needed care, more than 1.2 million additional people having trouble paying other bills due to higher medical costs, and potentially more than 10,000 additional deaths. This legislation would cost millions of hard-working middle-class families the security of affordable health coverage they deserve. Reliable health care coverage would no longer be a right for everyone: it would return to being a privilege for a few.
The legislation’s implications extend far beyond those who would become uninsured. For example, about 150 million Americans with employer-based insurance would be at risk of higher premiums and lower wages. And it would cause the cost of health coverage for people buying it on their own to skyrocket.
The Reconciliation Act would also effectively defund Planned Parenthood. Planned Parenthood uses both Federal and non-federal funds to provide a range of important preventive care and health services, including health screenings, vaccinations, and check-ups to millions of men and women who visit their health centers annually. Longstanding Federal policy already prohibits the use of Federal funds for abortions, except in cases of rape or incest or when the life of the woman would be endangered. By eliminating Federal Medicaid funding for a major provider of health care, H.R. 3762 would limit access to health care for men, women, and families across the Nation, and would disproportionately impact low-income individuals.
Republicans in the Congress have attempted to repeal or undermine the Affordable Care Act over 50 times. Rather than refighting old political battles by once again voting to repeal basic protections that provide security for the middle class, Members of Congress should be working together to grow the economy, strengthen middle-class families, and create new jobs. Because of the harm this bill would cause to the health and financial security of millions of Americans, it has earned my veto.
The Republiban may have used procedural shenanigans to enable them to pass HR 3762, but to override President Obama’s veto, the Republiban would need a two-thirds affirmative vote on repeal bill. The don’t have that. This was all for show for the rabid GOP base heading into the November election. But more than that, it’s a serious red-flag warning to Democrats that if we don’t overwhelm the polls this November to begin taking back Congress, and instead all the Republiban to hold onto Congress plus, take the White House, you can kiss the American Dream goodbye and buy the coffin as it will truly be dead.
Republicans, 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.
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.
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.
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.”
Clinton vs. Sanders vs. O’Malley On Fixing Banking
How do we fix Wall Street, a.k.a. “the banks”? How do the candidates compare? … The first place to look, of course, is CAF’s Candidate Scorecard … Clinton’s 63 percent rating is primarily based on not having a position on a financial transaction tax … as well as opposing reinstating some form of a Glass-Steagall Act and a lack of specific proposals related to the categories “Break Up Big Banks” and “Affordable Banking.” Meanwhile, Sanders rates 100 percent … O’Malley is stressing his positions on and independence from Wall Street [and] also has a 100 percent…
Blue States Make Voting Easier as Red States Add Restrictions
“In Illinois, a new provision allows voters to register electronically when they visit various state agencies. And in Delaware, some residents with criminal records will regain the right to vote … In Republican-controlled states, the story is different. North Carolina has instituted a new voter ID requirement. North Dakota has narrowed the forms of identification voters can present … Ohio’s GOP-controlled legislature has instituted … shorter early voting hours.” Meanwhile, here at home in Nevada, folks who wish to participate in the Democratic County Caucuses will enjoy the ability to “same-day” register to participate, while Republican caucus goers will need to have registered at least 10 days prior to the caucus date AND will be required to present a government issued photo ID card … no indication as to which will be allowed and which will not (e.g., will VA photo IDs be accepted?).
Ex-Gov turned Democrat Charlie Crist announced a run for U.S. House
On Tuesday, ex-Gov. Charlie Crist announced that he would run for the St. Petersburg FL-13 seat. Crist said all the way back in July that he’d run for this seat if he lived in it after redistricting, so this announcement was no surprise. However, Republican Rep. David Jolly, who is leaving this district behind to run for the Senate, unexpectedly crashed what would have otherwise been a routine campaign kickoff. Jolly told reporters that he cares too much about the seat “to lay down and let this huckster walk into office.” Republicans utterly hate Crist, who left the party in 2010, so this kind of stunt certainly won’t hurt Jolly’s chances in the GOP primary. If Crist wins, he’ll be one of only a few ex-governors to be elected to the House. The University of Minnesota’s Smart Politics blog finds that in the last half-century, only four other ex-governors have done this, and none of them had run a state anywhere near as large as Florida.
Meanwhile in the House of Representatives, the Freedom Caucus is vowing not to play nice —all this at a crucial time when some pretty critical votes will need to be taken:
A vote will be needed to pass a fiscal budget, not yet another let’s kick the can down the road continuing resolution to extend the current (previous) budget that was passed, and
A vote will be needed regarding the Iran Deal, which the US and other foreign nations have already begun to implement regardless of any approval/disapproval from our disfunctional Congress.
November should prove quite interesting. But, if all of that that is not enough agitprop for your tastes, Speaker Boehner is proposing that it’s possible that they could actually “repeal Obamacare” by the end of the year. What is he smoking, drinking or otherwise ingesting? Apparently he thinks President Obama is just gonna roll over and sign onto their repeal efforts taking away any and all opportunities for millions of Americans to be able to purchase health care insurance. Somebody needs to throw some ice water in his face and yell “Wake Up Bozo!”
Rep. Paul Ryan announces speaker bid, with conditions. NYT: “…Ryan called for … an end to the antics of ‘bomb throwers and hand wringers,’ according to members in the room … He suggested that he wanted an answer by Friday. Mr. Ryan made it clear that he would not accede to preconditions set by ‘one group,’ a clear reference to the members of the hard-line Freedom Caucus…”
Freedom Caucus resists. Politico: “They were dismissive of his Ryan’s request that they relinquish a procedural tactic they used to threaten to strip outgoing Speaker John Boehner of his title – one of the most potent weapons in the group’s arsenal.”
