Polling prescribes bipartisan compromise to move health care forward, argues Peggy Noonan – MarketWatch

Former Ronald Reagan speechwriter Peggy Noonan believes a patriotic bipartisanship is the path forward on health-care policy, and she says the polls back her up. To fellow Republicans worried that compromising with Democrats and leaving much of President Barack Obamas signature health-care law in place would represent abandonment of seven years worth of repeal promises, the Pulitzer Prizewinning Wall Street Journal columnist serves up this metaphor:

The Noonan recipe revolves in roughly equal parts around the Democratic Partys exhibiting humility in accepting that Obamacare [is] in some respects on the verge of collapse; the Republicans climbing down from a position wherein Majority Leader Mitch McConnell broaches with his caucus the notion of bipartisanship only in a manner that sounds threatening; and the adoption of a sort of Realpolitik that permits all parties to see that current health-care law requires improvement but also that polls suggest the American people are not in the mood for tax cuts to the comfortable and [health insurance] coverage limits on the distressed.

She name checks Democrats Joe Manchin, Joe Donnelly amd Heidi Heitkamp and Republicans Shelley Moore Capito, Bill Cassidy and Lindsey Graham as having shown hopeful recent signs of willingness to reach across the aisle. Noonan also takes heart from President Trumps palpable desire for a legislative accomplishment, no matter what the legislation itself prescribes.

Of Trump, Noonan writes:

Read the complete Peggy Noonan column at WSJ.com.

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Polling prescribes bipartisan compromise to move health care forward, argues Peggy Noonan - MarketWatch

As GOP struggles with health care, Democrats forge ties with ‘resistance’ – Washington Post

As Republicans return to their home districts to sell a flailing health-care bill, liberal groups are using the congressional recess to build opposition. They believe tens of thousands of phone calls, emails and in-person pushes will force on-the-fence senators to reject the legislation for good.

The fresh activism is coming with encouragement from Democratic lawmakers who are mired in the minority and have been mostly left to watch as Republicans struggle to reshape the nations laws to their liking. After starting the year on the defensive with their own base, party leaders and House and Senate Democrats are finally taking cues from these groups, believing that tactics honed far outside Washington could help scare Republicans into abandoning long-standing promises to upend the Affordable Care Act.

Ahead of the recess, while Republican senators toiled over details of their health-care overhaul behind closed doors, Sen. Brian Schatz (D-Hawaii) did whats become natural for Democrats lately: He lashed out on Twitter.

CBO confirms this thing is a %#$@ sandwich, he tweeted shortly after the release of the Congressional Budget Offices report that estimated 22 million more Americans would be uninsured under the Senate GOPs plan. He tweeted later that the lefts fight against the legislation is a test of the morality of our country. We have to win this one.

Democrats can see with their eyes where the energy is in American politics right now, said Ben Wikler, the Washington director of MoveOn.org, a liberal group initially launched to oppose the impeachment of President Bill Clinton.

Its to abandon politics as usual and put up a bare-fisted fight. Thats really sinking in.

Schatz won reelection last year with more than 70 percent of the vote and acknowledges he did so by airing really pretty ads and taking advice from expensive consultants. It might have worked for him in Hawaii, but President Trump won the White House and Democrats failed to win back control of the House or Senate.

So now he admits to being a recent convert to the tactics used by Wiklers group and other organizations such as CREDO Mobile; the American Federation of State, County and Municipal Employees; and the fast-growing Indivisible movement. The groups have organized protests or sit-ins at congressional district offices and urged followers to flood Capitol Hill phone lines in opposition to Education Secretary Betsy DeVoss appointment or Trumps travel ban. Neither pressure campaign stopped DeVos or the Trump ban, but Schatz said they signaled to Democratic lawmakers that the groups could quickly mobilize Americans against Trump.

Our playbook needs a refresh. Its predictable and its stale, Schatz said. That refresh is not just new language or a new standard-bearer, but a recognition that for Democrats to win, we need to fight for Democrats and then theyll fight for us.

For Schatz, that has meant firing off quick stream-of-consciousness tweets that have earned him headlines and 30,000 more followers so far this year. Its also meant marching in the streets for the first time in his life, as he did last week with activists who opposed the GOP health-care plan. And it means providing counsel to constituents or activists who still want a little guidance from an elected official.

The senator who once chastised Attorney General Jeff Sessions on Twitter for calling Hawaii an island in the Pacific said his change in tone is a recognition that people dont want to be sold soap.

They dont want a prepackaged product; they want to know that were people and that we respond to outrages in the same way that they do.

Democrats willingness to fight, particularly on health care, has not gone unnoticed by progressive activists who say they deserve credit for drawing in even wary moderates.

Democratic Sens. Joe Manchin III (W.Va.), Heidi Heitkamp (N.D.) and Claire McCaskill (Mo.) who are all up for reelection in states Trump won handily have all been eager to speak out. They joined a protest-turned-photo-op on the Senate steps with Senate Minority Leader Charles E. Schumer (N.Y.) and other Democrats, with each senator holding a portrait of a constituent who had benefited from Medicaid.

The way theyve coalesced around the health-care issue has been better than expected; theyve done so because of how many people were demanding it, said Winnie Wong, the co-founder of People for Bernie Sanders and an Occupy Wall Street veteran.

Schatz was one of only a handful of Democratic lawmakers to actually march in last weeks health-care rally other party leaders just showed up to give speeches. He waited restlessly as Sens. Ron Wyden (D-Ore.), Patty Murray (D-Wash.) and Schumer addressed the crowd.

They have lots of powerful wealthy people on their side, Schumer said of Republicans. Who do we have? You!

Schumer especially has seen his fortunes change with the far left. In February, thousands of protesters marched to Schumers Brooklyn home to demand resistance to Trumps Cabinet nominees; some chanted What the f---, Chuck.

The infighting has largely stopped since then. Schumer has been a regular presence at protests, thanking activists for having Senate Democrats back. Theyve returned the praise. Schumer is both speaking out at every opportunity and keeping the caucus aggressive, said Wikler, whose group helped organize the Capitol protest.

After Schumer spoke, Schatz stepped on stage and called the GOP health-care bill literally an $800 billion cut in Medicaid and literally an $800 billion wealth transfer to people who dont need it.

He offered some advice for the congressional recess: Dont wait for instructions from any organization. Whatever you think you can do in that moment, just do it.

Six months ago, everyone in that building thought that repeal of the Affordable Care Act was a done deal, Wikler said, pointing to the Capitol. Since then, he said, Democrats had learned to take some cues from the resistance.

Weve mobilized hundreds of thousands of people to participate in our democracy, and thats taught us something crucial about the resistance to Trump: its working, said Faiz Shakir, national political director for the American Civil Liberties Union.

In many ways, Schatz is an ideological counterweight to conservative foot soldiers such as Sens. Mike Lee (R-Utah), James Lankford (R-Okla.) or Joni Ernst (R-Iowa), other senators in their 40s with no obvious White House dreams who could find themselves in the Senate for decades to come. While many of his Democratic colleagues ponder a run for president, Schatz said he intends to stay in the Senate.

Somebody has to not run for president, Schatz quipped.

Schatz came to the Senate in late 2012 as the appointed successor of the late Sen. Daniel Inouye (D-Hawaii), who died after 49 years in the Senate just as Congress was in the throes of the fiscal cliff fight. The day after Christmas, Schatz flew to Washington aboard Air Force One with President Obama, who cut his annual Hawaiian vacation short to avert a financial disaster.

As Schatz prepared to travel from Washington to Honolulu on Thursday, a trip he makes nearly every weekend to see his wife and two young children, he admitted that despite doling out advice on how progressives should pressure Republicans during the upcoming recess, he hadnt determined what he will do. Schumer and House Minority Leader Nancy Pelosi (D-Calif.) have urged Democrats to hold news conferences, host rallies with progressive groups and submit op-eds to newspapers. Schatz said thats not good enough.

