How killing the ACA could lead to more opioid deaths in West Virginia and other Trump states

The following article by Simon Haeder was posted on the Conversation website July 24, 2017:

President Trump spoke at the National Scout Jamboree in West Virginia on July 24, joining a long list of presidents who have spoken to the huge meeting of Boy Scouts, troop leaders and volunteers. The visit was not surprising, as West Virginia, in the center of Appalachia, is overwhelmingly Trump Country.

It is also at the center of the nation’s opioid epidemic, with a rate of 42 overdose deaths per 100,000, more than double the national average. Indeed, on Aug. 15, 2016, Huntington, home of Marshall University, experienced more than two dozen overdoses in a span of just four hours.

West Virginia is also a state that has been aggressive in taking advantage of opportunities offered by the federal government under the Affordable Care Act, including the ACA insurance marketplaces and the Medicaid expansion. Continue reading “How killing the ACA could lead to more opioid deaths in West Virginia and other Trump states”

Trump threatens electoral consequences for senators who oppose health bill

The following article by Sean Sullivan, Kelsey Snell and David Nakamura was posted on the Washington Post website July 20, 2017:

The Congressional Budget Office on July 19 estimated that a GOP health-care bill ending parts of Obamacare with no immediate replacement would reduce federal deficits by $473 billion over a decade. (Video: Bastien Inzaurralde/Photo: Melina Mara/The Washington Post)

President Trump exhorted lawmakers Wednesday to resurrect the failed Republican plan to “repeal and replace” the Affordable Care Act, injecting fresh turmoil into an issue that had appeared settled the day before, when Senate leaders announced they did not have the votes to pass their bill.

Trump’s remarks, at a lunch with 49 Republican senators, prompted some of them to reopen the possibility of trying to vote on the sweeping legislation they abandoned earlier this week. But there was no new evidence that the bill could pass.

At the lunch, the president also threatened electoral consequences for senators who oppose him, suggesting that Sen. Dean Heller (R-Nev.) could lose his reelection bid next year if he does not back the effort. The president also invited conservative opposition against anyone else who stands in the way.

“Any senator who votes against starting debate is really telling America that you’re fine with Obamacare,” Trump said.

After the collapse of the Better Care Reconciliation Act, which would have repealed and replaced key portions of the Affordable Care Act, Senate Majority Leader Mitch McConnell (R-Ky.) on Monday announced plans for a vote on pure repeal instead, a move that seemed designed to either allow — or force — lawmakers to record a vote on what has been the GOP’s top campaign promise of the past seven years.

As he hosted Senate Republicans for a health-care meeting at the White House on July 19, President Trump touted GOP efforts to revamp the Affordable Care Act. (Photo: Jabin Botsford/The Washington Post)

A repeal-only approach, which also lacks the votes to pass, would increase the number of people without health coverage by 17 million next year and by 32 million at the end of a decade, according to a fresh analysis released Wednesday by the Congressional Budget Office.

The forecast by the nonpartisan CBO is nearly identical to estimates the office made in January based on a similar bill that passed the House and Senate in late 2015 — and that was vetoed by President Barack Obama.

“I think we all agree it’s better to both repeal and replace. But we could have a vote on either,” McConnell said after the lunch at the White House.

Trump’s remarks introduced a new level of chaos into the GOP, potentially setting up Senate Republicans to take the blame from angry conservatives for failing to fulfill a long-standing GOP vow.

The effort to undo the Affordable Care Act has been fraught for months with internal GOP divisions. The intraparty tension looms over other big-ticket items Republicans are hoping to pass as they control both chambers of Congress and the White House, including passing a budget and enacting major tax cuts. After six months, they can boast no major legislative achievements.

And now, Republican lawmakers head into the 2018 midterm cycle with a president who appears capable of not having their backs.

Despite those tensions, Trump claimed at the lunch that “we’re very close” to passing a repeal-and-replace bill. It was the latest sign of the disconnect between the president and the Senate. It also came a day after Trump tweeted “let ObamaCare fail” — and two days after he called for a repeal-only bill.

