Monday, March 13, 2017

Was Tom Cotton Right? Will Trumpcare Kill GOP Chances To Hold The House In 2018?


Republicans have been reciting their talking points like little automatons all week-- Obamacare is collapsing, premiums going up, deductibles, a third of the counties... etc. Few people people have been taken in other than those already brainwashed by Hate Talk Radio and Fox. Yesterday, though, Secretary of Health Tom Price took the campaign of lies a step further. He was on Meet the Press. He looked right into the camera and lied his ass off: "I firmly believe that nobody will be worse off financially in the process that we're going through. They'll have choices that they can select the kind of coverage that they want for themselves and for their family, not the government forces them to buy." What a load of bullshit from a real hustler!

Price's and Ryan's arguments were shattered yesterday in a powerful piece of reporting in the Washington Post by Jessica Contrera that goes beyond asserting that people will be hurt by Trumpcare and shows that the very people who will be most hurt are the desperate and deceived masses who voted for Trump and the Republicans in the first place. She focuses on ex-coal miners, the ones who believed Trump when he said he would bring back their jobs and protect Medicaid. All the biggest coal producing counties in America-- in Wyoming, West Virginia, Kentucky and Pennsylvania-- voted overwhelmingly for Trump. These are the 7 biggest coal mining counties and how they voted in November:
Campbell County, WY- 88% Trump, 7% Clinton
Marshall County, WV- 73% Trump, 22% Clinton
Boone County, WV- 75% Trump, 21% Clinton
Logan County, WV- 80% Trump, 17% Clinton
Pike County, KY- 80% Trump, 17% Clinton
Harlan County, KY- 85% Trump, 13% Clinton
Perry County, KY- Trump 77%, Clinton 20%
She writes about a 54 year old West Virginia man in Northfork in McDowell County, the county with the shortest life expectancy in the nation, and the county Bernie and Chris Hayes are broadcasting from this evening. McDowell went for Trump 75.8% to 20.5%. It also has America's mostly deadly opioid problem-- with the most deaths from overdose-- of any county in the country. Like so many in this corner of Appalachia, Clyde, she wrote, "used to have a highly paid job at a coal mine. Company insurance covered all of his medical needs. Then he lost the job and ended up here, holding a cane and suffering not only from heartburn but diabetes, arthritis, diverticulitis, high blood pressure and high cholesterol."
Because of the ACA, Clyde’s visit is covered by Medicaid. Before the law, most West Virginians without children or disabilities could not qualify for Medicaid, no matter how poor they were. The ACA-- better known here as Obamacare-- expanded the program to cover more people, such as Clyde, who can depend on Keisha to fix his heartburn without having to worry about the cost.

As for the other problems in his life, he has put his hopes in Trump, who came to West Virginia saying he would bring back coal and put miners back to work. When Trump mentioned repealing Obamacare, Clyde wasn’t sure what that might mean for his Medicaid. But if he had a job that provided health insurance, he reasoned, he wouldn’t need Medicaid anyway, so he voted for Trump, along with 74 percent of McDowell County.

Tug River Health Association treats about 8,700 patients, resulting in some 20,000 visits a year to its five clinics. In 2016, 12,284 of those visits were from patients on Medicaid, up from 5,674 in 2013, before the ACA took effect here. Without the ACA, many of those patients wouldn’t be able to afford care. Will they soon lose their coverage? Will they stop coming to the clinic? Lately, Tug River’s chief executive has been telling his staff, “The key word going forward is uncertainty.”

...In other parts of the country, the primary impact of the ACA has been requiring people to have private health insurance, but in poor and sick communities like McDowell County, the law’s dominant effect has been the Medicaid expansion, which has given more people access to the kind of health care that wasn’t widely available or affordable to them before. With an insurance card in her pocket, the patient at Tammy’s window can venture into the realms of medical care that are typically out of reach to those without one: blood work, immunizations, specialized doctors, surgery, physical therapy.

If she needs mental health counseling, the clinic no longer sends her to the next county over; last July, Tug River was able to hire a psychologist, who is now treating 180 people, many of whom are trying to overcome opioid addictions.

If she needs medication, the nurses won’t go digging in a closet of samples left by drug reps as they used to do for the uninsured. The medication will come from a pharmacy and cost no more than a few dollars.

