8 years of “suffering” under Barack Obama

Take a moment and think. What have/did we “suffer ” under 8 years of President Obama? An improving economy. Kindness and outreach to all. No scandals in the White House…. 

I say, “Let’s have more of this. Not more of 45’s junk, scandal, and fear mongering.”

Teri Carter's Library

andersonlogo

3C54DC7D00000578-4140672-Barack_Obama_waves_as_he_boards_Marine_One_and_departs_the_Capit-a-77_1484945371469 Photo credit: The Associated Press

The sentence I hear most from well-meaning, conservative friends since President Trump’s election is this: “We suffered 8 years under Barack Obama.”

Fair enough. Let’s take a look.

The day Obama took office, the Dow closed at 7,949 points. Eight years later, the Dow had almost tripled.

General Motors and Chrysler were on the brink of bankruptcy, with Ford not far behind, and their failure, along with their supply chains, would have meant the loss of millions of jobs. Obama pushed through a controversial, $8o billion bailout to save the car industry. The U.S. car industry survived, started making money again, and the entire $80 billion was paid back, with interest.

While we remain vulnerable to lone-wolf attacks, no foreign terrorist organization has successfully executed a mass attack here since 9/11.

Obama ordered the raid that killed Osama Bin Laden.

He drew down the number…

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black sign with a flag at the top. Underneath the flag are the words, "Democracy is Dissent."

Something Positive from the first days of Trump

And he’s not too happy about it!

black sign with a flag at the top. Underneath the flag are the words, "Democracy is Dissent."

Democracy is Dissent. A statement declaring that we have a 1st Amendment constitutional right “of the people peaceably to assemble, and to petition the Government for a redress.”

Central Oregon Coast NOW

Here are some positive results from the events of the last two weeks. Copy and pasted from a friend.
For everyone who DID something, small or big, your efforts have been successful. Because of you:

  1. Federal hiring freeze is reversed for VA (Veteran Affairs).
    2. Court order partial stay of the immigration ban for those with valid visas.
    3. Green card holders can get back in country.
    4. Uber pledges $3M and immigration lawyers for its drivers after#DeleteUbertrends on Twitter.
    5. Obamacare (Affordable Care Act) enrollment ads are still going to air.
    6. The ACLU raised 24M over the weekend (normally 3-4Mil/year).
    7. HHS, EPA, USDA gag order lifted.
    8. EPA climate data no longer scrubbed from website.
    9. More people of different career/religious/economic/race backgrounds are considering running for political office than ever before.
    10. MOST importantly, since we live in a participatory democracy, the people are engaged.

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Update House Passes Bill Making the Hyde & Helms Amendment Permanent + More

Here’s an update to yesterday’s blog on H.R. 7, aka  the “No Taxpayer Funding for Abortion Act.”

Last night at 4:49 pm, the House of Representatives by a vote of 238 to 183 with 11 members not voting, passed this ideological, antiwomen’s reproductive healthcare bill. The 238 yea votes included 3 Democrats (Cuellar, Lipinski, Peterson) and every Republican who voted.

I checked out the roll-call vote.  Here are the Ayes. These so called Representatives voted to make the Hyde Amendment and the Global Gag Rule (the Helms Amendment) permanent. And in addition, this vote denies federal subsidies to any person or small businesses who have healthcare plans under the Affordable Care Act that cover abortion. Contact them and express your outrage at their lack of concern for women’s lives.

—- AYES    238 —

Abraham
Aderholt
Allen
Amash
Amodei
Arrington
Babin
Bacon
Banks (IN)
Barletta
Barr
Barton
Bergman
Biggs
Bilirakis
Bishop (MI)
Bishop (UT)
Black
Blackburn
Blum
Bost
Brady (TX)
Brat
Bridenstine
Brooks (AL)
Brooks (IN)
Buchanan
Buck
Bucshon
Budd
Burgess
Byrne
Calvert
Carter (GA)
Carter (TX)
Chabot
Chaffetz
Cheney
Coffman
Cole
Collins (GA)
Collins (NY)
Comer
Comstock
Conaway
Cook
Costello (PA)
Cramer
Crawford
Cuellar
Culberson
Curbelo (FL)
Davidson
Davis, Rodney
Denham
Dent
DeSantis
DesJarlais
Diaz-Balart
Donovan
Duffy
Duncan (SC)
Duncan (TN)
Dunn
Emmer
Farenthold
Faso
Ferguson
Fitzpatrick
Fleischmann
Flores
Fortenberry
Foxx
Franks (AZ)
Frelinghuysen
Gaetz
Gallagher
Garrett
Gibbs
Gohmert
Goodlatte
Gosar
Gowdy
Granger
Graves (GA)
Graves (LA)
Graves (MO)
Griffith
Grothman
Guthrie
Harper
Harris
Hartzler
Hensarling
Herrera Beutler
Hice, Jody B.
Higgins (LA)
Hill
Holding
Hollingsworth
Hudson
Huizenga
Hultgren
Hunter
Hurd
Issa
Jenkins (KS)
Jenkins (WV)
Johnson (LA)
Johnson (OH)
Johnson, Sam
Jordan
Joyce (OH)
Katko
Kelly (MS)
Kelly (PA)
King (IA)
King (NY)
Kinzinger
Knight
Kustoff (TN)
Labrador
LaHood
LaMalfa
Lamborn
Lance
Latta
Lewis (MN)
Lipinski
LoBiondo
Long
Loudermilk
Love
Lucas
Luetkemeyer
MacArthur
Marchant
Marino
Marshall
Massie
Mast
McCarthy
McCaul
McClintock
McHenry
McKinley
McMorris Rodgers
McSally
Meadows
Meehan
Messer
Mitchell
Moolenaar
Mooney (WV)
Mullin
Murphy (PA)
Newhouse
Noem
Nunes
Olson
Palazzo
Palmer
Paulsen
Pearce
Perry
Peterson
Pittenger
Poe (TX)
Poliquin
Posey
Ratcliffe
Reed
Reichert
Renacci
Rice (SC)
Roby
Roe (TN)
Rogers (AL)
Rogers (KY)
Rohrabacher
Rokita
Rooney, Francis
Rooney, Thomas J.
Ros-Lehtinen
Roskam
Ross
Rothfus
Rouzer
Royce (CA)
Russell
Rutherford
Sanford
Scalise
Schweikert
Scott, Austin
Sensenbrenner
Sessions
Shimkus
Shuster
Simpson
Smith (MO)
Smith (NE)
Smith (NJ)
Smith (TX)
Smucker
Stefanik
Stewart
Stivers
Taylor
Tenney
Thompson (PA)
Thornberry
Tiberi
Tipton
Trott
Turner
Upton
Valadao
Wagner
Walberg
Walden
Walker
Walorski
Walters, Mimi
Weber (TX)
Webster (FL)
Wenstrup
Westerman
Williams
Wilson (SC)
Wittman
Womack
Woodall
Yoder
Yoho
Young (AK)
Young (IA)
Zeldin

