Category Archives: Health Care

Democratic Candidates for 2020: Warren Releases Plan to Reduce Health Care Costs and Transition to Medicare for All

Senator Elizabeth Warren provided more detail about how she would introduce universal health care, reduce health care costs and transition to Medicare for All © Karen Rubin/news-photos-features.com

The vigorous contest of Democrats seeking the 2020 presidential nomination has produced excellent policy proposals to address major issues. Clearly responding to the backlash against her radical plan to finance Medicare for All, Senator Elizabeth Warren released details of how she would reduce health care costs in America, eliminate profiteering from the health care system, and complete a full transition to Medicare for All in her first term. Warren has already released her plan to fully finance Medicare for All when it’s up and running without raising taxes on the middle class by one penny.

 “Medicare for All is the best way to guarantee health care to all Americans at the lowest cost. I have a plan to pay for it without raising taxes on middle class families, and the transition I’ve outlined here will get us there within my first term as president. Together, along with additional reforms like my plans to reduce black maternal mortality rates, ensure rural health care, protect reproductive rights, support the Indian Health Service, take care of our veterans, and secure LGBTQ+ equality, we will ensure that no family will ever go broke again from a medical diagnosis – and that every American gets the excellent health care they deserve. “

This is from the Warren campaign:

On Day One, Elizabeth will use her executive authority to:

Reverse Donald Trump’s sabotage of Obamacare 

Improve the Affordable Care Act, Medicare, and Medicaid.

Protect people with pre-existing conditions

Drastically lower pharmaceutical costs for millions of families for drugs including Insulin, EpiPens, and drugs that save people from opioid overdoses.

The first bill Elizabeth will pass is her comprehensive set of anti-corruption reforms which include ending lobbying as we know it and knocking back the influence of Big Pharma and insurance companies. 

And in her first 100 days, Elizabeth will use a fast-track legislative process called budget reconciliation to create a true Medicare for All option that will: 

Include all the health care benefits of Medicare for All described in the Medicare for All Act.

Be immediately free for nearly half of all Americans, including: 

Children under the age of 18

Families making at or below 200% of the federal poverty level (about $51,000 for a family of four)

Give every American over the age of 50 the choice to enter a substantially improved Medicare program.

Consumer costs will automatically decline, so eventually coverage under this plan will be free to everyone

Throughout her first term, she will fight for additional health system reforms to save money and save lives–including a boost of $100 billion in guaranteed, mandatory spending for new NIH research.  

And no later than her third year in office, she will pass legislation to complete the transition to Medicare for All: guaranteed comprehensive health care for every American, long-term care, vision, dental, and hearing, with a single payer to reduce costs and produce better health outcomes. 

Elizabeth’s plan can deliver an $11 trillion boost to families who will never pay another premium, deductible, or co-pay. 

And her plan will protect unions and make sure that there’s support for workers affected by these changes.

Read more about her plan here and below: 

My First Term Plan for Reducing Health Care Costs in America and Transitioning to Medicare for All

I spent my career studying why families went broke. I rang the alarm bells as the costs for necessities skyrocketed while wages remained basically flat. And instead of helping, our government has become more tilted in favor of the wealthy and the well-connected. 

The squeeze on America’s families started long before the election of Donald Trump, and I’m not running for president just to beat him. I’m running for president to fix what’s broken in our economy and our democracy. I have serious plans to raise wages for Americans. And I have serious plans to reduce costs that are crushing our families, costs like child careeducationhousing – and health care

The Affordable Care Act made massive strides in expanding access to health insurance coverage, and we must defend Medicaid and the Affordable Care Act against Republican attempts to rip health coverage away from people. But it’s time for the next step.

The need is clear. Last year, 37 million American adults didn’t fill a prescription because of costs. 36 million people skipped a recommended test, treatment, or follow-up because of costs. 40 million people didn’t go to a doctor to check out a health problem because of costs. 57 million people had trouble covering their medical bills. An average family of four with employer-sponsored insurance spent $12,378 on employee premium contributions and out-of-pocket costs in 2018. And 87 million Americans are either uninsured or underinsured.

Meanwhile, America spends about twice as much per person on health care than the average among our peer countries while delivering worse health outcomes than many of them. America is home to the best health care providers in the world, and yet tens of millions of people can’t get care because of cost, forcing families into impossible decisions. Whether to sell the house or skip a round of chemo. Whether to cut up pills to save money or buy groceries for the week. The way we pay for health care in the United States is broken – and America’s families bear the burden. 

We can fix this system. Medicare for All is the best way to cover every person in America at the lowest possible cost because it eliminates profiteering from our health care and leverages the power of the federal government to rein in spending. Medicare for All will finally ensure that Americans have access to all of the coverage they need – not just what for-profit insurance companies are willing to cover – including vision, dental, coverage for mental health and addiction services, physical therapy, and long-term care for themselves and their loved ones. Medicare for All will mean that health care is once again between patients and the doctors and nurses they trust–without an insurance company in the middle to say “no” to access to the care they need. I have put out a plan to fully finance Medicare for All when it’s up and running without raising taxes on the middle class by one penny.

But how do we get there? 

Every serious proposal for Medicare for All contemplates a significant transition period. Today, I’m announcing my plan to expand public health care coverage, reduce costs, and improve the quality of care for every family in America. My plan will be completed in my first term. It includes dramatic actions to lower drug prices, a Medicare for All option available to everyone that is more generous than any plan proposed by any other presidential candidate, critical health system reforms to save money and save lives, and a full transition to Medicare for All.  

Here’s what I’ll do in my first 100 days:

I’ll pursue comprehensive anti-corruption reforms to rein in health insurers and drug companies – reforms that are essential to make any meaningful health care changes in Washington.

I’ll use the tools of the presidency to start improving coverage and lowering costs – immediately. I’ll reverse Donald Trump’s sabotage of health care, protect individuals with pre-existing conditions, take on the big pharmaceutical companies to lower costs of key drugs for millions of Americans, and improve the Affordable Care Act, Medicare, and Medicaid. 

I will fight to pass fast-track budget reconciliation legislation to create a true Medicare for All option that’s free for tens of millions. I won’t hand Mitch McConnell a veto over my health care agenda. Instead, I’ll give every American over the age of 50 the choice to enter an improved Medicare program, and I’ll give every person in America the choice to get coverage through a true Medicare for All option. Coverage under the new Medicare for All option will be immediately free for children under the age of 18 and for families making at or below 200% of the federal poverty level (about $51,000 for a family of four). For all others, the cost will be modest, and eventually, coverage under this plan will be free for everyone.

By the end of my first 100 days, we will have opened the door for tens of millions of Americans to get high-quality Medicare for All coverage at little or no cost. But I won’t stop there. Throughout my term, I’ll fight for additional health system reforms to save money and save lives – including a boost of $100 billion in guaranteed, mandatory spending for new NIH research over the next ten years to radically improve basic medical science and the development of new medical miracles for patients.

And finally, no later than my third year in office, I will fight to pass legislation that would complete the transition to full Medicare for All. By this point, the American people will have experienced the full benefits of a true Medicare for All option, and they can see for themselves how that experience stacks up against high-priced care that requires them to fight tooth-and-nail against their insurance company. Per the terms of the Medicare for All Act, supplemental private insurance that doesn’t duplicate the benefits of Medicare for All would still be available. But by avoiding duplicative insurance and integrating every American into the new program, the American people would save trillions of dollars on health costs.

I will pursue each of these efforts in consultation with key stakeholders, including patients, health care professionals, unions, individuals with private insurance, hospitals, seniors currently on Medicare, individuals with disabilities and other patients who use Medicaid, Tribal Nations, and private insurance employees. 

And at each step of my plan, millions more Americans will pay less for health care. Millions more Americans will see the quality of their current health coverage improve. And millions more Americans will have the choice to ditch their private insurance and enter a high-quality public plan. And, at each step, the changes in our health care system will be fully paid for without raising taxes one penny on middle class families.

Every step in the coming fight to improve American health care – like every other fight to improve American health care – will be opposed by those powerful industries who profit from our broken system.  

But I’ll fight my heart out at each step of this process, for one simple reason: I spent a lifetime learning about families going broke from the high cost of health care. I’ve seen up close and personal how the impact of a medical diagnosis can be devastating and how the resulting medical bills can turn people’s lives upside down. When I’m President of the United States, I’m going to do everything in my power to make sure that never happens to another person again.

The First 100 Days of a Warren Administration

Donald Trump has spent nearly every day of his administration trying to rip health coverage away from tens of millions of Americans – first by legislation, then by regulation, and now by lawsuit. When I take office, I will immediately work to reverse the damage he has done. 

But I’ll do much more than that. 

In my first 100 days, I will pick up every tool Donald Trump has used to undermine Americans’ health care and do the opposite. While Republicans tried to use fast-track budget reconciliation legislation to rip away health insurance from millions of people with just 50 votes in the Senate, I’ll use that tool in reverse – to improve our existing public insurance programs, including by giving everyone 50 and older the option to join the current Medicare program, and to create a true Medicare for All option that’s free for millions and available to everyone.   

But first, we must act to rein in Washington corruption. 

Anti-Corruption Reforms to Rein in Health Industry Influence.

In Washington, money talks – and nowhere is that more obvious than when it comes to health care. The health care industry spent $4.7 billion lobbying over the last decade. And health insurance and pharmaceutical executives have been active in fundraising and donating to candidates in the 2020 Democratic primary campaign as well. 

Today, the principal lobbying groups for the drug companies, health insurers, and hospitals have teamed up with dozens of other health industry groups to create the Partnership for America’s Health Care Future – a front group whose members spent a combined $143 million on lobbying in 2018 and aims to torpedo Medicare for All in this election. The Partnership has made clear that “whether it’s called Medicare for All, Medicare buy-in, or the public option, one-size-fits-all health care will never allow us to achieve [our] goals.” 

Let’s not kid ourselves: every Democratic plan for expanding public health care coverage is a challenge to these industries’ bottom lines – and every one of these plans is already being drowned in money to make sure it never happens. Any candidate who believes more modest reforms will avoid the wrath of industry is not paying attention. 

If the next president has any intention of winning any health care fight, they must start by reforming Washington. That’s why I’ve released the biggest set of anti-corruption reforms since Watergate – and why enacting these reforms is my top priority as president. Here are some of the ways my plan would rein in the health care industry:

Close the revolving door. My plan will close the revolving door between health care lobbyists and government, and end the practice of large pharmaceutical companies like Novartis, United Health, Roche, Pfizer, and Merck vacuuming up senior government officials to try and monopolize government expertise, relationships, and influence during a fight for health care reform.

Tax excessive lobbying. My plan will also implement an excessive lobbying tax on companies that spend more than $500,000 per year peddling influence – like Pfizer, Amgen, Eli Lilly, Novartis, and Johnson & Johnson. Money from the tax would be used to strengthen congressional support agencies, establish an office to help the public participate in the rule-making process, and give our government additional resources to fight back against an avalanche of corporate lobbying spending.

End lobbyist bribery. My campaign finance plan will ban all lobbyists – including health insurance and pharma lobbyists – from trying to buy off politicians by donating or fundraising for their campaigns. This will shut down the flow of millions of dollars in contributions.

Limit corporate spending to influence elections. My plan bans all election-related spending from big corporations with a significant portion of ownership from foreign entities. That would block major industry players like UnitedHealthAnthemHumanaCVS HealthPfizer, AmgenAbbVieEli LillyGilead, and Novartis – along with any trade associations that receive money from them – from spending to influence elections. 

Crowd out corporate contributions with small dollar donations. I support a constitutional amendment to get big money out of politics. But until we enact it, my plan would institute a public financing program that matches every dollar from small donations with six more dollars so that congressional candidates are answering to the people who need health care and affordable prescription drugs, rather than health insurance and pharmaceutical companies.

Passing these reforms will not be easy. But we should enact as much of this agenda as possible, as quickly as possible. I will also use my executive authority to begin implementing them wherever possible – including through prioritizing DOJ and FEC enforcement against the corrupt influence-peddling game. And I will voluntarily hold my administration to the standards that I set in my anti-corruption plan so that all our federal agencies, including those involved in health care, serve only the interests of the people. 

Money slithers through Washington like a snake. Any candidate that cannot or will not identify this problem, call it out, and pledge to make fixing it a top priority will not succeed in delivering any public expansion of health care coverage – or any other major priority. 

Immediate Executive Actions to Reduce Costs and Expand Public Health Coverage.

There are a number of immediate steps a president can take entirely by herself to lower drug prices, reduce costs, and improve Medicare, Medicaid, and ACA access and affordability. I intend to take these steps within my first 100 days. 

Dramatically Lower Key Drug Prices

As drug companies benefit from taxpayer-funded R&D and rake in billions of dollars in profits, Americans are stuck footing the bill. The average American spends roughly $1,220 per year on pharmaceuticals – more than any comparable country. As president, I will act immediately to lower the cost of prescription drugs, using every available tool to bring pressure on the big drug companies. I’ll start by taking immediate advantage of existing legal authorities to lower the cost of several specific drugs that tens of millions of Americans rely on. 

Some drug prices are high because pharmaceutical companies jack up prices on single-source brand-name drugs, taking advantage of government-granted patents and exclusivity periods to generate eye-popping profits. Pharma giant Gilead, for example, launched its Hepatitis C treatment Harvoni at $94,500-per-twelve week treatment – leaving as many as 85 percent of more than 3 million Americans with Hepatitis C struggling to afford life-saving treatments. 

The government has two existing tools to combat price-gouging by brand-name drug companies, in addition to tough antitrust enforcement against companies that abuse our patent system and use every trick in the book to avoid competition. First, the government can bypass patents (while providing “reasonable and entire compensation” to patent holders) using “compulsory licensing authority.” The Defense Department has used this authority as recently as 2014. Second, under the march-in provisions of the Bayh-Dole Act, the government can require re-licensing of certain patents developed with government involvement when the contractor was not alleviating health or safety needs. Just in this decade, federal research investments have contributed to the development of hundreds of drugs – all of which could be subject to this authority.

But new drugs aren’t the only unaffordable drugs on the market. Even older, off-patent drugs can be expensive and inaccessible. Lack of generic competition allows bad actors like Martin Shkreli to boost the prices of decades-old drugs. Some of the biggest generic drug companies in the country are now being sued by forty-four states for price-fixing to keep profits high. Limited competition and other market failures can also lead to drug shortages. Fortunately, the government can also act to fix our broken generic drug market by stepping in to publicly manufacture generic drugs, stopping price gouging in its tracks and bringing down costs.. 

On the first day of my presidency, I will use these tools to drastically lower drug costs for essential medications – drugs with high costs or limited supply that address critical public health needs. And during my administration, we will use these tools to make other drugs affordable as well.

Insulin was discovered nearly 100 years ago as a treatment for diabetes – but today the drug is still unaffordable for too many Americans. Eli Lilly’s brand-name insulin prices increased over 1,200% since the 1990s. Insulin costs are too high because three drug companies – Novo Nordisk, Sanofi, and Eli Lilly – dominate the market, jacking up prices. Americans with diabetes are rationing insulin, and taxpayers are spending billions on it through Medicare and Medicaid. It’s obscene. No American should die because they can’t afford a century-old drug that can be profitably developed for $72 a year. I will use existing authorities to contract for manufacture of affordable insulin for all Americans. 

EpiPens deliver life-saving doses of epinephrine, a drug that reverses severe allergic reactions to things like peanuts and bee stings. Though epinephrine has been around for over a century, the pens that deliver it are protected by a patent that limits competition. In 2016, this lack of competition allowed Mylan, EpiPen’s manufacturer, to jack up EpiPen prices by 400%, leaving families unable to afford this life-saving medication. Though cheaper versions have recently entered the market, prices remain out of reach for many American families. As president, I will use existing authorities to produce affordable epinephrine injectors for Americans (and especially children) who need it.

Naloxone can reverse the effects of an opioid overdose. In 2017, more than 70,000 people died from a drug overdose in the United States, with the majority due to opioids. The opioid epidemic cost Americans nearly $200 billion in 2018, including more than $60 billion in health care costs. Health officials agree that naloxone is “critical” to curb the epidemic – but easy-to-use naloxone products like ADAPT Pharma’s Narcan nasal spray and Kaléo’s Evzio auto-injector are outageously expensive, and the approval of a generic naloxone nasal spray is tied up in litigation. Kaléo spiked the price of Evzio by over 550% to “capitalize on the opportunity” of the opioid crisis, costing taxpayers more than $142 million over four years. It doesn’t have to be this way: in 2016, it cost Kaléo just 4% of what it charged to actually make Evzio, and naloxone can be as cheap as five cents a dose. Both products benefited from government support or funds in the development of naloxone. My administration will use its compulsory licensing authority to facilitate production of low-cost naloxone products so first responders and community members can save lives.

Humira is a drug with anti-inflammatory effects used to treat diseases like arthritispsoriasis, and Crohn’s disease. It is the best-selling prescription drug in the world, treating millions. AbbVie, Humira’s manufacturer, has doubled the price of Humira to more than $38,000 a year. In 2017, Medicaid and Medicare spent over $4.2 billion on it – while AbbVie, its manufacturer, developed a “patent thicket” to shield itself from biosimilar competition. In May 2019, the company entered into a legal settlement preventing a competitor from entering the U.S. market until 2023 – probably because prices went down by up to 80% once biosimilars entered in Europe. My administration will pursue antitrust action against AbbVie and other drug companies that pursue blatantly anti-competitive behavior, and, if necessary, use compulsory licensing authority to facilitate production, saving taxpayers billions. 

Hepatitis C drugs like Harvoni are part of a class described as “miracle” drugs. Harvoni’s price tag – $94,500-per-treatment – left 85% of the more than 3 million Americans living with Hepatitis C without a lifesaving medication, while taxpayers foot a $3.8 billion bill. Although the price has come down in recent years, it is still expensive for too many. One estimate suggests that by using compulsory licensing, the federal government could treat all Americans with Hepatitis C for $4.5 billion – just 2% of the $234 billion it would otherwise cost. That is exactly what I will do.

Truvada is a drug that – until recently – was the only FDA-approved form of pre-exposure prophylaxis, which can reduce the risk of HIV from sexual activity by up to 99%. Truvada’s manufacturer, Gilead, relied on $50 million in federal grants to develop it, but today they rake in multi-billion dollar profits while Americans struggle to afford it. The CDC estimates a million Americans could benefit from Truvada, though only a fraction do today – largely due to to its $2,000-a-month price tag, which is nearly thirty times what it costs in other countries. My administration will facilitate the production of an affordable version – reducing HIV infections and saving taxpayers billions of dollars each year.  

Antibiotics provide critical protection from bacterial and fungal infections, and we are in desperate need of new antibiotics to combat resistant infections. Every year, nearly three million Americans contract antibiotic-resistant infections – and more than 35,000 people die. But antibiotics don’t generate much money, discouraging pharmaceutical investment, causing shortages, and contributing to price hikes. Earlier this year, one biotech firm filed for bankruptcy after marketing a new antibiotic, Zemdri, for less than a year. My administration will identify antibiotics with high prices or limited supply and help produce them to combat resistance and provide patients with the treatments they need.

Drug shortages leave doctors and patients scrambling to access the treatments they need, forcing many to ration medications and use inferior substitutes. Our nation’s hospitals, for example, are currently experiencing a shortage of vincristine – an off-patent drug that is the “backbone” of childhood cancer treatment. The vincristine shortage began when Teva, one of its two suppliers, made the “business decision” to stop manufacturing the drug. When I am president, the government will track drugs in consistent shortage, like vincristine, and I will use our administrative authority to ensure we have sufficient production.

Finally, I will also direct the government to study whether other essential medicines, including breakthrough drugs for cancer or high-cost drugs for rare diseases, might also be subject to these interventions because they are being sold at prices that inappropriately limit patient access.  

Make Mental Health and Substance Use Treatment A Reality 

The law currently requires health insurers to provide mental health and substance use disorder benefits in parity with physical health benefits. But in 2018, less than half of people with mental illness received treatment and less than a fifth of people who needed substance use treatment actually received it. As president, I will launch a full-scale effort to enforce these requirements – with coordinated actions by the IRS, Centers for Medicare and Medicaid Services, and Department of Labor to make sure health plans actually provide mental health treatment in the same way they provide other treatment. 

Reverse Trump’s Sabotage 

I will reverse the Trump administration’s actions that have undermined health care in America. Key steps include:

Protecting coverage for people with pre-existing conditions. The Trump administration has abandoned its duty to defend current laws in court, cheering on efforts to destroy protections for pre-existing conditions, insurance coverage for dependents until they’re 26, and the other critical Affordable Care Act benefits. In a Warren administration, the Department of Justice will defend this law. And we will close the loopholes created by the Trump administration, using 1332 waivers, that could allow states to steer healthy people toward parallel, unregulated markets for junk health plans. This will shut down a stealth attack on people with pre-existing conditions who would see their premiums substantially increase as healthier people leave the marketplace.   

Banning junk health plans. The Trump administration has expanded the use of junk health insurance plans as an alternative to comprehensive health plans that meet the standards of the ACA. These plans cover few benefits, discriminate against people with pre-existing conditions, and increase costs for everyone else. And in some cases they direct as much as 50 percent of patient premiums to administrative expenses or profit. I will ban junk plans.

Expanding ACA enrollment. I’ll re-fund the Affordable Care Act programs that help people enroll in ACA coverage, programs that have been gutted by the Trump administration.

Expanding premium tax credits. I will reverse the Trump administration rule that artificially reduced premium tax credits for many people, making coverage less affordable – and instead will expand these credits.

Rolling back Trump’s sabotage of Medicaid. I’ll reverse the Trump administration’s harmful Medicaid policies that take coverage away from low-income individuals and families. I’ll prohibit restrictive and ineffective policies like work requirements – which have already booted 18,000 people in Arkansas out of the program – as well as enrollment caps, premiums, drug testing, and limits on retroactive eligibility that can prevent bankruptcy.

Restoring non-discrimination protections in health care. I will immediately reverse the Trump administration’s terrible proposed rule permitting health plans and health providers to discriminate against women, LGBTQ+ people, individuals with limited English proficiency, and others.

Ending the Trump administration’s assault on reproductive care. I’ll roll back the Trump administration’s domestic and global gag rules, which deny Title X and USAID funding to health care providers who provide abortion care or even explain where and how patients can access safe, legal abortions. And I will overturn the Trump administration’s embattled proposed rule to roll back mandatory contraceptive coverage. 