...[T]here is another version of uncertainty in the clinic, this time a patient’s. If she signs up for Medicaid, which covers low-income, pregnant women, she’ll be covered through her pregnancy. But after that? Her access to insurance will depend on what happens over the next months in Washington, where so many plans for the ACA’s replacement are floating around. One, just unveiled in the House, would roll back the Medicaid expansion slowly, meaning Amanda could keep her public insurance after the baby is born. In a few years, however, someone like her might not be able to do the same, and instead might receive tax credits to help offset the cost of private insurance.

But that’s just one plan. There have been plans based on “block grants” and plans based on “per-capita caps.” Some plans give people tax credits based on their income. Some base the tax credits on their age; some on where a person lives. There’s the plan once proposed by Trump’s secretary of health and human services, which would get rid of the Medicaid expansion entirely. There’s the plan Vice President Pence implemented when he was governor of Indiana, which penalizes anyone who doesn’t pay for Medicaid coverage, even if all they can afford is a dollar a month. There’s even a plan that proposes keeping the Medicaid expansion just as it is.
The Democrats, of course, are already hoping to use health care insecurity as a cudgel to beat the Republicans over the head with in 2018. There isn't a candidate I speak to who doesn't bring up Ryan's Trumpcare bill when telling me how he or she plans to beat a Republican incumbent in 2018. In fact, NRSC staffers are whispering privately that their best shots to beat Democratic senators is with anyone but a House member who winds up voting for Trumpcare!

California's most progressive state legislator, Assemblyman Jimmy Gomez isn't running against a Republican, but in a special election for an open seat in Los Angeles. There are 23 candidates and not only is he way ahead, polling shows him with close to 40% with his nearest competitor, the closest thing this part of L.A. has to a Republican (developer and charter school-financed Sara Hernandez), polling around 6%, close to the margin of error, despite a barrage of expensive misleading and non-stop TV ads paid for by the right-wing special interests that support her. Jimmy appears to be ignoring her and focusing on what he plans to do in Congress. Nearly the entire congressional delegation has endorsed him, including outgoing Rep Xavier Becerra and district neighbors Judy Chu, Grace Napolitano and Ted Lieu. He's not pulling any punches; look at this tweet from yesterday:

Maybe that had something to do with the enthusiastic endorsement from Ted Lieu: "During these extraordinarily dangerous times, we need fighters like Jimmy Gomez in Congress. I served with Jimmy in the California Legislature and I know he will always and relentlessly fight for progressive values. More importantly, I need Jimmy with me as soon as possible so that we can keep punching back against the failing Donald Trump."

Yesterday Tom Cotton (R-AR) went on Meet the Press and warned House Republicans that if they vote for Trumpcare they're jeopardizing their reelection chances. "Do not walk the plank and vote for a bill that cannot pass the Senate and then have to face the consequences of that vote," he said. "I'm afraid that if they vote for this bill, they're going to put the House majority at risk next year." Cotton isn't right about much, but he's right about that. Right after Meet the Press I spoke with 3 Blue America candidates already taking it to GOP incumbents for the 2018 cycle-- Tom Guild, who's opposing Steve Russell in Oklahoma, Geoff Petzel, who's running for the seat Peter Roskam holds in Chicagoland and Tom Wakely, eager to finish the job of ending Lamar Smith's political career in the Austin/San Antonio area.

Tom Guild wanted to hear Steve Russell's excuses for backing TrumpCare so he went to his town hall. "Access to affordable health care," he told us, "is a prerequisite for reclaiming the American Dream that some Americans no longer feel is within their reach. Instead of helping Oklahomans and Americans gain health care coverage, my Republican Tea Party Opponent, incumbent Rep. Steve Russell, wants to take it away. I attended a recent town hall in Shawnee, which is a fairly conservative part of the fifth congressional district. Russell was asked about Medicare and was clearly confused as he talked about TrumpCare instead. The audience was calling out “answer the question” but to no avail. He then was questioned by a man whose daughter has autism and his wife was diagnosed with breast cancer. He said that before the Affordable Care Act, he was unable to cover either one of them because of their pre-existing conditions. Under the ACA, the man offered that he now has coverage for both at an affordable cost. He asked Russell what he would do to ensure that he could continue to cover both of them. Russell waxed eloquently about the health savings accounts that would be available under the proposed TrumpCare winding its way through Congress. The man said he spent every dime he had to survive and was unlikely a good candidate for a HSA. He also said the ACA made it illegal to put a lifetime cap on coverage under a health insurance plan, and that without that provision, he would have already busted through a million dollar cap. Russell indicated that he favors lifetime caps on health insurance coverage. Russell then again went back to his talking points and talked about the marvelous health saving accounts that would be available under the new Republican health care plan. People then asked Russell about his own health care coverage. People offered help from the audience that taxpayers pay for his health care coverage. He said taxpayers didn’t pay for his coverage, because he was covered by Tricare. People loudly offered that Tricare was funded by taxpayers, too, and counseled Russell that he was covered by government run socialized medicine. Russell got defensive and talked about his heroic military service for the third time at the town hall and went on to not answering the next question asked. Russell doesn’t get it that as many as 15 million Americans will lose their current health care coverage under TrumpCare. Russell was offering up dog food, but the audience was refusing to eat the food. He was clearly in over his head, and discombobulated and confused that his act wasn’t well received by an audience that ordinarily would have been eating out of his hand. Russell is clearly a threat to your health."

