Posts Tagged ‘obamacare’

McCain to oppose latest Republican health care bill — Keeps Obamacare alive

September 23, 2017

The US senator has said he will oppose the latest Republican attempt to replace Barack Obama’s health care law. Another ‘nay’ from the Arizona senator could be the fatal blow, given the party’s small Senate majority.

Münchner Sicherheitskonferenz (picture-alliance/dpa/M. Balk)

The announcement by Arizona Senator John McCain – a Republican often at odds with President Donald Trump and who cast a deciding ‘no’ vote in July that helped defeat the second Republican repeal bill this year – could sink Senate Majority Leader Mitch McConnell’s plans to pass the bill before the end of September.

“I cannot in good conscience vote for the Graham-Cassidy proposal,” McCain said of the bill proposed by Republican senators Lindsey Graham and Bill Cassidy. “I believe we could do better working together, Republicans and Democrats, and have not yet really tried,” the senator said in a statement.

McConnell has been trying to schedule a vote by September 30, the last day on which the bill could pass with only a simple majority of 51 votes in the Senate. A vote taken any later than that would have to get at least 60 votes.

To pass the Graham-Cassidy bill, the Republicans will need at least 50 votes in the 100-seat Senate, which they control 52-48, with Vice President Mike Pence casting a potential tie-breaking vote.

Several other Republicans are undecided, while no Democrats support the bill.

McCain said he would consider supporting the bill if it had come after extensive hearings, debate and amendment. “But that has not been the case,” he said.

 Image may contain: 2 people, people smiling, people standing and suit

The bill

The bill would take federal money spent on the Medicaid program for the poor and disabled, as well as subsidies to help Americans buy private insurance, and then allocate it to the states in block grants.

The Center on Budget and Policy Priorities – a liberal think tank in Washington – has estimated the bill would cause more than 30 million people to lose insurance.

Third time unlucky

If it fails, it would be the third failed attempt to repeal the Affordable Care Act, the 2010 law often referred to as “Obamacare,” which brought health insurance to millions of Americans and became former Democratic President Barack Obama’s signature domestic achievement.

President Donald Trump made repealing Obamacare one of his top campaign promises in 2016. Democrats have fiercely defended it.

In July, McCain made a dramatic return to Washington from Arizona after a brain cancer diagnosis to become one of three Republican senators who helped sink their party’s earlier efforts to replace Obamacare.

After McCain’s surprising vote against that effort, Graham said in a statement he was not giving up. “We press on,” he said.

“The Jimmy Kimmel test”

Late night television host Jimmy Kimmel, who criticized the Graham-Cassidy bill on his show, thanked McCain on Twitter. “Thank you @SenJohnMcCain for being a hero again and again and now AGAIN,” he tweeted on Friday. Kimmel became part of the healthcare debate in May when he discussed his newborn son’s emergency heart surgery.

The talk show host said he felt a sense of personal betrayal from the bill’s co-sponsor Cassidy, who made an appearance on “Jimmy Kimmel Live” in the spring. Cassidy came on the show to promise that the health care reforms he was proposing would “pass the Jimmy Kimmel test,” meaning that no family should be denied medical care because they cannot afford it.

Kimmel said earlier this week that Cassidy “lied right to my face” by giving him false assurances of Republican health care plans. Cassidy, in turn, said the comedian was misinformed and did not understand the bill’s components.

jbh/kl (AFP, Reuters)


Trump Backers Cheer Economic Agenda, Blame GOP for Setbacks

September 22, 2017

President’s responses on North Korea, white supremacist violence draw slightly lower rating

Image result for Donald Trump in Florida after hurricane, photos

By Valerie BauerleinArian Campo-Flores and Quint Forgey
The Wall Street Journal

As President Donald Trump approaches his 10th month in the White House, The Wall Street Journal revisited voters in six counties representing the economic underpinnings of his support. In each county, the Journal spoke to supporters, converts, abstainers and opponents to see how their economic situation is changing, and whether their expectations are being met.

Supporters of President Donald Trump generally approve of his overall performance on what they see as core issues such as jobs and taxes, and they blame Republicans in Congress for failing to support the White House agenda.

“I think he’s doing great,” said Emory Terensky, 66 years old, a former steelworker in Monessen, Pa. Similarly, Patti Thompson, who lives in the Phoenix-area retirement community of Sun City, said her support of the president hasn’t wavered, though she continues to be frustrated that “we can’t get Congress and Trump on the same page.” She puts the fault for that on congressional Republican leaders.

On a few issues, such as tensions with North Korea and clashes with white supremacists in the U.S., Mr. Trump received a slightly lower rating. “I’m very concerned about the North Koreans,” said John Golomb, 65, a former steelworker, in Monessen, Pa. “Is Donald Trump talk, or is he action? That’s the $64,000 question.”

Robert Lee, the 62-year-old owner of Rockingham Guns & Ammo in Richmond County, N.C., gives the president an overall grade of “B-minus, at best.” He is holding out hope that Mr. Trump will begin successfully working with Congress to get his agenda passed. “He is more intent on fighting,” Mr. Lee said. “You can’t fight all the time. You’ve got to step back away from it, take a look at the broader picture of what’s taking place and do something about it.”

Trump opponents, for the most part, remain angry, and, in some cases, disheartened, with his handling of several key issues over the past few months. Trish Collins, a 40-year-old human resources manager in Pinellas County, Fla., said she feels exhausted by the “roller coaster” of Mr. Trump’s presidency.

Rachel Kalenberg, 35, who voted for Gary Johnson, the Libertarian presidential candidate, said she hadn’t yet seen evidence of an economic boom in energy-rich Gillette, Wyo, where she owns a pizza shop. But she acknowledged that many people here still believe Mr. Trump’s support of the coal industry could ultimately mean more jobs and other good things. “I think Gillette is very hopeful, and we have seen a little bit of growth,” she said. “Maybe it’s not enough.”

Among Trump supporters, views were mixed on his response to the Confederate statue protests in Charlottesville, Va., which descended into a fatal confrontation. Some, including Mr. Lee in Richmond County, N.C., believe that Mr. Trump created unnecessary problems by blaming white nationalists for violent confrontations with counterprotesters in an Aug. 14 prepared speech, then saying there was “blame on both sides” in a news conference the next day at Trump Tower in New York.

“He added a little bit more to it than should’ve been added and that drove a wedge,” Mr. Lee said. “If you keep on tossing something into the wind, it’s going to blow back on you, and it did.”

But others, such as Earl Cassorla, 61, agreed with Mr. Trump’s stance, and blamed the media for not reporting his remarks accurately. “The president denounced white supremacists and neo-Nazis,” said Mr. Cassorla, co-owner of a fireworks shop in Battle Mountain, Nev. “The president said there were good people on both sides of the statue protest. The media responded that ‘No, there are no good Nazis.’ Fake news.”

Mr. Cassorla also agreed with Mr. Trump’s assertions in various tweets that removal of Confederate statues is wrong. In the case of Confederate Gen. Robert E. Lee, whose statue in Charlottesville was at the center of the Aug. 12 protest, Mr. Cassorla said the Southern war commander wasn’t the racist he has been portrayed to be.

“People were protesting the removal of a statue of Robert E. Lee, who fought for the rights of his state, despite his desire for the country to remain undivided,” he said. “Some opposing the removal of Lee’s statue were a fringe group of white supremacists. Additionally, some protesting were just people who simply opposed the removal of a historical statue.”

