THE HUMAN COST OF GOP TAX CUTS FOR THE RICH: 28,600 People Annually Could Could Needlessly Die, Says The Annals Of Internal Medicine — And, They Won’t All Be Democrats!

https://www.buzzfeed.com/danvergano/senate-healthcare-bill-might-mean-28600-more-deaths-a-year?utm_term=.bl8NwB9xV#.erwRnXJ9d

Dan Vergano reports on BuzzFeed:

“About 28,600 more people could die every year in the US, if a proposed Senate health care bill becomes law, suggests a review of medical studies released on Monday.

“Being uninsured can be lethal,” review author Steffie Woolhandler of City University of New York told BuzzFeed News.

Congress is in the middle of efforts to pass a Republican health care plan. The House has already passed its own version of health care legislation, while the Senate released its own draft Senate bill last week and unveiled an updated version earlier today. The Congressional Budget Office released an analysis late Monday finding the Senate bill would save $321 billion over the next decade at a cost of 22 million more uninsured people than under Obamacare by 2026.

“A little negotiation, but it’s going to be very good,” President Trump said of the bill on Thursday, when it was first unveiled.

Whether removing all those people from medical coverage, and cutting their access to preventive care for diseases such as diabetes, high blood pressure or cancer, would actually lead to more deaths has emerged as a point of contention in debate over repealing Obamacare, which has enrolled about 20 million people in health insurance and Medicaid plans since 2010.

In reality, people without health insurance face odds ranging from 3% to 29% higher of dying prematurely compared to someone who has health insurance, concludes the Annals Of Internal Medicine review. Taking the midpoint of those odds as a benchmark, Woolhandler suggested that about 1,300 people a year die prematurely every year in the US for every one million people who lose health insurance.

Obamacare, which added about 20 million people to the ranks of the insured, likely preserved lives at that same rate, she said.

. . . . .

Worth noting, the American College of Physicians, which publishes the journal that released the review, has opposed Republican efforts to repeal Obamacare, joining the American Medical Association and the National Association of Medicaid Directors, among medical groups criticizing the Senate’s draft bill. Woolhandler and Himmelstein served as unpaid advisors to Sen. Bernie Sanders’ presidential campaign and founded a doctor’s organization that advocates for universal health care.”

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Meanwhile, back at the ranch, the CBO predicts that an additional 22 million individuals would lose coverage under the GOP’s Senate Bill:

“Senate Republicans’ bill to erase major parts of the Affordable Care Act would cause an estimated 22 million more Americans to be uninsured in the coming decade — roughly a million fewer than similar legislation recently passed by the House, according to the Congressional Budget Office.

The forecast issued Monday by Congress’s nonpartisan budget scorekeepers also estimates that the Senate measure, drafted in secret mainly by Majority Leader Mitch McConnell and aides, would reduce federal spending by $321 billion by 2026 — compared with $119 billion for the House’s version.

The CBO’s analysis has been awaited as a crucial piece of evidence as McConnell (Ky.) and other Republican leaders try to hurry a vote on the bill this week. But they are navigating an expanding minefield of resistance from their own party’s moderate and conservative wings, while Democrats are united against it.

The additional deficit savings gives those leaders plenty of room to add more spending to win votes from skeptical moderate Republicans like Sens. Dean Heller (Nev.), Rob Portman (Ohio) and Bill Cassidy (La.), who want more money and a dedicated fund to help treat opioid abuse. Senate budget rules require that the final legislation save at least $133 billion, more than was saved in the House bill, giving senators $188 billion to make the bill more palatable.

Any extra spending risks alienating conservatives, however, and could threaten a delicate balance McConnell must strike to win votes from at least 50 of the 52 Senate Republicans. And some moderates have said they will decide whether they can support the Better Care Reconciliation Act based on how it will affect Americans who have gained coverage under the ACA during the past few years.”

Read the entire report by Amy Goldstein and Kelsey Snell in the Washington Post here:

https://www.washingtonpost.com/national/health-science/imminent-cbo-report-could-prove-pivotal-for-senate-republicans-health-care-bill/2017/06/26/cb8d61e2-59f7-11e7-a9f6-7c3296387341_story.html?hpid=hp_rhp-top-table-main_cbosenate-12pm:homepage/story&utm_term=.9f84cd94af4c

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When the Grim Reaper shows up, a GOP party card and a Trump “Make America Great” hat won’t do any good. You’ll have to go so that Trump, McConnell, Ryan, and their “fat cat” buddies can live “higher on the hog.”

