Health Care... Who Needs It Anyway!

Yesterday, writing for the Washington Post James Hohmann made the case that the blundering moron has wrecked the American health-care system by immediately halting cost-sharing reductions for 7 million Americans and now owns the dire consequences.

This is not “letting” Obamacare fail. Many nonpartisan experts believe that these active measures are likely to undermine the pillars of the 2010 law and hasten the collapse of the marketplaces.

The Pottery Barn rule comes to mind: You break it, you own it. Yes, the plate you just shattered had some cracks in it. But if you dropped it on the ground, the store is going to blame you.

As Barack Obama learned after the Great Recession, with heavy Democratic losses in the 2010 midterms, it’s hard to blame your predecessor for problems two years after you take office. Especially when your party has unified control of the federal government. No matter how much it might be the previous guy’s fault, many voters won’t buy it. People have very short attention spans.

The uncertainty about what Trump would do has already driven premium prices higher for 2018. Now it’s going to get worse. Amy Goldstein and Juliet Eilperin explain why: “Trump has threatened for months to stop the payments, which go to insurers that are required by the laws to help eligible consumers afford their deductibles and other out-of-pocket expenses. But he held off while other administration officials warned him such a move would cause an implosion of the ACA marketplaces that could be blamed on Republicans … The fifth year’s open-enrollment season for consumers to buy coverage through ACA exchanges will start in less than three weeks, and insurers have said that stopping the cost-sharing payments would be the single greatest step the Trump administration could take to damage the marketplaces … Ending the payments is grounds for any insurer to back out of its federal contract to sell health plans for 2018.”

Ileana Ros-Lehtinen, the dean of the Florida Republican delegation to Congress, complained that Trump's mind-boggling decision to unilaterally and precipitously cut health care subsidies "will mean more uninsured in my district." She reminded him that he promised "more access, affordable coverage" complaining that his actions do the opposite. Is it possible that she's the only Republican with the integrity and guts to even question Trump on this decision that will so drastically impact the lives of so many millions of Americans?

Carol Shea Porter (D-NH) told her constituents what most Democrats in Congress are telling theirs. "Late last night, President Trump announced that he will torpedo the individual insurance market by ordering the government to stop making the Cost-Sharing Reduction (CSR) payments it owes. He is right to be so ashamed of this spiteful action he would only announce it in the dead of night. Stopping these payments won’t just hurt the lower-income people whose out-of-pocket costs are defrayed by CSRs, it will also hurt every one of the millions of Americans who buy their own coverage. That’s because insurance companies say they are going to charge everyone more to make up for the lost funding. Congress must act immediately to fund CSRs and protect our constituents from Trump’s vengeful and destructive actions." Friday another Republican sheepishly joined Ros-Lehtinen in trying to separate himself from Trump's insanity. Tom Reed (R-NY): "If Congress doesn't get it done the people who suffer are the people back home."

We reached out to Laura Oatman, the progressive running for the Orange County seat (CA-48, just downgraded by Cook from "leans Republican" to "toss-up") occupied by Trump rubber-stamp Dana Rohrabacher. "What Trump has done with the stroke of his pen," she told us, "now ends government subsidies that help our nation’s poorest people obtain the life-saving health care they need. There are more than 6 million low-income people across our country that will be affected by this, and in our district, there may be as many as 76,000 that will be left without health insurance. Rohrabacher’s record is clear-- he has voted with Trump to dismantle Obamacare every step of the way, and seems to have no regard for those 76,000 people that he’s supposed to represent and whose very lives will now be at risk. This is immoral and unacceptable. No one should have to worry about dying or going bankrupt because they cannot afford the lifesaving medicine or surgery they need to survive. It is time for him to go. We need strong, bold, progressive leadership here in District-48 to represent us in DC now, to fight for health care as a human right."

When I reached Kendra Fershee in a West Virginia district where Trump beat Hillary 68.0-26.4%-- but where Bernie also beat Hillary and, in many counties got more votes than Trump did on primary day-- she told me that my question made her think we were separated at birth. "I drafted a post about this exact issue this morning. Over the last couple of weeks, voters in the West Virginia First have been receiving a glossy tri-fold mailing from David McKinley, who pats himself on the back for his vote for the American Health Care Act (AHCA), which the nonpartisan Congressional Budget Office said would kick 14 million Americans out of their healthcare plans by next year. The AARP said the bill could cost many older West Virginians "$6,332 to $8,482 more per year" for healthcare (and inflict a lot of pain district-wide). Despite knowing all of this, Rep. McKinley voted for the bill, which he reports in the mailer under a heading that says, 'Promises Kept.' Is this the kind of promise we want our Representative to make?" She continued with her own communication to people in the northern third of West Virginia, district that includes the Panhandle, Wheeling, Parkersburg, Morgantown and Clarksburg:

Yesterday, President Trump slashed subsidies to health insurance companies, which will strip insurance from the people who need it most (despite his promise in January that he would provide "insurance for everyone"). Rep. Paul Ryan said the move was appropriate because Congress controls the "power of the purse." So, West Virginians want to know whether Rep. McKinley is going to use the power his constituents granted him to do the right thing and seek support in Congress to fund the subsidies. After his vote to repeal and replace the Affordable Care Act with a much worse option (the AHCA), it's hard to imagine he will step up now. We need leadership who will ensure that this political gamesmanship will stop and fight for universal healthcare. I'm ready to be that leader.

State Senator Daylin Leach is the leading candidate contesting Pat Meehan's seat in the suburbs of Philadelphia (PA-07). He told us just what he's telling voters in Delaware, Montgomery, Berks, Lancaster and Chester counties. "It's clear that America's access to health care is more under attack than ever. And Pat is not someone you can have confidence will fight for us and our families on this. He was for the awful Republican health care bill before he was against it. But don't forget, he voted to completely and totally repeal the Affordable Care Act, with NO replacement at all, over 50 times. That's no replacement, zero protection for pre-existing conditions, zero minimum coverage, no subsidies to help families afford it, nothing. So like most of the rest of his Republican colleagues, ideology was more important than making sure kids can go to the doctor when they are sick."

Dayna Steele is running against one of the most extreme anti-healthcare Republicans in East Texas; maybe Louie Gohmert is worse, although Babin and Gohmert usually vote in tandem. "It is unfathomable to me how many times the incumbent Babin has voted to take away health care from thousands of his constituents in Southeast Texas," Dayna told me yesterday. "Instead of improving during his watch, the health of people in the district and their health care has declined every year. We have a large populated county in the district without a hospital. Texas has the #1 maternal death rate in the U.S. (and higher than many industrialized countries.) Women's clinics have been shut down. CHIP is being taken away. Veterans benefits will decrease. the list goes on. And now, in the aftermath of Harvey, national media is referring to the Gulf of Mexico and the Houston Ship channel as a "toxic gumbo" after all the leaks, spills, and explosions caused by the hurricane. This will add to an already catastrophic health situation in CD-36 over the next few years. It is as if they are 'culling the herd' as we say in Texas. One of the many reasons #whyIrun."

Lillian Salerno is another strong and brilliant progressive woman running in a completely different part of Texas (north Dallas) for a seat held by a slippery member of Paul Ryan's leadership team, Pete Sessions. Yesterday, she told us that she's "seen first hand how Sessions and the Washington elite use their positions as a way to line their own pockets from a broken healthcare system at the expense of working families. Pete Sessions does not have the background to understand healthcare, but that does not stop him from writing bills meant to gut Obamacare. By ending cost-sharing reduction payments, many ACA enrollees may see steep premium increases and some insurers may pull out of the marketplace all together. It has never been more critical for the people of Texas-32 to have a real leader in Congress-- let me have at 'em."

Here in California, 673,104 people rely on the cost-sharing reduction payments Trump just abolished, primarily so he could give the wealthiest 1% of Americans tax reductions-- while driving up the cost of insurance by around 20%. Any California Republicans willing to stand up to Trump's reckless gambling with the lives of so many of the state's citizens? Not Mimi Walters, that's for sure. Kia Hamadanchy, one of the progressives vying for the nomination to take her on told us that "Trump is going out of his way to deliberately sabotage and undermine the Affordable Care Act. His actions will lead to less people in this country having health insurance. There is no healthcare policy expert who thinks this is a good idea or that will it do anything to make health insurance more affordable or accessible. But yet again Mimi Walters continues to remain silent and refuses to say or do anything to contradict Donald Trump, even when she knows he is acting against the interests of her constituents. I've said a number of times that I think we need to transition to single payer. But that does not mean we should actively work to make the healthcare system worse, which Donald Trump and Mimi Walters are doing."