You cant fill a calendar and think thats a plan, he explained, meaning that he will avoid a strategy that dictates, Im going to use Facebook on Tuesday and use Twitter on Wednesday, and then Im going to send an op-ed in and hold a news conference on Friday.

Its a pretty chaotic environment out there, he said. We need to be a little more flexible.

Read more at PowerPost

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As GOP struggles with health care, Democrats forge ties with 'resistance' - Washington Post

Manchin: Dems want to work with Trump on health care – POLITICO – Politico

Sen. Joe Manchin's comments echo those of Senate Minority Leader Chuck Schumer. | AP Photo

Sen. Joe Manchin on Sunday said members of his party are willing to work with Republicans and President Donald Trump to find a bipartisan solution on health care.

Manchin, a moderate Democrat from West Virginia who has been seen as a potential partner on parts of Trump's agenda, made the comments in an interview on "Fox News Sunday."

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"I want him to know there are Democrats that want to work with him," Manchin said. "But right now, they can't even repeal it. They can't get 50 votes to repeal it because somebody's getting hurt more than what they're willing to sign on to."

"Look at some of us. Work with us Democrats who are willing to meet you in the middle, who have always been willing to meet you in the middle," Manchin said.

Manchin's comments echo those of Senate Minority Leader Chuck Schumer (D-N.Y.), who called for Trump to meet with Democrats to discuss how to fix problems in the health care system as a vote on the Senate GOP plan to replace Obamacare was delayed.

But Trump said at a recent rally he didn't think Democrats would vote for any health care bill, regardless of its merits. And earlier on Fox, White House legislative affairs director Marc Short called Schumer's calls to work on health care "disingenuous," citing Democrats' resistance to Trump's agenda so far, as well as resistance to confirmation of the president's nominees.

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Manchin also clarified during the interview that he has never supported the GOP's plan of repealing or replacing the law, but instead said the Affordable Care Act needs "repair."

"I think it needs repair," Manchin said. "I've thought from Day One. .. the private markets aren't working, and then on top of that we can do better through efficiencies."

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Manchin: Dems want to work with Trump on health care - POLITICO - Politico

Senate asks for CBO score on Cruz’s healthcare proposal – The Hill

Senate Republicans are asking the Congressional Budget Office to analyze a healthcare billthat includes changes proposed by Sen. Ted CruzTed CruzSenate asks for CBO score on Cruzs healthcare proposal The party of Lincoln has no soul the GOP and its toxic healthcare bill GOP scrambles to win centrist votes on ObamaCare repeal MORE (R-Texas), Axios reported Saturday.

They are also asking the independent scorekeeper to come out with an estimate on a healthcare bill without the proposed changes, in an effort to better understand the potential effects of Cruz's plan.

Cruz, who has said that he cannot vote for the Senate Republicans' healthcare bill in its current form, proposed an amendment to the measure this week that would allow health insurers to sell plans that do not meet the standards required by the Affordable Care Act.

Under that provision, insurance companies would still be required to sell at least one plan that meets the ACA's standards.

The plan could win support by some conservatives in the Senate, like Sens. Rand PaulRand PaulSenate asks for CBO score on Cruzs healthcare proposal Sunday shows preview: Trump clashes with media as health push delayed Surprise war vote points to shift in GOP MORE (R-Kent.) and Mike LeeMike LeeSenate asks for CBO score on Cruzs healthcare proposal Sunday shows preview: Trump clashes with media as health push delayed The party of Lincoln has no soul the GOP and its toxic healthcare bill MORE (R-Utah), who say the current Better Care Reconciliation Act (BCRA) does not do enough to repeal ObamaCare or lower insurance premiums.

By requiring insurers to offer at least one plan in each market that meets ObamaCare's regulatory standards, Cruz's plan could appease moderate Republicans, who have called for the Senate bill to maintain the ACA's rule prohibiting insurers from denying coverage to people with preexisting conditions.

The CBO released its assessment of the BCRA on Monday, estimating thatthe measure would trim the federal deficit by $321 billion, but would also increase the number of uninsured people by 22 million over the next decade.

Updated at 8:50 p.m.

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Senate asks for CBO score on Cruz's healthcare proposal - The Hill

Health care cuts: Rural hospitals ‘hanging on by their fingernails … – CNN

Raju pleaded with the hospital's owner to keep it open a few more days.

Ultimately, the hospital closed that Friday, leaving the rural town without a hospital for miles. Raju, who had been the hospital's chief of staff, is now the only doctor left in the town a two-hour drive south of Atlanta.

"I was very devastated when the hospital was closed," Raju said. "I was so attached to it. I practiced there for 33 years."

Raju knew that Richland's Stewart-Webster Hospital was "financially strained." Even for those patients covered by Medicaid, low reimbursement rates did not make a big enough dent. But Raju did not turn away any patients, even if they couldn't pay, he said.

Rural hospitals take a financial hit when they provide care to uninsured patients who can't afford it, said Elehwany. By insuring poorer patients, the Affordable Care Act hoped to remedy that. Despite its positive impacts, she said, it wasn't the magic bullet rural communities had hoped for.

"We strongly support the goals of the ACA," Elehwany said. "Everybody admits there's a few problems with the ACA, and unfortunately ... they seem to be magnified in rural America."

Sen. Shelley Moore Capito, a Republican from West Virginia, came out against the Senate health care bill this week for these reasons.

The Senate bill could cut revenues to rural providers by $1.3 billion each year, according to the Chartis Center and its partner iVantage Health Analytics. Roughly 34,000 jobs are also at risk, according to the analysis.

Raju, who sees 20 to 25 patients a day in his office, is not optimistic that hospital doors will reopen in Richland.

"I'm very doubtful it's going to happen, but we're not going to give up. We'll keep trying," he said.

That leaves his patients in what is known as a "medical desert." A long drive to the nearest hospital -- 45 minutes or more -- could be the difference between life and death, he said.

"Time is essential," he said. "We're going to lose some patients on the way because they cannot get the care in a reasonable amount of time."

But that doesn't deter Raju, who has been a staple in Richland for nearly four decades.

"I grew up in a rural area in India, and I always liked the small town," he said. "I've been here too long. I just can't go."

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Health care cuts: Rural hospitals 'hanging on by their fingernails ... - CNN

McConnell: Senate will stick with working on health care bill – USA TODAY

USA Today Network Morgan Watkins, The (Louisville) Courier-Journal Published 10:36 p.m. ET June 30, 2017 | Updated 10:40 p.m. ET June 30, 2017

Sen. Mitch McConnell slams the Democrats' efforts to preserve Obamacare during the Hardin County GOP's Lincoln Day Dinner. Sam Upshaw Jr./Courier-Journal/USA TODAY Network

Majority Leader Mitch McConnell speaks during a fundraising event at the State Theater in Elizabethtown, Ky on Friday evening. June 30, 2017(Photo: Alton Strupp/CJ)

LOUISVILLE Although his conservative comrades in the Senate are still butting heads over a controversial health care bill, Sen. Mitch McConnell of Kentucky was optimistic about the potential for compromise Friday evening.

President Trump tweeted Friday that congressional Republicans should consider repealing the Affordable Care Act popularly known as Obamacare first and then work on a replacement. Kentucky's other Republican senator, Rand Paul, has expressed support for that idea.

But McConnell told reporters Friday that he and his colleagues in the Senate will stick to working on their current health care bill, which would repeal and replace the ACA simultaneously.

Speaking to a friendly crowd in Elizabethtown during a fundraiser for the Republican Party of Hardin County, McConnell compared his current predicament to holding a Rubiks cube.

Read more:

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Senate health care bill negotiations: These are the big issues on the table

Poll: Only 12% of Americans support the Senate health care plan

The Senate majority leader said hes trying to figure out how to twist the dials to get enough votes to pass this proposal, which is expected to slash hundreds of billions of dollars from Medicaid over time and reduce some of the taxes paid by wealthy Americans.

Rolling back the ACA was a signature issue for Republicans during last year's election, and some conservative lawmakers have suggested shortening or eliminating Congresss recess in August so theyll have more time to work on that as well as other priorities.

