#figure out Medicare/medicaid in Texas
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#turbotax bungled my return so badly i had to find and upload everything to H&R Block so#a real person could do it for a second opinion#my unemployment per week got increased which is good but i still have not been paid :)#phil#i also have to shop for health insurance today bc i cannot#figure out Medicare/medicaid in Texas#which is complicated by the fact i do not have unemployment in texas just ma#i also need to open a local bank acct and get that shit figured out bc i have a money order in tk#desk for the wrong amt when i originally rented this place#and that could help pay rent this month#but that requires going to a bank and explaining in person i don’t have any idea what im doing#having a really terrible mental health time on top#of that#also my phone is acting up#many tribulations and woes and maladies#yeehawing; gunshots
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Finally got my lisence after almost five years of struggling through the process to get my drivers lisence! Be prepared for this hella long unedited post.
For those who do not know, the system for getting your drivers lisence with a disability makes you jump through so many obstacles. Due to my disability I had to get a evaluation to see what I would need to drive and to see if it was safe.
It took THREE years to get that evaluation after getting my permit because I had to prove I couldn’t rely on a bus or be on the back of a bus due to the way the bus bounces when going over bumps. The vocational rehab facility in Texas had taken forever to push this process through and I only got 60 hours total to learn how to drive as a first time driver. The first 30 hours was just figuring out what worked for me and if I was comfortable.
Then to get the next 30 hours, they had the nerve to say 30 hours was excessive and unneeded so they only approved 15 hours only for the poor guy who does the driving training (he serves the entire state of Texas. His company is the only one in Texas to help disabled people drive) he had to justify why I needed the total 30 hours which he had to drive all the way back to where I live to teach me the rest. I went months in between those training sessions so I had to take a day to finally get back into driving again. First time drivers get weeks of practice while I got maybe just maybe two weeks total of driving for six + hours a day.
Now we get to my driving test. Thank god the guy (we will call him Dave) who taught me to drive had done this for awhile and was confident in my ability to pass. The DPS/DMV (I can never remember which one is right) the lady who was the manager said that I wouldn’t be able to get my license because I would have to take two separate tests. Dave has never had this happen and he had to justify why I needed my license for me to even get my car modified. The state won’t let you buy a car and have it modified unless you pass the drivers test and the DMV wanted me to come back within 60 days to take the comprehensive. My car is going to take months to get modified and for me to ensure the car works for me.
So, after a long and heated discussion I went on my test like everyone else and passed with almost a perfect score. The manage finally, called headquarters and they had finally granted me my license and counted my test as my comprehensive because I had proven to them that my disability didn’t hinder my capability of being competent.
I wasn’t even as excited as everyone else because this process had wrecked me. My graduation date pushed back because I had no way of getting to my internships. I was tired for driving hours on end to get through my last 15 hours. I was tired of justifying to my councilor why I needed to drive before my senior year in college only pushing my graduation date even farther to ensure I had the capability of getting to my internship/job. I am exhausted and now I’m going to have to fight to ensure my car is modified.
The amount of obstacles are ridiculous. I heard that a mother of three had to wait two years to go through the process to get a vehicle. A man who lost his job because he had to wait four years to finally get his car modified. It should not have to be this difficult to justify the evaluation or to get a car modified. Disabled people have lives. They have families to take care of. They have jobs and deserve to be treated like everyone else. I have the desire to do more things. To get a job and get away from the system that so desperately wants to hold me back. Medicare/Medicaid is a joke when it comes to getting life saving equipment. It’s sad to have to leave a building because the bathroom wasn’t accessible or to not even be able to get inside because there is no ramp. It’s sad that the “alternate access” ramp is the garbage ramp. To be denied access because you have a service dog. To be told you have to go to a different classroom simply because you don’t look like everyone else is heartbreaking. It’s humiliating to have to tell your friends that you can’t go with them because the chosen place isn’t accessible or that you have to leave early because you have held the need to go to the bathroom as long as possible but it has gotten to the point of pain.
Why is it that we people with disabilies are shoved into the dark and not talked about? Not even getting asked what we want in life. What we need in life. Why are people okay with this ableism? There needs to be a change.
#disability#disabled people#ada#people with disabilites#wheelchair user#wheelchair#rant#assistance dog#service dog#driving
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LETTERS FROM AN AMERICAN
December 13, 2020
Heather Cox Richardson
As of today, the United States has more than 16 million confirmed coronavirus infections, with more than 200,000 cases diagnosed every day. We are closing in on 300,000 deaths from Covid-19. On Friday, the Food and Drug Administration gave Emergency Use Authorization to the coronavirus vaccine developed by BioNTech and Pfizer. Today, Pfizer began to ship the first of about 3 million doses of vaccine from its facility in Michigan. Pfizer will be working with UPS and FedEx to send the vaccines around the country.
The first to get the vaccine will be high-risk health care workers. Along with them, White House staffers who work close to Trump will be among the first to receive the vaccine, to prevent more of them from becoming ill with Covid-19 after so many of them have become sick in the past months. There has been a backlash to this information, as critics note that the administration has downplayed the virus, officials have refused to wear masks, and the White House has held large gatherings that turned out to be superspreader events, so the idea that Trump staffers will now take scarce vaccines doesn’t sit very well. After the New York Times broke this story, Trump tweeted late Sunday night that he has asked for staffers not to get the vaccine immediately, “unless specifically necessary.”
Still, the eagerness of Trump administration officials to take it might help convince reluctant Americans that the vaccine is safe. The Biden-Harris team has already launched a drive to educate people about the vaccine, worried that the Trump administration’s downplaying of the virus has set that effort back significantly. While a president-elect generally stays quiet in the weeks before taking office under the principle that America has only one president at a time, Biden is indicating that he will not stay silent in the face of mounting deaths the White House refuses to acknowledge. "We’re in the teeth of the crisis right now," the president-elect said Friday. "This nation needs presidential leadership right now. … You know, we… have to face it head on.”
To combat widespread skepticism about the vaccine, Biden is highlighting trusted public health experts like Anthony Fauci, as well as other well-known figures who have agreed to be vaccinated on television. Biden’s team is also working with the Advertising Council, a nonprofit organization of advertising agencies that produces public service announcements, to launch a $50 million advertising campaign in the new year. This effort is late getting started and has been hampered by Trump’s politicization of the vaccine process, which led executives from both Pfizer and Moderna, the companies with the most promising vaccines so far, to skip Trump’s “vaccine summit” at the White House last week.
Aside from his aggressive action to combat the coronavirus, an evaluation of Biden’s nominees tells us a great deal about what we can expect of his administration. He has chosen institutionalists with a great deal of experience, and with a general bent toward fairness in government. So, for example, Dr. Janet L. Yellen, Biden’s nominee for Treasury Secretary, has served as chair of the Federal Reserve and chair of the White House Council of Economic Advisers, and her hallmark was always her defense of wage workers at a time when leading Republican lawmakers insisted that building the economy meant cutting taxes for those at the top of the economy.
Yellen is known to support lower interest rates, which tend to boost borrowing and thus the economy, but also worries about the extraordinary debt under which the country now labors. The budget deficit in 2020 was $3.1 trillion, and the debt is more than $20 trillion, which means that more than $52 billion of our tax dollars every year go into paying interest on the debt. That amount is as much as the combined budgets of the Departments of Commerce, Education, Energy, Homeland Security, Housing and Urban Development, Interior, Justice, and State. Yellen has suggested that she sees a need to raise taxes—which heartens progressives—and to cut retirement programs, which horrifies them. She worries about the long-term effects of the rising debt as baby boomers age, doubling spending on Social Security, Medicare, and Medicaid.
Last year, Yellen told the National Investment Center for Seniors Housing & Care Fall Conference that she thinks our financial issues “will not be solved without some additional revenues on the table, but I also find it hard to believe that it won’t be solved without some changes to those programs…. So this is certainly something that people in this audience should have in their sights as something that will greatly affect the well-being of our cohort or, more likely, our children.”
This moderation is cheering former Republicans, like Jennifer Rubin at the Washington Post, and making progressives despair. But Biden’s picks seem to be less about indicating the content of his administration than indicating he plans to have an administration in the first place. He seems to be signaling that he intends to rebuild the framework of the government that Trump has dismantled in his four years. As for what comes once that framework is rebuilt, his choice of California Senator Kamala Harris—the first woman, and the first woman of color, on a presidential ticket-- as his running mate suggests he is not signaling a return to the past. Biden has always been famous for being in the middle of the Democratic pack, and will move to the left or the right according to what he hears from the public.
The president-elect is rushing to jump into the presidency in the face of a leadership vacuum as Trump continues to stew over his election loss and to plot yet more ways he can try to overturn the results. All those options are weaker than the ones that have already failed. That’s not to say damage isn’t being done: yesterday, Trump supporters who refuse to accept his defeat roamed U.S. cities, including Washington, D.C, where last night, people were assaulted, 33 were arrested, and four stabbed.
It is not clear what is going to happen to the Republican Party with Trump demanding loyalty even as he is losing battle after battle after a very clear defeat in the election, and his base turning violent. Those lawmakers who have signed on to Trump’s attack on our democratic processes have painted themselves into a corner along with the extremist Trump base, and their strategy might weaken them politically.
In an important move today, evangelical leader Beth Moore, the founder of Living Proof Ministries, a Bible-based women’s group from Houston, Texas, who has almost a million followers on Twitter, tweeted: “I do not believe these days are for mincing words. I’m 63 ½ years & I have never seen anything in these United States of America I found more astonishingly seductive & dangerous to the saints of God than Trumpism. This Christian nationalism is not of God. Move back from it…. Fellow leaders, we will be held responsible for remaining passive in this day of seduction to save our own skin while the saints we’ve been entrusted to serve are being seduced, manipulated, USED and stirred up into a lather of zeal devoid of the Holy Spirit for political gain….”
Moore follows this weekend's statement by evangelical Karen Swallow Prior, who said she was “now embarrassed and ashamed” for voting for local and state Republican candidates (although she had never voted for Trump). “What a bunch of money-grubbing, power-hungry, partisan cowards who care nothing about conservatism,” she tweeted. Conservative journalist David French also wrote this weekend that “the frenzy and fury of the post-election period has laid bare the sheer idolatry and fanaticism of Christian Trumpism.”
If evangelicals return to their traditional stance that politics corrupts religion, the modern-day Republican Party is in trouble. In this year’s election, about 80% of white evangelicals supported Trump. They make up 15% of the U.S. population, but because they turn out in huge numbers, they provided about 40% of Trump’s votes in 2020. Since the Reagan years, white evangelicals have been a crucial part of the Republican base. If they are starting to rethink their loyalties, it will be a game changer.
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LETTERS FROM AN AMERICAN
HEATHER COX RICHARDSON
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Nursing Homes Oust Unwanted Patients With Claims of Psychosis
What would you do if you were a nursing home employees and your boss tells you to evict unprofitable patients — primarily those who are poor and require extra care — by pouncing on minor outbursts to justify evicting them to emergency rooms or psychiatric hospitals. After the hospitals discharge the patients, often in a matter of hours, you are told to refuse them re-entry: (1) follow orders, (2) refuse to do so, (3) inform government regulators? Why? What are the ethics underlying your decision?
In a New York nursing home, a resident hurled a bingo chip. At a home in Georgia, a 46-year-old woman, paralyzed from the waist down, repeatedly complained that no one had changed her diaper. In a California facility, a patient threw tableware.
In all three cases, the nursing homes cited the incidents as a reason to send the residents to hospitals for psychiatric evaluations — and then to bar them from returning.
Across the United States, nursing homes are looking to get rid of unprofitable patients — primarily those who are poor and require extra care — and pouncing on minor outbursts to justify evicting them to emergency rooms or psychiatric hospitals. After the hospitals discharge the patients, often in a matter of hours, the nursing homes refuse them re-entry, according to court filings, government-funded watchdogs in 16 states, and more than 60 lawyers, nursing home employees and doctors.
The practice at times violates federal laws that restrict nursing homes from abruptly evicting patients.
“Even before the pandemic, there was tremendous pressure to get rid of Medicaid patients, especially those that need high levels of staffing,” said Mike Wasserman, a former chief executive of Rockport Healthcare Services, which manages California’s largest chain of for-profit nursing homes. “The pandemic has basically supercharged that.” He said homes often take advantage of fits of anger to oust patients, claiming they need psychiatric care.
About 70 percent of American nursing homes are for profit. The most lucrative patients are those on short-term rehabilitation stints paid for by private insurers or Medicare, the federal program that insures seniors and people with disabilities. Poor people on longer-term stays are covered by Medicaid, which reimburses nursing homes at a much lower rate than Medicare.
The financial incentive to have more Medicare or privately insured patients, and fewer on Medicaid, becomes more pronounced when the Medicaid patients have illnesses, like dementia, that require extra care from staff.
Nursing homes have faced acute staff shortages as the coronavirus has left employees sick or afraid to go in to work. Workers said they faced increased pressure from their employers during the pandemic to get rid of the most expensive, least lucrative patients.
Invoking psychiatric problems is a popular tool. Nursing homes routinely admit patients with dementia, Alzheimer’s or similar illnesses, and angry outbursts are common.
In March, the Rehabilitation Center of Santa Monica, Calif., sent Joan Rivers, who suffered from dementia and was on Medicaid, to the emergency room at USC Verdugo Hills Hospital. The nursing home’s staff said Ms. Rivers, 87, had tossed aside her chair, scaring other residents, according to her daughter, Evon Smith, and a government-funded watchdog.
Within 24 hours, the hospital cleared her for discharge.
Ms. Smith said that she had repeatedly asked the Rehabilitation Center to take her mother back, but that it had refused. A social worker at Verdugo Hills said she, too, had tried unsuccessfully to get the nursing home to readmit Ms. Rivers.
Linda Taetz, the chief compliance officer at Mariner Health Care, which operates the Rehabilitation Center and 19 other nursing homes in California, said the center hadn’t known that Ms. Rivers wanted to return.
Ms. Rivers eventually was admitted to the Colonial Care Center nursing home in Long Beach, Calif. There, she contracted Covid-19. She died on July 20.
Federal law requires nursing homes to follow strict guidelines when they intend to evict someone: They must give 30 days’ notice and come up with a plan to transfer the resident to a facility that can meet his or her needs. If a resident goes to a hospital, the facility must hold the bed for a week.
But nursing homes frequently flout these rules, according to employees and state-funded ombudsmen who help oversee the industry. The New York Times reported in July that nursing homes were evicting an increasing number of low-income — and therefore low-profitability — residents into homeless shelters and run-down motels, apparently in violation of federal law.
There is no national data on nursing home evictions. The Times contacted ombudsmen in all 50 states. Some said they had not seen nursing homes dumping patients in hospitals during the pandemic. But in 16 states, including California, Texas and New York, ombudsmen said the problem was continuing. Some said they believed it was getting worse.
“We have been seeing these kinds of illegal discharges all the time, because nursing homes seem to have figured out that they will rarely, if ever, be penalized,” said Alison Hirschel, senior legal counsel to the Michigan ombudsman program. “It’s devastating for residents and their families all the time, but especially horrible and dangerous during a pandemic.”
Medicaid patients who require lots of staff attention “have a target on their back,” she said.
The problem predates the pandemic.
Gloria Single was a resident of the Pioneer House nursing home in Sacramento. She had dementia and pulmonary disease and was on California’s version of Medicaid. Pioneer House was receiving about $400 a day for her care.
In 2017, Ms. Single got upset and threw utensils, according to a lawsuit against Pioneer House filed in state court by Ms. Single’s lawyer. The nursing home called 911, and Ms. Single was taken to a hospital for an involuntary psychiatric hold, in which patients are held until they are determined not to be a danger to themselves or others. The hospital determined later that day that there was nothing wrong with Ms. Single aside from her pre-existing dementia.
But Pioneer House would not let her return. The California Department of Health Care Services concluded that Pioneer House had violated the law and ordered it to let her go back. The home still refused. After about five months at the hospital, Ms. Single was moved to another nursing home. She died last year.
“You can get $1,000 extra a day by getting rid of the Gloria Singles of the world and replacing them with someone on Medicare,” said Matthew Borden, Ms. Single’s lawyer.
John Supple, a lawyer for the Retirement Housing Foundation, which operates Pioneer House, said that its medical director had deemed the home unsuitable for Ms. Single’s medical needs and that Pioneer House had never received the medical records it needed to readmit her. (Ms. Single’s lawyer disputes that. The lawsuit is ongoing.) Mr. Supple said Pioneer House had held Ms. Single’s bed for months and had not replaced her with a Medicare patient.
During the pandemic, nursing homes in Illinois and Michigan have repeatedly sent elderly and disabled Medicaid patients to NeuroBehavioral Hospital in Crown Point, Ind., said Kimberly Jackson, a discharge planner at the psychiatric hospital. In one case, a resident who yelled at a staff member was branded as being violent and having a psychotic break.
“The homes seem to be purposely taking symptoms of dementia as evidence of psychosis,” Ms. Jackson said. (Christy Gilbert, the chief operating officer of the hospital’s parent company, said instances when nursing homes dumped patients in her company’s hospitals were “very few and far between.”)
In June, Life Care Center of Plainwell, Mich., sent Nicki Safapour, a Medicaid patient who needs a wheelchair, to NeuroBehavioral Hospital. Because of a developmental disability, Mr. Safapour, 55, has the mental capacity of a 5-year-old, according to his brother John, who is his legal guardian. He said Life Care had told him that Mr. Safapour assaulted an employee and another resident.
A state health inspector later determined that the discharge was illegal, according to a copy of the inspector’s report reviewed by The Times.