Jocelyn Golomb, a 20-year-old Monessen, Pa., store clerk, who voted for Hillary Clinton in November, said she has always hated Mr. Trump. But her contempt for the president reached new heights following his response to the violence in Charlottesville.

“He kind of didn’t really have anything to say until after he was pushed to say something, and that wasn’t right,” she said. “I don’t think he’ll ever have my support. Ever.”

Ms. Collins in Pinellas County, Fla., who voted for Mrs. Clinton, thinks Mr. Trump’s handling of the Charlottesville violence was abysmal. “If I had to guess what is the worst way to respond to this, he nearly hit it, ” she said. “It was terrifying to see that.” At the same time, “this is not a surprise,” she said. “He’s been saying racist things from the beginning of his campaign.”

Some Trump supporters, such as Curtis Chambers, a 54-year-old financial adviser, in Pinellas County, praised the way the president has handled the North Korea problem. “It is the question no one seems to have an answer for,” Mr. Chambers said.

“I think the Obama period was a period of appeasement,” Mr. Chambers said. “The Trump approach is different. It will be more confrontational, highlighted by his rhetoric. I feel like he’s being strong with North Korea. … I wish there was a better answer, but at least he’s standing up to [ Kim Jong Un].”

“It’s a tough situation,” said Steve Lang, a 54-year-old contingency planner in Pinellas County. He backs the way the president is working with allies such as Japan to try to contain the threat. “I don’t think the American people want us to go to war with North Korea.”

But Mr. Golomb, the former steelworker in Monessen, Pa., who feels more “cheated” than ever after voting for Mr. Trump in November 2016, fears a growing threat from Pyongyang that he believes is exacerbated by Mr. Trump’s bluster on social media.

“I’m very concerned about the North Koreans,” he said. “Is Donald Trump talk, or is he action? That’s the $64,000 question.”

To Ms. Collins, the Clinton voter, Mr. Trump’s handling of hostilities with North Korea has been unsettling. “He and Kim Jong Un are very similar in what they say to each other, and it’s terrifying to see our president saber-rattling,” she said. “I can’t see how his approach is making things better.” Moreover, she said, Mr. Trump is alienating key allies such as China that could help defuse the situation.

The president’s August speech on Afghanistan, in which he backed a continued commitment there despite a campaign pledge to quickly pull out, earned mixed reviews from his supporters.

“I don’t think putting more troops on the ground in Afghanistan is the answer,” said Samme Engelson, 40, owner of an embroidery shop in Battle Mountain, Nev., who voted for the president. “I worry about the counsel the president is getting as far as this ‘war’ is concerned. We have been there so long.”

But Mr. Lang, who also backed the president, said the president’s change of heart was a positive step. “He sounded like he listened to his generals,” he said.

John Golomb, the former steelworker from Monessen, Pa., who early into Mr. Trump’s presidency began to regret his Trump vote, was particularly worried about the shift in Afghanistan which he hopes “doesn’t turn into another Vietnam.”

Responses to Hurricanes Harvey and Irma split along partisan lines, even in Florida, where Irma did the most damage.

Mr. Chambers, a Trump supporter in Pinellas County, thinks Mr. Trump performed well in the wake of the recent hurricanes.

“He went there right away,” Mr. Chambers said. “That kind of hands-on leadership, and showing up at the front where the trouble is, is a morale booster to everybody.”

But Ms. Collins, the Clinton supporter from Pinellas County, faulted Mr. Trump’s response.

“It seemed pretty obvious on his first visit [to Texas] that he was there just to promote himself,” she said. She credited the Federal Emergency Management Agency’s mobilization of resources, but said “this is another example of the career government staffers around him doing the best they can.”

Outside the hurricane zone, reactions were similarly divided.

“The president has behaved in a most compassionate manner related to the victims of this terrible storm,” said Mr. Cassorla of Nevada.

But Ms. Golomb of Monessen, Pa., viewed the president’s trip to Corpus Christi, Texas, in late August as nothing more than a glorified photo opportunity. “He wasn’t talking about, ‘Oh, we have a natural disaster, ‘” she said. “He was talking about, ‘What a huge crowd.'”

The president’s moves on DACA won praise from supporters for his initial move to toss the topic into Congress’s lap, but became more divisive when he began negotiating directly with Democrats. The suggestion to press for a continuance of such protections for young immigrants is also in line with a majority of Americans, according to a Wall Street Journal/NBC News poll.

Ms. Engelson, of Battle Mountain, Nev., expressed concern about the president’s handling of DACA.

“I originally thought that the president did the right thing in canceling DACA in six months,” she said. “Let Congress do their job. Now I am a bit worried that he is going to sacrifice immigration law to advance other items in his agenda, such as repealing Obamacare and tax reform. If that happens, I think he will have done great damage to his political future and perhaps our country’s future.”

But some supporters were willing to cut him more slack.

(MORE TO FOLLOW) Dow Jones Newswires

September 22, 2017 07:14 ET (11:14 GMT)

The Panic Over Graham-Cassidy

September 22, 2017

The single-payer Democrats won’t budge on health care.

Senate Republicans must be making progress on their latest attempt to reform health care, because the opposition is again reaching jet-aircraft decibel levels of outrage. The debate could use a few facts—not least on the claims that the GOP is engaging in an unfair process.

Republicans are scrambling to pass Lindsey Graham and Bill Cassidy’s health-care bill before Sept. 30, when the clock expires on the budget procedure that allows the Senate to pass legislation with 51 votes. The bill would devolve ObamaCare funding to…


CNN Money

The Graham-Cassidy Obamacare repeal bill would eliminate the law’s mandates, turn funding for the law’s subsidies and Medicaid expansion into block grants and reduce federal support for Medicaid overall.

GOP senators unveil alternative health plan

Republican senators’ latest attempt to repeal Obamacare could be the most far-reaching of GOP efforts this year.

Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana last week released a bill that would eliminate or overhaul major sections of the health reform law. The duo had been trying to garner interest in earlier versions of their bill for months, but hadn’t gotten much traction.

Now, however, Republicans likely have only two weeks left to use their 2017 budget reconciliation bill as a way to dismantle Obamacare with a simple majority in the Senate. The Graham-Cassidy bill is the only repeal effort left on the table, coming even as a bipartisan Senate committee is working on legislation to stabilize the Affordable Care Act.

The Congressional Budget Office said Monday it may take several weeks for it to release an analysis of the Graham-Cassidy bill so it remains to be seen how many fewer people could be insured under it or what the impact on premiums may be.

Graham-Cassidy in a nutshell:
Reduces federal spending and block grants it.
Caps Medicaid.
Waives community rating and essential benefits.

— Larry Levitt (@larry_levitt) September 18, 2017Here’s what’s in the bill:

Repeal Obamacare individual and employer mandates: Obamacare levies penalties on most Americans who don’t have health insurance and larger employers who don’t provide affordable coverage for their workers. The bill would eliminate the penalty, retroactive to 2016.

Related: GOP isn’t done with Obamacare repeal

Repeals Obamacare subsidies and ends Medicaid expansion funding: The legislation would eliminate Obamacare subsidies that lower premiums, deductibles and co-pays in 2020. It would also jettison federal funding for Medicaid expansion, which 31 states use to provide coverage for residents with incomes up to about $16,000.

The legislation would turn the federal funding for Medicaid expansion and the subsidies into a block grant program. States would be given a lump sum of money and would have a lot of leeway over how to spend it.

For instance, they could help enrollees pay their premiums and out-of-pocket costs or set up high-risk or reinsurance pools to help protect insurers from costly enrollees and entice them to stay in the individual market. States could use a portion of money to help those enrolled in Medicaid afford care.