McConnell didnt offer a definitive opinion about that idea Friday evening. Instead, he said, Well see what we need to do.

During his speech to a roomful of Hardin County Republicans on Friday, McConnell said he is confident that comprehensive tax reform another key goal for the GOP will happen.

Despite the deep divisions between Republicans and Democrats, McConnell said he sees infrastructure as an area where their interests may intersect. But Democrats aren't interested in comprehensive tax reform, he said. Instead, they'd prefer "raising taxes on people who are productive."

Sen. Mitch McConnell said wrestling with an Obamacare repeal is like working with a Rubik's Cube during the Hardin County GOP's Lincoln Day Dinner. Sam Upshaw Jr./Courier-Journal/USA TODAY Network

America is a land of second opportunities, he said. There are only two ways to fail in this country: Give up or die.

Do we want it to be a country in which risk-taking is applauded and failure is possible? Yes, he said. Failure has to be possible or you cant have success.

As McConnell spoke at the Historic State Theater in Elizabethtown on Friday evening, a small but passionate group of people concerned about the future of health care in America gathered across the street.

Approximately 85 people stoodtogether, chanting and waving anti-McConnell signs as passers-by occasionally honked their horns in solidarity or yelled "Trump" as they drove by.

Abbey Sorrells, 22,of Elizabethtown, who works at a rape crisis center, said she came to the rally with some friends who are part of a group called the Heartland Progressive Alliance.

Healthcare not Wealthcare, read the sign she carried.

I just feel like the health care bills really for the 1%, she said.

Audrey Morrison, 68, of Louisville drove down to Elizabethtown to join her daughter, who interns for Planned Parenthood.

I hope that we persist, she said, because the Republican plan to repeal and replace the Affordable Care Act isnt a done deal yet.

Morrison said she didnt expectthe rally to change McConnells mind.

I think hes been bought and sold. I dont think anythings going to make a difference to him, she said.

However, she still hopes Kentucky voters, whove repeatedly elected McConnell to the Senate for the past 30 years, will finally turn against him and call for change.

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Health care and health insurance are not the same thing – the fundamental disconnect in health care reform – Fox News

Politicians from both sides of the aisle continue to show a troubling disconnect from basic principles in their approach to health care reform. Among their many debates about changing health care, the single most essential reform reducing the cost of health care itself - is typically underemphasized or even entirely absent from the discussion. Yet that is the fundamental avenue to broader access to care, lower insurance premiums, and ultimately better health.

Instead, legislators continue to erroneously focus on increasing the percentage of people with health insurance. But the disregarded reality is that health insurance premiums are only a secondary manifestation of other factors, chiefly the cost of medical care and to a lesser extent the regulatory environment for insurance.

In a misguided attempt to insure more people at all cost, the Affordable Care Act (aka ObamaCare) doles out over $1 trillion of tax revenues to subsidize premiums and adds numerous regulations and taxes, many of which counterproductively increase premiums. At this point, there should be no need to debate the harmful impacts of this approach insurance premiums skyrocket; insurers withdraw from the marketplace; and for those with coverage, doctor and hospital choices narrow dramatically.

What is baffling is that todays Republican-dominated House and Senate both continue to focus on making insurance more affordable, mainly through cash to consumers in refundable tax credits. By ignoring the root problem, such policies artificially prop up insurance premiums for coverage that often minimizes out-of-pocket payment. This shields medical care providers from competing on price. While emerging GOP proposals rightfully strip back some of the ACAs harmful regulations and taxes, far more emphasis is urgently needed on reducing medical care costs, the core cause underlying high insurance costs.

It is also particularly disturbing that our own elected leaders ignore what we all should have already learned from those countries boasting about a fully insured population under socialized medicine. In those countries with government insurance for all, epitomized by the shameful NHS of the United Kingdom, their insured patients have far worse access to care for even the sickest patients. There are unconscionable delays for those needing urgent treatment for already diagnosed cancer (17% wait more than two months) and already recommended brain surgery (17% wait more than 18 weeks); delayed access to important medications; and factually worse outcomes from serious diseases like cancer, heart disease, stroke, high blood pressure, and diabetes compared to Americans pre-ObamaCare. Indeed, having insurance is not at all synonymous with having access to quality medical care.

Lowering the cost of medical care itself, though, is fraught with peril. It must be achieved without harming patients. That means without jeopardizing quality, restricting access, or inhibiting critical innovation of American medical care that - based on peer-reviewed data throughout the leading medical journals (see, for example, reviews such as In Excellent Health ) - is the standard of excellence for the world.

We first must create an environment where consumers care about prices and receive benefit from seeking value. But is it even realistic to suggest that people could shop for medical care and seek value, as Americans do for virtually every other good and service?

Some medical care, including emergency care, obviously does not lend itself to price consideration. But emergency care represents only six percent of health care expenditures.

Among privately insured adults under age 65, almost 60 percent of all health expenditures is for elective outpatient care; only 20 percent is spent on inpatient care and 21 percent on medications. Likewise, 60 percent of Medicaid money is spent for outpatient care. Even in the elderly, almost 40 percent of expenses are for outpatient care. Of the top one percent of spenders, the group responsible for more than 25 percent of all health spending at an average of $100,000 per person per year, a full 45 percent of care is also outpatient. Outpatient health care services dominate Americas health spending, and these are amenable to value-based decisions.

To fully leverage consumer power on health care prices, consumers must have an expanded role in directly paying for their care. Higher deductible insurance plans (HDHPs) are vehicles to position patients as direct payers for a higher proportion of their medical care. These plans are most effective when combined with large health savings accounts. When people have a reason to shop for value - when they have growing savings to protect in HSAs - the cost of care comes down without harmful impact on health. When paired with HSAs, spending of those with HDHPs decreased at least 15% annually in a March 2015 study. More than one-third of the savings by enrollees in such coverage reflected value-based decision-making by consumers. Cheaper, limited mandate, high deductible coverage; markedly expanded HSAs; and targeted tax incentives to expand their use are key to reducing medical care prices.

Leveraging the power of seniors, the biggest users of health care, is also important. The expected tripling of health expenses for a 65-year-old by 2030 projected by HealthView makes HSAs even more relevant, particularly since todays seniors with their longer lifespan need to save money for decades, not years, of future health care.

In addition, reforms must eliminate the artificial constraints on the supply of medical care. Although less publicized, almost two-thirds of the 2025 projected doctor shortage of 124,000 will be in specialists, not primary care. Medical school graduation numbers have stagnated for almost 40 years. Severe protectionist residency training program restrictions have been in place for decades. And archaic non-reciprocal licensing by states unnecessarily limits specialist patient care, especially as telemedicine proliferates. These anti-consumer practices need to be open to public scrutiny and abolished.

Primary care specifically could be far less costly with immediate modernization. Nurse practitioners and physician assistants can provide the vast majority of routine primary care, including flu shots, blood pressure monitoring, and prescription renewals. In a 2011 review, 88 percent of visits to retail clinics involved relatively simple care, 3040 percent cheaper than at physician offices and about 80 percentcheaper than at emergency departments. These clinics can potentially save hundreds of millions of dollars per year with high patient satisfaction. We need to simplify credentialing requirements for such clinics, and states should remove outmoded scope-of-practice limits on nurse practitioners and physician assistants.

The primary goal of health reform should be to reduce the costs of medical care, not to increase the number of insurance holders. Beyond regulatory reform and tax repeal, specific mechanisms to reduce the prices of health care without harming access, quality, or innovation have been proven effective, and they should be the focus of health care reform. Everything else follows.

Scott W. Atlas is the David and Joan Traitel Senior Fellow at Stanfords Hoover Institution and the author of Restoring Quality Health Care: A Six Point Plan for Comprehensive Reform at Lower Cost.

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Health care and health insurance are not the same thing - the fundamental disconnect in health care reform - Fox News

Oregon House OKs reproductive health care bill for women – The Register-Guard

SALEM The Oregon House engaged in a rare and often somber floor debate on abortion Saturday, as majority Democrats passed a womens health care bill.

