A Trumpian Version Of Medicare-For-All?

Many people still don't understand what Medicare-- let alone Medicare-for-All-- actually means. But, despite a barrage of propaganda against it from the Sickness-Industrial Complex, Fox News, Hate Talk Radio and the Republican Party, it polls very well. The brand new EconomistYouGov poll asked registered voters "Do you support or oppose Medicare for all ?" More people supported it nationally and in every region of the country:

Nationally

• Support- 49%
• Oppose- 34%

Northeast

• Support- 52%
• Oppose- 32%

Midwest

• Support- 47%
• Oppose- 38%

South

• Support- 50%
• Oppose- 31%

West

• Support- 47%
• Oppose- 38%

This seems to be worrying Señor Trumpanzee, whose regime has done nothing but make false promises and work towards kicking as many people off healthcare as possible. So, according to Health Exec Magazine, he's trying to come up with an alternative to Medicare-for-All that his base may like. Amy Baxter reported that "Trump’s more comprehensive healthcare plan will likely be revealed in a speech scheduled for September... While details of the plan are scant, it reportedly offers coverage for people with pre-existing conditions and will allow the sale of insurance between states... The reports come at a time when the ACA is facing a major legal battle after a federal judge found the healthcare unconstitutional in late 2018. Protection for people with pre-existing conditions is one of the most popular provisions of the ACA. The case is pending appeal. The Trump administration, which has backed the Republican-launched lawsuit to overturn the ACA, is also planning its healthcare reform in case the healthcare law is struck down."

The idea of electing some exceptionally smart people to Congress is an especially good idea when the Executive Branch is infected with rampaging stupidity and willful ignorance. CA-16 is on the verge of electing one of those rare, exceptionally smart people-- and to replace a pretty useless dumb one, Blue Dog Jim Costa. Kim Williams has worked as a diplomat and a college teacher, among other jobs. When I asked her about "TrumpCare," she pretty much explained why she's supporting Medicare-for-All and why we all should, telling me that "From 2002-2017, California’s family coverage premiums increased by 248.8%, and middle-class families now spend 24.8% more on healthcare than they did in 2007. In total, Americans spend $1 trillion on private insurance premiums, and we spend twice as much per person on healthcare as almost every other person on earth when you count in premiums, deductibles, co-payments and out-of-network charges. But this high cost comes with no guarantee of better access to care. In our district, which is also home to some of the worst air pollution in the U.S., residents can see their lives cut short by as many as 20 years based on the zip code they are born into, and we have 62,000 individuals with no insurance coverage at all. Meanwhile in Germany, a country with far more doctors per capita than the U.S., working people pay 7.5% of their income towards comprehensive insurance, and 76% percent of residents can access a doctor the same or next day. It’s time to change the debate around Medicare-for-All, and we can begin by acknowledging that the government already finances and/or manages healthcare for about 43% of the U.S. population. Moving everyone over to a plan that covers us all does not come with the impossible price tag that the medical industrial complex would suggest. Right now we spend approximately $900B on private premiums and $100B in public program spending. Its largely the same amount of money coming from a different place, only the majority of us would see an additional $3,000 back in their pockets at the end of the year. So it’s not just that Medicare for All would increase access to care, it is the best option to save more lives and more money for the country as a whole."

Around a third of Americans (34%) feel Trump is honest and trustworthy. It's not likely more than that expect him to help when it comes to healthcare. I asked some of the Blue America-endorsed congressional candidates how they tackle the problem when they're serving in the House. Shaniyat Chowdhury, who is running for a New Dem-held seat in southeast Queens, is an unabashed supporter of the House version of Bernie's Medicare-for-All bill (Pramila Jayapal's H.R 676). His statement is crystal clear and unambiguous. If you like it-- and what Kim had to say above and what Eva and Brianna said below-- please consider contributing to their campaigns by clicking on the 2020 thermometer:

The American healthcare system needs to be completely overhauled. Approximately 44 million people in this country have no health insurance, and an additional 38 million are underinsured. This means preventable catastrophes play out across our nation every day-- people lose their homes because they can’t pay their medical bills; they don’t seek medical attention when needed; and they ration the medication they need to survive and die as a result. Even for those who are insured, our current system is not an efficient or effective one. Americans pay some of the highest rates for medical care in the world but rank only 37th in health outcomes. This disparity is a result of health insurance companies wasting money on excessive administrative costs while patients have to fight for the services they need. Americans also pay significantly more for the same prescription drugs as our Canadian and European counterparts because the pharmaceutical industry has the power to set prices without any meaningful regulation. Our lawmakers have failed to act to make drug pricing fairer for all Americans, as they accept donations from the powerful pharmaceutical and insurance lobbies. We need to drastically shift how we see healthcare.  It is not a commodity-- it is a human right. Every person in the United States should have access to good doctors and the medical care they need.  Nobody should die because they can’t afford insulin, or lose their home because of exorbitant medical bills. There are approximately 55,000 people in our district without health insurance and this is unacceptable. Every New Yorker deserves healthcare.

Brianna Wu is running for an incumbent so reactionary that he didn't even vote for ObamaCare-- and in one of the bluest districts in the country! "The right," she told me this afternoon, "can’t argue against Medicare for All on the merits. Not only will it cost much less, guarantee coverage for all, it will also create jobs. That’s why they have to mislead people about what’s in it. Fox is nothing but propaganda wing for corporatists, convincing people to vote against their own best interests. That’s why we have to be consistent and clear. And let’s be clear. There’s a lot of money to be made by exploiting people in the midst of a medical crisis. That’s why Big Pharma spends so much money getting Congress to do nothing. I won’t take their money as a candidate, and I certainly will not take it as your congresswoman."