PWS

06-26-17

 

 

 

 

“TRUMP(Hell no, we don’t)CARE” Likely Would Destroy Health Insurance Market, According To Experts — Trump GOP’s “War On America & Americans” Shifts Into High Gear!

https://www.washingtonpost.com/news/wonk/wp/2017/06/23/republicans-say-the-health-insurance-market-is-in-a-death-spiral-their-bill-could-make-it-really-happen/?hpid=hp_regional-hp-cards_rhp-card-business%3Ahomepage%2Fcard&utm_term=.e61d8234b1ca

Kim Soffen writes in the Wonkblog columns in the Washington Post:

“Senate Republican leaders unveiled their health-care bill Thursday morning, after weeks of crafting it behind closed doors. The bill keeps some popular parts of the Affordable Care Act, such as the provision preventing insurance companies from charging people more or denying them coverage based on pre-existing conditions, and eliminates some unpopular parts, such as the individual mandate which requires people to buy insurance or pay a penalty.

[What the Senate bill changes about Obamacare]

But those two provisions, taken together, are likely to send the individual marketplace into a “death spiral,” ending with only the sickest people insured, sky-high premiums, and insurers exiting the individual market, according to experts across the political spectrum. The bill has a $112 billion market stabilization fund to prevent this, but experts doubt it, or a similar measure in the House bill, would be enough.

Here’s how a death spiral would happen. People shopping for insurance in the individual market all sit on a spectrum from healthy to sick.”

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Lots of “neat” graphics with the full article. Clink the link and see the GOP’s plan to “deconstruct” American healthcare in action.

Sobering thought: Millions of Americans voted to destroy their own healthcare and endanger their own lives and those of family members who can’t vote. Unfortunately, their lack of prudence and sound judgment is likely to take the rest of us into the abyss with them. The “silver lining:” Guys like the Koch Bros, Tom Price, Wilber Ross, et. al. will pay lower taxes. (I didn’t include Trump in this list because there is no hard evidence that he currently pays, or ever again will pay,  income taxes.)

PWS

06-24-17

NEW GAME IN TOWN: “GRAND THEFT GOP” — Party Plans Biggest Heist In US History — To Be Carried Out In Broad Daylight — GOP Voters Expected To Provide Getaway Car!

https://www.washingtonpost.com/opinions/senate-republicans-ready-themselves-for-a-massive-theft-from-the-poor/2017/06/22/902a1a96-5777-11e7-a204-ad706461fa4f_story.html?hpid=hp_no-name_opinion-card-b:homepage/story&utm_term=.6918f77c4db1

Eugene Robinson writes in a Washington Post op-ed:

“The “health-care bill” that Republicans are trying to pass in the Senate, like the one approved by the GOP majority in the House, isn’t really about health care at all. It’s the first step in a massive redistribution of wealth from struggling wage-earners to the rich — a theft of historic proportions.

Is the Senate version less “mean” than the House bill, to use President Trump’s description of that earlier effort? Not really. Does the new bill have the “heart” that Trump demanded? No, it doesn’t. The devil is not in the details, it’s in the big picture.

Fundamentally, what Republicans in both chambers want to do is cut nearly $1 trillion over the next decade from the Medicaid program, which serves almost 70 million people. Medicaid provides health care not just for the indigent and disabled but also for the working poor — low-wage employees who cannot afford health insurance, even the plans offered through their jobs.

Additionally, about 20 percent of Medicaid spending goes to provide nursing home care, including for middle-class seniors whose savings have been exhausted — a situation almost any of us might confront. Roughly two-thirds of those in nursing homes have their care paid by Medicaid.

 

Why would Republicans want to slash this vital program so severely? You will hear a lot of self-righteous huffing and puffing about the need for entitlement reform, but the GOP’s intention is not to use the savings to pay down the national debt. Instead, slashing Medicaid spending creates fiscal headroom for what is euphemistically being called “tax reform” — a soon-to-come package of huge tax cuts favoring the wealthy.

That’s the basic equation in both the House and Senate bills: Medicaid for tax cuts. Both bills start with various of the taxes imposed by the Affordable Care Act, but those are mere appetizers. The main course is intended to be big cuts in individual and corporate tax rates that would benefit the rich.

There is no other point to this whole exercise. All the “Obamacare is in a death spiral” talk is Republican wishful thinking, aided and abetted by active sabotage.”