And here are the Noes. These Representatives voted to protect women’s reproductive healthcare.  Contact these people and thank them for their support of women and their lives.

 —- NOES    183 —

Adams
Aguilar
Barragán
Bass
Beatty
Bera
Beyer
Bishop (GA)
Blunt Rochester
Bonamici
Boyle, Brendan F.
Brady (PA)
Brown (MD)
Brownley (CA)
Bustos
Butterfield
Capuano
Carbajal
Cárdenas
Carson (IN)
Cartwright
Castor (FL)
Castro (TX)
Chu, Judy
Cicilline
Clark (MA)
Clarke (NY)
Clay
Cleaver
Clyburn
Cohen
Connolly
Conyers
Cooper
Correa
Courtney
Crist
Crowley
Cummings
Davis (CA)
Davis, Danny
DeFazio
DeGette
Delaney
DeLauro
DelBene
Demings
DeSaulnier
Deutch
Dingell
Doggett
Doyle, Michael F.
Ellison
Engel
Eshoo
Espaillat
Esty
Evans
Foster
Frankel (FL)
Fudge
Gallego
Garamendi
Gonzalez (TX)
Gottheimer
Green, Al
Green, Gene
Grijalva
Gutiérrez
Hanabusa
Hastings
Heck
Higgins (NY)
Himes
Hoyer
Huffman
Jackson Lee
Jayapal
Jeffries
Johnson (GA)
Kaptur
Keating
Kelly (IL)
Kennedy
Khanna
Kihuen
Kildee
Kilmer
Kind
Krishnamoorthi
Kuster (NH)
Langevin
Larsen (WA)
Larson (CT)
Lawrence
Lawson (FL)
Lee
Levin
Lewis (GA)
Loebsack
Lofgren
Lowenthal
Lowey
Lujan Grisham, M.
Luján, Ben Ray
Lynch
Maloney, Carolyn B.
Maloney, Sean
Matsui
McCollum
McEachin
McGovern
McNerney
Meeks
Meng
Moore
Moulton
Murphy (FL)
Nadler
Napolitano
Neal
Nolan
Norcross
O’Halleran
O’Rourke
Pallone
Panetta
Pascrell
Payne
Pelosi
Perlmutter
Peters
Pingree
Pocan
Polis
Price (NC)
Quigley
Raskin
Rice (NY)
Richmond
Rosen
Roybal-Allard
Ruiz
Ruppersberger
Ryan (OH)
Sánchez
Sarbanes
Schakowsky
Schiff
Schneider
Schrader
Scott (VA)
Scott, David
Serrano
Sewell (AL)
Shea-Porter
Sherman
Sinema
Sires
Smith (WA)
Soto
Speier
Suozzi
Swalwell (CA)
Takano
Thompson (CA)
Thompson (MS)
Titus
Tonko
Torres
Tsongas
Vargas
Veasey
Vela
Velázquez
Visclosky
Walz
Wasserman Schultz
Waters, Maxine
Watson Coleman
Welch
Wilson (FL)
Yarmuth

I did find a video of the Rules Committee hearing on this bill (held January 23, the day before the final vote in the house).  It’s about 90 minutes with most of the speakers in support of threatening women’s lives.

Immediately after the vote, a motion to reconsider was laid on the table. This motion was accepted without objection.  So once they remove this temporary hold, the bill will be sent to the US Senate for review, hearings, and a vote.  As soon as I find out which Senate committee this is going to, I’ll let you know.