Strengthen the Affordable Care Act 

As president I will use administrative tools to strengthen the ACA to reduce costs for families and expand eligibility. Key steps include:

Stop families from being kicked out of affordable coverage. Because of something called the “family glitch,” an entire family can lose access to tax credits that would help them buy health coverage if one parent is offered individual coverage with a premium less than 9.86% of their family income. I’ll work to make sure that a family’s access to tax credits is based on the affordability of coverage for the whole family – not just one individual – so families who don’t actually have access to affordable alternatives don’t lose their ACA tax credits.

Expand eligibility to all legally present individuals. I’ll also work to extend eligibility for ACA tax credits to all people who are legally present, including those eligible for the Deferred Action for Childhood Arrivals program.

Put money back in workers’ pockets. The Affordable Care Act requires insurance companies to spend at least 80 percent of total premium contributions on health care claims (and, in many cases, at least 85 percent), leaving the rest to be spent on plan administration, marketing, and profit. Insurers who waste money must issue rebates – but too often, these are returned to employers who don’t pass on the savings to their employees. Insurance companies are expected to pay out $1.3 billion in rebates in 2019, with employers in the small-group market receiving an average rebate of $1,190 and employers in the large-group market receiving an average rebate of $10,660. My plan will require employers to pass along the full value of the rebate directly to employees. 

Strengthen Medicare 

As president I will use administrative tools to strengthen Medicare:

Expand Dental Benefits. The Medicare statute prohibits coverage of dental care that is unrelated to other medical care, unless it is medically necessary. This has been interpreted to largely exclude any oral health care. As a result, almost two-thirds of Medicare beneficiaries, or nearly 37 million people, lack access to dental benefits. I will use my administrative authority to clearly expand the medically necessary dental services Medicare can provide, improving the health of millions of Medicare beneficiaries.

Stop private Medicare Advantage plans from bilking taxpayers. Roughly one-third of Medicare beneficiaries get coverage through a private Medicare Advantage plan. Medicare payments to these plans for each enrollee are supposed to reflect the cost of covering that person through traditional Medicare, but overwhelming evidence shows that these private plans make their enrollees appear sicker on paper than they actually are to earn inflated payments at the expense of taxpayers. Some suggest that this adds $100 billion or more to Medicare spending over ten years. My administration will put an end to this fraud.

Strengthen Medicaid 

As president I will use administrative tools to strengthen Medicaid and potentially allow millions more to access the program.

Use waiver authority to increase Medicaid eligibility. With the approval of the federal government, states can use Section 1115 demonstration waivers to expand coverage to people who aren’t otherwise eligible for Medicaid. Currently, however, states can only obtain these waivers if projected federal spending under the new program will not be higher than without the waiver. While I pursue legislative reforms to expand coverage, I’ll also change this administrative restriction to allow these demonstrations to fulfill their promise of providing affordable health coverage, including working with states that want to expand Medicaid to uninsured individuals and families above the statutory upper limit of Medicaid (138% of the poverty level). Any state that chooses to expand in this way will not be penalized for doing so when full Medicare for All comes online.

Streamlining eligibility and enrollment. Far too many people miss out on Medicaid coverage because of red tape. Some states take coverage away if someone misses just one piece of mail or forgets to notify the state within 10 days of a change in income. These kinds of harsh policies help explain why more than a million children “disappeared” from the Medicaid and CHIP programs in the past year. I will eliminate these kinds of unfair practices, and instead work with states to make it easier for everyone – families, children, and people with disabilities – to maintain this essential coverage.

Ensuring access to care for beneficiaries in managed care plans. I’ll roll back the Trump administration’s proposed changes to rules regulating Medicaid managed care plans, which would dilute important standards, such as requiring health plans to maintain adequate provider networks guaranteeing access to care for Medicaid enrollees. 

Antitrust Enforcement for Hospitals and Health Systems 

For years, both horizontal mergers (where hospitals purchase other hospitals) and vertical mergers (where hospitals acquire physician practices) have produced greater hospital and health system consolidation, contributing to the skyrocketing costs of health care. Today, “not a single highly competitive hospital market remains in any region of the United States.” Study after study shows that mergers mean higher prices, lower quality, and increased inequality due to the growing wage gap between hospital CEOs and everyone else. Bringing down the cost of health care means enforcing competition in these markets. 

As president, I will appoint aggressive antitrust enforcers who recognize the problems with hospital and health system consolidation to the Department of Justice and Federal Trade Commission. My administration will also conduct retrospective reviews of significant new mergers, and break up mergers that should never have taken place. 

Bringing Health Records into the 21st Century 

Congress spent $36 billion to get every doctor in America using electronic health records, but we still do not have adequate digital information flow in health care – in part because two big companies make up about 85% of the market for medical records at big hospitals. As they attempt to capture more of the market, these companies are making it harder for systems to communicate with each other. My administration will ramp up the enforcement against information blocking by big hospital systems and health IT companies, and I will appoint leaders to the FTC and DOJ who will conduct a rigorous antitrust investigation of the health records market, especially in the hospital space.

Elevating the Voices of Workers in the Transition to Medicare for All

The fundamental goal of my presidency will be returning power to working people. Medicare for All accomplishes that by giving every American high-quality coverage and freeing them from relying on the whims of their employers or private insurance companies for the health care they need. My plan to transition to Medicare for All will also put working people first, and elevate their voices at each stage of the process. 

My plan seeks to build on the achievements of generations of working people and their unions who have fought for and won health care. I view good health plans negotiated through collective bargaining as a positive achievement for working people, and I will seek as part of the first phase of my plan the elimination of the excise tax on those plans.

In my first weeks in office, I will issue an Executive Order creating a commission of workers (including health care workers), union representatives, and union benefit managers that I will consult at every stage of the transition process. The commission will be responsible for providing advice on each element of the transition to Medicare for All, including, at a minimum:

Ensuring workforce readiness and adequate access to care across all provider types.

Determining national standards of coverage and benefits, including long-term care.

Learning from successful existing non-profit health care administrators and integrating them into the new Medicare for All system.

Ensuring a living wage for all health care workers and that savings generated within the new system by hospitals and other health care employers are shared fairly with all of the workers in the health care system.

Ensuring that workers are able to use the collective bargaining process during the transition period and under the new Medicare for All system to ensure both effective health outcomes and to ensure that savings generated by the new system are fairly shared with workers.

In administering the Medicare for All system, my administration will also rely on unions’ expertise on designing good benefits for workers and helping workers navigate our health care system. During the transition to Medicare for All – and even when we ultimately reach a full Medicare for All system – my administration will seek to partner with collectively bargained non-profit health care administrators. For example, we will draw upon their expertise in helping workers choose providers, and look for opportunities to enter into contracts with the administrators of unions’ collectively bargained health plans to provide these services. And my plan will guarantee that union-sponsored clinics are included within the Medicare for All system and will continue serving their members. 

Finally, Medicare for All will be an enormous boost to the economy, lifting a weight off of both workers and businesses and creating good new jobs, including in administering health care benefits. Still, the Medicare for All legislation includes billions of dollars to provide assistance to workers who may be affected by the transition to Medicare for All, and I plan on consulting with the new worker commission and other affected parties to ensure that money is spent as effectively as possible. In the past, transition assistance programs have been underfunded and have not been as responsive as they should have been to the actual needs of workers. That will not be the case in my administration. No worker will be left behind.

Legislation to Expand Medicare and Create a True Medicare for All Option 

In 2017, Senate Republicans came within one vote of shredding the Affordable Care Act and taking health care coverage away from more than 20 million people. How did they get so close? By using a fast-track legislative process called budget reconciliation, which only requires 50 votes in the Senate to pass laws with major budgetary impacts. President Obama also used this process to secure final passage of the Affordable Care Act. 

I am a strong supporter of eliminating the filibuster, which I believe is essential to preventing right-wing Senators who function as wholly owned subsidiaries of major American industries from blocking real legislative change in America. Any candidate for president who does not support this change should acknowledge the extreme difficulty of enacting their preferred legislative agenda. But I’m not going to wait for this to happen to start improving health care – and I’m not going to give Mitch McConnell or the Republicans a veto over my entire health care agenda.

That’s why, within my first 100 days, I will pass my own fast-track budget reconciliation legislation to enact a substantial portion of my Medicare for All agenda – including establishing a true Medicare for All option that’s free for millions and affordable for everyone. 

A True Medicare for All Option. There are many proposals that call themselves a Medicare for All “public option” – but most of them lack the financing to actually allow everyone in America to choose true Medicare for All coverage. As a result, these proposals create the illusion of choice, when in reality they offer tens of millions of Americans the decision between unaffordable private insurance and unaffordable public insurance. A choice between two bad options isn’t a choice at all.

My approach is different. 

Because I have identified trillions in revenue to finance a fully functioning Medicare for All system – without raising taxes on the middle class by one penny – I can also fund a true Medicare for All option. The plan will be administered by Medicare and offered on ACA exchanges. Here are its key features: 

Benefits. Unlike public option plans, the benefits of the true Medicare for All option will match those in the Medicare for All Act. This includes truly comprehensive coverage for primary and preventive services, pediatric care, emergency services and transportation, vision, dental, audio, long-term care, mental health and substance use, and physical therapy. 

Immediate Free Coverage for Millions. This plan will immediately offer coverage at no cost to every kid under the age of 18 and anybody making at or below 200% of the federal poverty level (about $51,000 for a family of four) – including individuals who would currently be on Medicaid, but live in states that refused to expand their programs.

Free, Identical Coverage for Medicaid Beneficiaries. States will be encouraged to begin paying a maintenance-of-effort to the Medicare for All option in exchange for moving their Medicaid populations into this plan and getting out of the business of administering health insurance. For states that elect to maintain their Medicaid programs, Medicaid premiums and cost sharing will be eliminated, and we will provide wraparound benefits for any Medicare for All option benefits not covered by a state’s program to ensure that these individuals have the same free coverage as Medicaid-eligible people in the Medicare for All option. 

Eventual Free Coverage for Everyone. This plan will begin as high-quality public insurance that covers 90% of costs and allows people to utilize improved ACA subsidies to purchase coverage and reduce cost sharing. There will be no premiums for kids under 18 and people at or below 200% of the federal poverty level. For individuals above 200% FPL, premiums will gradually scale as a percentage of income and are capped at 5.0% of their income. Starting in year one, the plan will not have a deductible — meaning everyone gets first dollar coverage, and cost sharing will be zero for people at or below 200% FPL. Cost sharing will scale modestly for individuals at or above that level, with caps on out-of-pocket costs. In subsequent years, premiums and cost sharing for all participants in this plan will gradually decrease to zero. 

Reducing Drug Prices. The Medicare for All option will have the ability to negotiate for prescription drugs using the mechanisms I’ve previously outlined, helping to drive down costs for patients. 

Automatic Enrollment. Anyone who is uninsured or eligible for free insurance on day one, excluding individuals who are over 50 and eligible for expanded coverage under existing Medicare, will be automatically enrolled in the Medicare for All option. Individuals who prefer other coverage can decline enrollment.

Employee Choice. Workers with employer coverage can opt into the Medicare for All option, at which point their employer will pay an appropriate fee to the government to maintain their responsibility for providing employee coverage. In addition, unions can negotiate to include a move to the Medicare for All option via collective bargaining during the transition period, with unionized employers paying a discounted contribution to the extent that they pass the savings on to workers in the form of increased wages, pensions, or other collectively-bargained benefits. This will support unions and ensure that the savings from Medicare for All are passed on to workers in full, not pocketed by the employer.

Provider Reimbursement and Cost Control. I have identified cost reforms that would save our health system trillions of dollars when implemented in a full Medicare for All system. The more limited leverage of a Medicare for All option plan will accordingly limit its ability to achieve these savings – but as more individuals join, this leverage will increase and costs will go down. Provider reimbursement for this plan will start above current Medicare rates for all providers, and be reduced every year as providers’ administrative and delivery costs decrease until they begin to approach the targets in my Medicare for All plan. The size of these adjustments will be governed by overall plan size and the progress of provider adjustment to new, lower rates. 

Expand and Improve Existing Medicare for Everyone Over 50. In addition to the Medicare for All option, any person over the age of 50 will be eligible for expanded coverage under the existing Medicare program, whose infrastructure will allow it to absorb new beneficiaries more quickly. The expanded Medicare program will be improved in the following ways: 

Benefits. To the greatest extent possible, critical benefits like audio, vision, full dental coverage, and long-term care benefits will be added to Medicare, and we will legislate full parity for mental health and substance use services. 

Eventual Free Coverage for Everyone. Identical to the Medicare program, enrollees will pay premiums in Part B and D, with a $300 cap on drug costs in Part D. Plugging a huge hole in the current Medicare program, out-of-pocket costs will be capped at $1,500 per year across Parts A, B, and D, eliminating deductibles and reducing cost sharing. In subsequent years, premiums and cost sharing will gradually decrease to zero. 

Employee Choice. Identical to the Medicare for All option, workers 50-64 can opt into expanded Medicare, at which point their employer will pay an appropriate fee to the government to maintain their responsibility for providing employee coverage. 

Reducing Drug Prices. The expanded Medicare program will receive the ability to negotiate for prescription drugs using the mechanisms I’ve previously outlined, helping to drive down costs for patients. And we will create a publicly run prescription drug plan that is benchmarked off the best current Part D plan. 

Automatic Enrollment. Every person without health insurance over the age of 50 will be automatically enrolled in the expanded existing Medicare program. 

Provider Reimbursement and Cost Control. Provider reimbursement for new beneficiaries will start above current Medicare rates for all providers, and be reduced every year as providers’ administrative and delivery costs decrease until they begin to approach the targets in my Medicare for All plan. It will be a new condition of participation that providers who take Medicare or other federally subsidized insurance also take the Medicare for All option. We will also adopt common sense reforms to bring down bloated reimbursement rates, including reforms around post-acute care, bundled payments, and site neutral payments.

Improving the Affordable Care Act. My reforms will also strengthen Affordable Care Act plans – including the new Medicare for All option – by making the following changes:

Expand Tax Credit Eligibility. We will lift the upper limit on eligibility for Premium Tax Credits, allowing people over 400% of the federal poverty level to purchase subsidized coverage and greatly increasing the number of people who receive subsidies. 

Employee Choice. We will allow any person or family to receive ACA tax credits and opt into ACA coverage, regardless of whether they have an offer of employer coverage. If an individual currently enrolled in qualifying employer coverage moves into an ACA plan, their employer will pay an appropriate fee to the government to maintain their responsibility for providing employee coverage.

Lower Costs. Right now, people may pay up to 9.86% of their income before they get subsidies. Under my plan, this cap would be lowered – and to make sure those tax credits cover more, we will benchmark them to more generous “gold” plans in the Marketplace. And we will increase eligibility for cost sharing reductions, ensuring that more individuals can get into an affordable exchange plan immediately.

Eliminate the Penalty for Getting a Raise. Right now, if someone’s income goes up, they can be forced to repay thousands of dollars in back premiums. We will change this and base tax credits on the previous year’s income. And if someone’s income goes down, they will get the higher subsidy for that year.

State Single-Payer Innovation Waivers. To help states try out different payer arrangements and pilot programs, we will allow states to receive passthrough funding to expand or improve coverage via the ACA’s Section 1332 waivers. Combined with Medicaid waivers, these changes will allow interested states to start experimenting immediately with consolidating public payers and move towards a single-payer system.
 

Additional Financing. My plan to pay for Medicare for All identifies $20.5 trillion in new revenue, including an Employer Medicare Contribution, which will cover the long-term, steady-state cost of a fully functioning Medicare for All system. The cost of this intermediate proposal will be lower. Any revenue needed to meet the requirements of fast-track budget reconciliation will be enacted as part of this legislation from the financing options that I have already proposed.

Additional Health System Reforms to Save Money and Lives

After pursuing administrative changes, expanding existing Medicare, and creating a true Medicare for All option, every person in the United States will be able to choose free or low-cost public insurance. Tens of millions will likely do so. But we can’t stop there. We must pursue additional reforms to our health system to save money and save lives. Some of my priorities include:

Investing in Medical Miracles. Many medical breakthroughs stem from federal investments in science – but in 2018, 43,763 out of 54,834 research project grant applications to the National Institutes of Health (NIH) were rejected. We will boost medical research by investing an additional $100 billion in guaranteed, mandatory spending in the NIH over ten years, split between basic science and the creation of a new National Institute for Drug Development that will help take the basic research from the other parts of NIH and turn it into real drugs that patients can use. We will prioritize treatments that are uninteresting to big pharmaceutical companies but could save millions of American dollars and lives. Any drugs that come out of this research and to American consumers can be sold abroad, with the proceeds reinvested to fund future breakthrough drug development. And by enacting my Affordable Drug Manufacturing Act, the government can manufacture generic drugs that are not available due to cost or shortage. 

Ending the Opioid Epidemic. The opioid epidemic is a public health emergency. In 2017, life expectancy in the United States dropped for the third year in a row, driven in large part by deaths from drug overdoses. We will enact my legislation, the CARE Act, to invest $100 billion in federal funding over the next ten years in states and communities to fight this crisis – providing resources directly to first responders, public health departments, and communities on the front lines of this crisis. 

Improved Administration. To cut down on time wasted on paperwork, we will create single standardized forms for things like prior authorizations and appeals processes to be used by all insurers (private and public), and we will establish uniform medical billing for insurers and doctors.

All-Payer Claims Database. Right now, there are so many middlemen in health care that no one knows for certain how much we pay for different services across the whole system. A centralized repository of de-identified claims data will help the government, researchers, and the market better understand exactly what we pay for health care and what kind of quality it gets us. Demystifying what we pay for what we get will be a critical part of ensuring fair reimbursement under Medicare for All.

Antitrust Enforcement. In addition to administrative actions to rein in anti-competitive hospital and electronic medical record practices, we’ll also ban non-compete and no-poach agreements and class action waivers across the board, while making it easier for private parties to sue to prevent anti-competitive actions. I’ll work with states to repeal Certificate of Public Advantage, or COPA, statutes that shield health care organizations from federal antitrust review and can lead to the creation of large monopolies with little to no oversight. And I’ll also push to ensure our antitrust laws apply to all health care mergers.

Ending Surprise Billing. Imagine being a woman who schedules her baby’s delivery with her obstetrician at an in-network hospital, but it turns out that the anesthesiologist administering the epidural isn’t in-network. Even though she had no choice – and probably had no idea that doctor was out-of-network – under the current system she gets hit with a huge bill. We will end the practice of surprise billing by requiring that services from out-of-network doctors within in-network hospitals, in addition to ambulances or out-of-network hospitals during emergency care, be treated as in-network and paid either prevailing in-network rates or 125% of the Medicare reimbursement rate, whichever is lower.

Preventing Provider Shortages. With more people seeking the care they need, it will be essential to increase the number of providers. I will make these critical investments in our clinicians, including by dramatically scaling up apprenticeship programs to build a health care workforce rooted in the community. I will lift the cap on residency placements, allowing 15,000 new clinicians to enter the workforce. I will expand the National Health Service Corps and Indian Health Service loan repayment program to allow more health professionals – including physicians, physician assistants, registered nurses, nurse practitioners, and other licensed practitioners – to practice in underserved communities. I will also provide grants to states that expand scope-of-practice to allow more non-physicians to practice primary care. And I will push to close the mental health provider gap in schools.

Completing the Transition to Medicare For All

By pursuing these changes, we will provide every person in America with the option of choosing public coverage that matches the full benefits of Medicare for All. Given the quality of the public alternatives, millions are likely to move out of private insurance as quickly as possible. 

No later than my third year in office, at which point the number of individuals voluntarily remaining in private insurance would likely be quite low, I will fight to pass legislation to complete the transition to the Medicare for All system defined by the Medicare for All Act by the end of my first term in office. 

Moving to this system would mean integrating everyone into a unified system with zero premiums, copays, and deductibles. Senator Sanders’s Medicare for All Act allows for supplemental private insurance to cover services that are not duplicative of the coverage in Medicare for All; for unions that seek specialized wraparound coverage and individuals with specialized needs, a private market could still exist. In addition, we can allow private employer coverage that reflects the outcome of a collective bargaining agreement to be grandfathered into the new system to ensure that these workers receive the full benefit of their bargain before moving to the new system. But the point of Medicare for All is to cut out the middleman.

Every successful effort to move the United States to create and expand new social programs – like Social Security and Medicare and Medicaid – has required multiple steps. In fact, every credible Medicare for All proposal has a significant, multi-step transition built in. That’s why it’s important to have both short-term goals and long-term goals to guide the process and to deliver concrete improvements to people’s lives at every stage.

I believe the next president must do everything she can within one presidential term to complete the transition to Medicare for All. My plan will reduce the financial and political power of the insurance companies – as well as their ability to frighten the American people – by implementing reforms immediately and demonstrating at each phase that true Medicare for All coverage is better than their private options. I believe this approach gives us our best chance to succeed.

Why do we need to transition to Medicare for All if a robust Medicare for All option is available to everyone? The answer is simple and blunt: cost and outcomes. Today, up to 30% of current health spending is driven by the costs of filling out different insurance forms and following different claims processes and fighting with insurance companies over what is and is not covered. I have demonstrated how a full Medicare for All system can use its leverage to wring trillions of dollars in waste out of our system while delivering smarter care – and I’ve made clear exactly how I would do it. The experience of other countries shows that this system is the cheapest and most efficient way to deliver high-quality health care. As long as duplicative private coverage exists, we will limit our ability to make health care delivery more effective and affordable – and the ability of private middlemen to abuse patients will remain. 

Medicare for All will deliver an $11 trillion boost to American families who will never pay another premium, co-pay, or deductible. That’s like giving the average working family in America a $12,000 raise. This final legislation will put a choice before Congress – maintain a two-tiered system where private insurers can continue to profit from being the middlemen between patients and doctors, getting rich by denying care – or give everybody Medicare for All to capture the full value of trillions of dollars in savings in health care spending. I believe that the American people will demand Congress make the right choice.

