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Mitch McConnell's "Secret" Healthcare Plan... and the SeniorHeroes who could stop him

When the House passed its American Health Care Act (AHCA) last month, conventional wisdom said it was doomed in the Senate.  Moderate Republican Senators would never go along with the more harmful provisions of the House bill – or so the narrative went.  It appears those predictions were off base.  If the latest reporting from Capitol Hill is accurate, Majority Leader Mitch McConnell has put the Republican healthcare plan on a fast-track for passage in late June or early July.  A 13-member working group has been meeting in secret to craft the Senate version of the AHCA – without committee hearings.  Zero open debate.  Zero public input.  Or as the Washington Post described the process:  “sabotage, speed and secrecy.”  In order to keep pushback to a minimum, McConnell may not release the details of the bill until about 48 hours before the Senate votes on it.  That is insufficient time for Senators – and the public at large – to evaluate legislation that could dramatically affect the lives of tens of millions of Americans.

 Another false prediction from a few weeks ago said that the Senate would scrap the House bill and start from scratch. But this week Senator John Cornyn (R-TX) revealed that the Senate bill retains about 80% of what the House passed.  Since the House bill was so unequivocally bad for older Americans, hearing that the Senate version is at least 80% as bad is cold comfort. The Senate leadership will try to appease GOP moderates with the same kind of token gestures that saved the AHCA from defeat in the House.  It is vitally important that those moderates not cave like their House colleagues did.  Too much is at stake for our nation’s seniors and Americans as a whole.

 The National Committee has identified 11 moderate GOP Senators who may be persuaded to vote against the Republican health care plan – if they are willing to put their constituents’ well-being above party and political expediency.  They are:

 Sens. Lisa Murkowski and Dan Sullivan (R-AK)

Sens. John McCain and Jeff Flake (R-AZ)

Sen. Cory Gardner (R-CO)

Sen. Charles Grassley (R-IA)

Sen. Susan Collins (R-ME) 

Sen. Dean Heller (R-NV)

Sen. Rob Portman (R-OH)

Sen. Lamar Alexander (R-TN)

Sen. Shelley Moore Capito (R-WV)

 In fact, we call on these Senators to become what we call “SeniorHeroes” – real-life superheroes standing up for older Americans while the rest of their party pursues a dubious scheme.  From what we know of the Senate bill, there isn’t much in the evolving Senate bill for moderates to applaud.  Sen. Lisa Murkowski expressed those doubts publicly on Thursday.  Here are some of the key areas where the Senate version will likely fail older Americans:

 MEDICAID EXPANSION.  Senate Republicans are considering “compromises” that would phase out funding more slowly – but do not appear to be considering any approach that would maintain Medicaid expansion over the long run.  (Many of the more moderate Senators represent states which chose to expand Medicaid – and have a lot to lose.)

 PER CAPITA CAPS.  The Senate reportedly will retain the House-passed bill’s Medicaid per capita caps, which would strain state budgets and possibly force rollbacks in benefits or outright termination of coverage for millions of seniors who depend on Medicaid to pay for long-term care.  Although it’s unclear whether the Senate will keep the House bill’s $834 billion in Medicaid cuts, Medicaid still likely will be slashed by hundreds of billions of dollars. 

PRE-EXISTING CONDITIONS AND ESSENTIAL HEALTH BENEFITS.  The Senate may reject provisions in the House bill that would have allowed insurers to charge higher premiums for individuals with pre-existing conditions, but will likely allow states to waive essential benefits coverage.  This would dearly cost older Americans seeking essential benefits, such as hospitalization, ambulance services, and rehabilitation services. 

TAX CREDITS.  The House bill would drive up seniors’ out-of-pocket costs by replacing Obamacare’s income-based subsidies with tax credits based solely on age.  Older Americans could pay up to 800 percent more in net premiums under this plan.  The Senate has toyed with making these tax credits more “robust,” but the more it increases these credits, the deeper it must cut Medicaid to match the savings in the House bill. 

We do not know whether the Senate will allow insurers to charge older enrollees five times more than younger ones, as the House legislation does.  Also uncertain is whether the Senate will repeal the Medicare payroll tax on high income wage earners (as the House did), which would reduce the solvency of Medicare by three years.