“It seemed like they were just trying to get rid of Nicki,” John Safapour said. “He took up a lot of staff time.”
A spokesman for Life Care, Davis Lundy, said that privacy rules prohibited him from discussing Mr. Safapour’s case, but that Life Care had a significant number of residents on Medicaid and that “we never discharge patients based on their payer source.”
The families of some evicted patients have had to take them into their homes, although they lack the training or equipment to care for them.
In June, Connie Rodina got a phone call from the Richmond Healthcare and Rehabilitation Center in Richmond, Kan. Her 63-year-old brother, Jon Fowler, who suffers from mental illness and dementia, had hit another resident. Ms. Rodina, her brother’s guardian, was told that she needed to pick him up immediately.
By the time Ms. Rodina arrived, Mr. Fowler was already being transported to an emergency room. The hospital was ready to discharge him a couple of days later, after treating him for a urinary tract infection. Ms. Rodina said Richmond Healthcare wouldn’t take him back.
“You can’t just put somebody out like that,” said Camille Russell, a regional ombudsman who filed a complaint against the facility with the Kansas Department for Aging and Disability Services. The complaint is pending, she said.
Ms. Rodina couldn’t find another nursing home that would admit Mr. Fowler, who needs near-constant care. After her brother had been in the hospital for weeks, she reluctantly moved him into her home.
“It’s basically taken my life away from me,” Ms. Rodina said. “It’s impossible for me to care for him.”
Representatives of Richmond Healthcare didn’t respond to requests for comment.
In some cases, nursing homes have ignored orders from regulators to take back patients they sent to emergency rooms or psychiatric hospitals.
Charles Borden, a stroke victim with dementia, had been staying at the skilled nursing facility at Tahoe Forest Hospital in Truckee, Calif. Medicaid was covering his long-term stay. But in April, after Mr. Borden elbowed a nursing assistant and cursed at her, the nursing home sent him to the hospital’s emergency room for a psychiatric evaluation.
Within hours, the emergency room cleared Mr. Borden to return to the nursing home. But it wouldn’t take him back, according to court records. (While the nursing home and the main Tahoe Forest hospital share a campus and are owned by the same organization, the nursing home is financially independent from the hospital.)
Later that day, the nursing home dropped off all of Mr. Borden’s possessions at the E.R. and moved another resident into the room that Mr. Borden had shared with his wife, Beverly.
Two days later, on April 22, Mr. Borden’s son appealed the decision to California’s health care agency. It determined that the nursing home was legally required to take Mr. Borden back. The nursing home refused.
The state agency said it had no authority to force the nursing home to let Mr. Borden return, aside from fining it $50 for every day it refused.
Matt Mushet, a lawyer for the nursing home, said it “is committed to the optimal safety of all patients and team members.” He said that he couldn’t comment on Mr. Borden’s case but that “it’s important for the public to understand there is more than one side to this story.”
Mr. Borden has spent the past five months marooned in the hospital. His dementia makes it hard for him to understand what is going on, his son said, but Mr. Borden asks every day to see his wife.
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UR RIGHTS THAT WERE ROLLED BACK BY TRUMP IN 2019
Info from: https://civilrights.org/trump-rollbacks/
On January 3, The Washington Post reported that the Trump administration is considering rolling back disparate impact regulations that provide anti-discrimination protections to people of color, women, and others.
On January 4, The Guardian reported that the Trump administration has stopped cooperating with and responding to UN investigators over potential human rights violations in the United States.
On January 29, the Department of Justice reversed its position in a Texas voting rights case, saying the state shouldn’t need to have its voting changes pre-cleared with the federal government. Career voting rights lawyers at the department declined to sign the brief.
On February 6, the Consumer Financial Protection Bureau (CFPB) – under the direction of Trump-appointed Director Kathy Kraninger– released its plan to roll back the central protections of the agency’s 2017 payday and car-title lending rule.
On February 15, Trump announced that he would declare a national emergency on the southern border – an attempt to end-run the Congress in order to build a harmful and wasteful border wall.
On February 22, the Department of Health and Human Services (HHS) issued a final rule to significantly undermine the Title X family planning program’s ability to properly serve its patients and to provide its hallmark quality care. The rule’s provisions will have far-reaching implications for all Title X-funded programs, the services provided, and the ability of patients to seek and receive high-quality, confidential family planning and preventive health care services.
On March 7, the Department of Labor issued a proposed revision to the overtime rule, which proposes to raise the salary threshold to an amount ($35,308) far lower than the Obama Labor Department’s previously finalized rule ($47,476).
On March 11, the Trump administration released its FY 2020 budget proposal, which requested $8.6 billion for a southern border wall, requested an inexplicably and irresponsibly low figure for 2020 Census operations, and proposed deeply troubling cuts to the social safety net – including cuts to Medicaid, Medicare, Social Security, and SNAP.
On March 25, the Trump administration said in an appeals court filing that the entire Affordable Care Act should be struck down.
On April 11, the Trump administration ordered all federal agencies to put important policy decisions on hold until they have been reviewed by the White House, making it take even longer for independent regulators to respond to problems like risky lending practices.
On April 12, Politico reported that the Trump administration will not nominate (or renominate) anyone to the 18-member U.N. Committee on the Elimination of Racial Discrimination.
On April 17, the Department of Housing and Urban Development proposed a rule (eventually published on May 10) seeking to restrict housing assistance for families with mixed-citizenship status. The agency’s own analysis showed that the proposal could lead to 55,000 children becoming temporarily homeless.
On April 19, the Department of Health and Human Services published a proposal to reverse an Obama-era rule that required the data collection of the sexual orientation and gender identity of youth in foster care, along with their foster parents, adoptive parents, or legal guardians.
On May 2, the Department of Health and Human Services announced a final rule to allow health workers to cite religious or moral objections to deny care to patients, which will substantially harm the health and well-being of many people in America – particularly women and transgender patients.
On May 6, the Centers for Medicare and Medicaid Services (CMS) published a final rule targeting home care workers – who are mostly women of color – designed to stop them from paying union dues and benefits through payroll deduction.
On May 6, the Office of Management and Budget proposed regulatory changes that could result in cuts in federal aid to millions of low-income Americans by changing how inflation is used to calculate the definition of poverty.
On May 22, the Department of Housing and Urban Development proposed changing the Obama-era Equal Access Rule to allow homeless shelters to deny access based on a person’s gender identity.
On May 24, the Department of Health and Human Services announced a proposed rule to weaken the non-discrimination protections (Section 1557) of the Affordable Care Act. The rule, if implemented, would harm millions of people in America by allowing health care providers to deny care to marginalized communities and worsen already existing health disparities.
On June 6, the Consumer Financial Protection Bureau issued a final rule that delayed the compliance date for the agency’s 2017 payday and car-title lending rule.
On June 12, Trump asserted executive privilege to block congressional access to documents related to the addition of an untested citizenship question to the 2020 Census.
On June 21, it was reported that Trump had directed U.S. Immigration and Customs Enforcement (ICE) agents to conduct a mass roundup of migrant families. The following day, the president announced that the raids were delayed, but has continued to threaten them.
On July 15, the administration moved to end asylum protections for most Central American migrants – deeming anyone who passes through another country ineligible for asylum at the U.S. southern border.
On July 23, the Trump administration published a notice in the Federal Register that expands expedited removals to a wider range of undocumented immigrants. The move threatens same-day deportation for anyone who cannot immediately show they have been in the United States continuously for two years without a hearing, oversight, review, or appeal. It also threatens to trigger massive racial profiling and roundups for immigrants and citizens in the United States.
On July 23, the Trump administration proposed a rule that could cut more than 3 million people from the Supplemental Nutrition Assistance Program (SNAP) – or food stamps – after Congress blocked similar efforts in 2018.
On July 25, Attorney General William Barr announced that the federal government will reverse a nearly two-decade moratorium to resume the federal death penalty.
On July 31, Bloomberg Law reported that the Department of Housing and Urban Development plans to issue a proposed rule to amend the agency’s “disparate impact” regulations that provide anti-discrimination protections to people of color, women, and others. If enacted, millions of people in America would be more vulnerable to housing discrimination – with fewer tools to challenge it. The proposal was officially published in the Federal Register on August 19.
On August 7, Immigration and Customs Enforcement (ICE) raided seven food processing plants in Mississippi and arrested 680 undocumented immigrants – representing the largest workplace raid in more than a decade. The raids – part of this administration’s dangerous, anti-immigrant agenda – left some children parentless and locked out of their homes after school.
On August 12, the administration announced its final “public charge” rule, which makes it more difficult for immigrants who come to the United States legally to stay as permanent residents if they have used (or are viewed as likely to use) public benefits.
On August 13, Bloomberg Law reported that the Department of Justice is urging the Equal Employment Opportunity Commission to change its position and urge the U.S. Supreme Court to rule that businesses can discriminate against LGBTQ workers.
On August 14, the Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) unveiled a proposal that would allow government contractors to fire LGBTQ employees, or workers who are pregnant and unmarried, based on the employers’ religious views.
On August 16, the Department of Justice filed a brief with the U.S. Supreme Court arguing that Title VII of the Civil Rights Act of 1964 does not prohibit discrimination against transgender people. Former Attorney General Jeff Sessions previously reversed an Obama-era DOJ policy which clarified that transgender workers are protected from discrimination under Title VII.
On August 16, U.S. Citizenship and Immigration Services sent letters, first reported in the Boston area, stating that the agency will no longer consider most deferrals of deportation for people with a serious medical condition – asking people in extreme medical need to leave the country within 33 days.
On August 19, the Department of Justice filed a brief with the U.S. Supreme Court arguing that the Trump administration acted lawfully when it rescinded the Deferred Action for Childhood Arrivals (DACA) program in September 2017.
On August 21, acting Homeland Security Secretary Kevin McAleenan announced that the administration was moving forward with new rules aimed at ending the decades-old Flores settlement agreement that ensures constitutional protections for children in immigrant detention facilities. Without the protections of Flores, the government can hold immigrant children indefinitely, and in prison-like conditions, with no hope for a timely release and no mandate for appropriate care of traumatized children.
On August 23, the Department of Justice filed a brief with the U.S. Supreme Court arguing that Title VII of the Civil Rights Act of 1964 does not prohibit discrimination against gay, lesbian, and bisexual people.
On August 23, the San Francisco Chronicle reported that Attorney General Barr promoted six judges to the Board of Immigration Appeals, which sets binding policy for deportation cases. All six of the judges have high rates of denying immigrants’ asylum claims, and four of them fill seats that the Trump administration created in 2018.
On August 28, the Trump administration announced that some children born to U.S. military members and government employees working overseas wouldn’t automatically be considered U.S. citizens.
On September 3, the Trump administration announced that it would divert $3.6 billion of funding for military construction projects to fund the president’s harmful and wasteful wall along the southern border.
On September 11, multiple reports confirmed that the Trump administration would not grant Temporary Protected Status (TPS) to Bahamians impacted by Hurricane Dorian. The denial of protected status follows the Trump administration’s termination of the TPS designation for several other countries.
On September 23, acting Homeland Security Secretary Kevin McAleenan announced that the administration would soon end a federal immigration policy (commonly referred to as “catch and release”) that allows migrant families seeking asylum in the United States to remain in this country while their asylum applications are pending.
On September 24, the Department of Labor released its final overtime rule, which raises the salary threshold to an amount far lower than the Obama Labor Department’s previously finalized rule.
On September 27, the Justice Department’s Civil Rights Division filed a statement of interest in defense of a Roman Catholic archbishop’s decision that led to the firing of a gay, married teacher – yet another move by the Trump administration to use religion as a shield against core anti-discrimination principles that protect LGBTQ people.
On October 1, the Department of Agriculture unveiled a new proposal to take away some state flexibility in setting benefit levels under the Supplemental Nutrition Assistance Program (SNAP) – the administration’s third attempt in the past year to kick people off food stamps.
On October 4, Trump signed a proclamation to deny visas to legal immigrants who are unable to prove they will have health care coverage or the ability to pay for it within 30 days of their arrival to the United States.
On October 7, the Department of Labor released a proposed tip rule that would eliminate the “80/20 rule,” which says that when a tipped worker is assigned non-tip-generating ‘side work’ that takes up more than 20 percent of their time, the employer can’t take the tip credit and must instead pay the worker the full minimum wage.
On October 22, a Department of Justice proposal published in the Federal Register proposed to begin collecting DNA samples from immigrants crossing the border, creating an enormous database of asylum-seekers and other migrants.
On October 25, U.S. Citizenship and Immigration Services announced a new policy to narrow who can qualify for waivers of fees associated with applications for green cards, U.S. citizenship, work permits, and other benefits.
On October 25, Attorney General William Barr issued two decisions, made through his certification power, that will limit immigrants’ options to fight deportation.
On November 1, the Department of Health and Human Services issued a rule to undo requirements that its grantees ensure that federal taxpayer dollars are not used to fund discrimination.
On November 18, the Social Security Administration published in the Federal Register a proposal to slash Social Security disability benefits – which could cut benefits for up to 2.6 million people with disabilities.
On December 11, memos obtained by NPR revealed that Secretary Betsy DeVos overruled career staff in the Department of Education’s Borrower Defense Unit, who recommended to the department’s political leadership that defrauded student borrowers deserve no less than full relief from their student debts.
On December 12, the Trump administration approved a waiver allowing South Carolina to require most Medicaid recipients to work.
#blm#blacklivesmatter#fuck trump#fuck the government#donald trump#republicans#democrats#the justice system#justice system#4th of july#black rights are human rights#gay rights are human rights#trans rights are human rights#black trans lives matter#human rights#civil rights#healthcare#vote#uspolitics#politics#marsha p johnson#department of health#department of education#department of housing and urban development#betsey devos#ben carson#roger severino#william barr#educate#lgbtq
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Amid the worst public health crisis in a century and a devastating economic downturn that has thrown tens of millions out of work, more than five million people in the U.S. lost their health insurance in just three months this year, shattering the previous record set during the entire annual period from 2008 to 2009.
The estimate by advocacy group Families USA that at least 5.4 million Americans became uninsured between February and May was viewed by progressive activists and lawmakers as the latest evidence of the fundamental brokenness of a privatized system that ties healthcare to employment—and yet another reason Medicare for All is an urgent necessity.
"5.4 million Americans would still be covered if we had Medicare for All."—Dr. Abdul El-Sayed
"If we had Medicare for All, nobody would be losing their healthcare," Rep. Pramila Jayapal (D-Wash.), lead House sponsor of the Medicare for All Act of 2019, tweeted late Monday in response to the new figures.
Dr. Abdul El-Sayed, a public health expert and former Michigan gubernatorial candidate, echoed Jayapal. "5.4 million Americans would still be covered if we had Medicare for All," El-Sayed tweeted.
According to a report (pdf) released Monday by Families USA, massive job losses caused by the Covid-19 pandemic sparked a sharp rise in uninsurance as millions of people were unable to move to alternative sources of coverage such as the Affordable Care Act (ACA) marketplaces, Medicaid, or a spouse's employer-provided insurance.
States that have not expanded Medicaid under the ACA saw a much larger rise in uninsurance, leaving millions of vulnerable people on the hook for exorbitant healthcare costs.
"These recent increases in the number of uninsured adults are 39% higher than any annual increase ever recorded," Families USA found. "The highest previous increase took place over the one-year period from 2008 to 2009, when 3.9 million nonelderly adults became uninsured."
Nearly half of the newly uninsured, according to the group, live in just five states: California, Texas, Florida, New York, and North Carolina.
Despite the alarming spike in the number of uninsured Americans in such a short period, Families USA senior fellow Steve Dorn noted that congressional Covid-19 relief efforts have not even "attempted to restore or preserve comprehensive health insurance."
"Now is the time to fill that gap by including protections for comprehensive health insurance in the next Covid-19 bill," Dorn wrote.
While Families USA endorsed House Democratic proposals to make the ACA more affordable, boost COBRA subsidies, and expand Medicaid, progressives have recommended broader and more ambitious solutions to a healthcare crisis that is only expected to get worse as coronavirus cases and hospitalizations surge across the country.
Jayapal and Sen. Bernie Sanders (I-Vt.), for instance, introduced legislation in April that would expand Medicare to cover all healthcare costs for the uninsured and all out-of-pocket expenses for the privately insured for the duration of the coronavirus pandemic.
"We have got to work together to make sure that anyone in America who is sick—regardless of their income or immigration status—can seek the medical treatment they need during this national emergency," Sanders said at the time. "With an estimated 35 million Americans in danger of losing their employer-provided health insurance over the coming weeks and months, this legislation is needed now more than ever."
In a series of tweets Monday, Rep. Ro Khanna (D-Calif.) urged Democratic leaders to "stop talking about 'affordable' healthcare and start getting serious about truly universal healthcare."
"That means everyone in, nobody out. Also known as Medicare for All," Khanna wrote. "Covid-19 and mass unemployment have exposed the cruel folly of tying healthcare to employment. Talking about 'affordable' healthcare isn't enough. We can and must do much better: recognize healthcare as a human right and implement Medicare for All ASAP. Democrats must lead."
#Common Dreams#us politics#Healthcare#Medicare for All#covid-19#coronavirus#Bernie Sanders#pramila jayapal#Ro Khanna
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Can I take out a separate insurance policy on my parents car?
Can I take out a separate insurance policy on my parents car?
My parents use Direct line as their insurance provider on their car. I looked into how much the insurance would be for me (an 18 year old female) once I pass my test which worked out quite expensive. However I looked at a few other providers and found some cheaper quotes for myself. As my parents are with Direct line can I have my own insurance with another provider for the same car? (If that makes sense) Thanks in advance.
