Cruz: VA Must Expand Options For Veterans

Texas Senator Ted Cruz partnered last week with Concerned Veterans for America executive director Mark Lucas to pen the editorial “Congress must expand health care choices for veterans” for the Houston Chronicle.

The editorial begins with the story of a woman named Linda, whose husband died as a result of Veterans Administration failure. It goes on to suggest two ideas that Cruz and Lucas say “can turn the tide at the VA and provide positive impact: increasing accountability and giving our veterans more choice and control over the health care benefits they’ve earned.”

The recently-passed VA Accountability and Whistleblower Protection Act made strong inroads toward reaching the first of those goals.

“Unlike previous legislative ‘fixes’ designed to improve the VA, this law has real teeth. It gives VA Secretary David Shulkin greater authority to get rid of unsatisfactory employees and reduces the time it takes to do so. Even better, these former employees will no longer be paid with taxpayer dollars as they undergo the termination process. The measure also allows the secretary to recoup bonuses awarded to employees who engaged in misconduct, affording greater protections to whistleblowers who expose wrongdoing.”

Cruz and Lucas also point out that the Veteran Choice Program has left many vets hamstrung in their efforts to receive care, particularly in its requirement that veterans seek help exclusively at a VA facility if there is one within 40 miles of their home that can see them within 30 days.

The pair further propose that information technology used by the VA be modernized in order to help the organization more effectively provide care.

“Sen. Cruz has sponsored a bill to address this issue by requiring the appointment of a chief information officer at the VHA, equipped to implement and manage a state-of-the-art IT system fully integrated with VHA clinics and medical centers. This straightforward, simple solution will improve health care outcomes and help remedy the long wait times that have compromised the health and safety of our veterans.”

But perhaps the biggest change proposed by Cruz and Lucas is to implement a new administrative process for the VA provider system, in an effort to expand veterans’ choices about “when and where to seek care”.

“As Concerned Veterans for America outlined in its bipartisan report, Fixing Veterans Health Care Taskforce, a government-chartered nonprofit or accountable care organization should administer the VA’s current provider system and allow for the creation of a veterans insurance program to offer veterans the ability to access care in the private sector with their VA benefits in a way similar to how most federal employees get coverage through the Federal Employees Health Benefit Program.”

As with Cruz’ previous proposals concerning ACA replacement, the intent of the proposed changes is to put patients in charge of their own healthcare rather than forcing them to rely on government-based care providers.

“Veterans should be able to access state-of-the-art care at any time, close to home with the benefits they’ve earned. And it is our hope that by bringing accountability to the VA and empowering veterans with health care choice, no veteran will ever have to go through what Linda and her husband experienced.”

Those who have willingly chosen to put their lives on the line – and their families – deserve nothing less.

NEW: Trump Plans to Sign Executive Order to Allow Americans to Purchase Health Insurance Across State Lines

After yet another apparently failed attempt to repeal (or at least overhaul) Obamacare, President Donald Trump appears to be preparing an executive order that will at least fulfill some of the GOP’s promises to alleviate the health care burden on Americans. The order would allow people to purchase health plans across state lines, a move that would make the marketplace much more competitive.

Kentucky Sen. Rand Paul first mentioned the action during a TV appearance Wednesday morning, saying Trump was considering taking matters into his own hands.

“I think there’s going to be big news from the White House in the next week or two, something they can do on their own,” Paul told MSNBC, adding that Trump “can legalize on his own the ability of individuals to join a group or a health association across state lines and buy insurance.”

For his part, the president told reporters in his inimitable way that he is working on a “very major” action that will make it possible for Americans “to go out across state lines, do lots of things, and buy their own healthcare.”

One Senate Republican source says that the executive order will be complete within the next few weeks, and a White House spokesman confirmed that the Trump administration is “considering several actions to provide flexibility and relief to the many Americans who continue to suffer under Obamacare.”

How much the move will help obviously remains to be seen, but it’s nice to see that someone in Washington is taking seriously the GOP’s promise to make healthcare more affordable and less of a burden.

The Democratic Party Has Finally Embraced Single-Payer

No one is really surprised – we all saw this coming. The Democratic Party has slowly encroached closer and closer to full-blown socialized health care for years now.