It’s a safe bet that, like the House version, the Senate GOP healthcare plan will cost older Americans more, make essential health benefits harder to obtain, and cause millions who desperately need healthcare to lose coverage.  GOP moderates will be under intense political pressure to toe the line and support the party’s plan, even though the Republican bill has scant public support in even the reddest of states.  In asking GOP moderates to don their capes and become SeniorHeroes, we hope they remember who they were elected to serve.  It certainly wasn’t Mitch McConnell. 

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For more about the GOP's secret Senate healthcare plan, watch this week's "Behind the Headlines" on Facebook Live from Capitol Hill. 

 

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House GOP Votes to Gut Medicaid, Weaken Medicare & Put Seniors' healthcare at Risk

The National Committee strongly condemns the American Health Care Act (AHCA) just passed by the House, which needlessly puts the healthcare of millions of older Americans in jeopardy. “Despite the bill’s name, risking the health of our nation’s most vulnerable citizens to give the wealthy an $880 billion tax cut is tremendously uncaring --- and does not reflect real American values,” says Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare. “In modifying the original AHCA bill to give reluctant Republicans political cover, the House leadership made a bad piece of legislation even worse.”

“Recent amendments to this cruel, ill-advised bill could put coverage for older Americans with pre-existing conditions like cancer and diabetes out of reach. The $8 billion (over 5 years) added to the legislation at the last minute to defray the cost of higher premiums is woefully inadequate.  It’s a thin veil that covers a head of snakes.”

Paul Waldman of the Washington Post wrote a scathing, but accurate article about the human costs of the GOP healthcare bill - especially to patients with pre-existing conditions: 

"Make no mistake, if you’re one of them and this bill passes, your life will become hugely  more complicated, potentially more costly and possibly in danger if you’re unlucky." - Paul Waldman, Washington Post 5/3/17

The bill contains several other poison pills for older Americans. It replaces Obamacare subsidies with meager tax credits which discriminate against older Americans.  A $4,000 annual tax credit doesn’t come to close to covering premiums for seniors ages 60-64, meaning millions of older Americans will lose coverage altogether.

The bill cuts nearly $1 trillion from Medicaid by converting it into a block grant program or imposing per capita caps, which will make it harder for impoverished seniors to access long term skilled nursing care and community or home care.  Overall, the Congressional Budget Office estimates that 14 million people will be kicked off the Medicaid rolls in the next 10 years if this bill becomes law.

The AHCA reduces Medicare’s solvency by repealing Obamacare’s 0.9% payroll tax on wages above $200,000. This could lead to cuts in Medicare, including privatizing the program --- harming current and future beneficiaries.  

Under the GOP bill, insurers can charge older enrollees five times more than younger ones.  The Congressional Budget Office predicts that by 2026 this provision will substantially raise premiums for older people by as much as 25%.

“We can only hope that the Senate majority will kill this reckless legislation before it punishes seniors - and millions of other Americans – for the crime of needing and wanting affordable health care,” Richtman says. 

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If you missed our "Behind the Headlines" analysis of the GOP healthcare bill on Facebook Live, you can watch it here

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The GOP's "Really, Really Good" Healthcare Reset is Really, Really Worse



 "The [GOP healthcare bill] is getting better and better"

 “A lot of people like it.”

 “Things are going very well.”

These are President Trump’s most recent pronouncements about the GOP’s American Health Care Act (AHCA).  Let’s hope for the sake of our nation’s seniors (and all Americans) that the President’s statements are wildly optimistic.  The White House is pressuring Congress to vote on the AHCA this week – lest the first 100 days of Trump’s presidency expire without a single major legislative victory.  Never mind that the healthcare of 24 million Americans hangs in the balance.

