#cassidy-graham

[thepoliticalpatient]

Graham-Cassidy may be the most fucked up ACA repeal proposal yet

I’m looking for more sources on this because it’s so fucked up that I almost don’t believe it’s real.

Apparently Graham-Cassidy would allow discrimination against the chronically ill to an extent that is even worse than it was before the ACA. In order to understand this, please take a moment to read these definitions from my earlier post on insurance vocabulary.

Pre-existing condition: This is a big one that I think many people misunderstand. A pre-existing condition is a health problem you have before being covered by insurance. So, for example, if you develop a health problem while you are uninsured, that is a pre-existing condition. If you develop a health problem while you are insured, but later on you have a lapse in your health insurance, that condition becomes a pre-existing condition. If you have a health condition, but you’ve never had a lapse in insurance coverage since diagnosis, you do not have a pre-existing condition. You can switch from one insurer to another without having your condition labelled pre-existing as long as you are covered continuously and do not have a lapse in between.

Before the ACA, insurers could discriminate against people with pre-existing conditions (see Underwriting below). This is now illegal.

Underwriting: The insurance practice of analyzing individuals based on their risk and charging them more if they’re considered riskier. For example, with home insurance (where underwriting is legal), you might get charged a higher premium to insure your home if it’s located where floods are common. In medical insurance, before the ACA, this resulted in higher premiums or even complete denial of coverage for people with pre-existing conditions. This is now illegal in medical insurance under the ACA.

Alright, so the essential thing here is that before the ACA, insurers could not hike up your insurance rates, even if you were sick, unless you had a lapse in coverage. So, even if you were chronically ill, you could protect yourself by being extremely careful to never allow your insurance to lapse - easier said than done, but possible.

But what I’m reading is that Graham-Cassidy would not simply remove protections for people with pre-existing conditions, but would also allow insurers to jack up the rates on people who become ill WHILE COVERED under an individual market plan.

Imagine that you’re healthy and you’ve been paying $200 a month for health insurance for years, while only using maybe $20-$50 of health services per month. You’re clearly operating at a loss, but you’re doing it because that’s what insurance is all about: pay now, benefit later. You expect your insurance to someday be there for you when you need it.

Then you get sick, and you start needing the occasional $2000 MRI, or $10,000 hospitalization, and your monthly prescriptions cost $100. Hey! That insurance you’ve been paying for all this time is finally going to pay off. It’s going to cover you, right?

Oh, yeah, sure, it’ll cover you. But your rate is going to go up to $1000 a month, which you can’t afford, so you don’t get to keep having insurance now that you need it. And you can’t afford the out-of-pocket medical costs either, so you just don’t get the healthcare you need, and you get sicker.

Or maybe you can afford it, but you find that most months you’re still paying more for insurance than it would have cost for you to cover your costs out of pocket, so what was even the fucking point of buying insurance in the first place?

Shit like this is the reason behind my ever-present advice, in so many of these posts, to get yourself covered under employer-sponsored insurance if you’re chronically ill, if that is in any way possible for you. The individual market isn’t safe for us, not these days.

https://thinkprogress.org/trumpcares-back-and-now-it-will-let-insurers-jack-up-premiums-as-soon-as-you-get-sick-38fff5001bf9/

Let me know if you have more info about this.

[glittercontusion]

