Jimmy Kimmel Rips Bill Cassidy Over Health Bill

Late night host Jimmy Kimmel veered off into leftist politics again last night when he ripped into Senator Bill Cassidy (R-La.). In a seven-minute monologue on Jimmy Kimmel live, Kimmel charged that Cassidy “lied right to my face” about promises that he made to Kimmel regarding Obamacare reform in an appearance on the show in May.

The controversy centers over Cassidy’s promise that a healthcare reform bill would meet the “Jimmy Kimmel test,” a term that Kimmel says was coined by the senator. “In a nutshell,” Kimmel said, the test holds that “no family should be denied medical care — emergency or otherwise — because they can’t afford it.”

“He said he would only support a healthcare bill that made sure a child like mine would get the health coverage he needs,” Kimmel continued, “no matter how much money his parents make, and that did not have annual or lifetime caps.”

Cassidy appeared on Kimmel’s show in response to another monologue in which Kimmel described how his infant son required heart surgery that could be considered a pre-existing condition.

Dr. James Madara, president of the American Medical Association, wrote in Fortune that the bill could possibly allow states to opt out of affordable coverage for pre-existing conditions. “While insurers are still required to offer coverage to patients with pre-existing conditions,” Madara wrote, “allowing states to get waivers to vary premiums based on health status would allow insurers to charge unaffordable premiums based on those pre-existing conditions.”

Kimmel said that the Graham-Cassidy bill passed a different Jimmy Kimmel test. “Your child with the pre-existing condition will get the care he needs if – and only if – his father is Jimmy Kimmel. Otherwise, you might be screwed,” he joked.

While the bill does not eliminated coverage for pre-existing conditions or allow insurance companies to establish caps for lifetime benefits, the bill does return the power to regulate insurance to the states. Politico notes, “States would be allowed to apply for waivers that could change what qualifies as an essential health benefit,” a term originally defined by the Affordable Care Act. The waivers could “impact people with pre-existing conditions and undermine prohibitions on annual and lifetime limits for insurance coverage.”

Kimmel thanked Senators Lisa Murkowski (R-Alaska), Susan Collins (R-Maine) and John McCain (R-Ariz.) for voting to kill the previous Republican healthcare bill. He urged the trio to vote against Graham-Cassidy as well.

In a part shot, Kimmel invited Cassidy to work for a health care bill that met with Kimmel’s approval, “and if not, stop using my name, because I don’t want my name on it.”

“There’s a new Jimmy Kimmel test for you,” Kimmel scolded Cassidy. “It’s called a lie detector test. You’re welcome to stop by the studio and take it anytime.”

Republican Senators Try a ‘Hail Mary’ On Obamacare

After their embarrassing failure to repeal and replace Obamacare over the summer, Republicans in the Senate are gearing up for a “Hail Mary” attempt to at least make a modicum of reforms to the health care law. The Senate, where the previous attempt to rein in Obamacare died, may vote on the last-gasp effort by the end of September.

As explained previously in The Resurgent, Republicans cannot fully repeal Obamacare without 60 votes. The previous attempt at reforming Obamacare fell apart over details of how the law’s subsidies should be treated and how to handle medical care for the uninsured. Moderate Republican support for the ACA’s expansion of Medicaid also caused serious problems in crafting a replacement bill.

The new bill, written by Senators Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), is much more modest than the failed American Healthcare Act. The proposal doesn’t completely repeal Obamacare, but does replace Obamacare’s tax subsidies with state block grants, repeals the individual mandate and scales back the Medicaid expansion.

“It’s basically federalism where you just block grant the whole thing,” Speaker Paul Ryan (R-Wisc.) told the Washington Examiner. “You block grant Obamacare back to the states. Just the whole thing.”

Majority Leader Mitch McConnell (R-Ky.) has indicated that he will bring the bill to the floor for a vote if at least 50 of the 52 Republican senators support it. At the moment, the bill is short of that mark, but Politico reports that it is gaining steam after Graham publicly lobbied President Trump and others. Estimates put Republican support for the bill at 48 or 49 senators.

The bill appears to be on a fast-track. The Washington Post reports that Republicans have already submitted it to the Congressional Budget Office for analysis. If the bill is not passed before the end of September, the Post notes that the authority to pass the legislation with a simple majority under budget reconciliation rules would expire. This would effectively kill any attempts to reform Obamacare until next year.

If the bill does pass the Senate, it faces an uncertain future in the House of Representatives. The previous bill, which originated in the House, had to be finely tuned to pass by a slim majority. Under budget reconciliation rules, the House would have to pass the Graham-Cassidy bill with no changes.

No Democrats are expected to support the bill. Sen. Elizabeth Warren (D-Mass.) tweeted, “The Graham-Cassidy @SenateGOP ‘health care’ bill IS Trumpcare, & it will rip health care away from millions of Americans.”