Conservatives warned that Obamacare would lead to this.. and now we are here.

Numerous Senate Democrats have openly embraced Sen. Bernie Sanders’ “Medicare for all” bill. This is legislation that would take the federal program that currently covers health care costs of citizens 65 and over and expand it to all Americans. If such a bill were to pass, the federal government would pay the tab of all medical expenses.

It’s not necessarily the number of Senate Democrats who have come out in support of this bill, but it’s the who. Sens. Cory Booker (D-N.J.), Elizabeth Warren (D-Mass.), Kamala Harris (D-Calif.) and Kirsten Gillibrand (D-N.Y.), among others, have publicly announced support for this legislation.

What do all four of these liberal senators have in common? They are all top contenders for the 2020 Democratic presidential nomination.

These are people who will lead (or already leading) the Democratic Party in the years to come. The fact that they have already announced support for this bill before it’s been formally introduced (the bill drops today) demonstrates how much of a litmus test this will be. Any Democrat wishing to run against single-payer will automatically be branded as too moderate for their party nomination.

Bernie Sanders – a Democratic socialist who refuses to call himself a Democrat – is the sponsor of this bill. After his stunning performance in last year’s Democratic primary, it’s no shocker he returned to the Senate chamber a more powerful man among his caucus. Democrats hoping to run in 2020 don’t want to be outflanked from the left as happened to Hillary last year.

This bill has already gained strong momentum among Democrats despite it only being introduced today (Wednesday). Other, less interesting Democrats have also signaled support for the measure. They include Sens Jeff Merkley (D-Ore.) and Sheldon Whitehouse (D-RI.) and others. Even Sen Jon Tester, who represents the red state of Montana, has expressed mild interest in such an expansion of government into the healthcare realm.

Expect many more to follow the herd.

All the action isn’t only happening in the upper chamber. John Conyers, a Democrat representative from Michigan, has re-introduced a single-payer health care bill that has amassed well over 100 supporters – over half the Democratic caucus stands in approval. Conyers’ bill, a measure he introduces in the House on a perennial basis, enjoys more backing now than it ever has since he began introducing it over 10 years ago.

In other words: single-payer is no longer a sensitive subject for Democrats. It’s now mainstream.

There are, however, still some holdouts within Democratic ranks. After previewing it on Tuesday, both House Minority Leader Nancy Pelosi and Senate Minority Leader Chuck Schumer have distanced themselves from Sander’s bill. Pelosi says she wants to focus on protecting Obamacare and Schumer more-or-less waffled by saying “there are many different bills out there” and did not endorse this particular one. The two are official congressional leaders of the Democratic Party – at least on paper.

These Democrats can hold their ground all they want, but the dam has already been flooded within their party.

Like it or not, Republicans are the only ones left to stop socialized health care from washing up on our shores.

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Trump to Decide Whether to Continue Obama’s Unconstitutional ObamaCare Subsidies




During an appearance on this week’s edition of “Fox News Sunday,” White House counselor Kellyanne Conway said that President Donald J. Trump would decide this week if his administration will continue to make cost-sharing reduction payments to insurance companies.

The payments, called CSRs, subsidize insurers for reducing co-pays and deductibles for low-income Obamacare customers.

When asked by moderator Chris Wallace if Trump was going to cut off those payments, Conway said, “He’s going to make that decision this week and that’s a decision that only he can make.” Here’s the exchange from the Fox News transcript:

WALLACE: Is the present going to cut off the CSR payments, the out-of-pocket payments? He can do it starting next month, this week.

CONWAY: Yes, he can. He can — he’s going to make that decision this week, and that’s the decision that only he can make.



But let’s go back to what we are really talking about here. When he said yesterday in the same tweet, I believe, about the bailout — the insurance companies’ bailout from members of Congress, he’s talked about the CSR payments. He’s also talking about this really sweet deal that members of Congress and their staffers have where they are not beholden to the same health healthcare that so many Americans say is unaffordable and unsustainable and untenable.