Eva Putzova is an enthusiastic campaigner for Medicare-for-All. She was a Bernie delegate to the DNC last cycle and replacing Blue Dog (and "ex"-Republican) Tom O'Halleran with her would be a godsend to the people in Arizona's sprawling first congressional district-- and to everyone impacted by what Congress does-- i.e., all of us. "Our healthcare system," she said this morning, "is broken and needs an immediate overhaul. When people choose to take an Uber instead of an ambulance because they can’t pay the bill or spend hours on the phone with their insurance company that keeps denying claims for their sick son’s medications-- stories from my district I’ve heard just in the last few weeks, something is terribly wrong. When thousands of people declare bankruptcy each year due to exorbitant medical bills, and low-income seniors are forced to choose between paying for their prescription medications or buying food, and the price of life-saving drugs like insulin are made unaffordable to those who need it by profiteering drug companies, and many rural areas have essentially NO emergency facilities, no hospitals, and no specialists, then it is time for a radical overhaul of our system. The Medicare-for-All legislation introduced into the House by Representative and the Senate would address the problems of access, affordability and quality of care. Healthcare should be a right and that’s what I will fight for when elected to Congress."

How Many Lies Did You Catch Trump Telling In His Michigan Stand-Up Comedy Routine?

Oil Can Harry by Nancy Ohanian

Earlier today we looked at one of Trump's lies that he's been spewing all week about wind energy which he repeated at his Michigan hate rally Thursday night. But I didn't want to leave anyone with the impression that the wind energy lie was the only lie he was spouting in Granbd Rapids. Oh no-- feeling vindicated by William Barr's silly press release and the media's buy in, he was feisty and crazed and eager to lie his way into the hearts of his jackass followers. It wasn't hard for him to do. Nor was it hard for fact checkers to fill pages and pages correcting his cascade of bold lies. The Associated Press catalogued them for newspapers and broadcast media across the country.

Some of the lies weren't that big a deal. Like when he started boasting about his electoral college win over Hillary almost two-and-a-half years ago. "We won 306 to 223." He did win-- with Putin's help-- but the score was 304 to 227. His numbers aren't true but I'd chalk it up to senility more than purposeful obfuscation. He also claimed "we did really well with women." I'm not sure what metric he's using but he lost among women, 54-41%. He did win, narrowly, among white women.

But the lies really started kicking in once he began rambling about health care. On Wednesday he told reporters that "If the Supreme Court rules that Obamacare is out, we will have a plan that’s far better than Obamacare" and at the rally he told his drooling fans that "The Republican Party will become the party of great health care... Republicans want you to have an affordable plan that’s just right for you" and "We will always protect patients with pre-existing conditions, always." AP:

Republicans may aspire to great health care but they don’t have a comprehensive plan for it. And there’s no indication that the White House, executive branch agencies like Health and Human Services, and Republicans in Congress are working on one.

Trump’s recent budget called for repealing “Obamacare” and setting hard limits on federal spending for Medicaid, which covers low-income people. Some Republicans argue that would be better, because the federal government would create a new program of health care grants to states. But when the nonpartisan Congressional Budget Office analyzed similar proposals a couple of years ago, it estimated such changes would result in deep coverage losses, not to mention weaker insurance protections for people with pre-existing medical conditions.

Trump’s budget also called for hundreds of billions of dollars in Medicare cuts to hospitals and other service providers, a nonstarter with lawmakers in Congress worried about re-election next year.

The Supreme Court has upheld the health care law twice in previous challenges. The five justices who first upheld it in 2012 are still on the court.

Congressional Republicans are generally trying to steer away from Obamacare spats. Some are trying to focus on areas where they might find common ground with Democrats and the president, such as reducing prescription drug costs.

...He’s not protecting health coverage for patients with pre-existing medical conditions. In fact, the Trump administration is pressing in court for full repeal of the Affordable Care Act-- including provisions that protect people with pre-existing conditions from health insurance discrimination.

Trump and other Republicans say they’ll have a plan to preserve those safeguards, but the White House has provided no details. And it’s a stretch to think they could get a Republicans-only plan passed through Congress with the House under Democratic control.

Meanwhile House Speaker Nancy Pelosi has unveiled her own plan to shore up and expand the ACA, which would make many more middle-class people eligible for subsidies to help pay their premiums, and also make the subsidy amounts more generous.

Former President Barack Obama’s health care law requires insurers to take all applicants, regardless of medical history, and patients with health problems pay the same standard premiums as healthy ones. Bills supported in 2017 by Trump and congressional Republicans to repeal the law could have pushed up costs for people with pre-existing conditions.

Since he was in Michigan, he had to spin some tall tales about the auto industry, which he's destroying. The big lie was "We’re bringing a lot of those car companies back. They’re pouring back in." They're not and after the rally he doubled down for reporters: "We’re opening up car plants in Michigan again for the first time in decades. They’re coming in, really pouring in... And this has been happening pretty much since I’ve been president. It’s really amazing what’s going on... We’ve brought back so much industry, so many car companies to Michigan, so we’re very happy.

The only automaker announcing plans to reopen a plant in Michigan is Fiat Chrysler, which is restarting an old engine plant to build three-row SUVs. It’s been planning to do so since before Trump was elected. GM is even closing two Detroit-area factories: one that builds cars and another that builds transmissions.

