Democrats And Republicans About To Clash Majorly-- On Health Care For Americans

But we can't afford to expand health care

Trump is celebrating his possible victory-- we'll see what's true and what's not when the whole Mueller Report is released instead of just a GOP press release from Barr's office-- by kicking millions of poor people off healthcare. Again, through Barr, Trump had told a reactionary Texas appeals court (the 5th Circuit), he wants the whole Affordable Care Act shit-canned. CNN reported that that is "a major shift for the Justice Department from when Jeff Sessions was attorney general. At the time, the administration argued that the community rating rule and the guaranteed issue requirement-- protections for people with pre-existing conditions-- could not be defended but the rest of the law could stand."

Note: protection for people with pre-existing conditions is the single most popular part of the ACA and if Trump has it struck down, it will be another nail in his political coffin. Last night, Robert Pear reported for the NY Times that Pelosi is on the verge of unveiling a plan ro expand health coverage-- far from Medicare-for-All, but far better than what Trump is offering America. Pear pointed out that "Democrats won control of the House in large part on the strength of their argument that Congress needs to protect people with pre-existing medical conditions and to lower the cost of health care and that today she's "putting aside, at least for now, the liberal quest for a government-run Medicare for all single-payer system and unveil a more incremental approach toward fulfilling those campaign promises. Building on the Affordable Care Act, they would offer more generous subsidies for the purchase of private health insurance offered through the health law’s insurance exchanges while financing new efforts to increase enrollment."

Did Pelosi stab the CPC in the back over Medicare-For-All? 

She and her lieutenants will offer legislation that also reverses actions by Trump that "allow insurance companies to circumvent protections in the Affordable Care Act for people with pre-existing conditions. Insurers could no longer sell short-term health plans with skimpy benefits or higher premiums for people with chronic illnesses. She says the legislation will 'strengthen protections for pre-existing conditions, reverse the G.O.P.’s health care sabotage and lower Americans’ health costs.'"

The legislative package, put together by Ms. Pelosi and several House committee chairmen, builds on the health law that the speaker was instrumental in passing-- and that was signed by President Barack Obama almost exactly nine years ago. And it seems to answer a question facing Democrats since they took control of the House: How would they balance the expansive demands of their most liberal members with the needs of more pragmatic Democrats elected in seats that were held by Republicans?

Ms. Pelosi, the committee chairmen and many other House Democrats see the new legislative package as a more efficient way of achieving universal coverage, a goal shared by champions of “Medicare for all,” led by Representatives Pramila Jayapal of Washington and Debbie Dingell of Michigan.

Democrats said they would probably try to pass the legislative package piece by piece, with the first votes on the House floor expected in May. Some elements could win support from Republican House members and from the Republican-controlled Senate.

With their new proposal, House Democratic leaders hope to finesse the disagreements within their caucus and to focus public attention instead on the gulf that separates Democrats of all stripes from President Trump on health care.

In his latest budget request, Mr. Trump urged Congress again to repeal the expansion of Medicaid under the Affordable Care Act, which has provided coverage to at least 12 million people newly eligible for the program. Mr. Trump attacked Senator John McCain last week, seven months after his death, for casting a decisive vote against repeal of the 2010 health law.

And in the economic report of the president, the White House boasted last week about how Mr. Trump had allowed small businesses and individual consumers to buy insurance plans that skirt many requirements of the Affordable Care Act, offering lower costs but fewer benefits.

Under a rule issued in August, Mr. Trump greatly expanded the market for sales of short-term insurance plans that do not have to cover prescription drugs, maternity care, drug abuse treatment or pre-existing conditions.

The House Democrats’ bill would turn back the president’s action by stipulating that short-term plans are included in the definition of “individual health insurance coverage” under the Affordable Care Act and therefore must comply with coverage requirements of the health law.

“These junk plans discriminate against people with pre-existing conditions,” said Representative Frank Pallone Jr., Democrat of New Jersey and an architect of the new legislation. “They deny access to basic benefits. They set arbitrary dollar limits for health care services, leading to huge surprise bills for consumers.”