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Undoubtedly, many of those who would die or suffer needlessly as a result of the GOPs “Reverse Robin Hood” operation would be Democrats and non-voters (like children). But, many in the GOP base also fall within the group of poor and “lower middle class” folks who would be sentenced to death or suffering by the GOP. Killing off your own voters, with their support, is an interesting new twist in modern GOP politics. But, obviously Trump, McConnell, Ryan, and their Fat Cat handlers are confident in the gullibility and inability of many in their base to discern either their own or the general public’s best interests. Difficult to comprehend.

PWS

06-23-17

 

BREAKING: GOP SENATORS ANNOUNCE PLAN TO TRASH HEALTH CARE FOR 10S OF MILLIONS OF AMERICANS, FUND MORE TAX BREAKS FOR RICH CRONIES! — Why? — Because They CAN!

http://www.slate.com/articles/news_and_politics/politics/2017/06/why_the_gop_would_pass_an_objectively_bad_health_care_bill.html

 writes in Slate:

“It is difficult to overstate the sheer unpopularity of the American Health Care Act, the Republican Party’s plan to “repeal and replace” the Affordable Care Act. And it’s not hard to understand why the bill is so unpopular. What’s mystifying is why Republicans insist on passing it, acting as if there won’t be political consequences for a plan that promises pain for tens of millions of Americans.

Jamelle BouieJAMELLE BOUIE

Jamelle Bouie is Slates chief political correspondent.

At Obamacare’s least popular moment, in the fall of 2014, 56 percent of Americans held a negative view of the law, versus 37 percent who approved. Compare that with the Republican version of the AHCA that passed the House of Representatives in early May. In a recent survey from CBS News, 59 percent of Americans disapprove of the GOP proposal, versus 32 percent who approve. A Roper Center analysis shows the proposal with just 29 percent support, making it the most unpopular piece of legislation Congress has considered in decades. And its unpopularity isn’t just a function of blue states like California, New York, and Illinois—there is no state in the union where a majority of voters support the bill.

If the AHCA ends up improving outcomes for Americans—if it delivers affordable health insurance or protects families from medical bankruptcy—it might recover some popularity in the implementation, as was true with the Affordable Care Act, which now has majority support. But we know from the Congressional Budget Office’s evaluation of the House bill that it would increase the number of uninsured by an estimated 23 million people; there are no signs the Senate version will be any less damaging. What’s more, the AHCA may upend the employer health market as well; its deregulatory measures could result in lifetime limits and substantially higher out-of-pocket costs for people who receive insurance through work. The universe of people potentially left worse off by the Republican bill is close to a cross-section of the American public: salaried employees, ordinary workers who rely on the Obamacare exchanges, and the millions of low-income people, children, elderly, and disabled Americans who rely on Medicaid.

Under most circumstances, this would be the ballgame. As a general matter, lawmakers don’t pass hugely unpopular legislation that might harm constituents in such a direct way. It’s easy to say that, for House and Senate Republicans, their “constituents” are those wealthy Americans who receive huge tax cuts under the bill. Still, it’s also true that winning donors isn’t the same as winning elections. Politicians don’t need to value the public interest to reject a bill like the AHCA; a survival instinct should be enough.

Which gets to what’s mystifying about the present situation. If the health care bill becomes law, there’s every indication the Republican Party will suffer for passing it. It is already responsible for a substantial and so-far enduring decline in the president’s approval rating, and it is fueling grass-roots opposition to the already-unpopular Trump administration. If Republicans face an increasingly difficult environment for the 2018 general election, it is at least in part because of the AHCA. And yet, Republicans are intent on passing the bill. Senate Majority Leader Mitch McConnell has cannily adopted an unprecedentedlysecretive process meant to insulate the proposal from criticism and expedite its passage. There have been no hearings and no debate. The plan, as it exists, is for a one-week period of public input before Congress votes.

It’s likely that Republicans know the bill is unpopular and are doing everything they can to keep the public from seeing its contents before passing it. As we saw with the Affordable Care Act, the longer the process, the greater the odds for a major backlash. But this presupposes a pressing need to pass the American Health Care Act, which isn’t the case, outside of a “need” to slash Medicaid, thus paving the way for large-scale, permanent tax cuts. The Republican health care bill doesn’t solve any urgent problem in the health care market, nor does it represent any coherent vision for the health care system; it is a hodgepodge of cuts and compromises, designed to pass a GOP Congress more than anything. It is policy without any actual policy. At most, it exists to fulfill a promise to “repeal Obamacare” and cut taxes.