As he hosted Senate Republicans for a health-care meeting at the White House, July 19, President Trump said he “worried” whether Sen. Dean Heller (R-Nev.) would support a revised GOP health-care bill that collapsed on July 17. (Photo: Jabin Botsford/The Washington Post)

The White House appeared determined to keep trying for something. Health and Human Services Secretary Tom Price and Centers for Medicare & Medicaid Services director Seema Verma met with roughly two dozen GOP senators for nearly three hours on Capitol Hill on Wednesday evening. The meeting was arranged by the White House to help persuade wavering senators to back the repeal-and-replace bill, according to people familiar with the meeting who spoke on the condition of anonymity to discuss private planning.

Following the meeting, several senators described the talks as productive, but none would name specific areas of progress or new agreement that resulted from the gathering.

Even as Trump’s team tried to work out policy and political disagreements among members, the president was strong-arming skeptical senators in public. Seated directly to Trump’s right at Wednesday’s lunch was Heller, who is up for reelection in 2018 in a state Democrat Hillary Clinton won.

“Look, he wants to remain a senator, doesn’t he?” Trump asked, Heller smiling at his side. “Okay, and I think the people of your state, which I know very well, I think they’re going to appreciate what you hopefully will do.”

After he returned to the Capitol, Heller sized it up this way: “That’s just President Trump being President Trump.”

Tensions have been evident for a while. After Heller came out against an earlier version of the Senate bill, a conservative organization aligned with Trump vowed to launch an expensive ad campaign against him, angering and shocking many mainstream GOP allies of the senator. Later, the group backed off.

Now, senators are not sure what they will be voting on in the coming days — pure repeal or repeal and replace.

“See, that hasn’t been decided. That’s part of the discussion. So, that’s why I don’t take a position at this point,” Heller said.

Sen. John Cornyn (R-Tex.), McConnell’s top deputy, said Wednesday: “I know it seems like we’ve got a bit of whiplash, but I think we’re making progress.”

But even he had no clarity on the next step. “We’re still discussing,” he said.

Sen. Lamar Alexander (R-Tenn.), the chairman of the Health, Education, Labor and Pensions Committee, told reporters Wednesday that there still are not enough votes for a repeal-only bill.

Separately Wednesday, members of the hard-right House Freedom Caucus started the process of bringing a repeal-only bill to the House floor — a process meant to sidestep GOP leaders reluctant to expose vulnerable members to a politically perilous vote on legislation unlikely to become law.

The House passed its own revision to the Affordable Care Act earlier this year. Wednesday’s gambit would not only allow conservatives to vote for a straight-repeal bill but also force moderates to do the same — adding to the political divisions that Trump had stoked earlier in the day.

“The American people do not know why we did not have something on President Trump’s desk on Jan. 20,” said Rep. Mark Meadows (R-N.C.), the group’s chairman. “Here we are at July 20 with nothing to show for it, and they’re tired of waiting.”

Sen. Ron Johnson (R-Wis.), who has expressed opposition at various times during the months-long health-care drive, said that he understood Trump’s push for repeal and replace at the lunch as a call to return to the broader bill McConnell pulled back earlier this week.

“I think the president showed some real leadership here,” Johnson said.

Even GOP senators who oppose the repeal efforts worry about being blamed for failing to act on health care. A recent Gallup poll found that 70 percent of GOP respondents said they support repealing and replacing Obamacare.

Conservative activists are already aggressively targeting centrist Republicans who have opposed the efforts. On Wednesday, a pair of influential conservative groups launched an “Obamacare Repeal Traitors” website attacking Sens. Lisa Murkowski (Alaska), Rob Portman (Ohio) and Shelley Moore Capito (W.Va.).

“They campaigned on ­REPEAL,” says the website, which the Club for Growth and Tea Party Patriots launched. But now, it says, “they are betraying their constituents by joining with Democrats to defeat Obamacare Repeal efforts!”

Capito has said that she supports repealing the Affordable Care Act, but only if it can be replaced with a bill that doesn’t force millions off their insurance and doesn’t “hurt people.”