(CNN)The Senate will not vote on the Graham-Cassidy bill to repeal Obamacare, Republican leaders announced Tuesday, dealing a devastating blow to President Donald Trump and GOP lawmakers who tried to make a last-ditch attempt to deliver on the party's years-long campaign promise. Majority Leader Mitch McConnell announced the decision at a lunch with fellow Republicans on Capitol Hill, conceding what had become clear Monday night: They didn't have the votes. "We haven't given up on changing the American health care system. We are not going to be able to do that this week," McConnell told reporters Tuesday. "But it still lies ahead of us, and we haven't given up on that." Even as McConnell and his colleagues vowed that their goal of overhauling the country's health care system was far from over, Tuesday marked a clear end to the latest campaign to try to jam through a partisan bill to gut the Affordable Care Act. The budget vehicle Republicans were using to move the bill forward without any Democratic support was set to expire at the end of this week. The sponsors of Graham-Cassidy said they were disappointed but would try again -- next time through a more transparent process. The new plan, they said, is to take another crack at health care through the 2019 budget reconciliation process (which would again only require 50 Republican votes for passage) and hold committee hearings, markups and reach out to Democrats. The political calculation leading up to Tuesday was agonizing for McConnell. Putting a controversial bill on the floor without the votes would have exposed members to political fallout and attack ads. Many Republicans hadn't even taken a public position on Graham-Cassidy, a bill that the Congressional Budget Office said Monday would drastically cut Medicaid and lead to millions of people not having health insurance compared to the status quo. In the end, three Republicans had publicly opposed the bill: Sens. John McCain, Susan Collins and Rand Paul. McConnell "didn't try to explain the decision" during the lunch, GOP Sen. Tim Scott said. "It's obvious -- we don't have the votes right now, you don't vote until you have them." Working with Democrats? At a bipartisan White House meeting, the President warned Republicans Tuesday that he would work with Democrats on health care if they fail to act. Trump mentioned how much he liked the deal he negotiated recently with Senate Minority Leader Chuck Schumer and House Minority Leader Pelosi on raising the debt ceiling and government spending, according to a source familiar with the discussion and with Democratic lawmakers. Democratic Rep. Linda Sanchez told reporters that Trump told the group he was "disappointed" in those Republican senators who came out against the Senate bill. She said he "chided" the GOP members there that he could end up working with Democrats on health care legislation  Democratic Rep. Richard Neal, ranking member on the Ways and Means Committee, said "clearly" when asked if the President was making a threat.  "He made that clear that if he didn't get what he wanted, he was going to work with Democrats on a plan," Neal told reporters.  Graham, however, brushed off the suggestion that Trump might once again catch Republicans off-guard by striking a deal with Democrats. "I think the President is not going to do anything that doesn't repeal and replace Obamacare in a substantial way -- don't sell him short," he told CNN. Will Republicans really move on? What's not clear is whether Republican lawmakers will truly move on from Obamacare repeal for the time being -- or attempt to find another way to try again. Before McConnell's announcement, there were signs that plenty of Republicans in Washington were simply not ready to give up.  Trump said Tuesday that he was "disappointed" in several senators, in an apparent reference to McCain, Paul and Collins. "At some point there will be a repeal and replace but we'll see whether or not that point is now or whether it will be shortly thereafter," Trump said. "But we are disappointed in certain so-called Republicans."  On Capitol Hill, there were rumblings among lawmakers about ways to keep trying on repeal if this week ends with defeat.   One idea -- which hardly enjoys widespread support at the moment -- is to tie both health care and tax reform to the 2018 budget.  Graham and Sen. Ron Johnson, who both sit on the budget committee, have advocated for this idea. It has raised concerns among Republican lawmakers and staff alike who know just how messy that could potentially be.  One GOP aide bluntly described that scenario as "a nightmare." 

[thepoliticalpatient]

Daily Graham-Cassidy Update, 9/25

Susan Collins (R-ME) is now, finally, officially a no. With 3 declared ‘no’ votes, this bill may be dead unless some body flip-flops. The bill has been updated to throw more money at the states with ‘no’ voting senators so we’ll have to watch and see if anyone takes the bait. If somebody does flip we can still hope for a no from Lisa Murkowski (R-AK).

The Senate hearing was today and you can watch it on C-SPAN. I admit I didn’t have the spoons to watch all 5 hours, but I didn’t hear anything unexpected in the first 1.5 hour that I did watch. Graham and Cassidy touted their bill as a way to add further “flexibility” to states (flexibility to fuck sick people I guess). Senator Mazie Hirono (D-HI), who has stage 4 kidney cancer, gave an excellent statement calling for compassion. ADAPT protestors, bless them, showed up again and interrupted proceedings for about 15 minutes shouting “No cuts to Medicaid, save our liberty” until they were hauled out by police. Several dragged from wheelchairs again.

Reminder that the Graham/Cassidy vs. Sanders/Klobuchar debate is tonight on CNN. Here are some ways to watch, though it’s not accessible to everyone. I’ll blog about it, of course.

The CBO has already stated that they won’t have time to properly analyze the bill before September 30, but they did say today that there would be a $133B reduction in the deficit and “millions fewer” insured under Graham-Cassidy. Previous bills to repeal the ACA have been estimated to reduce the number of insured by around 22 million.

That’s all I’ve got for today until after the debate.

[thepoliticalpatient]

Graham-Cassidy Daily Update, 9/20

Not a ton of new news on Graham-Cassidy today, not that I’ve found anyway.