Graham and Cassidy say that this provision would return power to the states and allow them to create programs that fit their residents’ needs. Also, it would equalize Medicaid funding across the states. The bill’s authors note that four states — New York, California, Massachusetts and Maryland — get 37% of Obamacare funding.

But Democrats and consumer advocates say that many states, particularly those that expanded Medicaid, would lose a lot of federal funding, making it harder for them to provide coverage or assistance to their residents. Also, they note, the block grant is only authorized through 2026, jeopardizing the continuation of funding after that.

Loosens Obamacare’s regulations regarding pre-existing conditions: The bill would also let states waive several key Obamacare protections for those with pre-existing conditions. While it would still require insurers to provide coverage to everyone, states could allow carriers to charge enrollees more based on their medical history. So younger, healthier folks could see their premiums go down, but sicker Americans could find themselves priced out of policies.

The legislation also would let states eliminate Obamacare’s essential health benefits provision, which mandates insurers cover an array of services, including hospitalization, maternity care, prescription drugs, mental health and substance abuse services. This could lower premiums somewhat and give consumers a wider choice of plans. But it would also make it harder for people to buy comprehensive policies so those with pre-existing conditions may not be able to find coverage that meets their health care needs.

Related: Democrats scramble to rally troops for another Obamacare fight

Revamps funding for Medicaid overall: The legislation would send the states a fixed amount of money per Medicaid enrollee, known as a per-capita cap, starting in 2020.

States could also opt to receive federal Medicaid funding as a block grant for the non-disabled adults and children in their program. Under a block grant, states would get a fixed amount of federal funding each year, regardless of how many participants are in the program.

States, however, cannot opt to receive block grant funding for elderly and disabled participants.

Graham-Cassidy would also shrink the program even more over time by pegging the annual growth rate of funding for children and non-disabled adults to standard inflation after 2024, rather than the more generous medical inflation.

Either per-capita caps or block grants would limit federal responsibility, shifting that burden to the states. However, since states don’t have the money to make up the difference, they would likely either reduce eligibility, curtail benefits or cut provider payments. The block grant would be more restrictive since the funding level would not adjust for increases in enrollment, which often happens in bad economic times.

Related: McCain, Murkowski undecided on new GOP health care bill

Allows states to institute work requirements for Medicaid: States would now be able to requireadultMedicaid recipients to work. The disabled, elderly and pregnant women would be exempt, however.

Permits everyone in the individual market to buy catastrophic plans: Obamacare only allows those under age 30 to buy catastrophic policies, which usually have higher deductibles and fewer benefits. This legislation would allow anyone to buy these plans starting in 2019.

Repeals a handful of taxes: The bill would repeal the tax on over-the-counter medicine, health savings accounts and medical devices, a levy unpopular on both sides of the aisle. But it keeps in place Obamacare’s taxes on the wealthy, health insurers and others.

Defunds Planned Parenthood: In keeping with longstanding Republican beliefs, the legislation prohibits federal funding for Planned Parenthood. But the restriction is only for a year, beginning when the bill is enacted.

Increases maximum contributions to health savings accounts: Today, individuals can save up to $3,400 and families can save up to $6,750 a year tax-free in a health savings account. The bill would raise that limit to the annual out-of-pocket maximum for high-deductible plans. For 2018, that would be $6,650 for individuals and $13,300 for families.

CNNMoney (New York) First published September 18, 2017: 8:46 PM ET

We may be witnessing a turning point in the Trump presidency

September 10, 2017

Image may contain: 1 person

By Michael Goodwin
New York Post

Keep these numbers in mind: 316 to 90 and 80 to 17. They were the lopsided votes in the House and Senate in support of the deal President Trump made with Democratic leaders on storm aid, the debt limit and government funding.

Remarkably, all the no voters were Republicans.

The numbers shout that we are witnessing a potential turning point in the Trump presidency, one that could further shake up Washington and rattle the calcified political parties.

Frustrated by the failure of GOP majorities in both chambers to pass his agenda, Trump followed through on threats to work with Democrats.

Signs suggest it was not a one-off deal, as the president already is discussing other topics with Chuck Schumer and Nancy Pelosi.

Hurricanes Harvey and Irma helped spark his decision. Trump was clear that, especially on storm relief, he wanted fast, bipartisan action that reflected the way ordinary Americans were helping each other, especially in hard-hit Houston. With Irma aiming at Florida and the southeast, the president recognized that the public would have rightly viewed political squabbling during national emergencies as an infuriating failure.

Still, the circumstances didn’t stop all the GOP grumbling, with some Republicans astonished that a president from their party had accepted Dems’ terms on the debt limit to get a quick deal. Not surprisingly, Trump was hardly apologetic, firing back on Twitter: “Republicans, sorry, but I’ve been hearing about Repeal & Replace for 7 years, didn’t happen!” — a reference to the failure to overturn ObamaCare.

He also issued a warning on tax reform, tweeting: “Republicans must start the Tax Reform/Tax Cut legislation ASAP. Don’t wait until the end of September. Needed now more than ever. Hurry!”

The developments show the president shedding the party straitjacket and being true to his disrupter candidacy. If he continues and is successful, he could create a new coalition that includes revolving members of both parties, depending on the issue.

That’s an ambitious scenario, given the hyper-partisan atmosphere in Washington and the cultural and political chasms across the country. But at least the president is proving in the short term that it is possible to get things done — and get them done quickly, a point he emphasized by signing the legislative package as soon as it reached his desk.

Naturally, the prospect of a bipartisan approach alarms both ends of the political spectrum, with leftists angry that Schumer and Pelosi dared to even talk to Trump, let alone make a deal. That attitude is both a cause and effect of the gridlock that has gripped the capital for the better part of two decades and turned compromise into an insult.

Yet beyond the professional activists, ideologues and consultants, much of America yearns for more government cooperation and less combat.

Like children watching their parents fight, most voters just want a productive peace, not an endless battle for ­total victory that yields nothing of common value.

Above all, they want a government that works for them, not one fixated on partisan scorekeeping and ideological litmus tests.

But it would be Pollyannaish to think that gridlock is just a big misunderstanding that can be resolved at a beer summit. There are legitimate differences between the parties’ reigning philosophies, and most major issues do not lend themselves to simply splitting the difference.

Debts and deficits, for example, can’t be resolved without goring somebody’s ox, and lawmakers are elected on the promise to make sure their backers are spared the bloodletting.

Tax reform is another issue that won’t go quietly. There’s a reason why there hasn’t been an overhaul of the revenue system since 1986.

Then there is the fact that gridlock offers advantages to incumbents. It allows them to raise money and hold onto their jobs by pledging purity, no small matter when everything from gerrymandering to technology means most pols are threatened more by primary opponents than by general elections.

But the big picture is that most Americans feel government in general and Washington especially has little concern for their lives and problems.

The tiresome duels of rehearsed talking points that offer no possibility of compromise reflect a broken model of politics.

Indeed, Trump’s promise to change Washington was a key ingredient in his victory, and he may be uniquely positioned to carve out a new model. Throughout his business life, he’s been on both sides of big issues, and comes to the presidency with less of a fixed political core than anyone in ­recent memory.

That’s made him understandingly suspect to many conservatives and his inexperience has been compounded by mistakes, but that outsider, pragmatic perspective can now work in his favor. If he can find both common ground and real solutions, we might look back one day and see a more bipartisan approach to governing as the one silver lining of the weather calamities of 2017.