The National Committee and other seniors’ advocates rightly breathed a sigh of relief when the bill was pulled from the House floor last month for lack of GOP votes.  The Republican healthcare bill would have gutted Medicaid, weakened Medicare, and allowed insurers to charge older Americans up to five times as much as young adults, among other travesties.  But just when everyone thought the AHCA was dead, some House Republicans have revived it, zombie-like, to stalk Capitol Hill again.  This week, representatives from the right-wing Freedom Caucus and the moderate Tuesday Group let it be known that they were hovering around a deal to get the AHCA passed

The supposed “deal” would amend the bill to allow states to seek waivers from requiring insurers to provide “essential benefits.”  If a state (say a Red one, for instance), didn’t want insurers to be forced to cover hospitalization in all health plans, they could ask the Department of Health & Human Services (led by Obamacare nemesis Tom Price) for permission to waive that requirement.  States could also request waivers so that insurance companies could force sicker patients into “high risk pools” where the premiums would be sky high.  Meanwhile, all of the really harmful parts of the original bill for seniors would remain intact.  President Trump says the GOP healthcare bill has “gotten really, really good.”  But in truth, the latest changes make a really bad bill even worse.

Here’s the good news, though:  all of this talk about a deal and bringing the AHCA to a vote within President Trump’s first 100 days may be magical thinking.  Just because the head of the Freedom Caucus, Rep. Mark Meadows (R-NC), and Tuesday Group co-chair, Rep. Tom MacArthur (R-NJ), seem to be close to agreement does not guarantee that their members will fall in line, especially House moderates who probably know that the new amendment endangers essential benefits coverage and that high risk pools could cost their constituents dearly (which could cost these moderates dearly in the 2018 congressional elections).  Congress-watchers have noted that there is no legislative language for the proposed amendment yet, and wonder how it could be produced so soon. Also, the plan to bring healthcare to a vote next week may be overly ambitious, considering the House must also craft an appropriations bill before April 28th to avoid a government shutdown.  This is why Democratic sources on the Hill say “no way” is healthcare going to come up for a vote next week.

Here's how National Politics Reporter M.J. Lee summed up the prospects for a quick vote on CNN this afternoon:

"If the White House wants a vote, they will have to win over many members of Congress who are skeptical about tackling this again." - M.J. Lee, CNN
 

President Trump insists (to no one’s surprise) he wants it all:  funding for his border wall AND passage of the American Health Care Act – a demand that, like his pronouncements that “a lot of people like” the GOP healthcare bill and “things are going very well,” are likely only loosely based on reality. 

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No Spring Break Ceasefire in the War on the Working Class

Congress may be home for Easter break and President Trump is busy dropping bombs in Syria and Afghanistan, but the War on the Working Class continues unabated.  In fact, it was quite a busy week for floating dangerous ideas about our nation’s healthcare and retirement security. 

First, the Associated Press ran a story based on information from an unnamed “GOP lobbyist” saying that Republicans are considering repealing the Social Security payroll tax.  Under this alleged plan, Social Security would be funded from general revenue and therefore subject to competition with other domestic programs --- and the whims of Congressional budget cutters.  Never mind that the payroll tax is what makes Social Security an earned benefit.  President Franklin D. Roosevelt set it up that way on purpose to “give the contributors a legal, moral and political right to collect” their Social Security checks.  Plus, the current payroll tax deduction has been working pretty well for the past 80 years.

Since enough members of Congress realize this is an awful proposal that would never pass the House and Senate, clearly someone is out there floating crazy ideas in the press.  (In addition, the A.P. story itself lacked any real sense of balance or context.) While the source for the A.P. story was unnamed, a top Trump administration official very publicly floated notions that seem to undermine President Trump’s promise not to touch Social Security and Medicare.  In an interview with CNBC’s John Harwood on Tuesday, Budget Director Mick Mulvaney just couldn't say whether President Trump would veto legislation to privatize Medicare.  “Let [Congress] pass that and let’s talk about it,” he demurred. 

When Harwood asked if Social Security Disability Insurance (SSDI) was on the list of potential programs to be cut, Mulvaney offered this non-reassuring response:

“I continue to look forward to talking to the president about ways to fix that program. Because that is one of the fastest growing programs that we have. It's become effectively a long-term unemployment, permanent unemployment program.” – Mick Mulvaney

Of course, that response is riddled with inaccuracies.  SSDI is not growing, it’s leveling off at a lower rate that is likely to plateau for the next 20 years.  It most definitely is not an unemployment program of any kind – permanent or otherwise. SSDI is one of the strictest federal disability programs in the world in terms of qualifying for benefits.  Only those who are able to demonstrate that they are unable to work for medical reasons qualify.  Among all the people who apply, only 40% are accepted.  If accepted, the average beneficiary receives only $1,170 per month, less than one could earn in a full time job at the federal minimum wage.