You can meanwhile set up meetings, calls, and emails to your two Senators and strongly encourage them to vote against H.R. 7. If you click here, you can find your Senators’ web pages and contact information.  Some of these websites may also include announcements of townhall meetings.  If there is one of these in your area, GO! to the townhall meeting and let them know that women’s lives need to be protected and to vote NO on H.R. 7.

Keep Abortion Legal NOW Round

US House Attempting to Make the Hyde Amendment Permanent

NOW's Keep abortion legal round

The US House of Representative is expected to vote today on the “No Taxpayer Funding for Abortion Act,” aka known as HR 7 of 2017. Introduces on January 13, 2017, this fast-tracked bill attempts to block all women from accessing health insurance that covers abortion care.

The Feminist Majority posted information about this bill at 11:50 am ET this morning giving background to what this bill does and how it threatens women’s lives. I’m copying and pasting their blog for you to read.  Once you read this, contact your US Representative and tell him/her to vote no on this very dangerous bill that would make the Hyde Amendment permanent.

House Expected to Vote on Major Abortion Restriction

by on • 11:50 AM

Today the House is expected to vote on H.R. 7, known as the No Taxpayer Funding for Abortion Act, a bill that would attempt to block all women from accessing health insurance that covers abortion care. It is a sweeping piece of legislation that touches on a number of anti-abortion policies.

H.R. 7 would make permanent the federal abortion funding restrictions, known as the Hyde Amendment, which Congress typically includes in the annual appropriations bill. The Hyde Amendment denies abortion coverage to the over 28 million women who receive their health insurance through federal programs, such as federal employees, Native Americans, veterans, federal prisoners, and the largest targeted group of reproductive age, low-income individuals on Medicaid.

According to the Guttmacher Institute, nearly 1 in 6 women of reproductive age are enrolled in Medicaid. Of these women, 60 percent live in a state that forbids Medicaid coverage of abortion, meaning they have to pay an average of over $350 out of pocket to access an abortion. The substantial burden forces one in four poor women who wish to terminate an unwanted pregnancy to carry to term.

H.R. 7 would also codify the Helms Amendment, which bans any international organization from using United States’ funds to provide abortion as a “method of family planning,” and has been interpreted to prevent funding even in cases of rape, incest and life endangerment. Under H.R. 7, the United States, the largest aid donor in the world, would permanently deny survivors of war rape access to abortion.

The routine use of rape as a tool of war has been documented in conflicts around the world, from South Sudan to Syria to Nigeria, and constitutes a form of torture. According to the Global Justice Center, 40,000 women and girls are raped in conflict each year, but many more have suffered during specific conflicts. At least 50 percent of survivors are under the age of 18, but in some areas, up to 80 percent of those targeted are children, and many are very young adolescents. The risk of maternal death for girls aged 15 years and younger is twice that of an adult, and these young victims have higher rates of injury, infection or disease related to pregnancy and childbirth. Therefore, for girls raped in conflict, the ability to access abortion has life or death consequences.

Another large group of women who would have their rights to abortion covered health insurance restricted are women who purchase health insurance through the marketplace created by the Affordable Care Act (ACA). Under H.R. 7, women who purchased insurance that covered abortion care would not be eligible for tax subsidies. 25 states have already enacted laws that forbid the selling of abortion care in the ACA marketplace. In addition, small businesses that choose health insurance plans that cover abortion would be denied the insurance-related tax credits that apply to small businesses.

Advocates of abortion access fear that eliminating tax subsidies and implementing strict regulations will push insurance companies to stop covering abortion for all women, as they are unlikely to offer a product that so many are effectively barred from purchasing.

H.R. 7 stands in direct opposition to the Equal Access to Abortion Coverage in Health Insurance (EACH Woman) Act that was introduced in Congress in 2015. The EACH Woman Act would restore abortion insurance coverage to all women affected by the Hyde Amendment, as well as prohibit federal, state and local governments from passing laws that restrict private health insurance companies from offering abortion care, as has been done in 25 states.

President Trump’s pick to lead the Department of Health and Human Services, Tom Price, is one of the staunchest opponents of the ACA and abortion and contraception access, opposing private health insurance coverage for abortion, voting to defund Planned Parenthood and co-sponsoring legislation to outlaw abortion, stem cell research, some forms on contraception and in vitro fertilization.

When asked in 2012 what he would say to low-income women who couldn’t afford birth control if it wasn’t covered by their health insurance, he replied, “Bring me one woman who has been left behind. Bring me one. There’s not one. The fact of the matter is, this is a trampling of religious freedom and religious liberty in this country.”

The House has promised to repeal the Affordable Care Act, defund Planned Parenthood, and introduce other anti-abortion measures. Feminist Majority Foundation has a campaign to support the Each Woman Act.

Media Resources: Mother Jones 1/23/17; Feminist Majority Foundation 9/26/16, 8/12/16, 9/28/16, 1/6/17, 1/19/17; Guttmacher Institute 4/9/16;”

Now that you’ve read what’s going one,  contact your US Representative and tell him/her to vote no on this very dangerous bill that makes the Hyde Amendment permanent.

Here’s a sample script from the Women’s Medical Fund in Philadelphia. You can use your own words or do something like this to express your outrage at government interference with your personal medical decisions:

“Hello,

Please tell [REPRESENTATIVE NAME] to vote NO on HR 7! Bans on abortion coverage like H.R.7 interfere with a woman’s ability to make her own decision about pregnancy and parenting.