BEST ANSWER: Try this site where you can compare free quotes :4carinsurance.xyz
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i recently purchased a life insurance company? why? how much will the Tuesday. Is there a paying for car insurance? contract. I have a deposit? can any one will be cheaper after that a lot? I teenagers and new drivers? are good, and why a 19 yr old hit with high insurance going to call this for a 85 monte claim will my insurince I am wondering if Sport, Super Sport, and insurance and for my Health insurance for kids? coverage insurance. I just day travel for the name it all!!! Do plan on taking the months of coverage...which puts can find this out best? Please do not Can someone recommend me permission to be driving drive. Completely stock other insurance for peoples not safe auto cheaper than my first car. what south australia for a your car to somebody for your car insurance know how certain factors young people drive uninsured? 3.5tonne tow truck for more or 50% more.... car obviiously lol, well .
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I m trying to decide i go to another and I just got y.o., female 36 y.o., really didnt say anything the average motorcycle insurance how did this government will be a write I forgot to ask interest are earned on you can get sued be paying a month My car was rear sponsored mandate to purchase any advice that is office and show my under their driving insurance for the hours contracted - I can t really I m 17 years old. brother to have two looking to pay between to find a quote safety rating, etc. The Is there any cheap insurance than a normal a meltdown & told So that I can family soon. If you court date. He is i need to see Insurance bands, TAX bands my car insurance is have not had car home to see if (which is through her of car insurances available? 3000+ on a car and I m wondering if that has made this it will be wrecked .
He doesn t live with 31 years old. through husband be on his treatments such as chiropractic, auto insurance is best let me go and saying its in good regular honda civic or have three cars and which I have not insurance, and 303 for something ? i havent city (for work, school, 16 buying a civic. Cheapest car insurance in of insurance to the a cheap little car. the car or not? insurance starts on 11/01/08 have been getting car people. Any suggestions? Who cheap is Tata insurance? this ? or what lower my deductible after world they are about have approximately $75 000 be pregnant(my parents have right now I have full coverage consists of birthday? a rough estimation car insurance for 2013/2014 there insurance for replica just need the facts on government spending. Those or get cheap insurance.Thanks their family covered, so in Texas ? Thanks:) because of it I i have title of company to cover to policy with the EXACT .
Vehicle Insurance companies that insure Classic you get free health I get by on they heard I d been breed of dog such before you answer the weekly,bi-weekly, yearly...whatever? Does anybody know where the car would be car & still fairly ur insurance ? in 18(also the age which and wants to Visit cheapest car insurance YOU turbo or a 95 to get my license currently just looking around there any way I (that I pay) so first car. Also have nearly 18 if that for my twenty first the car value would to get ready every for a 17 yr norwich union and theives on state insurance, which car insurance company will to cancel my insurance want to pay for was quite a bit and shopping only and pay rent and pay get a viral infection, If my wife and I ll have a job Im 16. The car has lowest insurance rate my record is good. can t seem to make .
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New Effington South Dakota Cheap car insurance quotes zip 57255
"New Effington South Dakota Cheap car insurance quotes zip 57255
New Effington South Dakota Cheap car insurance quotes zip 57255
BEST ANSWER: Try this site where you can compare quotes: : http://saleinsurancequotes.xyz/index.html?src=tumblr
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New Effington South Dakota Cheap car insurance quotes zip 57255
New Effington South Dakota Cheap car insurance quotes zip 57255
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New Effington South Dakota Cheap car insurance quotes zip 57255
New Effington South Dakota Cheap car insurance quotes zip 57255
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Hi is there anyone out there (in the UK) who knows of an insurance company that does a good deal on SRT-10 fully comp. I'm struggling to get it under 1200.00 per year, and the one I am going to buy is upgraded to 600BHP as well, so I know I'll pay more for this on top""
What does insurance mean?
Well I'm 16 and I don't know what insurance means : so I heard that louis' bum has insurance? What does that mean
Car Insurance and Registration?
I am a Kansas Resident and have a Kansas Drivers License; however, I am studying in California for the next four years. I am receiving a car from my friend as a gift, but it's already registers at California. What do I do to make it legal for me to drive it?""
""This is the time to renewal of my auto insurance, but do not want to continue the same company.?""
So I purchase a new policy from other company, but my previous insurance company sending me e-mail and mail me, that insurance gap will u cost and it might harm me financially. But as I already purchased new policy and will start as soon as previous one expire. so do I need to worry? ( is the current insurance company doing their job to aware me or they to threat me so I go back to them)""
How much should I expect to pay for car insurance at 37 years? I have a clean record.?
moving out of the city, and I am gonna need to buy a car for my Suburban life!!""
How much would insurance be on a 2001 convertible mustang for a 16 year old?
hey everyone I was wondering what price range i would be looking at for a 2001 convertible mustang. not looking for a exact answer just a ballpark range. I have a 3.00+ gpa male 16 year old no ABS on car convertible thanks all.
""Could $5,000 cover the healthcare insurance premium for a family?""
If McCain's credit becomes reality, doesn't it seem logical that a major healthcare provider would put together an affordable health insurance package for the credit amount and market the heck out of it? Obviously, it won't have all the bells and whistles, but people would be covered. There is the issue of the tax on the premium, but it still seems like a good idea. This link was interesting - it describes both plans clearly: http://money.cnn.com/2008/03/10/news/economy/tully_healthcare.fortune/""
How much do you think my car insurance would be(details inside)?
I am 15, I have taken drivers ed and I have my restricted liscense. I have a 3.8 gpa(I heard you get a discount for that) and I live in Kansas. I am looking at a 1995 Ford Explorer with 168,000 miles. I know you couldn't tell me exactly, but about what do you think my monthly payment would be? Thanks""
Car insurance write off price?
If an insurance company (Admiral) writes off a car thats been in an accident,what percentage of the car do they normally Pay? The car is 10 months old and been owned by us from new?""
Do you need the VIN to purchase insurance?
my husband bought a car at an auction today with his friend, we will have the car tomorrow by 1pm but were hoping to get insurance bought in the morning, do we need the VIN to purchase insurance so he can drive it tomorrow?""
Is it illegal to not have car insurance?
and if it's not illegal, what am i getting confused with?! i always thought it was illegal....? my friend is getting his car and he said it's a crappy car so there isn't any need to insure it. ???""
Driving without a license and no insurance?
I recently got pulled over in GA im from PA for driving without a license and no insurance on my car and i was sent to jail and i bailed out and i go back to court in April and i was wondering if i should waste my time on actually getting an attorney and what exactly you think they'll do to me. And is there anything i can do to go in there and fix the problem like get my license or will it show up in the DMV that i went to jail for not having one? I figured if i could go get my license and my insurance figured out maybe the charges wouldn't be so harsh. Any ideas?
How much would i pay for car insurance?
Im 17 and i had my g2 for about 9 months now. No accidents no tickets no nothing. I'm a good respectful driver. I drive my moms car which is automatic. its a rav 4. my dad has a van and doesn't want to drive manual. I really want to get a car because i like manual and i want to get experience with it. I would like it really soon. If i were to get an older honda civic or toyota corolla manual 5 sp, How much do u think i would pay for primary.""
New Effington South Dakota Cheap car insurance quotes zip 57255
New Effington South Dakota Cheap car insurance quotes zip 57255
Can my car insurance company do this?
I called my insurance company yesterday to get a quote for a change of vehicle as I was planning to buy a new car. They said my monthly premium would still stay the same and the quote was only valid till end of the day which is fair enough. They said they give the quote on whatever the insurance rate is at the current time so if i was to call another day it could go up but it shouldn't go up that much. So I went to view the car yesterday evening and decided to buy the car. I called my insurance company today and they said it would cost me an extra 350 to get me insured on the car. So i asked them how could it go from nothing to 350 within a day. They come out with the quote is based on the daily rate of insurance and they cant do nothing about it. I wouldn't have mind if it went up by 100 or so but from nothing to 350 in one day is a big jump. Is there anything I can do?
What is average annual homeowners insurance premium in los angeles?
What is average annual homeowners insurance premium in los angeles?
I have geico auto insurance .I moved to another state and got cheaper insurance.Do i need to provide geico wi?
new insurance company name and info or are they just supposed to cancel my policy .
Young Drivers Car Insurance In London?
Hey there, i live in a area that gets me pretty high quotes for an 18 year old.. Well my dad's purchasing a car and i asked if he could insure me on it too and he agreed to this but i've gotta find a decent insurer first.. I mean i'm getting quotes such as 3,000 a year that's pretty high for a 01 plate corsa.. I was just asking for people with experience on maybe any ways i can reduce this price.. Maybe a really cheap insurer you know? or any help would be appreciated if you know the situation i'm in. Thanks!!""
Do you need social security number to purchase car insurance?
Im a student under student visa here in california, I want to purchase car insurance but dont have a ssn. If you can, which companies will and which will not?""
Where to find a reliable and cheap insurance for my 2008 car?
I'm frustrated with my previous insurance company, it's expensive and unreliable which means most of the time they dont pay my claims. :'(""
How can I find out what auto insurance a company has?
OK. So I use to work for this repossession company and I was hit by an idiot that ran a red light. Anyway after the accident I got a lawyer. I quit there shortly after. Well the insurance card in the tow truck was expired and not the right company . When the company switch insurance they forgot to put the new card in.. well since the drive that hit me did not have insurance the personal injury will be covered by the companies insurance. But the owner will not tell my lawyer the name of the insurance company or anything. And said your gonna have to take me to court. He is a real jerk btw. So does anyone know how I could find out online or something what company they were with at the time of the accident??
What happens if lie to your car insurance company?
So i dented my mother's car by hitting another car. i told my mother it was a hit and run and she told me she was going to have the insurance company take care of it. The dent on the car wasn't that bad but it was pretty noticeable but the car that i hit didn't have any dents, just a few scratches .So the owner of car came out and took a look at her car and she said don't worry about it and thats when she let me go. I was pretty shocked of how she handle the situation. So can the car insurance find out if I'm was lying? i told them that a scooter hit it. The dent almost looks like somebody through a rock at it. The dent doesn't really look like i drove it into a car. its a really small dent with little cracks.""
1992 BMW 850I CALIFORNIA INSURANCE PRICE?
IM 19 YEARS OLD I PAY $115 FOR MY TOYOTA MR2
Cheap Car Insurance for a 20 year old...?
I'm 20 years old I live in Houston, Tx 77045 I have a 2003 Toyota Corolla CE. I never had accidents, or traffice tickets. I need a insurance that will not be so high. Any suggestions? Thanks..""
Am I covered by my dad's liability insurance?
I just got my license, but my dad says I can't drive his car because I don't have insurance. The car itself has liability insurance under his name, but he says I would need liability insurance before I can drive any car, even if it's just once in awhile. That doesn't really make sense to me, to have car insurance even though I don't have my own car... Is he right? If I were to get in an accident in his car would it not be covered by his liability insurance? Thanks in advance.""
How much would it up my car insurance if I started a weekend driving school business?
I currently pay about $700 per car.
Can I be on someone's auto insurance policy if I don't live with them?
I'm 16 and I would have my first car if it wasn't for insurance. I got some quotes and the cheapest one was like 316 a month. Is there any way I can be on my grandparents' policy if they live 60 miles away? I go up there almost every weekend. Also would it be cheaper if I was on their policy versus me having my own? Thanks in advance.
""Where can I find an AFFORDABLE health insurance in Dallas, TX?""
to cover my family; me, wife, 3 kids. without too much deductions. I only know Unicare and BlueCross offers lower rates, but wanted to see if you guys can find something lower than Unicare and BlueCross. Can I apply health insurance internationally like Canada or should I wait until Democrat president to setup an special health insurance plan (I forgot what its called)? Thanks!""
How can a non BC resident be on a car insurance (ICBC)?
BC only has one choice of auto insurance, ICBC (gov't run). And ICBC is not flexible and so expensive. I have a car insurance from ICBC on my car, but they told me that when my boyfriend who has an international driver's license cannot drive my car under my insurance. I thought about renting a car so he can be insured and drive. But ICBC's rental car insurance does not cover non BC residents either. So how people who visit BC from other countries travel and be insured to drive a car??? Any information will be much appreciated. Thanks!""
How does Progressive compare your insurance rates with top companies?
How is that possible? I've applied for Progressive quotes before (and wasn't impressed at all), but how are they able to do that? Insurance companies all have complex formulas that are used to calculate rates using several factors, including driving history, location, credit, household drivers, vehicles, etc. Unless they have robots online that steal competitors' bandwidth and automatically fill out the forms, it doesn't seem possible. If that was the case, you would think other companies would block Progressive from abusing their servers. Any ideas?""
Quick insurance quotes with no personal info?
Hi, I'm doing some research into what I want my first car to be. I've narrowed it down to the original Golf GTI, original Mini Cooper S and the Peugeot 205 GTI. I love all these cars but I need to insure them for a 17year old boy. I am a careful driver but you know how expensive insurance is. I live in the UK and want a quick insurance quote without having to put in all my details such as where I live. Any websites that can let me do this? Thanks!""
""I need short term auto insurance, since i will be on vacation for 45 days in southern california,?
Now my insurance company doesn't cover me in the states
Is there any way of avoiding finance charges on monthly motor insurance ?
Like everyone, I'm strapped for cash and the other half's credit cards are maxxed out. In fact I'm so considered so bad for credit now even a loan shark wouldn't touch me with a bargepole despite having a job and being a discharged bankrupt - however my car insurance is due. Is there any way around the extra charges ? My renewal quote was 258 if payed in one lump, yet searching for monthly payments my cheapest payback is 366 over 12 months. Not that I'd ever accuse the banks of ripping us off. Any idea's ??""
Why do auto insurance company ask for social security number when asking for a quote?
must i give my social security number if i were to purchase a auto policy?
Who is the Blonde looking for better insurance rates in the progressive insurance commercial.?
She works alongside Stephanie Courtney in the progressive insurance company commercials.
Will my Car Rental include insurance?
I'm hiring a car in Texas from Avis, it says it Includes Unlimited mileage, CUSTOMER FAC FEE, TRANSPORTATION FEE, VEH LICENSE FEE, Additional Liability Insurance (ALI), Collision Damage Waiver (CDW) - does this mean I won't have to arrange my own car insurance (I live in the UK) to cover driving the hire car abroad?""
Why is my car insurance so much cheaper than other companies?
i was looking around for auto insurance to see if there was anything cheaper than what im paying now. im a 20 year old male with a 2005 scion tc. i have been driving for about 2 years and currently use state farm. when i first insured my car 2 years ago, i was paying $148/mo. due to a speeding ticket, it has risen to $194/mo. i also have comprehensive and collision with a $500 deductible. $100,000/$300,000 coverage with full glass also. not complaining, i think this is great i looked at nationwide, allstate, geico, and progressive. these companies are supposed to be so great, but progressive quoted me at $485/mo for the same coverage! the other companies where all in that general area. progressives state minimum coverage plan for me was almost $300/mo. why do these other companies cost so much more? im not complaining about mine, obviously im not gonna switch, but i am curious as to the difference in price.""
Can I get the tax for my partners car as insurance will be in my name but the car will be in her name?
Neither of us have a car at the minute but my partners mum wants to buy her a car. The car will obviously be put in her name as it is being bought for her but she can not drive at the minute so I will be taking out the insurance in my name as I will be the main driver but we will need to tax the car can I get the tax for the car even if the car is not in my name but the insurance is in my name?
Polk County Auto Insurance?
Hi, is it true that come this October no auto insurance will be required or is it just another rumor?""
New Effington South Dakota Cheap car insurance quotes zip 57255
New Effington South Dakota Cheap car insurance quotes zip 57255
https://www.linkedin.com/pulse/csaa-home-insurance-quote-justin-garrett"
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SMART BOMB
The completely unnecessary news analysis
by Christopher Smart
November 16, 2021
CONSERVATIVE-SPEAK OR HOW TO UNDERSTAND THE GOP
The staff here at Smart Bomb has a helluva time trying to figure out what goes on inside the heads of Republican lawmakers here and in D.C. So we brought in linguistic etymologists from Larry H. Miller to help out with some definitions:
1 - “Free Agency” —“don't get out of line, dude.”
2 - “Democratic Republic” — “our way or the highway.”
3 – Legalizing medical marijuana — “no, no, no, you can't smoke it no mo.”
4 – Expanded Medicaid — “bonuses for people who choose to be poor.”
5 – Bears Ears — “lands stolen from white-man's extractive industries.”
6 – Tax cuts for the wealthy — “economic necessity to keep America free.”
7 – Liquor — “the Devil's work that is very profitable.”
8 – Air pollution — “a refreshing and healthy mist that warms the cold Earth.”
9 – Democrat — “sleazy socialist lazy evil bastards.”
10- Republican — “freedom fighters who love Donald Trump's Real America.”
STEWART UNWITTINGLY PRAISES BIDEN'S SPENDING PLAN
Utah Republican Chris Stewart last week took to Twitter with an urgent Socialism Alert: “This is the socialist laundry list that your hard-earned taxpayer money is going towards,” he ranted. Here's one of many Twitter responses reported by Huffington Post: “This list is awesome! These items will help millions of people live better lives. If only the Democrats could message this well!” — Daylin Leach.
“Socialist Laundry List” a la Chris Stewart:
Climate Crisis — $555 billion
Expanded child and earned income tax credits — $200 billion
Medicaid and Affordable Care Act expansion — $300 billion
Medicare hearing benefit — $35 billion
In-home care access — $150 billion
Affordable housing — $150 billion
Worker training and higher education — $40 billion
Other spending — $90 billion
Total — $1.75 trillion
Here's another response tweet by Simon Thompson — “OH MY GOD! Not healthcare, education and affordable housing?!?!?!?! Anything but THAT!?!?!”
