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Senate health care bill: 5th Republican senator comes out …

Another Republican senator came out against the GOP health care plan on Friday, making it nearly impossible for the package to pass the chamber in its current form.

Sen. Dean Heller, R-Nev., said on Friday that the bill is “simply not the answer,” joining Republican Sens. Rand Paul, R-Ky., Ted Cruz, R-Texas, Mike Lee, R-Utah, and Ron Johnson, R-Wis., in opposition.

“My point is this bill currently in front of the United States Senate is not the answer–it is simply not the answer,” Heller said at a press conference in Nevada on Friday. “I am announcing today that in this form I will not support it.”

Heller and Cruz are both up for re-election in 2018.

Senate Majority Leader Mitch McConnell, R-Ky., who rolled out the legislation on Thursday, needs 50 votes to pass the bill to the House, with Vice President Mike Pence serving as the tie-breaking vote. But without the support of Paul, Cruz, Lee, Johnson, and now Heller, passage of the bill in its current form will be nearly impossible, unless Republicans can manage to draw Democratic votes, which is highly unlikely.

AP (Sen. Dean Heller, R-Nev., in his office on Capitol Hill in 2011)

“Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor,” the joint statement from Cruz, Paul, Johnson and Lee said on Thursday. “There are provisions in this draft that represent an improvement to our current health care system but it does not appear this draft, as written, will accomplish the most important promise that we made to Americans: to repeal ObamaCare and lower their health care costs.”

Reuters (Sen. Rand Paul, R-K.Y., on Capitol Hill on March 7, 2017)

Paul told reporters on Capitol Hill Thursday that if members who support the bill know they don’t have the votes needed, discussion would begin earlier.

AP (Sen. Ron Johnson, R-Wis., on Capitol Hill )

“I didn’t run on ObamaCare lite,” Paul said. “I think we can do better than this –my hope is not to defeat the bill, but to make the bill better.”

Paul added: “Now the discussions begin — I think it could take longer than a week.”

AP (Sen. Ted Cruz, R-Texas, in Washington, D.C.)

Cruz acknowledged that he had not yet had “the opportunity” to fully review the bill in its entirity, but said “there are components that give me encouragement and there are also components that are a cause for deep concern.”

I have been clear from day one that I want to get to yes, Cruz told reporters on Capitol Hill Thursday. Nobody has fought harder against ObamaCare in the Senate than I have, but we have to actually have legislation that fixes the underlying problem.

Cruz said the current draft doesnt do nearly enough, and would be a disaster politically. Cruz said that key components to get everyone to yes are lowering premiums, and giving the states flexibility.

Reuters (Sen. Mike Lee, R-Utah, in Washington, D.C. on March 29, 2017)

Senate Republicans released the 142-page draft of their version of a “repeal and replace” health care plan on Thursday titled, Better Care Reconciliation Act of 2017, which eliminates a majority of ObamaCare provisions, already drawing backlash from Senate Democrats, and even some congressional Republicans.

The bill could go to a vote as early as next week, after the Congressional Budget Office reviews and gives a score to the new plan, but McConnell did not announce a specific timeline for consideration. The Congressional Budget Office expects to have a score for the draft early next week.

The bill repeals key components of ObamaCare, and manages to maintain some”crucial”conservative items congressional Republicans were looking for, like a cut to Planned Parenthood funding.

GOP SENATORS UNVEIL OBAMACARE OVERHAUL

But despite the early GOP-opposition, Sen. Chuck Grassley, R-Iowa, said hes glad the process is moving forward.

The Senate discussion draft is available for everyone to review, Grassley said. There will be a full debate before the Senate, with the ability for senators of both parties to offer amendments.

But Democrats, as expected, are slamming the billand most are hanging on comments made by President Trump earlier this week, suggesting the House bill, called the American Health Care Act, was mean.

The President said the Senate bill needs heart, the President says the House bill was mean, Senate Minority Leader Chuck Schumer, D-N.Y., said on the Senate floor Thursday after the bill was rolled out. The Senate version is meanerthe House bill is a wolf, but this bill is a wolf with sharper teeth — its a wolf in sheeps clothing.

At the White House, the president remained consistent in his comment from earlier in the week, and said he hoped to get something done with heart.

Wed love to have some Democratic support, but theyre obstructionist, Trump said. Hopefully well get something done and itll be something with heart and very meaningful.

Sen. Bernie Sanders, I-Vt., said the bill is even worse than expected and called it by far the most harmful piece of legislation I have seen in my lifetime.

Our job now is to rally millions of Americans against this disastrous bill to make sure it does not pass the Senate, Sanders said.

Despite Sanders, and other Democrats criticisms, Sen. Lamar Alexander, R-Tenn., said the bill makes no change in current law when it comes to protecting people with pre-existing conditions.

McConnell said on the Senate floor Thursday that Democrats made it clear early on that they did not want to work with us, but Sen. Ron Wyden, D-Ore., said he had never been asked.

It is not just a fiction, it is a gross fiction, Wyden said.

Still, many members have yet to read the 142-page legislation in its entirety, with some Republicans hesitant to forecast votes, prior to reading the bill in full.

WHAT’S IN THE SENATE PROPOSAL: KEY PROVISIONS OF BETTER CARE RECONCILIATION ACT OF 2017

I dont know, Sen. Luther Strange, R-Ala., told Fox News. Weve got a lot of work to do.

Sen. Susan Collins, R-Maine, already has a number of concerns, according to her spokesperson, and plans to read the bill in full.

She has a number of concerns and will be particularly interested in examining the forthcoming CBO analysis on the impact on insurance coverage, the effect on insurance premiums, and the changes in the Medicaid program, Collins spokeswoman Annie Clark said.

McConnell said that when legislation comes to the floor, it will present Senate Democrats another opportunity to do whats right for the American people.

Fox News’ Peter Doocy,Chad Pergram, Mike Emanuel, Jason Donner contributed to this report.

Brooke Singman is a Reporter for Fox News. Follow her on Twitter at @brookefoxnews.

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Senate health care bill: 5th Republican senator comes out …

Health Care Bill: Here’s What’s in the Proposal | Time.com

The Senate health care bill released Thursday would cut Medicaid for low-income Americans, roll back tax hikes passed under the Affordable Care Act and allow states to waive standards on insurance coverage.

Named the Better Care Reconciliation Act to distinguish it from the House version of the bill, a “discussion draft” was released publicly Thursday after a working group of Republicans put it together behind closed doors.

Senate Majority Leader Mitch McConnell said the legislation would allow Congress to repeal the Affordable Care Act.

“The Senate will soon have a chance to turn the page on this failed law,” Senate Majority Leader Mitch McConnell said on Tuesday . “We have to act, and we are.”

Senate Democrats, meantime, cited President Trump’s remark that the House version of the bill was “mean.”

“The way this bill cuts health care is heartless,” said Senate Democratic Leader Chuck Schumer. “The president said the House bill was mean. The Senate bill may be meaner. The Senate Republicans health care bill is a wolf in sheep’s clothing, only this wolf has even sharper teeth than the House bill.”

Heres what we know about the details of the bill and its differences between the Affordable Care Act and the the House bill, known as the American Health Care Act:

Under the Affordable Care Act, insurance companies are barred from refusing customers with pre-existing conditions and all coverage must include 10 essential health benefits , including maternity care and mental health coverage. Seniors cannot be charged more than three times the premiums of younger adults, and people with pre-existing conditions cannot be charged more than healthier people in their area. Insurers must also spend a certain amount of their revenue from premiums on claims and provide plans that cover a certain percentage of an individual’s overall health care cost.

Under the House bill, states would be able to apply for waivers to bypass these five major parts of Obamacare and establish their own guidelines for insurers.

Under the Senate bill , according to CNN , states would be allowed to apply for waivers for all but one of these five regulations: the community rating provision that prevents people with pre-existing conditions from being charged more . However, there is some doubt that this measure will survive to the final bill because of parliamentary rules on budget reconciliation bills.