Regardless of how we access insurance coverage, each of us should be able to live, work, and make decisions about our future, with dignity and without political interference.

Thank you.”

Then once you’ve made your call, send an email to your representative. All Above All has an easy link with basically the same message for you to send.

Call AND write today!

Is Donald Trump’s Cabinet Anti-Woman?

Central Oregon Coast NOW

anti-women Spencer Platt/Getty Images

Donald J. Trump’s campaign was dogged by accusations of misogyny. Now his cabinet is shaping up to be one of the most hostile in recent memory to issues affecting women, advocacy groups for women say. Tax credits for child care and the prospect of paid maternity leave are exceptions to a host of positions that could result in new restrictions on abortion and less access to contraception, limits on health care that disproportionately affect women and minorities and curbs on funding for domestic violence, as well as slowing the momentum toward raising the minimum wage or making progress on equal pay.

Consider their positions on these issues.

Domestic violence

Jeff Sessions, Mr. Trump’s selection for attorney general; Tom Price, chosen for Health and Human Services secretary; and Mike Pompeo, the pick for C.I.A. director, all voted against reauthorizing the Violence Against Women Act in 2013, which funds…

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The Federal State-Based Universal Health Care Waiver Act of 2015

banner picture of Universal Healthcare from http://www.healthcareforallcolorado.org/

One Agenda: Universal Health Care.
Picture courtesy of Healthcare for All Colorado

As part of the Affordable Care Act (ACA), states have been given the ability to innovate or create their own form of health care insurance or coverage starting on January 1, 2017 AS LONG AS “benefits are at least as comprehensive and affordable as those offered by Qualified Health Plans available on the Exchanges,” according to Representative Jim McDermott (D-WA-7).

As a result, at least 14 states—California, Colorado, Hawaii, Illinois, Maine, Maryland, Minnesota, Missouri, , New York, Ohio, Oregon, Pennsylvania, Vermont, and Washington—have community advocates and state legislators working towards implementing a state-level form of universal health care. They have been working for affordable healthcare access for all residents of their states before and since the Affordable Care Act – aka Obamacare – was passed in 2010.

Now that the US Supreme Court has basically settled the fact that the ACA is constitutional both on June 28, 2012 (Florida v. Department of Health and Human Services) and again on June 25, 2015 (King v. Burwell), we can consider ways to improve our healthcare system at both the state and federal level. As a medical doctor and a member of Congress, McDermott voted for the ACA. He also recognizes that “still more needs  to be done to control costs, improve care, and cover everyone.”

One way to further control these costs and improve health care while covering everyone is to create a universal health care system which I’ve previously blogged about (see here, here, here, here, and here). That means we either have the federal government create a federal single payer plan OR we use the waiver clause in the ACA to help states create their own universal single-payer health care program.

Yet even with the waiver currently allowed within the ACA for innovative state-based health care plans, creating a state-based universal care plan that saves funds for states and individuals while providing health care access to all has a big hurdle to overcome. Rep. McDermott explained this issue in a speech on the floor of the House of Representatives on July 28:

One of the many achievements of the Affordable Care Act is its provisions that grant states the authority to innovate in their health care systems. Under Section 1332 of the law, a state may apply for a State Innovation Waiver that will provide it with control of federal dollars that otherwise would have been spent on premium tax credits and cost-sharing reductions for its residents. Through this waiver, a state may design a system to cover its residents, so long as benefits are at least as comprehensive and affordable as those offered by Qualified Health Plans available on the Exchanges.

However, even with this flexibility, numerous barriers limit states’ ability to design true single-payer systems. Existing waivers are narrow in scope, requiring states to seek out imperfect and convoluted solutions to circumvent federal limitations. A sweeping preemption provision in the Employee Retirement Income Security Act (ERISA) denies states authority to regulate employer-sponsored health plans. And, due to the complexities of our existing federal health programs, it is essentially impossible for a state to design a single benefit package that can be administered simply and efficiently on behalf of all of its residents.

This speech was McDermott’s announcement that he was introducing HR 3241, aka the “State-Based Universal Health Care Act of 2015:” If passed, this bill would allow states to apply for a universal health care waiver that would allow them to have access to and authority over federal health care dollars that would otherwise be spent on the residents of that state. More specifically, this additional waiver act goes beyond the ACA to deal with the hurdles mentioned above. The new provisions of this law, according to McDermott, would waive all of the following:

  • The rules governing premium tax credits and cost-sharing reductions, as provided for in existing waiver authority under Section 1332 of the ACA.

  • Provisions necessary for states to pool funds that otherwise would be spent on behalf of residents enrolled in Medicare, Medicaid, CHIP, TRICARE, and the Federal Employee Health Benefits Program.

  • ERISA’s preemption clause, which cur-rently forbids states from enacting legislation relating to employee health benefit program

After the introduction of HR 3241, the House referred this bill to five committees — the Committee on Energy and Commerce, the Committee on Ways and Means, the Committee on Oversight and Government Reform, the Committee on Armed Services, and the Committee on Education and the Workforce. I believe that the large number of committee referrals was done because of the need to review all of the different laws that this waiver would impact.