“I think we all want to get to the right place,” Capito said after the White House lunch. On Twitter, she sought to use Trump’s words to defend her position, writing: “I’m glad @POTUS agrees that we cannot move to repeal Obamacare without a replacement plan that addresses the needs of West Virginians.”

At the lunch, Trump said, “People should not leave town unless we have a health insurance plan, unless we give our people great health care,” meaning that recess plans should be put off if a deal isn’t reached. Marc Short, the White House’s legislative director, told reporters afterward that “this is not something that we can walk away from.”

Trump, who had invited Republican leaders to a health-care strategy dinner Monday night, was apparently blindsided by the opposition from some conservative members, including Sens. Mike Lee (R-Utah) and Jerry Moran (R-Kan.), whose declared no votes effectively killed the legislation. At lunch, he scolded them.

“The other night, I was surprised when I heard a couple of my friends — my friends — they really were and are,” Trump said, without directly naming the duo. “They might not be very much longer, but that’s okay.”

Trump, as he has done numerous times in recent weeks, reminded the lawmakers that Republicans campaigned against the Affordable Care Act for years and that their supporters are counting on them to make good on their promises.

“I’m ready to act,” Trump said. “I have my pen in hand. I’m sitting in that office. I have pen in hand. You’ve never had that before. For seven years, you’ve had the easy route — we repeal, we replace, but he [Obama] never signs it. I’m signing it. So it’s a little different.”

Mike DeBonis, Juliet Eilperin, Ed O’Keefe, Abby Phillip and Amy Goldstein contributed to this report.

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Amid Trump’s Shifting Health Care Stances, a Recurring Infatuation

The following article by John T. Bennett was posted on the Roll Call website July 20, 2017:

President keeps bringing up letting 2010 law fail

President Trump in Warsaw on July 6. (Czarek Sokolowski/AP)

President Donald Trump on Wednesday again appeared to change his stance on just which path he wants Republican senators to take on health care. But he has long been infatuated with the notion of House and Senate Democratic leaders asking — begging, even — for his help on health care.

This week, the president and his aides have been posturing to put that very scenario in play, even as his own party attempts to resurrect a measure that would repeal most of and partially replace the 2010 health care law in one swoop.

For months, Trump has vacillated on his preferred way ahead on health care. He has at times advocated repealing the Obama-era law and immediately replacing it. On some days, repealing the law now and replacing it with a GOP plan down the road has been his message. And on others, like Tuesday, Trump opines that the GOP health care push has reached a point when the best option is to simply allow the 2010 law to fail. Continue reading “Amid Trump’s Shifting Health Care Stances, a Recurring Infatuation”

CBO: GOP Plan Would Spike Premiums, Cut 32M From Insurance Rolls

The following article by the Roll Call staff was posted on RollCall.com July 19, 2017:

Credit: Oscar Gronner

A new Senate GOP health care plan would result in 32 million more people without health insurance, according to a Congressional Budget Office analysis released Wednesday. The measure, similar to a 2015 bill passed by the Senate, would save $473 billion over a decade.

According to the analysis from Congress’ nonpartisan budget scorekeeper, average premiums in the individual marketplace would increased by about 25 percent next year, increasing to 5o percent by 2020 and 100 percent by 2026.

“Under this legislation, about half of the nation’s population would live in areas having no insurer participating in the nongroup market in 2020 because of downward pressure on enrollment and upward pressure on premiums. That share would continue to increase, extending to about three-quarters of the population by 2026,” CBO wrote on its website.  Continue reading “CBO: GOP Plan Would Spike Premiums, Cut 32M From Insurance Rolls”

Trump has changed his health care stance 3 times in past 36 hours. Here are the receipts.

The following article by Aaron Rupar was posted on the ThinkProgress website July 19, 2017:

CREDIT: AP Photo/Alex Brandon

He’s in favor of everything and nothing

After Senate Republican defections killed off the latest Trumpcare bill on Monday night, President Trump tweeted his support for changing course and immediately repealing Obamacare before a bipartisan replacement plan is drawn up at some point down the road. Continue reading “Trump has changed his health care stance 3 times in past 36 hours. Here are the receipts.”