Read Senator Warren’s plan here

Watch explainer video here

Democratic Candidates for 2020: Warren Details How She Would Finance Medicare for All

Sen. Elizabeth Warren, 2020 Democratic candidate for president detailed how she would finance her most controversial proposal, Medicare for All, without increasing taxes on middle class families. © Karen Rubin/news-photos-features.com

Senator Elizabeth Warren, Democratic candidate for President, has released details of her most controversial proposal, Medicare for All, promising that it will cover every person in America with health care, including long-term care, vision and dental, without increasing taxes on middle class families. Warren focuses on an overall restructuring taxes and spending – going after the loopholes and tax cheats and reining in military spending as well as drug costs and cutting healthcare costs by removing the for-profit insurance companies (gatekeepers) as middlemen. What her plan misses, though, is the obvious: collect the Medicare tax (1.45%, plus an extra 0.9% on income over $200,000) on all income, not just wages, and, if necessary raise the surcharge for incomes over $250,000. Interestingly, while employers would no longer pick and choose the private health insurance they subsidize, employers would still subsidize their employees’ Medicare cost. Health care is considered the leading issue for voters in 2020. Here is the detailed plan, from the Warren campaign: –Karen Rubin/news-photos-features.com.

Charlestown, MA – Today, Senator Elizabeth Warren, candidate for President, released her plan to finance Medicare for All. The coverage is identical to the coverage in the Medicare for All legislation in the Senate and it will cover every single person in America with excellent, high-quality health care, including long-term care and vision and dental. 

Elizabeth will pay for this plan without raising taxes one penny on middle class families. Instead, she will put about $11 trillion in the pockets of American families by eliminating what they would pay in premiums, deductibles, co-pays, and other out-of-pocket costs over the next ten years. 

Her numbers add up and are backed by experts including: 

Simon Johnson, the former Chief Economist at the International Monetary Fund and a professor at MIT

Dr. Donald Berwick, one of the nation’s top experts in health system management and improvement, who ran the Medicare and Medicaid programs under President Barack Obama

Mark Zandi, Chief Economist of Moody’s Analytics

Betsey Stevenson, former Chief Economist for the Obama Labor Department

Elizabeth’s plan to dramatically improve health care and cut family costs would cost the United States less than our current broken system. It would require $20.5 trillion in new revenue, nearly half of which comes simply from having employers pay Medicare instead of private insurance companies.

Elizabeth will finance the remainder of Medicare for All with targeted defense spending cuts, new taxes on financial firms, giant corporations, and the richest 1% of Americans, and by cracking down on tax evasion and fraud. The $11 trillion in household insurance and out-of-pocket expenses projected under our current system goes right back into the pockets of America’s working people — substantially larger than the largest tax cut in American history — and no middle class tax increases.

My daddy’s heart attack nearly sent our family skidding over a financial cliff. Today I think about all the kids this year who will face the double blow of nearly losing a parent and then watching their lives turn upside down as their families struggle to pay a growing stack of medical bills.  

I spent my career studying why so many hard-working middle class families were going broke. For years, my research partners and I traveled the country from bankruptcy courtroom to bankruptcy courtroom, talking directly to people who’d seen their lives turned upside down. We interviewed lawyers, judges, and families involved in bankruptcy cases. To save on printing costs, we lugged around a Xerox machine (I nicknamed him “R2-D2”) to save money on photocopying court records. 

Eventually, we built the largest and most comprehensive database of consumer bankruptcy data ever assembled. That first study surprised us: we found that 90% of families went bankrupt because of job loss, medical problems, and marital disruption. That finding was confirmed in 2007 by my later research, which found that the number one reason families were going broke was health care – and three quarters of those who declared bankruptcy after an illness were people who already had health insurance. 

It’s been nearly thirty years since we published that first groundbreaking study. And after all that time, here’s where we are: between 2013 and 2016, the number one reason families went broke was still because of health care – even though 91.2% of Americans had health insurance in 2016.

Families are getting crushed by health costs. Just look at the numbers. 

$12,378. That’s how much an average family of four with employer-sponsored insurance personally spent per year on employee premium contributions and out-of-pocket costs in 2018. And this figure has increased each year.

87 million. That’s how many American adults in 2018 were uninsured or “underinsured” – meaning either they have no insurance or their so-called health insurance is like a car with the engine missing. It looks fine sitting on the lot, but inadequate if they actually need to use it. Nearly one in every two adults not currently on Medicare has no insurance or unreliable insurance.

37 millionAmerican adults didn’t fill a prescription last year because of costs. 36 millionpeopleskipped a recommended test, treatment, or follow-up because of costs. 40 millionpeople didn’t go to a doctor to check out a health problem because of costs. 57 millionpeople had trouble covering their medical bills. 

Today, in 2019, in the United States of America, the wealthiest nation in the history of the world, inadequate health coverage is crushing the finances and ruining the lives of tens of millions of American families. 

I’m running for President based on a radical idea – calling out what’s broken and speaking plainly about how to fix it. 

All my plans start with our shared values. There are two absolute non-negotiables when it comes to health care:

One: No American should ever, ever die or go bankrupt because of health care costs. No more GoFundMe campaigns to pay for care. No more rationing insulin. No more choosing between medicine and groceries.

Two: Every American should be able to see the doctors they need and get their recommended treatments, without having to figure out who is in-network. No for-profit insurance company should be able to stop anyone from seeing the expert or getting the treatment they need.

Health care is a human right, and we need a system that reflects our values. That system is Medicare for All.

Let’s be clear: America’s medical professionals are among the best in the world. Health care in America is world-class. Medicare for All isn’t about changing any of that. 

It’s about fixing what is broken – how we pay for that care.

And when it comes to health care, what’s broken is obvious. A fractured system that allows private interests to profiteer off the health crises of the American people. A system that crushes our families with costs they can’t possibly bear, forcing tens of millions to go without coverage or to choose between basic necessities like food, rent, and health – or bankruptcy.

We must fix this system. And over the long-term, the best way to achieve that goal is to move from the system we have now to a system of Medicare for All. 

Medicare for All is about where doctors, hospitals, and care providers send the bill – to a collection of private insurance companies who make billions off denying people care or to the Medicare program for fair compensation. Under Medicare for All, everyone gets the care they need, when they need it, and nobody goes broke. 

A key step in winning the public debate over Medicare for All will be explaining what this plan costs – and how to pay for it. This task is made a hundred times harder by powerful health insurance and drug companies that make billions of dollars off the current bloated, inadequate system – and would be perfectly happy to leave things exactly the way they are. 

In 2017 alone, health industry players whose profiteering would end under Medicare for All unleashed more than 2,500 lobbyists on Washington. These industries will spend freely on shady TV ads and lobbying to convince people that a program that saves them massive sums of money will somehow cost them money. That being able to see the doctors and get the treatments they need regardless of what their employer or their insurance company thinks is somehow actually a loss of choice. That a program that covers more services, more people, and costs the American people less than what we currently spend on health care is somehow too expensive.

Meanwhile, where are the 2,500 lobbyists for the people who get sick and can’t pay their medical bills?  Where are the hundreds of millions being spent so that people who are trying to balance a budget around rising health care premiums and growing deductibles and copays can make their voices heard in Washington?  Washington hears plenty from the giant health insurance and giant drug industries, but not so much from families being squeezed to the breaking point.

So let’s focus on families’ expenses and families’ health care. 

Start with the Medicare for All Act – which I have cosponsored. The bill provides a detailed proposal for how to achieve our end goal. But as economists and advocates have noted, the legislation leaves open a number of key design decisions that will affect its overall cost, and the bill does not directly incorporate specific revenue measures. While much of this ambiguity results from the reasonable choice to delegate significant implementation discretion to the Executive Branch, it has also allowed opponents of Medicare for All to make up their own price tags and try to scare middle class families about the prospect of tax increases – despite the conclusions of expert after expert after expert that it is possible to eventually move to a Medicare for All system that gives both high quality coverage for everybody and dramatically lowers costs for middle class families.

The best way to fight misinformation is with facts. That’s why today, I’m filling in the details and releasing a plan that describes how I would implement the long-term policy prescriptions of the Medicare for All Act and how to pay for it. 

Under my plan, Medicare for All will cover the full list of benefits outlined in the Medicare for All Act, including long-term care, audio, vision, and dental benefits. My plan will cover every single person in the U.S., and includes common-sense payment reforms that make Medicare for All possible without spending any more money overall than we spend now. 

My plan reflects careful, detailed analyses from key national experts in health policy, tax policy, and economics. By filling in the details, we can strip away all the misleading political attacks and make plain the choice facing the American people: 

Option 1: Maintain our current system, which will cost the country $52 trillion over ten years. And under that current system – 

24 million people won’t have coverage, and millions can’t get long-term care.

63 million have coverage gaps or substandard coverage that could break down if they actually get sick. And millions who have health insurance will end up going broke at least in part from medical costs anyway. 

Together, the American people will pay $11 trillion of that bill themselves in the form of premiums, deductibles, copays, out-of-network, and other expensive medical equipment and care they pay for out-of-pocket – all while America’s wealthiest individuals and biggest companies pay far less in taxes than in other major countries.

Option 2: Switch to my approach to Medicare for All, which would cost the country just under $52 trillion over ten years. Under this new system –

Every person in America – all 331 million people – will have full health coverage, and coverage for long-term care.

Everybody gets the doctors and the treatments they need, when they need them. No more restrictive provider networks, no more insurance companies denying coverage for prescribed treatments, and no more going broke over medical bills.

The $11 trillion in household insurance and out-of-pocket expenses projected under our current system goes right back into the pockets of America’s working people. And we make up the difference with targeted spending cuts, new taxes on giant corporations and the richest 1% of Americans, and by cracking down on tax evasion and fraud. Not one penny in middle-class tax increases. 

That’s it. That’s the choice. A broken system that leaves millions behind while costs keep going up and insurance companies keep sucking billions of dollars in profits out of the system – or, for about the same amount of money, a new system that drives down overall health costs and, on average, relieves the typical middle class families of $12,400 in insurance premiums and other related health care costs. 

No middle class tax increases. $11 trillion in household expenses back in the pockets of American families. That’s substantially larger than the largest tax cut in American history.

Not every candidate for president supports moving to a system of Medicare for All. Some who support Medicare for All will have different ideas about how to finance and structure it. And everybody knows that there must be a real transition. But you don’t get what you don’t fight for – and my view is clear.  

Every candidate who opposes my long-term goal of Medicare for All should explain why the “choice” of private insurance plans is more important than being able to choose the doctor that’s best for you without worrying about whether they are in-network or not. Why it’s more important than being able to choose the right prescription drug for you without worrying about massive differences in copays. Why it’s more important than being able to choose to start a small business or choose the job you want without worrying about where your health care coverage will be coming from and how much it will cost.

Every candidate who opposes my long-term goal of Medicare for All should put forward their own plan to cover everyone, without costing the country anything more in health care spending, and while putting $11 trillion back in the pockets of the American people by eliminating premiums and virtually eliminating out-of-pocket costs. Or, if they are unwilling to do that, they should concede that they think it’s more important to protect the eye-popping profits of private insurers and drug companies and the immense fortunes of the top 1% and giant corporations, rather than provide transformative financial relief for hundreds of millions of American families. 

And every candidate who opposes my long-term goal of Medicare for All should put forward their own plan to make sure every single person in America can get high-quality health care and won’t go broke – and fully explain how they intend to pay for it. Or, if they are unwilling to do that, concede that their half-measures will leave millions behind.  

And make no mistake – any candidate who opposes my long-term goal of Medicare for All and refuses to answer these questions directly should concede that they have no real strategy for helping the American people address the crushing costs of health care in this country. We need plans, not slogans. 

THE COST OF MEDICARE FOR ALL

A serious conversation about how to pay for Medicare for All requires, first, determining how much such a system would cost. 

In recent years, several economists and think tanks have attempted to estimate the cost of a single-payer system in the United States. Those estimates consider how much our nation’s health care spending will change over a ten year window, and range from a $12.5 trillion decrease to a $7 trillion increase. They also consider how much additional money the federal government would need to fund this system, and those estimates range from a low of $13.5 trillion to a high of $34 trillion over ten years. 

Because nobody can actually see the future, some of this variation results from different assumptions about how parts of our health care system might work differently under Medicare for All. But most of the difference comes from policy choices. And while the Medicare for All Act is clear about some of these choices – for example, generous benefits, long-term care coverage, and virtually no out-of-pocket expenses – it is silent on a number of really important ones. How much will we pay for medical care and for prescription drugs? What do we do with the existing money that states spend on Medicaid? How aggressively will we cut administrative costs? Aggressive choices mean a lower total cost. Less aggressive choices result in a higher total cost. 

Serious candidates for president should speak plainly about these issues and set out their plans for cost control – especially those who are skeptical of Medicare for All. Because whether or not we make modest or transformative changes to our health care system, cancer, diabetes, strokes, Alzheimer’s, and Parkinson’s aren’t going to simply disappear. And without leadership from the top, neither will the mushrooming cost of care in America that’s bankrupting our families. 

I’ve asked top experts to consider the long-term cost of my plan to implement Medicare for All over ten years – Dr. Donald Berwick, one of the nation’s top experts in health system improvement and who ran the Medicare and Medicaid programs under President Obama; and Simon Johnson, the former Chief Economist at the International Monetary Fund and a professor at MIT. Their analysis begins with the assumptions of a recent study by the Urban Institute and then examines how that cost estimate would change as certain new key policy choices are applied. These experts conclude that my plan would slightly reduce the projected amount of money that the United States would otherwise spend on health care over the next 10 years, while covering everyone and giving them vastly better coverage. 

REDUCING INSURER ADMINISTRATIVE COSTS 

The business model of private insurers is straightforward: pay out less for medical care than they take in as premiums. This model is located right in the center of our health care system, wasting huge amounts of time and money documenting and arguing over who is owed what. Incredibly, insurance companies spend a whopping $350 billion on administration costs annually—and then, in turn, push huge additional administrative costs onto hospitals, doctors, and millions of other health care professionals in the from of complex billing—and then, in turn, drive up costs incurred by employers as they attempt to navigate the complexity of providing their employees with insurance.

Medicare for All will save money by bringing down the staggering administrative costs for insurers in our current system. As the experts I asked to evaluate my plan noted, private insurers had administrative costs of 12% of premiums collected in 2017, while Medicare kept its administrative costs down to 2.3%. My plan will ensure that Medicare for All functions just as efficiently as traditional Medicare by setting net administrative spending at 2.3%.

COMPREHENSIVE PAYMENT REFORM 

In 2016, the United States spent nearly twice as much on health care as ten high-income countries, and these costs have been steadily rising for decades, growing from 5.2% of U.S. GDP in 1963 to 17.9% in 2017. But instead of resulting in better health outcomes, Americans have the lowest life expectancy of residents in high-income countries, the highest infant mortality rate, and the highest obesity rates. 

Why? As a group of health economists famously wrote, “It’s the prices, stupid.” 

Studies have continued to show that it’s not how much people use the health care system, often referred to as “utilization,” but rather how much people pay that drives our high spending. Compared to other high income countries, Americans simply pay more for health care. We pay more for physicians and nurses. We pay more in administrative costs. We pay more for prescription drugs. 

A heart bypass surgery that costs nearly $16,000 in the Netherlands costs an average of $75,000 in the United States. A CT scan that costs $97 in Canada costs an average of $896 here. And in the United States, hospitals can charge new parents for holding their newborn after delivery. 

Meanwhile, private equity firms fight bipartisan legislation in Washington that might undermine the profitability of their investments or prevent their hospitals from sending patients surprise bills. And health care CEO salaries continue to soar. Between 2005 and 2015, non-profit hospital CEO salaries increased by 93% to an average of over $3 million, and last year, 62 health care CEOs raked in a combined $1.1 billion – more than the CDC spent on chronic disease prevention. 

If we expect the American people to be able to afford health care, we need to rein in these costs. Comprehensive payment reform, as part of Medicare for All, will reduce this component of health care spending. Under my approach, Medicare for All will sharply reduce administrative spending and reimburse physicians and other non-hospital providers at current Medicare rates. My plan will also rebalance rates in a budget neutral way that increases reimbursements for primary care providers and lowers reimbursements for overpaid specialties. While private insurance companies pay higher rates, this system would be expected to continue compensating providers at roughly the same overall rate that they are currently receiving. Why? This is partially because providers will now get paid Medicare rates for their Medicaid patients – a substantial raise. But it’s also because providers spend an enormous amount of time on billing and interacting with insurance companies that reduces their efficiency and takes away from time with patients. Some estimate that hospitals will spend $210 billion on average annually on these costs. 

The nonpartisan Institute of Medicine estimates that these wasted expenses account for 13% of the revenue for physician practices, 8.5% for hospitals, and 10% for other providers. Together, the improved efficiency will save doctors time and money – helping significantly offset  the revenue they will lose from getting rid of higher private insurance rates.

Under my approach, Medicare for All will sharply reduce administrative spending and reimburse hospitals at an average of 110% of current Medicare rates, with appropriate adjustments for rural hospitals, teaching hospitals, and other care providers with challenging cost structures. In 2017, hospitals that treated Medicare patients were paid about 9.9% less than what it cost to care for that patient. The increase I am proposing under Medicare for All will cover hospitals’ current costs of care – but hospital costs will also substantially decrease as a result of simpler administrative processes, lower prescription drug prices, the end of bad debt from uncompensated care, and more patients with insurance seeking care. 

Of course, as Medicare currently recognizes, not every provider situation is the same, and my Medicare for All program maintains these base rate adjustments for geography and other factors. In my plan for Rural America, for example, I have committed to creating a new designation under Medicare for rural hospitals due to the unique challenges health systems face in rural communities. That’s why my plan allows for adjustments above the 110% average rate for certain hospitals, like rural and teaching hospitals, and below this amount for hospitals that are already doing fine with current Medicare rates.Universal coverage will also have a disproportionately positive effect on rural hospitals. Because people living in rural counties are more likely to be uninsured than people living in urban counties, these hospitals currently provide a lot of uncompensated care. Medicare for All fixes that problem. And I’ve previously laid out additional investments to increase the number of Community Health Centers and grow our health care workforce in rural and Native American communities, while cracking down on anti-competitive mergers that lead to worse outcomes and higher costs for rural communities. 

We can also apply a number of common-sense, bipartisan reforms that have been proposed for Medicare. Today, for example, insurers can charge dramatically different prices for the exact same service based on where the service was performed. Under Medicare for All, providers will receive the same amount for the same procedure, saving hundreds of billions of dollars. We can also make adjustments to things that we know Medicare currently pays too much for – like post-acute care – by adjusting those payments down slightly while accounting for the patient’s health status, bringing health care costs down even more.  

We will also shift payment rates so that we are paying for better outcomes, instead of simply reimbursing for more services. We build on the success of value-based reforms enabled by the Affordable Care Act, including by instituting bundled payments for inpatient care and for 90 days of post-acute care. Instead of paying providers for each individual service, bundled payments reimburse providers for an entire “episode” of care and have been shown to both improve outcomes and control costs. These bundles help ensure that a patient’s different providers all communicate because they are all tied to the same payment.

RESTORING HEALTH CARE COMPETITION

Health care consolidation has also contributed to rising health care costs. One analysis found that over 90% of metropolitan areas had health care provider markets that were either highly concentrated or super concentrated in 2016. And despite the same kinds of empty promises we see every time there’s industry consolidation – in this case, that bigger hospitals would lead to better care – the data have not borne this out. In fact, it’s the opposite: more competition between providers creates incentives to improve care, and that incentive will only increase under a Medicare for All system where quality, not price, is the main differentiator in the system.

Under Medicare for All, hospitals won’t be able to force some patients to pay more because the hospital can’t agree with their insurance company. Instead, because everyone has good insurance, providers will have to compete on better care and reduced wait times in order to attract more patients. 

That’s why I will appoint aggressive antitrust enforcers to the Department of Justice and Federal Trade Commission and allow hospitals to voluntarily divest holdings to restore competition to hospital markets. I’ve also previously committed to strengthening FTC oversight over health care organizations, including non-profit hospitals, to crack down on anti-competitive behavior. And I will direct my FTC to block all future hospital mergers unless the merging companies can prove that the newly-merged entity will maintain or improve care. 

REINING IN OUT-OF-CONTROL PRESCRIPTION DRUG COSTS

Americans pay more for prescription drugs than anyone in the world – $333 billion in 2017 alone. Americans spent $1,220 per person on average for prescription drugs, while the next highest spending country, Switzerland, spent $963 per person. That’s not because Americans use more prescription medication – it’s because lax laws have allowed pharmaceutical companies to charge insurance companies and patients exorbitant rates. In a now-infamous example, when Turing Pharmaceuticals purchased the rights to the HIV medication Daraprim, the company raised the price of this life-saving drug from $13.50 per pill to a stunning $750 per tablet overnight. The price of insulin has skyrocketed, forcing people to risk their lives by rationing. And as prices continue to rise, more Americans are turning to Canada in search of affordable prices. 

Reining in prescription drug costs should be a top priority for any President – and there’s no better way to do it than through Medicare for All. My administration will use a suite of aggressive policy tools to set a net savings target that will bring down Medicare prices for brand name prescription drugs by 70% and prices for generics by 30%, with an initial focus on more expensive drugs. 

Under Medicare for All, the federal government would have real bargaining power to negotiate lower prices for patients. I will adopt an altered version of the mechanism outlined in the Lower Prescription Drug Costs Now Act which leverages excise taxes to bring manufacturers to the table to negotiate prices for both branded and generic drugs, with no drug exceeding 110% of the average international market price, but removes the limit of the number of drugs Medicare can negotiate for and eliminates the “target price” so Medicare could potentially negotiate prices lower than other countries. 

If negotiations fail, I will use two tools – compulsory licensing and public manufacturing – to allow my administration to ensure patient access to medicines by either overriding the patent, as modeled in the Medicare Negotiation and Competitive Licensing Act, or by providing public funds to support manufacturing of these drugs, as modeled in my Affordable Drug Manufacturing Act. Medicare for All will also incentivize pharmaceutical companies to develop the drugs we need – like antibiotics, cancer cures, and vaccines. And it’s not just about driving down drug prices. Making sure patients get important drug therapies up front that keep them healthy and cost a fraction compared to more severe treatment down the line can save money overall. Insurers, who may only cover individuals for a few years of their lives, see those investments in long-term health as a cost they’ll never recoup – so they have a financial incentive to deny patients these treatments. But Medicare for All covers each patient for their entire lifespan. There’s no perverse incentive to deny the prescriptions they need today because the long-term benefits to their health won’t benefit their current private insurance company. 