So is Peter Roskam. Geoff Petzel is running against the knee-jerk conservative incumbent in the suburbs west of Chicago. Geoff told us that "Roskam and other radical Republicans who vote for the Trumpcare proposal are at risk of losing their seats. Every day I have voters telling me how important the ACA is to their families-- these are not just Democrats-- Republican voters are telling me they also want to save the Affordable Care Act. In the IL-06 District, the ACA has decreased the number of uninsured patients by 31%. As one of those people now insured because of the ACA I know how personal and emotional this issue is for people. I am confident that any Republican who votes to take away our health insurance, will effectively be voting to give up their seat in Congress in 2018."

Goal Thermometer Tom Wakely has a completely different approach to health care from the one being advanced by Paul Ryan, Lamar Smith and the Republican Party. It's the classic progressive/populist approach, which excited Bernie supporters and Trump supporters alike, although which Trump supporters must now feel a little let down over as Trump has morphed into Paul Ryan. "One of the major complaints I hear about my Congressman Lamar Smith," he told us, "is that he is out of touch with his constituents and nothing could be closer to the truth than his support of the Republican plan to repeal and replace the Affordable Care Act. It does not seem to bother Smith that if the Republicans succeed in their efforts over 30,000 people in his district will be stripped of their health insurance. That is unacceptable to me. I believe what is needed  at this time is a public option, i.e a government-run health insurance agency which would compete with private health insurance companies for your business and a Kaiser Foundation poll taking just before last years presidential election shows that a majority of Americans support the public option. However, I see the public option only playing an interim role, a step in the right direction so to speak. What I believe we really need in this country is a single-payer national health insurance program otherwise known as 'Medicare for all.' Oh, I know that Smith and the Republicans as well as a few Democrats would scream and yell about 'socialized medicine' but we already have socialized medicine in this country serving over 17% of our population. Those two programs are the VA Health Care System and Medicare. If these two programs are good enough for our veterans and our senior citizens, it should be good enough for the rest of the country."

The Blue America thermometer above leads to a contribution page for the campaigns of Tom Wakely, Geoff Petzel, Tom Guild, Jimmy Gomez and our other congressional challengers forcefully speaking out about Ryan's Trumpcare proposal. Please consider helping them get their messages out in any way you can.

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At 12:27 PM, Anonymous Anonymous said...

People like the one(s) named are simply too stupid to be allowed to make decisions regarding their own well-being. Sadly, they are among a growing (mushrooming) majority of americans who are either relentlessly stupid or respond only to their many hatreds of others when "deciding" how to determine their own futures.

What EVERYONE, but especially intelligent writers who should know better, keeps getting wrong in this issue is the actual difference between insurance and health CARE.

NEITHER obamneycare nor trumpdeath nor anything else in the mix has dick to do with actual health care. They are merely competing strategies to "provide" the masses of dumbfucktards with access to INSURANCE.

Insurance can be good or useless. But, like having a mcjob, which counts you as "employed", merely HAVING insurance that is useless counts as healthCARE to the politicians and writers who should know better. As I can attest, insurance can and will and often does deny care because it or you are too 'spensive.

Good insurance is expensive. And it gets more expensive at something like an order of magnitude greater than inflation. Fewer and fewer have this each year. Under obamneycare, these policies were taxed which incentivized employers to NOT offer these any more.

Shitty insurance, that won't cover dick, can be cheap. So healthy people like these. And employers seeking to save money but keep up the charade of offering insurance, are migrating to these for their employees. Hopefully none of them ever get sick or hurt or old. But at least the savings can go to the ceo and board members to make them happy.