As with the previous Obamacare reform bill, opposition to the bill is expected to come from the right as well as the left. Senator Rand Paul (R-Ky.) has announced that he will oppose the bill, calling it “Obamacare lite.” If Paul stands firm, the defection of any other Republican will doom the bill.

Paul’s stance against “Obamacare lite” begs the question of whether he and the Freedom Caucus would prefer the full version of Obamacare to an imperfect Republican reform bill. For the foreseeable future, those are the only two options.

Bernie Sanders: GOP Healthcare Bill Like 9/11 Every Year

Last month, Elizabeth Warren took to the Senate floor and cried that cuts in the GOP healthcare legislation were “blood money.” Over the weekend on “Meet The Press,” Tom Perez literally claimed people will die if the bill is passed. On Sunday, Bernie Senders said the proposed healthcare overhaul is synonymous to the 9/11 terrorist attacks – every year.

OK now I’m scared.

Giving a speech in Morgantown, West Virginia on Sunday, Sen. Sanders loosely correlated the loss of health insurance to sure death. He then compared the number of estimated lives lost to the number of people killed on September 11, 2001. He didn’t stop there. Sanders suggested it would be like 9/11 EVERY YEAR.

“Now, obviously nobody can predict exactly how many people will die if they lose their coverage. Nobody can make that prediction,” Sanders said. “But what experts at the Harvard School of Public Health estimate is that if 23 million Americans were to be thrown off the insurance they currently have, which is what the House bill would do, up to, up to 28,000 Americans every single year could die.”

“That is nine times more than the tragic losses we suffered on 9/11, every single year,” he stated.

A bit harsh, no?

This kind of language should have no place in political discourse. It gives fodder to the extremes in our country and makes negotiation in Washington almost impossible. Opponents should be allowed to disagree with the legislation – that’s their right. But let’s not act like this is a bill calling for the end of times. You’d think Sen. Sanders would have learned this after one the volunteers for his presidential campaign attempted to go on a Republican killing spree because he genuinely believed the GOP wanted to kill people.

Unfortunately, this isn’t the first time Sanders has spoken gravely about the healthcare bill pushed by the Trump administration. Basically as soon as it was released he’s been crying doomsday:

By the way, many healthcare experts don’t buy Democrats’ doomsday prophecies. The Congressional Budget Office’s estimates of people to be bumped off heath insurance, should the GOP alternative pass, are based off assumptions of Obamacare enrollment skyrocketing – which many argue won’t happen. Avik Roy gives a superb analysis to the National Review.

Is It Worse for GOP if Health Bill Fails or Passes?

As the American Health Care Act heads toward an uncertain future in the House, there is speculation that Republicans might be better off if the bill is killed quickly in its first vote. With many members of the Freedom Caucus lining up against the bill, Margot Sanger-Katz and Nate Cohn, who respectively cover healthcare and elections for the New York Times opined on which was worse for the GOP, having the bill fail or having it pass.

“I think there are two big forces behind the progress of this bill,” Cohn said. “One is that no one wants to be responsible for its failure. So I agree that if the House passes something, there will be a lot more pressure for the Senate to figure something out. They might not be able to do it, but they might really try.”

“Two is that the speed is good for the Republicans,” he continued. “It has a better chance of passing if they move quickly, before public opinion turns against it. It’s better for the Republicans if it fails quickly, because they can move on to other things.”

“I think the Republicans are in a tough spot either way, but I think they’re better off if the bill fails,” Cohn continued. “They’ll get bad press, but voters have fairly short memories and I think the Republicans will move on. They’ll still be able to blame problems on Obamacare, even if it will be less credible. If they pass this plan, I have no idea how they intend to defend it. And I think hurting vulnerable Americans would go against the core of Trump’s appeal to the decisive Obama-Trump vote in the Midwest and Northeast, with little benefit. I think the best position for a lot of Republican members is to vote for the bill, but hope it fails. On the other hand, if the bill passes, it will be nice to be among the Republicans who voted against it.”

If the bill does manage to pass the House, it won’t pass the Senate as written. “The Senate has more of a moderate problem than the House, it appears,” said Sanger-Katz. “There are two senators — Lisa Murkowski and Susan Collins — who don’t like that the bill defunds Planned Parenthood. There are a few senators from states that expanded Medicaid who are worried about changes to that program. There are also some concerns about the generosity of tax credits, particularly for older Americans.”

If the bill is amended to win the votes of Murkowski (R-Alaska) and Collins (R-Maine), it will face increasing opposition from Senators on the right such as Rand Paul (R-Ky.) and Ted Cruz (R-Texas). Still, the best chance for repeal and replace seems to be to pass versions of the bill in both houses and work to improve it in the conference committee that irons out the differences.