STEMMING THE GROWTH OF MEDICAL COSTS

Year after year, U.S. health spending has grown at rates above GDP growth, reaching a whopping 17.9% of GDP in 2017. Experts believe the changes to prescription drug spending and value-based payment systems that I’ve already outlined will bring growth rates in line with U.S. GDP, which CBO projects to be an average of 3.9% for the next decade. And if growth rates exceed this rate, I will use available policy tools, which include global budgets, population-based budgets, and automatic rate reductions, to bring it back into line.   

REDIRECTING TAXPAYER-FUNDED HEALTH SPENDING

Through Medicaid and public health plans for state employees, state and local governments play a significant role in financing health care coverage in America. Under my approach to Medicare for All, we will redirect $6 trillion in existing state and local government insurance spending into the Medicare for All system. This is similar to the mechanism that the George W. Bush Administration used to redirect Medicaid spending to the federal government under the Medicare prescription drug program.Under this maintenance-of-effort requirement, state and local governments will redirect $3.3 trillion of what they currently spend to support Medicaid and the Children’s Health Insurance Program and $2.7 trillion of what they currently spend on employer contributions to private insurance premiums for their employees into Medicare for All. Because we bring down the growth rate of overall health spending, states will pay less than they would have without Medicare for All. They’ll also have far more predictable budgets, resulting in improved long-term planning for state and community priorities. 

Together, these policy choices represent significant reductions in health care spending over current levels. Compared to the estimate by the Urban Institute, they will save over $7 trillion over ten years, bringing the expected share of additional federal revenue to just over $26 trillion for that period. After incorporating the $6 trillion we will redirect from states to help fund Medicare, the experts conclude that total new federal spending required to enact Medicare for All will be $20.5 trillion.

PAYING FOR MEDICARE FOR ALL

Medicare for All puts all health care spending on the government’s books. But Medicare for All is about the same price as our current path – and cheaper over time. That means the debate isn’t really about whether the United States should pay more or less. It’s about who should pay. 

Right now, America’s total bill for health care is projected to be $52 trillion for the next ten years. That money will come from four places: the federal government, state governments, employers, and individuals who need care. Under my approach to Medicare for All, most of these funding sources will remain the same, too. 

Existing federal spending on Medicare and Medicaid will help fund Medicare for All.

Existing state spending on health insurance will continue in the form of payments to Medicare – but states would be better off because they’d have more long-term predictability, and they’d pay less over time because these costs will grow more slowly than they do today.

Existing total private sector employer contributions to health insurance will continue in the form of contributions to Medicare – but employers would be better off because under the design of my plan, they’d pay less than they would have otherwise. 

Here’s the main difference: Individual health care spending. 

Over the next ten years, individuals will spend $11 trillion on health care in the form of premiums, deductibles, copays, and out-of-pocket costs. Under my Medicare for All plan, that amount will drop from $11 trillion to practically zero. 

I asked top experts – Mark Zandi, the Chief Economist of Moody’s Analytics; Betsey Stevenson, the former Chief Economist for the Obama Labor Department; and Simon Johnson – to examine options for how we can make up that $11 trillion difference. They conclude that it can be done largely with new taxes on financial firms, giant corporations, and the top 1% – and making sure the rich stop evading the taxes we already have.

That’s right: We don’t need to raise taxes on the middle class by one penny to finance Medicare for All. 

Here’s how it would work.

REPLACING EMPLOYER HEALTH SPENDING WITH A NEW EMPLOYER MEDICARE CONTRIBUTION 

Let’s start with a basic fact: American companies are already paying a lot for health care for their employees. They are projected to pay nearly $9 trillion over the next ten years, mostly on employer contributions for employee health insurance and on health-related expenses for employees under workers’ compensation and long-term disability. My idea is that instead of these companies sending those payments to private insurance companies, they would send payments to the federal government for Medicare in the form of an Employer Medicare Contribution. 

In fact, it’ll be a better deal than what they have now: companies will pay less than they otherwise would have, saving $200 billion over the next ten years. 

To calculate their new Employer Medicare Contribution, employers would determine what they spent on health care over the last few years and divide that by the number of employees of the company in those years to arrive at an average health care cost per employee at the company. (Companies would count part-time employees towards the total based on the number of hours they worked during a year.) Under the first year of Medicare for All, employers would then take that average cost, adjust it upwards to account for the overall increase in national health care spending, and multiply it by their total number of employees that year. Their Employer Medicare Contribution would be 98% of that amount – ensuring that every company paying for health care today will pay less than they would have if they were still offering their employees comparable private insurance. 

A similar calculation would apply to pass-through entities, like law firms or private equity funds, even though many of the people that work there technically aren’t employees. People who are self-employed would be exempt from making Employer Medicare Contributions unless they exceed an income threshold. 

Small businesses – companies with under 50 employees – would be exempt from this requirement too if they aren’t paying for employee health care today. When either new or existing firms exceed this employee threshold, we would phase in a requirement that companies make Employer Medicare Contributions equal to the national average cost of health care per employee for every employee at that company. Merging firms would pay the weighted average cost of health care per employee of the two firms that are merging.  

Employers currently offering health benefits under a collective bargaining agreement will be able to reduce their Employer Medicare Contribution if they pass along those savings to workers in the form of increased wages, pensions, or other collectively-bargained benefits. New companies or existing companies who enter into a collective bargaining agreement with their employees after the enactment of Medicare for All will be able to reduce their Employer Medicare Contributions in the same way. Employers can reduce their contribution requirements all the way down to the national average health care cost per employee. 

That way, my plan helps unions that have bargained for good health care already, and creates a significant new incentive for unionization generally by making collective bargaining appealing for both workers and employers as a way of potentially reducing the employer’s Employer Medicare Contributions.

Over time, an employer’s health care cost-per-employee would be gradually shifted to converge at the average health care cost-per-employee nationally. That helps make sure the system is fair but also gives employers and employees time to adapt to the new system.  

If we’re falling short of the $8.8 trillion revenue target for the next ten years, we will make up lost revenue with a Supplemental Employer Medicare Contribution requirement for big companies with extremely high executive compensation and stock buyback rates.    

There are a variety of ways to structure an employer contribution to Medicare for All. This particular approach has the benefit of helping American employers in a few ways:

Employers would collectively save $200 billion over the next ten years.

Employers receive far more certainty about how their health care costs will vary over time and affect their finances.

Small businesses – who often suffer when competing for employees because they can’t afford to offer health care coverage – would no longer be at a competitive disadvantage against bigger businesses.

Employers can reduce their Employer Medicare Contribution by supporting unionization efforts and negotiating with workers to provide better wages and benefits – reducing costs and promoting collective bargaining at the same time.

Because my plan holds health care cost growth to GDP levels, businesses will have stable balance sheets that grow with the economy instead of crowding out other priorities.

By asking employers to pay a little less than what they are already projected to pay for health care, we can get almost halfway to where we need to go to cover the cost of my Medicare for All plan. 

Automatic Increases in Take-Home Pay 

Medicare for All puts a whole lot of money back in the American people’s pockets. One way it does that is by taking the share of premiums employees are responsible for paying through employer-sponsored insurance – that line on pay stubs each week or month that says “health insurance” – and returning it to working people. Congratulations on the raise! 

And higher take-home pay for workers also means additional tax revenue just from applying our existing taxes – approximately $1.15 trillion if we apply average effective tax rates.  

Medicare for All saves people money in other ways too. With Medicare for All, nobody would need to put money in Health Savings Accounts or medical savings accounts to try and protect themselves against the unthinkable. And because individual spending on premiums, deductibles, copays, and out-of-pocket costs will basically disappear, the tax break for medical expenses in excess of 10% of Adjusted Gross Income becomes irrelevant. Together, those changes would generate another $250 billion in revenue.

All told, another $1.4 trillion in funding for Medicare for All is generated automatically through existing taxes on the enormous amount of money that will now be returned to individuals’ pockets from moving to a Medicare for All system with virtually no individual spending on health care. 

Here’s what that means: we can generate almost half of what we need to cover Medicare for All just by asking employers to pay slightly less than what they are projected to pay today, and through existing taxes.  

So where does the rest of the money come from that allows us to eliminate premiums, deductibles, copays, and most out-of-pocket spending for every American? Four sources: (1) better enforcement of our existing tax laws so we stop letting people evade their tax obligations; (2) targeted taxes on the financial sector, large corporations, and the top 1% of individuals; (3) my approach to immigration; and (4) shutting down a slush fund for defense spending. 

CRACKING DOWN ON TAX EVASION AND FRAUD

The federal government has a nearly 15% “tax gap” between what it collects in taxes what is actually owed because of systematic under-enforcement of our tax laws, tax evasion, and fraud. If that 15% gap persists for the next ten years, we will collect a whopping $7.7 trillion less in federal taxes than the law requires. By investing in stronger enforcement and adopting best practices on tax reporting, withholding, and filing, experts predict that we can close the tax gap by a third – generating about $2.3 trillion in additional federal revenue without a single new tax. 

A big part of our current tax gap problem is that we’re letting wealthier taxpayers get away with paying less than what they owe. Studies show that the wealthiest 5% of taxpayers misrepresent their income more frequently than the bottom 90%. 

The wealthy and their allies in Washington have worked to slash the IRS budget, leaving it without the resources it needs. The agency today has about the same number of revenue agents as it did when the economy was one-seventh its current size in the 1950s. And the IRS insists on targeting low-income taxpayers rather than wealthy ones, even though the amount of revenue we can recover from wealthy taxpayers is far more. 

We know how to fix this problem. We can draw lessons from what works in other countries with much lower tax gaps and rely on the recommendations of tax experts. Here’s a game plan:

Substantially increase funding for the IRS, including the Criminal Investigation Division. The Treasury Department estimated in its Fiscal Year 2017 budget request that every $1 invested in IRS enforcement brings in nearly $6 in additional revenue – not even including an indirect deterrence effect three times that amount.

Expand third-party reporting and withholding requirements. Research shows that third-party reporting and withholding cuts down on the tax misreporting rate substantially.

Strengthen enforcement of the Foreign Account Tax Compliance Act (FATCA). FATCA requires foreign financial institutions to report the holdings and income of U.S. taxpayers, but the IRS is generally not systematically matching these reports to individual tax returns. We also don’t hold foreign financial firms truly accountable for ignoring their reporting obligations. Automatically matching FATCA reports to tax returns and instituting sanctions for non-compliant foreign financial institutions would help narrow the tax gap.

Simplify tax filing obligations in line with other comparable countries with lower tax gaps, including by adopting my Tax Filing Simplification Act and using “smart returns” to improve honest reporting.

Redirect enforcement resources away from low-income taxpayers towards high-income taxpayers. 

Increase the nonfiler compliance program, strengthen reporting requirements for international income, use existing currency transaction reports to enforce cash income compliance, and increase reporting requirements for virtual- or crypto-currencies, as suggested by the Treasury Department’s Inspector General.

Allow employees who disclose tax evasion and abuse to use the protections of the False Claims Act and other whistleblower protections. 

The experts who reviewed these ideas estimated that if we implemented them, we could close the tax gap by one-third from 15% to 10%, bringing us closer to the tax gap in countries like the United Kingdom (5.6%). That will produce another $2.3 trillion in net federal revenue – without imposing a single new tax. 

TARGETED TAXES ON THE FINANCIAL SECTOR, LARGE CORPORATIONS, AND THE TOP 1% 

We can generate a whole lot of the remaining revenue we need for Medicare for All just by eliminating bad incentives in our current tax system and asking those who have done really well in the last few decades to pay their fair share.

Let’s start with the financial sector. It’s been more than ten years since the 2008 financial crisis, and while a lot of families are still dealing with the aftereffects, the financial sector is making record, eye-popping profits. Meanwhile, the risk of another financial crisis remains unacceptably high. By imposing targeted taxes and fees on financial firms, we can generate needed revenue and also make our financial system safer and more secure.

For example, a small tax on financial transactions – one-tenth of one percent on the sale of bonds, stocks, or derivatives – would generate about $800 billion in revenue over the next ten years. The tax would be assessed on and collected from financial firms, and would likely have little to no effect on most investors. Instead, according to experts, the tax could help decrease what Americans pay in fees for their investments and reduce the size of relatively unproductive parts of the financial sector. 

We can also impose a fee on big banks that encourages them to take on fewer liabilities and reduce the risk they pose to the financial system. A small fee that applies only to the forty or so largest banks in the country would generate an additional $100 billion over the next ten years – while making our financial system more safe and resilient. 

Next, we can make some basic changes to ensure that large corporations pay their fair share and to fix some fundamental problems with our current approach that actually encourage companies to shift jobs and investment overseas. These changes will generate an estimated $2.9 trillion over the next ten years. 

For instance, our current tax system lets companies deduct the cost of certain investments they make in assets faster than those assets actually lose value. That means that if a company buys a machine for a million dollars, it gets to deduct a million dollars from its taxes that same year – even if the machine only loses $100,000 in value a year. Letting the company write off the extra $900,000 all at once is like giving them an interest-free loan from the government. 

That might be worth it if the company responded to this tax break by investing more and building out their businesses. But the data suggest this isn’t happening because companies don’t actually value these tax deferrals as much as policymakers assume. Companies are mostly making the same investments they would’ve made anyways – sometimes with small changes in timing – and getting a write-off in exchange. Some experts even suggest that accelerated expensing could induce less domestic investment, not more. 

That’s why I’m proposing to get rid of this loophole. Under my plan, businesses will still write off the depreciation of their assets – they’ll just do it in a way that more accurately reflects the actual loss in value. This would generate $1.25 trillion over ten years.

We can also stop giant multinational corporations from calling themselves American companies while sheltering their profits in foreign tax havens to avoid paying their share for American investments. 

Currently, a U.S. multinational corporation can make billions in profits and attribute it to a company it set up in a tax haven like the Cayman Islands, which has no corporate taxes. The Trump tax bill claimed to address that problem by creating a global minimum tax rate for corporations, but that minimum tax – the result of heavy lobbying by multinationals – is too low and easily gamed. While Trump and congressional Republicans claimed their minimum tax would keep companies from shifting profits to tax havens and limit offshoring, the opposite is happening. The current approach both encourages companies to shift their profits to tax havens and actually incentivizes American companies to outsource their operations overseas. 

That’s why I’m proposing to institute a country-by-country minimum tax on foreign earnings of 35% – equal to a restored top corporate tax rate for U.S. firms – without permitting corporations to defer those payments. Under my plan, corporations would have to pay the difference between the minimum tax and the rate in the countries where they book their profits. For example, an American corporation booking a billion dollars in profits in the Cayman Islands, taxed at 0% there, would need to pay the federal government a 35% tax rate – the difference between the new minimum rate (35%) and the foreign rate (0%) – on the billion dollars in profits. 

My plan would also collect America’s fair share of profits that foreign companies make by selling their products to Americans. Today, we have a “global tax deficit”: companies that sell their goods abroad don’t have to pay the extra taxes that they would have to pay if they were subject to a minimum effective tax rate in each country they operated in. Making U.S. firms pay a country-by-country minimum tax effectively collects their whole global tax deficit – but foreign companies should have to pay their fair share, too. That’s why I’m proposing that the U.S. collect the fraction of this global tax deficit that corresponds to the percentage of that company’s sales in the U.S. In other words, if a foreign company should owe an additional $1 billion in taxes if it were subject to a country-by-country minimum tax, the U.S. would collect a fraction of that $1 billion based on the amount of sales that company made in the United States. 

Together, the country-by-country minimum tax and the taxation of foreign firms based on their domestic sales would result in an additional $1.65 trillion in revenue. 

Finally, we can raise another $3 trillion over ten years by asking the top 1% of households in America to pay a little more. 

The tax burden on ultra-millionaires and billionaires is less than half that of working families in the United States. In 2019, the bottom 99% of families will pay 7.2% of their wealth in taxes, while the top 0.1% of households will pay just 3.2%. My Ultra-Millionaire Tax, a 2-cent tax on the wealth of fortunes above $50 million, tackles this head on. Under this tax, the top 0.1% – the wealthiest 75,000 Americans – would have to pitch in two cents for every dollar of net worth above $50 million and three cents for every dollar on net worth over $1 billion. With this version of the Ultra-Millionaire Tax in place, the tax burden on the wealthiest households would increase from 3.2% to 4.3% of total wealth – better, but still below the 7.2% that the bottom 99% are projected to pay.

Today, I’m going one step further. By asking billionaires to pitch in six cents on each dollar of net worth above $1 billion, we can raise an additional $1 trillion in revenue and further close the gap between what middle-class families pay as a percentage of their wealth and what the top one-tenth of one percent pay. 

Yes, billionaires will have to pay a little more, but they will still likely pay less than what they would earn just from putting their assets into an index fund and doing nothing. The average annual rate of return of the S&P 500 has regularly topped 10%. And billionaires have access to the kinds of fancy investment opportunities that can generate even higher returns on average. Put it this way – should we ask billionaires to pitch in an extra three cents on every dollar above $1 billion, or force middle-class families to bear another $1 trillion in health care costs?

We can also change the way the government taxes investment income for the top 1%. Today, taxes are only assessed on capital gains when securities are sold. That means wealthy investors can put their money in the stock market, see it grow, and not pay a dime in taxes on those earnings unless or until it is taken out of the market. Under the current system, they can then pass along those shares to their heirs when they die and their heirs will be able to pay even less when they choose to sell.

I’ve already proposed closing that loophole for how capital gains are treated when shares are passed on to heirs. But we can go a step further. Under “mark-to-market” system for the wealthiest 1% of households, we will tax capital gains income (excluding retirement accounts) annually, rather than at the time of sale, and raise the rates on capital gains to match the tax rates for labor income. Individuals would still only pay taxes on gains and could use current losses to offset future taxes.

Under this system, investment income will no longer be treated differently than labor income for the top 1% of households. Ultra-millionaires and billionaires won’t be able to earn income on giant fortunes year after year without paying a penny in taxes. And we can raise another $2 trillion over ten years to pay for my Medicare for All plan.

IMMIGRATION REFORM 

I support immigration reform that’s consistent with our values, including a pathway to citizenship for undocumented immigrants and expanded legal immigration consistent with my principles. That’s not only the right thing to do – it also increases federal revenue we can dedicate to Medicare for All as new people come into the system and pay taxes. Based on CBO’s analysis of the 2013 comprehensive immigration reform bill, experts project that immigration reform would generate an additional $400 billion in direct federal revenue. 

REINING IN DEFENSE SPENDING 

Since the attacks of 9/11, the United States has appropriated $2 trillion to fund combat and counterterrorism operations around the world via the Overseas Contingency Operations fund, or OCO. On average this spending has amounted to $116 billion per year – and in total, an amount equivalent to nearly 10 percent of all federal discretionary spending over that same time period. 

Republicans – including the President’s current Chief of Staff – and Democrats alike agree that OCO is a budget gimmick that masks the true impact of war spending. The emergency supplemental funding mechanism was never intended to fund the costs of long-scale, long-term operations outside of the normal appropriations process. And in recent years, OCO has also been used to fund so-called “base” requirements unrelated to the wars, outside of the Budget Control Act caps – in effect acting as a slush fund for increased Pentagon spending. And as everything from more F-35s to massive bombs never used in combat have migrated into the OCO account, the Department of Defense has been spared from having to prioritize or live within its means. It’s not just bad budgetary practice – it’s wasteful spending. 

I’ve called out this slush fund for what it is. I’ve also called for an end to endless combat engagements in places like Afghanistan, Iraq, and Syria, and to responsibly bring our combat troops home from these nations. These open-ended commitments are not necessary to advance American foreign policy or counterterrorism interests, their human cost has been staggering, and their financial cost has created a drag on our economy by diverting money better invested in critical domestic priorities. 

I’ve also called to reduce defense spending overall. The Pentagon budget will cost more this year than everything else in the discretionary budget put together. That’s wrong, and it’s unsustainable. We need to identify which programs actually benefit American security in the 21st century, and which programs merely line the pockets of defense contractors – then pull out a sharp knife and make some cuts. 

We can start by shutting down this slush fund and balancing with our overall defense priorities in the context of the actual defense budget. And as we end these wars, eliminating the Overseas Contingency Operations fund and forcing the Pentagon to fund any such priorities through its regular budgetary process will provide $798 billion over the ten-year period relative to current spending levels. 

As I have said repeatedly, under my Medicare for All plan, costs will go up for the very wealthy and big corporations, and costs will go down for middle-class families. I will not sign a bill that violates these commitments. And as my plan to pay for Medicare for All makes clear, we can meet these commitments without a tax increase on the middle class – and, in fact, without any increase in income taxes at all. 

America’s middle class is facing a crisis. For a generation, wages have remained largely flat while family costs have exploded. I’ve spent decades sounding the alarm about it. I’m running for President to fix it. That means doing whatever we can to reduce the overall strain on family budgets. 

Medicare for All can be a huge part of the solution. When fully implemented, my approach to Medicare for All would mark one of the greatest federal expansions of middle class wealth in our history. And if Medicare for All can be financed without any new taxes on the middle class, and instead by asking giant corporations, the wealthy, and the well-connected to pay their fair share, that’s exactly what we should do.

ACHIEVING MEDICARE FOR ALL

Of course, moving to this kind of system will not be easy and will not happen overnight. This is why every serious proposal for Medicare for All contemplates a significant transition period. 

In the weeks ahead, I will propose a transition plan that will specifically address how I would use this time to begin providing immediate financial relief to struggling families, rein in out-of-control health care costs, increase coverage, and save lives. My transition plan will take seriously and address substantively the concerns of unions, individuals with private insurance, hospitals, people who work for private health insurers, and medical professionals who worry about what a new system will mean for them. It will also grapple directly with the entrenched political and economic interests that would spend freely, as they have throughout modern American history, to influence politicians and try to frighten the American people into rejecting a plan that would save them thousands of dollars a year on premiums and deductibles while making sure they can always see the health care providers they need with false claims and scare tactics.  

But there’s a reason former President Barack Obama has called Medicare for All a good idea. There’s a reason the American people support it. It’s because when it comes to the cost of health care, we are in the middle of a full-blown crisis. 

We are paying twice as much as any other major nation for care – even as tens of millions lack coverage, and even as family after family sees its finances destroyed by a health issue. And the American people know that in the long-term, a simple system that covers everybody, provides the care they need when they need it, puts $11 trillion back in their pockets and uses all of the public’s leverage to keep costs as low as possible is the best option for their family budgets and for the health of their loved ones.

As President, I’ll fight to get it done.

