Posts Tagged ‘health care’

Dems meet Supreme Court pick with mixed message

July 11, 2018

Chuck Schumer, the Senate Democratic leader, says it’s all about health care. Sen. Richard Blumenthal, D-Conn., worries about the impact on the special counsel investigation. And Sen. Kamala Harris, D-Calif., sees an assault that could set women’s rights back decades.

There’s so much for Democrats to dislike about Brett Kavanaugh, President Donald Trump’s Supreme Court pick. And that may be the problem.

Chuck Schumer

In the hours after the Republican president tapped the conservative jurist, Democrats struggled to unify behind a clear and coherent message to combat the nomination, which could shift the court to the right for decades.

They’re energized, outraged and ready to fight. But what, exactly, is their argument to voters?

MoveOn’s Washington director Ben Wikler, who was among hundreds of liberal activists protesting outside the Supreme Court, acknowledged Democrats were far from unified behind a simple message to rally voters against Trump’s selection.

“The essential message is Roe,” Wikler said, citing the potential that a more conservative court would overturn the landmark Roe v. Wade decision that legalized abortion nationwide.

“The secondary message for most folks is ACA and health care,” Wikler continued, referring to the Obama-era health care law. “The third messaging plank is, ‘choose your own adventure.’”

It’s an all-too-familiar political challenge for Democrats, who’ve left voters confused in the Trump era about what the party stands for beyond simply opposing the president. And in this case, the muddled messaging threatens to dampen a new surge of voter enthusiasm just a few months before midterm elections.

For decades, Supreme Court battles have motivated the GOP’s socially conservative base far more than Democrats. But in an era where liberal protests have become nearly weekly events, Democratic strategists and activists say they see a new sense of urgency when it comes to the country’s highest court. In part, that’s because Kavanaugh’s confirmation would give the court a decisive conservative majority for a generation.

“Our phone is ringing off the hook,” said Nan Aron, who founded the liberal Alliance for Justice Action Campaign in 1979. “There’s much greater engagement because the stakes are so much higher.”

Democrats hope to model their opposition on their successful effort fending off a repeal of the Affordable Care Act last year, despite a Republican majority in Congress. But that fight featured a simple, clear argument — save the ACA — and the clear risk that millions of Americans could lose their health care.

The Associated Press


Pfizer delays drug price hikes after talking with Trump

July 11, 2018

Pfizer Inc (PFE.N) said on Tuesday it was deferring drug price increases for no more than six months after the company’s chief executive officer had an extensive conversation with U.S. President Donald Trump.

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FILE PHOTO: The Pfizer logo is seen at their world headquarters in Manhattan, New York

The rollback came a day after Trump took aim at Pfizer and other U.S. drugmakers for raising prices on some of their medicines, saying in a tweet that they “should be ashamed” and that his administration would respond.

Pfizer on Tuesday said it would defer price increases that went into effect on July 1 until the end of the year or until the president’s drug pricing blueprint goes into effect – whichever is sooner. The company said it would return drug prices to their pre-July 1 levels as soon as technically possible.

President Donald Trump speaks with the news media before boarding Marine One for travel to Europe from the White House, in Washington, U.S., July 10, 2018.

Leah Millis | Reuters
President Donald Trump speaks with the news media before boarding Marine One for travel to Europe from the White House, in Washington, U.S., July 10, 2018.

On Tuesday, Trump said in a tweet that Pfizer had agreed to roll back drug price hikes after he and U.S. Health and Human Services Secretary Alex Azar spoke with the company’s CEO, Ian Read.

“We applaud Pfizer for this decision and hope other companies do the same,” Trump, who is traveling in Europe, said in a tweet.Pfizer, one of the largest pharmaceutical companies, now likely will not raise drug prices until after the 2018 midterm elections in November. That gives Trump, who made lowering prescription drug prices a top 2016 presidential campaign issue, a short-term victory he can point to in the run-up to the elections, which are being closely watched to see if Trump’s fellow Republicans will be able to maintain control of both the Senate and the House of Representatives.

Pfizer raised list prices on around 40 medicines earlier this month. Those include Viagra, cholesterol drug Lipitor and arthritis treatment Xeljanz, according to Wells Fargo. List prices do not include rebates and discounts drugmakers may offer.

  • PFE.N

The Trump administration has not yet taken significant action to lower drug prices. Azar has said lowering prices long term will take years because of the complexity of the healthcare system.

Trump rolled out a blueprint in May on how his administration planned to lower drug prices. Trump said in May that some drug companies would announce “voluntary, massive” price decreases in two weeks, though none have materialized yet.

Pharmaceutical company shares rose after Trump unveiled his drug pricing blueprint.

Azar praised Pfizer on Tuesday. “I commend Pfizer for its constructive and professional approach, and its desire to work with President Trump to be part of the solution and not part of the problem,” he said in a statement.

Reporting by Yasmeen Abutaleb and Michael Erman; Additional reporting by Eric Walsh; Editing by Lisa Shumaker and Leslie Adler


Is Hillary Clinton secretly planning to run in 2020?

