Body Health, Mental Health, Politics

THE SENATE RELEASES THEIR HEALTHCARE BILL

Read my articles about the CBO analysis for the House bill here and the March AHCA bill here

In other news, before we get started—President Trump took to Twitter today to confirm that there were no tape-recordings of his conversations with former FBI Director James Comey; tapes he insinuated weeks ago he had.


Written when I was going to write about using self-tanner in preparation for New York Pride, and the realization that the healthy, sun-kissed glow I actually needed was for my soul—but more pressing matters have arisen.

This morning—Thursday June 22, 2017—the new healthcare plan was released after a cloud of mystery while it was being written in private by Senate Majority Leader Mitch McConnell and a small group of colleagues. The bill’s mystery was protested by Democrats and Republicans alike, who feared that this bill would be introduced and forced into a hasty vote before anyone had a chance to read it. according to CNN, the bill will have a one-week-turnaround, meaning that McConnell hopes to get it voted on within a week.

After a disastrous first attempt to vote on the original bill, the American Health Care Act, in March (the bill was pulled when it became clear that there were not enough votes for it to pass), the revised bill passed in the House of Representatives in early May. The next step was to bring it to the Senate for a vote, where GOP lawmakers such as McConnell revised and reworked the bill in an attempt to get it to pass in the Senate. If it passes the Senate, and then gets affirmed by the House, the bill would go to President Trump’s desk and, at his sign-off, become law. We good?

So, this morning, the bill was released. CNN also released an article comparing the three (the ACA, the AHCA, and the new bill) on key issues such as Medicaid expansion, coverage for pre-existing conditions, essential health benefits, Planned Parenthood and more. If you’re too lazy to read the article, here’s the major breakdown on some issues.

The Senate bill provides “skimpier coverage” for pre-existing conditions in states that get waivers for “essential health beneifts.” It allows states to redefine essential health benefits, which under the ACA were required for insurers to cover. These include mental health, maternity care and prescription drugs. The Senate bill cuts funding for Planned Parenthood for one year, which isn’t a surprise because the AHCA did that as well. It eliminates tax cuts for the wealthy and for insurers, taxes the ACA imposed to expand healthcare coverage. The ACA put a 3.8% tax on incomes $200,000 and higher ($250,000 for married couples). It gets rid of the individual insurance mandate, keeps the ACA provision for young people to remain on their parents’ insurance until 26, and removes the employer mandate to provide affordable healthcare to their employees.

At the moment, the bill can only afford to lose the support of two Republicans, which would put it at 50-50 and require a tiebreaking vote from Vice President Pence. As of writing this, four Republicans said they would oppose the bill in its current form and two more have withheld support.

The nonpartisan Congressional Budget Office is expected to release their independent findings on the bill early next week, a key component for some senators while considering their vote. The CBO will look at how many people could lose insurance under the new plan (24 million in the AHCA, and 23 in the House version) and the effects on the overall federal budget (the House bill would reduce the deficit by $119 billion).

In the near future, the bill will go into several hours of debate as well as something called the “vote-a-rama” where senators can suggest amendments that are relevant to the dialogue. The vote-a-rama can potentially go on indefinitely, but is largely centered on how long it takes for the senators to burn out and get tired. After all of that, the bill goes back to the House for affirmation, and if the House votes yes on it, then it goes to the White House. At the moment, it’s unclear if there’s enough support in the House for the bill to pass.

In the meantime, the public is reacting. Several dozen protestors were arrested Thursday after they staged a “die-in” outside of McConnell’s office. The protest was organized by the national disability rights group ADAPT. The cuts to Medicaid would greatly reduce access to medical care and services for the elderly and disabled. According to the police statement, several protestors removed themselves to “lay themselves on the floor, obstructing passage through the hallway and into nearby offices.”

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Politics

CB-OH NO: The Latest on the AHCA

The Congressional Budget Office releases its estimates on the new AHCA bill.


On May 24, 2017, the Congressional Budget Office (CBO) released new scoring for the latest iteration of the American Health Care Act. In their findings, the CBO and the Joint Committee on Taxation (JCT) estimated that over the next decade, the federal deficits would be reduced by $119 billion and that by 2026 23 million more people would be uninsured compared to the current law. Most of that 23 million would occur within the first year, with the CBO estimating that in 2018, 14 million people would be uninsured under the new bill (H.R. 1628).

The bill was passed in the House on May 4, 217 to 213 with 20 Republicans voting against and no Democrats voting for. The first attempt to pass the AHCA ended with Speaker of the House Paul Ryan (R-Wis.) pulling the bill hours before it was about to be voted on because it lacked the numbers to pass.

The new version passed without an official CBO score, having had mostly cosmetic tweaks to garner more support. According to The Atlantic, the AHCA stops states from “enrolling new people under Medicaid expansion” and it “incentivized states to drop the expansion altogether.” The new bill would also introduce per-capita caps on federal spending, reducing the number of people covered and their benefits. The AHCA also removes the employer mandate, which forces employers to provide affordable health insurance to 95% of their full-time employees and children up to the age of 26.

The bill also removes the individual mandate, which penalizes people who don’t sign up for health insurance. What this does, essentially, is take the burden off of healthy people who might not necessarily need insurance. But without those people paying into the system, the onus is on the sicker, older people to pick up the deficit.

The new bill also introduces a set of waivers: one that would allow states to “modify the requirements governing essential health benefits” (Remember that from last time?) and one that would allow insurers to “set premiums on the basis of an individual’s health status.” Roughly 1/6 of the population resides in areas where states would utilize those waivers and the result would be increasing difficulty for less healthy people to purchase insurance on account of rising premiums.

The waivers were the result of an amendment from Representative Tom MacArthur. Business Insider reported that it was the MacArthur amendment that gathered the support of 20 members of the Freedom Caucus, the conservation caucus that largely withheld support for the first AHCA on account of it being too lenient.

A CNBC article quoted Dr. Andrew Gurman, president of the American Medical Association, as saying, “Today’s estimates from the nonpartisan Congressional Budget Office show that last-minute changes to the AHCA made by the House offered no real improvements.”

The bill will now go to the Senate, where it requires at least 50 votes for it, thus leading to Vice President Mike Pence acting as a tiebreaker. Even with majorities in both chambers of Congress, and a 52-percent majority in the Senate, there is still the likelihood that the AHCA will not pass. Or that if it does, it will have to be severely rewritten to get any support.

Bottom line, even after months of rewriting, the AHCA bill has barely improved and, if anything, has gotten crueler by allowing states waivers on essential health benefits. Older, sicker Americans will see increased premiums and restricted care, and younger, healthier Americans won’t see any incentive to buy insurance. The GOP was more concerned with cosmetic Band-Aids to get conservative support than they were with crafting a bill that would benefit their constituents.

There is one bright side to the AHCA passing: this is probably the first time in months that Paul Ryan hasn’t had violent diarrhea from Congressional stress. Unfortunately, Congress-related diarrhea is no longer covered under the new plan.

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