Here’s a helpful map that shows how this bill would redistribute wealth among the states. G-C’s funding is essentially a redistribution of wealth from blue to red states. Graham and Cassidy claim that the percentage of funding that many blue states are currently receiving under the ACA is unfair - well, it’s not like it’s pure favoritism that’s causing this. Primarily blue states expanded Medicaid under the ACA. States that expanded Medicaid received grants for doing so.

One reporter has noticed something fishy in the bill - Alaska has, seemingly randomly, been granted larger subsidies than every other state. They’ve justified this with some threshold involving population density and healthcare spending wherein Alaska just happens to be the only state meeting the qualifications. K. This is clearly an attempt to woo Lisa Murkowski’s vote.

The CBO is aiming to have an estimate out regarding the effect on the budget early next week. However, they’re saying it would take several weeks to determine the effect on premiums or how many new uninsured there would be, and we don’t have several weeks, so it’s looking like they’re just going to go ahead and vote on a bill without having any estimates on these numbers. That’s fine, right?

It’s probably obvious and goes without saying, but I am just so disgusted right now, and also completely scared out of my mind. I just have this really horrible sinking feeling that this one is going to pass. I’m almost wishing that one of the less horrible bills, like skinny repeal, would have passed earlier so that the GOP could have taken their victory lap and given healthcare a break.

It doesn’t feel like a movement is mobilizing to stop this bill, the way it did with the AHCA and the BCRA. I think people are tired, and I think they got cocky back in July after the last vote. Activism is exhausting, I get that, but this shit must be resisted. This bill is going to kill people. It’s discouraging to see that only those of us whose lives are actually threatened seem to care anymore. Allies, where the fuck are you? Do you still give a shit about our lives? Did you ever?

I don’t know what more I can be doing right now. If there’s another sit-in I’ll go, again. Just let me know where to park my broken-ass body and I’ll be there.

[thepoliticalpatient]

Daily Graham-Cassidy Update, 9/24

Sorry I didn’t post yesterday. I really needed a break, and yesterday seemed like a safe time to do it.

Things are still looking good today - better even than on Friday - but I don’t want anyone to get cocky or complacent.

Susan Collins (R-ME) still hasn’t committed, but her “leaning towards no” stance has gotten firmer: “It’s very difficult for me to envision a scenario where I would end up voting for this bill.”

Meanwhile, the exact same shit that sank the BCRA is happening: while Collins’s reservation come from the fact that the bill is cruel and would gut Medicaid and kick people off their insurance, several other Senators are no votes because they think it doesn’t repeal enough of the ACA: Rand Paul (R-KY), who has been a no vote all along, and as of today, also Ted Cruz (R-TX) and possibly Mike Lee (R-UT).

Still, I remain firm in not trusting any of these supposed no votes that are coming from a place of wanting a more complete repeal - surely these guys realize that this may be their last shot and are willing to vote for some repeal if they can’t have full repeal. I think it’s a ploy to get amendments tacked on to the bill that make it even crueler, but even if they don’t get those amendments, if they had to vote today... I genuinely don’t think any of these guys are willing to be the vote that kills this bill.

If we’re not going to count the folks I don’t trust, we only have 1.5 no votes right now: McCain for certain, and Collins probably. We need commitment from Collins, and we need an answer from Lisa Murkowski (R-AK), who has voted down previous repeal attempts for the right reasons but has remained pretty silent so far on Graham-Cassidy.

That said, we’re in a good spot now: satisfying Cruz would require making the bill more conservative, which might throw Collins and/or Murkowski into firm “no” territory, and vice versa.

We’re looking at Wednesday, September 27 as a date for a possible vote, pushed back from their plan to vote on Monday. If we can make it to Saturday, September 30, their deadline, we may finally be done with this shit. We may finally be able to breathe.

I say that despite my earlier somewhat cynical statement that the repeal deadline would buy us 3 months of relaxation, because I’ve learned new information. The Senate wants to move on to tax reform in 2018, and they need to use the budget reconciliation process on that. This leaves them with only two options on healthcare: leaving it alone in 2018, or trying to bundle healthcare reform in with the tax reform, which would jeopardize their plans for tax reform. Imagine getting 50 Republican Senators to agree on a bill that covers tax reform AND healthcare when they can’t even agree on a plan for healthcare.

If they don’t get it done in 2018, they can pick it up again in 2019, but that’s after mid-term elections, so they may not have the same majority in both chambers that they have now. I am very worried about what happens in the Senate during midterms because there are many more Democrats in danger of losing their seats than Republicans, but there is a chance we could take back the House.