July 8, 2018

The messages convey a sense of urgency, and are coming with increasing frequency. They are short, focused reactions to the latest “outrage” committed by President Trump.

Some end by asking for money, some urge participation in protests. All read as if they are sent from the official headquarters of the resistance.

Hillary Clinton is up to something.

By Michael Goodwin
New York Post

Five times in the last month alone, she sent e-mails touting her super PAC’s role in combating President Trump. Most seized on headline events, such as the family-separation issue at the southern border.

Under the message line, “horrific,” she wrote June 18: “This is a moral and humanitarian crisis. Everyone of us who has ever held a child in their arms, and every human being with a sense of compassion and decency should be outraged.” She said she warned about Trump’s immigration policies during the 2016 campaign.

Three days later, she was back again, saying that her group, Onward Together, raised $1 million and would split it among organizations working to change border policy, including the American Civil Liberties Union and a gaggle of immigrant, refugee, Latino and women’s groups.

And the day after Supreme Court Justice Anthony Kennedy announced his retirement, Clinton introduced a newly minted resistance partner. Called Demand Justice, it promises to protect “reproductive rights, voting rights and access to health care” by keeping Senate Democrats united in opposing any conservative Trump nominee.

The instant, in-house nature of Demand Justice was reflected by the name of its executive director: Brian Fallon, Clinton’s campaign press secretary.

In truth, Fallon’s role doesn’t tell us something we didn’t know. Onward Together, formed in May of 2017, is a Clinton 2020 campaign vehicle in waiting.

Its homepage says the group “is dedicated to advancing the vision that earned nearly 66 million votes in the last election.”

Advancing the vision? More like advancing the candidate who collected those votes despite not having a vision.

With the Democratic Party locked in a battle between its far left wing and its far, far left wing, no single leader has emerged to unite it. Clinton is trying to play that role by being a mother hen to the fledgling activists drawn to politics by their hatred of Trump.

If they were active in 2016, most probably supported Bernie Sanders in his primary challenge to Clinton. But by helping to fund them now, she is putting them in her debt for later.

Ah, but will she need their support later? Is she really going to make a third run for the White House?

Not long ago, I told a group of friends, all liberal Dems, that I believed she was keeping open the possibility of a rematch against Trump, and might already have decided to run.

It was unanimous — they were horrified. “I would not give her a single cent,” one man, formerly a big donor to Clinton, said emphatically.

Their reasons are no surprise: Her moment has passed, she was a terrible candidate and her endless claims of victimhood are tiring rather than inspiring. It’s time to find new blood.

Those assessments are unassailable, and certainly are shared by the 20 or so Dems lining up to take their shot at the nomination.

Moreover, there isn’t any clamoring for another Clinton run in Hollywood or other leftist hotbeds. They want a new blockbuster, not a sequel to failure.

So she’s toast, right? Maybe.

On the other hand, the odds are zero that she is playing community organizer just to be a kingmaker. When it comes to money and power, the Clintons assume charity begins at home.

Here’s how I believe she sees the playing field, and why she can’t be ignored.

First, because there’s no clear front-runner for the nomination 18 months into Trump’s presidency, Clinton remains the closest thing to an incumbent. She’s also got numerous advantages, from name recognition to campaign experience to an off-the-shelf Cabinet, that could give her a head start.

Second, a crowded, diverse field diminishes the chances of anyone knocking her off. Recall how Trump outlasted 16 GOP rivals by having a committed core of supporters that grew as the field shrunk. Clinton could be in a similar position — unpopular among many, but also unbeatable by a single opponent.

Third, looking ahead to the 2020 primaries, she sees no reason to fear the favorite daughters and sons in key blue states. She would almost certainly beat Sen. Kamala Harris in California, Sen. Cory Booker in New Jersey and Gov. Andrew Cuomo in New York.

And please — forget Sanders and Joe Biden. Sanders is already 76 and Biden, at 75, has never been a viable candidate for president and still isn’t.

Fourth, money is not an issue. Some donors will resist Clinton at first, but any Dem nominee can count on all the money in the world to run against Trump.

To be clear, there are scenarios where Clinton doesn’t run. Health reasons, for example, or a younger rival could rocket to the top of the pack and become the party’s next Barack Obama. Either way, recurring nightmares of two previous defeats would send her back to wandering through the Chappaqua woods.

For now, I am convinced Clinton wants to go for it. Doubters should recall the line about pols who get the presidential itch: There are only two cures — election or death.

Besides, the third time could be the charm.

The Empire State of anarchy

For their next trick, will New York Dems try to secede from the United States?

First, Gov. Cuomo proposed cockamamie schemes to avoid new federal limits on state and local tax deductions. Now Manhattan Assemblyman Richard Gottfried fantasizes about a “workaround” of the Supreme Court ruling that allows municipal workers to skip union fees.

Remember way back, when Dems warned Donald Trump would not accept the election results if he lost? Well …

Doth protest too much

Most immigrants are grateful for the opportunity and freedom they find in America. Then there is Therese Patricia Okoumou.

An immigrant from the Democratic Republic of the Congo, where civil war is endless and where protesters are shot, the 44-year-old Okoumou caused visitors to be evacuated from Liberty Island on July 4th when she climbed the base of Lady Liberty to protest American immigration policies.

