Tag Archives: healthcare

NYS Gov Cuomo Devises Healthcare Model to Counter TrumpCare (Hint: Pre-Existing Conditions, Contraception, Abortion Would be Covered)

Governor Andrew Cuomo has come up with a list of items that any health insurance company that wants to sell in New York State would have to include. Among them: rehabilitative and habilitative services and devices, such as durable medical equipment, medical supplies, prosthetic devices, hearing aids, chiropractic care, physical therapy, occupational therapy, speech therapy, and home health care © Karen Rubin/news-photos-features.com

 

By Karen Rubin, News & Photo Features

As the fate of Americans’ health care falls in the hands of 13 Republican Senators conferring in secret without input from Democrats let alone health care experts or patients, deciding how much of the “harsh” House plan they incorporate into their own bill, it may well fall to states to take matters into their own hands. Indeed, New York State may provide the model for health care, just as California has dictated pollution standards to the auto manufacturing industry, exceeding federal standards.

New York State Governor Andrew M. Cuomo has directed the New York State Department of Financial Services to promulgate new emergency regulations mandating health insurance providers do not discriminate against New Yorkers with preexisting conditions or based on age or gender, in addition to safeguarding the 10 categories of protections guaranteed by the Affordable Care Act. The new first-in-the-nation measures will ensure that essential health services are protected and covered for all New Yorkers regardless of efforts at the federal level to strip millions of Americans of their healthcare.

At the Governor’s direction, the Department of Health will ban all insurers who withdraw from offering Qualified Health Plans on the State Health Marketplace from future participation in any program that interacts with the marketplace, including Medicaid, Child Health Plus, and the Essential Plan. New York is home to one of the most robust health marketplaces in the country, and insurers who do not comply will lose access to such profitable programs. The Governor will also direct state agencies and authorities to ban insurers who withdraw from the State Health Marketplace from contracting with the state and to consider all available actions to protect New Yorker’s access to quality healthcare.

Furthermore, the administration finalized regulations that will ensure that contraceptive drugs and devices are covered by commercial health insurance policies without co-pays, coinsurance, or deductibles no matter federal action. The regulations also ensure all medically necessary abortion services are covered by commercial health insurance policies without co-pays, coinsurance, or deductibles.

“We will not stand idly by as ultra-conservatives in Washington try to roll back the progress we have made to expand access quality, affordable health care, putting our most vulnerable New Yorkers at risk,” Governor Cuomo said. “As long as I am Governor, New Yorkers will not be subject to price discrimination based on age, gender, or pre-existing conditions, and essential health benefits will continue to be the rule, not the exception. These aggressive actions will make certain that no matter what happens in Congress, the people of New York will not have to worry about losing access to the quality medical care they need and deserve.”

Under the new regulations, DFS will require that individual and small group accident and health insurance policies, which provide hospital, surgical, or medical expense coverage, as well as student accident and health insurance policies cover the same categories of essential health benefits and be subject to the same benchmark plan rules that currently apply through the Affordable Care Act. Insurers must comply with the new regulations as a requirement of their license in New York.

  1. Ambulatory patient services, such as office visits, ambulatory surgical services, dialysis, radiology services, chemotherapy, infertility treatment, abortion services, hospice care, and diabetic equipment, supplies and self-management education;
  2. Emergency services, such as emergency room, urgent care services, and ambulance services;
  3. Hospitalization, such as preadmission testing, inpatient physician and surgical services, hospital care, skilled nursing facility care, and hospice care;
  4. Maternity and newborn care, such as delivery, prenatal and postnatal care, and breastfeeding education and equipment;
  5. Mental health and substance use disorder services, including behavioral health treatment, such as inpatient and outpatient services for the diagnosis and treatment of mental, nervous and emotional disorders, screening, diagnosis and treatment for autism spectrum disorder, and inpatient and outpatient services for the diagnosis and treatment of substance use disorder;
  6. Prescription drugs, such as coverage for generic, brand name and specialty drugs, enteral formulas, contraceptive drugs and devices, abortifacient drugs, and orally administered anti-cancer medication;
  7. Rehabilitative and habilitative services and devices, such as durable medical equipment, medical supplies, prosthetic devices, hearing aids, chiropractic care, physical therapy, occupational therapy, speech therapy, and home health care;
  8. Laboratory services, such as diagnostic testing;
  9. Preventive and wellness services and chronic disease management, such as well child visits, immunizations, mammography, gynecological exams including cervical cytology screening, bone density measurements or testing, and prostate cancer screening; and
  10. Pediatric services, including oral and vision care, such as preventive and routine vision and dental care, and prescription lenses and frames.