Automakers have made announcements about new models being built in the state, but no other factories have been reopened. Ford stopped building the Focus compact car in the Detroit suburb of Wayne last year, but it’s being replaced by the manufacture of a small pickup and a new SUV. That announcement was made in December 2016, before Trump took office.

GM, meantime, is closing factories in Ohio and Maryland.

Trump can plausibly claim that his policies have encouraged some activity in the domestic auto industry. Corporate tax cuts freed more money for investment and potential tariff increases on imported vehicles are an incentive to build in the U.S.

But automakers have not been “pouring in” at all, as he persistently claims, and when expansion does happen, it’s not all because of him.

Fiat Chrysler has been planning the SUVs for several years and has been looking at expansion in the Detroit area, where it has unused building space and an abundant, trainable automotive labor force.

Normally it takes at least three years for an automaker to plan a new vehicle, which is the case with the three-row Jeep Grand Cherokee and the larger Wagoneer and Grand Wagoneer SUVs that will fill the restarting Detroit-area plant and an existing one. Several years ago then-CEO Sergio Marchionne said the Wagoneer would be built in the Detroit area.

Detroit automakers usually build larger vehicles in the U.S. because the profit margins are high enough to cover the higher wages paid there versus Mexico or another lower-cost country.

Of course, he couldn't wait to start crowing about Putin-Gate and the Mueller Report he refuses to let anyone see. "After three years of lies and smears and slander, the Russia hoax is finally dead. The collusion delusion is over. The special counsel completed its report and found no collusion and no obstruction...Total exoneration, complete vindication." Polls show no one believes that but his dead-end supporters. He also said, referring to the charges in the Steele dossier, that "It came out after the election and everybody had a big fat yawn... All of a sudden I heard, 'Were you involved with Russia?' I said, 'Russia? What the hell does Russia have to do with my campaign?'" OK, let's get to the facts:

Mueller did not vindicate Trump in “total” in the Russia probe.

Mueller’s exact words in the report, as quoted by Attorney General William Barr, say: “While this report does not conclude that the President committed a crime, it also does not exonerate him.”

The four-page summary by Barr released Sunday notes Mueller did not “draw a conclusion-- one way or the other-- as to whether the examined conduct constituted obstruction,” but rather set out evidence for both sides, leaving the question unanswered of whether Trump obstructed justice. Barr wrote in the summary that ultimately he decided as attorney general that the evidence developed by Mueller was “not sufficient” to establish, for the purposes of prosecution, that Trump committed obstruction.

Barr’s summary also notes that Mueller did not find that the Trump campaign conspired or coordinated with Russia to tip the 2016 presidential election in Trump’s favor. To establish a crime, Mueller must generally meet a standard of proving an offense beyond a reasonable doubt. The summary did not clear the president of improper behavior regarding Russia but did not establish that “he was involved in an underlying crime related to Russian election interference,” Mueller said in a passage from the report quoted by Barr.

The summary signed by Barr gave the bottom line only as he and his deputy saw it. Democrats are pushing for release of Mueller’s full report, which is more than 300 pages. Barr is expected to release a public version of the document in the coming weeks.

There actually was plenty that Russia had to do with Trump’s campaign.

According to U.S. intelligence agencies and lengthy indictments brought by Mueller’s team, Russian President Vladimir Putin ordered a multipart influence campaign aimed at hurting Democrat Hillary Clinton’s candidacy, undermining American democracy and helping Trump get elected.

That effort included the hacking of the Democratic National Committee, Clinton’s campaign and other Democratic groups. Russian intelligence officers then coordinated the release of stolen emails and internal documents.

There were also plenty of people around Trump receptive to Russia’s help, though Mueller’s report ultimately did not find that those contacts amounted to a criminal conspiracy, according to Barr’s summary.

In the middle of the campaign, Donald Trump Jr. met at Trump Tower with a Russian lawyer thinking he would be getting “dirt” on Clinton. Trump Jr. agreed to the meeting, which included Trump son-in-law Jared Kushner and Trump campaign chairman Paul Manafort, despite it being described to him as part of a Russian government effort to help his father.

There's never a Trump rally where he doesn't throwin for a little racism for the Republican Party base. Bringing up diversity visas, he used the old refrain: "They’re giving us their worst people." AP explains why that is flat out false.

The diversity visa lottery program is run by the U.S. government, not foreign governments. Other countries do not get to sort through their populations looking for bad apples to put in for export to the U.S. Citizens of qualifying countries are the ones who decide to bid for visas under the program. Trump repeatedly blames foreign states.

The program requires applicants to have completed a high school education or have at least two years of experience in the last five years in a selection of fields. Out of that pool of people from certain countries who meet those conditions, the State Department randomly selects a much smaller pool of winners. Not all winners will have visas ultimately approved, because they still must compete for a smaller number of slots by getting their applications in quickly. Those who are ultimately offered visas still need to go through background checks, like other immigrants.

The lottery is extended to citizens of most countries, except about 20. The primary goal is to diversify the immigrant population by creating slots for underrepresented parts of the world.

Sensitive about his shirking of his own military duties, President Bone Spurs always spends some time gaslighting about veterans. Two big lies: "They’ve been trying to get VA Choice for over 40 years. Couldn’t do it. I got it. We signed it six months ago." And "Instead of waiting online for 1 day, 1 week, 2 months, ...they now go outside, they see a private doctor, we pay the bill, they get better quickly."