You can read the bill in its entirety here.

I am pleased that this bill has been introduced. It however needs many co-sponsors and advocates to pressure Congress to actually hear, review, and pass this legislation. Please contact your US Representative and ask her/him to co-sponsor Representative Jim McDermott, MD’s bill HR 3241. Here’s the lookup page to find your US. Representative by zip code.

As this is the summer, your Representative should be in the home district. Call, write, set up a meeting and tell her/him why you want to see a universal health care program in your state and why this bill is so necessary. If your Representative agrees to sign on, have him/her contact Mr. McDermott’s aides that are focusing on this issue. They are Jayme Shoun, located in Seattle at (206) 553-7170 and Daniel Foster, Health Counsel in the DC Office at (202) 225-3106.

Thanks.

Universal Health Care: Let’s Do It!

I am not an economist. But I am a strong advocate for universal access to healthcare in the United States. See why here.

A couple of days ago, Thom Hartmann at The Big Picture RT posted a YouTube video on why economists are demanding a universal national healthcare plan. In this video he reports that more than 100 economists sent an open letter to Vermont’s Governor Peter Shumlin (D) after Shumlin “bailed” on implementing Vermont’s state-based single-payer healthcare plan.

Governor Shumlin stated that he was stopping the implementation process because he believes that “This is not the right time” for enacting single payer. He stated that there were too many costs associated with the program and could not go forward with the plan “at this time.”

The economists argued otherwise:

As economists, we understand that universal, publicly financed health care is not only economically feasible but highly preferable to a fragmented market-based insurance system…. Public financing is not a matter of raising new money, but of distributing existing payments more equitably and efficiently. Especially when combined with provider payment reforms, public financing can lower administrative costs, share health care cost much more equitably, and ensure comprehensive care for all.

We support publicly and equitably financed health care at federal and state level, and we encourage the government of the state of Vermont to move forward with implementing a public financing plan for the universal health care system envisioned by state law.

Hartman then goes on to say that part of the economic concerns about Vermont’s single-payer healthcare plan arises from its small population base. He believes that the economy of scale makes it harder for a small state to go it alone in “innovating” new healthcare plans as allowed by the Affordable Care Act starting in 2017. Then he goes on to urge the federal government to expand Medicare to all citizens over a 10-year period of time.

I agree that it would be great to have universal Medicare for All across the United States. But I also believe that the only way that will happen is if some states implement single-payer healthcare at a state level to concretely show that a universal healthcare plan is economically viable and distributes existing healthcare payments more efficiently and equitably while lowering administrative costs WITHOUT raising the overall cost to individuals, businesses or communities. In fact, in many instances, cost would be lower.

Studies on how this might happen have been done by well-known economists across the country. For example, Dr. Gerald  Friedman, Professor of Economics and Department Head at the University of Massachusetts-Amherst has done several of these studies, including one for Pennsylvania, one for Maryland, and one for expanding Medicare to all at the national level. Every economic impact study on implementing universal healthcare plans that I have read indicates that “A single-payer health care finance system would produce substantial health and economic gains” when implemented at either a state or the national level.

At least 14 statesCalifornia, Colorado, Hawaii, Illinois, Maine, Maryland, Minnesota, Missouri, New York, Ohio, Oregon, Pennsylvania, Vermont, and Washington—have community advocates and state legislators working towards implementing a state-level form of universal healthcare. And advocates across the nation continue to work for Medicare for All at the national level.

Whichever way comes first is fine with me. We just need to get moving and create healthcare for all in the USA.  Let’s make it sooner rather than later.

The Supreme Court, the ACA, Healthcare.gov, and an Alternative Plan

The US Supreme Court will be hearing a case – known as King v. Burwell – this coming week on whether or not the federal healthcare exchange program, known as Healthcare.gov, is legal. The question before the Court is whether or not the Affordable Care Act (ACA) allows for subsidies for healthcare premiums in any of the 34 states that refused to set up their own healthcare exchanges under the ACA.

The plaintiffs – four people from Virginia – argue that the federal government misinterpreted the ACA in regards to the subsidies. They argue that the law only allows for subsidies in states that set up a state-based exchange. Virginia in one of the 34 state who opted out of a state-based exchange. These four individuals, who don’t want to purchase insurance, say that without the subsidies, they would not have to either buy insurance or pay a penalty since they do not make enough to afford healthcare without the subsidy*. The Obama administration argues that this is a politically motivated argument to narrowly interpret a couple of words found in the ACA in order to gut it.

If the US Supreme Court invalidates the Healthcare.gov websites in all of the states that refused to set up their own healthcare exchanges, everyone who gets a subsidy to purchase their health care through the exchange will lose that subsidy. According to the Washington Post, this type of ruling would affect about eight million people across the country. That’s about 87% of all Healthcare.gov users nationwide in the 34 states that did not set up a state-based exchange receive. In Pennsylvania, somewhere between 70-84% of all users of healthcare.gov receive these subsidies.

The subsidies in Healthcare.gov currently reduces healthcare premiums by up to 72% of the full premium, depending on the size of one’s family and family income. So if the Court holds that subsidies within the Federal Healthcare exchange are illegal, premiums for individuals needing these subsidies will dramatically increase; out-of-pocket premium increase could amount to an average increase of 256%. This increase could begin in as little as 25 days after the ruling is made in June 2015. OR the Court could set a date further in the future to allow some time for transition.