The Superintendent of the Department of Financial Services may issue model contract language identifying the coverage requirements for all individual and small group accident and health insurance policies that provide hospital, surgical, or medical expense coverage and all student accident and health insurance policies delivered or issued for delivery in New York State.

DFS will also mandate under existing New York law that health insurers:

  • Provide coverage for all contraceptive drugs and devices and cover at least one form of contraception in each of the FDA-approved contraceptive delivery methods without co-pays, coinsurance, or deductibles, regardless of the future of the Affordable Care Act.
  • Provide coverage for the dispensing of an initial three-month supply of a contraceptive to an insured person. For subsequent dispensing of the same contraceptive covered under the same policy or renewal, an insurer must allow coverage for the dispensing of the entire prescribed contraceptive supply, up to 12 months, at the same time.
  • Provide coverage for abortion services that are medically necessary without co-pays, coinsurance, or deductibles (unless the plan is a high deductible plan).
  • Provide full and accurate information about coverage, enforced in a letter available here.

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© 2017 News & Photo Features Syndicate, a division of Workstyles, Inc. All rights reserved. For editorial feature and photo information, go to www.news-photos-features.com, email editor@news-photos-features.com. Blogging atwww.dailykos.com/blogs/NewsPhotosFeatures.  ‘Like’ us on facebook.com/NewsPhotoFeatures, Tweet @KarenBRubin

Trump Budget is Criminal; Ryan & Republicans are Accomplices

Donald Trump delivers his joint address to Congress, as Mike Pence and Paul Ryan cheer him on. Trump’s 2018 budget may be unbelievably cruel and callous, but it mimics the principles that Ryan and the Republicans have been crusading for © 2017 Karen Rubin/news-photos-features.com

By Karen Rubin, News & Photo Features

It doesn’t matter that Trump’s preposterously named “A New Foundation for American Greatness” budget is “dead on arrival” according to even staunch Republican, Texas Senator John Cornyn. Much of it is the long-time wet dream of Paul Ryan and Republicans whose singular ambition has been to destroy the New Deal, Square Deal, Great Society. They would eliminate the minimum wage, child labor laws, food and product safety, Clean Air & Water protections, Social Security and Medicare and most notably Medicaid, sell off national parks and monuments to mining and oil and gas industrialists. And this is before taking into account tax “reform” that would take $2 trillion out of the national budget to put into the pockets of the wealthiest and corporations, so they have even more extra pocket change to spend on political campaigns.

Indeed, the Trump budget is everything that the Republicans have been dying to do, but didn’t dare. But Trump doesn’t care. He has shown that it really isn’t hard atall to cut the budget when you really don’t care what the numbers represent,when you have no clue and no interest.

The Trump Budget is built on “Trumponomics, as Office of Management and Budget Director Mike Mulvaney proudly exclaimed, “It’s a taxpayer-first budget, going line by line through the budget, trying to put yourself in the shoes of the people who are paying for those lines….What Trumponomics is and what this budget is a part of is an effort to get to sustained 3 percent economic growth in this country again..And by the way, we do not believe that that is something fanciful.”

Indeed, this is a “tough love” approach to force malingerers off things like food stamps – it’s not non-living wages paid by companies pocketing record profits that keep workers below the poverty line that’s the problem.