Predictably, three physicians running for Republican held seats felt very strongly about Trump's action. Alina Valdes is running for the south Florida seat occupied by Trump rubber-stamp Mario Diaz-Balart. She sent us a statement that says it all:

As a physician, who has taken care of the poor and uninsured for 35 years, I have always felt that a one payer health care system, without private for-profit companies, is the way to go in this country. Politicizing health care makes it seem like it is optional in people's lives, like something that could be bought or not. Sooner or later, we all need medical care and that is why I support Medicare for All or HR 676 and its counterpart in the Senate, S 1782.

While I support fixing the ACA as a temporary measure to continue healthcare coverage for the maximum number of people possible, the only way to guarantee healthcare, which is a human right, is to make it a benefit for all Americans guaranteed by the US government regardless of ability to pay.

Right now, for profit insurance companies, who are beholding to their investors and stock holders, determine who gets certain benefits and this, in turn, is determined by the users ability to pay. This translates into better healthcare for those able to pay more and many with no healthcare because they cannot afford it.  We need a humane, all inclusive option that will be cost effective while covering every single American. This leads to a one payer healthcare system run by the government, like Medicare, which has a 3% administrative cost when compared to a privatized insurance system, many having as high as 30% administrative costs.

Insurance is generally based on risk and this determines premiums but how can you assess risk on a newborn? By covering all 350 million with a minor increase in Medicare payroll deduction, you eliminate for profit companies and the attached premiums these bring. No matter which company provides your healthcare now, they are all increasing their premiums and crying poverty while their stocks continue to rake in record profits. Employers are removing many choices from their employee benefits because of these ever increasing costs to their bottom line.

We can eliminate all other forms of insurance beholding to Congress and its whims like CHIP, which has not been funded past this year, leaving 9 million children uninsured and Medicaid, which covers the destitute, disabled, and many elderly now being cut in the proposed budget. Businesses, especially small ones, can benefit by eliminating workmen's compensation, which now consumes a large portion of costs to companies.

I conclude that the logical solution to the difficult logistics of providing healthcare to the maximum number of people for the minimum cost is a one payer healthcare system backed by the US government, like Medicare For All. Until you have walked in somebody's shoes or side by side with them, healthcare may be a luxury many cannot afford but by making it available to all regardless of ability to pay, we can have a healthier, generally more productive working class.

Dr. David Gill, running for a seat in central Illinois, is laser focused on improving the healthcare system, not wrecking it. He just said "My Republican opponent, Rodney Davis, stated in a radio interview yesterday that President Trump's cut to health care subsidies will 'lower premiums.' This couldn't be further from the truth. There may be some small number of residents in the district that will see lower premiums, but the vast majority of IL-13 residents will see steep increases in premiums; in many cases, this will make health insurance completely unaffordable for families here in central Illinois. Mr. Davis' deceit and support of the president is not at all surprising-- he has backed every version of TrumpCare, and he has repeatedly lied in stating that TrumpCare would prevent insurers from billing higher premiums for those with pre-existing conditions. Mr. Davis and I are like night and day on the topic of health care: he stands with the for-profit private health insurance industry that subsidizes his campaigns, while I, as a 25-year member of Physicians for a National Health Program, advocate for the single-payer system which Americans have been deprived of for decades. I look forward to sending Mr. Davis home from Washington, and once I've taken his seat, I intend to speak as a boldly progressive physician in providing leadership toward the effort to finally bring a single-payer plan to fruition here in America."

Our third physician is an award winning oncologist and cancer researcher in Houston, Jason Westin. Early this morning he told us that "After Trump decided to allow 'junk' insurance plans and refused to pay critical CSR subsidies, it was clear to all that he was deliberately working to sabotage the ACA. Two Republican Members of Congress had the courage of their convictions to rightly declare Trump's moves to be wrong-- John Culberson was not one. Once again, Culberson has decided to stand with Donald Trump and turn his back on us in Texas 7th. After I take Culberson's seat in 2018, I will fight for true universal coverage, to bring down the drivers of healthcare costs like prescription drug prices, and to speed up our search for new cures. It's long past time for our leaders to lead on healthcare, and if career politicians like Culberson want to play partisan political games instead, we will need to elect new leaders to get the job done."