Under the Affordable Care Act, Medicaid was expanded to include more than 10 million more lower-income Americans . After the Supreme Court ruled on the law, the expansion was made voluntary, which led some states to choose not to expand.

Under the House bill, government spending on Medicaid would decrease by about $840 billion over 10 years . The bill would also eliminate funding provided to states for Medicaid expansion by 2020, meaning no new people would be able to enroll. It would also institute a per capita cap that placed restrictions on how much money the federal government spends on each recipient and allow states to choose to receive a block grant instead.

Under the Senate bill , there will be steeper cuts to the Medicaid program. The bill would grant states a fixed amount of money each year depending on the enrollment (per capita cap) or in the form of a block grant. But Medicaid’s annual growth rate would be based on standard inflation by 2025 , instead of medical inflation, causing a further slash in funds over time. In a concession to Senate moderates, the bill would instead phase out the Medicaid expansion by 2021 , instead of 2020.

Under the Affordable Care Act, individuals receive subsidies to help pay for insurance plans based on their income, age, where they live , and the cost of their coverage . Overall, 85 percent of enrollees qualify for financial assistance.

Under the House bill , individuals would receive subsidies based on their age , not income, health care plan, or where they live. The House also included $138 billion over ten years for high-risk pools to help states pay for people who require more expensive care, though critics say that would not be enough. According to a recent study conducted by the AARP , premiums could surpass $25,000 per year for these high-risk patients. Also, overall, Americans would receive significantly less money under the AHCA program than they do under the current Affordable Care Act subsidies system.

Under the Senate bill, the Obamacare subsidies program will remain largely intact. However, by 2020 , fewer people would receive coverage . Only individuals earning up to 350 percent of the poverty level would qualify, instead of 400 percent, as it was under Obamacare. There will also likely be more money added to the state stability fund . Though, this remains a point of contention among Republican senators.

Under the Affordable Care Act, patients could use Medicaid funds to get care at Planned Parenthood, which offers people a wide range of reproductive health care services. According to estimates, half of the 2.5 million people that go to Planned Parenthood clinics each year pay for their services with Medicaid.

Under the House bill, Planned Parenthood would lose 30 percent of its funding it gets through Medicaid reimbursements, unless the clinics stop offering abortions.

Under the Senate bill, the provisions would be the same . Planned Parenthood would be stripped of a large portion of its funding for one year.

Under the Affordable Care Act, the amount of uninsured Americans has dropped around 13.3 percent since 2013, or around 12.8 million people, according to the Census Bureau .

Under the House bill, 16 million people would lose health care by next year, and by 2026, 23 million people would be without insurance, according to CBO estimates .

Under the Senate bill, many Americans would still lose coverage , though Senators are hoping the CBO will project a smaller number of uninsured than the House bill. No one will know for sure until the CBO releases its score.

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Health Care Bill: Here’s What’s in the Proposal | Time.com

Senate health-care bill faces serious resistance from GOP moderates – Washington Post

A small group of moderate Republican senators, worried that their leaders health-care bill could damage the nations social safety net, may pose at least as significant an obstacle to the measures passage as their colleagues on the right.

The vast changes the legislation would make to Medicaid, the countrys broadest source of public health insurance, would represent the largest single step the government has ever taken toward conservatives long-held goal of reining in federal spending on health-care entitlement programs in favor of a free-market system.

That dramatic shift and the bills bold redistribution of wealth the billions of dollars taken from coverage for the poor would help fund tax cuts for the wealthy is creating substantial anxiety for several Republican moderates whose states have especially benefited from the expansion of Medicaid that the Affordable Care Act has allowed since 2014.

Their concerns that the legislation would harm the nations most vulnerable and cause many Americans to become uninsured have thrust into stark relief the ideological fault lines within the GOP. Though Senate conservatives were the first to threaten to torpedo the bill, contending that it is too generous, the potential loss of nearly half a dozen moderate lawmakers votes may be the main hurdle. Since the bill will get no support from Democrats, Senate Majority Leader Mitch McConnell can afford defections from no more than two Republicans as he tries to bring it to a vote this week.

His odds worsened Friday when Sen. Dean Heller (R-Nev.), who is up for reelection next year, said he could not support the bill in its current form. Heller specifically cited its cuts to Medicaid, not just by ending its expansion in Nevada and 30 other states but by restricting government spending for the program starting in 2025.

(Peter Stevenson/The Washington Post)

This bill is simply not the answer, he declared, describing some of the 200,000 Nevadans who have gained health coverage through the expansion. He rhetorically asked whether the Republican plan will ensure that they have insurance in the future. Im telling you, right now it doesnt do that, he said.

Though three of the other four wavering GOP centrists also come from Medicaid-expansion states, not all were as explicit as Heller in their reactions after the Better Care Reconciliation Act was finally unveiled late last week. Both Sens. Shelley Moore Capito (W.Va.) and Lisa Murkowski (Alaska) said that they would evaluate it with an eye toward its effect on low-income residents.

It needs to be done right, Murkowski said in a tweet. I remain committed to ensuring that all Alaskans have access to affordable, quality health care.

Part of the pressure the moderates now face is that Medicaid consistently draws widespread support in surveys. A poll released Friday by the Kaiser Family Foundation found that three-fourths of the public, including 6 in 10 Republicans, said they have a positive view of the program. Just a third of those polled said they supported the idea of reducing federal funding for the expansion or limiting how much money a state receives for all beneficiaries.

Even among Republicans, the foundation found, only about half favor reversing the federal money for Medicaid expansion.

Congressional budget analysts plan to issue their projections as early as Monday on the legislations impact on the federal deficit and the number of Americans with insurance coverage. Already, proponents and critics alike are predicting that the Senate proposal would lead to greater reductions through the Medicaid changes than the estimated $834 billion estimated for a similar bill passed by House Republicans last month.

The focus of Republican efforts largely has been on costs, said Lanhee Chen, a research fellow at Stanford Universitys Hoover Institution. You do have a different set of issues that the two sides have been focused on, which partly explains why this has been such an intractable and difficult debate to find common ground on.

Under the Senate GOP version, 2021 is when Medicaids transformation would begin. The expansion, which has provided coverage to roughly 11 million people, would be phased out. What is now an open-ended entitlement, with federal funding available for a specific share of whatever each state spends, would be converted to per capita payments or block grants.

Then, four years later, the federal government would apply an inflation factor to spending increases that would be equal to the urban consumer price index rather than the higher medical inflation rate used in the House bill.

There has never been a rollback of basic services to Americans like this ever in U.S. history, said Bruce Siegel, president of Americas Essential Hospitals, a coalition of about 300 hospitals that treat a large share of low-income patients. Lets not mince words. This bill will close hospitals. It will hammer rural hospitals, it will close nursing homes. It will lead to disabled children not getting services. … People will die.

To some extent, the division within the GOPs ranks reflects geography. Some of the most reticent senators come from states where health-care systems stand to lose the most financially if the bill passed.

According to an analysis by the Commonwealth Fund, hospitals in Nevada would be saddled over the next decade with at least double the costs in uncompensated care bills for which neither an insurer nor a patient paid. It examined the House legislation but noted that the Senate bill would doubtless hit harder because of its deeper reductions in federal Medicaid payments.

Hospitals in West Virginia would suffer an even greater spike in uncompensated care, about 122 percent during the decade. But the analysis showed that the greatest damage would come in McConnells own state: Kentucky, which has had the nations largest Medicaid expansion under the ACA, would see a 165 percent jump in unpaid hospital bills.

Yet conservative Sen. Patrick J. Toomey (R-Pa.), one of the bills champions, said it would establish a very, very gradual and gentle transition to a normal inflation rate for a program in which he said costs were spiraling out of control. Beyond Medicaid, it would permit private health plans to cover fewer services and would allow individuals and employers to eschew coverage without penalty elements that its authors say could lower how much consumers pay for their insurance.