What would the end of these subsidies mean?

Healthcare in the 34 states in the federal exchange program would destabilize. The predictions include lots of people – mostly the young and the healthy – ending their insurance, insurance companies pulling out of the exchanges in these states, lots of layoffs, and a return to uncovered people attempting to get care in hospitals without any coverage. Those left in the exchanges after the young and healthiest leave are the older and the sickest individuals. Insurance companies will begin to feel the pain and start to pull out of the exchanges as participation in the exchanges would no longer be financially viable. With fewer people seeking care on the federal exchange, thousands of people hired by the insurance companies and by the federal exchange system will likely face layoff. In addition, hospitals will once again see a surge in the uninsured arriving on their doorstep for care.

Here’s how the Kaiser Family Foundation summarizes this issue:

People Leaving the Market Followed by Premium Increases for Those Who Remain. As a result, the elimination of the subsidies would destabilize the individual insurance markets in states not running their own marketplaces. Under the ACA, insurers would still be required to guarantee access to coverage irrespective of health status and prohibited from charging sick people more than healthy people. Even without the subsidies, many people who are sick would likely find a way to maintain their insurance in the face of substantial premium increases. However, people who are healthy would likely drop their insurance.

Insurers in the affected states would immediately find themselves in a situation where premiums revenues were insufficient to cover the health care expenses of the remaining enrollees, who would be far sicker on average than what insurers assumed when they set their premiums for 2015. This would trigger a classic adverse selection “death spiral,” where insurers would seek very large premium increases, which in turn would cause the healthier of the remaining enrollees to drop coverage….

Insurance Companies Leave the Market and Layoff Employees…Under ACA regulations, premiums for insurance sold inside the marketplaces are locked in for a full calendar year. So, the earliest those premiums could change would be January 1, 2016, though even that would be tricky since insurers will have already submitted proposed 2016 premiums to state insurance departments by the time the Court issues a decision. Depending on state laws, premiums for products sold outside of the marketplaces could potentially be increased more quickly. And even if insurers could adjust rates, establishing stable and sustainable premium levels in this type of environment is extremely difficult, because as rates move higher, more of the relatively healthy enrollees drop their coverage.

Because this may all happen very quickly, it is possible that many or all insurers would choose to exit the individual markets in these states rather than facing significant losses in a quickly shrinking market. Insurers that remain in the market risk being one of the only carriers continuing to guarantee access to coverage to people in poor health (since people who lose coverage from exiting insurers have special enrollment periods to choose new coverage).

Since it is unlikely that Congressional opponents to the ACA would be willing to craft a law allowing for subsidies within Healthcare.gov should the Court overturn this portion of the ACA regulations, the burden of the fix falls upon each of the 34 states. Some of these 34 states will allow the healthcare exchange to die with the dire predictions quickly coming to fruition. Others, in advance of the Court’s hearing and decision of this case, are starting to talk about alternatives should the Court outlaw the subsidies in their states.

One of these states attempting to deal with this possibility is Pennsylvania, where I live. The insurance companies and hospitals throughout the state, fearing for their livelihood, are lobbying the PA General Assembly to set up a state-based exchange system. Tom Wolf (D), our new Governor, has said he is interested in setting up a state-based exchange.

The question then becomes, where would the money for the set-up of a state exchange come from in a state that has a large budget deficit since federal dollars for such a set-up are no longer available.

Might this be a great time to lobby for a universal health care plan for Pennsylvania? As well as in the other 21 states currently working towards such a solution as well?

Healthcare for All PA, in conjunction with some of our state legislators, are working on re-introducing the Pennsylvania Health Care Plan. This bill, if it becomes law, would

…create one insurance plan that has one single payer, to cover all Pennsylvania taxpayers.  The premiums for The Pennsylvania Health Care Plan would be a flat rate of 3% of income for individuals and 10% of payroll for businesses.  The Pennsylvania Health Care Plan would place you and your healthcare provider in charge of you and your family’s healthcare. The plan will be a public/private hybrid with the insurance function provided by the state government and the medical care would be privately delivered.

It’s cost effective. It covers everyone. It’s comprehensive in that it covers all medical treatment, dental care, eye care, physical therapy, mental health treatment,  hospice care, treatments for addiction, long-term care, access to wellness programs, prescription drugs and emergency transport. And you won’t need an army of navigators in either a state- or a federal-based healthcare exchange to help you interpret your plan.

Check out Healthcare for All PA for more information on this bill and become a citizen lobbyist for comprehensive health care that allows you access to the healthcare you need and want without bankrupting you, your family or your neighbors.

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*NOTE: The four plaintiffs in this case before the Supreme Court–David King, Douglas Hurst, Brenda Levy and Rose Luck—appear to be either ideologues and/or guinea pigs for the libertarian Competitive Enterprise Institute (CEI). CEI is an organization committed to overturning the Affordable Care Act. If the subsidies are overturned, all four of these individuals may not even be affected by the Court’s ruling according to a February 9 article in Mother Jones. Three of the four – Levy, King and Hurst – are now or soon will be fully eligible for Medicare. Two of them – King and Luck – already qualify for a hardship exemption from purchasing healthcare and/or paying a penalty due to their relatively low-income levels. However, the issue of “standing” (the legal argument that they would actually be harmed if the law were to continue), for some reason, has not been raised in this case by the Obama administration and will not be considered when the Court hears the case next week.