House Bill 3391 requires Oregon insurers to cover many reproductive health services for women, including abortion, without charging them any out-of-pocket expense. It also extends the same coverage to unauthorized immigrants, at a two-year cost to the state of $10.2 million.

The controversial bill passed on a largely party-line 33-23 vote, after several hours of debate.

All House Republicans voted no, joined by Rep. John Lively, a Springfield Democrat.

House Democratic Leader Jennifer Williamson of Portland said the policy would mean healthier individuals and healthier families.

The amount of money a person makes should not determine their access to health care, she said.

Added Rep. Julie Fahey, a Eugene Democrat and bill chief sponsor: Health care is a basic human right.

But the bill provoked an emotional response from House Republicans, many of whom are personally opposed to abortion.

Rep. Andy Olson, an Albany Republican, recounted the story of his granddaughter, born premature at 25 weeks. The girl died as an infant. Near tears, he said that child was a whole little girl, yet could have been legally aborted under Oregon law. I cant reconcile in my mind how anyone who has a walk with God, can support this, he said, slamming his hand on his desk. I just cant get there with you.

In addition to abortion, the bill requires insurers to provide free services for women that include: birth control; prenatal and postpartum care; screenings for sexually transmitted diseases, cervical and breast cancer; breastfeeding support and supplies; counseling for domestic violence victims; and tobacco cessation.

In a concession by Democrats, religious employers would be exempt from having to provide health plans with abortion or contraceptive coverage. And one major insurer in Oregon, Providence, a Catholic organization, successfully lobbied to be removed from the requirement as well. Providence covers around 260,000 Oregonians.

The bill grants similar health and reproductive services to unauthorized immigrant women who would otherwise qualify for the coverage under the Oregon Health Plan, the states version of Medicaid, because of their low income.

OHA estimates almost 23,000 authorized immigrants would receive such services during the next two years, costing the state $10.2 million. Of that, an estimated $500,000 would cover abortions for those women.

Rep. Duane Stark, a Grants Pass Republican, said he could feel rage coming up through (his) neck when he thought about taxpayer dollars paying for those abortions. These little humans have a heartbeat 18 days after conception, he said. Science clearly shows that life begins in the womb.

But House Democrats refused to be drawn into a dragged-out fight about abortion, with only three of their 35 present members speaking up on the bill at all.

Frustrated moderate Republicans, meanwhile, said the bill would heighten partisan tensions in the final days of session. Rep. Knute Buehler, a Bend Republican and likely gubernatorial candidate, said that hes personally pro-abortion. But he voted no on the bill, in part because of its cost.

Democrats, he said, are play(ing) politics with an issue thats deeply personal.

But the Oregon Pro-Choice Coalition said in a press release that the bill will ensure that every Oregonian can decide when and whether to become a parent regardless of income, type of insurance, citizenship status or gender identity.

The bill now heads to the Senate, where it is expected to pass.

Follow Saul on Twitter @SaulAHubbard . Email saul.hubbard@registerguard.com .

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The biggest winner in the current health-care debate: Single-payer – Washington Post

We still don't know who will ultimately prevail in the debate over the future of American health care: the Republicans who want to overhaul Obamacare, or the Democrats who want to keep it in place.

But after weeks of debate, there is one clear winner so far: single-payer health care.

No, single-payer isn't going to happen at the end of this debate or even the end of this year or this decade, necessarily. But the logical foundations for it are being laid in our political debate just about every single day. And when you pair that with the rising public support for government-run health care, it's clear in which direction this wholedebate is trending.

The most surprising aspect of the current health-care debate, for me, has been how Republicans have essentially given up on making the conservative case for their bills. They aren't even arguing that the free market would lead to higher-quality care, efficiency and medical advancements, as the GOP of old might have. Instead, they are trying to obscure the reality that their bills would cut Medicaid by hundreds of millions of dollars (versus where funding is currently set) and would increase the number of uninsured Americans by potential 20 million or more.

Part of this is because that's a losing argument. The reality of entitlement programs and government benefits is that, once they are instituted, it's very, very difficult to get rid of them or even scale them back. Just look at what happened to the GOP when it suggested privatizing Social Security last decade.

That political reality has also basically forced Republicans to concede this point: that people being uninsured is a very bad thing, and that cutting funding to Medicaid is a bad thing. They have basically conceded that government involvement in health care is a good thing or, at least, a necessary thing. That wasn't the argument they were making against Obamacare eight years ago.

Democrats, meanwhile, are gradually talking themselves into supporting single-payer, it would seem. Their laser-like focus on the number who are uninsured and the Medicaid cuts has a logical conclusion. There is only one way to make sure nobody is uninsured, after all.

And there are signs that both parties' bases are indeed moving toward government health care. APew studyin January showed 60 percent of Americans felt it was the government's job to guarantee health-care coverage for all Americans up from 51 percent in early 2016.About 8 in 10 Democratic-leaning voters and 3 in 10 Republican-leaning voters agreed with this statement.

That's not quite single-payer, of course, so Pew broke it out a little bit more in its most recent study. It asked those who supported a government guarantee whether they backed single-payer or a mix of government and private programs. In this case, support for single-payer was 33 percent overall 52 percent on the Democratic side and 12 percent on the GOP side.

One of the realities of polling, though, is that when you give people more than two options, they will tend toward the middle-ground response. A "mix of government and private programs" is a pretty safe middle ground, it would seem, and may actually undersell single-payer support.

And sure enough, a Gallup poll from mid-2016 actually showed a 58 percent majority of Americans wanteda "federally funded healthcare program providing insurance for all Americans." A CBS News poll in February 2016 asked more directly about single-payer and found 44 percent support. NORC pegged it at 38 percent but only 24 percent if people were told that it would greatly increase government spending. (Philip Bump summarized all of these data here.)

What we can say with certainty, though, is that the debate over this topic has taken on a new flavor as Republicans have been working to finally undo Obamacare. And it's a flavor that reflects a growing move toward government health care.

The GOP may yet move the needle away from government health care by the time all is said and done, but the center of this political debate has moved noticeably to the left.

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The biggest winner in the current health-care debate: Single-payer - Washington Post

Here’s How the Wealthy Gain From GOP Health Care Bill – NBCNews.com

Some Republicans are interested in easing the bill's Medicaid cuts and making subsidies for private insurance more generous at low incomes, but the math doesn't add up as long as the bill gives them $700 billion less in revenue to work with than Obamacare.

And some Republican senators have

The point is, you cannot increase the burden on lower-income citizens and lessen the burden on wealthy citizens, Senator Bob Corker, R-Tenn., told NBC News on Thursday. Thats not an equation that works.

Keeping Obamacare's tax on investment income adds $172 billion over 10 years, which is significant. But there's little talk of keeping the taxes on medical companies, which critics say are passed on in higher prices for consumers. Nor is there any indication yet that Republicans are willing to raise taxes elsewhere to make up the income.

That could leave them with the same fundamental problem: Less spending that provides fewer benefits than Obamacare can deliver.

Continued here:

Here's How the Wealthy Gain From GOP Health Care Bill - NBCNews.com

Finally Everyone Agrees: Health Care Is a Human Right – RollingStone.com

Many years ago, while researching a book chapter on health care reform, I visited a hospital in Bayonne, New Jersey that was having problems. Upon arrival, administrators told me a story that summed up everything that is terrible and stupid about American health care.

A patient of theirs suffering from a chronic illness took a bad turn and had to come in for a minor surgical procedure. The only problem was, the patient had been taking Coumadin, a common blood thinner, as part of his outpatient care.

So they brought him in to the hospital, weaned him off the Coumadin, did the surgery successfully, then sent him home. All was well until they billed the insurer. The answer came back: coverage denied, because the operation had not been conducted in "timely fashion."

Of course, had they operated in a more "timely fashion," the patient would have bled to death on the operating table. But such is the logic of the American health care system, a Frankenstein's monster of monopolistic insurance zones peppered with over a thousand different carriers, each with their own (often cruel) procedures and billing systems.