Private Bone Spurs, America's biggest victim ever, has grievances galore

He’s not the first president in 40 years to get Congress to pass a private-sector health program for veterans; he expanded it. Congress first approved the program in 2014 during the Obama administration. The program currently allows veterans to see doctors outside the VA system if they must wait more than 30 days for an appointment or drive more than 40 miles (65 kilometers) to a VA facility.

Now they are to have that option for a private doctor if their VA wait is only 20 days (28 for specialty care) or their drive is only 30 minutes.

...Veterans still must wait for weeks before they can get private care outside the VA system.

The program currently allows veterans to see doctors outside VA if they must wait more than 30 days for an appointment or drive more than 40 miles (65 kilometers) to a VA facility. Under new rules to take effect in June, veterans are to have that option for a private doctor if their VA wait is only 20 days (28 for specialty care) or their drive is only 30 minutes.

But the expanded Choice eligibility may do little to provide immediate help. That’s because veterans often must wait even longer for an appointment in the private sector. Last year, then-Secretary David Shulkin said VA care is “often 40 percent better in terms of wait times” compared with the private sector. In 2018, 34 percent of all VA appointments were with outside physicians, down from 36 percent in 2017.

At a hearing Tuesday, the top health official at VA, Dr. Richard Stone, described the start of the expanded Choice program to “almost be a non-event,” in part because wait times in the private sector are typically longer than at VA.

The VA also must resolve long-term financing because of congressional budget caps after the White House opposed new money to pay for the program. As a result, lawmakers could be forced later this year to limit the program or slash core VA or other domestic programs.

Democratic Hopefuls by Nancy Ohanian

Polls consistently show that most Americans now agree that Trump is a liar. Less than a third of Americans believe anything he says. Remember how the Russians won him the election by targeting Michigan, Wisconsin and Pennsylvania? Today he'd lose all three of those seats, regardless of who the Democrats nominate. In Michigan, Biden beats him 54-46, Klobuchar beats him 53-47%, Bernie beats him 52-47%, and both Kamala Harris and Elizabeth Warren beat him 51-49%. In Wisconsin Biden beats him 54-46%, Bernie and Elizabeth Warren each beat him 52-48%, Beto beats him 51-49% and both Kamala nd Klobuchar are at a 50-50% tie with him. And here's the results of the head-to-head matchups that came out yesterday on Pennsylvania:

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?

When the Spirit is Willing: Religious Leaders Condemn Graham-Cassidy

John McCain Votes on Healthcare by Nancy Ohanian 

-by Skip Kaltenheuser

The Graham-Cassidy attempt to hamstring the health care of millions-- the latest fruit of Justice Anthony Kennedy’s eternal gift to democracy, the Citizens United accelerant of bribery-- has flamed out. But the donors to bought-and-paid for members of Congress will not go quietly, not when their congressional minions have their tin cups out. Increasingly desperate to fill campaign coffers, the minions seek to please their paymasters. Politico is reporting Senator Lindsey Graham (R-SC) vows to vote against a budget resolution that doesn’t resuscitate the health care battle. Noises are being made about reconciliation instructions for both health care and tax reform in the fiscal 2018 budget resolution. While this might increase the odds of more happy flameouts, including of tax gifts to the very well-heeled. That would displease plenty of big donors. But even if taxes become the major focus, kicking the health care can down the road, Democrats shouldn’t let up on educating the public on the perils of mischief like Graham-Cassidy. And they need to make the case for real health care evolutions, explaining why significant improvement requires sidelining profits of the big donors fighting single-payer, primarily insurance and pharmaceutical interests.

Toward that end, perhaps a bit of spiritual guidance. Enclosed below is Monday’s letter to the Senate from the Interfaith Healthcare Coalition, with their message that “healthcare is an essential human right," and detailing risks facing the most vulnerable among us.

September 25, 2017

Dear Senators:

We, the more than 3,000 undersigned faith leaders representing Jewish, Christian, Muslim, Sikh, and Buddhist traditions, believe that healthcare is an essential human right. We believe that individuals and families should not have to worry about the future of their healthcare coverage and whether or not it will be ripped away.

It was a tremendous relief that Congress was working in an open, bipartisan way to improve our healthcare system. But now, we are outraged that Congress would abandon these efforts for another partisan attempt that would take healthcare away from millions of our people. For the sake of our people, please oppose the Graham-Cassidy proposal and support the reauthorization of the vital Children’s Health Insurance Program (CHIP) and Disproportionate Share Hospitals (DSH) program.

The Graham-Cassidy proposal would cause millions to lose health coverage, and people experiencing vulnerability, sickness, and poverty would be hit the hardest. Over the next decade, ACA funding would be eliminated, Medicaid would be gutted, and critical protections, such as for people with preexisting conditions, could be eliminated in certain states. Graham-Cassidy would end Medicaid as we know it by instituting a per capita cap and shifting billions of dollars onto states. The result would be nothing short of reducing access to quality healthcare, raising premiums, and eliminating protections for millions of Americans. In 2027 alone, Graham-Cassidy would cut federal health care spending by $299 billion. More than 37 million children would be affected by cuts to Medicaid.

Graham-Cassidy not only threatens the health coverage of millions of children through cuts to Medicaid, but it also delays bipartisan congressional action to extend funding for programs like the Children’s Health Insurance Program (CHIP). Since its creation in 1997, the uninsured rate of low- and middle-class children has decreased from 14% to just 5%. Without reauthorization, CHIP funding will expire at the end of September, and the nearly 9 million children on CHIP might begin to receive termination notices.