Perhaps that’s enough to explain the zeal to pass the bill. Republicans made a promise, and there are forces within the party—from hyperideological lawmakers and conservative activists to right-wing media and Republican base voters—pushing them toward this conclusion. When coupled with the broad Republican hostility to downward redistribution and the similarly broad commitment to tax cuts, it makes sense that the GOP would continue to pursue this bill despite the likely consequences.

But ultimately it’s not clear the party believes it would face those consequences. The 2018 House map still favors Republicans, and the party is defending far fewer Senate seats than Democrats. Aggressively gerrymandered districts provide another layer of defense, as does voter suppression, and the avalanche of spending from outside groups. Americans might be hurt and outraged by the effects of the AHCA, but those barriers blunt the electoral impact.

The grounds for political combat seem to have changed as well. If recent special elections are any indication—where GOP candidates refused to comment on signature GOP policies—extreme polarization means Republicans can mobilize supporters without being forced to talk about or account for their actual actions. Identity, for many voters, matters more than their pocketbooks. Republicans simply need to signal their disdain—even hatred—for their opponents, political or otherwise. Why worry about the consequences of your policies when you can preclude defeat by changing the ground rules of elections, spending vast sums, and stoking cultural resentment?

It seems, then, that we have an answer for Republicans insist on moving forward with the American Health Care Act. Because they can. And who is going to stop them?”

Here’s some analysis of the GOP Senate Bill from the Washington Post:

“The Senate proposal largely mirrors the House measure with significant differences, according to a discussion draft circulating Wednesday among aides and lobbyists. While the House legislation would peg federal insurance subsidies to age, the Senate bill would link them to income, as the ACA does.

The Senate measure would cut off expanded Medicaid funding for states more gradually than the House bill but would enact deeper long-term cuts to the health-care program for low-income Americans. It also would eliminate House language aimed at prohibiting federally subsidized health plans from covering abortions, a provision that may run afoul of complex Senate budget rules.

But McConnell faces the prospect of an open revolt from key conservative and moderate GOP senators, whose concerns he has struggled to balance in recent weeks. Republicans familiar with the effort said Senate leaders have more work to do to secure the 50 votes needed to pass the measure, with Vice President Pence set to cast the tiebreaking vote, from the pool of 52 GOP senators. No Democrats are expected to support the bill.

According to two Republicans in close contact with Senate GOP leadership granted anonymity to describe private conversations, McConnell is threatening to bring the bill to a vote next week even if he doesn’t have the votes to pass it. But some believe that message is aimed at trying to pressure Republicans to support the bill, rather than an absolute commitment. A McConnell spokeswoman declined to comment.

Republican aides stressed that their plan is likely to undergo more changes to secure the votes needed for passage, but there were major concerns Wednesday from senators on opposite ends of the GOP spectrum.

“My main concern is I promised voters that I would repeal — vote to repeal Obamacare. And everything I hear sounds like Obamacare-lite,” said Sen. Rand Paul (R-Ky.).

Sen. Shelley Moore Capito (R-W.Va.), whose state expanded Medicaid and has been pushing for a more gradual unwinding of that initiative than many conservatives prefer, said she is waiting to scrutinize what is released but has not seen anything yet that would make her drop her concerns with the proposal.

“Up to this point, I don’t have any new news — tomorrow we will see it definitively — that would cause me to change that sentiment,” she said.

Like the House bill, the Senate measure is expected to make big changes to Medicaid, the program that insures about 74 million elderly and lower-income Americans and was expanded in most states under the ACA. In effect, the revisions would reduce federal spending on the program.

The Senate measure would transform Medicaid from an open-ended entitlement to one in which federal funding would be distributed to states on a per capita basis. The Senate measure would also seek to phase out the program’s expansion — although at a more gradual rate than the House version.

Yet the Senate bill would go further than the House version in its approach to cutting Medicaid funding in the future. In 2025, the measure would tie federal spending on the program to an even slower growth index than the one used in the House bill. That move could prompt states to reduce the size of their Medicaid programs.”

Here’s a link to the complete Post article: https://www.washingtonpost.com/powerpost/senate-gop-leaders-set-to-unveil-health-care-bill/2017/06/22/56dbe35c-5734-11e7-a204-ad706461fa4f_story.html?hpid=hp_rhp-top-table-main_healthcare835am%3Ahomepage%2Fstory&utm_term=.31690d0232b7

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As long as folks stubbornly keep voting for their own demise, that is, against their own best interests, Trump and the GOP are going to take them to the cleaners every time. The GOP Congressional leadership has “bought into” the Trump “Time Square” theory:   “There’s absolutely nothing that we could do that would make these folks vote against us. And, we’re going to take full advantage of them by sticking it to them just like they were Democrats or minorities (or both).”