“Getting people back to work. Create an environment where people more comfortable staying at …We no longer measure compassion by the number of programs or number of people on programs. We measure success by how many get off programs and have success in lives.”

But the figures don’t actually add up.

Economists from across the spectrum say that the math that underlies the main selling point for Trump’s budget, that it will “balance the budget” in 10 years, is a crock. It doesn’t take into account the $1 trillion or so in tax cuts that will go entirely to the wealthiest and to corporations that Trump sketched out; it assumes a 3% rate of annual economic growth, which would mean 50% more economic activity, which everyone says is beyond pie-in-the-sky; and it actually double-counts $2 trillion, prompting headlines like this one from Slate, “Donald Trump’s budget is based on a hilarious accounting fraud” and “The dumb accounting error at the heart of Trump’s budget “ from Vox.

Health care a right, not a privilege? Trump’s budget projects a 28.3% DROP in spending for health services, $2 trillion less spending, over a 10-year period – despite the aging and increase in population. This includes a 27% decrease in spending for the Centers for Disease Control & Prevention (imagine another Ebola, Zika or Swine Flu outbreak); 25% drop in Substance Abuse and Mental Health Services Administration (even as Trumpcare will no longer include mental health or addiction), 25% less spending for research and training, including 25% cut for the National Institutes of Health (no interest in finding therapies or cures for Zika,  Alzheimers or “orphan” diseases that wouldn’t be profitable enough for Big Pharma); 40% cut for the Food & Drug Administration (let Big Pharma do what they will); 15% drop in food safety and inspection; 17% cut to the Consumer Product Safety Commission, 16% cut in already strapped Occupation and Mine Safety and Health spending even as he overturned regulations.

$1.4 trillion gap in infrastructure spending to repair decaying roads, bridges airports? Trump would cut Transportation spending by 25% cut (65% cut to National Infrastructure Investments; 50% cut to air transportation which is already woefully in need of upgrades); 28% cut to Education, Training, Employment and Social Services.

His cuts to environmental protection – on top of slashing regulations that give communities a fighting chance to protect their air, water and public health – amount to Hague Tribunal level of war criminality for what he will do to the planet, let alone our communities. The allocation is cut 27.1% – $132 billion worth – including a 34% cut in Pollution control and abatement, 42% cut in Regulatory, enforcement and research programs, 37% cut in Hazardous substance superfund ($330 million less in 2018).

Trump would end funding for the Clean Power Plan, international climate change programs, climate change research and partnership programs, and related efforts—“saving” over $100 million in 2018. He cuts out $129 million in funding for the EPA’s Office of Enforcement. He cuts out $233 million in 2018 for the EPA’s Research & Development (ie. climate change science). It eliminates more than 50 EPA programs, $347 million worth in 2018; and ends funding for specific regional efforts such as the Great Lakes Restoration Initiative and the Chesapeake Bay, amounting to $427 million in 2018.

Trump would cut General Science, Space & Technology spending by 14.7%, including 18.9% cut to General Science and basic research.

International Affairs would be cut nearly in half, including 26% cut in spending for Global Health programs; 74% cut in Refugee programs; 66% percent cut in International Disaster Assistance, 83% cut in “other” development and humanitarian assistance.”

(See the New York Times, “How Trump’s Budget Would Affect Every Part of Government”).

Setting aside for a moment that Trump and his billionaire friends don’t actually pay their fare share of taxes, nor do many profitable American companies which have stashed $2 trillion in offshore accounts, the Republicans’ approach is what Hillary Clinton correctly observed, “trickle down economics on steroids.” It didn’t work with Reagan or George W. Bush. And this is even worse.

No matter: the extremity of Trump’s proposed budget, the callousness of it, will give cover to Ryan and the House Republicans and make anything they do seem “moderate”, even “compassionate.” So they cut Medicaid by $600 billion instead of $866 billion and call it a “win” for the little people; they cut the State Department by 20% instead of 30% and pat themselves on the head; they cut the EPA by 25% instead of 31%.