The idea that theres a sector of our economy that has to permanently have a higher inflation rate than the rest of our economy is ridiculous, Toomey said Thursday. I think that its absolutely essential to putting [Medicaid] on a sustainable path so that it will be there for future generations.

Avik Roy, a conservative health expert who serves as president of the Foundation for Research on Equal Opportunity, said the legislations proponents need to show that competitive insurance markets can work for the poor and the vulnerable and the sick.

People too often equate federal spending with establishing a safety net, when greater competition and a free market could produce better results at a lower cost, in Roys view. The Senate bill would extend quite robust tax credits to many people, he said, even to those living in poverty who were not eligible for Medicaid: Republicans have a different view of what a safety net should look like.

Pressure is coming from outside groups on the right. Though the four conservatives who have voiced opposition to the bill might be pushed hard Sens. Rand Paul (Ky.), Mike Lee (Utah), Ted Cruz (Tex.) and Ron Johnson (Wis.) Heller will be a special target. A super PAC, America First Policies, reportedly is planning a seven-figure ad buy just in Nevada.

But patient-advocacy organizations that focus on an array of diseases are intensifying their own lobbying on the bill, including running print and online ads in several key states. If one health issue has emerged as a flash point, however, it is the nations opioid epidemic.

Shatterproof, a national nonprofit organization focused on addressing addiction, estimates that 2.8 million people have gained access to substance-abuse treatment under Medicaid expansion. In Ohio alone, total federal funding provided 70 percent of the $939 million that the state spent to combat the epidemic last year.

Capito and Sen. Rob Portman (Ohio) have asked the chambers Republican leaders to provide in the bill $45 billion over 10 years to address opioids; the measure currently provides $2 billion. But that amount, Shatterproof chief executive Gary Mendell said Friday, is less than a tenth of what experts predict will be needed over the next decade. And providing a designated fund while leaving millions uninsured makes little sense, he added.

Shatterproof just launched a six-figure advertising buy in Ohio, West Virginia and Maine which is represented by another undecided Republican, Sen. Susan Collins to urge the states senators to vote against the bill. Mendell noted that Portman has been a champion on substance-use treatment for years, and it was difficult to run ads targeting him.

His people need to understand that this has to be a no vote, Mendell said.

Specific constituencies aside, some policy experts regard the Senates plan as a wholesale reversal of the governments path to offer health insurance to ever-wider groups of Americans, piece by piece. That started with the creation of Medicaid and Medicare as part of President Lyndon B. Johnsons Great Society and could be ending with the ACA.

This is bringing us back to where we were before 1965, said Paul Starr, a Princeton University professor of sociology and public affairs who has written extensively about the history of U.S. health-care policy. There is no longer the federal commitment to back up the states in terms of health care for the poor.

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Senate health-care bill faces serious resistance from GOP moderates – Washington Post

Bernie Sanders headlining ‘don’t take our health care’ rallies in three states – ABC News

Sen. Bernie Sanders is headlining a “don’t take our health care” rally tonight in Pittsburgh as a first stop on a three-state tour to mobilize opposition to the Senate health care bill, which the Vermont senator has called “by far the most harmful piece of legislation I have seen in my lifetime.”

Sanders teamed up with progressive advocacy organization MoveOn.org to hold rallies this weekend in Pittsburgh; Columbus, Ohio; and Charleston, West Virginia, with the goal of pressuring Republican senators in each of the states to oppose the legislation released Thursday.

Republican Sens. Pat Toomey in Pennsylvania, Rob Portman in Ohio and Shelley Moore Capito in West Virginia have said theyre reviewing the legislation and have not made a final decision.

Toomey issued the most supportive statement of the three, calling the Senate bill, an important and constructive first step in repealing Obamacare and replacing it.

Five GOP senators have so far announced their opposition to the bill drafted by some of their Republican colleagues. Republicans can afford only two defections from the 52 senators in their ranks to pass the bill.

The nonpartisan Congressional Budget Office is expected to release its assessment of the bill early next week.

Sanders has slammed the legislation as “disastrous,” saying in a statement Thursday that it “has nothing to do with health care. It has everything to do with an enormous transfer of wealth from working people to the richest Americans.”

Sanders spokesperson Josh Miller-Lewis told ABC News, Were at a pivotal moment in the fight to save health care and the goal this weekend is to elevate that fight.

All three of the states where the senator and MoveOn are holding rallies were won by President Trump in the 2016 election.

The first rally is tonight at 7 p.m. in Pittsburgh, followed by events Sunday in Ohio and West Virginia.

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Bernie Sanders headlining ‘don’t take our health care’ rallies in three states – ABC News

Koch chief says health care bill insufficiently conservative – ABC News

Chief lieutenants in the Koch brothers’ political network lashed out at the Senate Republican health care bill on Saturday as not conservative enough, becoming a powerful outside critic as GOP leaders try to rally support for their plan among rank-and-file Republicans.

Tim Phillips, who leads Americans For Prosperity, the Koch network’s political arm, called the Senate’s plans for Medicaid “a slight nip and tuck” of President Barack Obama’s health care law, a modest change he described as “immoral.”

“This Senate bill needs to get better,” Phillips said. “It has to get better.”

Some Republican senators have raised concern about cuts to Medicaid, which provides health care coverage to millions of poor and middle-income Americans. Several more conservative senators have voiced opposition because they feel it does not go far enough in dismantling what they call “Obamacare.”

The comments came on the first day of a three-day private donor retreat at a luxury resort in the Rocky Mountains. Invitations were extended only to donors who promise to give at least $100,000 each year to the various groups backed by the Koch brothers’ Freedom Partners a network of education, policy and political entities that aim to promote small government.

“When I look at where we are at the size and effectiveness of this network, I’m blown away,” billionaire industrialist Charles Koch told hundreds of donors during an outdoor evening reception. His brother, David Koch, looked on from the crowd along with Sens. Mike Lee of Utah and Jeff Flake of Arizona.

“We’ve got to keep doing it at an accelerated pace,” Charles Koch said.

No outside group has been move aggressive over the yearslong push to repeal Obama’s health care law than the Kochs’, who vowed on Saturday to spend another 10 years fighting to change the health care system if necessary. The Koch network has often displayed a willingness to take on Republicans including President Donald Trump when their policies aren’t deemed conservative enough.

Network spokesman James Davis said the organization would continue to push for changes to the Senate health care bill over the coming week.

“At the end of the day, this bill is not going to fix health care,” Davis declared.

The network’s wishes are backed by a massive political budget that will be used to take on Republican lawmakers, if necessary, Phillips said.

He described the organization’s budget for policy and politics heading into the 2018 midterm elections as between $300 million and $400 million. “We believe we’re headed to the high end of that range,” he said.

On Friday, Nevada Republican Dean Heller became the fifth GOP senator to declare his opposition to the Senate health care proposal. Echoing the other four, Heller said he opposes the measure “in this form” but does not rule out backing a version that is changed to his liking.

Heller, facing a competitive re-election battle next year, said he was opposing the legislation because of the cuts it would make in Medicaid.

Senate Majority Leader Mitch McConnell, R-Ky., has said he’s willing to alter the measure to attract support, and promised plenty of back-room bargaining as he tries pushing a final package through his chamber next week.

Republican leaders have scant margin for error. Facing unanimous Democratic opposition, McConnell can afford to lose just two of the 52 GOP senators and still prevail.

At least two of the current opponents, Lee and Texas Sen. Ted Cruz, were among 18 elected officials scheduled to attend the Koch retreat. Two more undecideds were also on the guest list: Flake and Nebraska Sen. Ben Sasse.

President Donald Trump continued to push for replacing Obama’s health care law, tweeting Saturday: “I cannot imagine that these very fine Republican Senators would allow the American people to suffer a broken ObamaCare any longer!”

The Senate measure resembles legislation the House approved last month that the nonpartisan Congressional Budget Office said would mean 23 million additional uninsured people within a decade and that recent polling shows is viewed favorably by only around 1 in 4 Americans.