The hospitals I visited all told me they devoted enormous resources as much as half of all administrative staff, in one case to chasing claims. Patient care in American is in this way consistently reduced to a ludicrous and irrational negotiation of two competing professional disciplines: medicine, and extracting money from insurance companies.

Patients get trapped between hospitals that overcharge for simple procedures and insurers who deny coverage for serious ones. Administrative costs and profit are two of the bigger factors explaining why Americans spend about twice as much per person or more on health care compared with other industrialized countries, but get consistently worse results.

Ideas like a single-payer system, or ending the antitrust exemption for insurance companies, would be obvious fixes. But when they came up during the Obamacare debate, they were dismissed as politically unfeasible and/or too costly. Because the United States will not do what other countries do as a matter of course declare health care to be a universal human right and work backward from that premise we are continually stuck with patchwork political solutions that protect insurance and pharmaceutical company profits while leaving masses of people uninsured.

This is why it's so interesting to see so many of the opponents of universal health coverage attacking the idiotic Trumpcare bill on moral, rather than financial, grounds. Trumpcare is, like most Republican health care concepts, a depraved and transparent effort at slashing coverage and converting the benefits into tax breaks for rich people. This has resulted in howls of outrage from people who seem to have only just discovered that denying people health care might be bad for their health.

Take Paul Krugman's piece in the New York Times today, "Understanding Republican Cruelty":

"More than 40 percent of the Senate bill's tax cuts would go to people with annual incomes over $1 million but even these lucky few would see their after-tax income rise only by a barely noticeable 2 percent.

"So it's vast suffering including, according to the best estimates, around 200,000 preventable deaths imposed on many of our fellow citizens in order to give a handful of wealthy people what amounts to some extra pocket change."

This is interesting, because only last year Krugman was telling us we should abandon efforts to seek universal health care and focus "on other issues." As he put it:

"If we could start from scratch, many, perhaps most, health economists would recommend single-payer, a Medicare-type program covering everyone. But single-payer wasn't a politically feasible goal in America."

Krugman then went on to explain that the "incumbent political players" private insurers, among others simply had too much power, so it was better to give them something and get some health care than to take something away from them and get nothing.

He also said that additional tax revenue would make a more universal program politically untenable; he said this even as he admitted that such a program would probably reduce costs overall, but countered that "it would be difficult to make that case to the broad public, especially given the chorus of misinformation you know would dominate the airwaves."

Krugman's concession to what he called "Realities" meant that it was OK to leave an expected 31 million people uninsured. This was the argument last January, when most pundits and Vegas bookmakers were sure we were looking at four more years of a Democratic White House.

Instead, the monster Trump is in power, and trying to further roll back coverage in a field he surely doesn't understand through legislation he apparently doesn't even like. Reports say he has "shown little interest in what's in the bill," but that he thought the House version was "mean, mean, mean."

That doesn't mean Trump or the Republican Party plans on doing anything substantive to fix their idiotic health care bill. In a scene straight out of Swift or Gogol, Republican Senators were apparently stunned to their cores to discover via the Congressional Budget Office that their steal-from-the-poor, give-to-the-rich mutant of a bill would push 23 million people off the health care rolls.

"It knocked the wind out of all their sails," a GOP aide told reporters.

While the Republicans scramble to figure out the next step, Democrats continue to hammer the theme that Republicans want to kill their voters. I'm not a big fan of this kind of rhetoric, but I'll take it if it means the party is having an epiphany about the moral aspects of the health care debate. Surely if pushing some people off health care is killing them, then leaving tens of millions more without care is no better.

Health care is an absolute human right. On a policy level we already recognized this decades ago, during the height of the Reagan era, when the Emergency Medical and Treatment Labor Act made it illegal for public and private hospitals alike to turn patients away in an emergency. There is simply no moral justification for denying aid to a sick or dying person. Any country that does so systematically is not a country at all.

Let's hope the awful Trump era awakens us to the broader issue. The sad thing is that doing the right thing is also the smart thing. As other countries have already discovered, universal coverage systems that put the right incentives back into health care greatly reduce costs and waste. Getting there isn't "unrealistic." It's necessary, morally and otherwise.

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Finally Everyone Agrees: Health Care Is a Human Right - RollingStone.com

Trump Backers ‘Furious’ That Senator Stood Against Health Care Bill – New York Times

The political fallout from Mr. Hellers high-profile news conference a week ago offers a vivid illustration of the new fault lines on the right in the Trump era. After years of fierce clashing between Republican hard-liners and mainstream conservatives, the purity-versus-pragmatist wars have given way to a new, Trump-centered debate that highlights how fully the president has taken over the party.

On the other hand, Mr. Heller faces enormous grass-roots pressure to stand his ground against the bill. He has clung tightly to his states popular Republican governor, Brian Sandoval, a staunch opponent of the repeal who accepted the Medicaid expansion dollars in the Affordable Care Act. More than 200,000 Nevadans have gained insurance through Medicaid since the passage of the health law.

What angered the Republican rank and file about Mr. Hellers critique was not so much his unease with the compromise Senate legislation a measure that many on the far right are also displeased with but that he would so purposefully undermine the presidents agenda.

And it is not just party activists who are displeased with the senator.

Mr. Adelson and Mr. Wynn, two of Las Vegass leading gambling titans, each contacted Mr. Heller at the request of the White House last week to complain about his opposition to the Republican-written health overhaul, according to multiple Republican officials.

One ally of Mr. Hellers acknowledged that Mr. Adelson and Mr. Wynn were unhappy with the senator at the moment and that their relationship needed some repair work.

Both billionaire donors are close to Mr. Trump, a fellow tycoon. Mr. Adelson played a pivotal role in Mr. Trumps election, showering Republican groups last year with tens of millions of dollars. Mr. Wynn is the finance chairman of the Republican National Committee and oversaw a fund-raiser on Wednesday at the presidents Washington hotel that Mr. Trump said had raised about $7 million for the party committee and his re-election campaign.

Earlier that day, America First Policies held a donor meeting for those who were in the capital for that evenings fund-raiser. Every contributor who raised the issue of the anti-Heller campaign an extraordinary offensive against a vulnerable senator in ones own party expressed approval of the attacks, according to an attendee.

Ronald M. Cameron, a major Republican donor who gave the maximum $5,400 donation to Mr. Hellers re-election campaign this year, said he would consider investing in primary race challenges to Republican lawmakers who oppose the health care bill or other White House legislative priorities.

I might support a challenger, and would certainly withhold support from someone that I thought was against Trumps agenda, said Mr. Cameron, an Arkansas poultry magnate who donated more than $2 million to committees supporting Mr. Trumps 2016 campaign and attended the Wednesday fund-raiser for his re-election.

Mr. Cameron who was solicited by America First but said he had not donated to the group said that he was not familiar with the groups ads against Mr. Heller, but that he did not object to the idea of publicly calling out lawmakers who oppose the health care bill.

They should shape up or get out of the way, he said.

Mr. Trump himself, while acknowledging the complaints of the Republican senators at the White House meeting, has in other private sessions with his aides and allies made clear that he very much approved of the onslaught against Mr. Heller. At the wedding of Treasury Secretary Steven Mnuchin last Saturday and then again in the White House this week, he told advisers that he supported the ad blitz, according to multiple Republican officials who have spoken to the president.

Officials with America First insist that Mr. Trump and the White House staff all supported their decision to target Mr. Heller. But there has been some unease in the administration over the strategy, which created a significant rift with the Senate majority leader, Mitch McConnell of Kentucky, and other Republican senators at the very moment they were trying to forge consensus around the repeal bill.

At least one White House official sought to halt the attacks out of fear that alienating Mr. Heller would carry adverse ramifications well beyond the health debate. The Nevada senator is a crucial vote not only in the chamber where Republicans have a bare two-seat majority but also on the finance and banking committees. The two panels have jurisdiction over legislative priorities like tax cuts and presidential appointments.

Close advisers to Mr. Heller say he is open to eventually supporting the legislation, if significant changes are made.