We also urge you to protect funding for DSH, which supports safety-net hospitals that provide health services to people without insurance. Without this funding, many hospitals will face difficult decisions to cut services or close entirely. In rural areas especially, lower-income Americans will face a crisis. The $43 billion in proposed funding cuts over the next eight years will cause job loss, a decrease in the quality and number of services hospitals provide, and create life-threatening gaps in healthcare service for many Americans.

To allow Graham-Cassidy to pass the Senate-- and to allow the CHIP and DSH programs to lapse-- is to allow the health of America’s most vulnerable people to face unnecessary and immoral obstacles. Jobs will be lost, local economies will be harmed, and access to healthcare will become a challenge for many. Therefore, we deplore this proposed legislation and these potential funding cuts and pray that you will work with your colleagues in Congress to prevent any disruption of healthcare for Americans.

As faith leaders, it is our duty to care for and minister to people in our communities. As Senators, you have a similar duty to care for your constituents. Please focus on bipartisanship rather than political posturing, oppose Graham-Cassidy, and extend CHIP and DSH funding.

Sincerely,
National Faith Leaders

Here’s a few comments that typify the unifying views of the religiously diverse signatories:

Sister Simone Campbell, SSS, NETWORK Lobby for Catholic Social Justice:

Once again, a group of white, male Senators have crafted a plan that is out of touch with the realities of millions of ordinary families and fails the moral tests of our faith. The Graham-Cassidy-Heller-Johnson proposal is immoral policy that would hurt millions of people, and their plan to rush it through without knowing the impact is reckless. This new repeal bill goes far beyond the BCRA by eliminating all ACA premium and copay supports, gutting Medicaid, and removing protections for people with pre-existing conditions. These policies target people struggling to get by, the sick, and the elderly—the very people Jesus teaches us to put first. Catholic sisters stand with our nation’s most vulnerable people and we must stand against this anti-health, anti-life legislation.

Rabbi Jill Jacobs, T’ruah: The Rabbinic Call for Human Rights:

Our insistence on the moral duty of the government to ensure health care for all comes from our grounding both in human rights, and in Jewish teachings. Rabbi Eliezer Waldenberg, one of the most important twentieth-century legal authorities, notes, “When poor people are ill and cannot afford medical expenses, the community sends a doctor to visit them, and the medicine is paid for by the communal fund.” (Tzitz Eliezer 5:4) And Rabbi Shlomo Goren, former Ashkenazi Chief Rabbi of Israel declares, “the government may not excuse itself from responsibility toward the sick since the government is responsible for the health of the people.” (Assia journal 21:40) The Universal Declaration of Human Rights requires that all countries provide “standard of living adequate for the health and well-being of himself and of his family, including … medical care.”

Colin Christopher, Islamic Society of North America:

We have a moral obligation in this country to care for those who are young, elderly, sick, or unable to fend for themselves. If we can build the mightiest defense system the world has ever known, we also have the ability to fund the best preventative health care system. The Graham-Cassidy bill would decimate patient protections, decrease care, and directly lead to thousands of preventable lives lost that are currently being saved by the affordability and coverage of the ACA.

Sr. Patricia McDermott, RSM, Sisters of Mercy of the Americas:

The Sisters of Mercy, who have been providing healthcare services for people who are poor and vulnerable for nearly 175 years in the U.S., believe that access to health care and adequate health insurance coverage is a fundamental human right. Rather than taking away health care for millions of Americans over the next several years, we should be finding ways to strengthen and expand health coverage and improve affordability.

Dr. Noel Castellanos, Christian Community Development Association:

As people of faith we lift our voices to declare to our lawmakers that eliminating healthcare for millions of vulnerable Americans is shameful and immoral. To do so is putting politics over the needs of people and cannot be justified. Fix ACA so more Americans can get coverage, don’t obliterate it at the expense of the poor.

Diane Randall, Friends Committee on National Legislation:

The Cassidy-Graham health care proposal violates the very values that lie at the core of Quaker morals. This bill would threaten the health and dignity of millions of Americans, especially low-income children, seniors, and people with disabilities. Cassidy-Graham includes extreme cuts to Medicaid, undermines critical protections for individuals with pre-existing conditions, shifts billions of dollars onto states, and will cause tens of millions of Americans to lose health coverage. Moreover, advancing this legislation will destroy the productive and bipartisan work currently taking place. Rather than trying to force through yet another rushed, ultra-partisan, dysfunctional health care proposal that causes millions of Americans to lose health coverage, Congress should refocus back on the bipartisan negotiations so desperately needed to stabilize the insurance markets and lower health care costs.

Legislating Legislation by Nancy Ohanian

As good as members of Congress are at feigning religion, they might take heed of the moral imperatives expressed in such sentiments. Or at least the increasing number of voters embracing those ideals.

A quick plug, the most promising way out of a health care system fractured by special interests is the proposal by Bernie Sanders, as expressed in his NY Times essay. The more the public learns of it, the more it appears to warm to it, and to discount the special interest knives flashing across mainstream media. If there’s another economic crisis gifted by Wall Street, ramping up the bankruptcies, foreclosures and general miseries from family health crisis cost bombs, the public may warm up with torches and pitchforks, or at least take a sober look at what many of those claiming to represent them in Congress are really all about. Sure, the proposal is a work in progress. So progress. There is no other way out of our quagmire.