Liberals’ ‘supreme’ smugness

Since labels are everything, a friend offers a new one: liberal supremacists.

It fits those who demand safe spaces and want to erase history. They’re the ones whose argument starts and ends with “shut up.”

Take Sen. Dianne Feinstein, who revealed herself to be a liberal supremacist through badgering insults to Amy Coney Barrett, a Trump nominee to a federal appeals court. A law professor at Notre Dame, Barrett’s sin is to be too much of a devout Roman Catholic for Feinstein’s refined taste.

“Whatever religion is, it has its own dogma,” the California Democrat declared. “The law is totally different. And I think in your case, professor, when you read your speeches, the conclusion one draws is that the dogma lives loudly within you….”

Abortion was the topic, and critics were quick to accuse Feinstein and other Dems who joined her chorus, of declaring that “No Catholics need apply” and setting an illegal religious test for public office. Bet they wouldn’t do that to a Muslim.

Then again, maybe they would because liberal supremacists have their own dogma. They believe they are smarter and better than everybody else.

People who buy individual health insurance policies with no ACA subsidies face premiums to rival a mortgage payment

September 3, 2017

Patty Murray, Lamar Alexander

WASHINGTON (AP) — Millions of people who buy individual health insurance policies and get no financial help from the Affordable Care Act are bracing for another year of double-digit premium increases, and their frustration is boiling over.

Some are expecting premiums for 2018 to rival a mortgage payment.

What they pay is tied to the price of coverage on the health insurance markets created by the Obama-era law, but these consumers get no protection from the law’s tax credits, which cushion against rising premiums. Instead they pay full freight and bear the brunt of market problems such as high costs and diminished competition.

On Capitol Hill, there’s a chance that upcoming bipartisan hearings by Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., can produce legislation offering some relief. But it depends on Republicans and Democrats working together despite a seven-year health care battle that has left raw feelings on both sides.

The most exposed consumers tend to be middle-class people who don’t qualify for the law’s income-based subsidies. They include early retirees, skilled tradespeople, musicians, self-employed professionals, business owners, and people such as Sharon Thornton, whose small employer doesn’t provide health insurance.

“We’re caught in the middle-class loophole of no help,” said Thornton, a hairdresser from Newark, Delaware. She said she’s currently paying about $740 a month in premiums, and expects her monthly bill next year to be around $1,000, a 35 percent increase.

“It’s like buying two new iPads a month and throwing them in the trash,” said Thornton, whose policy carries a deductible of $6,000. “To me, $1,000 a month is my beach house that I wanted to have.”

A suggestion that she could qualify for financial assistance by earning less only irritates her more. “My whole beef is that the government is telling me: ’If you work less, we’ll give you more,’” said Thornton, who’s in her 50s.

If people such as Thornton drop out, they not only gamble with their own health. Their departure also means the group left behind gets costlier to cover as healthier customers bail out. That’s counter to the whole idea of insurance, which involves pooling risk.

It wasn’t supposed to be this way.

Buying health insurance has always been a challenge for people getting their own policies outside the workplace. Before “Obamacare,” insurers could turn away those with health problems or charge them more. Former President Barack Obama sold his plan as the long-awaited fix.

It would guarantee coverage regardless of health problems, provide tax credits and other subsidies for people of modest means, and generate competition among insurers to keep premiums in check for all. The overhaul sought to create one big insurance pool for individual coverage in each state, no matter whether consumers bought plans through or traditional middlemen such as insurance brokers.

But an influx of sicker-than-expected customers drove up costs for insurers, while many younger, healthier people stayed on the sidelines. Political opposition from Republicans complicated matters by gumming up the law’s internal financial stabilizers for insurers.

The result was a 25 percent average increase in the price of a midlevel plan on heading into this year. Many states expect a similar scenario for 2018, but this time insurers say uncertainty about the Trump administration’s intentions is driving up their bids ahead of the Nov. 1 start of open enrollment.

About 17.6 million people buy individual health insurance policies, and half of them get no subsidies under the law, according to estimates by the nonpartisan Kaiser Family Foundation. The number of unsubsidized customers with ACA plans outside the health insurance marketplaces dropped by 20 percent this year, after the big premium increases.

“The unsubsidized part of the market outside the exchanges has shrunk noticeably as premiums have increased,” said Kaiser’s Larry Levitt. “It’s likely that the people dropping out of the market are healthier overall. So the pool has potentially deteriorated.”

It’s time to shift focus in the health care debate, said Sen. Alexander, chairman of the Senate Health, Education, Labor and Pensions Committee, which plans hearings beginning this coming week.

“The people who are really getting hammered — they are the ones we need to help,” said Alexander, R-Tenn. “We’ve got a few weeks to come to consensus in this seven-year-old partisan stalemate and if we don’t break it, some people will be priced out and badly hurt.”

Alexander envisions limited legislation that guarantees disputed subsidies for copayments and deductibles another year, while giving states more leeway to design less-costly plans. Democrats are looking for financing to help insurers with high-cost cases. Experts say that guaranteeing the subsidies should lead to an immediate cut in premiums in many states.

Thornton, the Delaware hairdresser, said she doesn’t know what to believe anymore. She said she voted for Donald Trump — her first time for a Republican — partly out of frustration with her health care costs.

“I’m ready to stomp on the White House lawn,” she said. “I am fuming.”

Healthcare: Senator Lindsey Graham pushing “fundamentally different approach than Obamacare.”

August 30, 2017



29 Aug 2017

Senator Lindsey Graham (R-SC) told Breitbart News in an exclusive interview that while the congressional  leadership’s healthcare bills kept Obamacare’s infrastructure in place, his coalition’s plan to repeal and replace “is truly and fundamentally a different approach than Obamacare.”

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Lindsey Graham. Credit J. Scott Applewhite for AP

Breitbart News reported on former Senator Rick Santorum’s plan to block grant Obamacare to the states. Santorum continues to work with Sen. Lindsey Graham, House Freedom Caucus Mark Meadows (R-NC), and Wisconsin Governor Scott Walker on a Republican alternative to the Affordable Care Act. These lawmakers’ support for the idea could culminate in a consensus that could allow the bill to pass through the Senate and fulfill Republicans’ promise to repeal and replace Obamacare. Meadows told Breitbart News Daily that the plan has “real merit.”

Santorum told Breitbart News that the plan could pass through the House and the Senate. Graham concurs with Santorum, suggesting that bill goes much further than the House-passed American Health Care Act (AHCA) and the Senate leadership’s Better Care Reconciliation Act (BCRA). Graham told Breitbart News:

Number one, we promised to repeal and replace, not to change the margins here. The House and the Senate bills were definitely improvements to Obamacare; however, it’s a stretch to say that they were a Replace because we did not really, the infrastructure stayed in place. This is truly and fundamentally a different approach than Obamacare. It relies upon the concept of federalism. Instead of Washington, D.C. managing Obamacare, having national exchanges, having payments going to insurance companies to prop up the system that cannot work. We’re going to block grant the health care to the states.

The House-passed AHCA and the Senate’s BCRA kept much of the infrastructure of Obamacare in place. Instead of the Obamacare subsidies for low-income Americans to purchase health insurance, congressional leadership swapped out the subsidies for refundable tax credits for Americans to purchase health insurance. Unlike the Santorum and Graham plan, the AHCA and the BCRA kept Obamacare’s federal exchanges and winded down Obamacare’s Medicaid expansion, although, Medicaid expansion was eliminating after several years. Graham’s plan eliminates Obamacare’s Medicaid expansion. Conservatives chided the original AHCA for not repealing enough of Obamacare, labelling the legislation, “Ryancare” and “Obamacare-Lite.”