Obamneycare was designed to "help" people afford insurance based on income. If you (and an ever-mushrooming portion of the populace) are poor, you get help with the premia based on how much help you need.

drumpfdeath gives tax credits based on age. This pre-supposes that everyone is buying a single policy and it allows a little more for the elders than for the youngsters. Might get you most of the way there if your income can otherwise support you (food, shelter, warmth, oxy...) because it's a tax credit rather than an entitlement. If you pay no taxes because you have a mcjob, a tax credit doesn't do shit.
Also, for elders, the credit is wholly insufficient. If you have a pre-existing, like a lot do (HBP, arthritis... anything), then you can't afford a policy that will allow you to seek care for ... anything.

What will happen when (not if) some form of drumpfdeath passes is 15 million (according to some predictions already) will pass on the insurance due to costs or suppression due to pre-existings and increased costs. As insurance premia rises at 12X the rate of inflation, by 2027, as many as 80 million will decide to pass as they prioritize eating and staying warm in winter over giving their thousands/year to insurance ceos.

The other part of this is Rx, which is correlated, but is not quite as predictable due to gouging on life-saving drugs. As the pricing blows up, the coverage is denied by insurance.

So, how many people will die every year due to the unavailability and unaffordability of CARE (as opposed to insurance)??

Before obamneycare, it was nearly 50,000/year. For each 5 million additionally insured, the rate goes down as much as 10,000 per year (It's currently at something like 20,000/year). At 80 million losing insurance, expect the corpses to stack up at close to 200,000/year. And, as fate would have it, a majority of those will be those complete dumbfucktards who elected der fuhrer. Indeed, 150,000/year will likely be republicans.

Maybe this is how the problem will self-correct... might take 20 years... but culling several million racist/christibanazi/Nazi dumbfucktards could be a very good thing.

We'll still have the problem of idiot leftys still voting for corporate shill democraps... but one solution at a time I suppose.

At 1:44 PM, Anonymous Hone said...

It is not only the poor and unemployed who will suffer. My friend's two grown children, both in their late 40's, make decent money but are independently employed. They have been covered through the ACA. They are very nervous that they will lose this coverage, what they will be able to find instead and how much it will cost. Many middle class Americans who cannot get health insurance through their employment will suffer as well. And they vote.

At 3:55 PM, Anonymous Anonymous said...

TRUMPCARE... which president trump should own since he pushed it so hard. I have not forgotten when mitt Romney and paul ryan ran... it was ryan then that wanted to push granny over cliff. he has dreamed of taking social security away for along time. since trump wants to do what ever ryan wants he should own it breaks every promise he made.some senior have $ 300.00-$500.00 amonth to live on trying to buy food medications and paying rent is hard... they already go without... under trumpcare its not income but age for seniors healthcare the older pays the most. what id FICA tax... we worked we paid for medicare and social security.then remove the Fica tax and people will have more to live on. I am worried many seniors will be on the streets without food shelter or medication that are life saving if you only have 500.00 a month coming in how do you pay 2,00.- 5,800 insurance plan? tell how?!

At 4:42 PM, Anonymous Anonymous said...

Well, now that the CBO has spoken.. maybe voters will listen. Maybe not. Why would they start now.

24 million losing coverage? a majority of them being idiot drumpf voters? Some large number of them expiring due to no medical CARE?? Will that make the idiot drumpf voters finally wake the fuck up??


How a nonleftist votes is a matter of religion at this point. Facts don't matter to a truly pious moron. Drumpf could never get elected to a school board in a town of 50 before the electorate became so religiously deluded. So I doubt that even being killed a million at a time by the guys they elect would register with these morons.

Same as the lefty morons who keep electing people like obamanation, $hillbillary, Pelosi, hoyer, scummer, reid...

At 5:57 PM, Anonymous Anonymous said...

Considering that Tom Cotton is a useless waste of oxygen, he had to have gotten elected by knowing the voters of his state. As a result, I'd listen to what he's saying. He really doesn't want to go back to being a mere mortal again!

At 7:19 AM, Anonymous Anonymous said...

Calling Jimmy Gomez California's most progressive legislator is silly. All you have to do is look at his voting scorecards from his entire time in the Assembly to see that he is a moderate (which is also how he has always described himself). Gomez is getting support from most prominent Democrats throughout the state, because he is the only person they know since he holds office in Sacramento and used to be the political director for a union. Nothing wrong with any of that, but he is not a progressive and doesn't believe in that kind of politics.


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