Don’t think there’s plenty of time because of the most recent failure to upend health care. When the big money-- including insurance and pharmaceutical-- sloshes about both parties, it has a hell of track record of making steady gains, fighting on a number of fronts. Here’s an informative piece from The Intercept on lobbyists cranking up to derail Single-Payer as it builds steam. Here’s another, on Republican efforts to pre-empt attempts by states to create their own single-payer programs, revealing the farce in claims that Graham-Cassidy repeal efforts aim to empower the states.

King of Diamonds by Nancy Ohanian

Allow a digression, a nod to Senator McCain, responding to his summer health care vote. It also revisits a long-haul look at the slide toward banana republic status greased by Washington’s campaign finance industry, a not-so-distant cousin to the vampire squid.

Thank you again, Senator McCain, and to Senator Collins and the others jumping that dark ship flying the Jolly Roger.

On health care, Congress should take the sweetest of oaths: do no harm.

From a translation of the line of the Hippocratic Oath, “I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous.” Play doctor, Congress, but put your heart in it.

US Healthcare by Nancy Ohanian

Louie Gohmert-- Not A Shred Of Human Decency... Like Trump

Louie Gohmert is a reactionary neanderthal from northeast Texas, in a district with no cities-- Tyler has around 97,000 people and Longview has 80,000 and Nagodoches 33,000-- bordering on Louisiana and a lot closer to Arkansas than to Houston. Last year the PVI was R+24, the 17th reddest congressional district in America. This year the PVI is even worse-- R+25. Louie Gohmert was elected in 2004 when a legally dubious mid-decade gerrymander by Tom Delay shoved Republican-leaning Smith and Gregg counties into the district, allowing Gohmert to beat Democratic incumbent Max Sandlin. In 2012 Obama didn't even get 30% of the vote and last year Hillary fared even worse, Trump beating her 72.2% to 25.3%. Gohmert's lowest ever reelection number was 68%.

As far as I know, Gohmert, a rabid anti-healthcare extremist, didn't attack Ted Cruz wen Cruz announced he would vote against the latest version of TrumpCare. Instead, Gohmert went on Fox & Friends Monday and called for Arizona to recall John McCain, couching his sick idea in humanitarian guise. McCain had just reported that his doctors had given him "a very poor prognosis" of recovering from glioblastoma, a deadly form of brain cancer, the same type of cancer that Ted Kennedy in 2009. On 60 Minutes Sunday night McCain said that he thinks about Kennedy a lot and said that Kennedy continued to work despite the diagnosis and "never gave up because he loved the engagement." Gohmert wants to take that engagement in his last months away from him, even though it would have no impact on actually being able to pass TrumpCare. Gohmert's a monster. "He’s got cancer, it’s a tough battle," he said piously on Fox & Friends yesterday. "But stress is a real inhibitor to getting over cancer." Yeah, what about the stress of a recall election?

“I think Arizona could help him, and us. Recall him, let him fight successfully this terrible cancer, and let’s get someone in here who will keep the word he gave last year,” Gohmert said.

...“If he had said last year what he was going to do, Kelli Ward would have beat him,” Gohmert said, referring to the former Arizona state senator who ran against McCain in the primary, losing by 11 points. Ward is challenging Arizona’s other GOP senator, Jeff Flake, next year.

Gohmert is not the first Republican lawmaker to connect McCain’s medical status to his opposition to his party’s efforts to repeal and replace the health care law.

In August, Wisconsin Sen. Ron Johnson suggested McCain’s cancer could have affected his decision to cast the decisive “no” vote the previous month.

“Again, I’m not going to speak for John McCain-- he has a brain tumor right now-- that vote occurred at 1:30 in the morning, some of that might have factored in,” Johnson told a Chicago talk radio show on Aug. 8.

The Wisconsin Republican later walked back his remarks, but not before he was criticized by McCain spokeswoman Julie Tarallo.

“It is bizarre and deeply unfortunate that Senator Johnson would question the judgment of a colleague and friend,” she said in a statement. “Senator McCain has been very open and clear about the reasons for his vote.”

Meanwhile, Mr. Empathy-- a sobriquet sometimes used to describe Señor Trumpanzee-- was on the Rick & Bubba radio show in Alabama Monday morning attacking McCain and calling his decision to back Arizonans rather than the party line on healthcare "a tremendous slap in the face to the Republican Party." And all for naught, since McConnell couldn't muster the voters to pass the thing and after a Republican lunch today, called off the vote, effectively killing any chance of the Republicans repealing Obamacare this year.

What Keeps Drug Prices So High In America-- A Bipartisan Culture Of Corruption In DC

I wonder if anyone from the DCCC or DSCC will try to figure out the implications

A new poll CBS released this morning shows that only 20% of respondents said they approved of the latest Republican legislation aimed at repealing and replacing the Affordable Care Act. Probably in response to badmouthing of Medicare-For-All by Blue Dogs and New Dems-- conservative senators Chris Murphy (CT) and Tammy Duckworth (IL), both former House New Dems, have been publicly negative in recent days-- Our Revolution president Nina Turner said yesterday that "Anyone who does not believe Medicare-For-All can be done needs to get out of the way of those who know it will be done. Duckworth and Murphy are Hillary leftovers who believe if they berate Trump every now and then, people will be fooled into thinking there's something remotely "progressive" about them. There isn't.

Last week a Harvard poll commissioned by Politico showed Democrats overwhelmingly backing Bernie's universal/single-payer approach (Medicare-for All). Among Democrats 80% already back Medicare-For-All (15% oppose), while among independents 67% are on board and 38% oppose. Even among Republicans, 44% are in favor (48% oppose).