I suppose if it works, why not line your pockets (and those of your buddies) to the full extent possible at the expense of the People until the party ends (which it might never do — and, if it does, the GOP will be laughing all the way to the bank)?

PWS

06-22-17

GOP’S WAR ON AMERICA EXPOSED — 23 Million Would Lose Health Coverage To Provide Tax Breaks To Fat Cat Cronies!

https://www.nytimes.com/2017/05/24/us/politics/cbo-congressional-budget-office-health-care.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region®ion=top-news&WT.nav=top-news

Robert Pear reports in the NYT:

“WASHINGTON — A bill to dismantle the Affordable Care Act that narrowly passed the House this month would leave 14 million more people uninsured next year than under President Barack Obama’s health law — and 23 million more in 2026, the Congressional Budget Office said Wednesday. Some of the nation’s sickest would pay much more for health care.

Under the House bill, the number of uninsured would be slightly lower, but deficits would be somewhat higher, than the budget office estimated before Republican leaders made a series of changes to win enough votes for passage. Beneath the headline-grabbing numbers, those legislative tweaks would bring huge changes to the American health care system.

In many states, insurance costs could soar for consumers who are sick or have pre-existing conditions, while premiums would fall for the healthy, the new estimate concludes.

The forecast by the nonpartisan Congressional Budget Office, Capitol Hill’s official scorekeeper, is another potential blow to efforts to undo Mr. Obama’s signature domestic achievement. Republican senators have said they will make substantial changes to the measure passed by the House, but even Senator Mitch McConnell of Kentucky, the majority leader, sounds uncertain about his chances of finding a majority to repeal and replace the health law.”

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Read Robert’s complete article at the link. Decades ago, when we were both young, Robert covered the “immigration beat” for the NYT. In the days before Administrations of both parties went to war with the press, he used to call me on a regular basis to get the “official INS position” on various controversies, particularly those involving legal issues.

PWS

05-24-16

Judge Posner, Split 7th Circuit, Slam IJ, BIA On Denial Of Protection To Honduran With HIV!

http://media.ca7.uscourts.gov/cgi-bin/rssExec.pl?Submit=Display&Path=Y2017/D01-19/C:15-2619:J:Posner:aut:T:fnOp:N:1898108:S:0

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The case, full text at the above link, is VELASQUEZ‐BANEGAS, v. LYNCH.  

I agree with Judge Posner’s bottom line that protection should have been granted on this record.  But, I think that he was overly harsh on the Immigration Judge.

These would be difficult cases for any judge at any level of our system.  One of the significant problems is that the Appellate Division of the Immigration Court, the Board of Immigration Appeals (“BIA”) has failed to provide adequate positive guidance on granting protection.

The overwhelming number of BIA precedent cases dealing with asylum, withholding of removal, and relief under the Convention Against Torture are denials by the BIA.  But, even with asylum grant levels leveling off and actually falling slightly over the past several years, the majority of applicants for protection actually qualify for some form of relief at the trial level based on fear of persecution or torture.

The unnecessarily negative approach of the BIA in its precedent decisions both gives a misleading negative guidance to Immigration Judges and creates the impression with U.S. Court of Appeals Judges that the system is even more skewed against applicants than it actually is.

Although I agreed with the majority in Velasquez, I think that the concluding paragraph of the Judge Ripple’s dissent also makes some good points:

“Immigration cases always pose a special burden on United States judges. As Jacques Maritain so eloquently put it: “We are all wounded souls.” See Jacques Maritain, Réflexions sur lʹAmerique 87–91 (1958). Every American, including every United States judge, has a family memory that includes ancestors who came from some place where life was not as good as it is here. The DNA of our national character makes it very difficult to tell an individual that he cannot enjoy the same liberty, safety, and security that we enjoy. When the individual suffers from a medical condition that cannot be treated as well in the country to which he is returned, basic humanitarian values make the task even more difficult. No doubt, those who must make necessary policy choices and those who must enforce those choices feel, or should feel, that same angst. But immigration must be regulated, and, in this Country, national policy is set by Congress and enforced by the Executive. Our own task as judges is limited. Because the immigration judge’s determinations were supported by substantial evidence, I respectfully dissent.”

Food for thought.

PWS

01/23/17