Charles Koch and his chief lieutenants met privately with Vice President Mike Pence for nearly an hour Friday. Pence, a longtime Koch ally, was in Colorado Springs to address a gathering of religious conservatives.

Phillips said it was “a cordial discussion” about policy, but that neither side asked the other for anything specific.

Also Saturday, retired football star Deion Sanders announced plans to partner with the Kochs to help fight poverty in Dallas.

The unlikely partnership aims to raise $21 million over the next three years to fund anti-poverty programs in the city where Sanders once played football. The outspoken athlete also defended Koch, who is often demonized by Democrats, as someone simply “trying to make the world a better place.”

“I’m happy where I am and who I’m with because we share a lot of the same values and goals,” Sanders said when asked if he’d be willing to partner with organizations on the left.

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Koch chief says health care bill insufficiently conservative – ABC News

Why Washington should continue billions in health care subsidies – CNN

The Cost Sharing Reduction (CSR) payments, which have been paid on a monthly basis to insurers for the past three years, are an integral part of the Affordable Care Act (ACA). Whether to continue with the payments is a central issue in the ongoing health care reform debate in Washington.

The CSR program is critical to our ability to provide comprehensive and affordable care to patients across the country but it is caught in an unresolved legal quagmire.

Assuming the payments are made, a question remains: For how long?

Regardless, the outcome would likely be millions either losing or dropping coverage with the consequence that they would no longer seek medical care until it was an emergency — a return to the old days. If this market disruption happens, I believe individual and community health will decline because patients will be shut out of the health care system because it’s no longer affordable.

Hospitals will certainly be negatively impacted if the subsidies are eliminated. If millions of Americans lose or drop their coverage, we will see a jump in bad debt and uncompensated care — that is care for which we receive no payments. In this scenario, everyone else will face higher premiums, higher deductibles and higher out-of-pocket costs to help cover those who no longer have coverage.

Eliminating CSR payments would have an immediate, negative impact on patients — their health and their finances will take a huge hit. These payments give patients who need the most help the stability they need to ensure they receive the high-quality care they deserve.

Our elected officials, in the name of individual and community health, must continue to fund CSR payments until a better solution is developed for the people who need care the most.

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Why Washington should continue billions in health care subsidies – CNN

Could Senate health care bill make opioid crisis ‘worse’? – CNN

“That’s not true, and that is not fair. That is so not fair,” said Conway, the senior counselor to President Trump, during a back-and-forth with CNN anchor Alisyn Camerota.

She added, “It actually helps no one to peddle the false rumor that this health care bill does ‘nothing’ to help.”

“If there’s anything in the new health care bill that will help the opioid crisis, I haven’t seen it,” said Dr. Andrew Kolodny, co-director of the Opioid Policy Research Collaborative at Brandeis University.

“I would say the health care bill is more likely to make the opioid crisis worse, rather than better,” he added. “If people right now who have opioid-addiction treatment paid for, and the health care bill results in their loss of coverage, it means people could lose their lives.”

Conway told CNN that the administration has launched a “multi-Cabinet assault on this.”

Kolodny noted that those grants are “money that came from a bill that President Obama signed on his way out.” While praising the administration for talking about the issue and forming an opioid commission to look into the problem, Kolodny said it’s time for the Trump team to act.

“I don’t really see anything the Trump administration has done, other than just talk about the problem,” he said. “What I’d like to see from the Trump administration is a large investment in building up an opioid addiction treatment system that doesn’t yet exist.”

Those struggling with addiction, Kolodny said, need easy access to maintenance therapy drugs like buprenorphine. He also said the government must do more to regulate opioid manufacturers to prevent new cases of people becoming addicted to opioids.

“If heroin, fentanyl and painkillers remain easier to get, then we’re really not going to be able to see deaths come down.”

Other experts agree,

Arthur Evans, CEO of the American Psychological Association, said the new bill will weaken Medicaid and allow states to waive essential health benefits, including for those seeking treatment of their opioid addictions.

“At a time that we are trying to get more people access to treatment, we’re essentially taking away access,” Evans said. “I think this really undermines any efforts that we might have in trying to curb the opioid epidemic.”

The nation has not seen a reduction in the numbers of people overdosing and becoming addicted, he said, adding that “the timing of reducing the numbers of people covered by health insurance is very unfortunate.”

“The thing we know about addiction is that having coverage does make a difference in terms of people’s access and ultimate recovery,” Evans said.

What would he tell Conway if he were to meet with her?

“The net effect is, the bill is going to make it worse,” Evans said. “I don’t think there’s any doubt about that.”

The National Alliance on Mental Illness also sharply criticized the bill, urging its supporters to call senators to voice their opposition, especially to the billions of dollars in cuts to Medicaid.

Ohio Gov. John Kasich, a Republican whose state is at the epicenter of the opioid crisis, said he was deeply concerned about the bill and the way it was handled behind closed doors.

“I have deep concerns with details in the US Senate’s plan to fix America’s health care system and the resources needed to help our most vulnerable, including those who are dealing with drug addiction, mental illness and chronic health problems and have nowhere else to turn,” Kasich tweeted.

Pennsylvania Gov. Tom Wolf slammed the bill: “#BCRA makes care worse for everyone.”

“The Republicans that wrote this bill don’t want you to understand the damage it will cause before they vote on it,” said Wolf, a Democrat.

Kasich and Wolf were among a bipartisan group of governors who wrote a pointed letter to Senate Majority Leader Mitch McConnell and Minority Leader Chuck Schumer ahead of the bill’s release this week.

“It calls into question coverage for the vulnerable and fails to provide the necessary resources to ensure that no one is left out, while shifting significant costs to the states,” said the letter, signed by seven governors: three Republicans and four Democrats. “Medicaid provisions included in this bill are particularly problematic.”

For states hit hard by the opioid epidemic, addiction specialists say the loss of funding could have a devastating impact on treatment and recovery programs.

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Could Senate health care bill make opioid crisis ‘worse’? – CNN

Trump’s Washington News of the Week: Health Care Bill, Karen … – New York Times

Ms. Handels victory showed she was able to bridge the divide in her own party between admirers of President Trump and those made uneasy by his administration.

Seen as a referendum on Mr. Trump, the race in the heavily conservative and affluent district outside Atlanta was the latest in a string of demoralizing losses for Democrats.

_____

The death of Otto Warmbier, the American student who was returned from North Korea in a coma, drove a new wedge between Washington and Pyongyang.

President Trump condemned the North for its brutality, but he and Secretary of State Rex Tillerson stopped short of announcing fresh sanctions.

Mr. Trump said that China had not succeeded in getting Pyongyang to curb its nuclear and ballistic missile programs. He now faces a range of unattractive options in dealing with what he has called Americas most urgent foreign threat.

Speaking in Iowa on Wednesday, President Trump commended Gary D. Cohn, his top economic adviser and a former executive at Goldman Sachs, saying he would keep the world from taking advantage of the United States.

President Trump said on Wednesday that he was crafting legislation to bar new immigrants from receiving welfare for at least five years. He announced the proposal in a conquering-hero-returns speech in Iowa, his first trip back to the political battleground state since he won it in the 2016 general election.

His mood buoyant after twin Republican wins in congressional special elections the night before, the president also revealed his anticipated plan for putting solar panels on a proposed wall on the Mexican border an idea he boasted he had come up with himself.

Our fact-check of the rally found the president made 12 inaccurate claims about the economy, health care and his own accomplishments.

Senate Republicans, who have promised a repeal of the Affordable Care Act for seven years, took a major step on Thursday toward that goal, unveiling a bill to cut Medicaid deeply and end the health laws mandate that most Americans have health insurance.

The 142-page bill would create a new system of federal tax credits to help people buy health insurance, while offering states the ability to drop many of the benefits required by the Affordable Care Act, like maternity care, emergency services and mental health treatment.

The legislation would shift money from the poor to the rich, making deep cuts to Medicaid and creating a system of tax credits to help people buy health insurance. Despite being described as a revamp, its similar to a measure passed by the House last month.