Conservatives, mostly Republicans but with help from the Republican wing of the Democratic Party, have always built plums into healthcare legislation for the pharmaceutical industry with bribes so many conservatives on both sides of the aisle. The public is sick of it and 89% of Democrats, 87% of independents and even a startling 88% of Republicans say that favor the federal government negotiating with pharmaceutical companies to lower the prices of prescription drugs for seniors on Medicare.

These are the criminals currently in Congress who have worked the hardest to make sure Big Pharma was protected from this reasonable step over the years. First the 10 worst in the Senate:

• Orrin Hatch (R-UT)- $2,767,140
• Richard Burr (R-NC)- $1,513,262
• John McCain (R-AZ)- $1,224,519
• Mitch McConnell (R-KY)- $1,102,122
• Roy Blunt (R-MO)- $1,003,106
• Patty Murray (D-WA)- $915,797
• Chuck Schumer (D-NY)- $898,566
• Chuck Grassley (R-IA)- $883,582
• Rob Portman (R-OH)- $874,120
• Bob Menendez (D-NJ)- $858,325

And here are the 10 most corrupt in the House, who have conspired with the drug companies to keep the prices of prescription drugs unreasonably high in return for big campaign contributions:

• Anna Eshoo (D-CA)- $1,513,561
• Fred Upton (R-MI)- $1,408,006
• Frank Pallone (D-NJ)- $1,153,155
• Paul Ryan (R-WI)- $1,133,183
• Kevin McCathy (R-CA)- $1,020,625
• Erik Paulsen (R-MN)- $1,019,329
• John Shimkus (R-IL)- $996,215
• Joe Barton (R-TX)- $973,038
• Steny Hoyer (D-MD)- $954,872
• Greg Walden (R-OR)- $897,095

Since 1990 the pharmaceutical companies have paid out $202,456,697 in direct bribes to congressional candidates-- $114,826,226 to corrupt Republicans and $86,403,775 to corrupt Democrats. So far this cycle only 4 corrupt House members-- Greg Walden, Paul Ryan, Kevin Brady (R-TX) and Kevin McCarthy-- and 3 Senators-- Orrin Hatch, Bob Casey (D-PA) and John Barrasso (R-WY)-- have been able to shake down the drug companies for 6 figure bribes. But we have a long way to go 'til the end of the cycle. Last cycle Ryan took the biggest bribes to protect drug prices: $395,174; his hatchet man, Kevin McCarthy got $323,650.

GOP plans to pass TrumpCare appear to have been foiled Sunday when Susan Collins (R-ME) announced on Jake Tapper's show that she is following Rand Paul (R-KY) and John McCain (R-AZ) into the NO camp. Alaska Senator Lisa Murkowski is a probable NO as well, giving the anti-TrumpCare forces a little breathing room if Randy Paul worms out of his commitment to oppose it. (Ironically, Ted Cruz and Mike Lee also indicated they would vote NO, for the same reason as Rand Paul... the bill isn't harsh enough.)

One of the bill's sponsors, Lindsey Graham (R-SC), was on ABC's This Week yesterday and he told the viewers that he thinks "we’re going to get the votes next week." He insisted that he and radical right lunatic Ron Johnson (R-WI), "who are both on the Senate Budget Committee, would try to force Republicans to continue Obamacare repeal attempts with reconciliation next year.

'We're not going to vote for a budget resolution that doesn't allow the health care debate to continue,' he said." Neither Graham nor Johnson are up for reelection next year, but they have likely killed the reelection chances of Dean Heller (R-NV) and Jeff Flake (R-AZ).

How The Politics Of Healthcare Have Made Dean Heller Unelectable In Nevada

Dean Heller is a squishy mainstreamish Republican senator from Nevada. He was appointed to the seat by Republican Governor Brian Sandoval in 2011 when corrupt Republican John Ensign was forced to resign. Before getting into politics, Heller was a stock broker. In 2012 he was challenged by a corrupt New Dem, Shelley Berkley and managed to beat her 457,656 (45.87%) to 446,080 (44.71%)-- an 11,576 vote margin (against an incredibly weak and unattractive candidate who many Democrats just couldn't persuade themselves to vote for).

This cycle, Heller is a dead dog. He has a Trumpist opponent, Danny Tarkanian and another crappy DSCC-backed conservaDem just like Berkley (totally unqualified Jacky Rosen) and a Berniecrat the DSCC is trying to derail, Jesse Sbaih. Sarah Palin has already endorsed Tarkanian and the most recent poll of Republican voters shows Heller losing the primary to Tarkanian 39-31%. There is no doubt that Bannon's whole Roy Moore neo-fascist support team will be showing up in Nevada to destroy Heller as soon as they've finished destroying Luther Strange in Alabama-- and teaching Trump a lesson about where he gets his marching orders.

Unlike Heller, Rand Paul stood up to Trump's bullying and bribes

You know the TrumpCare bill that John McCain just torpedoed, commonly known as Graham-Cassidy? That was actually short for Graham-Cassidy-Heller-Johnson. And that's weird for someone who made such a big deal about sticking with the very popular Governor who originally appointed him to the Senate, Brian Sandoval. Sandoval has denounced the bill as detrimental to Nevadans. This week the Nevada Independent report on this sounded like an early Dean Heller political obituary.

Gov. Brian Sandoval said Thursday that the flexibility fellow Republican Sen. Dean Heller promised will be good for Nevada in a health-care bill he’s sponsoring is a “false choice” because the legislation will also slash funding.