Read the plan here
Read expert letter on cost estimate of Medicare for All here 
Read expert letter on financing Medicare for All here
Calculator here

AOC, Michael Moore, Stars of Progressive Politics Endorse Bernie Sanders at Queens Rally

Bernie Sanders for President rally, Queens, New York © Karen Rubin/news-photos-features.com

By Karen Rubin, News-Photos-Features.com

Amid a sea of “Bernie” signs and chants of “We are the 99%” and “We will win”, Jane Sanders, looked out over the massive crowd of 25,000 that overflowed Queensbridge Park, beneath the Queensborough Bridge, onto the street, and said, “Here are people from every background in the melting pot called New York. Most of our ancestors came to America for a better life- mine from Ireland to escape famine, poverty; Bernie’s from Poland escaping anti-Semitism, poverty.

Jane Sanders at Bernie Sanders for President rally, Queens, New York © Karen Rubin/news-photos-features.com

“All believed they could have a better life. But in the last 40 years that promise has eroded. Bernie plans to change that.” And, noting that this is his first rally since his heart attack, she said to massive cheers, “Bernie is back. He’s healthy and more than ready to continue his lifelong fight for working people of America.”

Michael Moore: “This is not just about defeating Trump, but the rotten system that gave us Trump’

Democracy, said documentary filmmaker Michael Moore, is where “Everyone gets a seat at the table, a slice of the pie and not fight for last crumbs. We don’t just need a democratic politics, we need a democratic economy.”

Filmmaker Michael Moore at Bernie Sanders for President rally, Queens, New York © Karen Rubin/news-photos-features.com

Moore said, “The powers that be are very unhappy you’re here, that Bernie is back. The pundits, the media [boo] are throwing everything out there to get people to think differently:

“That Bernie is too old. Here’s what’s too old: the Electoral College, the $7 minimum wage, women not being paid the same as men, thousands and thousands of dollars of student debt, $10,000 deductible for health care, Super Delegates, the fossil fuel industry – that’s what’s too old.

“It’s a gift we have 78-year-old American running for president. The experience he has, what he has seen. He knows what a pay raise is, a pension – look it up. What it looks like to defend against fascism and white supremacy, to have the library open every day, what regulations are (Boeing). I’m glad he’s 78.

“Health? We should be talking about the health of planet that’s dying [crowd chants “Green New Deal”]; the health of kids in Flint Michigan, of 40 million living in poverty, of young black males shot in back by police [chant Black Lives Matter, Black Lives Count]. The only heart attack we should talk about is the one Wall Street will have when Bernie wins.

Bernie Sanders for President rally, Queens, New York © Karen Rubin/news-photos-features.com

“Next, that Bernie can’t win. He will win he has won 8 times to the House, 2 times to the Senate, 22 states in 2016 – almost half [chant “We will win.]. In 2016 [Democratic primary], Bernie won Michigan, Wisconsin, Minnesota. Of the 11 states that border Canada, Bernie won 10 (not NY) [boo] – we can fix that. Of the 5 states that border the Pacific, he won 4; of 6 in New England, won 4; Bernie won West Virginia – all 55 counties. According to a poll, he is #1 in Nevada, a dead heat in Iowa, #1 in New Hampshire. He has raised more money from more donors with the smallest amount.

“Why say Bernie can’t win? Because they are lying to the American people. Bernie will win. [Chant, “We will win”]

“They say he can’t win because he is a [Democratic] socialist [yay!]. That’s not going to fly. The American people have loved socialism for the last 70 years. Social Security, free public school, Medicare, Medicaid, fire department – all are socialist.

“What they don’t want to do is tell the truth, what would happen if they structured economic policies with democracy instead of capitalism. And this isn’t capitalism of your great grandpa, this is a form of greed, selfishness so that just few at the top succeed, the  rest struggle paycheck to paycheck.

“Afraid taxes on rich will go up under Sanders? It was depressing during the debate to watch Democrats go after Medicare for All. What would Franklin Roosevelt say?

“They say we can’t afford it? How does Canada afford it? Every other industrialized country has figured it out, why can’t we? They don’t want us to figure it out.

“They say taxes will go up? That is part of the big lie – your taxes already are up. We don’t call it a tax – in Canada, France, Finland they get free health care, free or nearly free day care and college, but pay more in tax for these things. The average American family pays $12,000 a year for child care, $4000 in student loans, $6000 for deductibles, co-pays and premiums for health care – too damn much – the average is $20,000/year but we don’t call it a tax.

Over 25,000 turned out for the Bernie Sanders for President rally, in Queensbridge Park, Queens, New York © Karen Rubin/news-photos-features.com

“We are here in Queensbridge Park, Manhattan Island just across the river is headquarters of corporate America [boo], corporate media [boo], Wall Street

[boo]

. So much misery has been visited on the American people from a half mile away. It must stop.

“They must hear us at Goldman Sachs, Fox News, Trump Tower – the scene of the crime.

“This [election] is not just about defeating Trump, but the rotten system that gave us Trump…. beating Trump isn’t enough.  We must crush Trump at the polls, then fix the rotten corrupt economic system that gave us Trump.”

Bernie Sanders for President rally, Queens, New York © Karen Rubin/news-photos-features.com

San Juan Mayor Cruz: “Move forward on the path of progressive agenda. We are equal. We will win. We must win.”

Calling herself a “climate change survivor,” San Juan Mayor Carmen Yulín Cruz Soto, attacked Trump for “killing us with inefficiency” that contributed to 3,000 Puerto Ricans dying after being smacked by back-to-back hurricanes.

Carmen Yulín Cruz Soto at Bernie Sanders for President rally, Queens, New York © Karen Rubin/news-photos-features.com

“Why we have to win” she says is for Medicare-for-All, so no one has to choose between groceries and insulin; to be able to afford college and life after college, to “stand against those who earn $100 million and pay workers starving wages; who take away women’s right to choose; the crime of separating families at southern border; climate change.

“I am a climate change survivor. Climate change is real – 3000 Puerto Ricans were killed because Trump Is a racist, xenophobic, paper throwing demagogue.” [Chant, “Lock him up. Vote him out.”]

“The time is now to be fearless, relentless. I stand with Sanders – I respect every other candidate but there is one name only who can get the job done. Be united in one progressive voice, cross generations. Move forward on the path of progressive agenda. We are equal. We will win. We must win.”

Nina Turner: “We must knock out Billionaire class that doesn’t believe working people deserve a good life.”

National co chair Nina Turner quoted Congresswoman Barbara Jordan who said American people want an America as good as its promise. “That means an America where people don’t die because have to ration insulin; hospitals are not closing; where there is clean water, air, food; a justice system that doesn’t gun down black folks in their houses.

Nina Turner at Bernie Sanders for President rally, Queens, New York © Karen Rubin/news-photos-features.com

“We need to clean up the criminal injustice system, Truth & Reconciliation about the ravages of racism, a health care system not commodified. We need to take care of Mother Earth.”

Alluding to the Democratic candidates, she said, “There are many copies but only one original. We finally have somebody in our lifetime, his own special interest is people of nation.

“We must knock out Billionaire class that doesn’t believe working people deserve a good life.”

Bernie Sanders for President rally, Queens, New York © Karen Rubin/news-photos-features.com

Congresswoman Alexandria Ocasio-Cortez: “We need a United States truly, authentically operated, owned by working people.”

“We must bring revolution of working class to the ballot box of America,” declared Congresswoman Alexandria Ocasio-Cortez. She prompted chants of “Green New Deal,” saying, “Queensbridge Park is ground zero in the fight for public housing and environmental justice.

“Last February I was working as a waitress in Manhattan, shoulder to shoulder with undocumented workers who were putting in12 hour days with no healthcare, not a living wage. We didn’t think we deserved it. That is the script we tell working people: your inherent worth, value as human depends on income another underpays. Turn around that basic language… We must change the system that puts corporate profit ahead of all human and planetary costs.”

Congresswoman Alexandria Ocasio-Cortez at Bernie Sanders for President rally, Queens, New York © Karen Rubin/news-photos-features.com

After her parents put all they had to buy a house, she said she learned from an early age that “kids’ destiny determined by zipcode. Income inequality is a fact of life of children.” Her father died of cancer when she was 18 and she learned, “We all are one accident away from everything falling apart.

Sanders, she said, has fought for Planned Parenthood, for public education, for CHIP, for single-payer health care, for gender rights, to end “life-crushing” student debt.

“He didn’t do it because it was popular. He fought when it came at the highest political cost in America.

“In 2016, he changed politics in America. We now have one of the best Democratic fields – much because of Sanders.

“I’m in Congress today but one year ago I was a sexually harassed waitress. This freshman class in overwhelming numbers rejected corporate money – thanks to Bernie – endorsed Medicare for All, sees the climate crisis as an existential threat.

Alexandria Ocasio-Cortez at Bernie Sanders for President rally, Queens, New York © Karen Rubin/news-photos-features.com

“[In Congress] it is no joke to stand up against corporate power and establishment interests. Arms are twisted, political pressure psychological and otherwise applied to make you abandon the working class.

“I have come to appreciate the nonstop advocacy of Sanders. It’s not just what he fights for but how: mass mobilization of the working class at the ballot box, a movement (against) racism, classism of Hyde Amendment, imperialist and colonial histories that lead to endless war and immigration crisis.

“NYCHA is underfunded by $30 billion –that is not an accident, but an outcome of system that devalues poor, Logic that got us into this won’t get us out.”

Alexandria Ocasio-Cortez at Bernie Sanders for President rally, Queens, New York © Karen Rubin/news-photos-features.com

“We need a United States truly, authentically operated, owned by working people.

“Bernie showed you can run a grass roots campaign and win in America when others thought it impossible.”

__________

© 2019 News & Photo Features Syndicate, a division of Workstyles, Inc. All rights reserved. For editorial feature and photo information, go towww.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

Democratic Candidates for 2020: Senator Amy Klobuchar Advances Plan for Universal Coverage, Lower Health Care Costs

Senator Amy Klobuchar,left, on stage in Houston for the third Democratic Debate, hosted by ABC News.

Senator Amy Klobuchar had her best moments in the third Democratic Debate, Sept. 12, in addressing health care and drawing the distinction between Senator Bernie Sanders’ Medicare-for-All solution in the quest, shared by all the Democratic candidates, of universal health care at an affordable cost, health care as a right, not a privilege.

This is from the Klobuchar campaign:

MINNEAPOLIS, MN — Senator Amy Klobuchar has been a leader in the Senate to lower the cost of prescription drugs, expand access to affordable health care and protect reproductive rights. She was the first candidate in this race to release a comprehensive plan to combat addiction and prioritize mental health — two issues she’s championed her entire career. 

Senator Klobuchar supports: 

Universal health care for all Americans, and she believes the quickest way to get there is through a public option that expands Medicare or Medicaid.

Changes to the Affordable Care Act to help bring down costs to consumers including providing cost-sharing reductions, making it easier for states to put reinsurance in place, and continuing to implement delivery system reform.

Lifting the ban on Medicare negotiations for prescription drugs, allowing personal importation of safe drugs from countries like Canada, and stopping pharmaceutical companies from blocking less-expensive generics.

Taking on mental health and addiction by launching new prevention and early intervention initiatives, expanding access to treatment, and giving Americans a path to sustainable recovery because she believes everyone has the right — and the opportunity — to receive effective, professional treatment and help.

Stopping the concerted attack to undermine and eliminate a woman’s right to make her own health care decisions. She believes recent bans in states are dangerous, they are unconstitutional, and they are out of step with the majority of Americans. Amy will continue working to protect the health and lives of women across the country.

In her first 100 days as president, Senator Klobuchar will take the following actions:

Immediately suspend the Trump Administration’s efforts to eliminate the Affordable Care Act’s protections for people with pre-existing conditions. 

Immediately allow for the safe importation of prescription drugs from countries like Canada. 

Expand VA health benefits for women veterans and their babies. 

Prioritize mental health and addiction. 

End “pay for delay” agreements that increase the cost of prescription drugs. 

Propose legislation to get us to universal health care.

Develop best models of care to address disparities in maternal and infant mortality and address the shortage of maternity care health professional in underserved rural and urban areas. 

Stop Trump sabotage of the ACA by ending workarounds that allow states to raise premiums for sicker people and shift ACA premium subsidies away from lower-income enrollees. 

End the sale of junk insurance policies that eliminate existing protections for consumers. 

End anticompetitive practices that increase the price of prescription drugs.  

Encourage reinsurance programs. 

Expand Medicaid reimbursement for people receiving mental health or substance use treatment. 

Ensure funding for Planned Parenthood, end the gag rule, and restore the Title X program

Expand investments in veterans telehealth services. 

Invest in the Veterans Health Administration. 

Reassess the granting of Medicaid waivers, including states that have privatized Medicaid. 

Direct the Department of Defense and VA to track servicemembers and veterans exposed to toxic chemicals.

Direct the Department of Health and Human Services to consider VHA facilities when designating Health Professional Shortage Areas. 

Strengthen the National Science Foundation and the National Institutes of Health.

Invest in Alzheimer’s research. 

Prioritize health care delivery system reform to reduce health care costs.

Expand the open enrollment period for health insurance under the Affordable Care Act so more people can get insurance coverage.

Bernie Sanders Defends Medicare-for-All, Attacks Insurance Companies, Big Pharma for Dysfunctional, High-Cost Healthcare

Bernie Sanders, seen at a Brooklyn rally, is defending his signature plan, Medicare-for-All, and blaming the greed of the insurance and pharmaceutical industries as the reason for dysfunctional, high cost health care system that causes 30,000 premature deaths a year and bankrupts 530,000 Americans a year. © Karen Rubin/news-photos-features.com

WASHINGTON – U.S. Senator Bernie Sanders, running to be the Democratic nominee for president, on July 17 delivered a major address on Medicare for All, coinciding with the 54th anniversary of Medicare being signed into law. In his remarks, Sanders outlined his plan to make health care a human right for all Americans. Here is highlighted transcript of remarks as they were prepared for delivery: – Karen Rubin, News & Photo Features

Thank you all very much for being here to discuss one of the major crises facing our country.  Let me also thank the dozens of organizations throughout America who support Medicare for All and the tens of thousands of doctors, nurses and other health professionals who support my legislation.  Let me thank the 14 Senate co-sponsors that we have on this legislation and the 118 Members of the House who support similar legislation.  And mostly, let me thank the American people who by the millions understand, as I do, that health care is a human right, not a privilege.

Together, we will end the international embarrassment of the United States being the only major country on earth that does not guarantee health care to all of its citizens.  

It is not acceptable to me, nor to the American people, that some 87 million people today are either uninsured or underinsured.

It is not acceptable to me that we end up spending almost twice as much as any other major country on health care, while our life expectancy continues to decline and our healthcare outcomes lag behind many other countries.

Frankly, I am sick and tired of talking to doctors who tell me about the patients who died because they were uninsured or underinsured, and walked into the doctor’s office when it was too late.  And we are talking about over 30,000 Americans who die every year because they are uninsured or under-insured.  What a tragedy. 

I am sick and tired of seeing working class families and small businesses pay far more for healthcare than they can afford, and 530,000 Americans declare bankruptcy each year because they cannot pay off the outrageous cost of a medical emergency or a hospital stay.  Families should not be driven into financial ruin because someone in the family became seriously ill.  How insane is that?

I am sick and tired of hearing from Americans who lost loved ones because they could not afford the unbelievably high cost of prescription drugs, or hearing from constituents who are forced to cut their pills in half due to the cost. 

In fact, later this month, I will be travelling from Detroit, Michigan to Windsor, Ontario with a busload of Americans who have diabetes in order to purchase insulin in Canada at one-tenth of the price that they pay in America.

I am sick and tired of talking with people who are struggling with mental illness but cannot afford the mental health counseling they desperately need. 

I am tired of talking to people who have teeth that are rotting in their mouths, but cannot afford the high cost of dental care

Let me be very honest and tell you that, in my view, the current debate over Medicare for All really has nothing to do with healthcare.  It has everything to do with greed and the desire of the healthcare industry to maintain a system which fails the average American, but which makes the industry tens and tens of billions of dollars every year in profit. 

It is about whether we maintain a dysfunctional system which allows the big drug and health insurance companies to make over $100 billion in profits last year, while the top CEOs in that industry made $2.6 billion in total compensation – all the while 1 out of 5 Americans cannot afford the prescription drugs their doctors prescribe.

It’s about whether we maintain a system in which the CEO of the Aetna insurance company, Mr. Mark Bertolini, received a golden parachute worth nearly $500 million after his company merged with CVS Health, while elderly people lack the resources to purchase a hearing aid.

It’s about whether we maintain a system that allows the former CEO from Gilead (John Martin) to become a billionaire by charging $1,000 a pill for a hepatitis c drug called Sovaldi that costs a dollar to manufacture.

Let us make no mistake about it.  The struggle that we are now undertaking, to guarantee health care to all Americans as a right and to substantially lower the cost of prescription drugs, will be opposed by some of the most powerful forces in America – entities that have unlimited amounts of money.  We’re talking about the insurance companies, the drug companies, private hospitals, medical equipment suppliers, Wall Street and other powerful entities.  

Let me make a prediction. In order to defeat the Medicare for All movement, powerful special interests will be spending millions on 30 second television ads, full page magazine ads, and corporate-sponsored “studies” to frighten the American people about Medicare for All – which is exactly what happened before the passage of Medicare in the 1960s. They failed then and they’re going to fail now.

And let me give you an example of the kind of money and power we are talking about. 

Over the last 20 years, the insurance industry and pharmaceutical companies have spent more than $330 million in campaign contributions and over $4 billion in lobbying to get Congress to do its bidding. 

The pharmaceutical industry alone has hired some 1,200 lobbyists – including the former leadership of both political parties.

I find it quite interesting that Billy Tauzin, the Republican Congressman who wrote the bill to prevent Medicare from negotiating for lower drug prices and then went on to become the President and CEO of Pharma, received over $11.6 million in compensation in 2010.

That’s how business is done in Washington.  Well, I have a different vision of what a rational healthcare system is all about.  Instead of massive profits for the drug companies, the insurance companies and Wall Street, we must provide a healthcare system that provides quality healthcare to all in a cost effective way.

And that is exactly what Medicare for All does.

Under this legislation, every family in America would receive comprehensive coverage, and middle-class families would save thousands of dollars a year by eliminating their private insurance costs as we move to a publicly funded program.

The transition to the Medicare for All program would take place over four years. In the first year, benefits to older people would be expanded to include dental care, vision coverage and hearing aids, and the eligibility age for Medicare would be lowered to 55. All children under the age of 18 would also be covered. In the second year, the eligibility age would be lowered to 45 and in the third year to 35. By the fourth year, every man, woman and child in the country would be covered by Medicare for All.

Medicare for All will reduce – let me repeat, reduce — overall health care spending while lowering the number of uninsured and underinsured people in this country to zero.   

We accomplish this because Medicare for All creates a system of health care insurance that isn’t designed to generate profits for insurance and drug companies — it will be a system focused on delivering actual health care. It will save lives, save money, and end the frustration of endless paperwork, denials, and desperate fights with an insurance company to cover medically-necessary medications and procedures.

Medicare for All will fully eliminate health insurance premiums, deductibles and co-payments. Make no mistake about it: These are nothing less than taxes on the middle class. 

And when we do that, the average middle class family will save an estimated $3,000 each and every year.

Further, unlike the current dysfunctional system, Medicare for All allows people the freedom to choose any doctor, clinic, and hospital without worrying about whether their provider is in-network or not.  People will be able to make the health care choices that are best for themselves and their families without some insurance bureaucrat telling them which providers they can see or not see. Medicare for All is at the end of the day empowering patients and health care providers. 

In addition, a Medicare for All system will allow us to address the serious problem of medically underserved areas. 

Just to demonstrate how absurd our health care system is, I was in Philadelphia two days ago rallying with the people of that city to try to stop the closure of Hahnemann University Hospital, an important, safety net hospital in that community.  Why do the owners want to close this hospital? Because they can make more money redeveloping that property into condominiums and hotels.

Let me address some of the half-truths, misinformation, and, in some cases, outright lies that people may be hearing about Medicare for All.  

Medicare for All critics tell us that Americans just love their private health insurance companies. We heard this most recently from UnitedHealth CEO David Wichmann, who by the way, made $83 million in 2017 and who said Medicare for All would “destabilize the nation’s health system.” 

But let’s remember: the current system is already disrupting and destabilizing millions of people’s lives. In the current system, 50 million Americans every year lose their existing health insurance when their employer changes insurer, when they change jobs, or when they cannot afford their current plan. For many of them, they will no longer be able to see the doctor they have relied on for years.  For others, important treatments for long-term conditions or disabilities will be changed or stopped altogether.  

Here is the simple truth. The American people do not like their private health insurance companies. In fact private health insurance companies are quite unpopular.  What the American people do like are their doctors, nurses and other health care providers. 

While our opponents claim that Medicare for All is too expensive, the reality is that it is much more cost effective than our current system.

The Center for Medicare and Medicaid Services estimates that, if we do not change the system, this country will be spending $50 trillion over the next ten years –19.4 percent of our nation’s GDP.  This is unsustainable and will be incredibly harmful to the people of our country, to the business community, and to the entire economy.

And the reason why we spend so much is obvious.  It is not just the huge profits in the insurance industry and the pharmaceutical industry, but it is the incredible and wasteful bureaucratic maze developed by thousands of different healthcare plans.  Today, hospitals and doctors must deal with patients who have different deductibles, different co-payments, different networks of coverage, and different coverage for pharmaceuticals, or no insurance at all.  All of this is not only driving doctors and nurses and hospital administrators to distraction, but it is wasting up to $500 billion a year on unnecessary administrative costs.

Unlike our current system, there is broad consensus – from conservative to progressive economists – that Medicare for All would result in substantial savings to the American people.  Two of the most recent studies on this issue have estimated that Medicare for All would save the American people between $2 trillion and $5 trillion over a 10-year period.

Let us be clear, the fight against Medicare for All today is not a new development.  Powerful special interests have always opposed healthcare programs that work for the people and not for corporate interests.

Let us not forget that when President Harry Truman first proposed a program guaranteeing health care to seniors that idea was billed as radical, “un-American,” and an attack on basic freedom. And because of that assault, the idea stalled in Congress for years — until voters made their voices heard.

In 1960, America elected John F. Kennedy after he campaigned in support of Truman’s idea. That election prompted serious work on universal health care bill, and Kennedy at the time noted that “what we are now talking about doing, most of the countries of Europe did years ago.”