Mitch McConnell, the Senate majority leader, wants a vote next week, but four Republican senators said they wouldnt support it without changes.

We tracked where Republican senators stand, and compared the proposal to current law.

During an interview with Fox News on Friday morning, President Trump indicated that his tweet hinting at taped conversations with James Comey had been intended to influence the fired F.B.I. directors testimony before Congress. On Thursday, the president acknowledged that he had not recorded the conversations.

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The Supreme Court unanimously rejected the governments position that it could revoke the citizenship of Americans who made even trivial misstatements in naturalization proceedings.

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Federal investigators are examining financial transactions involving Paul Manafort, President Trumps former campaign manager, and his son-in-law, who embarked on a series of real estate deals in recent years fueled by millions of dollars from Mr. Manafort, The Times reported.

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Trump’s Washington News of the Week: Health Care Bill, Karen … – New York Times

Rep. Maxine Waters speaks out on Republican health care bill at packed town hall meeting, as protesters gather outside – Los Angeles Times

To illustrate why she believes everyone should have access to comprehensive health care, Rep. Maxine Waters said she and her 12 siblings never saw a physician or a dentist their entire childhood.

I was born at home in St. Louis back in the day when it was hard for minorities to get into hospitals, she said.

To soothe cavities, Waters said her family relied on turpentine and cotton. If it was really bad, the tooth was yanked out using string and a slammed door.

The California Democrat, who spoke Saturday at a packed town hall meeting in Gardena, said she worries some Americans will be forced to do what her family did if the Republican health care bill passes. Senate Republicans have pledged to pass a bill before the July Fourth holiday.

Some GOP senators have said they want to review the analysis of the bill from the Congressional Budget Office before making up their minds. The budget office has said it will release that assessment early next week.

Waters said the existing bill would deny access to people with preexisting conditions, cause millions to lose their healthcare and penalize millennials.

We can do better than this, she said.

Supporter Gwen Bailey, 59, who works doing admissions at a hospital, said she worries especially about the people who could lose their insurance and the strain it would put on hospitals.

Its a lot that people would be losing, she said.

Inside, chants of USA! USA! could be heard from around 80 protesters who paced back and forth outside the venue.

Waters opponents were dressed in pro-Trump garb and called her Dirty Waters.

Chanell Temple said she lost her job a few years ago and hasnt been able to find a new one because she doesnt speak Spanish. She said Waters has destroyed the black community by supporting immigrants.

Waters criticized key members of President Trumps cabinet, including Education Secretary Betsy DeVos, Attorney General Jeff Sessions, and Secretary of State Rex Tillerson. She said Housing Secretary Ben Carson should go back to being a surgeon and that shell take him apart when he goes before the House Committee on Financial Services, of which she is the ranking Democrat.

Waters said some Republicans might vote against the health care bill.

She told the crowd that they deserve a president who will represent everyone. A woman in the audience stood up with a sign that said Impeach Mad Max and began walking through the rows and up to the foot of the stage, yelling that Waters needs to go.

Waters didnt skip a beat. She led her supporters in a chant to Impeach 45, repeating it over and over as her supporters turned to face the woman and narrowed in on her, clapping to the beat. The chant lasted more than four minutes.

A short while later, Waters closed by repeating a phrase that millennials, who call her Auntie Maxine, taught her: Stay woke.

andrea.castillo@latimes.com

An earlier version of this article said Rep. Maxine Waters had 13 siblings. She had 12.

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Rep. Maxine Waters speaks out on Republican health care bill at packed town hall meeting, as protesters gather outside – Los Angeles Times

Bernie Sanders ‘extremely disappointed’ by stalling of California’s single-payer health care bill – Sacramento Bee


Sacramento Bee
Bernie Sanders 'extremely disappointed' by stalling of California's single-payer health care bill
Sacramento Bee
I am extremely disappointed that the speaker of the California Assembly is refusing to allow S.B 562, the single-payer health care bill passed by the state Senate, to come to the Assembly floor for a vote, Sanders said in a statement issued Saturday.
California Assembly Speaker Anthony Rendon shelves single-payer healthcare bill, calling it 'woefully incomplete'Los Angeles Times
Single payer health care put on hold in California – The Mercury NewsThe Mercury News

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Bernie Sanders ‘extremely disappointed’ by stalling of California’s single-payer health care bill – Sacramento Bee

Senate health care bill: 4 key Republicans come out against …

Key Republican senators came out against the Senate Republican health care plan on Thursday, and their opposition is enough to defeat the package before a vote.

Sens. Rand Paul, R-Ky., Ted Cruz, R-Texas, Mike Lee, R-Utah, and Ron Johnson, R-Wis., said they would not vote on the Senate Republican plan in its current form.

“Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor,” the statement said. “There are provisions in this draft that represent an improvement to our current health care system but it does not appear this draft, as written, will accomplish the most important promise that we made to Americans: to repeal ObamaCare and lower their health care costs.”

Paul told reporters on Capitol Hill Thursday that if members who support the bill know they don’t have the votes needed, discussion would begin earlier.

“I didn’t run on ObamaCare lite,” Paul said. “I think we can do better than this –my hope is not to defeat the bill, but to make the bill better.”

Reuters (Sen. Rand Paul, R-K.Y., in Washington, D.C. on March 7, 2017)

Paul added: “Now the discussions begin — I think it could take longer than a week.”

Cruz acknowledged that he had not yet had “the opportunity” to fully review the bill in its entirity, but said “there are components that give me encouragement and there are also components that are a cause for deep concern.”

Sen. Mike Lee (R-UT) speaks at a rally for nominee Neil Gorsuch outside the Supreme Court in Washington, D.C., U.S. March 29, 2017. REUTERS/Aaron P. Bernstein – RTX339ZH

I have been clear from day one that I want to get to yes, Cruz told reporters on Capitol Hill Thursday. Nobody has fought harder against ObamaCare in the Senate than I have, but we have to actually have legislation that fixes the underlying problem.

Cruz said the current draft doesnt do nearly enough, and would be a disaster politically. Cruz said that key components to get everyone to yes are lowering premiums, and giving the states flexibility.

AP (Senate Majority Leader Mitch McConnell, R-K.Y., on Capitol Hill Dec. 12, 2016)

Senate Republicans released a 142-page draft of their version of a “repeal and replace” health care plan on Thursday titled, Better Care Reconciliation Act of 2017, which eliminates a majority of ObamaCare provisions, already drawing backlash from Senate Democrats, and even some congressional Republicans.

U.S. Sen. Ted Cruz, R-Texas, pauses as he delivers a speech to 2014 Red State Gathering attendees, Friday, Aug. 8, 2014, in Fort Worth, Texas. Possible presidential candidate Cruz predicts Republicans will retake the Senate this year and that “2016 will be even better.” (AP Photo/Tony Gutierrez) (AP)

The bill could go to a vote as early as next week, after the Congressional Budget Office reviews and gives a score to the new plan, but McConnell did not announce a specific timeline for consideration. The Congressional Budget Office expects to have a score for the draft early next week.

Senate Majority Leader Mitch McConnell, R-Ky., who rolled out the legislation, needs 50 votes to pass the bill to the House, with Vice President Mike Pence serving as the tie-breaking vote. But without the support of Paul, Cruz, Lee, and Johnson, passage of the bill in its current form will be nearly impossible, unless Republicans can manage to draw two Democratic votes, which is highly unlikely.

The bill repeals key components of ObamaCare, and manages to maintain some “crucial” conservative items congressional Republicans were looking for, like a cut to Planned Parenthood funding.

GOP SENATORS UNVEIL OBAMACARE OVERHAUL

But despite the early GOP-opposition, Sen. Chuck Grassley, R-Iowa, said hes glad the process is moving forward.

The Senate discussion draft is available for everyone to review, Grassley said. There will be a full debate before the Senate, with the ability for senators of both parties to offer amendments.