Senator Graham explained to Breitbart News the construct behind the plan to repeal and replace Obamacare through block grants. Graham told Breitbart News:

They’ll have to cover pre-existing illnesses; they cannot use the money for roads and bridges or football stadiums. They have to spend the money on health care. It gives the consumer a voice they would never have in Obamacare. You can complain to your congressman or senator, but we do not run the program. Trying to find somebody in charge of your health care is almost impossible. Most of the people that run Obamacare are unelected bureaucrats. It is very hard to get their attention when things do not work well and Obamacare is based upon the idea of an unlimited printing press, you just keep printing money. Under the block grant approach, you can complain to somebody about the quality of your health care. That somebody would be your representative and the governor of the state. Chances are the person you are complaining has the same doctor that your family has. From a consumer’s point of view you have a much stronger voice, from an accountability perspective you have a much stronger voice in how it works because it will not be a 50 state conglomerate. There will be 50 different state solutions.

Here’s the construct. We are going to repeal the individual mandate, and the employer mandate. That generates about $200 billion in savings. The states can reemploy the individual mandate and the employer mandate if they would like but you cannot drag everyone else down with you. You can go to single-payer health care in a state if you wanted to, I think you would be foolish, but you cannot drag 49 other states with you.

So, what we did this will repeal the individual and employer mandate, and medical device tax. We left the other taxes in place and created a block grant. Under Obamacare, 4 states got 40% of the money. That’s New York, California, Maryland, and Massachusetts. They’re 20 percent of the population and so by 2026 our goal is to have parity. It will be roughly the same no matter whether you live in South Carolina or California. We help states that did not expand their Medicaid under Obamacare catch up. High-cost expansion states will have a glide path down to a number that will be parity by 2026.

Senator Graham told Breitbart News that key to getting the new Obamacare repeal plan to pass through Congress remains the governors’ support for the bill. Graham said, “So what we’re trying to do is get governors on board. The intellectual force behind this for governors has been Scott Walker from Wisconsin and Doug Ducey from Arizona. One expansion state and one non-expansion state. Most Republican states did not take Medicaid expansions. By 2026 we want to have parity. We’re trying to lock the formula down this week and send the text to CBO so they can score it.”

Senator Graham explained how the bill will increase flexibility for states to implement their own health care systems. Conservative states will have much greater freedom to implement their health care plans compared to Obamacare.

Graham continued: “There’s going to be three forms of flexibility. 1332 waivers from the HHS, which the governors like. There is going to be waivers through the children’s health program CHIP, which is a fairly flexible program, we’re going to be as flexible as possible with reconciliation and the parliamentarian. The fourth level of flexibility comes through the administration, Labor Department, HHS, they will have a wide ability to make waivers and grant flexibility.”

Increased flexibility with health insurance regulations could allow Republican states to design more innovative and more affordable health care plans.

Sen. Graham revealed that not only has he worked with Health and Human Services (HHS) Secretary Tom Price and Centers for Medicare and Medicaid (CMS) Administrator Seema Verma on a plan for his proposal, they have will also work to draft the formula used to figure out how much money every state gets for their local health care system.

“They have helped us design the formula. We have been working close with the administration to try to find a formula that would have been spent on Obamacare and block grant it back to the states and achieving parity by 2026, with as much flexibility as possible. This will be the end of single-payer health care, because the money and the policy making will be out of Washington,” the South Carolina senator said.

Graham told Breitbart News that he believes that the bill will score better than the House-passed American Health Care Act (AHCA) and the Senate leadership’s Better Care Reconciliation Act (BCRA). Graham told Breitbart News:

I think this bill will score very well. I think it will score well in terms of fiscal deficit impact. I think it will do as good as the House bill if not better. Once you repeal the individual and employer mandate, 14 million people will drop coverage because they no longer have to pay the fine. So 14 million just made a personal choice. I don’t feel like I’m denying anyone coverage because they made a choice.

Here’s what they can’t lose sight. Obamacare is a nightmare, it will never work, these exchanges cannot be propped up. It was always the plan to go to single-payer health care. It’s to make insurance so costly in the private sector that people will drop coverage and then pay the fine and their employees will join the exchanges and then people will have cradle to grave health care. I think that’s Obamacare goals was.

I think that the goal of Obamacare was to take over the patients that to exchange. This is a stake in the heart of Obamacare through a block grant.

Graham said that he believes that Sen. Lamar Alexander (R-TN) – the Health, Education, Labor, and Pensions (HELP) Committee chairman – will likely hold hearings in September on his proposed plan to repeal and replace Obamacare.

Graham also suggested that the plan could get to the 50 votes necessary for a repeal and replace legislation to pass through the Senate and perhaps a couple of votes from the Senate Democrats.

Graham explained, “When it comes to getting to 50, Alaska does very well under this approach. I think we can get Senator McCain, Senator Murkowski if it works out well for their states. So, conceptually John likes it if it’s good for Arizona. If you can get it to 50, I do not think that a Democrat is going to make it the 50th vote, but I do believe that once we get 50 Republicans there’s going to be a handful of Democrats that will vote for more money and more flexibility for their states.”

Graham criticized the House and Senate leadership’s approach to repealing and replacing Obamacare, arguing that the leadership “got too much in the weeds of tweaking Obamacare.” He argued that Republicans should have started from their principles to revert power back to the states, rather than tweaking the government’s power to hand out health care as an entitlement. Graham also said that he will continue to work with Senators Ted Cruz (R-TX) and Mike Lee (R-UT) on empowering states with more regulatory flexibility to implement their health care plans and lower premiums.

Graham also suggested that House Freedom Caucus members Mark Meadows and Sen. Bill Cassidy (R-LA), and former Senator Rick Santorum have been instrumental in pushing forward this strategy to empower states to create their own health care systems. Rick Santorum was instrumental in passing welfare reform in the 1990s, and Freedom Caucus chairman Mark Meadows led the drive that improved the AHCA enough for the bill to pass through the House.

Graham told Breitbart News:

I’m working with Mark Meadows in the House. The Freedom Caucus guys have been terrific. You know, this should have been our first idea, not our last idea. As Republicans, I think we got too much in the weeds of tweaking Obamacare. We should have went back to our basic philosophy of getting as much money and power out of Washington as possible. If we started with this concept, we would’ve had it done by now. I had a bill that would have allowed people to opt out of Obamacare and so Rick Santorum called me and said, ‘Why don’t we just block grant and instead opting out?’ So myself, Rick Santorum, and Mark Meadows started meeting and if this becomes law it will be because of Rick Santorum, he’s been indispensable. Bill Cassidy has been a great partner. Santorum has been instrumental, he knows his stuff backwards and forwards. We just need to remember this whole experience. When you [are] confronted with what happened in Washington you shouldn’t try to make Frankenstein look better, we should build something new.

Graham concluded, “This is may be the most important thing that I’ll ever do. If we can take money and power out Washington when it comes to health care, then we can achieve a great feat. Health care that is closest to the patient is the best health care.

Is The Republican Party Committing Suicide?

August 27, 2017

By Brent Bozell — For Breitbart

The Grand Old Party is about to commit suicide.

All this talk about Trump this, and Trump that, masks a far bigger political controversy. The Republican Party leadership in Washington, D.C., has fundamentally betrayed its constituents and they are about to learn that they’ve been double-crossed — for years.