Keep fighting hard on healthcare until we pass that Sep 30 deadline. We can’t afford to relax until then. And when that’s done, fight for Democratic seats Congress.

[autisticadvocacy]

Bill Pushed by Sens.

The proposal is a partisan attempt to rollback health care gains for previously uninsured people, especially vulnerable populations.

[thepoliticalpatient]

Daily Graham-Cassidy update, 9/19

Given how fast shit is going to happen with Graham-Cassidy (the deadline to pass it is 9/30), I’m going to just go ahead and start posting all new news I hear daily.

Here’s what I’ve heard so far today:

A bipartisan group of governors has announced their opposition to Graham-Cassidy and has instead expressed their support for the bipartisan reform currently being drafted by Lamar Alexander (R, TN) and Patty Murray (D, WA). This is excellent news, especially because some of the governors are from states containing key swing-voting Senators: Alaska/Lisa Murkowski, Ohio/Rob Portman, Colorado/Cory Gardner.

Unfortunately, the governor of Arizona, Doug Ducey, has come out in support of Graham-Cassidy. This is a problem because John McCain is a Senator in Arizona, and his vote is key, given that his no vote was the one that ultimately shut down skinny repeal in July. McCain is likely to be influenced by Ducey’s endorsement, although there’s still hope that he will be a no vote. His no vote on skinny repeal was mostly motivated by disgust with the hurried and secretive process that Senate leadership used with the bill, and this bill has been no better in that regard.

Paul Ryan and Trump are also laying the pressure on Senate Republicans by publicly opposing Alexander and Murray’s bipartisan reform bill. Ryan is stating that the House will not pass the bipartisan reform, which I think is an effort to make it seem like there are no options available aside from passing Graham-Cassidy.

Finally, one GOP senator, John Kennedy (R, LA), is saying he’s going to propose an amendment to Graham-Cassidy that would bar states from using their block grants to set up statewide single-payer systems. I’m almost in disbelief over how petty this is. They’re saying, let’s give the states more freedom - just not the freedom to do liberal things. I firmly believe he’s doing this to prevent a situation where 2 years down the line, someone can point at California and say, hey look, single-payer is working really well there, maybe we should implement that nationwide.

Let’s flood the phone lines with calls in opposition to Graham-Cassidy. Senators still have their reelections to worry about, and they won’t feel good about passing a bill that is wildly unpopular with their constituents.

Here is a script I wrote that you can use for calling Senators’ offices regarding Graham-Cassidy.

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https://www.colorado.gov/governor/sites/default/files/bipartisan_governors_letter_re_graham-cassidy_9-19-17.pdf http://www.huffingtonpost.com/entry/ducey-mccain-obamacare-repeal_us_59c014dde4b093cfe7761052 http://www.politico.com/story/2017/09/19/obamacare-stabilization-bill-status-242875 http://thehill.com/policy/healthcare/351344-gop-senator-eyes-ban-on-states-single-payer-systems

[comtedemoney]

Hundreds of activists gathered on Capitol Hill Monday to fight the latest attempt to repeal Obamacare.

Copy and paste into a new tab: http://www.huffingtonpost.com/entry/activists-graham-cassidy_us_59c92f66e4b0cdc773336edd

From the article:

Hours before the hearing was set to begin over the controversial health care legislation, first introduced by Sens. Cassidy and Lindsey Graham (R-S.C.) in late July, a line of activists waiting to sit in on the Senate hearing had grown so long it stretched into another building.

Sen. Orrin Hatch (R-Utah) put the committee in recess while police removed the protesters. Later, he told the shouting activists that if they can’t remain quiet, “then get the heck out.”

Sen. Bill Cassidy (R-La.), the main co-sponsor of the repeal legislation, appeared undisturbed by the activists’ opposition, and was observed yawning as some protesters were forcibly removed.

In light of the New York Times article Behind New Obamacare Repeal Vote: ‘Furious’ G.O.P. Donors (see link below) which showed us that the reason the Republican Senators are pushing this is that the oligarchs who own them are demanding it, jeopardizing re-election campaign funds and careers, this is no longer about mere differences of opinion on how to meet the needs of the American people: this is about premeditated murder for personal, political, and financial gain.

NYT: Behind New Obamacare Repeal Vote: ‘Furious’ G.O.P. Donors https://www.nytimes.com/2017/09/22/us/politics/republican-donors-obamacare-repeal.html