She was also arrested in a demonstration last year. In 2011, she was hit with $4,500 in fines after illegally posting ads for services as a personal trainer, The Post reports.

Since America isn’t up to her standards, Okoumou should try another country. Perhaps a return to her homeland would make her happy.

Hot-dogged competitor

The stomach-turning quote of the week comes from Joey Chestnut, the Nathan’s July 4th hot-dog-eating champ. Judges initially ruled he ate 64 dogs in 10 minutes, but Chestnut knew he had eaten 10 more.

“At the end,” he said, “I knew I’m at 74 — 64 feels a lot different in the stomach than 74.”



Trump Administration Expected to Suspend ACA Program Related Payments to Insurers — Freezing risk-adjustment payouts

July 7, 2018

Companies could take financial hit from freezing of risk-adjustment payouts

The main page of the website on May 21. It isn’t clear if a suspension of the risk-adjustment payments could lead some insurers to seek higher rates for next year’s plans.
The main page of the website on May 21. It isn’t clear if a suspension of the risk-adjustment payments could lead some insurers to seek higher rates for next year’s plans. PHOTO: /ASSOCIATED PRESS

The Trump administration is expected to suspend an Affordable Care Act program that plays a key role in the health law’s insurance markets, a move that could deal a financial blow to many insurers that expect payments.

The suspension of some payouts under the program, known as risk adjustment, could come in the wake of a recent decision by a federal judge in New Mexico, who ruled that part of its implementation was flawed and hadn’t been adequately justified by federal regulators, people familiar with the plans said.

The Centers for Medicare and Medicaid Services, which oversees the program, may at least temporarily suspend the payments insurers expected to receive this fall, stemming from their 2017 business, and next fall, which would have reflected their 2018 business, the people said.

CMS has made no new policy announcement on the payments.

The agency had been expected to put out a report at the end of June detailing the next round of risk-adjustment payments, but it hasn’t been issued.

The program plays a major role in the ACA markets as insurers with healthier consumers enrolled in health-law plans reimburse insurers that have sicker and more expensive enrollees. The aim is to encourage all insurers to participate in the exchanges and sign up a broad consumer base instead of just targeting young, healthy people.

For 2016, risk-adjustment transfers were valued at 11% of total premium dollars in the individual market, according to a CMS report.

New Mexico Health Connections and Minuteman Health of Massachusetts, both small nonprofit insurers, in 2016 filed lawsuits over the program, asserting that the Obama administration created an inaccurate formula that overly rewarded big insurers.

Earlier this year, U.S. District Judge James Browning in New Mexico ruled that the formula used by CMS was flawed. CMS is expected to halt expected payments as a result of that decision, the people familiar with the plans said. In the Massachusetts case, a federal judge upheld the formula, however.

The expected suspension may draw second-guessing from insurers and supporters of the ACA. Timothy S. Jost, an emeritus professor at Washington and Lee University, said it appeared that federal officials might still have other legal options before suspending payments. Mr. Jost said federal regulators could issue a rule formally offering a justification for the risk-adjustment methodology’s use in past years, then ask the judge to consider that.

The impact of the risk-adjustment program on individual insurers varies widely. Some pay into it and don’t get money back, so a suspension wouldn’t likely be a financial challenge.

But it could be a financial blow to those insurers that are expecting payments this fall based on 2017 plans, and potentially for those that expected payments in the fall of 2019 based on their 2018 business. It would rattle those insurers if a suspension occurs, said Larry Levitt, a senior vice president at Kaiser Family Foundation.

For insurers expecting payments, abruptly suspending them “would be a big hit to their financial position,” said Deep Banerjee, an analyst with S&P Global Ratings. Estimates of the next round of payouts had already been entered in many insurers’ books as receivables because they are related to 2017 business, he said.

It isn’t clear if a suspension of the risk-adjustment payments could lead some insurers to seek higher rates for next year’s plans. Mr. Banerjee said some insurers might seek to “reprice for the coming year” if it is clear they wouldn’t be getting the expected money based on prior years’ business.

So far, insurer filings for the 2019 ACA marketplaces have reflected an array of projections, with some insurers seeking significant rate increases but rates in other places looking relatively stable.

Filings so far have signaled that some insurers are expanding their ACA offerings into new regions heading into next year, with no signs they are pulling back, as had been common in previous years. Analysts said the trend reflected how insurers’ financial results on the ACA plans for 2017 and 2018 had improved markedly over earlier years, after a series of rate increases.

Write to Stephanie Armour at and Anna Wilde Mathews at

Alexandria Ocasio-Cortez: Democratic Party’s New Wave

June 28, 2018

Every election year brings a few wild surprises, and the biggest this year so far happened Tuesday night in the Bronx-Queens congressional district that had happily sent Rep. Joe Crowley off to the House of Representatives with no complaints for two decades.