Every Republican candidate’s stock speech sounds the same, the thunderous roar about a government out of control, federal spending out of control (insert charts and graphs and why, if you stack hundred dollar bills, they will reach the edge of the universe), federal taxes out of control (insert comparisons to socialist countries), the federal bureaucracy out of control (insert metaphors about chains, yokes, and the like), the family shattered with federal funding of abortion a crime against humanity (watch for it — there! The heart-wrenching sob), and our military is emasculated.

Two more items were added to the menu, courtesy of Obama. Obamacare Will Be Repealed! and Illegal Immigration Will Not Stand!

In 2009, the Democrats controlled everything, partly due to the Republicans’ cowardice on Capitol Hill, and in part because of some of the most inept candidates and campaigns America has seen in years. The Obama folks could have played it safe but went for socialist gold, using the power of the legislative and the executive branches (and later the judiciary, thank you Justice Roberts) to advance their agenda.

That included federal spending on a level unmatched in human history resulting ultimately in a $19 trillion in debt we simply cannot pay, and with so many tens of trillions of dollars in unfunded liabilities that “infinity” is not far behind. One seventh of the economy was confiscated by the federal government with the passage of Obamacare. Our national borders were declared open and discussions over our national sovereignty closed. And to top it off, the Democrats all but declared themselves above the law.

The GOP harrumphed that this would not stand, by God! If only… if only America would vote them into the majority.

In 2009, the Tea Party was born. The Grand Old Party was rejuvenated. Happy days were here again.

Just one year later, the Republicans captured the House, and with that, the power of the purse. They now had the authority to stop the insane spending on so many obnoxious and wholly unnecessary ventures. They could end Obamacare simply by not funding it.

Instead, under the “leadership” of John Boehner, it did absolutely nothing. Why, if only we had the Senate! Then we could take on the President!

So in 2014, after spending hundreds of millions of campaign dollars running hundreds of thousands of television and radio ads pledging to end illegal immigration while repealing Obamacare “root and branch” (author: Mitch McConnell), they were given control of the Senate.

And within a month McConnell re-authorized both, along with every single other thing Harry Reid and Obama wanted for yet another year.

But that’s because we can’t do what we promised until we have the Presidency! The excuse was as predictable as summer heat in the Sahara.

In 2016, they were given that too.

They were given everything.

In January of this year, they formally controlled both houses of Congress and the executive branch. Every single thing they’d ever promised was now possible.

They now had the power to enact every single spending cut they’d ever solemnly pledged. All those wasteful programs designed to fill the liberal sandbox — PBS, NPR, Planned Parenthood, NEH and the rest of the alphabet soup; all the hundreds of billions of dollars in corporate welfare to multi-billion-dollar corporations; all of the hundreds of billions of dollars directed toward leftist social engineering — poof! All of it could come to an end with a stroke of a pen.

They now had the power to restore fiscal tax sanity too. Remember the flat tax? The fair tax? Slashing the highest corporate taxes in the world? Giving you a tax break? All of it could be done with a snap of the fingers.

Repeal Obamacare? Check. End illegal immigration? Check. Build the wall? Check.

Crush the Deep State? Done, by God, done!

There was not a damn thing the Democrats could do to stop them from draining the swamp.

Except the Republican leadership didn’t mean it. With the exception of the Freedom Caucus in the House, and literally a handful in the Senate, the rank-and-file didn’t either. Not one word of it.

The opportunity arose for the vote to repeal Obamacare, and after huffing and puffing, and huffing and puffing some more, the dust settled and socialized health care remains the law of the land, perhaps permanently.

The opportunity arose for tax reform, to enact the cuts America desperately needs. It was never a matter of if, it was a matter of how much. It is now mid-August and nothing, absolutely nothing has been accomplished — even attempted!

And now we face the final test: the debt ceiling. Will we or won’t we stop the spending madness? Will the Republicans enact the cuts they’ve promised, or will they now be the ones to kick the can, piling evermore trillions of dollars of debt on their own grandchildren?

By every indication that’s precisely what they plan to do. The signal has come from President Trump, from Speaker Ryan, and from Majority Leader McConnell. The debt ceiling will be raised and no fiscal sanity will be restored.

There is no difference between Republicans and Democrats. Put them together. They are the swamp.

Just as Republicans have the power to enact the agenda they’ve pledged in toto, so too do they now own the federal government, in toto. It’s no longer Obamacare. It’s GOPcare. It’s no longer crazy liberal Democratic spending. It’s crazy liberal Republican spending. It’s no longer socialist Democratic Party taxation, it’s socialist Republican Party taxation. All the legislation authorizing all these programs, all the graft, all the waste, all the obscenity, all the immorality, and where Planned Parenthood is concerned, all the killing — all of it is now formally authored by the Republican Party.

Come the Congressional elections next year, and the presidential election in 2020, the Grand Old Party will once again bellow its hallowed promises. But this time it won’t work. This time there will be no straw men to blame. This time their voters will know those hallowed promises are not even hollow promises. They are lies.

These voters are tasting betrayal. They will not vote to swallow more vomit.

We are watching the GOP systematically committing suicide.

Brent Bozell is the Chairman of ForAmerica, a national grassroots organization whose mission is to use social media to reinvigorate the public with the principles of American exceptionalism: freedom, prosperity, and virtue. ForAmerica has over 9 million members and is a non-profit 501(c)4.

Doctor Shortage? — Overwork taking a toll on Malaysian doctors — Public healthcare — Rising cost of living drives patients to seek cheaper treatment

August 20, 2017

Image may contain: 1 person, sitting and crowd

Klinik Kesihatan Kuala Lumpur, one of KL’s largest government clinics, which can treat up to 1,000 patients a day.PHOTO: BERNAMA

Public hospitals stretched as rising cost of living drives patients to seek cheaper treatment

As a paediatrician in training, Dr Nurul Huda Ahmad dreamed of making healthcare fun for children.

But her dream will never come true. The 33-year-old from Kuala Terengganu was driving home after working for 33 hours straight, with little rest, when she died in an accident on May 9.

In July last year, another young doctor, anaesthesiologist Afifah Mohd Ghazi, also died in similar tragic circumstances.

Worn out after a long shift, Dr Afifah lost control of her car and crashed into a tree, resulting in fatal injuries to her chest and brain. She was only 27.

Post-call fatigue is nothing new in the medical world, especially for doctors in the public health sector.

But the situation is worsening as more Malaysians switch to public hospitals to cope with the rising cost of living in recent years, especially since the 6 per cent goods and services tax (GST) was introduced on April 1, 2015.

The influx has added to doctors’ workloads and, in many instances, led to deadly consequences, according to anecdotal accounts from physicians and surveys by medical associations.

Dr Nurul Huda Ahmad also died in a crash after completing a 33-hour shift.
  • 55% Percentage of accidents that occurred after respondents had worked for 25 to 36 hours, according to a 2015 survey of 440 healthcare professionals.65% Percentage of respondents who admitted they suffered from post-accident psychological trauma.


We (doctors) are happy to be of service but I believe it is slowly taking a toll on us. A doctor at a public hospital sometimes has to take care of up to 500 patients. Imagine the exhaustion.

DR KUAN, on how the workloads of public hospital doctors have become heavier in recent years


Cost is definitely a factor because the prices of goods and services are steadily increasing. But another reason is that the waiting time (at public hospitals) is almost the same as at private hospitals.

MR MUHAMMAD NAJMI ABDULLAH, 36, an engineer, on how public hospitals are just as efficient as private ones.


When you have more people seeking treatment at public hospitals… it will also affect the doctors attending to them – they get overworked.