But Democrats, as expected, are slamming the billand most are hanging on comments made by President Trump earlier this week, suggesting the House bill, called the American Health Care Act, was mean.

The President said the Senate bill needs heart, the President says the House bill was mean, Senate Minority Leader Chuck Schumer, D-N.Y., said on the Senate floor Thursday after the bill was rolled out. The Senate version is meanerthe House bill is a wolf, but this bill is a wolf with sharper teeth — its a wolf in sheeps clothing.

At the White House, the president remained consistent in his comment from earlier in the week, and said he hoped to get something done with heart.

Wed love to have some Democratic support, but theyre obstructionist, Trump said. Hopefully well get something done and itll be something with heart and very meaningful.

Sen. Bernie Sanders, I-Vt., said the bill is even worse than expected and called it by far the most harmful piece of legislation I have seen in my lifetime.

Our job now is to rally millions of Americans against this disastrous bill to make sure it does not pass the Senate, Sanders said.

Despite Sanders, and other Democrats criticisms, Sen. Lamar Alexander, R-Tenn., said the bill makes no change in current law when it comes to protecting people with pre-existing conditions.

McConnell said on the Senate floor Thursday that Democrats made it clear early on that they did not want to work with us, but Sen. Ron Wyden, D-Ore., said he had never been asked.

It is not just a fiction, it is a gross fiction, Wyden said.

Still, many members have yet to read the 142-page legislation in its entirety, with some Republicans hesitant to forecast votes, prior to reading the bill in full.

WHAT’S IN THE SENATE PROPOSAL: KEY PROVISIONS OF BETTER CARE RECONCILIATION ACT OF 2017

I dont know, Sen. Luther Strange, R-Ala., told Fox News. Weve got a lot of work to do.

Sen. Susan Collins, R-Maine, already has a number of concerns, according to her spokesperson, and plans to read the bill in full.

She has a number of concerns and will be particularly interested in examining the forthcoming CBO analysis on the impact on insurance coverage, the effect on insurance premiums, and the changes in the Medicaid program, Collins spokeswoman Annie Clark said.

On the other side of the Capitol, House Speaker Paul Ryan, R-Wis., said he had been briefed on the legislation, and is not going to opine the Senates process.

I know how hard this process is from personal experience — Last thing I want is to be disrespectful of the process ahead of them, Ryan said. We made a promise to repeal and replace — eager for them to pass it but not going to opine on the details as they go along.

Rep. Tom MacArthur, R-N.J., who authored a key amendment to the Houses plan, seemed satisfied with the Senates draft proposal.

I am glad to see the Senate further improve the AHCA and put us one step closer, MacArthur said.

McConnell said that when legislation comes to the floor, it will present Senate Democrats another opportunity to do whats right for the American people.

Fox News’ Chad Pergram, Mike Emanuel contributed to this report.

Brooke Singman is a Reporter for Fox News. Follow her on Twitter at @brookefoxnews.

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Senate health care bill: 4 key Republicans come out against …

Senate GOP unveils health care plan after weeks of secrecy …

Senate Republicansunveiled a “discussion draft” of the bill Thursday of their plan to repeal and replace Obamacare that would end the health care law’s penalties for people who don’t buy insurance, cut back an expansion of Medicaid, but would keep protections for people with pre-existing conditions, compared to the House-passed bill.

Here’s the full text of the “discussion draft” of the bill.

The 142-page measure would provide tax credits, based on income, age and geography, which would make more money available to lower income recipients to help them buy insurance. This differs from the House bill, which tied its tax credits to age. Obamacare taxes would be repealed under the bill. The Senate bill would provide for expanded tax-free Health Savings Accounts, and it would also eliminate federal funding for Planned Parenthood.

Medicaid would be phased out under the bill beginning in 2021, with gradual reductions until 2024 in the amount of federal Obamacare funds that have financed the entitlement program’s expansion. The Senate bill would also slash funding to Medicaid from what Republicans call “gimmicks that drive up federal costs.” President Trump repeatedly promised during the 2016 presidential campaign that he would not cut Medicaid, Medicare or Social Security.

Senate Majority Mitch McConnell, R-Kentucky, aims to hold a vote on the legislation before lawmakers leave at the end of next week for the week-long July 4 recess.

“Obamacare isn’t working. By nearly any measure, it has failed, and no amount of 11th-hour, reality-denying or buck-passing by Democrats is going to change the fact that more Americans are going to get hurt unless we do something,” he said on the floor after the bill was posted. “Republicans believe we have a responsibility to act, and we are.”

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Senate Republican leaders say they will release a draft of their health care bill Thursday, as lawmakers from both parties complain about being c…

Senate Minority Leader Chuck Schumer, D-New York, noted that the president had asked for a bill with more “heart” than the House bill, but this bill, Schumer said, is “every bit as bad” as the House version and maybe “meaner.” “The way this bill cuts health care is heartless,” he said on the floor.

“This bill will result in higher costs, less care and millions of Americans will lose their health insurance, particularly through Medicaid,” Schumer added.

Republicans need a simple majority to pass it, rather than a supermajority since they’re using the budget reconciliation process. They may still have to rely on Vice President Mike Pence to cast a tie-breaking vote. The Senate currently has 52 Republicans and 48 Democrats. That means if all Democrats vote against the bill, only three no votes from Republicans can torpedo it. Even if Republicans are successful in getting it through the upper chamber, they would then still need to reconcile it with version passed by the House in early May, reach a bicameral agreement with House Republicans, and hold votes in the House and Senate on that version again.

A cost estimate of the bill from the nonpartisan Congressional Budget Office (CBO) is expected to be released by early next week. White House staff met with Senate Republican staffers Wednesday night on Capitol Hill to review the bill.

On Thursday morning, the Senate Republican Conference sat through a closed-door briefing for an hour and a half to learn about the bill’s substance. Many inside the meeting didn’t actually see the text even though it was posted online.

“You’ve seen the text?” Moderate Sen. Lisa Murkowski, R-Alaska, asked a reporter. “Well, you’ve seen it before we’ve seen it.”

Sen. John McCain, R-Arizona, called it a “good proposal overall,” but that there’s “a lot to absorb.”

Senators who emerged from the meeting didn’t appear entirely confident it would pass next week.

“I think we have a long way to go before we know the answer to that question, Sen. Tim Scott, R-South Carolina, said when asked if it could pass next week, adding that the draft version could be modified before a vote happens. “I’m open to moving forward on the legislation. We have a lot of time now — seven days — to figure out what parts we like about it, what parts we plan to keep. This is only a draft legislation. We’re going to make a lot of changes over the next seven days.

Several senators are already expressing concerns about the proposal.

“At first glance, I have serious concerns about the bill’s impact on the Nevadans who depend on Medicaid. I will read it, share it with Governor Sandoval, and continue to listen to Nevadans to determine the bill’s impact on our state,” said Sen. Dean Heller, R-Nevada, in a statement. Heller is up for re-election next year and is considered by Democrats to be one of the most vulnerable Republicans.

Sen. Rand Paul, R-Kentucky, didn’t appear to be a fan of the bill.

“Conservatives have always been for repealing Obamacare, and my concern is that this doesn’t repeal Obamacare,” Paul told reporters. “What I’ve seen so far is that it keeps 10 out of 12 regulations, it continues the Obamacare subsidies, and I think ultimately will not bring down premiums, because instead of trying to fix the death spiral of Obamacare, it simply subsidizes it with taxpayer money to insurance companies. So for those reasons, it looks a lot like Obamacare instead of a repeal of Obamacare.”

Sen. Bill Cassidy, R-Louisiana, said he’s happy that the bill makes an effort to lower premiums “immediately,” but he said he wants to ensure that as Medicaid is scaled back, “We don’t lose the the ability for lower-income folks to be able to afford insurance.”

Sen. Lindsey Graham, R-South Carolina, said in a statement that he needs to carefully review the text first, but “would prefer to address health care reform in a bipartisan manner,” accusing Democrats of being unwilling to negotiate with Republicans.