The House of Representative is in chaos. John Boehner announced his intention to step down as Speaker at the end of the month. There doesn’t appear to be anyone to take his place. The leading candidate, Majority Leader Kevin McCarthy, abruptly withdrew from the race yesterday. Another popular choice, Paul Ryan, says he’s not interested.What happened? How did we get to this point? One document, produced by the House Freedom Caucus, holds all the answers. Framed as a “questionnaire” the document effectively makes it impossible for any candidate to both: (1) Get elected speaker, and (2) Not send the entire country (and maybe the world) over a cliff.
Why the Freedom Caucus has so much power
The House Freedom Caucus, a relatively new group of about 40 Republicans loosely associated with the Tea Party, has an extraordinary amount of power in this process. Any potential speaker needs the support of 218 Republicans on the floor of the House. There are currently 247 Republicans in the House. That’s a large majority but without the Freedom Caucus, no candidate can get to 218.
What the Freedom Caucus says they want
The Freedom Caucus says they are just fighting for arcane rule changes that will enhance “democracy” in the House. On CNN yesterday, David Brat, a prominent member of the Freedom Caucus outlined his criteria for a new speaker. (You may remember Brat for his surprise victory over Eric Cantor, the man many assumed would replace Boehner as speaker.)
Anyone that ensures a fair process for all sides. That’s what we are all looking for, right… We’ve shown principle. We are waiting for leadership candidates to put in writing moves that ensure you have a democratic process within our own conference. That is what everyone is waiting to see. And it’s got to be in writing, ahead of time for that to be credible.
Sounds perfectly reasonable, right?
What the Freedom Caucus actually wants
Yesterday, Politico published the House Freedom Caucus “questionnaire”which it described as pushing for “House rule changes.” The document does do that. But it also does a lot more. It seeks substantive commitments from the next speaker that would effectively send the entire country into a tailspin.
For example, the document seeks a commitment from the next speaker to tie any increase in the debt ceiling to cuts to Social Security, Medicare and Medicaid.
Cutting Social Security, Medicare and Medicaid is extremely unpopular, even among Republicans. These programs are sacrosanct to most Democratic members of Congress. There is effectively no chance that President Obama or Senate Democrats — both of whom would need to support such legislation — would agree to “structural entitlement reforms” in the next month under these kind of conditions.
The House Freedom Caucus essentially wants to make it impossible for the next speaker to raise the debt ceiling. But that is just the beginning.
The House Freedom Caucus also wants the next speaker to commit to numerous conditions on any agreement to avoid a government shutdown:
The House Freedom Caucus wants the next speaker to commit to not funding the government at all unless President Obama (and Senate Democrats) agree to defund Obamacare, Planned Parenthood and a host of other priorities. This is essentially the Ted Cruz strategy which prompted at 16-day shutdown in 2013. They’re demanding to have this now be enshrined as the official policy of the Speaker of The House.
The House Freedom Caucus wants the next speaker to commit to oppose any “omnibus” bill that would keep the government running. Rather, funding for each aspect of government could only be approved by separate bills. This would allow the Republicans to attempt to finance certain favored aspects of government (the military), while shuttering ones they view as largely unnecessary (education, health).
Why McCarthy thinks the House might be ungovernable
For McCarthy, the document helps explain why he dropped out of the race. If he doesn’t agree to the demands of the House Freedom Caucus, he cannot secure enough votes to become speaker. But if he does agree to their demands, he will unable to pass legislation that is necessary to avoid disastrous consequences for the country.
Top Republicans are calling Paul Ryan and begging him to be speaker. But thus far, he hasn’t agreed to run. None of the candidates currently running appear to have substantial support.
The agenda of the House Freedom Caucus makes a difficult job effectively impossible. Agreeing to their demands means presiding over a period of unprecedented dysfunction in the United States.
Even if a candidate was able to become speaker without formally agreeing to the Freedom Caucus’ most extreme requirements, one would still have to deal with the group — and a larger group of House Republicans sympathetic to them — in order to get anything done.
This is why Boehner wanted out and why no one really wants to take his place.
I’m very pleased that many presidential candidates will be here today to address you. It is a signal that the work you’ve been doing – laboring in the vineyards for decades – is getting the political attention it deserves. But the real test of a candidate’s commitment is not whether we come to speak at your national conference, as important as that is. It’s whether we’re still around after the cameras are gone and the votes are counted. It’s whether our positions live up to our rhetoric.
And too often we see a mismatch between what some candidates say in venues like this, and what they actually do when they’re elected. I don’t think you can credibly say that everyone has a “right to rise” and then say you’re for phasing out Medicare or for repealing Obamacare. People can’t rise if they can’t afford health care. They can’t rise if the minimum wage is too low to live on. They can’t rise if their governor makes it harder for them to get a college education. And you cannot seriously talk about the right to rise and support laws that deny the right to vote.
On November 14, the U.S. Supreme Court announced that it would take up the case King v. Burwell, which challenges health premium subsidies at the heart of the Affordable Care Act. While that case has received loads of attention, what’s been unexamined is private foundations helping to pay for this and other lawsuits against Obamacare. Philanthropic support for the legal attack on Obamacare is just one way that funders are channeling money into nonprofits to attack a law that has extended health coverage to millions of low-income Americans.
Who are the funders gunning to destroy Obamacare? Read more ….
Appeals will continue, but let’s take the Halbig decision at face value. How much will this decision cost the working poor? The amount varies with income and other variables, but for a 40 year old individual making $30,000 a year, the tax credit was estimated at $1345 (KFF estimate here). Retroactive tax bills under Halbig will be significant and everyone impacted will have trouble paying for health insurance going forward (about 57% of exchange participants were previously uninsured, according to a KFF survey).