DR AZLAN HELMY ABD SAMAT, from the Islamic Medical Association of Malaysia, on how the rising cost of living has resulted in a higher number of patients going to public

Dr Rozaimi (not his real name), a 35-year-old doctor at a public hospital in Selangor, told The Straits Times that he and his peers suffer from chronic fatigue and high levels of stress. “There is no job without stress and fatigue, but I’ve lost count of how many times I’ve accidentally fallen asleep behind the wheel post-call,” said Dr Rozaimi.

“One incident will always stand out – I had just completed a 35-hour shift and was driving to my home in Shah Alam. I accidentally swerved into the fast lane when a car was already speeding along it. The loud honks (from the driver) saved me, I managed to swerve back into my lane.”

Dr Kuan (not his real name), 32, has also had his share of near-miss post-call experiences.

He said: “Although most of us (doctors) have adjusted to our hectic schedules, I can never forget an incident several years ago when I almost lost my life. I crashed into a divider and my car ended up in a drain. My injuries were minor but I could have drowned.

“After transferring to a research department two years ago, I no longer work more than 24 hours at a stretch. My quality of life has improved tremendously and I have not fallen asleep behind the wheel any more.

“We have all been guilty of falling asleep post-call while driving.”

Both Dr Rozaimi and Dr Kuan say their workloads have become heavier in recent years due to more patients going to public hospitals.

Dr Kuan said: “The number of patients has definitely doubled compared with several years ago. Most of the patients I have attended to have cited the higher cost of living as the reason they’re seeking treatment at public hospitals.

“We (doctors) are happy to be of service but I believe it is slowly taking a toll on us. A doctor at a public hospital sometimes has to take care of up to 500 patients. Imagine the exhaustion.”

In 2015, a survey of 440 healthcare professionals on the topic of post-call motor vehicle accidents was published by the Islamic Medical Association of Malaysia (Imam) and Pertubuhan Amal Perubatan Ibnu Sina Malaysia, a non-profit organisation.

Some 55 per cent of the accidents the respondents had been involved in occurred after they had worked for 25 to 36 hours.

Nearly 65 per cent of respondents also admitted they suffered from post-accident psychological trauma.

Imam’s Dr Munawwar Salim said that at the time, the survey highlighted the need for further investigations into the correlation between motor vehicle accidents and the preceding hours of duty.

After serving the standard 24 hours, most doctors have to work for a further four to 10 hours just to clear the backlog of work.

Sleep deprivation is one of the recognised factors contributing to motor vehicle accidents.

Research has shown that drivers who are suffering from fatigue are as cognitively impaired as drivers who are intoxicated.

The high cost of living has been cited as the top reason that more Malaysians are seeking treatment at public hospitals.

Last year, public hospitals saw 20 per cent more patients compared with the year before, according to the Health Ministry’s deputy director-general, Dr Jeyaindran Sinnadurai. He noted that even before 2016, the number had been increasing.

Restaurateur Rita Liyana Rahmat, 41, said she started going to government-funded hospitals and clinics after the GST kicked in.

“It’s already hard to cope with daily expenses these days. Forking out money for medical treatments at private medical institutions just doesn’t make sense to me,” she told The Straits Times.

Engineer Muhammad Najmi Abdullah, 36, said he prefers going to public hospitals, which he said are just as efficient as private ones.

“Cost is definitely a factor because the prices of goods and services are steadily increasing. But another reason is that the waiting time (at public hospitals) is almost the same as at private hospitals,” said Mr Najmi.

“Instead of using up my deposit – which always happens at private hospitals after I get discharged – I would rather get treated at or admitted to government hospitals.”

Dr Azlan Helmy Abd Samat from the medical association Imam said there is a definite link between the rising cost of living and the rising number of patients opting for public hospitals.

“When you have more people seeking treatment at public hospitals… it will also affect the doctors attending to them – they get overworked,” he said.

This shift also means that private outfits have seen a drop – of almost 30 per cent – in patient numbers, according to Association of Private Hospitals of Malaysia president Jacob Thomas.

He told The Malaysian Insight news site last month that patients are turning to public hospitals asthese hospitals are exempt from GST and treatment is almost fully subsidised by the government.

Dr Jacob urged the Health Ministry to collaborate with the private sector to reduce long waiting times for procedures such as magnetic resonance imaging, computerised tomography and positron emission tomography scans.

At some private hospitals, patients who have been referred by public hospitals are offered these services at reduced prices, he noted.

“We understand that 25 per cent of patients at public hospitals have access to private healthcare insurance. We can manage them in our private hospitals,” Dr Jacob was quoted as saying.

In May, government representatives from the Road Safety Department and the Health Ministry’s Occupational Health and Safety Unit, as well as medical associations, held a meeting to discuss ways to prevent doctors from getting into road accidents after exhausting shifts.

The meeting was held in response to concerns aired by a group of medical non-governmental organisations (NGOs) on May 13 about the number of medical professionals who were involved in road accidents after working long hours.

“Until today, we do not have data on this subject. This is the reason why we need to have our own research on this,” Dr Munawwar from Imam told The Straits Times.

For now, the NGOs are working to raise awareness of the problem through campaigns and engagements, he added.

They will also launch a discounted ride-hailing service for post-call doctors in collaboration with GrabMalaysia on Sept 16.




Republicans Face Looming Deadline on Health Law

August 20, 2017

Lawmakers will have 12 legislative days to decide whether to pass a bipartisan health bill

Republican lawmakers have to decide whether to shore up the health law or continue with efforts to roll it back.
Republican lawmakers have to decide whether to shore up the health law or continue with efforts to roll it back. PHOTO: MICHAEL REYNOLDS/EUROPEAN PRESSPHOTO AGENCY

Aug. 20, 2017 6:00 a.m. ET

WASHINGTON—A fast-approaching deadline for insurers to commit to selling health plans next year under the Affordable Care Act is pressuring Republican lawmakers to decide quickly whether to shore up the law and ease the path for insurers or continue efforts to roll it back.

Lawmakers returning to the Capitol from recess on Sept. 5 will have only 12 legislative days to decide whether to pass a bipartisan bill aimed at bolstering the ACA’s markets before insurers must commit to participating in the law’s exchanges in 2018. At the same time, a plan from Sens. Lindsey Graham (R., S.C.) and Bill Cassidy (R., La.) that would largely topple most of the ACA is gaining traction among Republicans.

The looming deadline means that Republican lawmakers who have been bogged down for months on legislation to rework most of the ACA will have little time to decide whether to pivot and instead help bolster the current health law—or, possibly, to pursue both courses.

A bipartisan plan from Sens. Lamar Alexander (R., Tenn.), chairman of the Senate’s health committee, and Patty Murray (D., Wash.), the committee’s top Democrat, would need support from senators in both parties to clear a 60-vote threshold in the Senate. Hearings are slated for the first two weeks after Congress returns.

Their proposal would likely preserve for next year billions of dollars in federal payments to insurers known as cost-sharing reduction subsidies. Insurers have said that without the payments they likely would raise premiums or stop participating on the ACA’s individual markets. In return for guaranteeing the payments next year, any bill would likely give states more flexibility on ACA implementation, a change GOP lawmakers have sought.

The pressure on Republicans has intensified after the nonpartisan Congressional Budget Office reported last week that cutting off the subsidies could spur a 20% increase in 2018 premiums for some of the exchange’s most popular, midtier priced plans. President Donald Trump has threatened to halt the payments, which compensate insurers for lowering out-of-pocket costs for some low-income consumers.