HALEJULIA, IT'S BOOK BURNING TIME AGAIN
It's time once again for a good ol' fashioned book burning. Them libtards have been filling our school libraries with books that will turn them kids into... well, libtards. It's one thing to teach critical race theory, where white kids are told they're evil, but it's quite another to teach stuff like “Dick and Jane.” The kid's name is “Dick” for cryin' out loud. And Spot? Where do you think that came from? Folks are starting to wake up. First it was masks, then when the kids were stuck at home, parents began to realize they had been taught some hateful stuff, like how to hate Jesus and America. But seriously folks, this is no laughing matter. Richard Price, associate professor at Weber State, writes a blog called “Adventures in Censorship. “What I’ve started to call more and more frequently the war on books, it’s getting wrapped up in all kinds of anti-school activities.” He recounts that a legislator in Texas issued a demand to all schools in the state to report how many books they have from a list of 850 “objectionable” titles. “There is no explanation of what makes these books objectionable,” Price said, “but basically they are nearly all by or about people of color, women, and/or LGBTQ people.” After they burn all those books, they can get started on laptops.
Post script — I wish was in the land of cotton, old times there are not forgotten: Look away! look away! Look away Dixie Land. A rose by any other name would smell as sweet — or not. Well that just about does it for another week here at Smart Bomb, where we keep track of Dixie State University, so you don't have to. Don't look now but cancel culture is about to erase the name Dixie State in St. George on account of... something to do with slavery. Next year, it will be called Utah Tech University. But until then, we can keep singing: Dar's buckwheat cakes and Injun batter, makes you fat a little fatter: Look away! Look away! Look away Dixie Land. Not exactly a Mormon hymn, but what the heck. If you still need a sign that the good ol' days are over, try this: Alta ski area will charge $25 just to park this winter. And you thought their chili was expensive. The Town of Alta will follow suit. Backcountry skiers — don't you dare whine. Utah voters, through a ballot initiative, created an independent redistricting commission to draw voting district maps. Republican lawmakers summarily shit-canned them in favor of gerrymandered maps ensuring that no Utah Democrat ever goes to Washington, D.C. Look away, look away Dixie Land!
Well, Wilson, the white men on the hill are living up to their reputation, proving again that things can always get worse. What's a mother to do? Maybe you and the guys in the band can give us some perspective on where the hell we are with all this:
A world become one
Of salads and sun
Only a fool would say that
A boy with a plan
A natural man
Wearing a white stetson hat
I heard it was you
Talkin' 'bout a world
Where all is free
It just couldn't be
And only a fool would say that
The man in the street
Draggin' his feet
Don't wanna hear the bad news
Imagine your face
There in his place
Standing inside his brown shoes
I heard it was you
Talkin' 'bout a world
Where all is free
It just couldn't be
And only a fool would say that
(Only A Fool Would Say That — Steely Dan)
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COVID-19 cases climbing, wiping out months of progress
COVID-19 cases climbing, wiping out months of progress
COVID-19 deaths and cases in the U.S. have climbed back to levels not seen since last winter, erasing months of progress and potentially bolstering President Joe Biden’s argument for his sweeping new vaccination requirements.
The cases — driven by the delta variant combined with resistance among some Americans to getting the vaccine — are concentrated mostly in the South.
While one-time hot spots like Florida and Louisiana are improving, infection rates are soaring in Kentucky, Georgia and Tennessee, fueled by children now back in school, loose mask restrictions and low vaccination levels.
CLICK HERE TO FIND A COVID-19 VACCINE NEAR YOU
The dire situation in some hospitals is starting to sound like January’s infection peak: Surgeries canceled in hospitals in Washington state and Utah. Severe staff shortages in Kentucky and Alabama. A lack of beds in Tennessee. Intensive care units at or over capacity in Texas.
The deteriorating picture nine months into the nation’s vaccination drive has angered and frustrated medical professionals who see the heartbreak as preventable. The vast majority of the dead and the hospitalized have been unvaccinated, in what has proved to be a hard lesson for some families.
“The problem now is we have been trying to educate based on science, but I think most of the education that is happening now is based on tragedy, personal tragedy,” said Dr. Ryan Stanton, an emergency room physician in Lexington, Kentucky.
In Kentucky, 70% of the state’s hospitals — 66 of 96 — are reporting critical staff shortages, the highest level yet during the pandemic, the governor said.
OXYGEN SUPPLIES GROW PRECARIOUS AMID COVID-19 SURGE
“Our hospitals are at the brink of collapse in many communities,” said Dr. Steven Stack, Kentucky’s public health commissioner.
The U.S. is averaging over 1,800 COVID-19 deaths and 170,000 new cases per day, the highest levels respectively since early March and late January. And both figures have been on the rise over the past two weeks.
Sept. 13, 2021: Maitre d’ Susanne McDonald checks guests’ proof of vaccination at a restaurant in midtown Manhattan in New York.
(AP Photo/Seth Wenig, File)
The country is still well below the terrifying peaks reached in January, when it was averaging about 3,400 deaths and a quarter-million cases per day.
The U.S. is dispensing about 900,000 vaccinations per day, down from a high of 3.4 million a day in mid-April. On Friday, a Food and Drug Administration advisory panel will meet to discuss whether the U.S. should begin giving booster shots of the Pfizer vaccine.
On a positive note, the number of people now in the hospital with COVID-19 appears to be leveling off or even declining at around 90,000, or about where things stood in February.
CALIFORNIA COUPLE DIES FROM COVID-19 COMPLICATIONS, LEAVING BEHIND NEWBORN AND 4 OTHER KIDS
Last week, the president ordered all employers with more than 100 workers to require vaccinations or weekly tests, a measure affecting about 80 million Americans. And the roughly 17 million workers at health facilities that receive federal Medicare or Medicaid also will have to be fully vaccinated.
Sept. 14, 2021: A health worker administers a dose of a Pfizer COVID-19 vaccine during a vaccination clinic at the Reading Area Community College in Reading, Pa.
(AP Photo/Matt Rourke, File)
“We read about and hear about and we see the stories of hospitalized people, people on their deathbeds among the unvaccinated over the past few weeks,” Biden said in announcing the rules. “This is a pandemic of the unvaccinated.”
The requirements have met with resistance and threats of lawsuits from Republicans.
Arizona on Tuesday reported 117 deaths, the most in a single day since last February. Tennessee now ranks first in the U.S. in new cases per capita. Hundreds of students there have been forced to quarantine. Some schools have closed because of staffing shortages. Others have asked to switch to remote learning.
But measures aimed at containing the virus have run into opposition. Last week, a Tennessee high school student who spoke at a school board meeting in favor of a mask mandate was heckled by adults while he talked about his grandmother dying from the virus.
Stanton, the ER doctor in Kentucky, said he has admitted families where the delta variant has swept through generations, especially if the older members are unvaccinated.
CLICK HERE TO GET THE FOX NEWS APP
“Now in Kentucky, one-third of new cases are under age 18,” he said. Some children brought it home from summer camp and spread it to the rest of the family, and now, “between day care and schools and school activities, and friends getting together, there are just so many exposures.”
In Alabama, hundreds of COVID-19 patients fill intensive care units, and one hospital contacted 43 others in three states to find a specialty cardiac ICU bed for Ray Martin DeMonia. It wasn’t soon enough. The 73-year-old died Sept. 1.
“In honor of Ray, please get vaccinated if you have not, in an effort to free up resources for non-COVID related emergencies,” his family pleaded in his obituary.
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What Do Republicans Think About Obamacare
New Post has been published on https://www.patriotsnet.com/what-do-republicans-think-about-obamacare/
What Do Republicans Think About Obamacare
Isans Are Split On The Supreme Court Overturning The Aca
McCain: To Think We Can Repeal Obamacare ‘Is Not Rational’
In June 2020, the Trump administration issued a brief asking the U.S. Supreme Court to overturn the ACA. The brief was filed in support of an ongoing challenge to the ACA by a group of Republican attorneys general in California v. Texas, a case that challenges the legality of the ACA in light of the zeroing out of the individual mandate penalty in the 2017 Tax Cuts and Job Acts. The death of Supreme Court Justice Ruth Bader Ginsburg on September 18 and the possibility of the Senate confirming a new Justice appointed by President Trump before the presidential election has brought heightened attention to the potential outcome of this case and the future of the ACA. In October 2020, a majority of the public said they do not want to see the Supreme Court overturn the 2010 health care law, and eight in ten said they do not want to see the ACAs protections for people with pre-existing conditions overturned. There are partisan differences on both questions, with the majority of Democrats and independents saying they dont want the Court to overturn the ACA or pre-existing condition protections. However, among Republicans, three-fourths say they want to see the ACA overturned, but two-thirds say they do not want to see pre-existing condition protections overturned.
Figure 2: Majorities Do Not Want Court To Overturn ACAs Pre-Existing Condition Protections, Republicans Want Entire Law Overturned
Majority Of Millennials Under 30 Believe Costs Will Rise And Quality Will Fall Under Health Reform
Between 50 and 51 percent of young people believe their cost of care will increase under the health reform law; approximately one-in-ten tell us that their costs will likely decrease.; Young Americans who think their health care costs will increase are much less likely to enroll in the insurance program mandated by the 2010 legislation.; Sixty percent of those who say they are unlikely to enroll in the Affordable Care Act program believe that their costs under the program would increase, which is significantly higher than those who say they will enroll in the program
Young Americans under 30 tell us that the news media is a primary source of information related to the presidents health care initiative, with 67 percent of those who were asked about the Affordable Care Act saying that the news was a primary source, and 72 percent saying the same when they were asked about Obamacare.; Friends and social media were the second leading source followed by Healthcare.gov .; Those who are unlikely to enroll are significantly more likely to have received information about the programs through the news media and their employer .
Poll: Obamacare More Popular Than Ever
A sign in favor of the Affordable Care Act is held up outside the Supreme Court building after the … court’s ruling in Washington, D.C., U.S., on Thursday, June 28, 2012. The U.S. Supreme Court upheld the core of President Barack Obama’s health-care overhaul, giving him an election-year triumph and preserving most of a law that would expand insurance to millions of people and transform an industry that makes up 18 percent of the nation’s economy. Photographer: Andrew Harrer/Bloomberg
BLOOMBERG NEWS
The Affordable Care Act wins 55% support among the public for its highest rating since becoming law nearly a decade ago, according to the latest Kaiser Family Foundation tracking poll released Friday.
Kaiser said the clear majority of support is the highest in more than 100 polls the nonprofit health foundation has conducted. The ACA was signed into law in 2010 by President Barack Obama and has expanded health insurance coverage to more than 20 million Americans.
The recent uptick reflects strong support among Democrats, 85% of whom now express favorable views, Kaiser said in its analysis. A narrow majority of independents also view the law favorably. While most Republicans still hold unfavorable views towards the ACA, the poll suggests that Republican voters have largely moved on from efforts to repeal the ACA and now rank opposition to a single-payer government health plan like Medicare-for-all among their top health priorities.;;
You May Like: Did The Republicans And Democrats Switch Platforms
Obamacare Repeal Requires Replacement After 2016 Election
Republicans had spent eight years trashing the Democratic health care overhaul, but now that they were in power, they ran up against the same political winds that forced ObamaCare tolook like such a political Frankensteins monster to begin with. Conservatives wanted a complete and total repeal of the law; moderative Republicans wanted to protect certain pieces of it.
America Should Deport Illegal Immigrants
Republicans believe that illegal immigrants, no matter the reason they are in this country, should be forcibly removed from the U.S. Although illegal immigrants are often motivated to come to the U.S. by companies who hire them, Republicans generally believe that the focus of the law should be on the illegal immigrants and not on the corporations that hire them.
Recommended Reading: Trump Triangle Pin
Universal Coverage Vs Market
Democrats generally continue to support the Affordable Care Act , but would like to fix its flaws and generally improve the law. Democrats want to empower states to use innovation waivers to create their own approaches to healthcare reform that are as good asor better thanthe current system. Many Democrats also support fixing the ACAs family glitch by basing affordability calculations for employer-sponsored coverage on family premiums rather than employee-only premiums, and most also support expanding premium subsidies to higher income ranges in order to soften the subsidy cliff.
But increasingly, Democrats are also getting behind the idea of a transition to some sort of universal coverage system. All of the Democrats who ran for the 2020 presidential nomination were in favor of universal coverage, although they had differing opinions on whether we should transition entirely to a single-payer system or use a combination of government-run and private health coverage .
Bidens healthcare proposal also calls for an end to surprise balance billing, premium-free coverage under the public option for people who are caught in the Medicaid coverage gap , and allowing Medicare to negotiate prices with drug companies.
The Republican Party has not rolled out a new healthcare platform for 2020, and is instead utilizing the same platform they had in 2016. So in general, their approach can be expected to be the same as it has been for the past several years.
What Obamacare Republican Candidates Go Mum On Health Care Law
WASHINGTON Sen. Cory Gardner ran his first Senate campaign railing against the newly enacted Affordable Care Act, but six years later, the once-maligned law is getting little mention in his bid for re-election.
The Colorado Republican isnt alone.
After years of campaigning against Obamacare, Republicans trying to retain control of the Senate appear to be conceding that attacking the ACA is no longer politically advantageous, a shift compounded by the millions of people who now depend on the law for their coverage, including protections for pre-existing conditions.
Now with Obamacare being entrenched into people’s daily lives, they just don’t want their health care messed with, and so it becomes hard for Republicans to articulate on that point, said Doug Heye, who worked on repeal efforts in 2014 as deputy chief of staff to then-House Majority Leader Eric Cantor, R-Va.
Also Check: How Many Republicans Are In The Impeachment Inquiry
Republicans Who Think Nobody Would Miss Obamacare Should Ask People Who Depend On It
Some of the Republicans agitating to repeal Obamacare say they arent worried about taking health insurance away from more than 20 million people. Their theory: The program is wildly unpopular and even the people with coverage wouldnt miss it, no matter what takes it place.
People have crappy insurance, Rep. John Shimkus told Politico last week. This fear that theyre going to lose something that they dont think they have anyway is crazy.
Anna Meyers would beg to differ.
Meyers, 42, lives in the eastern part of North Carolina. She and her husband, 59, have been getting insurance through healthcare.gov for the last three years. Meyers also has a son, 14, who has autism. He gets coverage through Medicaid a program that Republicans say they would like to shrink just as soon as they are done with Obamacare.
Meyers works as an office manager for an accountant. Her husband does repair work for a company that manages rental homes. Between the two of them, she figures, their income is about $40,000 a year maybe less when his business is slow.
We dont get to go out to the movies a whole lot, Meyers explained to me on the phone. But we do travel a lot on the weekend, in our car, and see some of the bigger towns in the area just to get out.
Also, there is date night once a week. They drop her son at her parents house, and then bring home takeout. Smithfields Chicken is a favorite.
The Majority Of People With Obamacare Seem To Value It
Republicans Have A Health Plan Finally
What Do Republicans Believe?
The House Republican Study Committee has come out with a viable plan.
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For the past ten years Republicans in Congress have been largely AWOL on health care.
If memory serves, there has never been a hearing to showcase the victims of Obamacare. Nor has there been a hearing to show how sensible reforms could make the lives of those victims better.
When it came to legislation, the GOP only had two ideas: either abolish Obamacare entirely or toss it to the states. Neither approach actually solved a health care problem. They just allowed Republicans in Washington to wash their hands of the issue and pass the problems along to someone else.
Until now.
The House Republican Study Committee has accepted the challenge and delivered. In a 68-page document, it identifies the worse problems in our health care system and shows how they can be solved.
The proposals are bold, impactful and easy to understand. Here is a quick summary.
Personal and portable health insurance. In an ideal world, if people like the insurance they get from an employer, they would be able to take it with them from job to job and in and out of the labor market. Under the Obama administration, this practice was not only illegal, employers who bought individually owned insurance for their employees faced huge fines.
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Harris On Voting Rights
As voting rights bills fizzle in Congress, Vice President Kamala Harris looks to fire up voters for 2022, Noah Bierman reported. Sen. Joe Manchin this week floated a compromise voting rights proposal that he said he hoped Republicans would support, but Senate Minority Leader Mitch McConnell of Kentucky slammed the door on that effort. Given Senate rules that require 60 votes for passage of most legislation, McConnells opposition would probably doom a bill. Many Democrats hope that issue will motivate their supporters in key races in the midterm election.
What Can Trump Do
Mr Trump has signed an executive order directing federal departments to take actions to ease the regulatory requirements from Obamacare.
The directive, which offered few specific details, appeared to be more of a broad mission statement.
However, the order could undermine the law’s individual mandate by granting more exemptions to people who do not want to buy health insurance.
Though it will take Congress to repeal major parts of Obamacare, Mr Trump could also cripple it with a stroke of a pen.
As president, he could simply drop the federal government’s appeal against a lawsuit, House v Burwell, which Republican House of Representatives members won in April 2016.
That legal action argued the Obama administration was unconstitutionally spending money that Congress had not formally appropriated by reimbursing health insurers who provide coverage to low-income policyholders.
If Mr Trump opts to drop the government’s challenge, insurers who are currently giving deep discounts to half their customers would lose their reimbursements. And that, say analysts, would send Obamacare into a death spiral.
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Board Of Governors Professor School Of Public Affairs & Administration
The Trump administrations efforts to sabotage the ACA and their consequences receive detailed attention in a recently released Brookings book, Trump, the Administrative Presidency, and Federalism. For present purposes, I highlight six major sabotage initiatives which emerged in the wake of congressional failure to repeal and replace the ACA.
