Tag 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: 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

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.

_____________________________

© 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.

Honor Mothers by Respecting Our Right to Self-Determination

To be the best mother she can be, a woman needs the ability to choose. © Karen Rubin/news-photos-features.com

By Karen Rubin, News & Photo Features

To be the best mother she can be, a woman needs the ability to choose.

A woman needs to have the dignity of making decisions, to have the same right to self-determination as a man, to be the master of her own destiny.

Unless the government is going to adopt all the children who are born who should have been aborted because of ailments or deformities which would lead to a life of suffering, and pay for their care, their schooling, their continued support and health care into adulthood, a faceless government should not be making those decisions for the people who would be required to provide that care, draining resources from the family’s other children and any opportunity for a woman to fulfill her own full potential.

A woman whose husband is abusive, a family that already has four children and can’t afford more, a mother who doesn’t have access to affordable day care and can’t work (and therefore would not be eligible for food stamps or housing vouchers under the Trump Administration’s new policies), should not be forced by the state to bear a child.

Iowa just passed a law banning abortion as soon as a fetal heartbeat can be detected – around six weeks – which is before many women would even realize they are pregnant, and certainly would not be aware of any grave abnormalities. Governor Kim Reynolds (R) invited a challenge to the Supreme Court, where anti-abortion activists are pretty confident the Trump Majority with Neil Gorsuch in the commandeered Supreme Court seat will overturn Roe v Wade altogether, despite each of the Justices’ promises during their respective Senate confirmation, to respect “settled law” like Roe.

Meanwhile, Trump and the Republicans continue to chip away at access to affordable health care – for women, for children. The Trump administration is considering new tactics to take funds away from Planned Parenthood, often the only access to health services a family might have, proposing to cut off Title X funding to any organization that refers patients for abortion. Waivers for states will allow them to effectively cut off health care based on new work requirements, lifetime limits and such. Trump is also “rescinding” $15.4 billion in spending that had already been approved by Congress, including $7 billion from CHIP (Children’s Health Insurance Program).

Consider the irony, then, of a Trump Administration pandering to the Religious Right, has moved to enable employers to deny women access to contraceptives, and attempted to prematurely cut off grants for programs that have already proved successful in bringing down the rate of teen pregnancy, replacing them with a return to useless abstinence education programs.

And this administration has shown zero interest in controlling for such birth-defect-inducing illnesses as Zika.

Texas now has maternal mortality rates on par with Third World countries. Yet, two bipartisan bills that would seek to solve America’s maternal mortality crisis have been stuck in committee for about a year. The bills, sponsored by Rep. Jaime Herrera Beutler (R-Wash.) in the House and Sen. Heidi Heitkamp (D-N.D.) in the Senate, would support state-level efforts to form review committees that specifically track and investigate pregnancy-related deaths, and then look for ways to prevent future deaths from occurring. Despite having no organized opposition from members of Congress or outside groups, the bill hasn’t had a hearing, moved out of committee or been scheduled for a vote. It has 107 co-sponsors in the House, including 23 Republicans.

My guess is the conclusion would have something to do with expanding and improving Obamacare, rather than sabotaging it (and what ever happened with that bipartisan committee?).

Instead, taking the anti-abortion crusade to an extreme, women are being prosecuted for miscarrying. A 2013 study by the National Advocates for Pregnant Women revealed a number of cases in which pregnant women were arrested and detained for complications during pregnancy, including miscarriage, with low-income and African American women most commonly targeted.

Utah is the first state to actually criminalize miscarriage, applying the legal standard of an “intentional, knowing or reckless act of the woman” as punishable as criminal homicide. This means that a woman who fails to wear a seatbelt and is in a car accident could be charged with reckless homicide if she miscarries. It also means that a woman who has a substance abuse problem would likely forego necessary prenatal care out of fear she could be prosecuted for “knowing” or “reckless” homicide by continuing to use illegal substances while pregnant.

I can’t wait to see Trump’s Mother’s Day proclamation. Will he remark how much he cherishes Melania’s motherhood so much that while she was still nursing 4-month old Barron, he had an affair with Stormy Daniels among others? Or will he take bows for terrorizing undocumented mothers with the prospect  they will be forced to abandon their American-citizen children, with continuing to terrorize DACA recipients over the prospect they will soon be deported, and threatening any mother fleeing with their children violence in Central America with having their children taken from them?

Indeed, Attorney General Jeff Sessions is actively trying to end asylum for domestic violence and sexual abuse survivors – which would be consistent with an Administration led by a sexual predator who enables other sexual abusers, and who wants to take America back to the “good ol’ days” when men had all the power, control and rights and women had none.