“We passed the Affordable Care Act to rein in exactly these types of abuses,” said Mr. Pallone, who is investigating the short-term plan as chairman of the Energy and Commerce Committee.

The Affordable Care Act provides two main types of financial assistance to people of modest means buying private insurance: tax credits to help them pay premiums, and cost-sharing reductions to lower their deductibles, co-payments and other out-of-pocket costs.

The House Democrats’ bill would revise the law to provide more of both types of assistance.

In addition, the bill would make subsidies available to some working families who are now ineligible. The law, as interpreted by the Internal Revenue Service, bars subsidies to workers who have access to affordable employer-sponsored coverage for themselves-- even if the cost of coverage for the entire family is unaffordable. The House Democrats’ bill would eliminate this quirk in the law, sometimes called the family glitch.

...The package will also include a bipartisan bill offered by Representative Andy Kim, a freshman Democrat from New Jersey, that would provide federal money to states that want to set up their own insurance marketplaces but have yet to do so.

“With skyrocketing premiums in the federal marketplace, state-based exchanges have proven to be more effective at increasing the rate of coverage and lowering costs,” said Representative Brian Fitzpatrick, Republican of Pennsylvania, who helped write this proposal with Mr. Kim.

Karoli Kun is an editor at Crooks and Liars and a friend and colleague. She is just coming out on the other side of a serious health issue, which she details at C&L. "After six days in the hospital," she wrote last night, "doctors finally narrowed the cause to a carotid artery stenosis, a blockage likely caused by years of smoking and (also undiagnosed) high cholesterol. Last Monday, an excellent vascular surgeon performed surgery to place a stent in my carotid artery, opening it up and getting rid of the debris still left in that artery. The description of the procedure is terrifying, but it went without a hitch and is successful. I'm told I may have come out of the anesthetic growling 'Fck Trump' since he really is to blame for every bad thing. Going forward, I just have a lovely zipper on my neck now, but it’s a small price to pay to have the artery open and working properly.

In the aftermath, I am wearing a continuous heart monitor for the next 2 weeks to rule out atrial fibrillation as a cause. The doctors doubt it, but recommend it out of an abundance of caution.

I will likely be on medication for high blood pressure and blood thinners for the rest of my life. The side effects are a challenge but in the end it’s a small price to pay. Thursday I start physical and speech therapy to fix the remaining speech and fine motor skills issues, which are improving every day but still linger when I’m tired or talking too fast. I’m seeing a neurologist and cardiologist for follow-ups, and an ophthalmologist to evaluate vision changes and fix my glasses prescription.

The way I have been treated is the way everyone’s health care should be handled. From the moment I arrived at the ER through my surgery last week, Kaiser has been in charge of my healthcare needs. Not their bottom line: my needs. If I needed surgery, I got surgery. No fighting, no initial denials. If I needed a test, I got a test. If I needed a specialist, I got a specialist. This is how medicine should work: Doctors healing, health professionals and support staff healing, while the patient does not worry.

In all of my conversations with the health professionals treating me over the past 4 weeks, I realized that one of the reasons for my superior treatment is mainly because Kaiser really knows how to deliver health care, but also because California in particular has higher standards for health care professionals. Nurses, for example, cannot be responsible for more than 4 patients in a hospital. That means they’re available, less stressed, more attuned to their patients’ needs. Several of the nurses caring for me told me they moved here from other states where the standards are far lower in order to feel like they were able to do their best work. That suggests there should be national standards for health care delivery rather than letting some states race to the bottom and cheap it up. (Yes, the states they left were red states. Deep red states.)

Health care needs to be that way for everyone, not just lucky ones with good insurance in blue states. At this point, I don’t care how we get there but we have to get there. Soon.

Well, Trump sure isn't offering it-- and neither are Pelosi and her lieutenants. And Trump is also proposing cutting billions of dollars from Medicare and Medicaid (and Social Security). You know who is offering real healthcare to Americans, though, right?