And this is exactly what so many Americans hate about Washington, D.C. They feel like they have their nose pressed up against the glass, peering into the special interests, the swamp, these lobbyists, the folks on Capitol Hill. They want people to live under the same rules they do. And, frankly, if people had the same rules on Capitol Hill, maybe they would have a stronger taste of what it feels like to be in a short — what it feels like —

WALLACE: Kellyanne —

CONWAY: — to have to choose between paying your premiums and paying your grocery bill.

President Obama’s CSR payments have been found unconstitutional. On May 12, 2016, United States District Judge Rosemary Collyer of the federal district court for the District of Columbia decided that the Obama administration could not constitutionally reimburse insurers for the costs they incur in fulfilling their ObamaCare obligation to reduce cost sharing because Congress had not appropriated money to cover the CSR payments.

As Timothy Jost explains, the lawsuit was an attempt by the Republican-controlled House of Representatives to hold President Obama responsible for his abuses of presidential power. On July 30, 2014, the House voted to file a lawsuit challenging the President’s implementation of the law. The complaint, filed on November 21, 2014, focused on two issues: the decision by the Obama administration in 2013 to delay the implementation of the employer mandate for a year, and the funding by the administration of the Affordable Care Act’s CSR payments, without an explicit appropriation.

Judge Collyer’s decision was a clear victory for the House of Representatives.

The Washington Examiner reports that President Trump has threatened to allow Obamacare to collapse and implode after Congress failed to pass legislation to repeal and replace the Affordable Care Act. President Trump also said on Twitter that he wants the Senate to keep working on healthcare after Republicans were unable to get the votes for a “skinny repeal” bill last week.

As Conway told Wallace, President Trump isn’t willing to move on to other legislative priorities just yet:

CONWAY: The president will not accept those who said it’s, quote, time to move on. He wants to help the millions of Americans who have suffered with no coverage. They were lied to by the last president. They couldn’t keep the doctor. They couldn’t keep their plan.

We’ve met with the ObamaCare victims at the White House several times now. They’re real people, they’re suffering.

And when he talks about the 51 votes, the president is basically making the case that so many of the components of real healthcare reform, Chris, requires 60 votes — the drug pricing, the selling of insurance across state lines, the associated health plans that allow those who don’t get their health insurance to the employers like you and I do, or to government benefits, who have been left out because the premiums are too high.

Premiums have doubled. We see in some states that there are no insurers —

(CROSSTALK)

WALLACE: Let’s talk about that. Kellyanne —

CONWAY: So, he will. He will stick with it.

If President Trump refuses to continue Obama’s unconstitutional CSR payments, Obamacare will have even more problems.

Republicans and Conservatives are at Odds Over Taxes in Obamacare Replacement Bill

In 2010, 2012, 2014, and 2016, the American people elected Republicans to Congress with a clear mandate: repeal and replace Obamacare. Yet somehow the GOP has managed to do little more than propose watered-down versions of the health care legislation that citizens so desperately want replaced.

As the Senate hammers out their version of Obamacare replacement, there’s one sticking point that is making the negotiations more difficult – taxes.

Specifically, senators are divided over the inclusion of Obamacare’s 3.8 percent net investment income tax. Conservatives want the tax repealed, while more moderate Republicans are fine with keeping the tax as a way to help fund health care for those with lower incomes.

Some in the Senate emphasize the importance of keeping the tax embedded in the new legislation:

“We [want to] address the issue of ensuring lower-income citizens are in a position to buy plans that are actually provide them appropriate healthcare,” Sen. Bob Corker (R-Tenn.) told reporters last week.

While other members of Congress understand a need to keep the tax in place whether they like it or not.

“Our official position is we want to repeal all the taxes. That being said, we understand the logistics of having to have enough revenue,” House Freedom Caucus Chairman Mark Meadows (R-N.C.) said. “And so I’m not at this point closing that off to negotiations because I think it would be premature to do that.”

Sen. Ron Johnson (R-Wis.) told his constituents in a telephone town hall last week that he’s “personally not opposed” to keeping ObamaCare taxes to pay for health benefits.

On the other end of the spectrum are taxpayer advocacy groups who are adamantly opposed to the tax remaining in any GOP replacement.

“Cutting the capital gains tax gets you growth,” said Americans for Tax Reform President Grover Norquist. He called keeping the investment tax an “economically illiterate bad idea.”