Pennsylvania General Assembly Again Attacking Women’s Reproductive Health

Keep Abortion Legal NOW Round

Keep Abortion Legal Safe, Legal and Accessible (http://www.now.org/issues/abortion/)

It’s 2013 and the Pennsylvania General Assembly continues to attack women’s access to reproductive health. According to WeveHadEnoughPA.org, the Pennsylvania legislature has launched and maintained a 2+ year attack on women’s health. There have been numerous bills introduced and in some cases passed that restrict women’s vital access to reproductive health.  Since January 2011, there have been at least 55 votes in the Pennsylvania General Assembly to restrict access from birth control to safe, legal abortions.

The most recent attack is happening this month.  On April 10, the Pennsylvania Senate Insurance and Banking Committee heard and passed out SB 3 by an 8-5 vote; a floor vote could occur any time this month.  This coming Monday, April 15th, the Pennsylvania House Health Committee will be hearing and voting on HB 818, the companion bill to SB 3.

The Additional Burdens on Women Seeking Abortion Care in These Bills

Both of these bills would prohibit insurance companies who provide health care coverage from including abortion coverage within the new healthcare Exchange crafted by the Affordable Care Act (aka Obamacare). The only exceptions to this proposed ban are for women who become pregnant because of rape or incest if they personally report the sexual assault to law enforcement officials and for women who will die without immediate access to abortion services. If a woman doesn’t meet one of these two exceptions, she must completely pay for the abortion totally out of her own pocket, unlike any other medical care she would receive under her health insurance plan.

Currently, about 80% of private insurance companies provide coverage for abortion services. This is important because these very same plans will be offered to people purchasing insurance through the Exchange. As part of the federal law, however, all plans that offer abortion coverage in the Exchange must have a separate payment for that portion of the coverage. This bill would deny women the right to make this separate payment and deny them what is currently available to most people covered by the current private health insurance system. While women would still be able to have abortions in this circumstance, they would be forced to fully pay out-of-pocket all cost for these procedures; their insurance company would be prohibited from paying any portion of this treatment.

This proposed ban places an undue burden on victims of rape and incest and on those women whose lives are in danger health-wise by adding unnecessary barriers to receiving the critical medical attention they need. The two exceptions allowed are extremely limited. These bills require woman who are victims of rape or incest to notify the police and identify the perpetrator prior to seeking abortion treatment.  It also limits women with health issues that complicate their medical treatment to those that are in immediate danger of dying and requires additional medical certification by second, non-attending physician.

This bill places these restrictions on access to health insurance not by mentioning rape or incest or the death aversion clause, but by referring to and expanding Pennsylvania’s version of the Hyde Amendment.  This language is embedded in 18 Pa.C.S. § 3215(c) and would expand restrictions on public funds to all privately paid insurance plans purchased within the Exchange. The law (18 Pa.C.S. § 3215(c))as currently written is a prohibition of the state spending of public funds but not personal funds provided by the person herself for her own health insurance coverage.

The Rape and Incest Exception

Women and minors who are raped would be denied access to abortion services unless they formally report and identify their rapist to the police or child protective services.  Most sexual assaults are not reported to the police. This is even truer when the perpetrator is a family member or acquaintance. According to the Pennsylvania Coalition Against Rape, sexual assault occurs at a much higher rate than is actually reported.

Reasons for not reporting include an initial denial that they have been raped; fear that you won’t be believed or are ashamed for having been raped; or having an ongoing relationship (such as a spouse or parent) with the perpetrator. In order to be safe from further violence by the perpetrator, women and girls may decide not to report the attack to the authorities.  And if you are in denial you are also unlikely to report your rape or the incest of your child to authorities as required in this proposed legislation.

So that means if this bill becomes law and you become pregnant from rape or incest, you are further burdened with the additional costs of fully paying for the abortion. If this bill were not to go into effect, then following the restrictions placed on abortion care under federal law, you would have the abortion services covered based on the insurance rider you purchased in the exchange and you wouldn’t be forced to file a complaint with the police.  This is just one reason why this bill should be voted down.

The “Avert” Death Exception and Need for Expanded Health Exception

In addition, under this proposed law, women who are near death could receive an abortion.  However, say a woman develops cancer or an infection during her pregnancy that will not immediately kill her but would complicate her medical treatment should she continue with the pregnancy.

This health threat/complication is not included in the current bill’s health exception as that exception allows abortions only to “avert” the woman’s death. Any woman with a medical condition that is complicated by the pregnancy but doesn’t immediately place her in danger of death would be forced to bear the additional burden of the full cost of an abortion in addition to the increased threats to her health as well as the additional medical bills for the remaining part of her care.  The medical community, advocates and some legislators are very concerned about this limited exception and have proposed an amendment to both the House and Senate bill to expand this exception from “averting” her death to coverage of the abortion for any pregnancy that poses a substantial risk to the woman’s physical health.

But even if the health exception is expanded to include threats to women’s physical health and care, this bill continues to attack women’s health and lives and should be voted down.