The tyranny over mothers is also through various institutionalized economic levers, including the fact that women still earn 77% of what men do for the same job (African-American women earn 64 cents and Latina women earn 56 cents for every dollar earned by a Caucasian man) – which carries forward in terms of pension, Social Security and other retirement savings.

The lack of access to affordable quality child care is also a significant burden that impacts a woman’s ability to achieve professionally. As Tammy Duckworth, the first US Senator to give birth while in office, noted, “Why should child care cost more than college tuition in most states? These are questions that simply should not exist in one of the most prosperous nations on the planet. And let’s not forget that this is an economic issue, as well. When we lose people in the workforce because of outlandish childcare costs or inadequate family leave policies, it negatively impacts the economy as a whole. And those Americans who drop out of the workforce have a hard time re-entering.”

In other words, women are not able to fulfill their full potential or productivity, are in less of a position to compete or challenge a man for a position or a male supervisor and are more dependent an unable to leave abusive relationship.

The last time women made inroads in the workplace – when there were screams for on-site child care, job-sharing, flex-time, work-at-home – was when there was such a demand for workers, employers were forced to draw women into their workplaces and retain them. It is not a coincidence that the “#MeToo” and “#TimesUp” movement coincides with another tight labor market.

“The Family and Medical Leave Act currently on the books was signed in 1993. The Internet had just gone public. Cell phones were still the size of bricks — and had just begun to text. Bill Clinton had just been inaugurated… The world was very different then. Our technology and our nation have come a long, long way. And yet our policies on paid family leave have gone nowhere,” Duckworth writes.

“America remains one of the only industrialized nations in the world with no set policy on paid family leave. It leaves working parents in a tough position. And I’m one of millions working to balance family and career.”

Though women are the main breadwinners or joint breadwinners, in two-thirds of the families in America, having a child is the single best predictor that a woman will end up in financial collapse; single mothers are more likely than any other group to file for bankruptcy and more likely than people living in poor neighborhoods; and single mothers who have been to college are 60 percent more likely to end up bankrupt than those with just a high school diploma.

Women make up two-thirds of minimum-wage workers, but Republicans in Congress have fought against raising the minimum wage or even thinking of requiring a living wage.

Yet the Republican-controlled Congress just gave the richest 1% of households in America a huge tax windfall of over $48,000 per millionaire, and slashed corporate tax rates virtually in half (even though many profitable companies paid zero or minimal tax), is now pushing to cut $20 billion in SNAP (Supplemental Nutrition Assistance Program), commonly known as food stamps, used by 40 million people, mainly children, seniors and people with disabilities. Walmart is getting a tax cut of $2.2 billion this year alone. Yet in just one state – Ohio, more than 11,000 of its employees and their family members qualify for SNAP because they earn so little. Walmart’s ten-year tax cut could pay for the entire $20 billion in SNAP cuts proposed in the farm bill.

Policies like these put mothers in a constant state of insecurity – over finances, health care, child care.

“The deck has been stacked against working women and moms for years. And with the Republicans in charge, it’s getting worse — a lot worse,” noted Senator Elizabeth Warren.

In Trump’s misogynistic, right-wing America, motherhood has come to mean a means of controlling, containing, disempowering women.

Here’s a radical idea for Mothers Day: Honor mothers by respecting their rights, beginning with the right to choose motherhood. Add to that the right to access affordable health care, child care, and equal pay.

_____________________________

© 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

New Yorkers Need to Demand State Legislators Support Cuomo’s Women’s Agenda

New York State Lt. Governor Kathy Hochul addresses the Council on Women and Girls Regional Forum at Long Island University: “The torch has now been passed to us. Our job is not just to pass it along, but to make sure it glows even brighter, so we look back 100 years from now, and can say, yes, we made a difference in lives in a profound way © Karen Rubin/news-photos-features.com

By Karen Rubin, News & Photo Features

New York State, the birthplace of women’s rights, is pushing for a second round of legislation to address persistent and institutional gender inequity. The state legislature needs to hear from advocates before the April 1 budget deadline.

It is laudable that these initiatives – in categories of Health, Safety, Workplace, Girls, and Family being forcefully advanced by Governor Cuomo – came after months of information gathering, listening tours, and the formation of regional Women’s Councils, coordinated by the governor’s Director of Women’s Affairs, Kelli Owens. Just having such a position is notable.