Sandoval, in a statement to the Nevada Independent, said he would not “pit seniors, children, families, the mentally ill, the critically ill, hospitals, care providers or any other Nevadan against each other” because of the steep cuts to federal funding the state would face if the Heller-sponsored measure were to pass. A state analysis, also obtained by the Nevada Independent, agrees with independent calculations from various health-care organizations estimating Nevada will lose between $600 million and $2 billion in federal funding by 2026 if the legislation passes.

As tensions mounted this week with Senate Republicans renewing a health-care debate thought to be laid to rest, Heller publicly touted the “flexibility” the measure would create by dividing up the federal dollars currently spent on the Affordable Care Act among the states in the form of a block grant. Where Sandoval only gently rebuffed Heller on Tuesday, saying he appreciated the “intended flexibility” of the bill, the careful, deliberative Sandoval-- not one to rush to the presses with a strongly worded statement-- didn’t mince words on Thursday.

“Flexibility with reduced funding is a false choice,” Sandoval said in the statement. “I will not pit seniors, children, families, the mentally ill, the critically ill, hospitals, care providers, or any other Nevadan against each other because of cuts to Nevada’s health-care delivery system proposed by the Graham-Cassidy amendment.”

Sandoval’s statement stands in sharp relief against one issued just two days earlier, in which the even-keeled governor attempted to soften the blow to Heller after authoring a letter with a group of nine other bipartisan governors urging Senate leadership not to consider the proposal. In the earlier statement, Sandoval said that Heller is “working in the best interest of the state” while gently, but firmly reiterating that he favors a bipartisan fix to the nation’s health-care system.

The recent rift between the two Republicans is also a sharp turn of events from June, when Sandoval and Heller stood side by side to harshly condemn Senate Republicans’ last repeal-and-replace plan, saying that it would strip health care away from millions of Americans and hundreds of thousands of Nevadans. Sandoval remained mum for weeks on the measure, initially drafted by South Carolina Sen. Lindsey Graham and Louisiana Sen. Bill Cassidy and signed onto by Heller amid a week of heated health-care negotiations in the Senate in July.

Heller publicly touted that “Nevada wins” under the measure, which would divvy up the block grant annually based on states’ numbers of poor or near-poor residents as well as create a per capita cap on the half-century old Medicaid program. The Republican senator, who is up for re-election in 2018, has had to walk a fine line amid discussions in the Senate over the past couple of months about repealing and replacing the Affordable Care Act, facing a challenge from the more conservative Danny Tarkanian.

...[W]hile the bill sponsors compare the amount of money Nevada will receive in 2026 under Graham-Cassidy when the block grant ends to how much it will receive in 2020 when the block grant begins, the correct analysis would be to compare the projected funding Nevada will receive in 2026 under the Affordable Care Act under the status quo compared to what it would receive in 2026 under Graham-Cassidy. When that comparison is done, Nevada loses between $600 million to $2 billion by most organizations’ calculations, the state analysis says.

Over months of discussions about repealing the Affordable Care Act, Sandoval has repeatedly argued against touching the extra dollars the federal health-care law made available to states that chose to opt in to an expansion of Medicaid, a point he reiterated in the Thursday statement. Sandoval was the first Republican governor to opt in to Medicaid expansion, and the state has since entirely restructured the way it provides services, such as mental health care, to rely on those new federal Medicaid dollars.

“As Governor, I made a commitment to use all the tools available to ensure Nevadans had access to affordable and quality health care. I made the decision to expand Medicaid to never before covered populations, including childless adults and pregnant women,” Sandoval said. “I made the decision to leverage all the federal funding possible through the Affordable Care Act (ACA), and to work to improve the health-care system for those with mental illness, addictions and disabilities.”

Before the state expanded Medicaid, the uninsurance rate was 20.7 percent, 27 percent for adults under 65 and 14.8 percent for children; after, the uninsured rate dropped by 9.3 percentage points, down to 11.4 percent in 2016. Between Medicaid expansion and the Silver State Health Insurance Exchange, nearly 400,000 Nevadans have gained access to health care, including more than 300,000 in Medicaid and nearly 90,000 on the exchange, Sandoval said.

According to the state’s analysis, more than 200,000 people currently receiving Medicaid will lose coverage when the block grant goes into effect on Jan. 1, 2020 and need to be moved to other coverage with unknown costs. An additional 90,000 Nevadans who purchase insurance on the exchange would also be left without access to subsidized coverage.

The per capita cap that Graham-Cassidy places on Medicaid funding, which organizations who have analyzed the bill do not believe will keep pace with the costs of providing health care, will “fundamentally” change the federal Medicaid program without analyzing the cost of long-term impacts to the state, the state analysis says.

The legislation will also reduce the ability for states to levy provider taxes from 6 percent to 4 percent over time, which will limit Nevada’s ability to help finance increased Medicaid payments to nursing homes. The reduction will result in a $10 million per year reduction in payments to nursing homes by 2025, according to the state’s analysis.

The state analysis says Graham-Cassidy will also reduce the $8 million in prevention and public health funding Nevada receives annually to pay for immunizations and conduct disease investigations to protect public health, as well as reduce Nevada’s hospitals from accessing Medicaid funds in retroactive months of eligibility in many cases, resulting in more uncompensated care and cost burdens being shifted to other parts of the health-care system.

“I have said many times before that I will not support legislation that may result in a cost shift to the State or result in Nevadans losing insurance coverage,” Sandoval said. “I cannot in good faith support the Graham-Cassidy amendment.”