 

Here’s what Senator Elizabeth Warren (D-Massachusetts) wrote: “Speaker of the House Paul Ryan says that Donald Trump’s new budget is ‘right on the target.’ That’s all you need to know about just how devastating Trump’s budget will be for working families in Massachusetts and across this country.

“It’s obscene:

  • $5 billion in cuts to public education
  • $73 billion in cuts to Social Security
  • $191 billion in cuts to food stamps
  • $610 billion in cuts to Medicaid (and that’s in addition to the $880 billion the House Republicans are slashing in their so-called “health care” bill)

“Those are just a few of the highlights. What else gets cut? Money for children’s health care, money to combat the opioid epidemic, money for medical research, money for the Corporation for Public Broadcasting, and so much more.

“This budget is ‘right on the target’ only if the target is to sucker-punch kids, seniors, the poor and the sick. If the Republicans make good on this budget, they could deliver the final blow to America’s working families.

We don’t build a future by ripping health care away from tens of millions of people. We don’t build a future by starving education, by letting our roads crumble and our bridges collapse, and by shutting down the big pipeline of medical and scientific research in this country.

“We build a future by making the investments in ourselves and all of our people – so the next kid can get ahead, and the kid after that, and the kid after that. We’ve done this before in our country, and we can do it again.

”Budgets aren’t just about dollars and cents. Budgets are about our values, and this budget is morally bankrupt,” Warren wrote.

Trump and the Republicans would cut out all the things that have “made America great,” and a world leader in innovation and entrepreneurship, not to mention the main tools for spreading democracy and human rights across the globe (through capitalist investment, which is what China and Russia are now doing).

This is the midst of an actually strong economy, near “full employment” and as we keep hearing, a record stock market.

The Trump budget is the essence of everything that Trump is doing to weaken the US as an economic power, a world power, and its ability to be a moral leader, that Reaganesque “beacon on a hill” of political righteousness.

As we marked Memorial Day this past weekend, a New York Times book review of “The Allure of Battle: A History of How Wars Have Been Won and Lost,” by Cathal J. Nolan, pointed out that “Generally, one side, usually the one with a smaller economy and population, becomes exhausted, and gives up. Talk about élan and audacity all you like, he counsels, but what wins wars is demography and economic strength.” That is to say, winning a war is more a matter of “hearts and minds” vs. “bombs and brigades” as we have been seeing in America’s longest wars, in Afghanistan and Iraq.

Everything that Trump has done so far (putting aside the fact that he is an illegitimate occupier of the Oval Office by selling out to an adversary government), will weaken the US as an economic power, a world power, and its ability to be a moral leader, that Reaganesque “beacon on a hill” of political righteousness.

Indeed, Trump, who cozied up to the Saudis while hectoring NATO allies and the G7, on his “epic” overseas trip, came back declaring “a home run”, while Germany’s Angela Merkel told Europe,  “We can no longer depend on the US or UK. We are on our own.”

New York State, along with other “blue” states like California, already send way more income tax money to Washington than we get back while the “red” states, which so pride themselves in low state taxes and low wages get far more than they send. Like tenants with a legal fight against their landlord, I would propose that New Yorkers collect their federal income tax money in an escrow account, to pay for services that should be paid by the federal government, such as police and security protection (which Trump is threatening to cut to New York and other states that don’t cooperate in his roundup of undocumented individuals), environmental restoration, health care for those whose subsidies have been eliminated, public schools, infrastructure repair, food stamps and school lunch program.

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© 2017 News & Photo Features Syndicate, a division of Workstyles, Inc. All rights reserved. For editorial feature and photo information, go to www.news-photos-features.com, email editor@news-photos-features.com. Blogging at www.dailykos.com/blogs/NewsPhotosFeatures.  ‘Like’ us on facebook.com/NewsPhotoFeatures, Tweet @KarenBRubin