By John Podhoretz
New York Post

In the 2014 midterm election, Crowley won 50,000 votes. On Tuesday night, he received fewer than 12,000 and lost in a 58-42 blowout to Alexandria Ocasio-Cortez. She was a Ted Kennedy intern and later Bernie Sanders organizer, member of the far-left Democratic Socialists of America and (most impressive) second-place finisher nationwide in microbiology at the Intel Science Fair back in high school.

Party leaders in Albany concocted the cockamamie idea of running a mid-June primary for national races while saving the statewide races for the usual September primary. This decision to create a deliberately small voter pool is an old-time cynical ploy designed to give incumbents like Crowley an insuperable advantage — because low turnout almost always favors candidates who have institutional support.

Almost always. But not always. In this case, Ocasio-Cortez quietly played a series of cards against Crowley — Hispanic vs. white, leftist vs. liberal, young vs. old, female vs. male — that built her a 15,000-voter following apparently invisible to him and his team.

That was enough to finish him off. I suspect that had he been paying sufficient attention, Crowley could have ginned up another 4,000 voters from the Democratic Party’s database in a district where he received 150,000 votes in November 2016.

The tiny size of the electorate, Crowley’s incompetence and Ocasio-Cortez’s charming personability should be enough to ensure we show caution about assigning too much meaning to this one outlier result.

But there are aspects to Ocasio-Cortez’s ideological approach that do offer us a crystal-ball view into the Democratic Party’s future.

The issues she ran on include single-payer health care, an end to the use of fossil fuels, a guaranteed income, the abolition of the national immigration enforcement bureau, and free higher education.

Columnist Noah Rothman points out that there is no way to pay for all this and so her platform is dead on arrival. And that is true. Crowley, the congressman she defeated, is a member of the House leadership that refused to support a “Medicare-for-all” bill Bernie Sanders had proposed last year.

But the question is: Which of these proposals would Crowley or other party leaders be willing outright to say is wrong or misguided? By this point, you would be hard-pressed to find any leading Democrat who would not support single-payer in theory, at the very least, and I imagine the same would be true for the entire issue set.

There are so-called “red-state Democrats,” like Sen. Joe Manchin, for whom much of this would be anathema, but he represents the party’s past, not its future. Ocasio-Cortez is its future, and the future is some form of socialism.

She is also its future because she is the embodiment of what Democrats want their party to be: identitarian, diverse, socially but not ideologically inclusive, fourth-wave feminist and possessing an element of radical dismay at current economic and social conditions and the belief that active measures of some sort need to be taken to overthrow the present and radically redirect the country’s course in very short order.

The technical specifics of her victory may not be duplicable. But Alexandria Ocasio-Cortez is now the vanguard of the Democratic Party.

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NHS use of ‘unsafe’ syringes to be examined — NHS Scotland staff offered pay rise

June 25, 2018

The government will examine claims the NHS was slow to take a “dangerous” automatic syringe out of service.

It follows a whistleblower’s warning, reported in the Sunday Times, that the devices could have caused widespread deaths among elderly patients.

The syringes, used to give powerful painkillers, were in use until 2015.

Heath Secretary Jeremy Hunt said there were questions over how quickly the NHS reacted “when we knew these syringes were dangerous”.

Image result for Jeremy Hunt, photos

Heath Secretary Jeremy Hunt

NHS officials issued warnings of the risk of fatalities from user error in the 1990s but the devices continued to be permitted by the NHS until three years ago.

Doctors were concerned that confusing two models of the infusion pumps could lead to a day’s dose of drugs being delivered in one hour.

Mr Hunt said: “We need to be absolutely certain that the NHS does react as quickly as possible when you have suggestions a piece of equipment is not safe.

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“Urgent guidance was sent out in 2010 and they were finally removed from use in 2015 but we will look at whether that was as quick as it should have been.”

Last week the government inquiry into hundreds of deaths at the Gosport War Memorial Hospital found more than 450 patients died after being given powerful painkillers inappropriately.

Speaking to the Sunday Times, the whistleblower said the decision makers on the inquiry panel had “ignored” evidence that the devices caused fatalities because they were worried about a national scandal.

The newspaper claims the syringes were also linked to overdose-related deaths in Wales, South Yorkshire, North Yorkshire, Derbyshire, Devon, Cornwall and the Isles of Scilly.

“Anyone who has lost their granny over the past 30 years when opiates were administered by this equipment will be asking themselves, ‘Is that what killed Granny?’,” the whistleblower told the paper.

Mr Hunt said claims of a cover-up had been “categorically denied” by the independent panel, who had a “free hand”, adding “if they thought there was an issue with the syringe drivers I know they would have said so”.

Hundreds of lives were cut short due to prescribed opioids at Gosport War Memorial Hospital

What were the syringe warnings?

  • The syringe drivers, called Graseby MS26 and Graseby MS16A, were loaded with capsules and programmed to release drugs into a patient’s bloodstream over an extended period
  • They delivered drugs at different rates – MS26 delivered in mm per 24 hours, MS16A delivered in mm per hour
  • Cases emerged of the drivers being confused, causing dangerous over-infusion of drugs
  • The NHS’s Purchasing and Supply Agency (PSA) said the devices appeared “very similar aside from colour”
  • Hazard notices were issued by the Medicines and Healthcare products Regulatory Agency (MHRA) to ensure NHS staff knew the difference between the models

In 1994, the NHS in Scotland issued a hazard notice warning of the risk of death due to confusion between the two models causing drugs to be delivered at the incorrect rate.