Megan Taylor, a spokeswoman for Mr. Heller, did not respond to questions about his call with the casino magnates or the prospect of a primary race next year.

In a statement, she said Mr. Heller continues to engage with his colleagues, leadership and the administration to discuss what Nevada needs to see in this bill. But, she said, its not about Senator Heller getting to a yes; its about improving the legislation so that it achieves his goals of lowering costs and protecting Nevadas most vulnerable.

Mr. Trump and Mr. Heller have little in the way of a relationship. The senator never supported the presidents campaign, and Mr. Trump identifies him with a larger group of Nevada Republicans, including Mr. Sandoval, who either remained on the sidelines throughout 2016 or spurned him in the wake of the Access Hollywood tape disclosure last October.

The day after Mr. Trump was revealed to have boasted on that tape about sexually assaulting women, a pair of Republican lawmakers in Nevada made a show of abandoning their party nominee at a rally outside Las Vegas. In doing so, Representative Joe Heck, who was running for the Senate, and Representative Cresent Hardy, who was seeking re-election, enraged Mr. Trumps supporters.

Both lost their campaigns, making Nevada a rare bright spot in an otherwise lackluster year for Democrats.

To Nevada conservatives, it was an instructive moment and one they said Mr. Heller appears not to have learned a lesson from.

Hes making a tragic mistake that I thought had already been learned by the G.O.P. delegation in Nevada, said Wayne Allyn Root, a conservative talk show host and columnist in Las Vegas. When you abandon Trump, you dont get one Democrat, but you lose Republicans.

Both Mr. Root and Chuck Muth, another Nevada-based conservative activist, said they had been inundated with emails and calls from grass-roots Republicans who are angry about Mr. Heller. But whether that fury translates into a viable primary race challenge is far from certain. The senator will have significant financial support from his allies in Washington, and there is no obvious Republican opponent on the horizon. Mr. Tarkanian said he was also eyeing another run for the House seat he narrowly lost last year.

Another potential challenger, the state treasurer, Dan Schwartz, said he was likely to run for governor and has signaled to Mr. Heller through intermediaries that he will not take on the senator.

He will pay some price, but I just dont think its realistic, Mr. Schwartz said, citing the money needed to challenge Mr. Heller. Hes in a tight spot, but I dont think its dire.

Maggie Haberman contributed reporting from New York.

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A version of this article appears in print on July 1, 2017, on Page A1 of the New York edition with the headline: Fury in Nevada for Senator Who Defied President on Health Bill.

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Trump Backers 'Furious' That Senator Stood Against Health Care Bill - New York Times

What exactly does Trump want from this health care bill? – CNN

On Friday morning, he awoke to fling a new wrench into already tense negotiations. "If Republican Senators are unable to pass what they are working on now," Trump tweeted, "they should immediately REPEAL, and then REPLACE at a later date!"

The message represented yet another twist in the long series of contradictions that mark his ever-shifting prescription for health care.

It wasn't the first time Trump very clearly rejected the notion of any health care layover.

But the most glaring difference between what Trump touted on the trail and what the Senate bill might deliver involves Medicaid, a program he pledged to protect, along with Medicare and Social Security, while warning that other Republican candidates might not.

The CBO, a nonpartisan agency, has estimated that the House and Senate bills would, respectively, lead to 23 and 22 million people losing insurance -- in comparison to the numbers expected under current law -- over the next ten years.

"We're going to have insurance for everybody," he told reporters. "There was a philosophy in some circles that if you can't pay for it, you don't get it. That's not going to happen with us."

Except that, according to the plans Republicans are now pushing, it will. Trump must sense this as he has twice now referred to the GOP health care plan as "mean." When former President Barack Obama derided what he called its "fundamental meanness" in a Facebook post, Trump actually responded by reminding Fox News that he used the language first.

"Well, (Obama) actually used my term, 'mean.' That was my term," Trump said. "Because I want to see -- and I speak from the heart -- that's what I want to see, I want to see a bill with heart."

Senate Republicans, however, facing the prospect of an unpopular vote much like their House colleagues nearly two months ago, have revolted against Senate Majority Leader Mitch McConnell's proposal. All of which set the stage for Trump's endorsement Friday of repealing Obamacare and then replacing it later -- the very thing he so publicly rejected months earlier.

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What exactly does Trump want from this health care bill? - CNN

Fresh polls find Republicans’ health-care proposal is still a clunker – Washington Post

A slew of new national surveys completed during the past week shed light on how voters are reacting to Republicans bills to repeal and replace the Affordable Care Act. The surveys show opposition continues to outpace support by a wide margin, with tepid support among Republicans and overwhelming opposition among Democrats.

Comparing polls, there is a range in how much opposition outweighs support. Among recent national live-interviewer polls, the Republicans health proposal fares best in a Fox News poll conducted June 25 to 27 that showed 27 percent of registered voters favored and 54 percent opposed the Senate Republican bill released last Thursday, a 2-to-1 margin of opposition. By contrast, a Suffolk University-USA Todaypoll starting one day earlier found a nearly 4-to-1 margin of opposition (45 percent opposed while 12 percent supported). The margin was similar in a Quinnipiac University poll begun the day Republican senators released their draft bill, with 58 percent who disapproved and 16 percent who approved. A fourth survey released this week by NPR-PBS NewsHour-Marist found a 3-to-1 margin of opposition, with 55 percent who disapproved and 17 percent who approved.

Almost all the polls on the issue had high percentages of people saying they had no opinion, probably as a result of the complicated and changing nature of legislation as well as whether the polling firm explicitly offered respondents a no opinion option. For instance, the Suffolk-USA Today survey asked whether respondents support or oppose the GOP plan, or don't you know enough to have an opinion? and found 43 percent of registered voters took that option.

There are sharp partisan differences in opinion on the GOP health-care proposals, as there is with the Affordable Care Act, but also a clear imbalance, with Democrats far more united in opposition than Republicans are in support. Across seven polls conducted since mid-month, Democratic opposition varied from 70 percent opposed in the Suffolk-USA Today poll to 84 percent disapproving in the CBS poll and Quinnipiac polls. By contrast, Republicans support for the law is lowest at 26 percent in the Suffolk-USA Today poll and highest at 63 percent in the CBS poll, a massive range indicating ambivalence toward their partys top legislative initiative.

Polls asking about the House and Senate bills dont appear to show dramatically different results, a sign that as debate over the law has continued, Republicans repeal and replace efforts do not appear to be gaining or losing popularity.

The polls also asked different groups of people Fox, Suffolk-USA Today and Quinnipiac polls all interviewed registered voters while the other polls pulled from American adults overall.

Beyond that, each of the seven polls worded their questions on the Republican health-care plan somewhat differently. Fox News asked whether voters favored or opposed the Senate health-care plan that would replace the Affordable Care Act, while NPR-PBS NewsHour-Marist asked whether people approved or disapproved of the Republican health-care plan. And NBC News-Wall Street Journal asked whether Americans thought the House bill was a good idea or bad idea.

Heres the full wording for each of the seven surveys:

Fox News: As you may know, the Senate recently released its version of a health care plan that would replace the Affordable Care Act, also known as Obamacare. Do you favor or oppose this legislation?

Suffolk-USA Today: Senate Republicans have unveiled their proposed healthcare plan to replace Obamacare. Do you support or oppose the GOP plan? Or dont you know enough to have an opinion?

Quinnipiac University: There is a Republican health care plan to replace Obamacare. Do you approve or disapprove of this Republican health care plan?

NPR-PBS NewsHour-Marist: From what you have read or heard, do you approve or disapprove of the health care plan Senate Republicans have proposed?

NBC News-Wall Street Journal: The health care bill passed by the House is a good idea or a bad idea?

CBS News: As you may know, Republicans in Congress passed a bill in the House of Representatives to repeal and replace the 2010 health care law. From what you have heard or read, do you approve or disapprove this plan?

Kaiser Family Foundation: As you may know, Congress is currently discussing a health-care plan that would repeal and replace the Affordable Care Act. Given what you know about this proposed new health-care plan, do you have a generally (favorable) or generally (unfavorable) opinion of it?