Taxpayers Protection Alliance President David Williams said that failing to repeal the investment tax would cause investors to delay selling assets and would “discourage more entry into the stock market.”

So many questions remain. Can the GOP create a replacement that will keep taxes low while still allowing the poor to have more options? Will they proceed with or without the tax in place? Will they scrap Obamacare altogether and create something new? Is a free market solution possible at this point?

But the biggest question of all that is yet to be answered is this one: will the Republicans keep the promises they’ve made to the voters time and time again to repeal and replace Barack Obama’s signature domestic accomplishment?

Cruz Healthcare Bill Amendment Gets Traction

 

At RedState, Andrea Ruth reports that House Freedom Caucus Chair Mark Meadows broke from withholding comment on the process in the Senate to tweet that he is in favor of the health care bill currently making its way through the Senate if an amendment to the bill offered by Sen. Ted Cruz is a part of it.

The text of the Cruz amendment hasn’t been publicly released, but it is being circulated on typed handouts. It would allow insurance companies to offer plans that did not meet certain Affordable Care Act requirements if they also offer plans that do. In allowing such plans to be sold, insurers would be able to offer more affordable plans that don’t adhere to ObamaCare’s insurance regulations to individuals who don’t necessarily need or want to pay for certain coverage.

According to the New York Times “The Upshot” blog, The Cruz Consumer Freedom amendment wouldn’t explicitly create and fund the special insurance markets, as the House bill did. Instead, insurance experts said, it would create a sort of de facto high risk pool — encouraging customers with health problems to buy insurance in one market and those without illnesses to buy it in another.

This is how Sen. Cruz described his plan last week:

If an insurance company offers at least one plan in the state that is compliant with the (Obamacare) mandates, that company can also sell any additional plan that consumers desire.

What that does is it maintains the existing protections, but it gives consumers additional new options above and beyond of what they can purchase today.

Marc Short, President Trump’s director of legislative affairs, said on Fox News Sunday, that they support the Cruz proposal.

In addition, the Washington Examiner reports that the Club for Growth expressed support for Cruz’s plan on Wednesday.

Axios reports that Senate Republicans have asked the Congressional Budget Office to analyze Cruz’s proposal — asking for one estimate of a health care bill that includes his changes and one that doesn’t.

Bernie Sanders Wants to Turn Medicaid into National Single-payer

Senator Bernie Sanders (I-Vt.) thinks the Republican health care plan is going to fail, but he has a plan. The sometimes-Democrat from The Green Mountain State announced that after the presumed defeat of the Republican bill, he intends to introduce legislation to make “Medicare for All” the national health care system of the United States.

“We are going to introduce it literally as soon as we’re through with this debate. I don’t want to confuse the two issues,” Sanders said on CNN’s “State of the Union.”

Sanders said that the initial phase of his plan would lower Medicaid eligibility to age 55, but would ultimately expand to cover all Americans. “Longer term, we need a Medicare for all,” Sanders said.

Sanders has been talking about universal Medicaid for years. The further expansion of Medicaid was a plank of Mr. Sanders presidential platform in 2016. Details of the plan are still available on BernieSanders.com. Last March, after the Republican bill failed its initial vote in the House, Sanders raised the prospect of introducing his Medicaid plan to the Republican-controlled Congress.

“President Trump, come on board. Let’s work together,” Sanders said in Politico at the time. “Let’s end the absurdity of Americans paying by far the highest prices in the world for prescription drugs.”

Sanders claims that his plan would save the typical middle class family more than $5,000 in annual health care costs. In reality, the plan would shift costs from insurance premiums to private companies to healthcare taxes paid to the government. Families would pay a 2.2 percent tax and employers would pay a 6.2 percent payroll tax for the health insurance. The increase in payroll taxes would likely translate into lower wages.

The Sanders plan contains a long list of other taxes that would be increased to pay for his healthcare plan as well. These include increases in the income tax, the dividend tax, the capital gains tax and the estate tax. He would also limit deductions for households earning more than $250,000 per year.