Australia and New Zealand had programmes in the late 2000s to remove the devices from use.

A 2008 paper by the NHS’s Purchasing and Supply Agency (PSA), which closed in 2010, said the devices were an “essential component of palliative care”.

An estimated 40,000 devices – a quarter of the worldwide total – were in the UK, the majority in primary care.

The syringes were briefly mentioned in the report released on Wednesday looking into the deaths at Gosport War Memorial Hospital.

The report said: “The panel has considered issues concerned with the particular syringe drivers, known by their tradename of Graseby, and is aware of the hazard notices which applied.

“The panel’s analysis does not rest upon any issue relating to these notices.”

A Department of Health and Social Care spokesman said: “While there is a range of statutory requirements to monitor and improve safe management and use of controlled drugs, we would not hesitate to take further action to improve safety.”



NHS Scotland staff offered 9% pay rise over three years

NHS staff

The bulk of NHS staff in Scotland have been offered a 9% pay rise, spread across three years. GETTY IMAGES

The offer, to staff like nurses and midwives who earn under £80,000 a year, is being considered by NHS unions.

Scottish Health Secretary Shona Robison said she was “proud” to be offering a pay rise which “not only matches the NHS England deal, but exceeds it”.

The offer would not affect doctors, dentists or senior managers. Staff consultations will run until 15 August.

The Royal College of Nursing in Scotland (RCN) said the offer was “the best deal that can be achieved through negotiation at this time”, and that it was vital for staff to take part in the consultation.

The Royal College of Midwives Scotland (RCM) recommended that members accept the “good deal” on offer, but said they saw it “as the starting point for better pay for NHS staff, not the end point”.

Pay offer

The pay rise would be linked to changes to terms and conditions, including sickness leave policy and career progression, which will have to be agreed by December 2018.

Many staff have already been given a 3% pay rise for the current year, which was recently announced by Nicola Sturgeon at the SNP conference.

This could now be extended across three years, with 147,000 staff earning up to £80,000 receiving a minimum uplift of 9%. Workers who are not at the top of their wage band could see bigger increases, depending on where they sit in the pay scale.

Those earning above £80,000 will be given a flat-rate increase of £1,600 a year.


More than a million NHS workers in England are receiving a three-year pay deal worth 6.5% after staff voted in favour of that offer in June.

Ms Robison said she was “delighted” to be making the offer in the 70th anniversary year of the health service.

She said: “Our NHS is built on the dedication and hard work of healthcare staff up and down the country. They are our health service’s beating heart, and I’m proud to be offering them this significant pay rise in recognition of the work they do caring for the people of Scotland.

“We’re doing all we can to recruit new talent and retain existing staff, ensuring NHS Scotland has the right skills and experience to meet future demand and rising expectations. Today’s announcement will help make our NHS an attractive employment option for many.”

‘A good deal’

The pay proposal will now be put to staff in a consultation running from 2 July to 15 August, with the lead unions describing it as a “good deal”.

RCN Scotland director Theresa Fyffe said: “This is the largest pay rise offered to nurses in 10 years, and we believe it is the best deal that can be achieved through negotiation at this time.

“It is now time for members to make up their own minds on whether to accept or reject it.”

RCM Scotland negotiator Emma Currer said the offer would see staff get “a real increase in their pay after years of pay freezes and stagnation”.

She added: “This is something the RCM and other unions have been fighting for. This is a good deal and one that we believe is the best that can be achieved in the current economic climate.

“However, we also see this as the starting point for better pay for NHS staff, not the end point.”

The Scottish Conservatives welcomed the offer, saying it was needed to offset tax rises in Scotland, while Labour said it was “essential” a longer-term settlement was reached.

Brexit Has Already Cost the U.K. More than Its EU Budget Payments, Study Shows

June 24, 2018

The damage to the U.K. economy caused by the vote to leave the European Union two years ago already exceeds the size of the budget contributions Britain will be able to claw back when it finally leaves the bloc, according to an economic study by the Centre for European Reform.

Image result for Brexit not worth it, protester, photos

Uncertainty caused by Brexit has already caused a 2.1 percent dip in economic output, even before Britain’s departure next March, the CER said late Friday in an emailed statement. That’s cost the public finances 23 billion pounds ($30 billion) in lost tax revenue, the think tank said.

The economic damage means the Treasury has less money to spend on public services, and knocks on the head the idea that Britain will enjoy a “Brexit dividend” when it no longer has to contribute to the European budget, it said.

“Two years on from the referendum, we now know that the Brexit vote has seriously damaged the economy,” said CER Deputy Director John Springford, who authored the study. “We know that the government’s Brexit dividend is a myth: the vote is costing the Treasury 440 million pounds a week, far more than the U.K. ever contributed to the EU budget.”

Foreign Secretary Boris Johnson, who spearheaded the Brexit campaign in 2016, toured the country at the time in a red bus promising to use the budget contributions of 350 million pounds a week to instead fund the National Health Service.