As Lieutenant Governor Kathy Hochul, a singular champion of women’s rights in New York State, said in her remarks that opened the Council on Women and Girls Regional Forum at Long Island University on March 1,The genesis for the Council of Women and Girls came because of Washington – on the day the president said ‘We don’t need to be concerned’ and abolished the [Obama-era] Commission on Women and Girls, our governor, as in so many cases [climate action, environmental protection, gun control], stepped up to fill void created by Washington.”

Trump has moved aggressively to roll back gains women have made: restoring being a woman as a “pre-condition” for medical insurance, overturning the mandate that insurance companies provide contraception without co-pays, attacking Title X funding for health clinics including Planned Parenthood, advocating for legislation to curtail access to abortion.

Unless Congress takes action, the Violence Against Women Act will run out of funding in September. This landmark piece of legislation is a life-saver. Since its original passage, domestic violence cases are down by more than 65% nationally. If Congress’ “action” on reauthorizing CHIP is an indication, the Republican-controlled Congress will likely let this lapse as well, even as they cut billions of dollars for programs that directly affect women and families.

New York State – which Cuomo never fails to point out has been a progressive leader for the nation, a status he has worked to reclaim – has made some important gains during his administration, including aggressively pushing for economic development opportunities for Minority & Women-owned Enterprises, for wider access to pre-K programs, gun control, access to health care and guarantee for women’s reproductive rights.

In this second round of legislation and policies – notably several of which need to be adopted by the State Legislature before the April 1 deadline for adopting the budget – he is going after sexual harassment, pay equity, domestic violence, expanding access to child care, educational opportunities, job training and business investment.

New York has been celebrating the centennial of Women’s Suffrage since 1917, the year the state on its own gave women the right to vote, three years before the nation adopted the 19th Amendment.

But despite New York’s progressive policies, New York women still earn less than men for the same work: white women 89c, African American 66c, Hispanic women 54 c in New York, “and we’re the good state, where people are better off. Does that not tell you we have a long way to go?” Hochul said.

“We are convening forums around the state, to drill down why this is happening – part is institutional, cultural, part is that women don’t have childcare but want to continue on a career track, have talent, brilliance, but are primarily responsible for making sure kids are okay and there is not enough child care.” Also parental leave, not just for a newborn or adoption, but when a child or parent gets sick.

“You should be proud your state recognizes this challenge – we now have the most generous paid family leave policy – to relieve the stress of possibly losing a job when you are home with a new baby.”

“It’s about economic empowerment: getting more girls into STEM education and careers. It’s about safety and security – domestic violence” – something that has been crystallized in the Trump White House, notably with the tolerance of a credibly accused wife-beater as Trump’s secretary.

Budget initiatives (see details at https://www.ny.gov/2018-womens-opportunity-agenda-new-york/womens-opportunity-agenda-proposals) include:

Health initiatives: passing Comprehensive Contraceptive Coverage Act codifying access to contraception; codifying Roe v. Wade into state law and constitution to insure health care professionals can provide these crucial services without fear of criminal penalty; mandating insurance coverage and insuring access to IVF and fertility services; combat maternal depression and establish a maternal mortality review board (NY ranks 30th in maternal mortality); add experts in women’s health and health disparities to the State Board of Medicine.

Safety: pass the Equal Rights Amendment to add sex as a protected class; remove firearms from domestic abusers; combat sextortion and revenge porn; extend storage timeline for forensic rape kits at hospitals (from 30 days to at least five years, or when the victim turns 19); advance legislation to amend the Human Rights Law to protect all public school students from discrimination.

Workplace: combat sexual harassment in the workplace; call on NYS Common Retirement Fund to invest in companies with women and minority leadership; reauthorize the State’s Minority and Women-owned Business Enterprise Program; close the gender wage gap; support women returning to or advancing in the workforce with job training and placement services; invest $20 million in Women-Owned Businesses;  encourage more use of flexible work schedules.

Girls: expand access to computer science and engineering (STEM); launch “If You Can See It You Can Be It,” a day for girls to see what is possible; create K-12 learning module on healthy relationships; legislation requiring school districts to provide free menstrual products, in restrooms, for girls in grades 6 through 12.

Family: invest $25 million to expand pre-K and after-school programs; increase state funding by $7 million  to provide working families with affordable child care; continue enhanced Child Care Tax Credit for working families; establish a new Child Care Availability Task Force.

“All these areas converge,” Colleen Merlo, Executive Director, Long Island Against Domestic Violence, said. “Gender equality cannot be achieved unless we address all these buckets….We see that women lose time at work because of domestic violence, so if we don’t create safety at home, they are losing time at work, so are not advancing, not getting equal pay or promotion – all are interconnected with safety.”