Finally, following the 1964 Democratic election landslide, the new Congress was able to pass what is now known as Medicare despite intense opposition from the health insurance industry and the pharmaceutical companies.

More than a half-century after that achievement, the time is now to go forward.  The time is now to expand Medicare to every man, woman and child in this country. 

Let us be very clear.  When it comes to health care, the insurance and drug industries have been able to control the political process.  

If we are going to break the stranglehold of corporate interests over the health care needs of the American people, we have got to confront a Washington culture that is corrupt, that puts profits before people.

That is why I am calling on every Democratic candidate in this election to join me in rejecting money from the insurance and drug industries. That means not accepting donations over $200 from health insurance or pharmaceutical company PACs, lobbyists or executives. Candidates who are not willing to take that pledge should explain to the American people why those corporate interests believe their campaigns are a good investment.

Of course, President Trump should do the same but I am not going to even waste my breath suggesting that he will.  His efforts to throw 32 million people off their health insurance to have it replaced with junk insurance shows exactly what side he is on.

Finally, let me say, eliminating health insurance and drug company money from the Democratic primary won’t solve all the problems, but it is an important step forward. Now is the time to tell the health care industry that your profits are not more important than the lives of the American people.

See also: Biden Plan for Universal Healthcare: Protect, Build on Obamacare

Biden Plan for Universal Healthcare: Protect, Build on Obamacare

Vice President Joe Biden, in the race for the Democratic nomination for President, has staked out a position on improving on the Affordable Care Act (Obamacare) as his solution to providing universal healthcare  – essentially, enabling people keep their private insurance but creating a new public option. That is more moderate than the Democrats like Bernie Sanders and Elizabeth Warren who want a more extreme Medicare for All that replaces private insurance (though it is unlikely that there will not still be a market for supplemental private insurance, just as there is now for Medicare). Here, is the Biden campaign’s description and rationale for Biden’s plan to protect and build upon the Affordable Care Act: – Karen Rubin, News& Photo Features

Vice President Joe Biden, in the race for the Democratic nomination for President, has staked out a position on improving on the Affordable Care Act (Obamacare) as his solution to providing universal healthcare  – essentially, enabling people keep their private insurance but creating a new public option. © Karen Rubin/news-photos-features.com

On March 23, 2010, President Obama signed the Affordable Care Act into law, with Vice President Biden standing by his side, and made history. It was a victory 100 years in the making. It was the conclusion of a tough fight that required taking on Republicans, special interests, and the status quo to do what’s right. But the Obama-Biden Administration got it done.

Today, the Affordable Care Act is still a big deal. Because of Obamacare, over 100 million people no longer have to worry that an insurance company will deny coverage or charge higher premiums just because they have a pre-existing condition – whether cancer or diabetes or heart disease or a mental health challenge. Insurance companies can no longer set annual or lifetime limits on coverage. Roughly 20 million additional Americans obtained the peace of mind that comes with health insurance. Young people who are in transition from school to a job have the option to stay covered by their parents’ plan until age 26.

But, every day over the past nine years, the Affordable Care Act has been under relentless attack.

Immediately after its passage, Congressional Republicans began trying again and again to repeal it. Following the lead of President Trump, Republicans in Congress have only doubled down on this approach since January 2017. And, since repeal through Congress has not been working, President Trump has been unilaterally doing everything he can to sabotage the Affordable Care Act. Now, the Trump Administration is trying to get the entire law – including protections for people with pre-existing conditions – struck down in court.

As president, Biden will protect the Affordable Care Act from these continued attacks. He opposes every effort to get rid of this historic law – including efforts by Republicans, and efforts by Democrats. Instead of starting from scratch and getting rid of private insurance, he has a plan to build on the Affordable Care Act by giving Americans more choicereducing health care costs, and making our health care system less complex to navigate.

For Biden, this is personal. He believes that every American has a right to the peace of mind that comes with knowing they have access to affordable, quality health care. He knows that no one in this country should have to lay in bed at night staring at the ceiling wondering, “what will I do if she gets breast cancer?” or “if he has a heart attack?” “Will I go bankrupt?” He knows there is no peace of mind if you cannot afford to care for a sick child or a family member because of a pre-existing condition, because you’ve reached a point where your health insurer says “no more,” or because you have to make a decision between putting food on the table and going to the doctor or filling a prescription.

In the coming months, Joe Biden will build on today’s plan by rolling out his proposals to tackle some of our greatest public health challenges – from reducing gun violence to curing devastating diseases as we know them like cancer, Alzheimer’s, diabetes, and addiction.

I. GIVE EVERY AMERICAN ACCESS TO AFFORDABLE HEALTH INSURANCE

From the time right before the Affordable Care Act’s key coverage-related policies went into effect to the last full year of the Obama-Biden Administration, 2016, the number of Americans lacking health insurance fell from 44 million to 27 million – an almost 40% drop. But President Trump’s persistent efforts to sabotage Obamacare through executive action, after failing in his efforts to repeal it through Congress, have started to reverse this progress. Since 2016, the number of uninsured Americans has increased by roughly 1.4 million.

As president, Biden will stop this reversal of the progress made by Obamacare. And he won’t stop there. He’ll also build on the Affordable Care Act with a plan to insure more than an estimated 97% of Americans. Here’s how:

Giving Americans a new choice, a public health insurance option like Medicare. If your insurance company isn’t doing right by you, you should have another, better choice. Whether you’re covered through your employer, buying your insurance on your own, or going without coverage altogether, the Biden Plan will give you the choice to purchase a public health insurance option like Medicare. As in Medicare, the Biden public option will reduce costs for patients by negotiating lower prices from hospitals and other health care providers. It also will better coordinate among all of a patient’s doctors to improve the efficacy and quality of their care, and cover primary care without any co-payments. And it will bring relief to small businesses struggling to afford coverage for their employees.

Increasing the value of tax credits to lower premiums and extend coverage to more working Americans. Today, families that make between 100% and 400% of the federal poverty level may receive a tax credit to reduce how much they have to pay for health insurance on the individual marketplace. The dollar amount of the financial assistance is calculated to ensure each family does not have to pay more than a certain percentage of their income on a silver (medium generosity) plan. But, these shares of income are too high and silver plans’ deductibles are too high. Additionally, many families making more than 400% of the federal poverty level (about $50,000 for a single person and $100,000 for a family of four), and thus not qualifying for financial assistance, still struggle to afford health insurance. The Biden Plan will help middle class families by eliminating the 400% income cap on tax credit eligibility and lowering the limit on the cost of coverage from 9.86% of income to 8.5%. This means that no family buying insurance on the individual marketplace, regardless of income, will have to spend more than 8.5% of their income on health insurance. Additionally, the Biden Plan will increase the size of tax credits by calculating them based on the cost of a more generous gold plan, rather than a silver plan. This will give more families the ability to afford more generous coverage, with lower deductibles and out-of-pocket costs.

Expanding coverage to low-income Americans. Access to affordable health insurance shouldn’t depend on your state’s politics. But today, state politics is getting in the way of coverage for millions of low-income Americans. Governors and state legislatures in 14 states have refused to take up the Affordable Care Act’s expansion of Medicaid eligibility, denying access to Medicaid for an estimated 4.9 million adults. Biden’s plan will ensure these individuals get covered by offering premium-free access to the public option for those 4.9 million individuals who would be eligible for Medicaid but for their state’s inaction, and making sure their public option covers the full scope of Medicaid benefits. States that have already expanded Medicaid will have the choice of moving the expansion population to the premium-free public option as long as the states continue to pay their current share of the cost of covering those individuals. Additionally, Biden will ensure people making below 138% of the federal poverty level get covered. He’ll do this by automatically enrolling these individuals when they interact with certain institutions (such as public schools) or other programs for low-income populations (such as SNAP).

II. PROVIDE THE PEACE OF MIND OF AFFORDABLE, QUALITY HEALTH CARE AND A LESS COMPLEX HEALTH CARE SYSTEM

Today, even for people with health insurance, our health care system is too expensive and too hard to navigate. The Biden Plan will not only provide coverage for uninsured Americans, it will also make health care more affordable and less complex for all. 
 
The plan’s elements described above will help reduce the cost of health insurance and health care for those already insured in the following ways:

All Americans will have a new, more affordable option. The public option, like Medicare, will negotiate prices with providers, providing a more affordable option for many Americans who today find their health insurance too expensive.

Middle class families will get a premium tax credit to help them pay for coverage. For example, take a family of four with an income of $110,000 per year. If they currently get insurance on the individual marketplace, because their premium will now be capped at 8.5% of their income, under the Biden Plan they will save an estimated $750 per month on insurance alone. That’s cutting their premiums almost in half. If a family is covered by their employer but can get a better deal with the 8.5% premium cap, they can switch to a plan on the individual marketplace, too.

Premium tax credits will be calculated to help more families afford better coverage with lower deductibles. Because the premium tax credits will now be calculated based on the price of a more generous gold plan, families will be able to purchase a plan with a lower deductible and lower out-of-pocket spending. That means many families will see their overall annual health care spending go down.

The Biden Plan has several additional proposals aimed directly at cutting the cost of health care and making the health care system less complex to navigate. The Biden Plan will:

Stop “surprise billing.” Consumers trying to lower their health care spending often try to choose an in-network provider. But sometimes patients are unaware they are receiving care from an out-of-network provider and a big, surprise bill. “Surprise medical billing” could occur, for example, if you go to an in-network hospital but don’t realize a specialist at that hospital is not part of your health plan. The Biden Plan will bar health care providers from charging patients out-of-network rates when the patient doesn’t have control over which provider the patient sees (for example, during a hospitalization).

Tackle market concentration across our health care system. The concentration of market power in the hands of a few corporations is occurring throughout our health care system, and this lack of competition is driving up prices for consumers. The Biden Administration will aggressively use its existing antitrust authority to address this problem.

Lower costs and improve health outcomes by partnering with the health care workforce. The Biden Administration will partner with health care workers and accelerate the testing and deployment of innovative solutions that improve quality of care and increase wages for low-wage health care workers, like home care workers.

III.  STAND UP TO ABUSE OF POWER BY PRESCRIPTION DRUG CORPORATIONS
 
Too many Americans cannot afford their prescription drugs, and prescription drug corporations are profiteering off of the pocketbooks of sick individuals. The Biden Plan will put a stop to runaway drug prices and the profiteering of the drug industry by:

Repealing the outrageous exception allowing drug corporations to avoid negotiating with Medicare over drug prices. Because Medicare covers so many Americans, it has significant leverage to negotiate lower prices for its beneficiaries. And it does so for hospitals and other providers participating in the program, but not drug manufacturers. Drug manufacturers not facing any competition, therefore, can charge whatever price they choose to set. There’s no justification for this except the power of prescription drug lobbying. The Biden Plan will repeal the existing law explicitly barring Medicare from negotiating lower prices with drug corporations.

Limiting launch prices for drugs that face no competition and are being abusively priced by manufacturers. Through his work on the Cancer Moonshot, Biden understands that the future of pharmacological interventions is not traditional chemical drugs but specialized biotech drugs that will have little to no competition to keep prices in check. Without competition, we need a new approach for keeping the prices of these drugs down. For these cases where new specialty drugs without competition are being launched, under the Biden Plan the Secretary of Health and Human Services will establish an independent review board to assess their value. The board will recommend a reasonable price, based on the average price in other countries (a process called external reference pricing) or, if the drug is entering the U.S. market first, based on an evaluation by the independent board members. This reasonable price will be the rate Medicare and the public option will pay. In addition, the Biden Plan will allow private plans participating in the individual marketplace to access a similar rate.

Limiting price increases for all brand, biotech, and abusively priced generic drugs to inflation. As a condition of participation in the Medicare program and public option, all brand, biotech, and abusively priced generic drugs will be prohibited from increasing their prices more than the general inflation rate. The Biden Plan will also impose a tax penalty on drug manufacturers that increase the costs of their brand, biotech, or abusively priced generic over the general inflation rate.

Allowing consumers to buy prescription drugs from other countries. To create more competition for U.S. drug corporations, the Biden Plan will allow consumers to import prescription drugs from other countries, as long as the U.S. Department of Health and Human Services has certified that those drugs are safe.

Terminating pharmaceutical corporations’ tax break for advertisement spending. Drug corporations spent an estimated $6 billion in 2016 alone on prescription drug advertisements to increase their sales, a more than four-fold increase from just $1.3 billion in 1997. The American Medical Association has even expressed “concerns among physicians about the negative impact of commercially driven promotions, and the role that marketing costs play in fueling escalating drug prices.” Currently, drug corporations may count spending on these ads as a deduction to reduce the amount of taxes they owe. But taxpayers should not have to foot the bill for these ads. As president, Biden will end this tax deduction for all prescription drug ads, as proposed by Senator Jeanne Shaheen.

Improving the supply of quality generics. Generics help reduce health care spending, but brand drug corporations have succeeded in preserving a number of strategies to help them delay the entrance of a generic into the market even after the patent has expired. The Biden Plan supports numerous proposals to accelerate the development of safe generics, such as Senator Patrick Leahy’s proposal to make sure generic manufacturers have access to a sample.

IV. ENSURE HEALTH CARE IS A RIGHT FOR ALL, NOT A PRIVILEGE FOR JUST A FEW
 
Joe Biden believes that every American – regardless of gender, race, income, sexual orientation, or zip code – should have access to affordable and quality health care. Yet racism, sexism, homophobia, transphobia, and other forms of discrimination permeate our health care system just as in every other part of society. As president, Biden will be a champion for improving access to health care and the health of all by:

Expanding access to contraception and protect the constitutional right to an abortion. The Affordable Care Act made historic progress by ensuring access to free preventive care, including contraception. The Biden Plan will build on that progress. Vice President Biden supports repealing the Hyde Amendment because health care is a right that should not be dependent on one’s zip code or income. And, the public option will cover contraception and a woman’s constitutional right to choose. In addition, the Biden Plan will:

1) Reverse the Trump Administration and states’ all-out assault on women’s right to choose. As president, Biden will work to codify Roe v. Wade, and his Justice Department will do everything in its power to stop the rash of state laws that so blatantly violate the constitutional right to an abortion, such as so-called TRAP laws, parental notification requirements, mandatory waiting periods, and ultrasound requirements.

2) Restore federal funding for Planned Parenthood. The Obama-Biden administration fought Republican attacks on funding for Planned Parenthood again and again. As president, Biden will reissue guidance specifying that states cannot refuse Medicaid funding for Planned Parenthood and other providers that refer for abortions or provide related information and reverse the Trump Administration’s rule preventing Planned Parenthood and certain other family planning programs from obtaining Title X funds.

3) Just as the Obama-Biden Administration did, President Biden will rescind the Mexico City Policy (also referred to as the global gag rule) that President Trump reinstated and expanded. This rule currently bars the U.S. federal government from supporting important global health efforts – including for malaria and HIV/AIDS – in developing countries simply because the organizations providing that aid also offer information on abortion services.

Reducing our unacceptably high maternal mortality rate, which especially impacts people of color. Compared to other developed nations, the U.S. has the highest rate of deaths related to pregnancy and childbirth, and we are the only country experiencing an increase in this death rate. This problem is especially prevalent among black women, who experience a death rate from complications related to pregnancy that is more than three times higher than the rate for non-Hispanic white women. California came up with a strategy that halved the state’s maternal death rate. As president, Biden will take this strategy nationwide.

Defending health care protections for all, regardless of gender, gender identity, or sexual orientation. Before the Affordable Care Act, insurance companies could increase premiums merely due to someone’s gender, sexual orientation, or gender identity. Further, insurance companies could increase premiums or deny coverage altogether due to someone’s HIV status. Yet, President Trump is trying to walk back this progress. For example, he has proposed to once again allow health care providers and insurance companies to discriminate based on a patient’s gender identity or abortion history. President Biden will defend the rights of all people – regardless of gender, sexual orientation, gender identity – to have access to quality, affordable health care free from discrimination.

Doubling America’s investment in community health centers. Community health centers  provide primary, prenatal, and other important care to underserved populations. The Biden Plan will double the federal investment in these centers, expanding access to high quality health care for the populations that need it most.

Achieving mental health parity and expanding access to mental health care. As Vice President, Biden was a champion for efforts to implement the federal mental health parity lawimprove access to mental health care, and eliminate the stigma around mental health. As President, he will redouble these efforts to ensure enforcement of mental health parity laws and expand funding for mental health services.

In the months ahead, Biden will put forward additional plans to tackle health challenges affecting specific communities, including access to health care in rural communities, gun violence, and opioid addiction.

SUPPORTING HEALTH, NOT REWARDING WEALTH

Joe Biden believes in rewarding work, not just wealth – and investing in hard-working Americans’ health, not protecting the most privileged Americans’ wealth. Warren Buffett said it best when he stated that he should not pay a lower tax rate than his secretary.
 
The Biden Plan will make health care a right by getting rid of capital gains tax loopholes for the super wealthy. Today, the very wealthy pay a tax rate of just 20% on long-term capital gains. According to the Joint Committee on Taxation, the capital gains and dividends exclusion is the second largest tax expenditure in the entire tax code: $127 billion in fiscal year 2019 alone. As President, Biden will roll back the Trump rate cut for the very wealthy and restore the 39.6% top rate he helped restore when he negotiated an end to the Bush tax cuts for the wealthy in 2012. Biden’s capital gains reform will close the loopholes that allow the super wealthy to avoid taxes on capital gains altogether. The Biden plan will assure those making over $1 million will pay the top rate on capital gains, doubling the capital gains tax rate on the super wealthy.

WATCH: Joe Biden talks more about the need to build on and protect ACA in THIS new video.

See also: Biden Gives Speech on Foreign Policy that Defines His Quest for Presidency

New Yorkers Rally to #StopTheBans and Preserve Reproductive Freedom

New York City Stop the Bans rally to preserve reproductive rights: “I Survived.” © Karen Rubin/news-photos-features.com

By Karen Rubin, News& Photo Features

As women rallied across the country in a national day of action against the rush of abortion bans, New York City said New York State would become a sanctuary and the city would seek to create a fund to help women who cannot afford to obtain abortion services.

Hundreds turned out in downtown Manhattan across from the US Court Building at a rally to #StopTheBans – the epidemic of increasingly draconian anti-abortion legislation designed to force the Supreme Court to render a new decision they believe will overturn the landmark 1973 Roe v. Wade which established that women have a constitutional right to terminate a pregnancy up until the time the fetus was viable outside the womb, 24 weeks. Many states not only put significant barriers that have forced clinics to close, chipping away at the “undue burden” provision that has endured subsequent Supreme Court scrutiny, leaving only one or two clinics in a state, but all but 15 states deny  Medicaid funding to cover abortions, while many private insurance companies also do not cover abortion services.

“A right without true access is merely a privilege,” said New York Abortion Access Fund’s Maddy Durante.

At the federal level, Republicans in Congress have tried multiple times to end funding to Planned Parenthood despite the Hyde Amendment’s prohibition of any federal funds to be spent on abortion services, is . Now, the Trump Administration is allowing private insurers to offer policies that do not cover maternity care, dismissing the rising rates of maternal mortality, especially among minorities and lower income women, as Trump reverses the gains in access to care made under Obamacare.

New York City Stop the Bans rally to preserve reproductive rights: “Maternal mortality is increasing.” © Karen Rubin/news-photos-features.com

But though New York State’s recently adopted Reproductive Health Act not only allows for abortions beyond 24 weeks of gestation in cases where the mother’s life is at risk or the fetus is not viable, and also expands the professionals authorized to conduct abortions to certain physicians assistants, nurses and midwives, if the Supreme Court adopts the concept of fetal personhood, as these new extreme laws propose, that could jeopardize the legality of abortions everywhere.

That is a reason that many of the speakers at the Tuesday Stop the Bans Day of Action rally in New York called for a renewed rise in a nationwide movement to protect reproductive freedom, and insisted, “We are not going back.”

Here are highlights from the rally:

New York City Stop the Bans rally to preserve reproductive rights: “Together We Fight For All” © Karen Rubin/news-photos-features.com

“From Alabama to Ohio, extremist politicians are trying to ban safe, legal abortions,” declared Leann Risk, associate director, community organizing for Planned Parenthood, NYC.  “Activists in all 50 states are engaged in a massive show of strength. We will not stand for the bans, not now, not ever, no way.”

Laura McQuade, Pres, CEO of Planned Parenthood NY: “We won’t stand for blatant injustice against our reproductive rights. ” © Karen Rubin/news-photos-features.com

Laura McQuade, President and CEO Of Planned Parenthood NYC, declared,  “We say to delusional politicians, stop the abortion bans. ..We are facing a sick attempt to strip us of fundamental humanity and autonomy. This is a coordinated attempt to drive care underground, to force a showdown in the Supreme Court…

“Fact: 73% of Americans do not want to overturn Roe; nearly one in four women in the United States will have an abortion in her lifetime.

New York City Stop the Bans rally to preserve reproductive rights: “We Will Not Go Back.” © Karen Rubin/news-photos-features.com

“These are not lawmakers, but lawbreakers, trying to dismantle rights we have had for nearly five decades. We won’t stand for blatant injustice against our reproductive rights. Abortion is the law of the land – legal today, will be legal tomorrow, as long as Planned Parenthood (which has existed over 103 years) and ACLU and so many others exist.”

NYC Comptroller Scott Stringer declared, “It’s time for NYC to become the first in the nation to directly fund abortion care – guarantee access to abortion regardless of the ability to pay.” He is advocating a New York City Abortion Access Fund.

Gloria Allred: “We will never allow abortion to be criminalized again.. No elected official has the right to make a choice for us. Resist. Insist. Persist. Elect Pro Choice candidates.”   © Karen Rubin/news-photos-features.com

Gloria Allred, the high-profile attorney, revealed her own terrifying experience, nearly bleeding to death when she was in her 20s because of a back alley abortion after being raped at gunpoint.

“As I lay hemorrhaging in a bathtub, [the abortionist] said, ‘It’s your problem now.’ Back then, the only time you would be admitted to a hospital is if you were bleeding to death. I was running 106 degree fever. I was put in a ward with others suffering after an illegal abortion” where the patients were shamed.

“The nurse told me, ‘This should teach you a lesson,’” Allred said. “It taught me a lesson all right: abortion should be safe, legal, affordable and accessible!