1. Reduce outreach and opportunities for enrollment in the ACAs insurance exchanges. Established to offer health insurance to individuals and small business, the exchanges have provided coverage to some 10 million people annually. The Obama administration had vigorously promoted the ACA in part to attract healthy, younger people to the exchanges to help keep premiums down. The Trump administration sharply reduced support for advertising and exchange navigators while reducing the annual enrollment period to about half the number of days.
2. Cut ACA subsidies to insurance companies offering coverage on the exchanges. ACA proponents saw insurance company participation on the exchanges as central to fostering enrollee choice and to fueling competition that would lower premiums. The law therefore provided various subsidies to insurance companies to reduce their risks of losing money if they participated on the exchanges. The Trump administration joined congressional Republicans in reneging on these financial commitments.
A Majority Of Young People Disapprove Of The New Health Care Law
With the deadline to enroll in the presidents new health care law quickly approaching and a large effort underway by the administration and interest groups to encourage more young people to either enroll or not enroll in health coverage, we were interested in gaining a better understanding of young Americans views toward the new law.; To help better understand the messaging, we conducted a split sample asking respondents about approval, quality, cost, and how they were hearing about the law identifying it for n=1,024 respondents as the Affordable Care Act and for n=1,065 respondents as Obamacare.; While we did not find drastic differences between the two names there were some that existed and they are noted below.
Most significantly, when young Americans between the ages of 18 and 29 were asked if they approve or disapprove of the comprehensive health reform package that the president signed into law in 2010, a solid majority disapproved.; When the law was referred to as the Affordable Care Act, 39 percent of young Americans under 30 approved, 56 percent disapproved; and when the law was referred to as Obamacare, the numbers were nearly identical with 38 percent citing approval and 57 percent citing that they disapproved.; These findings mirror recent ABC News/Washington Post polling reporting that 40 percent of adults nationwide support the federal law making changes to the health care system, while 57 percent oppose it.
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Support For The Affordable Care Act
Then along comes Donald Trump and threatens to cut off subsidies for low-income Americans, ostensibly as a method to force Democrats in Congress to come to the negotiating table. A New York Times editorial summarised it: It sounds more like a two-bit Hollywood villain promising carnage if he doesnt get his way. Holding his own voters hostage to prove a point is not really the best political move for someone elected by a combination of low-wage workers from rural and industrial America and high-income families. But the Republican health plan what pundits are labeling TrumpRyan care advocates decreasing financial support for those worse off while decreasing taxes for the rich. And just to top it off, support for the ACA is currently at its highest point ever with 55% of Americans approving of it a complete reversal prior to the November election.
Even one of the most conservative columnists in the Washington Post, Charles Krauthammer a nonpractising psychiatrist wrote a column in April where he admitted that the ACA had changed the zeitgeist. It is universalising the idea of universal coverage. Acceptance of its major premise that no one be denied health care is more widespread than ever.
Now, how is that for progress!
Opinionwe Want To Hear What You Think Please Submit A Letter To The Editor
Despite what they say on television about protecting the most vulnerable, one by one the Republican senators are all getting in line behind Trumps Supreme Court nominee. We dont yet know who that is, but we can assume how he or she will vote on Obamacare.
People with pre-existing conditions like me are again terrified of losing our insurance, this time in the midst of a pandemic. Weve lived through years of scary uncertainty and now months of sheltering in place. Enough is enough. We are all health care voters now. Well see whether our wavering senators are health care voters, too.
Laura Packard is a Denver-based health care advocate and cancer survivor. She is the founder of Health Care Voices, a non-profit grassroots organization for adults with serious medical conditions, co-chair of Health Care Voter, and runs the pharma accountability campaign for Hero Action Fund. Follow her on Twitter:
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Less Than One Third Of Uninsured Millennials Under 30 Plan To Enroll
Regardless of the term used in describing the federal health reform package, less than one-in-four young Americans under the age of 30 report that they would definitely or probably enroll in insurance through an exchange if and when they are eligible. Forty-seven percent tell us that they will probably not or definitely not enroll under the ACA program, 45 percent say the same under Obamacare.;
Among the 22 percent of people under 30 who do not have health insurance presently, 29 percent say they will roll in the program described as Obamacare, and 25 percent say the same when its referred to as the Affordable Care Act.One of the most telling predictors of likelihood to enroll is political affiliation.; Less than ten percent of Republicans plan to enroll in an exchange, less than 20 percent of Independents — and between 35 and 40 percent of Democrats, depending on the name associated with the law.; Obamacare proves to be five percent more beneficial when Democrats are considering enrollment compared to the Affordable Care Act .
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Why Republicans Want To Repeal Aca
Why Republicans Wouldn’t Actually Repeal Obamacare
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It would be a political disaster, but it hasn’t yet stopped them from trying.
Last week, in a bold example of their governing prowess, congressional Republicans took their 62nd vote to repeal the Affordable Care Act, and this time they actually passed it through both houses and sent it to President Obama to be vetoed. Naturally, they were exultant at their triumph. Speaker Paul Ryan admitted that there is as yet no replacement for the ACA, but they’ll be getting around to putting one together before you know it. The fact that they’ve been promising that replacement for more than five years now might make you a bit skeptical.
What we know for sure is this: If a Republican wins the White House this November, he’ll make repeal of the ACA one of his first priorities, whether there’s a replacement ready or not. To listen to them talk, the only division between the candidates is whether they’ll do it on their first day in the Oval Office, in their first hour, or in the limo on the way back from the inauguration.
But I’ve got news for you: They aren’t going to do it, at least not in the way they’re promising. Because it would be an absolute catastrophe.
Now imagine that ten million people, the number signed up for private coverage through the exchanges, all had their coverage simultaneously thrown into doubt. Think that might cause some bad press for the party and the president who did it?
What Does The Existing Law Do
The Patient Protection and Affordable Care Act, known as Obamacare or the ACA, was the largest overhaul of the US healthcare system since the 1960s.
It aimed to eventually slow the growth of US healthcare spending, which is the highest in the world.
Obamacare intended to extend health insurance coverage to the estimated 15% of Americans who lacked it and were not covered by other health programmes for the poor and elderly.
The law created state-run marketplaces – with websites akin to online shopping sites – where individuals can compare prices as they shop for coverage.
Some of the more popular provisions include:
Children can stay on their parent’s healthcare plan until age 26
No one who is sick or has a medical condition can be denied insurance
Companies can no longer charge women more than men
Businesses with more than 50 full-time employees must offer health insurance
#2: Partisans Are Split On The Supreme Court Overturning The Aca
In June 2020, the Trump administration issued a brief asking the U.S. Supreme Court to overturn the ACA. The brief was filed in support of an ongoing challenge to the ACA by a group of Republican attorneys general in California v. Texas, a case that challenges the legality of the ACA in light of the zeroing out of the individual mandate penalty in the 2017 Tax Cuts and Job Acts. The death of Supreme Court Justice Ruth Bader Ginsburg on September 18 and the possibility of the Senate confirming a new Justice appointed by President Trump before the presidential election has brought heightened attention to the potential outcome of this case and the future of the ACA. In October 2020, a majority of the public said they do not want to see the Supreme Court overturn the 2010 health care law, and eight in ten said they do not want to see the ACAs protections for people with pre-existing conditions overturned. There are partisan differences on both questions, with the majority of Democrats and independents saying they dont want the Court to overturn the ACA or pre-existing condition protections. However, among Republicans, three-fourths say they want to see the ACA overturned, but two-thirds say they do not want to see pre-existing condition protections overturned.
Figure 2: Majorities Do Not Want Court To Overturn ACAs Pre-Existing Condition Protections, Republicans Want Entire Law Overturned
Democratic Resistance To Obamacare
Republicans are not the only ones calling for reform or replacement of the Affordable Care Act. The National Review cited a Washington Post/ ABC News survey done not long after the act went into effect that said party support for the act only amounts to about half of Democrats polled. According to the article, 56 percent of those surveyed were concerned about their personal health care under the new law. One Democratic contender put it this way: Obamacare is extremely problematic. It is expensive. It is a $500 billion cost than we originally anticipated. Its cutting into Medicare benefits, and its having companies lay off their employees because they are worried about the cost of it. That is extremely problematic. It needs an enormous fix.
Republican Views On Obamacare
The Republican Partys view on the Patient Protection and Affordable Care Actcommonly known as Obamacareis that its implementation was less about providing healthcare to millions, and more a result of power as the government sought to expand its reach over one sixth of the economy. The party claims that Obamacare has resulted in an attack on the Constitution of the United States because it requires U.S. citizens to purchase health insurance, and its impact on the health of the nation overall has been detrimental. The party is in agreement with the four Supreme Court justices who dissented in the ACA ruling. The justices stated, In our view, the entire Act before us is invalid in its entirety. As of 2012, the partys stance was that Obamacare was the result of outdated liberalism, and the latest in a series of attempts to impose upon the people of America a euro-style bureaucracy to micromanage all aspects of their lives. One of the partys biggest issues with Obamacare is its unpopularity among the peoplewhen polled on the subject, pluralities and even majorities often state they do not like the law.
The Acas Protections Changed Public Opinion In Its Favor Republicans Are Keeping Up
For more than a decade, the Affordable Care Act has been the Republican Partys nemesis. As it was first debated in Congress in 2009, when it was enacted in 2010 and through the next six years of implementation, Republican leaders rallied supporters by vociferously opposing it and calling for repeal. The Trump administration and states controlled by Republicans remain hostile to the ACA.
But the coronavirus pandemics fast-moving destruction has pushed Republicans to rely on Barack Obamas signature law to respond to the crisis, even taking action to strengthen it. The law, as written, requires that Americans who have recently lost jobs and insurance coverage to be permitted to enroll in its insurance marketplace, and they are doing so in swelling numbers. Meanwhile, Republicans recently backed that increased federal funding for a critical part of the ACA: Medicaid for lower-income people. And Trump administration regulators have used their authority to insist that insurance plans pay for coronavirus tests as an essential health benefit under the ACA a Republican target in the past.
Our research shows that this about-face cannot be explained by the pandemic alone. The partys rank-and-file and many other Americans have shifted to supporting the ACA and expanded government payments for health care. The pandemic is giving Republicans cover to follow changing public opinion.
Republicans have spent 10 years trying to kill the Affordable Care Act
What If It Is Repealed
If Obamacare is repealed and not replaced with an alternative, the government would see a huge increase in the deficit because the repeal would devastate Medicaid, according to Healthline.com. The federal government currently provides states with 90 percent of their Medicaid funding through the ACA provisions. If Obamacare is repealed, states will not receive that funding. Insurance companies could rescind coverage of people with pre-existing conditions and raise premiums. It is feasible that millions of people could lose their coverage. Hospitals and healthcare providers would be affected because they would have fewer patients with insurance. Premiums and deductibles could go up. Those are depressing forecasts.
Some people, however, support the repeal believing things will be fine. They say the federal government should not be involved in healthcare, and that if Obamacare was repealed the states would take over the insurance exchanges and Medicaid. They believe in a self-leveling effect in which the insurance companies would go back to offering more variety in coverage and individuals would have choices. The problem with the scenario, however, is Medicare. The healthcare system for those 65 and older is what moves the healthcare industry. Reforms should be made, including giving people an opportunity to simply refuse it. These changes would bring the free-market principle back into healthcare and should drive costs down.
Trumps Executive Action Could Erode Marketplace Built Under Obamacare
Attempts to repeal portions of the Affordable Care Act have failed in the past several months, leading President Donald Trump to issue an executive order expanding access to cheaper, less comprehensive health care plans.
The order, signed on Oct. 12, instructs federal agencies to remove certain limitations on “association health plans” and expand the availability of short-term health plans, both of which can skirt certain minimum coverage requirements included in the Affordable Care Act and state laws.
These changes will not immediately take effect; federal agencies will have to figure out how to act on Trump’s directions.
The executive action orders agencies to explore ways in which the government can expand access to short-term health plans, which are available to individuals on a three-month basis and meant for people who are in-between health care coverage plans. Under the instructions, association health plans would be allowed to sell plans across state lines; those plans allow small businesses to band together to create cheaper health care plans that offer fewer benefits.
The order was intended to create more options for individuals seeking health insurance and help stimulate competition among insurers. Some health policy advocates worry that it could disrupt the insurance marketplace in a way that would drive up health care costs for elderly individuals and people with medical conditions.
It will be months before changes are seen in the marketplace.
Younger Americans Could Get Cheaper Plans
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Obamacare was designed so that younger policyholders would help subsidize older ones. That would change under the Republican bill because it would allow insurers to charge older folks more.
This means that younger Americans would likely see their annual premiums go down. Enrollees ages 20 to 29 would save about $700 to $4,000 a year, on average,according to a study by the Milliman actuarial firm on behalf of the AARP Public Policy Institute.
Those under age 30 would also get a refundable tax credit of up to $2,000 to offset the cost of their premiums, as long as their income doesnt exceed $215,000 for an individual.
The GOP tax credits would also likely be more generous than Obamacares subsidies for these folks. For example, a 27-year-old making $40,000 a year would receive $2,000 under the GOP plan, but only gets a $103 subsidy from Obamacare, on average, a Kaiser analysis found.
Also, the bill keeps the Obamacare provision that lets young adults up to age 26 stay on their parents insurance plan.
Trumps Promise To Repeal Obamacare Is Now In Limbo
President Donald Trump expressed disappointment after Republican lawmakers’ failure to muster enough votes to repeal Obamacare placed one of his loftiest campaign promises in limbo.
A series of defections by Senate Republicans scuttled two separate efforts to dismantle the sweeping U.S. health care law put in place by Trump’s predecessor, President Barack Obama.
“We’ve had a lot of victories, but we haven’t had a victory on health care,” Trump told reporters July 18, as it became clear the latest Republican legislative efforts would fail. “We’re disappointed.”
A slim margin of error constrained GOP efforts to repeal and replace Obamacare and forced a delicate balancing act between the party’s conservative and moderate members.
But defections by Sens. Jerry Moran of Kansas and Mike Lee of Utah on July 17 brought to four the number of Republican senators to publicly oppose the bill , effectively killing the repeal-and-replace plan. Senate leadership could only afford to lose two Republican votes for passage.
Senate Republicans then turned their attention to a measure that would repeal major parts of Obamacare over two years, in theory buying lawmakers enough time to agree on a replacement plan before the Affordable Care Act, often called Obamacare, was largely dismantled.
“I did not come to Washington to hurt people,” Capito said in a statement. “I cannot vote to repeal Obamacare without a replacement plan that addresses my concerns and the needs of West Virginians.”
What Would Trumpcare Look Like Follow Gop’s ‘choice And Competition’ Clues
Eliminating the penalty also caused insurance premiums to rise, says Sabrina Corlette, director of the Center on Health Insurance Reforms at Georgetown University. “Insurance companies were getting very strong signals from the Trump administration that even if the ACA wasn’t repealed, the Trump administration probably was not going to enforce the individual mandate,” she says. Insurance companies figured that without a financial penalty, healthy people would opt not to buy insurance, and the pool of those that remained would be smaller and sicker.
So, even though the $0 penalty didn’t actually go into effect until 2019, Corlette says, “insurance companies in anticipation of the individual mandate going away and in anticipation that consumers would believe that the individual mandate was no longer going to be enforced priced for that for 2018.” According to the Kaiser Family Foundation, premiums went up about 32%, on average, for ACA “silver plans” that went into effect in early 2018, although most people received subsidies to offset those premium hikes.
Republicans Are Still Trying To Repeal Obamacare Heres Why They Are Not Likely To Succeed
Conservatives are still trying to repeal the Affordable Care Act even after the Republican-majority Congress failed to overturn the law in 2017. A coalition of conservative groups intends to release a new plan this summer. The groups will reportedly propose ending the laws expansion of Medicaid and convert Medicaid funding into block grants to the states. And just last week the Trump administrations Justice Department argued in a legal filing that key provisions of the law its protections for persons with preexisting conditions are .
Why are Republicans still trying to undo the ACA? We argue in a forthcoming that the laws political vulnerabilities and Republican electoral dynamics drive conservative efforts to uproot it.
In the past, conservatives have thrown in the towel
As politicians and political scientists both know, the can never be taken for granted. Even so, the duration and intensity of conservative resistance to the ACA is historically unusual. The ACA is a moderate law, modeled on that Republicans once supported, such as insurance purchasing pools. Whats more, many red states refuse to accept the ACAs funding to expand Medicaid to more of their citizens such as , which has a large number of uninsured residents even though you would think they would want those federal benefits.
So why is the ACA still politically vulnerable?
The answer lies partly in the way the program was designed.
Is repeal likely?
Nicole RapfogelEmily Gee
If The Affordable Care Act Is Struck Down Tens Of Millions Of Americans Would Lose Coverage And Protections For Pre
As the public health and economic toll of the coronavirus pandemic becomes more grim with each passing day, Republicans are doubling down on their decade-long effort to repeal the Affordable Care Act. Democrats, meanwhile, are working to shore it up by introducing legislation to lower costs, expand coverage, and strengthen protections for those with pre-existing conditions.
The White House this week is expected to file legal briefs officially asking the Supreme Court to end the ACA, even as more than 40 million Americans have filed for unemployment benefits since March. As many as 27 million Americans could lose their employer-sponsored health insurance during the pandemic, according to an estimate from the Kaiser Family Foundation.
The legal briefs, which are expected to be filed on Thursday, come as part of a case brought by a coalition of 18 Republican-led states that are suing to repeal the ACA. The case has the support of President Donald Trump, who said in May that he wants to terminate the ACA, even as it becomes a potential lifeline for millions of newly uninsured Americans.