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Fresh polls find Republicans' health-care proposal is still a clunker - Washington Post

A Price for the GOP’s Health Care Insanity – New York Times

Average premiums for the benchmark Obamacare plan rose 8 percent in 2016 and 21 percent in 2017, according to Kaiser Family Foundation data, while deductibles were up by about 15 percent. For some markets and plans, the premium increases were considerably higher: 67 percent in Oklahoma City; 71 percent in Birmingham, Ala.; 145 percent in Phoenix.

Same deal for employer-sponsored plans. While Sen. Obama promised during his campaign in 2008 that the average family would see health insurance premiums drop by $2,500 per year, the average family premium for employer-sponsored coverage has risen by $3,671, noted Maureen Buff and Timothy Terrell in the Journal of American Physicians and Surgeons. That was back in 2014, and premiums continue to rise.

Meanwhile, insurers keep walking away from Obamacares unprofitable exchanges. Anthem and MDWise announced last month that they were withdrawing from Indiana, which will leave 76,000 Hoosiers in need of a new insurer. Anthem said it would be pulling out of the exchange in Ohio. Aetna warned it was pulling out of Virginia in May and Iowa in April. Humana did as much in Tennessee in February. More than 1,000 counties in the United States a third of the total are down to just one insurer, according to a Bloomberg analysis.

This was predictable. Obamacare was sold using the language of choice and competition, but it is actually reducing both, a Wall Street Journal editorial warned back in 2010, when the law was months old. Health insurance doesnt work when it isnt allowed to operate as insurance: when it cannot tailor its products to the preferences and budgets of consumers, and when it cannot make business decisions based on considerations of risk.

You do not get to insure your house after its on fire. Why should Americans have the unalienable right to wait till they get sick (at least during open enrollment) before buying health insurance?

Here, however, is where the philippic against the Affordable Care Act ends. Barack Obama inherited a broken health care model and made it worse, unless you count shunting millions of people into Medicaid as a triumph. For all the liberal angst about the Republican House and Senate bills, they are only tinkering with the same unfixable formula.

The only genuinely promising reform in the Republican health bills are proposals to nearly double contribution limits for heath savings accounts and allow them to be used to pay for premiums. Enrollment in tax-deductible, investable H.S.A.s has roughly doubled since Obamacare took effect, to about 20 million, because they help cover out-of-pocket costs for low-premium, high-deductible plans.

But as Peter Ubel of Duke pointed out last year, theyre mainly attractive to wealthier people with income to spare. Government subsidies of H.S.A.s for low-income people, Ubel writes, could turn H.S.A.s into something other than another tax break for the wealthy and make our health care system more responsive to consumer needs. This is what Singapore does, along with mandates for employees to set aside a portion of their income for H.S.A.s, and for employers to match it.

H.S.A.s can restore sanity to a market in which prices are invisible and costs keep rising, and in which the concept of insurance has lost its meaning. Republicans who want to salvage a conservative policy victory from their health care fracas would be wise to leave Obamacare alone, so that its authors can pay the price for its failure, just as the G.O.P. restores price to the rest of the health care system.

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A Price for the GOP's Health Care Insanity - New York Times

Will Trump deliver on his health-care promises to the American people? – Washington Post

On the campaign trail and since taking office, President Trump has made some significant promises about the kind of health care hed provide for the American people.

But Trumps efforts to come through on these promises have faced several hurdles along the way. In March, the House failed to bring a bill to the floor for a vote, before later managing to pass a controversial one. The Congressional Budget Office determined that bill, if enacted, would leave 23 million more Americans uninsured in the next decade.

That House bill then moved to the Senate, and this weeks episode of Can He Do That? examines whats happened since.

On Tuesday, Senate Majority Leader Mitch McConnell (R-Ky.) decided to delay a vote on his health-care proposal, with a goal to submit a new version of the bill to the CBO by Friday. (The CBO determined the first version of the Senate bill would leave 22 million Americans uninsured in the next 10years and would reduce the deficit by $321 million.)

The new CBO review will take about two weeks, making for a pretty tight timeline for Senators to vote before August recess. The bill needs to win over 50 of the 52 Republican senators to pass.

So where do things stand now? What is President Trumps role in all of this? What changes can we expect in the Senates forthcoming version of the bill? And how far does this effort move the needle on the Republican promise to repeal and replace Obamacare?

Health policy reporter and author of The Health 202 newsletter Paige W. Cunningham answers these questions and explains whats at stake. Plus, we talk to Republican Mayor John Giles of Mesa, Ariz., about how health-care legislation affects his constituents.

Listen to the full episode below.

Each week, Can He Do That? examines the powers and limitations of the American presidency, focusing on one area where Trump is seemingly breaking precedent. We answer the critical questions about what todays news means for the future of the highest office in the nation.

Subscribe on Apple Podcasts, Stitcheror wherever you get your podcasts.

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Will Trump deliver on his health-care promises to the American people? - Washington Post

Prostitutes speak out against Senate health bill – CNN

Licensed prostitutes in Nevada, working in legal brothels, are organizing against legislation they say will devastate them, other prostitutes across the nation and their families.

With Obamacare (Affordable Care Act), now under threat of being repealed and replaced, "thousands of prostitutes nationwide were, for the first time, able to obtain affordable health care insurance for themselves and their families," said a press release issued Thursday.

So, dubbing itself "Hookers for Health Care," this group plans to go "on a political offensive ... lobbying politicians, protesting in the streets, and waging battle on social media to stop the Republican effort."

At the helm is Alice Little, 27, who works near Carson City at Dennis Hof's Sagebrush Ranch brothel. She thinks about the cuts being proposed, the slashes to coverage for things like pregnancies and eating disorders and is outraged by the toll it will take on women.

"When I look at the folks that are making decisions, the majority of them are male voices," she said by phone. "They have no idea how they're affecting women's lives."

About a hundred women working in Hof's seven brothels have already signed up to be involved with this new movement. She says several dozen women and counting have already agreed to sign onto a petition she's drafting and that many are waiting to have their perspecitves recorded for social media purposes.

"These ladies are often stereotyped and I want to bring some humanity to their stories," said Little, whose mother is a cancer survivor. "We are people. We have families. We have the same health concerns as other Americans."

As independent contractors, she said, prostitutes are "at the mercy of the health care marketplace to obtain our own insurance" and are often reliant on Medicaid.

"I have been fortunate to amass a strong clientele and establish myself as a financially successful businesswoman within Nevada's legal brothel industry, but that can take time," Little said in the release. In fact, she's so successful Hof says she made about $500,000 last year.

But even with her success, Little knows plenty of women need a break.

"A young woman entering our business, who in some cases may also be a single mother with limited financial means, will also need time," Little said. "Expanded access to Medicaid for her or her child may be the only way that she is able to know that they will be protected in case of medical misfortune."

It's not just the prostitutes and their families that stand to lose if this new bill passes, Little adds. Consider the housekeepers, bartenders and cashiers who also work hard to be self-sustaining Nevadans. Also, added to the list of those she hopes to protect: brothel clients.

"Under Trumpcare insurers will be able to charge older consumers five times more than young consumers," she said. "People over the age of 65 make up a very large percentage of Nevada brothel clients. If these clients are forced to pay unfairly augmented health care costs, they will not have money on hand to spend on the things that make life worth living in the first place -- like sex."

Her advocacy, however, is not mirrored by her employer. Hof describes himself as fiscally conservative, "but don't bother me about abortion, who's having sex with who and weed; it's a personal choice."

He is a Trump supporter, though, who'd love to see Obamacare get tossed out.

"I believe in people taking responsibility for their own lives, and not asking for these kind of government handouts," he said. "You start giving these working girls free or discounted health care coverage, then what comes next? ... This is definitely not a road we want to go down."

But even while Hof disagrees with the politics of "Hookers for Health Care," he supports the involvement of women who work for him. He says there are 540 prostitutes affiliated with his brothels, and "These aren't your daddy's old hookers."