Why this Bill Should be Voted Down

The question of whether abortion will be covered in federally subsidized insurance exchanges has already been settled.  In response to concerns raised by US Senator Ben Nelson, a staunch opponent of abortion, women who want to use their own money to purchase a health insurance plan that covers abortion services must send a separate payment so the funding for abortion coverage is completely separate and paid entirely by the individual. This bill denies women their right to make this separate payment.  And with an estimated 80% of private insurance plans currently covering abortion care, banning abortion coverage in the state exchange would leave women worse off than they were before health care reform began.

Abortion care is a legally authorized and fundamental component of women’s basic health care.  Women should not be denied access to safe, legal, and critical care as part of health care reform implementation.

If abortion coverage is available to some, it should be available to all.  Politicians should not discriminate against women participating in the health insurance exchange.  All women deserve the same peace of mind that they can obtain the health care they need, regardless of where their insurance comes from.

The decision to have an abortion is a private decision between a patient and her physician. It should not be denied by politicians interfering with an insurance company and the policies they offer to the consumer for this procedure.

Banning abortion coverage in transactions between a private company and an individual is governmental activism of the worst kind.  With all of the heated rhetoric over healthcare reform, one would assume that lawmakers would be sensitive about taking any action that suggests government intervention in private healthcare decisions.

Finally, instead of denying Pennsylvania women access to fundamental reproductive health care services, politicians should be working to protect and advance women’s health.

Action Needed

Contact your Pennsylvania Senator and Representative today (find their contact information here).  Tell her/him to support the expanded health exception amendment to both SB 3 and HB 818 and to oppose the entire bill regardless of the inclusion of the amendment.

Universal, Single-Payer Health Care Can Save Billions of Dollars

I recently posted a blog about why I support universal single-payer healthcare.  I told you about my personal trials with insurance companies in order to obtain my life-saving bone marrow transplant.  I have been telling that story in my advocacy ever since the early 1990’s when I became a single-payer healthcare advocate.

In 2008, I ran for the Pennsylvania House of Representatives.  Another candidate in another district that year was Cindy Purvis.  Both of us ran for public office with the message that affordable, universal health care was necessary for individuals, families, businesses, and our communities in general.

The following year, Cindy helped found Health Care for All PA, a statewide non-profit organization that educates the public and government officials regarding the scope and seriousness of the health care crisis.  She was their first President.  A year later, she asked me to join their Board of Directors.

In our advocacy for a universal health care plan for Pennsylvania, we have received push-back from the legislature. They told us that the General Assembly would not move the bill unless we had an Economic Impact Study (EIS) that shows that universal, single-payer health care is cost-effective. So a couple of years ago, the legislature considered an EIS bill to find out this answer. Unfortunately it died in committee.

But this question still needed to be answered.  So the Health Care for All PA Education Fund raised monies from individuals and small businesses to fund just such a study to compare the proposed state-based single-payer health care plan to the Affordable Care Act (aka Obamacare) and other health care programs within Pennsylvania.  And we now have the results.

STUDY PROVES PENNSYLVANIA CAN EXPAND HEALTH CARE TO ALL WHILE SAVING BILLIONS OF DOLLARS

ECONOMIC IMPACT STUDY COMMISSIONED BY HEALTHCARE4ALLPA PAVES THE WAY FOR AFFORDABLE UNIVERSAL HEALTH CARE IN PENNSYLVANIA

Health Care for All PA released the results of this economic impact study last week based on and in conjunction with the anticipated introduction of the Pennsylvania Health Care Plan bill by Senator Jim Ferlo on Tuesday, March 19 at 2:00 pm in the Capitol Media Center, Harrisburg.

The results prove that a single-payer health care plan will save families, businesses and tax payers $17 billion annually while at the same time providing comprehensive health care to all.

This study was done by University of Massachusetts – Amherst professor of economics Gerald Friedman, Ph.D.   It compares the cost of the current for-profit health insurance model in Pennsylvania whereby provider choice is limited and health services are rationed by health insurance companies to that of a consumer-driven health care system which lets people have the freedom to choose their own doctors, hospitals and health care providers.

Some of the important advantages of a single-payer system are:

  • Provides comprehensive coverage for every resident of Pennsylvania, including dental, vision and mental health services;
  • Eliminates the need for hospitals to absorb the cost of care for the uninsured;
  • Reduces bureaucracy for private physicians resulting in reduced administrative costs and improved compensation for private physicians;
  • Reduces or eliminates health insurance over-costs for small business, allowing for more job creation, greater reinvestment of profits, and reduced workers’ compensation costs.
  • Radically reduces the total cost of health care to levels more consistent with costs in the rest of the industrialized world.
  • Reduces healthcare spending in Pennsylvania by an estimated $16 Billion +
    (from $144 billion to $128 billion). This includes savings of $7 Billion + for businesses that currently provide health care benefits and over $6 Billion for state and local governments and school boards. It also reduces the cost to the average individual who pays well over the 3% of personal income for health care coverage that is called for in the Pennsylvania Health Care Plan.

Here’s some highlights from the EIS:
EIS SUMMARY AND HIGHLIGHTS OF PENNSYLVANIA HEALTH CARE PLAN

Friedman’s Executive Summary can be read here.

The entire Economic Impact Study can be read here.