That didn’t stop the Washington Post from echoing some of the same right-wing myths about SSDI in a recent feature story and an editorial entitled, “The Social Security Disability Program Needs Reform.”  The story wrongly intimates that rural, working-class Americans are using SSDI as a unemployment program.  On Monday, Media Matters for America attempted to correct the record:

“The Post’s mischaracterization of SSDI follows a long history of misinformation from mainstream outlets, which often publish error-riddled stories filled with anecdotal evidence portraying disability recipients as undeserving. These pieces sound as if they come from right-wing media, which have spent years attacking the program and its recipients.” – Media Matters, 4/10/17

While the press was replete with nutty notions about Social Security and Medicare, the President and Congressional Republicans were reviving the specter of the moribund GOP healthcare bill.  Just when you thought it was dead, Freedom Caucus members say they are close to a deal with the White House and Speaker Ryan to repeal and replace Obamacare within three weeks.  Meanwhile, Politico reports that President Trump is threatening to cut off cost-sharing subsidies that help pay for low income earners’ health coverage in order to force Democrats to the negotiating table on the GOP health plan.

Fortunately, protesters are out in full force this week at town halls pushing back against supporters of the Republican bill, including one of the National Committee’s own grassroots volunteers who organized a rally outside a Florida congressman’s office.  This proves that Spring break is a good time for grassroots action. Just because it’s holiday time doesn’t mean those waging war against the working class won’t put some rotten eggs in our Easter baskets.

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Note to Paul Ryan: Let Sleeping Healthcare Bills Lie

Speaker Paul Ryan made some extraordinary statements on today's CBS This Morning – even for him.  First, he chastised President Trump for offering to work with Democrats on health care reform, saying it was “hardly a conservative thing” to do.  The reason:  “Democrats are not for repealing Obamacare. We are.”  Clinging to ideology over reality, Ryan declared, “I don’t want government running healthcare.”  Oh really?  Has he heard of a program called Medicare? Oh, that’s right - he wants to privatize it.   Ryan hasn’t gotten around to turning Medicare into a voucher program just yet, but at least seniors can rest easier knowing that the GOP health plan went down in flames.

Less than a week later, a rift seems to be opening between the President and the Speaker on this issue.  President Trump may have finally realized that the only way to get a real healthcare fix through Congress is to work with Democrats and stop coddling right-wingers in the House.  He even fired off a tweet this morning aimed squarely at the ultraconservative House Freedom Caucus, which helped defeat the Republican plan:

"The Freedom Caucus will hurt the entire Republican agenda if they don't get on the team, & fast. We must fight them... in 2018!” – Trump Tweet, 3/30/17

Of course, Democrats won’t work with Trump unless he gives up on repealing Obamacare and pivots toward fixing its flaws.  That’s something Ryan and the House Republicans have refused to do during the entire seven years that Obamacare has been “the law of the land.”  In fact, Republicans have taken measures both on the Hill (and in the new Trump White House) to actively undermine the law.  Trump’s offers to work with Democrats won’t mean much unless his HHS Secretary and his administration refrain from manipulating regulations to stifle Obamacare.

This afternoon, Congressman Luis Gutierrez (D-IL) told CNN, “[Obamacare] needs to be modified to give more people coverage. If Trump wants to do that, I’m all for working with him.”

It’s hard to believe, but in this case Trump – not Ryan – may be taking the more politically savvy approach.  Here’s why:  the American people by and large loathe the defeated GOP healthcare bill.  A new Associated Press poll indicates 62% of Americans dislike the dead GOP legislation.  Here’s an even more eye-opening number:  8 in 10 Republicans oppose the provision that would have allowed insurers to charge seniors 5 times as much as younger people.  President Trump’s spider sense has told him to move toward the middle on health care. Meanwhile, Paul Ryan threatens to bring the moribund GOP healthcare bill back to life.  He would be wise to study those poll numbers and let sleeping bills lie. 

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If you missed our Facebook Live discussion with Social Security champion, Rep. Jan Schakowsky (D-IL), you can watch it here. 

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