During the congressional recess, support also has grown for the plan championed by Mr. Graham, which would give states the billions of dollars spent on the ACA to create their own health-care approaches. It also would end the requirement that most people purchase insurance or pay a penalty. Conservative lawmakers in both the House and Senate see it as the most viable path toward a repeal of the ACA.

The idea, backed also by GOP Sen. Dean Heller of Nevada, could draw other Republicans away from any plan to bolster the ACA’s markets. A spokesman for Mr. Cassidy said the two bills could move on parallel tracks, with lawmakers choosing to shore up insurance markets in the short term while pursuing more sweeping changes to the law.

Some Republicans want legislation to shore up the markets and preserve the cost-sharing payments. Others, along with Mr. Trump, are eager to repeal most of the ACA. They see the subsidies as a bailout of insurers.

Concern is growing among governors, Democrats and insurance commissioners that any effort may come too late to help consumers in fragile ACA exchanges.

Though the Trump administration recently pushed back some key federal due dates, insurers are still supposed to file their 2018 premiums by Sept. 5. However, industry officials said, the more binding deadline may be Sept. 20, when states must submit completed rates to federal officials. Ultimately, insurers have until Sept. 27 to sign federal contracts to offer 2018 plans.

“There has to be a clear set of rules for 2018 for us to participate,” said David Holmberg, chief executive of Highmark Health. “We need answers. We need to know what the playing field is and who the refs are.”

Mr. Alexander said earlier this month in a statement that if Congress doesn’t act by Sept. 27, “millions of Americans with government subsidies…may find themselves with zero options for buying health insurance on the exchanges in 2018.”

If they pass a bill to stabilize the markets, Republican officials could face a backlash in the 2018 elections from conservative voters who feel GOP lawmakers reneged on their pledge to repeal the ACA.  Voters may also hold lawmakers accountable if nothing is done and premiums climb next year.

“The Republican base expects some results, and that’s not unreasonable of them,” said Doug Heye, a former deputy chief of staff to then-House Majority Leader Eric Cantor (R., Va.).

Some conservative outside groups have given the bipartisan proposal to shore up the markets a chilly reception.

“They’re basically bailouts to prop up Obamacare,” said Andy Roth, vice president of government affairs at the conservative Club for Growth.

But there is some support for such a rescue mission in the House. Reps. Mark Meadows (R., N.C.), chairman of the conservative Freedom Caucus, and Tom MacArthur (R., N.J.), a centrist, have been collaborating on a stabilization package seen as a companion to Mr. Alexander’s work in the Senate. That plan would authorize the subsidy payments in 2018 and build more flexibility into ACA waivers. Mr. Meadows is also spearheading a parallel effort to force a vote on a clean repeal of the ACA on the House floor.

Write to Stephanie Armour at and Michelle Hackman at

With New Remarks on Charlottesville, Trump Leaves Himself Isolated

August 16, 2017

Republicans distance themselves from president’s latest comments on last weekend’s violence

President Trump in the lobby at Trump Tower in New York on Tuesday.
President Trump in the lobby at Trump Tower in New York on Tuesday. PHOTO: JIM WATSON/AGENCE FRANCE-PRESSE/GETTY IMAGES

Updated Aug. 15, 2017 9:22 p.m. ET

Throughout the strange odyssey that was the 2016 presidential campaign, Candidate Donald Trump never seemed afraid to be isolated from the political mainstream, standing on an island apart from those inside his party, to say nothing of those outside it.

Yet even Candidate Trump may never have left himself quite so isolated as President Trump did with a remarkable news conference inside Trump Tower on Tuesday afternoon.

Almost inexplicably, one day after Mr. Trump sent a sense of relief washing over his party by unambiguously condemning neo-Nazi groups at the forefront of a protest in Charlottesville, Va., last weekend, the president did a U-turn. He said again that both the white supremacist marchers and those who were there to protest them were equally to blame for the violence there. In that violence, a 32-year-old woman was killed by a young man who drove his car into a gathering of people opposing the white supremacists.

Within minutes of Mr. Trump’s comments, David Duke, a former Ku Klux Klan leader, was tweeting his thanks to the president. Meanwhile, a variety of Republicans were separating themselves from their president.

The organizers of events which inspired & led to are 100% to blame for a number of reasons. 1/6

Mr. President,you can’t allow  to share only part of blame.They support idea which cost nation & world so much pain 5/6

Sen. Marco Rubio retweeted an earlier comment that the president should “describe events in #Charlottesville for what they are, a terror attack by #whitesupremacists,” and proceeded to reel out a new string of tweets underscoring that view. Rep. Will Hurd, a Republican on the House Intelligence Committee—which is looking into the question of whether Mr. Trump’s campaign got inappropriate help from Russia in the 2016 campaign—declared on CNN that the president should “apologize…Racism and bigotry and anti-Semitism in any form is unacceptable, and the leader of the free world should be unambiguous about that.”

House Speaker Paul Ryan said “white supremacy is repulsive” and “there can be no moral ambiguity.” Jeb Bush, a former Florida governor who ran against Mr. Trump last year, tweeted: “This is a time for moral clarity, not ambivalence. I urge President Trump to unite the country, not parse the assignment of blame for the events in Charlottesville.”

And that was the reaction among Republicans. Among Democrats, the president’s remarks were essentially radioactive. Ironically, they came at an event set up so he could, among other things, woo Democrats to work with him on a plan to rebuild the nation’s infrastructure.

Moreover, the response came less than a week after Mr. Trump entered into a rhetorical war with his party’s leader in the Senate, Mitch McConnell, over the failure to pass a bill to repeal and replace Obamacare. Mr. McConnell said the president had “excessive expectations.” The president told his top Senate ally to “get back to work.”

Meanwhile, a number of business and labor leaders have resigned from the president’s manufacturing advisory council in protest over how Mr. Trump has reacted to the Charlottesville violence.

The upshot is that the August recess, a time Mr. Trump might have been able to build support and momentum for what is supposed to be a fall legislative push on the most important items on his domestic agenda, has become anything but. Instead, Mr. Trump may be on his way to emerging from the August period working with a shaken-up White House staff and fewer reliable congressional allies than he had coming in.

The real mystery is why. Mr. Trump had endured a weekend of criticism for saying in his initial reaction to the Charlottesville violence and the death there that there were “many sides” to the unrest. But on Monday he had begun to put that behind him with a statement that more explicitly condemned white supremacists and neo-Nazis, as well as the driver who plowed into a crowd of protesters objecting to their views.

He had no real reason to dive back into the controversy a day later. Yet he apparently couldn’t resist, and instead appeared to be eager to vent anger at the criticism of his original statement—and to justify it by arguing that there were excesses by both the white supremacists and the counterprotesters on the fatal day in Charlottesville.

One immediate problem for Mr. Trump is that his argument that the crowd gathered in Charlottesville included a lot of good people who had simply come to protest the removal of a Confederate statue flew in the face of video footage showing the white nationalists marching to such chants as “Jews will not replace us” and “blood and soil.”

Where things go from here is anybody’s guess. Mr. Trump has never really seemed to mind being isolated from the political establishment. In fact, he often seems to relish that position as proof he is right, and in this case he gave voice to those who think that it is unnecessary to remove all historical symbols of the Confederacy from the South. But that also leaves him mired in a debate over the ugliest aspects of American history—a debate that could get uglier still.

Write to Gerald F. Seib at

Appeared in the August 16, 2017, print edition as ‘In Ugly Debate, President Isolates Himself.’