U.K. Contribution to EU Half Amount Claimed by Brexit Campaign

In reality, Britain pays only half that amount, since it gets back around 9 billion pounds from the EU, though that didn’t stop Prime Minister Theresa May touting a “Brexit dividend’’ this week when she announced a 20.5 billion-pound boost for health care.

The CER used a statistical model that compared the U.K.’s economic performance against predicted output if the referendum result had gone the other way. It did so by identifying which OECD countries’ gross domestic product, consumption and investment data best replicated the U.K. economy in the two decades leading up to the referendum.


Trump Tests His Appeal in Nevada, a State Clinton Won

June 24, 2018

President headlines fundraiser for Sen. Dean Heller, who is seeking re-election

Sen. Dean Heller (R., Nev.), left, shakes hands with President Donald Trump during a discussion on tax reform in Las Vegas on Saturday.
Sen. Dean Heller (R., Nev.), left, shakes hands with President Donald Trump during a discussion on tax reform in Las Vegas on Saturday.PHOTO: KEVIN LAMARQUE/REUTERS

LAS VEGAS— Donald Trump took his economic nationalism and insult-driven politics to Nevada on Saturday, testing whether his campaign style can help Republicans in a state carried by his Democratic rival Hillary Clinton in 2016.

Mr. Trump made the trek to Las Vegas to headline a fundraiser for Sen. Dean Heller, the only Republican senator in the state seeking re-election this year.

“He was with me all the way—once we got elected,” Mr. Trump said, repeatedly recalling Mr. Heller’s delay in backing his bid for the White House. “A little bit shaky in the beginning.”

Mr. Heller “cut your taxes and nobody fought harder to cut your taxes than Dean Heller, let me tell you,” Mr. Trump said. The Democrats, he said, “want tax increases. They want open borders.”

Mr. Heller’s race is one of the most consequential Senate contests of the year, as Republicans seek to hold on to their 51-49 majority in November’s elections. Nevada, a swing state, will be critical come November, with a Senate seat, the governor’s office and two competitive House races on the ballot.

It’s an open question whether Mr. Trump’s trademark bare-knuckled campaigning will help or hurt Mr. Heller and the rest of the GOP Nevada ticket this fall. More registered voters in the state disapproved of the president than approved of him—49% to 47%—in a May poll conducted by Morning Consult.

In addition to trying to paint state Democrats as weak on border security and favoring higher taxes, Mr. Trump hurled personal insults at the opponents of the Republican candidate.

He called Mr. Heller’s challenger, Rep. Jacky Rosen, as “Wacky Jacky” at Saturday’s Nevada Republican Party Convention. Democrats were holding their own state convention in Reno, featuring Sen. Elizabeth Warren of Massachusetts.

“Wacky Jacky is campaigning with Pocahontas, can you believe it?” Mr. Trump said, reviving his derogatory nickname for Ms. Warren, a reference to the senator’s claims to have Native-American heritage. “A vote for her is a vote for increased taxes, weak, weak borders, it’s really a vote for crime, it’s a vote to get rid of police officers.”

Shortly after the president concluded his remarks, Ms. Rosen tweeted, “Is that the best you’ve got, @realDonaldTrump? Let’s fight back.” She used Mr. Trump’s appearance in the state to raise funds on her website, where she cites opposition to his presidency and policies as a driving force for her campaign.

“President Trump is trying to pull up the ladder behind him, leaving the middle class stranded while his super-wealthy buddies turn the federal government into a source of enrichment for themselves,” Ms. Rosen’s site says. “Trump ridicules women, people of color, the LGBTQ community, immigrant families, and anyone who challenges him.”

Ms. Warren has called the Pocahontas nickname a “racial slur.”

Despite the GOP’s majority in Congress, Mr. Trump has struggled to secure support for some of his top-priority campaign pledges, like his efforts to replace the Affordable Care Act, to fund a wall along the Mexican border and to pass legislation curbing immigration.

“The fact is we need more Republicans because the Democrats are obstructionists,” the president said Saturday. He drew boos from the crowd when he mentioned Senate and House minority leaders Chuck Schumer of New York and Nancy Pelosi of California.

Facing mounting political pressure, Mr. Trump signed an executive order last week to end the separation of families crossing the U.S. border illegally. Images of unaccompanied children at shelters near the border sparked outrage from members of his own party.

Still, he insisted he would pursue a policy of zero tolerance of illegal immigration and continued to hammer at the Democrats for failing to take a tougher stance. “We’re the only country that says ‘Please, would you like to register?’—other countries say ‘Get the hell out’,” Mr. Trump said. “I think I got elected largely because we are strong on the border.”

That line may be a tough sell in Nevada, where more than a quarter of Nevada’s population is Latino. The percentage is higher in Clark County, which includes Las Vegas. Mr. Trump touted his administration’s economic record, highlighting record-low levels of Hispanic unemployment.

Mr. Trump also noted his own property in Las Vegas, joking, “I don’t think about that anymore.”