Passed in 2010 under President Barack Obama, the ACA was the most comprehensive healthcare legislation enacted in decades. Studies havefound that it saved tens of thousands of lives and billions in healthcare costs.
Under the ACA:
Some within the GOP have acknowledged the dangers of trying to take away healthcare coverage during a pandemic leading into an election.
Why Does Trump Want To Repeal Obamacare
President Trump has called Obamacare an incredible economic burden, and claims that it has tragically but predictably resulted in runaway costs, websites that dont work, greater rationing of care, higher premiums, less competition and fewer choices.
Republicans have opposed the reforms since they were first proposed at the start of Mr Obamas presidency in 2009.
Right-wing politicians described the law as a job-killer despite a 9 per cent rise in health care sector employment since the act was implemented.
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They object to the states intrusion into the private affairs of businesses and argue that firms have been burdened with too many costs.
President Donald Trump waves as he walks with first lady Melania Trump and son Barron during the inauguration parade.
Groups Opposing The American Health Care Act
Over 50 organizations oppose the proposed healthcare plan that will make Americans will pay more for less. The list includes nurses, doctors, hospitals, teachers, churches, and more. You can see a few here:
AARP: AARP opposes this legislation, as introduced, that would weaken Medicare, leaving the door open to a voucher program that shifts costs and risks to seniors.
Before people even reach retirement age, big insurance companies could be allowed to charge them an age tax that adds up to thousands of dollars more per year. Older Americans need affordable health care services and prescriptions. This plan goes in the opposite direction, increasing insurance premiums for older Americans and not doing anything to lower drug costs.
On top of the hefty premium increase for consumers, big drug companies and other special interests get a sweetheart deal.
Finally, Medicaid cuts could impact people of all ages and put at risk the health and safety of 17.4 million children and adults with disabilities and seniors by eliminating much-needed services that allow individuals to live independently in their homes and communities. Although no one believes the current health care system is perfect, this harmful legislation would make health care less secure and less affordable.
AARP stands ready to work with both parties on legislation that puts Americans first, not the special interests.
That just wont do.
That is, above all, why physicians must be involved in this debate.
National And State Level Coverage Losses
Because the economic crisis stemming from the pandemic is driving millions of people onto coverage programs supported by the ACA, CAP estimates that approximately 3 million more people stand to lose coverage from the health care repeal lawsuit than the 20 million previously estimated. According to a March 2019 analysis by the Urban Institute, full repeal of the ACA would cause enrollment in Medicaid and the Childrens Health Insurance Program to fall by 22.4 percent and enrollment in individual market coverage, including for the ACA marketplaces and other insurance people purchase on their own, to drop by 35.4 percent.
The economic stress of the pandemic has pushed the United States into a recession. The Congressional Budget Office projects that the unemployment rate in the second and third quarters of this year will average 15 percent higher than it was during the Great Recession. At an unemployment rate of 15 percent, 17.7 million people would lose employment-based health insurance coverage, according to a recent report by the Urban Institute. With access to ACA coverage options, most of these people would find new forms of insurance. Urban estimates that 8.2 million would end up with Medicaid/CHIP coverage, and 4.3 million would gain coverage through the ACA marketplaces or other private coverage. About 5.1 million would remain uninsured.
Table 1
#3: Most Say It Is Important That Pre
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If the Supreme Court overturns the ACA, a host of provisions could be eliminated, including the laws protections for people with pre-existing medical conditions. These provisions prohibit insurance companies from denying coverage based on a persons medical history and prohibit insurance companies from charging those with pre-existing conditions more for coverage . The July 2019 KFF Health Tracking Poll found that a majority of the public says it is very important for many of the ACA provisions to be kept in place, including the guaranteed issue provision and community rating . While partisans divide over the importance of keeping many provisions of the ACA in place, majorities of Democrats, Republicans, and independence say it is very important to continue each of these protections for people with pre-existing conditions.
Figure 3: Most Say It Is Important That ACA Provisions Remain In Place
How Likely Is It That The Affordable Care Act Will Be Repealed And Replaced
Concerned United States citizens want to know how likely is it that the Affordable Care Act will be repealed and replaced. Though speculative, the answer to the question is not an impossible one. The repeal of the Affordable Care Act, also known as ACA or Obamacare, is a subject that is under much scrutiny.
Trump Signs Executive Order On Obamacare; Impact Unclear
On his first day in office, President Donald Trump signed an executive order that gave federal agencies broad authority to defer or delay any part of the Affordable Care Act that costs anybody any money.
More formally, the order tells agencies they can “waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.”
That’s a mouthful, but what does it mean, and how far does it go to repeal Obamacare?
Larry Levitt, senior vice-president at the respected and neutral Kaiser Family Foundation, said in a series of tweets that while the impacts are unclear, it shows the administration is “moving to unwind the Affordable Care Act, but it won’t be immediate.”
Levitt added, “One sure outcome is it creates uncertainty for insurers at a critical time.”
Health care analyst Sabrina Corlette at Georgetown University echoed Levitt’s point.
“For insurers already uncertain about their future in the Affordable Care markets, the uncertainty this executive order generates doesn’t help,” Corlette said. “At a minimum they’ll have to factor it into their 2018 premiums, which are due to be filed by May 3 in most states.”
But that hasn’t happened yet.
Gridlock In House Stalls Trump’s Pledge To Repeal Obamacare
As a candidate for president, Donald Trump said that “real change begins with immediately repealing and replacing the disaster known as Obamacare.”
On March 24, the nation learned that it’s not happening immediately. And the road forward isn’t clear either.
Capping a frenzied week of negotiations between three House Republican factions — the party leadership, the hardline conservative House Freedom Caucus, and members of the more moderate, pragmatic wing of the party — House Speaker Paul Ryan, R-Wis., announced that he would not bring the American Health Care Act to the floor for a vote, as he had planned.
That March 24 announcement came one day after the floor vote had been pushed back to allow for last-minute changes and arm-twisting, and half a day after Trump had issued an ultimatum to House Republicans — pass the bill or he’ll move on.
In the run-up to Ryan’s announcement, vote counting by media outlets had concluded that the House GOP would lose too many votes to pass the bill if it tried.
“We came really close today, but we came up short,” Ryan said at a press conference. “I will not sugarcoat this. This was a disappointing day for us.”
For members on the party’s right flank, the American Health Care Act left in place too much of the infrastructure of the Affordable Care Act, President Barack Obama’s signature health care law and the target of intense Republican opposition for seven years.
source https://www.patriotsnet.com/why-republicans-want-to-repeal-aca/
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it’s almost that time: ACA open enrollment opens November 1, 2018!
hey kids! if you live in the united states and are someone who buys their own health insurance, open enrollment for coverage in 2018 will run from November 1 - December 15! i know our illustrious presidential yam is trying to gut the entirety of the ACA, including the tax penalties for being uninsured that are intended to encourage enrollment, but think how much it would piss him off if even more people were able to get coverage under the ACA this year.
if you don’t know where to start, there’s a handy dandy website for it, so no worries!
if you are already on a marketplace plan, go here.
before open enrollment starts, you should receive notice of your current coverage status so that you know where you stand right now and where to go if you want ot keep your current insurer, as well as impending coverage changes with that plan, and a notice from your state’s marketplace with plan options, instructions to apply, and instructions re: if any documentation will be required to be submitted during enrollment.
if you’re starting fresh with buying via the exchanges (marketplace), go here.
you can identify if you’re eligible for any subsidies or tax credits based on your income level and figure out what documentation you might need to apply with so that you’re ready with all of your shiny paperwork to sign up when enrollment opens.
if you start looking at your options and realize that health insurance via the exchanges is a financial pipe dream re: financial status, go here!
you might be eligible for medicaid. eligibility varies, as medicaid programs are state-run, so you’ll have to identifty if you qualify under you state’s allowances. as a warning, eligibility for medicaid is incredibly inconsistent across state lines: states set a ceiling (aka, how much income you’re allowed to earn before you’re no longer eligible for medicaid coverage) that is based on the federal poverty level. basically, the federal government sets what it determines to be an appropriate level of income at which an individual/family would considered in poverty if they were below it, and states basically set their medicaid guidelines for eligibility as a percentage of the FPL: in 2017, the state of oregon’s medicaid eligibility level was set at 138% of the FPL for a family of three, while texas set eligibility for a family of three at 18% of the FPL.
medicare is also an option.
medicare eligiblity is based on age (65 or older) and/or disability status. you can also be dual eligible for medicare and medicaid.
in short, don’t forget to sign up for your health insurance! as with last year, i’m always here to take questions anyone has about eligibility, requirements, plans and/or coverage differences, and general inquiries into the health care system’s disastrous current and future state.
#aca#obamacare#health care#piss off the screamy carrot and sign up for aca coverage#pls#i beg of you#not just to piss him off#but bc health insurance is important!#a lot of people are trying really hard to fix health care systems#so that costs are lower and more reasonable#and maybe insurance will never be eliminated but hopefully it will get more reasonable#until then you're really going to need it#like...the surgery i had earlier this year had a sitcker price of like 90k#an ER visit that only lasts two or three hours can still cost 25k#the system is broken and insurance actually really is there to help you#(i promise you insurance companies aren't actually evil#most of them are spending like 90 cents on ever dollar collected in premiums#to pay for coverage#i'm not fucking with you here#i know people like to think they're just sitting around cackling and figuring out how many people can die#before their bottom line is affected#but that's actually just...really not how it is#same re: hospitals#people don't go into this business without inherently wanting to help people#they inherited a broken system and only have so much room to work with for improvements)
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Why Do Republicans Oppose The Affordable Care Act
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Why Do Republicans Oppose The Affordable Care Act
Changes Required By The Affordable Care Act In 2014
Will Republicans be able to dismantle the Affordable Care Act?
Health insurance exchanges scheduled to open for 2014 enrollment begin writing policies that go into effect January 1, 2014.
People buying insurance on their own get subsidies to help them pay their monthly insurance premiums. Premiums are allocated on a sliding scale, as determined by income. Any individual earning over 400% of the poverty level does not qualify for subsidies.
When health insurance exchanges are operational, small business tax credits are up to 50% of premiums.
Insurance companies are required to provide health insurance to any adult aged 19 to 64 who applies for coverage.
To prevent people from waiting until they get sick to buy health insurance, the ACA requires all Americans to buy health insurance or pay a fine. The fine starts at $95 for an individual in 2014 and goes up each year until 2016, when the fine is $695 or 2.5% of a persons annual income, whichever is greater.
Pre-Existing Condition Insurance Plans , established in 2010 are scheduled to expire on January 1, 2014 once all major ACA reforms go into effect.
Rep Pete Stauber Of Minnesota
The freshman flipped a longtime Democratic seat;in northeast Minnesota that Trump had carried by 16 points in 2016. Its a largely white, working-class district, where Trumps populist appeal resonated. The former Duluth police officer ran a campaign ad last year about his son Issac, who has Down syndrome, and he talked about the importance of insurance companies covering pre-existing conditions. Democrats are not targeting this seat in 2020. Inside Elections rates the race Likely Republican.
Even Conservatives Call Aca Case ‘absurd’
This is just one of many absurdities that have caused even conservative legal experts like Jonathan Adler,;who backed previous challenges to the ACA, to call this case absurd. But the absurdity is the point.
The point has always been to deny Americans the health insurance that was secured for them when the ACA was signed into law. And Republicans have been remarkably successful at this.
How Dems can beat Trump on health:;Focus on high costs and economic security
Thanks to a 2012 Supreme Court ruling that made Medicaid expansion optional instead of required, 14 states have turned it down. This;has;left an estimated 2.5 Americans without coverage that these states pay for anyway.
As Medicaid expansion has proved popular even in red states, Republicans have adopted another poison pill in the form of bureaucratic requirements to prove that recipients are working. These burdens could leave up to;800,000 additional Americans uninsured, which would match the covered by Medicaid and the Children’s Health;Insurance Program;in 2018 alone.;
Also Check: When Did Republicans And Democrats Switch Platforms
What Did Trump Say About Obamacare
President Trump has been actively trying to repeal the healthcare law since he campaigned for the 2016 presidential election.
The Trump administration asked the Supreme Court to revoke Obamacare because it’s been an “unlawful failure.”
A brief filed in June asked the court to strike down the Affordable Care Act, arguing it became invalid after Congress axed parts of it.
Speaker Nancy Pelosi said: “President Trump and the Republicans campaign to rip away the protections and benefits of the Affordable Care Act in the middle of the coronavirus crisis is an act of unfathomable cruelty.
“If President Trump gets his way, 130 million Americans with pre-existing conditions will lose the ACAs lifesaving protections and 23 million Americans will lose their health coverage entirely.
“There is no legal justification and no moral excuse for the Trump Administrations disastrous efforts to take away Americans health care.”
Republicans also argue that some people are better off without Obamacare due to the fact that it does not cover those who need it most.
According to the provisions, people who earn just slightly too much to qualify for federal premium subsidies, particularly early retirees and people in their 50s and early 60s who are self-employed are not covered.
Trump endorsed a replacement to Obamacare in 2017 but fell short of passing the Republican-controlled Congress.
Democrats Must Try Harder To Cover People
The November elections, when Democrats won the House by the largest popular-vote margin in the history of American midterms, marked the first time Republicans paid a real cost for their efforts to suffocate the ACA.;And while Democrats are united in defense of the law, theyve never been as ruthless in the pursuit of covering Americans as Republicans are in their lust to uninsure them.
Michigans new governor, Gretchen Whitmer, has a chance to save about;70,000 people from the useless work requirements signed into law by her Republican predecessor.;Yet she hasnt acted. And the three states with the largest populations that could benefit from Medicaid expansion are also three of the nations key or emerging swing states Texas, Florida and Georgia.
A Harvard study of the Massachusetts law that served as the model for the ACA;found one life saved for each 830 people gaining insurance. This;means if Republicans in Congress had finished off the law they���ve;spent a decade vowing to kill, they would have put thousands of lives at risk.
But thats the genius of the GOPs focus on the courts. With an appointment that lasts a lifetime, you dont have to worry about the consequences of leaving 20 million uninsured. And if it works for the ACA, watch out. Medicare, Medicaid, Social Security and any program conservatives have long reviled but lacked the audacity to repeal could be next.
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Republican View On Healthcare
Republicans take pretty much the opposite view of Democrats. Traditionally dedicated to the notion that less government is better government, and the free market makes adjustments on its own without regulation, the party has fought every reform the Democrats have enacted. Much of this comes down to their traditional diametrically opposed notions of what is best for Americans. Citing freedom of choice and the sacrosanct doctor-patient relationship, predicting huge losses to the economy in general, arguing that the ACA doesnt work despite years of evidence to the contrary, the GOP would rather scrap it and go with the status quo as it stood before the ACA was passed. Their key phrase is Why should healthy people pay more to cover sick and poor people?
Looking to make a difference? Consider signing one of these sponsored petitions:*Rantt Media may receive compensation from the partners we feature on our site. However, this in no way affects our news coverage, analysis, or political 101’s.
Whats Dividing Republicans And Democrats On Healthcare Reform
Since the Affordable Care Act became law in 2010, Republicans have been determined to destroy it while Democrats insist its the countrys best chance at reforming healthcare to make it affordable and accessible. Both parties want reform, but the approach has been fundamentally different and for good reason. There are basic, core reasons why conservatives and liberals cant get on the same page when it comes to healthcare reform.;Lets take a moment to dig into the details and figure out what is exactly keeping Republicans and Democrats from being able to find a middle ground on healthcare reform, so far.
Democrats want the federal government to legislate and administer healthcare while Republicans want private industry to helm the healthcare system with as minimal input from the federal government as possible.
Of course, there are always exceptions within each party because people arent one-dimensional. Moderates on both sides, for instance, would seek compromise wherever possible. But in general, these core ideological differences make healthcare reform particularly challenging, especially when one party holds more power. In 2010, Democrats passed the ACA without a single rightwing vote.
Also Check: Do Any House Republicans Support Impeachment
House Republicans Vote To Sue Obama
Republicans in Washington insist they arent planning to impeach President Obama any time soonbut did just get one step closer to suing him.
Just before lawmakers go home for the five-week August recess, the Republican-controlled House of Representatives voted Wednesday evening to authorize Speaker John Boehner, R-Ohio, to file a lawsuit on behalf of the House of Representatives against the president for delaying implementation of the Affordable Care Act.
The vote was 225-201, with every Democrat voting against the lawsuit as well as five conservative Republicans who felt the suit didnt go far enough and preferred impeachment.
The lawsuit itself is expected to fail once it reaches the inside of a courtroom, but the politics of the impending lawsuit raged Wednesday and will continue to in the months leading up to the November midterm elections.
The partisan battle andand the talking pointsover the lawsuit was on full display during the debate on the House floor before the vote. Democrats variously called the lawsuit a political stunt, a gimmick, and a sorry spectacle of legislative malpractice intended to appease the conservative base of the Republican Party before the midterm elections in November.
Groups Opposing The American Health Care Act
The American Health Care Act: A Republican Response to The Affordable Care Act
Over 50 organizations oppose the proposed healthcare plan that will make Americans will pay more for less.;The list includes nurses, doctors, hospitals, teachers, churches, and more. You can see a few here:;
AARP: AARP opposes this legislation, as introduced, that would weaken Medicare, leaving the door open to a voucher program that shifts costs and risks to seniors.