“We will never allow abortion to be criminalized again.. No elected official has the right to make a choice for us. Resist. Insist. Persist. Elect Pro Choice candidates.”

New York City’s First Lady Chirlane McCray: “The bans are about control. The people pushing the bans are chipping away at our rights…We cannot be silent.” © Karen Rubin/news-photos-features.com

New York City’s First Lady, Chirlane McCray, said, “The bans are about control. The people pushing the bans are chipping away at our rights…We cannot be silent. Women are more than half the population. We will tell [these politicians] ‘Women brought you into this world and women can take you out [pause] of office. We will march, organize, donate and vote.”

NYC Mayor Bill DiBlasio with wife Chirlane McCray: “We know women will die because of these laws. We know the American people will support freedom of women. The rights of women matter most.” © Karen Rubin/news-photos-features.com

She was soon joined by Mayor Bill DiBlasio who said, “New York respects women. We are not going back. This is a fight for our lives. We know women will die because of these laws. We know the American people will support freedom of women. The rights of women matter most.”

Eve Ensler, who wrote The Vagina Monologues: “Get your invasive, violent hands off our bodies. Our vaginas, uterus, minds are out of the bottle and we ain’t going fucking back.” © Karen Rubin/news-photos-features.com

Eve Ensler playwright, performer, feminist, and activist, best known for her play “The Vagina Monologues,” shared her own experience getting an abortion. “That abortion was the smartest thing I have done…. Tell that predator-in-chief and those misogynists, ‘Get your invasive, violent hands off our bodies. Our vaginas, uterus, minds are out of the bottle and we ain’t going fucking back. My body, my choice. Are you up for the fight?”

“We are here because we are outraged,” said Andrea Miller, president and CEO of the National Institute for Reproductive Health (NIRH). “These anti-abortion extremists tell women they can’t be trusted to make our own decisions. They don’t believe we should have the right to control our bodies, our families, our futures. That we are not able to choose our destiny. We say no. The decision whether, when, with whom to have children belongs to us, not politicians.

Andrea Miller, president and CEO of the National Institute for Reproductive Health: The decision whether, when, with whom to have children belongs to us, not politicians. .” © Karen Rubin/news-photos-features.com

“New York State passed the Reproductive Health Act. We knew what was coming, coming for our rights. We aren’t just seeing things go back. We are partnering with people moving forward. New York is not done if reproductive rights are not accessible, affordable.”

The NIRH is partnering with New York City on the first Abortion Action Campaign Fund – seeking $250,000 in the city’s budget to fund abortion care for those who cannot afford it. Call the City Council to show support.

“We know our health, our lives, our futures depends on stopping the bans. Make sure abortion is safe, legal, accessible, affordable.”

Manhattan Borough President Gale Brewer: “A frigging tough fight is ahead but we will never back down.” © Karen Rubin/news-photos-features.com

Manhattan Borough President Gale Brewer urged support for the city to pass the funding. “To say we’re livid is an understatement… [The impact of these fetal personhood bills means] that a woman who suffers a miscarriage could be in the middle of a criminal investigation. Before Roe, women died, now abortion is one of the safest medical procedures that can be performed.

“A frigging tough fight is ahead but we will never back down,” she declared, prompting chants of “Won’t go back. Won’t go back.”

Clara Williams, a Planned Parenthood patient, related how difficult, how complicated and how personal the decision to seek an abortion is. At the time of her abortion, she was very young, her partner had left her, she did not feel she could properly care for a child.

Clara Williams, a Planned Parenthood patient, “What kind of life is it if we aren’t the authority, don’t have the right, to control our own destiny.” © Karen Rubin/news-photos-features.com

“That is a decision no one can make for you, least of all a politician,” she said. “The rash of bans sweeping the nation, to force a showdown with the Supreme Court, make abortion inaccessible to communities of color, people of low income. Banning doesn’t end abortion, just marginalizes it.

“Abortion is nobody’s business. Whatever the reason, it is not undertaken flippantly. But what kind of life is it if we aren’t the authority, don’t have the right, to control our own destiny?”

“Abortion is necessary health care, and health care is a human right. Punishing those who provide health care, the doctors, is inhumane and cruel.”

Donna Lieberman of the New York Civil Liberties Union said, “We won’t let them turn the 21st century into Handmaid’s Tale…If they cared about life, they would be expanding health care, not making it a crime.” © Karen Rubin/news-photos-features.com

Donna Lieberman of the New York Civil Liberties Union said, “We won’t let them turn the 21st century into Handmaid’s Tale. It is ironic that those who would ban abortion claim to care about life, but Georgia has the highest maternal mortality rate in the country, Alabama has the highest infant mortality rate. If they cared about life, they would be expanding health care, not making it a crime.

“I am fortunate to live in New York. New York has stepped up to pass the Reproductive Health Act, which codifies Roe, protects New York from criminals led by the philanderer-in-chief and his sanctimonious minions. He may have stacked the court, but we won’t let them turn back the clock.”

The ACLU is mounting legal challenges in Georgia and Alabama.

“We will tell the philanderer in chief, ‘We’ll see you in court.’”

The vast majority – almost three out of four Americans – support a woman’s right to choose and preserving Roe, and they vote.

New York City Stop the Bans rally to preserve reproductive rights: “The Handmaid’s Tale is not an instruction manual.

“We know New York supports women’s right to control their own bodies. We rallied to make New York a sanctuary city against the Trump crusade against immigrants. We must also be a sanctuary for women. Thanks to the effort of the ACLU and others, abortion is legal in all 50 states and we have stopped the bans [from being enacted] so far. New York City, New York State must be a sanctuary..”

But even though New York State was one of the first to legislate reproductive rights, before the 1973 Roe v Wade decision, the laws were still surprisingly repressive, criminalizing abortion after 24 weeks.

Garin Marshall related his experience when he and his wife learned at 30 weeks that the fetus she was carrying, “a baby that was very much wanted”, was not viable. “We were denied care in New York State [because of the 24-week ban].” But they had the means to seek services elsewhere. Nonetheless, their experience helped change the law in New York, passing the Reproductive Health Act.

“Abortion was the right choice for our family. People are deserving of autonomy, dignity, respect,” Marshall said.

Garin Marshall helped pass the Reproductive Health Act in New York. “Men benefit from access to legal, safe, affordable abortion. Men created this problem. The house is on fire, but it is our house.” © Karen Rubin/news-photos-features.com

But, he argued, this is not just women’s issue. Men have much at stake as well, for the women in their lives they love, and their families.

“Men benefit from access to legal, safe, affordable abortion. Men created this problem, especially white men, who held on to power and used it. Good men who do nothing have allowed this situation…This is our problem, too. The house is on fire, but it is our house.

“Fight for access to abortion throughout pregnancy, with no person left behind.”

NYC Councilmember Helen Rosenthal: “We can’t let these men who have no idea what they’re talking about get away with this crap. I used to walk around with a necklace with a hangar. We won’t go back, but only if we become a movement. Abortion access saves lives.” © Karen Rubin/news-photos-features.com

Councilmember Helen Rosenthal, who has been fighting for abortion rights for 20 years, declared, “We can’t let these men who have no idea what they’re talking about get away with this crap.

#StopTheBans Rally, NYC
New York City Stop the Bans rally to preserve reproductive rights: “Never Again.” © Karen Rubin/news-photos-features.com

“I used to walk around with a necklace with a hangar. We won’t go back, but only if we become a movement. Abortion access saves lives.

Planned Parenthood of NY Chief Medical Officer Ila Dayananda, “This is an attack on all of us. Under these laws, the fact a doctor can receive jail time for providing service is horrific. One in four women will have an abortion in their lifetime. Health care is a fundamental human right.

Planned Parenthood of NY Chief Medical Officer Ila Dayananda: “There is no banning abortion, only banning safe, legal abortion…People deserve to be empowered to make their own decision. We won’t go back. Smash the patriarchy.” © Karen Rubin/news-photos-features.com

“There is no banning abortion, only banning safe, legal abortion. These bans particularly hurt women of color, low income. They should receive nothing less than compassion, expert health care, and to be able to make the decision for themselves. There are many complicated factors in this decision. People deserve to be empowered to make their own decision.

“We won’t go back. Smash the patriarchy.”

[Poster: Keep your filthy laws off my silky drawers]

New York Abortion Access Fund’s Maddy Durante urged financial support for those in New York seeking abortion.

“Abortion access is out of reach for many for a long time – both financial and legal access. If private insurance doesn’t cover an abortion, it is a potentially astronomical cost. Often, people can’t use insurance because of privacy and safety, because they fear partner violence.

Maddy Durante of New York Abortion Access Fund: “Care has been inaccessible for a long time. A right without true access is merely a privilege.” © Karen Rubin/news-photos-features.com

“Our clients are immigrants, people living in affordable housing, undergoing family separation, parents and caregivers, and increasingly, people traveling to New York. They may have Medicaid but many states don’t allow Medicaid coverage for abortions.”

She said her organization has already provided assistance to 590 people through grass roots fundraising.

“Care has been inaccessible for a long time. A right without true access is merely a privilege. Petition the City Council to fund Abortion NYC.”

[Poster: I wish my uterus shot bullets, so the government wouldn’t regulate it.]

Shaavronna Newsome, Director of Operations for Black Lives Matter, NYC: “People imposing bans are hiding behind Christianity, but this is really about declining birthrate, capitalism, patriarchy. I am grateful to be in New York where I can choose.” © Karen Rubin/news-photos-features.com

Director of Operations for Black Lives Matter, NYC, Shaavronna Newsome. “People imposing bans are hiding behind Christianity, but this is really about declining birthrate, capitalism, patriarchy. I am grateful to be in New York where I can choose.”

Celia Petty, a founding member of NYC for Abortion Rights, told how she has had three abortions in her life – the first when she was very young and had just broken up with her boyfriend. “This was the 1970s. I wasn’t capable of raising a child. I was afraid I would regret. But I was relieved that I could wait until ready.”

Celia Petty of New York for Abortion Rights: “We seek full reproductive justice, the right to bear children in a safe, healthy environment. We want a grass roots movement to demand reproductive freedom – the right to control our bodies and our lives.” © Karen Rubin/news-photos-features.com

Her second was when she found she was pregnant with a six month old baby (don’t believe you can’t get pregnant if you are nursing). “I was trying to work full time and still care for a new baby. I couldn’t manage.”

The third time was again, despite using birth control, when she got pregnant with a 10-month old baby in the house. “I had to work to make ends meet. An abortion saved my life,” she says as her young granddaughter, clings to her leg as she speaks at the podium.

“A lot of women have abortions out of more desperate situations.”

An active founding member of New York for Abortion Rights, she said, “We seek full reproductive justice, the right to bear children in a safe, healthy environment. We want a grass roots movement to demand reproductive freedom – the right to control our bodies and our lives.”

That prompts the chant:  “Without this basic right, women can’t be free. Abortion on demand, without apology.”

#StopTheBans Rally, NYC
#StopTheBans Rally, NYC
#StopTheBans Rally, NYC
#StopTheBans Rally, NYC
New York City Stop the Bans rally to preserve reproductive rights: “Trust Women.” © Karen Rubin/news-photos-features.com

The New Yorkers who rallied in front of the US Courthouse in downtown Manhattan, were among tens of thousands of people gathered at more than 500 events in all 50 states, DC, and Puerto Rico on the Stop the Bans Day of Action.

Add your name to ppaction.org

Speak out on social media, #StopTheBans

See also:

Protesters Take to the Streets Against Escalated War on Women

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© 2019 News & Photo Features Syndicate, a division of Workstyles, Inc. All rights reserved. For editorial feature and photo information, go towww.news-photos-features.com, email editor@news-photos-features.com. Blogging atwww.dailykos.com/blogs/NewsPhotosFeatures.  ‘Like’ us onfacebook.com/NewsPhotoFeatures, Tweet @KarenBRubin

Cuomo Calls on New York Lawmakers to Vote to Codify Roe v Wade Protections in Special Session

New York State Governor Andrew Cuomo with JoAnn Smith, CEO of Nassau County Planned Parenthood, Nassau County Executive Laura Curran, Nassau County District Attorney Madeline Singas and members of Planned Parenthood. © Karen Rubin/news-photos-features.com

By Karen Rubin, News & Photo Features

Governor Andrew M. Cuomo was joined today by Nassau County leaders at a rally in New Hyde Park to fight to protect women’s reproductive rights. State and local leaders called on the Senate to return to Albany to codify Roe v. Wade into New York State Law. The rally follows the federal government’s decision Monday night to nominate Brett Kavanaugh to the Supreme Court. The Governor vowed to take action to defend New York’s progressive values against the extreme conservative agenda of the Trump Administration, including the fight to codify the protections of Roe v. Wade into state law. New actions were also announced by the Governor on Monday to protect reproductive rights in anticipation of this Supreme Court Justice nomination.

“This federal government is threatening basic values New York and this entire nation were built upon, and while extreme conservatives in Washington make destructive decisions that violate the rights of our residents, New York is fighting to protect the progressive accomplishments that we have made,” Governor Cuomo said. “I call on every Senate Republican to come back and reconvene in Albany – no excuses. The Assembly will support codification of Roe v. Wade, I will sign the bill, the Senate Democrats will vote in favor of it and we will pass Roe v. Wade for New York.”

At a rally on Long Island, Governor Andrew Cuomo vowed to take action to defend New York’s progressive values against the extreme conservative agenda of the Trump Administration, including the fight to codify the protections of Roe v. Wade into state law. New actions were also announced by the Governor on Monday to protect reproductive rights in anticipation of this Supreme Court Justice nomination. © Karen Rubin/news-photos-features.com

Noting that elections have consequences, Cuomo laid out the challenge to return to Albany to codify Roe into state law as a line in the sand.

“When you’re talking to our friends the Republican Senators, remind them in 1970, before Roe v. Wade, which was 1973, this state legalized abortion. 1970. With a Republican Senate and a Republican Governor because we understood it wasn’t a partisan issue, it was a fairness issue. It was a health issue. It was an equality issue. It was a woman being able to control her own body issue. We did it in 1970, don’t tell me in 2018 the Republican Senate is going to go backwards from 1970. We have to call to question. Elections have consequences and this is binary. They’re with us, they’re against us. And if they don’t come back, if they don’t codify Roe v. Wade, you know what we’re going to say?

“In the immortal words of President Trump, to the senators who won’t come back and sign a bill, you’re fired. We’re protecting the women in the state of New York. Women’s rights come first. Let’s sign the state Executive Order.”

Lieutenant Governor Kathy Hochul who attended a similar rally to protective reproductive rights with Governor Cuomo in Yonkers earlier, said, “I lost my seat in Congress over my steadfast support of the Affordable Care Act and the contraception mandate, and I know how critically important it is to protect these rights at the state level. That is why I stand with the Governor and the women of this great state in fighting back to ensure protections and safety for women when it comes to their reproductive health. Given all that is happening in Washington, these actions will protect women’s reproductive rights. As President of the State Senate, I’m also calling on Senate Republican leadership to protect the women of this state and pass the Reproductive Health Act and codify Roe v. Wade. No one should tell us what to do with our bodies. Not now, not ever.”

For years, Governor Cuomo has pushed to codify the Supreme Court’s Roe v. Wade decision and subsequent rulings into state law to secure women’s access to reproductive health options, and noted that Republicans made a pretense of supporting women’s rights but blocked any consideration on the floor based on the federal protection under Roe. Now the Governor is calling their bluff and calling for the passage of legislation to protect the right of women to make personal health care decisions and ensure that health care professionals can provide these crucial services without fear of criminal penalty. The Assembly has passed legislation to codify the protections of Roe v. Wade for the last six years, including during the 2018 Legislative Session.

Additionally, through regulations by the Department of Financial Services and Department of Health, as directed by the Governor on Monday, New York State will ensure an insurer must cover over the counter emergency contraception in addition to all other contraceptive drugs, devices or other products for women approved by the Federal Food and Drug Administration and, as well as the dispensing of 12 months of contraceptive at one time, all without co-insurance, co-pays or deductibles. The Executive Order signed by the Governor on Monday, in addition to today’s rally, builds on Governor Cuomo’s 2018 Women’s Agenda: Equal Rights, Equal Opportunity.

The updated DFS regulation mandates that health insurers:

  • Expand coverage requirements for contraceptive drugs, devices or other products for women approved by the Federal Food and Drug Administration. Require coverage for emergency contraception with no cost sharing when acquired in any lawful manner including on an over the counter basis from an out of network pharmacy;
  • Permit a woman to fill 12 months of a prescribed contraceptive at one time, removing the previously required three-month trial period;
  • Cover voluntary sterilization procedures for women and over-the-counter contraceptives without cost-sharing; and
  • Do not place restrictions or delays on contraceptive coverage not otherwise authorized under the regulation.  This provision would prohibit quantity limits and other such restrictions.

The regulation codifies guidance issued in January 2017 regarding information that must be provided in formularies regarding contraceptives, including noting which contraceptives are covered without cost-sharing.  Insurers will be required to publish an easily accessible, up-to-date, accurate and complete list of all covered contraceptive drugs, devices and other products on their formulary drug lists, including any tiering structure and any restrictions on the manner in which a drug may be obtained.

The accompanying DOH regulations permit a woman insured through Medicaid to fill 12 months of a prescribed contraceptive at one time, whereas previously, the limit was three months.

A copy of the proposed regulations can be found here.

Governor Andrew Cuomo signs executive order to expand access to contraception, as 3-year old Emily Mollar, with her mother, Sue, of Merrick, look on, along with Nassau County Executive Laura Curran, Nassau County Planned Parenthood CEO JoAnn Smith, and other women’s rights advocates. © Karen Rubin/news-photos-features.com

“Women’s rights are under attack. Another Trump-appointed Justice will guarantee an ultra-conservative Court that is even more hostile to women’s health care protections. This will have dire consequences if we don’t act because New York decriminalized abortion before the Roe v. Wade decision,” Senate Minority Leader Andrea Stewart-Cousins said. “The women of New York State are looking to us to protect their hard-won rights, and we must not fail them.”

“The administration in Washington is preparing yet another assault on women’s reproductive rights with the nomination of an ultra-conservative Supreme Court justice. Earlier this year, and in countless previous legislative sessions, the New York State Assembly passed legislation to codify Roe v. Wade,” Assembly Speaker Carl Heastie said. “Year after year, our Republican colleagues in the Senate neglect to pass this legislation, insisting there is no threat to Roe v. Wade. Their inaction has shamefully put women’s reproductive health care in jeopardy. It’s time to codify Roe v. Wade. No more excuses.”

“The Trump Administration is committed to ensuring that millions of women across America lose essential access to the health care they absolutely require. We are facing an unprecedented attack on our health care, and rights by a federal government determined to replace evidence-based medically accurate public policy with politically driven ideology,” Robin Chappelle Golston, President & CEO, Planned Parenthood Empire State Acts, said. “Governor Cuomo is standing up today to remind the nation that New York won’t go backwards; we won’t sit back quietly as our rights evaporate and we will resist this dismantling of our constitutionally protected rights.”

“Armed with a Supreme Court vacancy, the Trump regime is poised to pack the court in an effort to undo Roe v. Wade and curtail abortion to an extent not seen since 1973. New York can no longer put off fixing our state’s broken abortion law,” New York Civil Liberties Union Executive Director Donna Lieberman said. “The Reproductive Health Act would take abortion out of the criminal code so that New York can be a safe-haven where women and their health are valued and protected. That means codifying Roe and ensuring access to the information and services women — including pregnant women — need to protect their health.”

Andrea Miller, President of the National Institute for Reproductive Health said, “Governor Cuomo’s executive order today proves that, regardless of what happens at the federal level, states have tremendous power to shape their own state laws and can act now to protect women from the full-blown assault on their reproductive health and rights. The best defense against a hostile Supreme Court and Trump-Pence Administration is a strong state-level offense. States around the country should take note of this action – and Governor Cuomo’s previous regulations – and help lead the movement for reproductive freedom from the ground up.”

Governor Andrew Cuomo stands with Planned Parenthood at rally in New Hyde Park, Long Island © Karen Rubin/news-photos-features.com

Cuomo Draws Line in the Sand for State Republican Lawmakers

Cuomo said that with the Trump administration dismantling rights – civil rights, voting rights, environmental and financial protections, a woman’s right to choose – it is up to the states to take action.

“Every day this federal government does something that is shocking to our senses…It’s shocking to us in New York because we are the exact opposite. We’re night and day from who they are and what they believe so we’re continually in a state of shock, but they are doing what they said they were going to do, and elections have consequences.

“And it is a wake-up call to all of us. My daughters, you know if you’re 21, 22, 23, young women you never even questioned your reproductive rights. You grew up in a generation where you just assumed, you know Roe v. Wade was 1973. 1973. Generations just grew up assuming this was the way it was. Couldn’t even imagine that a woman wouldn’t have the right to control her own body. That’s what they are saying. And they are serious. And it’s not just politics and this isn’t just a game. They are doing it. They’re doing what they said they would do

“They have their own view of what religions are right and what lifestyles are right and what sexuality is right and who should be an American and who shouldn’t be an American, and they are going to enforce that. It’s the greatest act of political hypocrisy, because conservatives used to stand for limited government, right? Less federal government. Leave it to the states, leave it to the individual rights.

“They are on track to overturn Roe v. Wade. That’s what they want to do. That’s what they’ve wanted to do since it was passed in 1973. And it is a shock to the system. How could we possible go back to those days? Who even remembers what it was like before, when a woman couldn’t have an abortion? How many lost their lives, were damaged because of what they had to do in that situation? And that is what we’re looking at. They are pro-life.

“They also have their view of sexuality and they don’t agree with the LGBTQ community and that’s why they treat them as second-class citizens. Wanted to keep transgender out of the military, regardless of service, regardless of merits. They believe who should be an immigrant and who shouldn’t be an immigrant. A little hypocritical since we’re all immigrants, but they now decide they’re going to close the door. The separation of family policy – isn’t that a coincidence? They knew exactly what they were doing. They wanted to stop people at the border. The first point was, build a wall. I am going to build a big wall, nobody can come. The President didn’t get a wall so he went to the “zero tolerance” policy. And now what he says to families is, if you show up, I’m going to take your children from you and send them to a place where you don’t even know where they are. He knew exactly what he was doing. It was a deterrent to stop people from coming when he couldn’t get the wall.