As he concluded his speech, he said that he is committed to making sure Republican voters turn out come November. “It’s an incredible state,” he said. “I will be back a lot…”

Corrections & Amplifications 
Sen. Dean Heller is a Republican. An earlier version of the caption on this article incorrectly stated he was a Democrat. (June 23, 2018)

Write to Vivian Salama at

New Trump Administration Rule to Expand Access to Health Plans Without ACA Protections

June 20, 2018

Small businesses and self-employed will be allowed to obtain coverage under ‘association plans’

Many of the ‘association health plans’ will be subject to the same rules as larger employers, which means they won’t have to provide comprehensive benefits mandated under the ACA.
Many of the ‘association health plans’ will be subject to the same rules as larger employers, which means they won’t have to provide comprehensive benefits mandated under the ACA. PHOTO: DANIEL ACKER/BLOOMBERG NEWS

Millions of small businesses and self-employed people will be able to buy health-insurance plans exempt from many Affordable Care Act consumer protections under a much-debated rule released Tuesday by the Trump administration.


The rule is a far-reaching step by the administration to wield its regulatory powers to chisel away at the Obama-era health law. It was undertaken at the behest of President Donald Trump, who last year called for the change in an executive order.

The rule makes it far easier for small businesses and self-employed individuals to band together and obtain “association health plans” for themselves and their employees. Many of the plans will be subject to the same rules as larger employers, which means they won’t have to provide comprehensive benefits, such as maternity services, prescription drugs, or mental health care, mandated under the ACA.

That is expected to lead to lower prices for people who enroll. “You may be able to buy a policy that’s several thousand dollars cheaper,” said Sen. Lamar Alexander (R., Tenn.), said in an interview before the rule’s release. “This is the most promising proposal for quality insurance for self-employed people who might make $60,000 to $70,000 but get no subsidies.”

Business groups such as the U.S. Chamber of Commerce and the National Restaurant Association praised the move, saying it will give small employers the flexibility to cover workers at a lower cost. Democrats said it would drive up costs for people with pre-existing conditions and people who buy their own coverage on the individual market.

“Let’s be clear—this policy has nothing to do with patients and everything to do with appealing to extreme Republican donors and special interests,” Sen. Patty Murray (D., Wash.) said in a statement.

While premiums for association plans will probably be significantly cheaper, costs for consumers who buy their own coverage on the individual market are likely to rise, analysts say. Those higher premiums are expected to increase the number of Americans without coverage.

An additional four million Americans are expected to enroll in these less-comprehensive plans by 2023, according to a senior Labor Department official who cited a recent federal analysis. Among the enrollees will be about 400,000 Americans who are currently uninsured.

Democrats say a proliferation of the association plans would imperil the individual insurance market by attracting healthy people, which could raise costs for sicker and older consumers, and leave people with inadequate insurance. They also say these plans have been prone to fraud and scams.

They depict the move as part of a series of Republican actions designed to undermine the ACA in ways that could hurt consumers. “Since day one, this administration has been working to sabotage the Affordable Care Act,” Rep. Mark Takano (D., Calif.) said at a recent hearing.

The proposal has been championed by Republicans who say it will provide coverage to individuals who can’t afford insurance on the ACA’s individual market. Current ACA requirements on small businesses, such as array of mandatory benefits many must provide, drive up costs, they say.

Under the new rule, small companies or self-employed people with a shared industry or geographic location will be able to form an association focused on a business interest and buy insurance. A regional Chamber of Commerce could offer association plans to members.

A group could use its collective membership to negotiate prices with payers and providers, according to a senior administration official. The associations couldn’t charge an individual higher premiums based on pre-existing health conditions, but they could base premiums on other factors, such as age, industry and employee classification.

Premiums could be $9,700 a year less for association plans compared with those on the individual market, according to a February report on the proposed rule by the health-consulting firm Avalere. Their premiums would be about $2,900 a year less than those for plans in the small-group market, which includes employers with less than 50 employees.

Women couldn’t be charged more within individual plans, but associations with a preponderance of female employees could be charged more overall, according to the senior Labor Department official.

Some critics have said women and older people will pay more, and they’ve said the plans will essentially be able to discriminate against consumers by offering some benefits and omitting others, such as cancer treatments or certain prescriptions.

Supporters of the association plans say consumers stand to benefit from a much broader array of choices, allowing them to choose policies that fit their needs.

“You don’t have the regulatory burden, and you have economy of scale,” the Labor Department official said.

Fully funded plans, where an insurance carrier pays claims, will generally be regulated by states like a large employer. That means many federal ACA requirements such as mandatory benefits won’t apply, although states can impose them.

Plans that are self-funded, where an association assumes the final risk of providing the benefits, must comply with amendments passed in 1983 that allow states to enforce insurance laws, including those regarding liquidity and solvency.

The association plans will have the option of not taking any self-employed individuals. Current plans will be grandfathered in, the official said.

The administration is also working on a rule that would open up greater access to individual health plans that don’t have to abide by the ACA consumer protections.

The administration’s preparations for the association health plan rule have spurred hundreds of comments from across the country. States including Iowa, Massachusetts and Wisconsin sought continued state oversight of association plans. America’s Health Insurance Plans, a major industry trade group, raised concerns about the potential for fraud in association plans.