The biggest problem for Republicans is the lack of a clear direction if the AHCA fails. “My sense is that there’s just no policy consensus about health care among Republicans,” Sanger-Katz said. “I think they would need that kind of vision and consensus to get something ready in advance.”

Finding a consensus is easier said than done. Many of the problems with the current bill result from trying to find a consensus where there is none. Conservatives want a complete repeal of the Affordable Care Act which is not mathematically possible in the current Congress without Democrat defections. Moderates want to protect citizens of their states that rely on the Obamacare’s Medicaid expansion. The resulting standoff makes it unlikely that enough Republicans can be satisfied to pass any bill without compromise from both sides.

The current bill is the result of an “effort to write this bill, in a hurry, with a jumble of provisions, [that] seems to suggest that they are just trying to find something that can pass, as opposed to articulating a clear policy vision for what they want health care to look like in this country,” Sanger-Katz said.

If the current compromise bill, written to get something passed, cannot pass, what is the future of the Republican repeal and replace effort? Amending it to satisfy members of the Freedom Caucus would probably spur moderates to vote “no” and vice versa. If the bill dies, there is no clear path forward.

Failure of the current bill might have the effect of moving healthcare reform to the left. If conservatives cannot be brought on board, President Trump may tack to the left and craft a bill that could pass with a coalition of moderates from both parties.

Failing to repeal Obamacare won’t be good for Republicans. Neither is passing a bill that leaves much of Obamacare intact. Finding a bill that can pass will require walking a tightrope that leaves the GOP vulnerable to attacks from both the left and the right.

 

 

 

 

Republican Health Plan Is Worth a Closer Look

There has been a firestorm of conservative opposition to TrumpCare, as the American Health Care Act is already becoming known. The Republican health care plan has been widely panned and even viewed as a betrayal by many on the right.

To find out more about what the bill contains, I sat down and read it. Unlike Obamacare, the Republican health care bill is posted on the internet in its entirety. The bill took less than two hours to read. You can read it for yourself by going here. References to sections of other laws such as the ACA make it difficult to get the full grasp of some parts of the bill, but it’s easy to get a general overview of most of the proposals.

The first two sections deal with “Patient Access to Public Health Programs” and “Medicaid Program Enhancement.” These sections dealt with reforms to Medicaid. Some of the items included, listed in order with their section number were:

  • Banning Medicaid money for abortion providers such as Planned Parenthood (103)
  • Repealing the Medicaid expansion effective January 1, 2020 (112) – The Medicaid expansion was the largest expansion of coverage under Obamacare.
  • Limits the eligibility for Medicaid (114)
  • Creates incentives for states to qualify Medicare recipients more often and penalizes those that carry ineligible people on the rolls (116)

The next section, “Per Capita Allotment for Medical Assistance,” also deals with Medicaid reform.

  • Caps Medicaid spending on a per person basis (1903A)

Subpart D is entitled “Patient Relief and Health Market Stability.”

  • Repeals Obamacare’s cost-sharing subsidy with insurance companies (131)
  • Creates a Patient and State Stability Fund that empowers states to create risk pools for high risk individuals, promote preventive care, reduce costs and reduce out-of-pocket costs for insureds (2202)
  • This section also describes the Continuous Health Coverage Incentive for people who drop their health insurance and sign up again. This is a 30 percent penalty for people who do not have 63 days of continuous coverage in the previous 12 months. This is not a popular provision, but Obamacare’s clause guaranteeing insurability for previous conditions is something most Americans want to keep. If this provision is to be kept, some sort of mechanism is necessary to prevent people from waiting until they get sick to buy insurance. (133, 2711)
  • Amends Obamacare to increase insurance policy options (134)

There are many individual sections of the bill that repeal Obamacare taxes as well. One section of the bill is titled “Repeal and Replace of Health-Related Tax Policy.”

  • Repeals the tanning tax
  • Repeals the tax on prescription medications
  • Repeals the Health Insurance Tax
  • Repeals the Net Investment Income Tax
  • Prohibits tax credits for abortion coverage (02-04)
  • Repeals individual mandate (05)
  • Repeals tax on employee insurance premiums and benefits (07)
  • Repeals tax on over-the-counter medications (08)
  • Repeals tax increase on Health Savings Accounts (09)
  • Repeal of limits on Flexible Savings Account contributions (10)
  • Repeal of medical device tax (11)
  • Repeals the increase in the threshold of the medical income tax deduction. The threshold would return to 7.5 percent of adjusted gross income from the current 10 percent. (12)
  • Repeal of the Medicare tax increase (14)
  • Section 15 deals with the refundable tax credits for insurance premiums. Section 7529 allows advance payment of the credit. This is a problematic section.
  • Increases the HSA contribution limit to equal the amount of the policy’s deductible and out-of-pocket limits (16)
  • Permits catch-up contributions to HSAs (17)
  • Treats medical expenses within 60 days of the establishment of an HSA as occurring on the first day the account was opened. This would allow HSA funds to be used for a condition that occurred shortly before opening the account. (18)

The AHCA is not a perfect bill. It is also not a betrayal of the Republican promise to repeal and replace Obamacare. In fact, many of the provisions in the bill have been on the wish list for conservatives long before Obamacare became law.