The House bill, which narrowly passed in a 217-213 vote on May 4, would significantly reduce the funding for Obamacare subsidies, revamp tax credits so that they’re tied to a person’s age, freeze the Medicaid expansion in 2020 and allow states to seek waivers from a rule that requires states to offer essential benefits in their plans and a provision that prevents insurers from charging people with pre-existing conditions more money compared to healthy people. Instead of Obamacare’s insurance mandate, the House Republican bill would incentivize people to have continuous coverage. Should coverage be interrupted for more than 63 days, insurers would be able to charge a 30 percent penalty over the original premium for one year.

The CBO didn’t release its cost estimate on the House bill until May 24, which projected that 23 million more people would be without health insurance over the next decade under the bill.

The Senate’s version was supposedly crafted by a working group consisting of 13 Republican men — and no women — but one of the group’s participants, Sen. Mike Lee, R-Utah, said even he had been left in the dark. Lee said the measure was “apparently being written by a small handful of staffers for members of the Republican leadership in the Senate.”

Other Senate Republicans voiced frustration that the process had been too secretive and out of the public eye. Senate Republicans don’t intend to hold any committee hearings on the bill, despite their commitment to so-called “regular order.”

Nearly three-quarters of Americans said Senate Republicans should discuss their health care plans publicly, according to a CBS News poll released Tuesday. A quarter of the public, by contrast, said it should be developed in private. It also found 57 percent said Obamacare needs some changes, 28 percent said it should be repealed entirely and 12 percent said it should be kept in place.

CBS News’ Nancy Cordes and Alan He contributed to this report.

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Senate GOP unveils health care plan after weeks of secrecy …

Here’s how much the average American spends on health care – CNBC

According to eHealthInsurance, for unsubsidized customers in 2016, “premiums for individual coverage averaged $321 per month while premiums for family plans averaged $833 per month. The average annual deductible for individual plans was $4,358 and the average deductible for family plans was $7,983.”

That means that, last year, the average family paid $9,996 for coverage alone, and, if they met their deductible, a total of just under $18,000. Meanwhile, an average individual spent $3,852 on coverage and, if she spent another $4,358 to meet her deductible, a total of $8,210.

These figures do not take into account any additional co-insurance responsibility she might have. In addition to co-pays and deductibles, an increasing number of plans now require co-insurance payments, which require that, even once you meet your deductible, you continue paying some percentage of all costs until you hit your out-of-pocket maximum.

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Here’s how much the average American spends on health care – CNBC

What Americans really want from health care reform is impossible – New York Post

It is an old joke among health-policy wonks that what the American people really want from health care reform is unlimited care, from the doctor of their choice, with no wait, free of charge.

For Republicans, trying to square this circle has led to panic, paralysis, and half-baked policy proposals such as the Obamacare-replacement bill. For Democrats, it has led from simple disasters such as Obamacare itself to a position somewhere between fantasy and delusion.

The latest effort to fix health care with fairy dust comes from California, whose Senate voted to establish a statewide single-payer system. As ambitious as the California legislation is, encompassing everything from routine checkups to dental and nursing-home care, its authors havent yet figured out how it will be paid for. The plan includes no copays, premiums, or deductibles. Perhaps thats because the legislatures own estimates suggest it would cost at least $400 billion, more than the states entire present-day budget.

In fairness, legislators hope to recoup about half that amount from the federal government and the elimination of existing state and local health programs. But even so, the plan would necessitate a $200 billion tax hike. One suggestion being bandied about is a 15 percent state payroll tax. Ouch.

The cost of Californias plan is right in line with that of other recent single-payer proposals. For example, last fall, Colorado voters rejected a proposal to establish a single-payer system in that state that was projected to cost more than $64 billion per year by 2028. Voters apparently took note of the fact that, even after figuring in savings from existing programs, possible federal funding, and a new 10 percent payroll tax, the plan would have still run a $12 billion deficit within ten years.

Similarly, last year Vermont was forced to abandon its efforts to set up a single-payer system after it couldnt find a way to pay for the plans nearly $4 trillion price tag. The state had considered a number of financing mechanisms, including an 11.5 percent payroll tax and an income-tax hike (disguised as a premium) to 9.5 percent.

On the national level, who could forget Bernie Sanderss proposed Medicare for All system, which would have cost $13.8 trillion over its first decade of operation? Bernie would have paid for his plan by increasing the top U.S. income-tax rate to an astounding 52 percent, raising everyone elses income taxes by 2.2 percentage points, and raising payroll taxes by 6.2 points.

Of course, it is no surprise that Medicare for All would be so expensive, since our current Medicare program is running $58 trillion in the red going forward. It turns out that free health care isnt really free at all.

How, though, could a single-payer system possibly cost so much? Arent we constantly told that other countries spend far less than we do on health care?

It is true that the U.S. spends nearly a third more on health care than the second-highest-spending developed country (Sweden), both in per capita dollars and as a percentage of GDP. But that reduction in spending can come with a price of its own: The most effective way to hold down health-care costs is to limit the availability of care. Some other developed countries ration care directly. Some spend less on facilities, technology, or physician incomes, leading to long waits for care.

Such trade-offs are not inherently bad, and not all health care is of equal value, though that would seem to be a determination most appropriately made by patients rather than the government. But the fact remains that no health care system anywhere in the world provides everyone with unlimited care.

Moreover, foreign health-care systems rely heavily on the U.S. system to drive medical innovation and technology. Theres a reason why more than half of all new drugs are patented in the United States, and why 80 percent of non-pharmaceutical medical breakthroughs, from transplants to MRIs, were introduced first here. If the U.S. were to reduce its investment in such innovation in order to bring costs into line with international norms, would other countries pick up the slack, or would the next revolutionary cancer drug simply never be developed? In the end, there is still no free lunch.

American single-payer advocates simply ignore these trade-offs. They know that their fellow citizens instinctively resist rationing imposed from outside, so they promise unlimited care for all, which is about as realistic as promising personal unicorns for all.

In the process, they also ignore the fact that many of the systems they admire are neither single-payer nor free to patients. Above and beyond the exorbitant taxes that must almost always be levied to fund their single-payer schemes, many of these countries impose other costs on patients. There are frequently co-payments, deductibles, and other cost-sharing requirements. In fact, in countries such as Australia, Germany, Japan, the Netherlands, and Switzerland, consumers cover a greater portion of health-care spending out-of-pocket than do Americans. But American single-payer proposals eliminate most or all such cost-sharing.

Adopting a single-payer system would crush the American economy, lowering wages, destroying jobs, and throwing millions into poverty. The Tax Foundation, for instance, estimated that Sanderss plan would have reduced the U.S. GDP by 9.5 percent and after-tax income for all Americans by an average of 12.8 percent in the long run. That is, simply put, not going to happen. So Americans are likely to end up with a lot less health care and than they have been promised.

Santa Claus will always be more popular than the Grinch. But the health-care debate needs a bit more Grinch and a lot less Santa Claus. Americans cannot have unlimited care, from the doctor of their choice, with no wait, for free. The politician that tells them as much will not be popular. But he or she may save them from something that will much more likely resemble a nightmare than a utopian dream.

Michael Tanner is a senior fellow at the Cato Institute and the author of Going for Broke: Deficits, Debt, and the Entitlement Crisis. You can follow him on his blog, TannerOnPolicy.com. This piece first appeared in the National Review.

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What Americans really want from health care reform is impossible – New York Post

Trump and health care: Promises made, promises broken – MSNBC


MSNBC
Trump and health care: Promises made, promises broken
MSNBC
That's hopelessly bonkers on a wide variety of fronts, but it's especially striking when it comes to health care. The president promised the American public, We're going to have insurance for everybody. Everybody's going to be taken care of. He

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Trump and health care: Promises made, promises broken – MSNBC

AARP warns senators against supporting GOP healthcare bill – Washington Examiner

AARP doesn’t want any senator to support the Republican healthcare proposal introduced on Thursday.