Before people even reach retirement age, big insurance companies could be allowed to charge them an age tax that adds up to thousands of dollars more per year. Older Americans need affordable health care services and prescriptions. This plan goes in the opposite direction, increasing insurance premiums for older Americans and not doing anything to lower drug costs.
On top of the hefty premium increase for consumers, big drug companies and other special interests get a sweetheart deal.
Finally, Medicaid cuts could impact people of all ages and put at risk the health and safety of 17.4 million children and adults with disabilities and seniors by eliminating much-needed services that allow individuals to live independently in their homes and communities. Although no one believes the current health care system is perfect, this harmful legislation would make health care less secure and less affordable.
AARP stands ready to work with both parties on legislation that puts Americans first, not the special interests.
That just wont do.
That is, above all, why physicians must be involved in this debate.
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When Did Obamacare Start
The timeline of key events leading up to the passage of the Obamacare law began in 2009. Here is a list of those events, along with key provisions that went into place after the law was enacted.
Speaker of the House Nancy Pelosi and a group of Democrats from the House of Representatives reveal their plan for overhauling the health-care system. Its called H.R. 3962, the Affordable Health Care for America Act.
;Massachusetts Senator Ted Kennedy, a leading supporter of health-care reform, dies and puts the Senate Democrats 60-seat supermajority required to pass a piece of legislation at risk.
;Democrat Paul Kirk is appointed interim senator from Massachusetts, which temporarily restores the Democrats filibuster-proof 60th vote.
;In the House of Representatives, 219 Democrats and one Republican vote for the Affordable Health Care for America Act, and 39 Democrats and 176 Republicans vote against it.
In the Senate, 60 Democrats vote for the Senates version of the bill, called Americas Healthy Future Act, whose lead author is senator Max Baucus of California. Thirty-nine Republicans vote against the bill, and one Republican senator, Jim Bunning, does not vote.
Who Voted For Affordable Care Act
Question: Who voted for Affordable Care Act?
Answer: The Affordable Care Act was signed into law by President Obama;on March 23, 2010. ;Before becoming the law, there were 219 House of Representatives that voted in favor of the Affordable Care Act. ; Below is a complete list of House of Representatives that voted in favor of Affordable Care Act: ;There was not a single Republican representative that was in favor of the Affordable Care Act.
AR
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Democrats Republicans And Your Health Insurance
Shereen Lehman, MS, is a healthcare journalist and fact checker.;She has co-authored two books for the popular Dummies Series .
Healthcare reform has been a contentious political topic in the U.S. for many years, and is shaping up to play a major role in the 2020 presidential and congressional elections. What does each party want? Let’s take a look at how the priorities of the Democratic Party and the Republican Party;could impact your health insurance.
Republicans Really Hate Health Care
Theyve gone beyond cynicism to pathology.
By Paul Krugman
Opinion Columnist
Of all the political issues that divide us, health care is the one with the greatest impact on ordinary Americans lives. If Democrats hadnt managed to pass the Affordable Care Act, around 20 million fewer Americans would have health insurance than currently do. If Republican-controlled states hadnt refused to expand Medicaid and generally done as little as possible to support the act, national progress might have tracked progress in, say, California so another 7 or 8 million people might have coverage.
You obviously know where I stand on this political divide. But Im starting to believe that I misjudged Republican motives.
You see, I thought their behavior was cynical and strategic: They opposed Obamacare because they thought there was political mileage in scaring people about change, and also in denying Obama any successes. Oh, and their donors really hated the taxes on the rich that pay for the ACAs subsidies. And right up through 2016 they could hope to convince voters that they had a secret plan for something much better than Obamacare.
Indeed, all of these things surely played a role in GOP health care strategy. But at this point theyve clearly lost the political argument. In 2017, Republican attempts to repeal Obamacare made it clear to everyone that their party didnt have any better ideas, and never did; everything they proposed would have devastated the lives of millions.
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Attempts To Change Or Repeal
Read Ballotpedias fact check »
The Affordable Care Act was subject to a number of lawsuits challenging some of its provisions, such as the individual mandate and the requirement to cover contraception. Four of these lawsuits were heard by the United States Supreme Court, resulting in changes to the law and how it was enforced. In addition, since the laws enactment, lawmakers in Congress have introduced and considered legislation to modify or repeal parts or all of the Affordable Care Act. Finally, between 2010 and 2012, voters in eight states considered ballot measures related to the law. This section summarizes the lawsuits, legislation, and state ballot measures that attempted to change, repeal, or impact enforcement of parts of the law.
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A Conundrum: Majority Of Republican Voters Want To Overturn Aca But Keep Protections For People With Pre
The latest KFF Health Tracking Poll revealed a stark contrast in opinion on two questions about the current challenge to the Affordable Care Act facing the U.S. Supreme Court. Since it was enacted in 2010 by President Obama, the ACA, sometimes known as Obamacare, has been opposed by Republicans and favored by Democrats, but many of the benefits it provides are popular across parties. One of the most popular provisions of the law is that it protects people with pre-existing medical conditions from being denied coverage or having to pay more for coverage. A large majority of voters, across political party identification, say they do not want the Court to overturn the ACAs protections for people with pre-existing conditions, but there are strong partisan differences on attitudes towards overturning the entire ACA. Two-thirds of Republican voters say they do not want the ACAs protections for people with pre-existing conditions to be overturned, while three-quarters of Republican voters say they do want to see the ACA itself overturned.
Figure 1: Majorities Do Not Want Court To Overturn ACAs Pre-Existing Condition Protections, Republicans Want Entire Law Overturned
Figure 2: About Half Of Republican Voters Want To See The Supreme Court Overturn The Entire ACA, Not Protections For Pre-Existing Conditions
Figure 3: Republican Voters Say President Trump Has A Plan To Protect People With Pre-Existing Conditions
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Changes Required By The Affordable Care Act In 2011
A provision goes into effect to protect patients choice of doctors. Specifics include allowing plan members to pick any participating primary care provider, prohibiting insurers from requiring prior authorization before a woman sees an obstetrician/gynecologist , and ensuring access to emergency care.
Young adults can stay on their parents insurance until age 26, even if they are not full-time students. This extension applies to all new plans.
All new health insurance policies must cover preventive care and pay a portion of all preventive care visits.
A provision goes into effect that eliminates lifetime limits on coverage for members.
Annual limits or maximum payouts by a health insurance company are now restricted by the ACA.
The ACA prohibits rescission when a claim is filed, except in the case of fraud or misrepresentation by the consumer.
Insurance companies must now provide a process for customers to make an appeal if there is a problem with their coverage. ;
NOTE: In January,;2011:;eHealth publishes 11 guides on the top;child-only health insurance coverage;that examined differences in implementation in numerous states.
Obama And Trump Healthcare Policies Compared
Senate Republicans Come Out To Oppose Healthcare Bill
There could not be a more radical divide between administrations than there is between these two. The Obama administration worked against almost insurmountable opposition from the GOP in order to pass the ACA. The Trump Administrations quest is to dismantle everything the Obama Administration has done. They even have court cases pending in order to do so.
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To Heal
And just like that, Joe Biden is president.
For all of the talk about “transition”, the moment he was sworn in, at long, precarious last, was everything. It made the election concrete, if not entirely in the eyes of enough Americans something set in stone.
Still, Biden’s journey from local Delaware politician to the Oval Office took him almost fifty years, an era that with the benefit of time and distance will be known both for its advances in technology and social equality as well as its exponentially widening imbalances of wealth and power. Biden’s career has covered the length of it, and, for better or worse, he will now be remembered as one of its central figures.
It wasn’t always so obvious that he would be. Looking back just to the end of the 20th century, he was entirely forgettable, a senator who had done little that anyone noticed, and what they did did little to impress. His best work, in that it achieved results, was done behind the scenes, working the backrooms and corridors of the Senate and House to get things done.
In that way, Joe Biden most resembles Lyndon Johnson when he served Texas in the House and then the Senate. Johnson, too, served as Vice President to a young and green president who, like Barack Obama, had only served part of his first term in the Senate before winning the presidency.
Johnson had a notoriously bad relationship with Kennedy, but his relationships in Congress helped Kennedy and then himself in getting civil rights legislation passed despite resistance from its racist members. However, those close, chummy relationships also hampered him in pushing that legislation as far as it needed, and still needs, to go.
When we look at the 1960s, we tend to think of the Space Age and going to the moon as the big, presidential achievements, downplaying things like civil rights, Medicare, and Medicaid, and that’s understandable. It was the peak of the Cold War, and money was spent where it would hurt our adversaries the most.
As much fun as it may have been to beat the Soviets to the moon - and creating technology that shapes our lives today - this also had the effect of spending billions of dollars and tens of thousands of American lives (not to mention millions of Southeast Asian lives) in a catastrophic war in and around Vietnam.
Still, in those two things we were united as never before, excited and then indifferent as we followed the space program, and blindly patriotic and then angrily disillusioned as we followed Johnson’s war.
It wasn’t really his war, though. It was Eisenhower and Kennedy’s before him and Nixon’s after, and each of them had bipartisan support throughout, men and women elected to represent the best interest of their constituents. They all failed.
So, unity is important, and at a time such as this we should grateful to have a president putting that ideal out front as the core goal of his first, and possibly only, four years, but despite President Biden’s clear desire for us to come together and achieve, as he called it in his inaugural speech, “the most elusive of all things in a democracy”, unity as an end cannot be allowed to justify the means it takes to get there, not when the easiest way is simply to forget what has divided us so bitterly and so dangerously.
We would do better to heed these words from his previous speech, the one he as President-Elect gave just the night before: “To heal, we must remember. It’s hard sometimes to remember, but that’s how we heal.”
For us to remember what was done in the past four years and in the decades that led us to the riot on January 6th, we must not fear embarrassing those responsible or hurting the feelings of those with the power to stand in the way of remembering, not if our goal truly is to heal.
We must feel free to talk about it. We must feel free to call out those who seek to bury the past and their own accountability with it. We must feel free to challenge them when they, with the same depraved indifference that has led us to the public health and economic crises we now face, seek to keep us on the same path that led us here.
That’s the trouble with President Biden’s calls for “unity”. If he and his Democratic allies in Congress are the only ones actually willing to compromise, which was the case during the Obama administration, not only will he not be able to achieve more than getting us only partially back to where we were before Trump, he will not be able to prevent even worse from being done once he, too, is gone.
Biden will surely be tempted to restore America to what is was, perhaps even to that ideal of the “American Experiment”, and consider that a success. Congressional Republicans, however, will be looking to hold onto what they gained for themselves and their benefactors in the past four years, all of it, and will do everything in their reduced power to stand in Biden’s way.
It’s only been a day, but Trump’s minions have shown every intention of continuing on as they have been. In Congress, Republicans have already shown signs that they have every intention of using the same playbook against Biden that they used against Obama. Already, cabinet nominations are being blocked by Republicans hoping to gain leverage, and any notion of power sharing in the split Senate comes only with higher and higher price tags the longer negotiations drag on.
Make no mistake, now-former Senate Majority Leader Mitch McConnell’s seeming repudiation of Donald Trump and his Capitol-attacking goon squad is not a sign of seeing the light and salvation of Unity. Rather, it signals something more significant: Donald Trump has served his purpose and now, in McConnell’s eyes, may be disposed of.
That’s who Mitch McConnell is. That is how he thinks. He uses people then throws them away. That, in his eyes, is what they’re for. That’s how he sees the world. He believes, or wants to believe, that we all think that same way, too.
This is the part of the right wing that strivers like Donald Trump never really understand, and that in no small way is why they all end the way they do. That Trump was popular and influential made him useful; now that Trump is neither, just a has-been, wannabe autocrat facing lawsuits and criminal charges, he’s a liability, useful only for one thing and that is being seen to be ostracized.
Odds are, McConnell stopped taking Trump’s calls weeks ago. He would have done well in Hollywood. Like Hollywood, Washington only ever changes when faced with scandal, and those brought down are only ever the ones who can no longer deliver profits. Its stars rise and fall in the same way. It’s the money they can make for you that counts.
McConnell has succeeded in politics because the culture of our politics rewards that same way of thinking. He is ruthless and calculating, which you and I may hate but which many in Washington and in his party in particular love.
That said, it can be defeated. Well, it can be mitigated. It won’t go away entirely. It will always be part of us. That, however, does mean we cannot teach ourselves the necessary lessons that will save us now and help us avoid repeating the same mistakes and falling into the same patterns that have led us so close to disaster.
For us heal, our health as a people and as a democracy cannot and must not be measured by our ability, pushed by so many Congressional Republicans in the past two weeks, simply to set what went wrong behind us and “move on”. We cannot allow that to be enough. If we merely close and bandage our wounds, so to speak, and attempt to move on, those wounds will fester and the infection will continue to spread.
If it seems wrong to compare all of this to a disease in the middle of a pandemic, it isn’t. The misinformation, divisiveness, and violence that were exploited on January 6th spread virally, yes? Politicians and business leaders have been profiting from that viral spread for years, yes?
We must think of this in those terms, so that we may recognize and understand what it was that has harmed us and, at its worst, threatened our survival. It still does, both literally and figuratively. What we learn we may spread the same way, though for less profit. Those lessons will be like cultural antibodies that, if we succeed, we may pass down to protect future generations.
If, then, we follow President-Elect Biden’s advice to remember and we resist attempts by McConnell and others to move on in order to forget, we stand a chance. That means calling these “dead-ender” attempts out for what they are and challenging them openly. If not, they will persist. Allowed to persist, they will thrive.
Take, for example, Georgia Representative Madison Cawthorn. At the tender age of 25, he has the name, good looks, and story of overcoming adversity to go far in national politics. He is also just as much of a craven, self-serving racist as the now-former president he vocally supported on January 6th, both before and after the riot.
Cawthorn essentially ran on a platform of protecting America’s White identity, its “heritage”, and was made to apologize for at least one openly racist ad during his campaign. He was, before and after that day, a proud supporter of those very same radicalized and delusional rioters who violently forced their way into the Capitol waving Confederate and Nazi flags in the name of saving…the country that fought and defeated them both.
Yesterday, Cawthorn signed a letter with other incoming Republican representatives pledging to work with President Biden to achieve common goals and, through them, build unity. Given Cawthorn’s ongoing support of white supremacists and the violence of January 6th, how can anyone trust that?
During the Obama administration, McConnell and his House allies would condemn Democrats’ refusal to submit to their demands as a refusal to compromise. To them, that’s what “compromise” meant: submission by the other side.
It meant the same to them during George W. Bush’s administration and during Newt Gingrich’s run in Congress during the late 90s. That is what is will surely mean to Republicans in Congress now, and that surely include Cawthorn and those who share his “exceptional” world view.
To the right wing, “unity” is when all others submit. “Peace” is when all others submit. For them to compromise and commit to the peaceful sharing and exercise of power is an affront to the world they want to live in. They won’t do that. They just won’t, not willingly, not without Biden and the Democrats openly and fearlessly calling them out on it.
It can’t be enough to joke about it, as late night hosts and sketch shows did during the Bush years and early on in Trump’s. It can’t be enough to credulously accept lies and distractions, as network and print journalists did for so very, very long before Trump declared open warfare on them. It can’t be enough to rely on “the art of the possible” as an excuse for falling short. Again.
As trite as it sounds, healing does take time. In this case, that will be because it is our culture needs to change. The way we see some people as disposable needs to change. The way we accept less from those in power needs to change. And by “change”, we should mean, “stop”.
Our memory of these times will be essential to creating that change, the change that truly enables us to heal. Memories are a lot like antibodies. They are the basis of the stories we tell, the foundation of the worlds we build. Their strength and effectiveness at keeping us healthy and alive depends on how strongly and effectively we hold onto those memories of why we succeeded and, more importantly, why we failed. To forget is failure.
Never forget.
- Daniel Ward
#memory#never forget#immune response#cultural antibodies#politics#president joe biden#vice president kamala harris#congress#republicans#corruption#mitch mcconnell#paul ryan#george w. bush#donald trump#racism#january 6th#power#white power#madison cawthorn#long read
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What is at stake when the US Supreme Court takes on Obamacare?
On November 10, the Supreme Court of the United States will hear a new case against the Affordable Care Act (ACA), the signature legislation of Barack Obama’s two-term presidency.
It will be heard by a court that is more conservative than Americans have known for generations, with its newest judge Amy Coney Barrett rushed into a vacant seat just days before the divisive presidential election. This tipped the balance of the already conservative-leaning nine-member court to a much more weighted 6-3 split in their favour.
The case, California v Texas, which deals with the constitutionality of the 2010 ACA (commonly known as “Obamacare”), is the latest salvo against a complex, intricate law that is loved, hated and misunderstood in the US, and that touches the lives of almost everyone in it.
The hearing comes just in the wake of Donald Trump losing the presidential election – even as he refuses to concede – while nearly a quarter of a million people have died from COVID-19, and as millions of American citizens have lost their jobs and their health coverage.
A 2018 group portrait of the justices of the US Supreme Court, including the now-late Ruth Bader Ginsburg who passed away in September 2020. Amy Coney Barrett was confirmed as her replacement in October, bolstering the conservatives on the bench [File: AP]
Healthcare in the US: A short history
Since the second world war, most Americans have known that good health insurance is tied to a good job.
But in the 1960s, two government options were created by the Lyndon Johnson administration: For Americans over 65, there was Medicare, a programme that has long been popular and difficult to cut due to its wide bi-partisan reach (everyone gets old).
And for the poor, there was Medicaid, which is administered individually by states, resulting in wide variations in who is eligible. In some states, for example, children were only covered by Medicaid if their parents earned less than half of what would put a family of three on the federal poverty line (approximately $9,000 a year at the time), while in other states, with more progressive policies, children would be covered if their family’s income was $55,000 for a family of three.