Republicans are in a weaker position than Democrats were when they passed Obamacare. As Jamie Dupree of the Atlanta Journal points out, Democrats had 60 votes, enough to break a Republican filibuster, when the Senate originally passed the bill on Christmas Eve 2009. They subsequently lost a vote when Scott Brown (R-Mass.) was elected to the Senate and used the reconciliation process for the second bill of the Obamacare package. Both bills ultimately became law in March 2010.

Republicans have only 52 Senate votes, which is not enough to end a Democrat filibuster. At least four of the Republican votes would not be reliable for a clean repeal bill. A perfect bill is simply not possible.

The current Republican plan is three-pronged. First, the reconciliation process will repeal as much of Obamacare as possible with the AHCA. Second, President’s Trump’s appointees will kill as much Obamacare regulation as possible through administrative rulemaking. Finally, the remainder of Obamacare will be repealed and replaced through a traditional bill. This bill would ideally enact other reforms that cannot be part of the budget reconciliation such as allowing health insurance to be sold across state lines. The third phase will be the most difficult since that bill would be subject to a Democrat filibuster.

Since an outright repeal is impossible and since the AHCA does contain many good conservative reforms, the best solution is to improve the current bill. The American Enterprise Institute has identified several changes that could be incorporated into the AHCA to lower costs and help stabilize the insurance market. Other conservative think tanks and members of Congress could probably improve the bill even more.

Now that the Republican plan is in the open, party leaders should slow down and allow time for a national debate on the merits of the legislation. By rushing forward with an unpopular and flawed bill, Republicans may well repeat the experience of the Democrats who pushed through a bill that only became less popular as its cobbled together provisions made the problem worse. The Democrats ultimately lost control of both houses of Congress and the presidency because of Obamacare. Republicans should learn from these Democrat mistakes.

Conversely, killing the Republican health care reform would be a major victory for the Democrats and may well scuttle efforts to repeal Obamacare permanently. A better solution is to work to improve the current House bill.

Republicans could just say no when Barack Obama was president, but with a Republican in the White House, they have to be realistic. They have to have a plan… a realistic one that can pass the House and Senate. Right now, improving the AHCA seems to be the best option.

Read the American Health Care Act

Unlike the Affordable Care Act, the Republican Health Care Plan is posted on the internet. You can read the entire bill in just a couple of hours. If you are interested in health care reform and repealing Obamacare, you owe it to yourself to take the time to look at what the GOP has proposed.

A link to download the bill is on the House Republican page.

A direct link to the text of the bill is on Congress.gov.

Find out what is in the bill before it passes.

Cruz Warns Current GOP Health Plan ‘Cannot Pass’

As a number of other Republican senators line up against TrumpCare, Sen. Ted Cruz (R-Texas) warned that he doesn’t think that the bill can pass in its current form. Speaking to The Hill, Cruz said, “The House bill is a beginning. The House bill as drafted, I do not believe, would pass the United States Senate.”

In his measured comments, Cruz declined to say if he would support the current bill, but indicated that he is working with other congressmen to improve the Republican plan. “There is not nearly enough in the House bill to drive down the cost of premiums,” he said. “I [also] believe there [are] significant challenges with the Medicaid expansion provision.”

Preserving the Medicaid expansion in the near term was a requirement of the Medicaid Four, a quartet of centrist Republican senators from states that expanded Medicaid under Obamacare. The four said that they would not vote for a bill that did not provide an orderly transition from Medicaid to new coverage. The current bill preserves federal funding for the expanded version of Medicaid until 2020.

Cruz said that he favors a bill that provides block grants to states for Medicaid. Block grants would allow the states more freedom in how to spend federal money allocated to the government health program.

Later, Cruz and his family attended a dinner with President Trump. This was undoubtedly a part of Trump’s charm offensive that aims to bring wavering Republicans on board with TrumpCare. Cruz posted photos of the event and called the Trumps “warm and gracious.”

There is no indication that the dinner with the president altered Cruz’s views on the Republican health plan, but in his comments prior to the meeting Cruz did express more optimism about the future of repeal than many of his colleagues.

“I believe we can and will repeal Obamacare,” he told reporters. “I believe at the end of the day we will get to yes.”