By that he says he means, "These aren't street walkers. They're professional working girls that work in a legal environment."

In fact, he says half of them have college educations, 20% have master's degrees, a few have doctorate degrees and one, an Ivy League educated professor, picks up hours to help pay off her huge student loans.

"I love that they're involved," he said. "These girls are smart, they will be running our country, and they vote."

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Prostitutes speak out against Senate health bill - CNN

GOP races to strike health care deal by Friday, before July 4 recess – CBS News

Senate Republican leaders are racing to strike a health care deal by Friday that appeases opposing factions of their conference and there appears to be no breakthrough yet in negotiations.

On one hand, there are moderate senators who are critical of the original bill's Medicaid provisions, who want more funding for opioid treatment, who want pre-existing conditions protected and who want low-income people to have access to affordable insurance.

"My focus is really again on ensuring lower-income citizens actually have the ability to have health plans that really cover the kind of things that need to be covered," said Sen. Bob Corker, R-Tennessee, who said Republicans are "moving to a place that resolves that issue."

"I'm not there yet, I know that," Sen. Shelley Moore Capito, R-West Virginia, told reporters as she headed to a closed-door Senate Republican Conference lunch. She had been pushing for an increase in opioid treatment funding.

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Senate GOP leaders are making changes to their proposed health care plan in hopes of receiving a better score from the Congressional Budget Offic...

Senate leaders have added two provisions to the measure: $45 billion in opioid treatment funding and the ability to use Health Savings Accounts (HSA) to pay for premiums.

Then there are conservatives who have been demanding for a full repeal of Obamacare, which they say the original plan wouldn't deliver.

"Unless it changes to a repeal bill, I can't vote for it," said Sen. Rand Paul, R-Kentucky, who advocated Thursday splitting the legislation into two pieces in order to improve the chances of passage.

One proposal floated by Sen. Ted Cruz, R-Texas is gaining some traction. It would allow any health insurance company to offer insurance plans that don't comply with Obamacare in a state if they're offering at least one that does comply with the health care law.

"I think there's a lot of appeal to that idea," Sen. Pat Toomey, R-Pennsylvania, said about the plan. "Anybody that likes Obamacare so much, they would have their Obamacare plan and they would also have the freedom to buy anything they like. I think it makes a lot of sense."

Sen. John Thune, R-South Dakota, a member of Senate leadership, told reporters that Cruz's plan could potentially be added to the bill as long as it's structured in a way "that ensures that the pools aren't adversely affected."

Some, like Sen. Rob Portman, R-Ohio, are concerned about whether Cruz's amendment would cover pre-existing conditions. Asked whether he backs the plan, he said, "It hasn't been fleshed out yet, so -- I believe that pre-existing conditions ought to be covered...There are a lot of moving parts."

Most lawmakers are leaving for their week-long July 4 recess Thursday and leadership has been aiming to reach an agreement on a revised health care bill by Friday in order to send it to the Congressional Budget Office (CBO) to have it scored over the break.

Sen. Lindsey Graham, R-South Carolina, warned Thursday that getting a deal by Friday is essential.

"If there's going to be one, it'll be by the end of the week. I don't think that not having a deal and going home is gonna get you a deal," he said. "I just think the further you get away from this place, the more pushback you'll get."

Members of Congress could almost certainly face unhappy constituents in their districts next week. A series of polls released Wednesday found that a majority of the public oppose the bill.

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GOP races to strike health care deal by Friday, before July 4 recess - CBS News

On Health Care, a Promise, Not a Threat – Wall Street Journal (subscription)


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On Health Care, a Promise, Not a Threat
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So this is no time for gloom. This moment in fact may be, perversely, promising. The failure so far of Senate Republicans to agree on a health-care bill provides an opening. Whatever happens the next few days, moderates and centrists... To Read the ...

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On Health Care, a Promise, Not a Threat - Wall Street Journal (subscription)

40 arrested as health-care bill protesters swarm Capitol Hill this week – Washington Post

It seems everyone at the various health-care protests in Washington this week brought a story.

The Pennsylvania man who relied on the Affordable Care Act for his dialysis and was willing to get arrested so his senator understood the legislation was life and death. The D.C. woman who feared that her 27-year-old, nonverbal, autistic brother would be forced into an institution without Medicaid. And the Arlington father, Rick Hodges, who wondered if the Republican-proposed health-care bill would afford his teenage daughter with Down syndrome the opportunity to live a semi-independent life as an adult.

Its about so much more than health insurance, Hodges said. She has a preexisting condition. The country has chosen Medicaid to be the source of funding for people with disabilities. Thats terrifying for people with disabilities and their families.

Hodges joined a rally Wednesday in front of the U.S. Capitol urging the Senate to reject health-care legislation curbed in the Senate, which the nonpartisan Congressional Budget Office estimates would leave 22million more people uninsured by 2026. It was one in a string of legal and illegal protests on Capitol Hill this week decrying the bill.

[How the push for a Senate health-care vote fell apart amid GOP tensions]

On Wednesday, U.S. Capitol Police arrested 40 people who blocked hallways in Senate office buildings demanding to meet with their senators.

Please Mr. Toomey, dont let me die. Sen. Toomey, will you kill me? a group of about 10 Pennsylvania protesters with severe illnesses chanted in front of the office of Sen. Patrick J. Toomey (R-Pa.). U.S. Capitol Police officers dragged protesters away in handcuffs as they chanted, Kill the bill, dont kill me.

Similar protests were staged in the offices of Sens. Rob Portman (R-Ohio), Tom Cotton (R-Ark.), Marco Rubio (R-Fla.) and Lisa Murkowski (R-Alaska).

Eva Malecki, a spokeswoman for U.S. Capitol Police, said officers responded to numerous incidents of protests in office buildings, making arrests if demonstrators did not leave when asked.

After officers arrived on the scene, they warned the demonstrators to cease and desist with their unlawful demonstration activities, Malecki wrote in a statement, saying that protesters were charged with crowding, obstructing or incommoding. Those who refused to cease and desist were placed under arrest.

Later in the afternoon on Wednesday, hundreds of demonstrators gathered in front of the Capitol for a rally organized by Planned Parenthood, the American Civil Liberties Union and other progressive groups. The Senate bill would block federal funding to the womens health organization.

Protesters said the fact that Senate Majority Leader Mitch McConnell (R-Ky.) delayed a vote on the legislation until after the July4 recess meant protests were working.

Its a sign of how powerful peoples voices can be, said Erica Sackin, director of political communications at Planned Parenthood. But its too soon to claim victory. The bill is moving fast, and it may have been delayed, but we know that the fights not over.

[In the Trump era, a D.C. group has formed to help activists plan their protests]

Several high-profile Democrats spoke at Wednesdays rally, including Senate Minority Leader Charles E. Schumer (N.Y.), Rep. John Lewis (Ga.), House Minority Leader Nancy Pelosi (Calif.), and Sens. Chris Murphy (Conn.) and Cory Booker (N.J.).

If there is no struggle, there is no progress, Booker said, quoting a famous line by Frederick Douglass.

At a 23-hour interfaith prayer vigil nearby, clergy members and community leaders prayed that Medicaid would be preserved and the Senate would reject the health-care legislation. The vigil was to end Thursday afternoon.

Earlier in the week, protesters dressed as women from The Handmaids Tale stormed Capitol Hill as part of a protest organized by Planned Parenthood. In the novel and subsequent TV series, a right-wing religious group rules the country and fertile women are forced into reproductive servitude.

Last week, more than 40 disability advocates were arrested in front of McConnells office after the protesters, most of whom had a disability, removed themselves from wheelchairs and staged a die-in.

Raquel Bernstein, a policy intern for the National Council for Independent Living who attended Wednesdays rally in front of the Capitol, said the bill would devastate many in the disability community who rely on Medicaid to live independently. Bernstein, 22, has arthrogryposis and is covered by her parents insurance.

The last thing people want to do is go to institutions, she said. They would go without care and die before going to an institution.

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40 arrested as health-care bill protesters swarm Capitol Hill this week - Washington Post