What would Americans get for their money? The Sanders plan does not go into detail about what the expanded Medicaid would cover or out-of-pocket costs such as deductibles and coinsurance, but there are well-known problems with Medicare. The government only reimburses doctors for part of their costs in treating patients. Under the current system, states pay for Medicaid services and then the federal government reimburses the state for a percentage of its Medicaid costs. Forbes notes that Medicaid pays less than private insurers at the same time that Medicaid patients take more time than other patients. Increased paperwork and delays in payment mean that many doctors limit access for Medicaid patients or don’t see them at all. FactCheck.org estimates that only about 70 percent of the nation’s doctors participate in Medicaid.

Despite Sanders’ claims that expanding Medicaid would save money, the plan merely shifts the burden of paying for healthcare to the states and the federal government. Already, Medicaid is the second largest budget item for most states, only coming in behind education spending.

When states face budget crunches, a common response is to cut reimbursement rates. These cuts can cause increase in wait times for treatment, lead to higher out-of-pocket costs for patients or even cause some providers that rely heavily on Medicaid funds to go out of business.

With Republicans in control of both Houses of Congress, the Sanders plan for national Medicaid will be dead-on-arrival when he submits the bill. However, if Republicans fail to reform the health insurance system, the threat of single-payer from leftists like Bernie Sanders will not go away.

 

Ben Sasse Has a Plan to Get Health Care Reform Back on Track

Health care reform seems to be something every Republican in Washington agrees needs to happen, even as there is no agreement on how to do it. Senate Majority Leader McConnell delayed the vote on the Better Care Reconciliation Act until after the July 4th recess because the votes to pass it simply aren’t there. The bill is bleeding support from both the right and the middle — everyone from Mike Lee to Susan Collins to John Kasich have spoken out against it.

Part of the problem is that the consensus campaign promise — repeal and replace of the so-called Affordable Care Act — has been abandoned. According to Ramesh Ponnuru’s interpretation, centrists had not thought in detail about health care policy; without a plan, they fell back on leaving Obamacare in place and simply patching the holes.

Once Republicans were in a position to do something about the law, though, they were forced to think, apparently for the first time, about specific health-policy decisions. At that point the moderates decided that they want to keep Obamacare but make it cheaper.

Ben Sasse has a different plan: Congressional Republicans should start by keeping their promises. First, repeal Obamacare to the extent possible, with a one-year delay on implementation. Second, cancel the August recess and get the job done. The Omaha World-Herald reports that “Sasse is hoping his suggestion will create both political pressure for action and a fresh slate.”

“After we gave our word to repeal and replace Obamacare’s monstrosity, we should not go back to our states during August as the American people struggle under fewer choices and skyrocketing costs,” Sasse wrote in a letter to Trump Friday morning….

The Senator went on to say that

On the current path, it looks like Republicans will either fail to pass any meaningful bill at all or will instead pass a bill that attempts to prop up much of the crumbling Obamacare structures. We can and must do better than either of these – both because the American people deserve and because we promised better.

Sasse is not the only Senate Republican to suggest skipping, or at least shortening, the August recess in order to spend more time enacting the promised agenda. Axios reports that 10 senators have signed a letter sent to Mitch McConnell asking him to do just that if the Senate does not make legislative progress in July.

Those senators are Mike Lee (UT), David Perdue (GA), Steve Daines (MT), Joni Ernst (IA), John Kennedy of (LA), James Lankford (OK), Mike Rounds (SD), Luther Strange (AL), Thom Tillis (NC), and Dan Sullivan (AK).

Sasse is right that Republicans in Congress — sadly — need an incentive to do what they were elected to do. More to the point, it is imperative to remove the health care debate from the Obamacare paradigm (and not into Elizabeth Warren’s and noted health care expert Warren Buffet’s paradigm of single-payer). No legislation working on the same faulty assumptions of the problems of the American health care system and their solutions will work noticeably better than the current law.

Yet, even though the law’s defenders acknowledge Obamacare’s vast problems, all they can envision is a leftward leap in the direction Britain’s scary bad National Health Service. That’s understandable, but it is no excuse for the complete lack of imagination and planning on the right — or the lack of leadership at the top of both houses of Congress.

Thank goodness for people like Ben Sasse and Mike Lee who keep the possibility of real fixes alive.