Tom Guild's campaign keeps picking up steam in Oklahoma City and we could wind up with a progressive Democrat in Congress from Oklahoma for the first time in more decades than anyone remembers. "Trump," he said, "has done it again! He never misses an opportunity to disappoint us. Although he said all the politically correct things running for president about health care, at every opportunity he does everything in his power to undermine health care for Americans. He has undermined Medicare, Medicaid, and gone after the Affordable Care Act with a vengeance rarely seen in American politics. Steve Russell goes merrily along with each and every attempt the Donald cooks up to hurt hard working Americans. He wants to cut trillions from Medicare, Medicaid, and the ACA, and Russell supports Trump at every turn. The new federal budget, voted for by Russell takes from working people and the middle class and gives to the top 1% in huge tax cuts. Both must have been distracted when their teachers read the story of Robin Hood to their classes. Now Trump has signed an executive order with the intent of further weakening the ACA and destroying the individual market place created under the law. Once again, like two peas in a pod, Russell is on board and a member of the Trump Wrecking Crew. I am disgusted that Trump and Russell have intentionally sabotaged the ACA, needlessly leaving 130,000 Oklahomans seeking health care coverage with an avoidable 30% increase in their premiums. Dr. Terry Cline, Oklahoma’s Secretary of Health and Human Services and Commissioner of Health at the Oklahoma State Department of Health recently chided both Trump and his recently departed HHS Secretary Tom Price for denying the state of Oklahoma a waiver provided for in the ACA that would have helped more than 130,000 Oklahomans struggling with dramatic increases in premiums. It would have afforded a more than 30% premium reduction for 130,000 Oklahomans, who now are forced to buy health insurance under the ACA rendered unreasonably more expensive because of the malicious actions of Trump’s appointees, supported by his lackeys in Congress like Russell. Russell does the bidding of a treacherous and toxic president while laying waste to working people in our congressional district. It is time to repeal and replace Russell in the 2018 elections and elect a hard working progressive to represent the fifth district of Oklahoma. The more the twin towers of tyranny work to destroy health care coverage for Americans, the more inevitable and necessary universal affordable healthcare becomes. Single payer. Dragon slayer."

Paul Clements is running for a seat in southwest Michigan held by one of the architects of Trumpcare, Fred Upton. He told us today that "at the end of April Upton opposed the Republican health care plan. Then Donald Trump called him for a meeting and promised $8 billion dollars to address insurance costs for pre-existing conditions-- a pittance compared to their actual cost, and Upton flipped. On May 4 the Upton Amendment got the bill the final handful of votes it needed to pass the House. This bill would have hurt poor people, older Americans, people with pre-existing conditions, state governments, hospitals, and Planned Parenthood. It would have helped high-income earners and people who wish to go without health insurance. If Upton had held firm, Congress would have had a chance to actually start a bipartisan discussion. Now Trump is throwing our health care system into chaos, doing even more to hurt poor people, older Americans, and people with pre-existing conditions. Sadly, evidence on how the health of Americans can actually be improved at lower cost has had no role in Republican plans. Opposing President Obama seems to have been a priority. For the evidence is clear-- it is the private health insurance system that gave us the most expensive health care system in the world, one that yields worse health results. The way to make care cheaper and better is to move to single payer, such as, for a first step, by making an expanded Medicare available to all."

Dan Canon is running against right-wing Indiana freshman Trey Hollingsworth (IN-09) and the two couldn't be more different when it comes to healthcare. "I've been very clear that I believe healthcare is a human right," said Canon, "and should be accessible to everyone regardless of how wealthy they are. Representative Hollingsworth voted to repeal the ACA but, like most of his colleagues, hasn't offered any solutions to replace it. Now, as Trump unilaterally dismantles the ACA from the inside out, Hollingsworth lacks the integrity to speak on the matter at all, even as his fellow Republicans are finally starting to show some courage. Hollingsworth knows full well that Trump's actions will take away meaningful access to healthcare from hundreds of thousands of Hoosiers. He just doesn't care."

Today the DCCC was railing against Republicans who support Trump's healthcare plans and who voted against aid for the victims of Hurricane Maria in Puerto Rico. Virginia Foxx fits both categories to a "t." Yet, for all their bluster, the DCCC is just collecting money for itself and doing absolutely nothing for the candidates running against these Republicans who fit that description. Nothing! Jenny Marshall is taking on Foxx on her own. Yesterday she told us that Foxx "has sought to dismantle the ACA at every turn since it's passage. In Foxx's opinion 'The American people desperately need relief from a failed health care law that has increased costs, taken away choices, destroyed jobs, and burdened small businesses. Republicans are committed to delivering that relief.' Well, the past 24 hours gave Foxx what she has been seeking, the dismantling of the ACA. A position that will increase costs and raise the uninsured rates across the country. I, on the other hand, advocate for a single payer universal healthcare system that would cover everyone without worry of co-pays or deductibles. We must join the rest of the industrialized countries by investing in our citizens and accepting that healthcare is a basic human right."