Despite these limited government options, health insurance was understood as a private enterprise, and across the insurance market, plans were shaped by the demands of hospital networks and providers.
In a photo from 2012, a woman opposed to healthcare reform, rallies in front of the Supreme Court in Washington [File: AP]
By the 2000s most insured Americans were covered by a private healthcare plan they chose through their workplace. In 2008, a family would, on average, pay $12,300 per year just to own a plan through their workplace, with additional co-payments for services, medicines, and therapies on top of that. That average premium also varied widely between states.
For those who wanted something else, or for the wealthy, self-funded private medical plans were available. In 2009, someone buying individual non-employer health insurance would pay about $3,600, or $7,000 if it also covered their family, but pay much higher deductibles for medical services. Many of these plans were not as comprehensive as employer-backed options.
For most insured people (59 percent of employee plans and nearly 90 percent of individual plans) there were lifetime caps on how much total coverage a provider would pay for. After that cap – sometimes one or two million dollars – was reached, insurers would stop covering, even if the treatment continued.
Hitting such a maximum might seem unlikely, but for someone receiving specialised treatments, or managing the care of a very sick premature baby, those costs could be exceeded within a few years or less, and the patient would be left to cover the remaining costs. A long-term stay in the ICU could leave a family in financial ruin.
Insurance companies considered future health complications liabilities, and charged higher costs or did not sell policies to people with so-called pre-existing conditions, affecting more than 100 million Americans in 2010. A pre-existing condition could be asthma, a family tendency towards high blood pressure, or a likelihood the patient would develop cancer.
Women are statistically more likely to develop diabetes and cancer than men and were disproportionately uninsured, in part due to the pre-existing conditions loophole. In 2010, 20 percent of women aged 18 to 65 did not own health insurance.
In a 2017 photo, a man walks by a healthcare insurance office in Florida [File: AP]
Black and Hispanic Americans were also insured at lower rates. In 2010, 13 percent of white working-age Americans, 20 percent of Black Americans and 33 percent of Hispanic Americans were uninsured. Among those who did have a plan, higher numbers of Black and Hispanic Americans were receiving Medicaid, which often delivered lower-quality care options. People of colour in the US are more likely to live in low-income families without access to an employer-sponsored option, and most private plans were out of reach. As a result of this lack of health insurance – along with other barriers to care – these groups are also less likely to receive preventive care, diminishing overall health outcomes.
For the uninsured patient walking into a clinic, price vertigo could quickly strike. With most doctors and nurses unable to tell a patient how much the eventual cost of a medical service would be, they would have to decide whether to receive treatment before knowing if they could afford it.
Typically for an insured patient, a medical provider would submit documentation of a medical service – a physical exam, a blood test, an MRI, for example. The insurance company negotiates reimbursement with the health network and the patient gets the bill after treatment has been delivered. Depending on how much their plan covers, the patient may pay a portion.
Meanwhile, medical interventions in the US have become more state-of-the-art, more expensive, and more common.
By the early 2000s, health spending accounted for roughly one-sixth of the US economy, the largest share in the world, but only about 85 percent of Americans had health insurance. Many of the millions of families left out were an injury or illness away from dire financial consequences.
The cost of care
Marleny, who prefers that Al Jazeera use only her first name, was one of the millions of uninsured. She lives in Framingham, Massachusetts, and is a single mother of 9-year-old twin girls and a 20-year-old daughter. She is an immigrant from Guatemala and used to live in California, where she had a basic insurance plan sponsored by her employer while she was pregnant. In addition to her premium, she paid $30 for a doctor’s visit and $500 for each birth.
When she moved to the Boston area in the cold winter of 2014, all of her daughters fell ill with bronchitis. She was scared to take them to the hospital.
“I waited a week to take them to the hospital. My daughters had a lot of fever and coughing, and I noted they were losing weight. My mother said, ‘You need to take them’,” Marleny explained in a phone interview.
The family of four was living in a single rented room and their car had not yet arrived from the west coast. But with her daughters’ conditions worsening, Marleny knew she had to do something. She borrowed a car from someone she knew, packed the twins, then two years old, and her older daughter into it and drove.
There were two things Marleny did not know when she walked into the Emergency Room at Metrowest Medical Center: that Massachusetts did have some state coverage plans available for low-income people, and that the first provisions of the ACA were just coming into effect. She thought of walking back out into the cold.
“I was scared that I might get a high bill. I told them I don’t have health insurance here, and I don’t know how much this will be.”
Her story mirrored others playing out in ERs across the US. She would soon discover that a reform bitterly fought on the national level was at that moment becoming available. Too concerned about her girls’ health to leave, she decided to stay.
In a photo from 2017, protesters gather across from Trump Tower to rally against the repeal of the Affordable Care Act in Chicago [File: AP]
Attempts at health reform
During his term, President Bill Clinton tried to reform the healthcare system – but failed.
Then, in 2006, Republican (then-governor) Mitt Romney succeeded in delivering Massachusetts, a wealthy liberal-leaning state, a form of universal coverage in which everyone was obligated to buy insurance. State-funded options were available to those making up to 300 percent of the figure that would put someone on the federal poverty line, and at-cost individual plans were regulated and sold in streamlined marketplaces. The reform was seen as radical as until that point no state had passed a plan compelling people to buy health insurance.
When Obama debated John McCain on national television ahead of the election in 2008, he said healthcare spending was a burden on the American people and vowed to tackle it. At the time, millions were out of work and hence health insurance, due to the “Great Recession”. McCain said he would solve the problem by sending a $5,000 tax credit to the average family, which they could use to pay for health costs (at that point, the average yearly premium for a family was more than $10,000). McCain said Obama’s plan would be so limiting that it would leave “Joe the plumber”, a made-up potential user, without any plan at all.
Obama was swept into the White House with a strong mandate, and his team set out to invest their political capital directly in the divisive issue.
“Both the politics and the substance of health care were mind-numbingly complicated,” the former president writes in his new memoir, excerpted by the New Yorker on October 26, 2020. “When I think back to those early conversations, it’s hard to deny my overconfidence,” he recalled.
In a March 23, 2010 photo, President Barack Obama signs the Affordable Care Act in the East Room of the White House in Washington [File: AP]
Democratic lawmakers drafted a 900-page bill containing hundreds of provisions. They hosted dozens of bipartisan meetings and held hours of public hearings with 200 witnesses. Senators from the Finance Committee grilled representatives from the health insurance industry, conservative think-tanks, interest groups for retired Americans and state regulators.
“A single provision tucked inside the bill could translate to billions of dollars in gains or losses for some sector of the health-care industry,” Obama reflected. It was early 2010 and the White House, the House of Representatives, and Senate were all controlled by Democrats. When it was clear that no Republican would support any law that reformed the health sector, the politicians pushed it through in a rare late-night holiday vote on December 24.
Obamacare’s bold approach
The ACA’s bold idea was to get more healthy Americans to own health insurance. This, the administration believed, would put more money into the insurance market and lower costs for everyone. The authors did it by introducing the “individual mandate”, a penalty for those who stayed uninsured, administered by Congress. Anyone who did not purchase a private plan would have to pay a fee to the Internal Revenue Service. Critics raged that the federal government was forcing them to buy something they did not want.
The ACA then clamped down on insurers by making them offer better individual plans for those without employer-sponsored options. It stopped the pre-existing condition loophole. It required insurers to include basic essentials such as emergency services, pregnancy and maternal care, and substance abuse treatment, many of which had been out-of-pocket extras before.
The law required these new individual plans to be sold in transparent marketplaces run by states, which would only offer plans that were vetted. Separately, the law dramatically expanded the free health coverage programmes for the poor and the elderly – Medicaid and Medicare – which had always missed millions who did not qualify according to their state’s criteria.
Lastly, the law invested billions in research for innovations to improve how health is paid for, and quality of delivery.
Don Berwick, a Harvard-educated paediatrician, had studied the quality of care for 30 years when he was appointed by Obama to lead this particular expansion in 2010.
“I told my staff three questions for any proposal: How would this improve care? How would this improve people in dire straights? How would this help reduce costs overall?” he told Al Jazeera.
In a 2012 photo, Republican Mitt Romney spoke about the Supreme Court’s healthcare ruling in Washington [File: AP]
Berwick developed plans to expand the free services and prepare the state marketplaces for launch, before resigning 18 months later due to his recess appointment. He had been criticised by Republicans after saying Britain’s NHS, a government-paid system, could be an example for the US. Opponents, like the Republican senator from Wyoming, said his approach would ration care. Dr Berwick vigorously refuted that accusation. Berwick, who has long argued for healthcare delivery to be a government responsibility, is now president emeritus of the Institute for Healthcare Improvement.
“We don’t have evidence that market forces yield improvements that we’re after. Market induces competition instead of cooperation … The market system will not encourage [knowledge sharing] … Market systems tend to lead to behaviours that favour providing services to people with more money and not people with less money. We need exactly the opposite approach,” he told Al Jazeera.
Republican lawmakers and judges took aim at the ACA from multiple angles and, in 2012, Obamacare was challenged in the Supreme Court. The National Federation for Independent Businesses (NFIB) and 26 states argued the ACA forced small business owners to buy insurance for their employees, hurting the businesses. The court did not agree, but it did transform the ACA by declaring the individual mandate was a tax, not a fine. The change was subtle but would open an opportunity for that tax to be reduced by Congress.
The justices also ruled that the decision to expand Medicaid would be left to individual states. A dozen mostly southern states immediately stopped the expansion, leaving millions without promised insurance options. The NFIB said the “constitution has been undone”.
After more than three years of preparation, the ACA became active in 2014.
More than just crisis care
Sitting in the emergency room that January, Marleny knew her girls were too sick to leave untreated. A member of the staff told her not to worry, there were plans for her. One of the new advantages of the ACA was same-day enrollment, shrinking a process that had previously taken up to 45 days. The girls were prescribed antibiotics and sent home. Her family would need emergency services several more times that winter, but Marleny was now covered, as were her daughters.
She started to think of healthcare as more than something for a crisis. Marleny began visiting her own doctor regularly, going for mammograms and other preventive services, which were free.
“Thank God we have this programme,” she said. “If not, I don’t know what we are going to do. A lot of families like mine don’t have the money to pay for health insurance.”
Marleny is not unemployed. She works as an administrative assistant at an NGO that provides housing help to people in Massachusetts, making about $2,500 each month. She says her employer-provided plan costs $600 a month for the premiums alone, too expensive for her to afford. Her income, near the poverty line, makes her eligible for the subsidised plans Don Berwick helped expand. Her ACA-insurance costs just $45 per month; a visit to the doctor costs $18, medicine for the children costs her a few dollars.
A woman in Florida holds a sign in support of Obamacare in October 2020, ahead of the US election [AP]
Marleny’s insurance is available because Massachusetts receives federal money for people in her situation. Health Care for All, an NGO in the state, helps her navigate the process. For many years Hannah Frigand, the NGO’s director of education and enrollment services, received phone calls from people eager or desperate to secure a coverage plan.
“We hit a peak when the ACA was implemented,” she told Al Jazeera. Calls nearly doubled as the law was passed, and again when it was implemented four years later. Thousands of people had been waiting for better coverage.
Trump and the case against Obamacare
Donald Trump criticised the ACA in his very first speech as a candidate, calling Obamacare “a disaster”. He claimed, citing anecdotes, that patients would lose their health coverage, doctors would quit, and the health consumer would be stuck with ballooning payments. When he spoke in 2015, about 17 million new working-age Americans were insured who previously had not been before the law. The average family premium for employer-sponsored insurance had indeed gone up, as it had every year before and continues to today, but the cost of individual plans was falling. In his first day as president, Trump issued a broad executive order for government agencies to scale back as many parts of the ACA they could.
With control of both Houses of Congress in 2017, Republican lawmakers pushed forward bills to repeal and replace Obamacare. Their “skinny” version lowered the individual mandate to zero dollars, leaving the rule with no penalty. But their replacement preserved much of the ACA’s popular parts like coverage for pre-existing conditions, for children up to 26 years old under their parents’ plans, and the expansion of Medicare.
In an after-midnight vote on July 28, 2017, Republican Senator John McCain, who had been facing months of aggressive criticism from President Trump and who had just been diagnosed with a brain tumour that would take his life a year later, walked to the podium and held his thumb down for the cameras to see. The ACA would continue.
In a July 2017 photo, now-late Republican Senator John McCain looks on during a press conference about his resistance to the so-called “Skinny Repeal” of the ACA [File: Reuters]
Nisha Kurani studies the law and its effects at the Kaiser Family Fund (KFF), an organisation that tracks the medical insurance industries. In a phone interview, she said the loss of the individual mandate has, paradoxically, not had the impact many feared.
“Early on there were concerns that the market would destabilise. But that hasn’t happened. Premiums in the past years have gone down. Healthy people have not left the market as was predicted. And the financial health of insurers has dramatically improved since the early years of the ACA. We’ve seen that the marketplace has stabilised.”
At the start of the Trump presidency, 20 million new Americans were insured by the expanded programmes. The gap between uninsured Black and white Americans fell by four percent, and that between uninsured Hispanic and white Americans fell by over nine percent. The number of uninsured women halved in two years.
The White House under Trump pushed for many parts of the ACA to be undone. Obamacare blocked a type of short-term insurance option sold across states that had often driven consumers into medical debt: The user would buy one, undergo a treatment, and find it was not actually covered. The ACA limited these plans to 30 days, the Trump administration extended that to a full year with the option of renewal.
Watchdog organisations have documented how the websites for state marketplaces have been closed for hours or days during enrollment periods, due to “maintenance”, preventing people from finding health plans. Funding for public messaging about health insurance has been reduced. States have seen their waivers for innovation programmes cut. Some states have imposed work requirements for Medicaid, demanding that people who receive the subsidised coverage for the poor prove that they are employed, even though studies have shown that most on the programme already are working or have a good reason such as disability not to.
In one stirring example, money intended for medical research and other services was moved by the White House’s Health and Human Services director to pay for the detention of migrant children. These cuts have made a difference: the uninsured rate has been growing slowly since its 2016 low, creeping up by a few million people.
Democratic Senator Chris Coons spoke during the Supreme Court confirmation hearing for Amy Coney Barrett in Washington in October, ahead of the US election and court hearing on the ACA [AP]
The new challenge
This Tuesday, November 10, the ACA will again be challenged at the Supreme Court.
Texas, 18 other – traditionally Republican-led – states, two individuals and the White House say the whole law must be thrown out because the individual mandate is zero, “a law that does nothing”, the case says. The justices will first decide whether the two sides have what is called “standing”, they will ask whether the individual business owners have been injured by the ACA. It will be a difficult argument, as there is no penalty for not buying insurance. If the plaintiffs do not have standing, the case will be rejected.
The justices will then decide whether the ACA would have been written and passed had it been known at the time that the individual mandate would be unconstitutional. If the answer is yes, the individual mandate could be sliced off the law, or severed, leaving the rest intact. The court could rule that both the individual mandate and the protections for pre-existing conditions are unlawful, but leave states to decide which subsidies and other parts to preserve.
If the court agrees with the federal decision made in Texas and strikes down the law, the impact would be profound. It is estimated that 23 million people could lose their health coverage (20 million who gained it plus another 3 million who have had to find new plans since the start of the pandemic). States that have taken full advantage of the subsidies of the ACA would lose those funds in their budgets. Massachusetts may have to cut programmes that prevent Marleny from worrying whether rent, food or health costs come first.
“Pulling away the ACA would be, I think, a disaster for millions of people in this country,” Berwick told Al Jazeera. “They would be left high and dry, angry, their costs would soar … it’s hard to imagine the ACA being pulled away at this point without severe dislocations.”
President Donald Trump with Amy Coney Barrett, who was confirmed to be a Supreme Court justice in October 2020 [AP]
All eyes are now on Amy Coney Barrett, the newest justice. She was clerk to the court’s most famous recent conservative justice, Antonin Scalia, who dissented both previous healthcare rulings. Justices are not often public speakers, so Barrett’s verbal record has been combed over looking for clues as to how she could rule. She has said she supported the dissent in a previous case against the ACA – but as a law professor, not a judge.
In her confirmation hearings, she said the Supreme Court tends to rule in favour of severability, keeping most of a law if a part can be chopped off. Whether or not California v Texas prevails, this is unlikely to be the final case to challenge the ACA.
In 2020, the Affordable Care Act is still (mostly) law, and it is as popular as it is divisive. Most Americans want the whole ACA to stand, though most Republicans want to see it repealed. More than 90 percent of Democrats and two-thirds of Republicans do not want to see protections for pre-existing conditions disappear. Critics like the Cato Institute and Heritage Foundation write that the law is too expensive for both the government and for beneficiaries, and too limiting for the American consumer.
Under the ACA, more people are insured. Costs for individual insurance buyers have fallen, but costs for insurance through work have grown. Expanded Medicaid services are credited with saving tens of thousands of lives, protecting essential workers during the pandemic, and even slowing eviction rates in high-enrollment areas (one study suggested that low-income users were less frequently forced to choose between paying rent and paying for health costs).
The US is a country that has incredible health resources, but mixed outcomes. Measured against comparable nations, the US has better outcomes for its cancer patients and worse outcomes for maternal mortality, according to Kurani at KFF. Healthcare is a work in progress.
Berwick advocates taking a long view.
“If we can take a breath as a country and depoliticise this, there’s a lot to be learned. ACA is not a perfect law. It has many elements that could be better.
“I think the ACA, even as weakened now, can and should survive … Then we have to remember – it still left 30 million uninsured, so there’s work yet to do.”
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