The organization dedicated to lobbying for older Americans over 50 years old took issue not only with some of the cuts the legislation would make but also the circumstances in which it was devised.

“This new Senate bill was crafted in secrecy behind closed doors without a single hearing or open debateand it shows,” AARP Executive Vice President Nancy LeaMond said in a statement. The Senate bill would hit millions of Americans with higher costs and result in less coverage for them. AARP is adamantly opposed to the Age Tax, which would allow insurance companies to charge older Americans five times more for coverage than everyone else while reducing tax credits that help make insurance more affordable.”

The group also complained that the bill would make cuts to Medicare and Medicaid.

“AARP is also deeply concerned that the Senate bill cuts Medicaid funding that would strip health coverage from millions of low-income and vulnerable Americans who depend on the coverage, including 17 million poor seniors and children and adults with disabilities. The proposed Medicaid cuts would leave millions, including our most vulnerable seniors, at risk of losing the care they need and erode seniors’ ability to live in their homes and communities,” LeaMond said. “The Senate bill also cuts funding for Medicare which weakens the programs ability to pay benefits and leaves the door wide open to benefit cuts and Medicare vouchers. AARP has long opposed proposals that cut benefits or weaken Medicare.”

The bill introduced Thursday follows the passage of the healthcare reform bill passed by the House, which aims to partially repeal and replace Obamacare care, the signature healthcare law of former President Barack Obama. AARP says that like it did with all the members of the House, it will hold all 100 senators “accountable” for their votes on this “harmful” bill.

“Our members care deeply about their health care and have told us repeatedly that they want to know where their elected officials stand. We strongly urge the Senate to reject this bill,” LeaMond concluded.

50 GOP votes are needed to pass the bill under the process of reconciliation, with a tie-breaker vote from Vice President Mike Pence. Already four of 52 Republicans, Sens. Ted Cruz of Texas, Ron Johnson of Wisconsin, Mike Lee of Utah and Rand Paul of Kentucky, have said they are “not ready” to support the bill in its current form. It is expected that all Democrats will oppose its passage. President Trump chimed in on Twitter on Thursday to say he supports the Senate bill.

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AARP warns senators against supporting GOP healthcare bill – Washington Examiner

Medicaid Restructuring Under the American Health Care Act and Children with Special Health Care Needs – Kaiser Family Foundation

Medicaid and CHIP cover 44% of children with special health care needs, providing access to a broad range of medical and long-term care services that enable many to live at home with their families and making coverage affordable. This brief includes state-level data on the share of children with special health care needs covered by Medicaid and describes Medicaids role for these nearly five million children to help inform the debate about the American Health Care Acts (AHCA) reduction of federal Medicaid funding under a per capita cap or block grant.

Nearly of all children with special health care needs live in low or middle income families, below 400% of the federal poverty level (FPL). About one in five are below 100% FPL (

Medicaid/CHIP children with special health care needs have significantly greater health needs compared to those with private insurance alone, with children covered by both Medicaid/CHIP and private insurance having the greatest needs. Medicaid/CHIP children with special health care needs are nearly two and one-half times as likely (24%), and those with both Medicaid/CHIP and private insurance are three times as likely (30%), to have four or more chronic conditions, compared to those with private insurance alone (10%). Medicaid/CHIP children are more than one and one-half times as likely (58%), and those with both Medicaid/CHIP and private insurance are nearly twice as likely (63%), to have four or more functional difficulties compared to those with private insurance (33%). Medicaid/CHIP cover 60% of the 2.9 million children with special health care needs whose health conditions consistently and often greatly affect their daily activities, with Medicaid/CHIP as the sole source of coverage for nearly half of these children.

Medicaid/CHIP children with special health care needs have access to care on par with those with private insurance alone. For example, Medicaid/CHIP children (92% for both those with and without private insurance) are about equally as likely to have had a preventive care visit in the last year compared to those with private insurance alone (91%). Medicaid/CHIP children are significantly more likely than those with private insurance to report that their coverage is adequate to meet their needs (69% vs 64%).

Medicaid/CHIP children with special health care needs are significantly more likely to report that their coverage is affordable compared to those with private insurance alone. Medicaid/CHIP children are more than five times less likely (6%), and those with Medicaid/CHIP and private insurance are half as likely (16%), to incur out-of-pocket costs of $1,000 or more, compared to those with private insurance alone (32%). Medicaid/CHIP is a safety net, covering 59% of the 2.7 million children with special health care needs whose families have had to reduce their work hours or stop working altogether due to their childs health status, and serving as the sole source of coverage for nearly half of these children.

Medicaid children with special health care needs may be particularly affected by changes in the AHCA, including the shift to per capita capped federal financing. Per enrollee spending for Medicaid children who use long-term care services is over 12 times higher ($37,084) compared to those who do not ($2,836), due to these childrens greater health needs and reliance on Medicaid for expensive but necessary services that are generally unavailable through private insurance and too costly to afford out-of-pocket. Many Medicaid coverage pathways for children with disabilities, and some community-based long-term care services provided through waivers, are offered at state option, making them subject to potential cuts as states adjust to substantial federal funding reductions under a per capita cap.

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Medicaid Restructuring Under the American Health Care Act and Children with Special Health Care Needs – Kaiser Family Foundation

Democrats Calling the GOP Health Care Bill Mean Are Impotent and Pathetic – Slate Magazine (blog)

Chuck Schumer speaks during a press conference on the Senate health care bill on June 22, 2017.

AFP/Getty Images

Last week, behind closed doors, Donald Trump apparently called the House health care bill mean. Unlike pretty much everything else the president has done since taking office, this description played to great popular acclaim. The word was like a wisp of a song that got caught in the countrys heada tune by Taylor Swift, perhaps: Why did the Grand Old Party have to be so mean?

On Thursday, Senate minority leader Chuck Schumer upped the rhetorical ante, critiquing the Senates Better Care Reconciliation Act by dramatically scribbling an -er on a piece of poster board.

Also on Thursday, Barack Obama wrote a Facebook post decrying the fundamental meanness at the core of this legislation, noting the act would snatch coverage away from 23 million Americans.

While we wait for the bill to pass and plunge whole swathes of the nation into crisis, lets muse for a moment on this childlike descriptor. Mean. It contains the requisite letters to compose the word men, which is great if youre racking your brain for epithets for a law that identifies womanhood as a costly preexisting condition. It rhymes with green, which is the color of the dollars that insurance and drug companies will bathe in as old people, pregnant people, and people with mental health issues lose their access to affordable health services. Mean also carries the slightly archaic connotation of miserliness or selfishness, and of shoddiness, too. I dont need to belabor the salience of those qualities as we watch a measure scotch-taped together out of the cruel fragments of Scrooge McDucks id work its way through the House of Representatives.

When Trump used the word mean, it seemed at once inadequate and innocenta plaintive plea from the mouth of a babe. The presidents moral imagination is a Chinese violin with only two strings: nice and mean. The House bill plucked the second one.

When Schumer used the comparative meaner, it seemed full of foolishness. The Democrats were so absorbed in and amused by their lame performance of outrage that they turned genuine moral indignation into kindergarten-grade insult comedy. That bill was mean. This bill is mean-ER. Weve got your votes, amirite?

Obamas meanness, however, felt just right, drawing attention to Republicans small-mindedness as well as their cruelty. The effect was similar to Hillary Clintons reclaiming of nasty. Sometimes it takes an adult to reveal a six-year-olds unintentional eloquence.

Read the original:

Democrats Calling the GOP Health Care Bill Mean Are Impotent and Pathetic – Slate Magazine (blog)

With the health care system threatened, Obama speaks up – MSNBC


MSNBC
With the health care system threatened, Obama speaks up
MSNBC
Less than two weeks after leaving office, this led Obama to issue a statement responding to the Trump White House's proposed Muslim ban. This afternoon, with the American health care system in peril, the former president spoke up again, this time via

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Here is the original post:

With the health care system threatened, Obama speaks up – MSNBC


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