A coalition of 17 Democratic attorneys general criticized the proposal as an “unlawful attempt to accomplish by executive rulemaking changes in law and policy that lie within the power of Congress.”

Republicans and some retail and restaurant organizations, however, praised the proposal.

Corrections & Amplifications 
About 400,000 Americans who are currently uninsured will be enrolled in health insurance under a new rule allowing businesses to buy less-comprehensive plans, according to a Labor Department official. An earlier version of this article incorrectly cited the official as saying the new rule would increase the number of uninsured by about 400,000.

Write to Stephanie Armour at

Appeared in the June 20, 2018, print edition as ‘Rule Expands Plans Skirting Health Law.’

Conservatives Make New Push to Repeal Affordable Care Act

June 19, 2018

Group proposes a new system that lifts national consumer protections and gives control of health care to the states

Under the conservative plan, states would receive ACA money in the form of block grants to help low-income consumers buy coverage.
Under the conservative plan, states would receive ACA money in the form of block grants to help low-income consumers buy coverage. PHOTO: ANDREW HARRER/BLOOMBERG NEWS

The Affordable Care Act should be repealed in August and replaced with a new system that lifts national consumer protections and gives control of health care to the states, according to a proposal by a conservative group set to be released Tuesday.

The proposal risks irking centrist Republicans who want to focus on other subjects. Republican leaders have said they have no appetite for another push to repeal the ACA before the November midterm elections unless such a bill clearly has the votes to pass.

Republicans faced a series of obstacles—including internal division and unified Democratic opposition—as their effort to repeal the ACA collapsed last year. There is little evidence those dynamics in Congress have changed.

Still, the proposal’s release reflects the continuing eagerness of conservatives to topple the ACA, a longtime Republican promise whose window could close if Democrats make gains in the midterms as expected.

The conservatives’ proposal would drive control of health care almost entirely to the states, reversing the ACA’s federal mandates that seek to provide basic minimum benefits and consumer protections, which Republicans argue limit people’s choice.

Under the conservative plan, states would receive ACA money in the form of block grants to help low-income consumers buy coverage. Health savings accounts, which let people set aside tax-free money for medical expenses, would be expanded. Insurers could give discounts to people who are young or maintain continuous coverage.

The proposal, which echoes provisions of a bill offered last year by Sens. Lindsey Graham (R., S.C.) and Bill Cassidy (R., La.), comes from the Health Policy Consensus Group, which includes representatives from such conservative think tanks as the Heritage Foundation, American Enterprise Institute, Galen Institute and the Manhattan Institute. The group has been meeting weekly for nine months.

The Hoover Institution on Wednesday will host a coalition of think tanks and governors, including Republican Gov. Matt Bevin of Kentucky and former GOP Sen. Rick Santorum of Pennsylvania, in Washington to discuss the proposal.

Centrist Republicans, however, haven’t been pushing a new repeal effort as part of their campaigns, especially as polls suggest the health-care issue is favoring Democrats more than in recent elections.

“Moderate Republicans are like, ‘Can’t we just let this go?’” said Simon Haeder, assistant public policy professor at West Virginia University. “It puts them in a terrible spot. They’re in a situation where if they don’t go along with them, they have to worry about making it through a primary, because these groups are well-resourced.”

Democrats face their own divisions over health care, with some liberals pushing for a sweeping “single-payer” plan and others arguing for a more limited option, such as an expansion of Medicare, that may be more palatable to centrist voters.

The block grants would be the backbone of the conservative plan. Half of the grant funding would go toward supporting the purchase of private health coverage, and half toward helping low-income Americans get coverage, although the two categories would likely overlap. The grants would ban states from using the money to fund abortions, according to the draft proposal. Medicaid expansion would also be repealed, and people on Medicaid would be able to buy private insurance coverage.

“The solution to the problem is to put program direction to states, and the federal government provides resources in a defined way,” said Yuval Levin, vice president at the Ethics and Public Policy Center. He is part of the group making the health-care proposal.

Liberals say moves to reverse the ACA, also known as Obamacare, hurt consumers by weakening or removing health coverage from many people.

“It’s just the monstrosity of Trumpcare,” House Minority Leader Nancy Pelosi (D., Calif.) said recently. “What they’re doing continues to drive up premium costs with their senseless sabotage.”

The conservative groups argue that this could be Republicans’ last chance to deliver on the eight-year GOP promise to end the ACA. That is a better electoral strategy, conservatives say, than moving toward Democratic positions or changing the subject.

The latest plan is one front of a continuing assault on the ACA by Republicans and conservatives in the aftermath of the failed previous effort to repeal it. While the Justice Department has asked a court to toss out key provisions of the health law, the 20 GOP state attorneys general in the lawsuit want the court to end the law altogether.

Some Republicans, including Sen. Ron Johnson (R., Wis.), have voiced interest in a repeal, and others have talked about passing a health-care package in coming months. Health and Human Services Secretary Alex Azar, in testimony last week, said he would work with Congress should lawmakers decide to modify or repeal the ACA.

Write to Stephanie Armour at