“They’re going to tell you which religion is right. They don’t believe that Muslims are an appropriate religion, and that’s the travel ban. They don’t believe with labor unions. Thank God for the teamsters. They don’t want labor unions. They just passed the Janus decision with the Supreme Court because they don’t want these annoying unions being able to organize employees, making it harder for management to negotiate with the workforce. It’s who they are and what they said they were going to do. And it is a frightening reality.

“We believe the opposite and it’s incumbent on us to act. To act. We’re not going to let them change our values. We’re not going to let them change or philosophy. We’re not going to let them change the way we treat one another. We’re not going to let them change our tolerance to intolerance. We’re not going to allow them to divide us. They’re not going to pick who has the right lifestyle and who has the right religion and who has the right sexuality and who has the right income level to deserve respect. We’re not going to let them do that.

Governor Andrew M. Cuomo was joined today by Nassau County leaders at a rally in New Hyde Park to fight to protect women’s reproductive rights: NH Councilwoman Lee Seeman, NC Legislator Ellen Birnbaum, North Hempstead Supervisor Judi Bosworth, Planned Parenthood NC CEO JoAnn Smith, Town Clerk Wayne Wink, NH Councilwoman Anna Kaplan, Nassau CountyExecutive Laura Curran. State and local leaders called on the Senate to return to Albany to codify Roe v. Wade into New York State Law. The rally follows the federal government’s decision Monday night to nominate Brett Kavanaugh to the Supreme Court © Karen Rubin/news-photos-features.com

“Federal government has rights, but you know what there was before the federal government? There were state governments and there were states’ rights. And states have the ability to stand up and act. And when they wouldn’t do anything in the face of the #MeToo movement, this state stood up and said, we’re going to pass the strongest anti-sexual harassment law in the United States of America. When they separated families at the border, this state stood up and said, that’s unconstitutional, it’s illegal, it violates due process, and we’re suing the federal government to put those families back together and to stop the separation.

“And we have to do the same thing on the issue of choice. They are going to overturn Roe v. Wade. We need a New York State law that codifies Roe v. Wade into the New York State law. And we need that law in place before they overturn Roe v. Wade in the Supreme Court. Now, we’ve been trying to get the New York State legislature, the Senate, to pass a New York State Roe v. Wade. That’s all the law would say. Take the federal ruling in Roe v. Wade—1973—and enact it into a state law.

“Currently, the New York State law is not as strong as Roe v. Wade because we had Roe v. Wade. And I’ve been arguing with the Republicans in the Senate, frankly, why don’t we codify it into New York state law? And the Republican Senators have been saying to me, well we have Roe v. Wade. We don’t need it. No one would be crazy enough to overturn Roe v. Wade. That’s the answer JoAnn has been getting for years when Planned Parenthood would lobby for New York State law. We don’t need it, we have Roe v. Wade. Well you know what? Now we need it. Now we need it.

“And I want the New York State Senators to come back today, tomorrow, to go to Albany, and pass and New York State Roe v. Wade, period. And no excuses. No excuses. For years they’ve been doing this dance, the Republican Senators. Privately they say, I’m pro-choice, I’m pro-choice. When the bill comes up, I’m going to vote pro-choice. [Planned Parenthood of Nassau County CEO]JoAnn [Smith] will tell you. But then, they never let the bill come up. We tried to force a vote this legislative session. They won’t put the bill on the floor. Why? It’s a little game they play. It allows them to say privately, when the bill comes up, I’ll vote yes. But, the bill never comes up, so they can tell one audience, yes, I’m pro-choice. Then they can go to another audience and say, we’ll never pass choice in the state of New York.

“We have to call to question. This is binary. This is black and white. You are either pro-choice or you are not pro-choice and we don’t have Roe v.Wade to fall back on anymore. It’s only what we have in New York State law. And the New York State law does not go as far as Roe v. Wade and if we have only the New York State law, we’re in trouble. It does not do life and health. It is in the criminal code. We will have a problem. We need that law. We have to call to question and we have to say to the Republican Senators who have been having it both ways for too long, that’s over. You are with us or against us. And if you are with us don’t just tell me. Go up to Albany and pass a bill. That’s how I know that you are with the women and the men of this state who support choice. That’s what it has to be.

“In the meantime, I’m going to sign an Executive Order that guarantees the women in this state the right to contraception. I don’t care what the insurance company says or what the bureaucracy says. Women have the right to contraception. But we have to learn the lesson, my friends. Elections have consequences. Elections have consequences. And this is a wakeup call. If what they did on immigration and unions and what they did to Muslims wasn’t enough, this is an attack on every woman’s rights to control her own reproductive health in the United States of America. This is a direct attack on what we knew in 1970.”

Nassau County leaders who joined the Governor today in calling on the State Senate to reconvene and codify Roe v. Wade into state law included:

  • Nassau County Executive Laura Curran
  • Nassau County District Attorney Madeline Singas
  • Nassau County Legislator Ellen Birnbaum
  • Town of North Hempstead Supervisor Judi Bosworth
  • Town of North Hempstead Councilwoman Anna Kaplan
  • Town of North Hempstead Councilwoman Lee Seeman
  • Town of North Hempstead Clerk Wayne Wink
  • Town of Hempstead Clerk Sylvia Cabana
  • JoAnn Smith, President and CEO, Planned Parenthood of Nassau County
  • Rebecca Sanin, President and CEO, Health and Welfare Council of Long Island
  • Matty Aracich, President, Nassau and Suffolk Building Trades Council

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© 2018 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

May Days: Trump’s Many Ironic Proclamations, From Law Day to Memorial Day, with Mothers Day in the Middle

May finishes with Memorial Day. Trump will no doubt issue a proclamation honoring those who have made the ultimate sacrifice to preserve American freedoms and values, while doing everything to undermine them © Karen Rubin/news-photos-features.com

 

By Karen Rubin, News & Photo Features

Normally rote proclamations take on a sardonic, sarcastic, ironic tone when signed by Donald J. Trump.

It may surprise people that May 1 (in many places called May Day) is proclaimed Law Day – particularly ironic as Trump, insisting he doesn’t have to answer to the investigation into possible Russian collusion with his campaign and obstruction of justice while in office, is nothing but undermining the Rule of Law and the concept that “No Man is Above the Law.” He has said as much, in such statements echoing Nixon’s “When the President does it, well, that means it’s not illegal”. Or in his echo of Louis XIV’s “L’etat s’est moi” – when he decried the “raid” on his lawyer Michael Cohen as an attack on the nation (what does he make of sending his goons to raid his Dr. Bornstein’s office without any kind of warrant and steal his medical records over his pique at being outed for using a hair-growth prescription? That press shill Sarah Huckabee Sanders said was “routine” when someone becomes president? Does anyone recall any other president raiding their doctor’s office to seize records? ).

Here’s what Trump signed (and clearly did not write and likely never read):

     On Law Day, we celebrate our Nation’s heritage of liberty, justice, and equality under the law.  This heritage is embodied most powerfully in our Constitution, the longest surviving document of its kind.  The Constitution established a unique structure of government that has ensured to our country the blessings of liberty through law for nearly 229 years.

     The Framers of our Constitution created a government with distinct and independent branches — the Legislative, the Executive, and the Judicial — because they recognized the risks of concentrating power in one authority.  As James Madison wrote, “the accumulation of all powers, legislative, executive, and judiciary, in the same hands . . . may justly be pronounced the very definition of tyranny.”  By separating the powers of government into three co-equal branches and giving each branch certain powers to check the others, the Constitution provides a framework in which the rule of law has flourished.

     The importance of the rule of law can be seen throughout our Nation’s history.

It is not really a coincidence that May 1 (May Day, a celebration of Workers rights around the world, including in the US of A where May Day began), is also designated as Loyalty Day – a McCarthy-era direct assault on Communism (but apparently, not on Russia, which is no longer communist but fascist and Trump’s best bud).

Loyalty Day, just like National Prayer Day, is actually a violation of what this nation holds dear. In America, we are not supposed to be required to pledge allegiance, certainly not to swear “under God”. No doubt, Trump signed the proclamation, thinking that Loyalty Day meant to swear loyalty to himself, the Dear Leader. I have no doubt he actually read the proclamation:

     On Loyalty Day, we reflect with humility and gratitude upon the freedoms we hold dear, and we reaffirm our allegiance to our Nation and its founding principles.  We cherish our system of self-government, whereby each American citizen is free to exercise their God-given and inalienable rights to life, liberty, and the pursuit of happiness.  We honor and defend our Constitution, which constrains the power of government and allows us freely to exercise these rights.  We also recognize the great responsibility that accompanies a free people and vow to preserve our hard-won liberty.  For we know, as President Ronald Reagan once said, that “freedom is never more than one generation away from extinction.”

     This Loyalty Day, we remember and honor the thousands of Americans who have laid down their lives to protect and defend our Nation’s beautiful flag.

May is also when this government has decided to hold the National Prayer Breakfast – another action (along with “In God We Trust” as a motto on money) to institutionalize the violation of the Constitution’s separation of church and state.

Instead, Trump went a step beyond what even George W. Bush did in setting up the Office of Faith Based Initiatives, to sign his own Faith-Based Initiative.

The nexus of Capitalism and Christian Zealotry came during the McCarthy era, when the notion of Christian charity was replaced by the Puritan concept that you got what you deserved, so rich people were rich because they deserved it; poor people were impoverished because they deserved it. Such zealotry was used to justify slavery as well as prohibiting abortion to rape victims.

Much of today’s malevolent political climate can be traced to the McCarthy era, including Trump’s own mentor, Roy Cohn, who was McCarthy’s own counsel, and taught Donnie everything he knows about attacking in order to evade legal or moral accountability.

And of course, May features Mothers Day… Trump’s proclamation for May 13, 2018 begins this way:

     Mother’s Day is a very special occasion and opportunity to express our endless gratitude to the women who give their unyielding love and devotion to their families, and their unending sacrifices to guide, protect, and nurture the success of their children.  Our country has long appreciated and benefited from the contributions women have made to empowering and inspiring not only those under their roofs, but those in our schools, communities, governments, and businesses…

     Today, and every day, let us express our utmost respect, admiration, and appreciation for our mothers who have given us the sacred gifts of life and unconditional love.  In all that they do, mothers influence their families, their communities, our Nation, and our world.  Whether we became their children through birth, adoption, or foster care, we know the unmatched power of the love, dedication, devotion, and wisdom of our mothers.

Certainly, Trump cherishes motherhood so much, he had an affair with Stormy Daniels, among others, while Melania was still nursing 4-month old Barron.

This is the man who directs his administration to terrorize undocumented mothers, that they will be forced to abandon their American-citizen children, who pulls away parents who are the major breadwinners for their families, who have lived in the United States for decades and are contributing to their communities.

The precious sentiment of his Mothers Day proclamation is belied by the cruelty the Trump Administration has shown to refugees claiming asylum, purposefully separating children, even infants, from their parents in order to discourage people fleeing violence from attempting to find refuge in the United States.

“There is no law enforcement or other legitimate basis for separating children from their parents at the border,” Congressman Adam Schiff tweeted. “It is simply cruel. Imagine the terror of a young child in a strange land, pried away from his or her parents. Whatever happened to compassion or family values?”

“Arresting and ripping apart parents and children is a new low in demagoguery. It’s another reminder of President Trump’s failure to craft a genuine set of border laws and his inhumane outlook,” the San Francisco Chronicle wrote.

“It’s a chilling but predictable new low for an administration that reacts blindly and harshly to any mention of immigrants. Families may be fleeing persecution, seeking a better life or trying to find relatives already in the U.S.”

It doesn’t stop there.  The Republicans, which just passed a tax scam that shifts $1.5 trillion in wealth from working people to the richest and adds that much to the national debt,so Trump is clawing back $7 billion in spending from the Children’s Health Insurance Program (CHIP), and  $252 million from a fund that earmarked to combat the Ebola outbreak.

Trump also is advocating for a Republican-pushed Farm Bill which cuts SNAP – the food stamp program that helps 40 million people, the majority who are children, seniors and disabled – by $20 billion,  literally taking food from babes’ mouths. Attaching new work requirements to qualify for the very benefits that are necessary because wages have not kept pace, despite record corporate profits and now $1.5 trillion in tax windfall for the richest.

He also sheds crocodile tears for how devastating the opioid crisis has been. But what has Trump actually done to address the opioid crisis? And for that matter, what has he or the Republican majority done to solve the life/death problem of access to affordable health care, instead, making impossible demands for the very people most desperate for health care to access Medicaid.

Indeed, he chose Mother’s Day to proclaim the start of National Women’s Health Week the guy who is doing everything possible to shut down Planned Parenthood, to sabotage access to affordable health care, who would make being a woman a “pre-existing condition”, who appears to care less that the US is facing a maternal mortality crisis, that up to 900 women die from pregnancy or childbirth complications each year with Black women are 3 to 4 times more likely to die than white women from those complications, not to mention that a woman who suffers a miscarriage may well be jailed for infanticide. (See: Virginia Woman Given a Jail Sentence for “Concealing a Dead Body” After Her Stillbirth)

Trump proclaims:

This is an opportunity to honor the importance of women across America and renew our pledge to support their health and well being.

One of the most LOL ironic among the May proclamations was the one Trump issued as a nod to his wife, Melania, who after  a year and a half as First Lady, finally declared her “agenda” branded as “Be Best” (which turns out to be copied from an Obama handbook on social media and bullying), declaring May 7,  “Be Best  Day”.

Trump’s remarks at this heralded event in which he followed up by signing a proclamation of “Be Best Day” did not speak at all to the essence of anti-bullying. No, not at all. It was all praise for Melania.

     America is truly blessed to have a First Lady who is so devoted to our country and to our children.

     On Be Best Day, we encourage and promote the well-being of children everywhere.  In an increasingly complex and inter‑connected world, nothing is more important than raising the next generation of Americans to be healthy, happy, productive, and morally responsible adults.  This begins with educating our children about the many critical issues they must confront in our modern world that affect their ability to lead balanced and fulfilled lives.

Our Nation’s children deserve certain knowledge that they are safe to grow, learn, and make mistakes.  Adults must provide them with the tools they need to make positive contributions in their schools, with their friends, and in their communities.

It will surprise people that May is also Jewish American Heritage Month, and here we can recall Trump’s varied and many dogwhistles to bigotry and hate and his tacit encouragement of White Supremacists.

      Jewish Americans have helped guide the moral character of our Nation… The contributions of the Jewish people to American society are innumerable, strengthening our Nation and making it more prosperous.

Lumping other minorities together in the same month’s celebrations, May is also Asian Americans and Pacific Islander Heritage Month, as a gratuitous nod to an appreciation of “diversity”:

       Americans of Asian and Pacific Islander descent have contributed immeasurably to our Nation’s development and diversity as a people.

It’s also Older Americans Month, as Trump declared:

      Our country and our communities are strong today because of the care and dedication of our elders.  Their unique perspectives and experiences have endowed us with valuable wisdom and guidance, and we commit to learning from them and ensuring their safety and comfort.

       My Administration is focused on the priorities of our Nation’s seniors. The Department of Justice, for example, is focused on protecting seniors from fraud and abuse.  My Administration is also committed to protecting the Social Security system so that seniors who have contributed to the system can receive benefits from it.  We are also dedicated to improving healthcare, including by increasing the quality of care our veterans receive through the Department of Veterans Affairs and by lowering prescription drug prices for millions of Americans.

Except that everything Trump’s administration has done goes against seniors, including rolling back the Consumer Financial Protection Board which helps seniors (and everyone else) address predatory tactics by financial industry, including Obama-era rules reining in PayDay lenders; has exploded the budget deficit in order to justify pulling billions out of Medicare and Social Security, is determined to narrow Medicaid, has sabotaged the Affordable Care Act resulting in higher premiums, and is risking the Veterans Administration’s ability to provide the specialized health care veterans require by its intent to privatize and put in charge Dr. Ronny with absolutely no experience whatsoever. And let’s examine again what this administration has not done to address opioid addiction or skyrocketing cost of prescription medication. What exactly has this administration done for seniors?

And now Republicans are taking $800 million out of Medicare and standing by as drug costs continue to skyrocket.

Of course, May finishes with Memorial Day, and Trump will no doubt pull out one of the proclamations that express such appreciation for those who have made the ultimate sacrifice to preserve America’s liberty and freedoms – 660,000 have died in all America’s wars since the Revolution (when 4,435 died), including 1,000 in the Indian Wars (1817-1898), 225,000 in the Civil War (140,414 for the Union, 74,524 Confederates); 53,402 in World War I, 291,557 in World War II, 33,739 in the Korean War, 47,434 in Vietnam and 6915 in the Global War on Terror (2001 to present).

Millions more have returned home, some with lifelong injuries both physical and mental. Trump’s answer to these Veterans isn’t the same as during Michelle Obama and Jill Biden’s Joining Forces campaign, or the efforts taken to improve access to health care and other services including a new GI Bill. Trump is moving forward with plans to privatize the Veterans Administration which is opposed by most veterans.

On the same day as Trump proclaimed “Military Spouse Day,” he adds to the list of military spouses deported, as well as veterans who had been promised citizenship in exchange for their military service.

      We ask so much of our military spouses:  frequent moves; heartbreaking separations; parenting alone; incomplete celebrations; and weeks, months, and sometimes years of waiting for a loved one’s safe return from harm’s way.  Time and time again, however, military spouses respond with resilience that defies explanation.  Our service members are often praised as national heroes, but their spouses are equally worthy of that distinction.

     My Administration is committed to taking care of our Armed Forces and ensuring that our military is equipped to defend our country and protect our way of life.  This mission also includes caring for the unique needs of military spouses, whose service to our Nation cannot be overstated.

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© 2018 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

Theater of the Absurd: Trump Proclaims National Women’s Health Week

Donald Trump proclaims “National Women’s Health Care Week” even as he does everything possible to shut Planned Parenthood, sabotage access to health care, cut food stamps by $20 billion, Medicare by $800 million, and does nothing to address the opioid crisis, spiraling cost of life-saving drugs or promote research to address the Alzheimer’s epidemic. © Karen Rubin/news-photos-features.com

How much more Theater of the Absurd can it get than Trump proclaiming National Women’s Health Week starting on Mother’s Day, the guy who is doing everything possible to shut down Planned Parenthood, to sabotage access to affordable health care, who would make being a woman a “pre-existing condition”, who would take away food stamps, access to Medicaid, who touts a tax cut of $1.5 trillion to the richest companies and Americans in order food stamps by $20 billion, to cut Medicare by $800 million, cut out access to contraceptives,  do nothing to address the spiraling cost of life saving drugs or research advancements in Alzheimer’s.

“For some time, we have been facing a maternal health crisis in this country that will have damaging effects on generations to come. If we truly appreciate and admire mothers, we must do better,” writes Adrienne Kimmell, Vice President of Communications and Strategic Research, NARAL Pro-Choice America.

Between 700 to 900 women die from pregnancy or childbirth complications each year in the U.S. and of that, Black women are 3 to 4 times more likely to die than white women from those complications

The U.S. is one of the most industrialized, medically-advanced nations in the world, yet has a rising maternal mortality rate. The horrifying mistreatment many mothers receive, Black mothers particularly, doesn’t align with our progress in this country, but still exists.

The stories are real. Women and mothers who didn’t have health insurance for prenatal care; who’ve suffered a postpartum hemorrhage with a devastating effect on future pregnancies; and even all-star tennis player, Serena Williams’ frightening near-death postpartum experience after a nurse refused to listen to her.

There are countless other stories and these troubling examples show the racial and economic disparities in maternal health that cost lives and hurt women.”

Trump’s “Presidential Message on National Women’s Health Week” is one lie compounded on another –  Karen Rubin, News & Photo Features

Presidential Message on National Women’s Health Week

This is an opportunity to honor the importance of women across America and renew our pledge to support their health and well being.”

Women are integral members of our families and communities who can face unique healthcare challenges.  Whether breast cancer, heart disease, or Alzheimer’s, my Administration is committed to continue addressing women’s health through advancements in medical research, rapid reviews and approvals of new safe and effective therapies, and affordable treatments and care options.

The ongoing opioid crisis is of particular concern for women.  On average, 115 Americans die each day from opioid-related overdoses—a factor that has contributed to the decrease in life expectancy over the past two years.  The crisis has hit women particularly hard in part because they are more likely to suffer from chronic pain conditions for which opioids are often prescribed.  Since 1999, the rate of deaths among women from prescription opioid overdoses have increased 461 percent.  Remarkably, more American women aged 15-35 lost their lives to accidental opioid overdose in 2016 than to all cancers combined.

These harrowing statistics underscore the urgent need to save American lives and why my Administration declared the opioid crisis a nation-wide public health emergency.  The Department of Health and Human Services (HHS) has developed a comprehensive strategy to combat the opioid epidemic and enhance non-addictive pain treatments by working with medical experts, policymakers, community groups, and families who have experienced the tragedy of opioid addiction.  Through these partnerships, the HHS Office of Women’s Health has awarded 20 grants to public and private organizations that are on the frontlines of the opioid crisis.

The Substance Abuse and Mental Health Services Administration has also published guidance for treating pregnant women and new mothers with opioid use disorder, a critical resource for the Nation’s hardworking medical professionals.  It is vital for the wellbeing of our Nation that we support those who are suffering from drug addiction as well as all expecting and postpartum mothers.  Similarly, the National Institutes of Health is engaging in research regarding interventions to help both the mothers and infants born to women with opioid use disorder.

My Administration is also committed to supporting our working families.  Through robust tax reform, we championed a doubled Child Tax Credit to ensure parents can adequately support their children.  We are also focused on expanding access to paid family leave benefits for new mothers and fathers.  The new reality is that in more than 60% of the homes of American married couples with children, both parents work.  Additionally, women are now the primary earners in more than 40% of all families.  Today, however, only 12% of private-sector workers have access to formal paid leave through their employers.  Recent research suggests that women’s labor force participation in the U.S. has stalled due to the lack of family-friendly policies, including paid leave.  There is a critical need to ensure that working mothers and fathers have access to paid family leave, which can support women’s participation in the labor force and promote greater financial stability for American families.  Additionally, and in part to have a long-term effect on women’s health, I recently signed an Executive Order to expand access to sports, fitness, and nutrition, with a specific focus on helping girls from economically challenged communities live active and healthy lifestyles.

During this week, we reaffirm our Nation’s commitment to women and girls across America, and we continue to encourage them to put their health first.  When women prosper, so do our families, our communities, and our entire Nation.