Obamacare’s Future Now Depends on an Unhappy White House

The following article by Steven Pressman was posted on the Conversation website July 18, 2017:

Tom Price, the secretary of health and human services, has repeatedly warned that Obamacare is near collapse. “The situation has never been more dire,” he said on July 10. Credit Jim Watson/Agence France-Presse — Getty Images

The congressional effort to overhaul the health care system appears to be in shambles. But the current health care system lives on. And decisions the Trump administration makes about how to manage it could have big effects on who has coverage next year, and what it costs them.

The Department of Health and Human Services is in charge of administering Obamacare, and so far the department’s staff has given many public indications that it does not enjoy such duties.

The Department of Health and Human Services is in charge of administering Obamacare, and so far the department’s staff has given many public indications that it does not enjoy such duties. Continue reading “Obamacare’s Future Now Depends on an Unhappy White House”

Governors Call for Bipartisan Fix to Health Care

The following article by Kyle Stewart was posted on the Roll Call website July 18, 2017:

State leaders want to be at decision table with Congress

Ohio Gov. John Kasich is one of 11 governors calling for a bipartisan solution to health care reform. (Bill Clark/CQ Roll Call)

Following the collapse of the Senate’s health care overhaul bill, a group of governors are suggesting a new way forward: bipartisanship. And the group wants a spot at the decision table.

Eleven governors from across the nation issued a statement Tuesday morning calling on the Senate to stop the effort to repeal the 2010 health care law without a replacement.

“This could leave millions of Americans without coverage,” the statement said. “The best next step is for both parties to come together and do what we can all agree on: fix our unstable insurance markets.” Continue reading “Governors Call for Bipartisan Fix to Health Care”

Estimated Premium Increases from Repeal and Delay

The following article by Emily Gee and Thomas Huelskoetter was posted on the Center for American Progress July 18, 2017:

Senate Majority Leader Mitch McConnell at his office on Thursday, when the Republican health plan was made public. Credit Doug Mills/The New York Times

After the failure of the Better Care Reconciliation Act (BCRA), Senate Majority Leader Mitch McConnell (R-KY) has reverted to the previously-rejected strategy of repealing major parts of the Affordable Care Act (ACA) with no replacement.

McConnell’s revived strategy of repeal and delay would cause immediate chaos in the individual insurance market despite putting off the implementation of certain provisions for two years. The Congressional Budget Office (CBO) has projected that this approach would increase premiums in the individual market to levels 20 percent to 25 percent higher relative to those under the ACA in the first year after enactment. By 2026, premiums would be about 100 percent higher than under current law. Continue reading “Estimated Premium Increases from Repeal and Delay”

Trump suggests Republicans will let ACA market collapse, then rewrite health law

The following article by Juliet Eilperin and Sean Sullivan was posted on the Washington Post website July 18, 2017:

The Senate Republicans’ health-care bill was dealt a fatal blow on July 17, when two more senators came out against it. Now President Trump is suggesting to repeal Obamacare, let the insurance market fail and then make “a great healthcare plan.” (Jenny Starrs/The Washington Post)

As divisions between the two main ideological camps within the GOP widened Tuesday, Republicans were scrambling to contain the political fallout from the collapse of a months-long effort to rewrite former President Barack Obama’s signature domestic accomplishment.

President Trump predicted Tuesday that Republicans would wait for the federal insurance market to collapse and then work to broker a deal to rewrite the nation’s landmark health-care law, while Senate leaders pressed ahead with a plan to repeal the Affordable Care Act with no immediate replacement. Continue reading “Trump suggests Republicans will let ACA market collapse, then rewrite health law”

Failure

The following article was posted on the TrumpAccountable.org website July 18, 2017:

With Senators Jerry Moran (R-KS) and Mike Lee (R-UT) releasing separate statements Monday night confirming they will not support the Senate version of Obamacare repeal and replace, the legislation was dealt a near fatal blow. The failure to rally enough senators around the Senate version – especially with deep cuts to Medicaid that will hurt millions of constituents – resulted in a quick tweet by President Trump calling for simple repeal of Obamacare with a promise to work (possibly with Democrats) to craft new legislation. Continue reading “Failure”