It’s also about making it easier to vote, adding early voting (which NYS doesn’t yet have), so women who work and care for children aren’t shut out of casting a ballot – part of Cuomo’s “Democracy Agenda.”

“The torch has now been passed to us,” Hochul stated. “Our job is not just to pass it along, but to make sure it glows even brighter, so we look back 100 years from now, and can say, yes, we made a difference in lives in a profound way, that we spoke up for people without voices.”

What to do? First: contact state representatives to urge them to vote on the budget and legislation bolstering the Women’s Agenda. Planned Parenthood of Nassau County, among others, is mounting a lobbying day in Albany on March 13, to join Cecile Richards, President of the Planned Parenthood Action Fund, and more than 1,000 activists from across New York State, to advocate for pro-reproductive health legislation.

Call and write representatives, yes. March, yes, Protest, yes. Spread the word with social media, yes. Vote, absolutely.

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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

Trump, Republicans’ Dickens Vision of America: Where Money is Entitlement, ‘Please Sir, I’d Like Some More’

Long Islanders protesting for the 99% against foreclosures by banks too big to fail, bailed out by taxpayers. The Republican tax scam, combined with Trump deregulation and obliteration of the Consumer Financial Protection Bureau, sets up an even greater Recession and foreclosures. Seniors on Long Island, facing the inability to deduct state and local taxes and the likelihood of Republican cuts to Social Security and Medicare, will be forced out of their homes. © Karen Rubin/news-photos-features.com

by Karen Rubin, News & Photo Features

This is supposedly the season of “giving,” of “good will to all mankind.” Not with Donald Trump in the White House.

Trump is so giddy to take credit for displacing “Happy Holidays” with “Merry Christmas.” That’s all he cares about. But just as Trump, who makes money off of hotels but has no concept of “hospitality” and is more like the craven Snidely Whiplash than Barron Hilton, he has no clue and no care what “Christmas” means.

Indeed, this Christmas, 9 million children and pregnant women are losing access to health care and the ability to live a good life or realize their full potential. 13 million Americans don’t know if they will be able to afford or access health care.  800,000 Dreamers don’t know whether they will be thrown out of jobs, housing, and the nation, exiled to a country that is completely foreign to them. Seniors and retirees don’t know if they will be able to continue to afford living in their homes and whether their Medicare and Social Security benefits will be cut.

The Tax Scam rammed through by Republicans is just the beginning: they are giddy about how adding $1.5 trillion to the national debt, the same amount (coincidentally) that it redistributes from working people to the already obscenely rich and richest corporations sitting on $2 trillion in cash they refuse to use to raise wages will “justify” slashing the social safety net, cutting Medicare, Social Security, Medicaid – you know the so-called “entitlements” that working people have paid into their entire working lives.

Trump made it clear, in his ignorant, short-hand way, what will come next, in his speech in St. Louis:

“Then we will have done tax cuts, the biggest in history…I know people, they work three jobs and they live next to somebody who doesn’t work at all. And the person who’s not working at all and has no intention of working at all is making more money and doing better than the person that’s working his and her ass off. And it’s not going to happen. Not going to happen. (Applause.) So we’re going to go into welfare reform.”

You only have to look at what is happening in every quarter of civic life which is shifting the balance to the wealthiest while cutting off upward mobility for anyone else. The Trump FCC’s plan to overturn net neutrality is exactly that: it cements the control that the internet oligopoly wields not only to keep out upstart competitors but control what information or culture gets wide viewing. What Pai wants is for money to rule both content and access (that’s what “free market” means). Don’t have money to keep an internet subscription so you can access news, information or jobs? Tough luck. But the FCC intends to couple this with more government surveillance of what goes up over the Internet – quite literally the worst of both worlds.

It is apparent also in how Trump is pawning off national monuments to commercial exploitation – Bears Ears, Grand Staircase-Escalante, the Arctic Refuge and the Atlantic Marine Sanctuary – basically stealing what is our collective heritage and birthright to give to commercial interests. Interior Secretary Ryan Zinke, who has no compunction to waste taxpayer money for his own use, is even raising admission fees to the national parks, further putting what is owned by all Americans off limits for those who can’t pay the freight.

Money is the new “entitlement.” It determines who can afford to weigh the scales of justice in their favor, and, thanks to Citizens United, who runs for election and wins, and therefore what policy gets written and enacted, and even who has access to the voting booth. Billionaire venture capitalist Tom Perkins actually said that out loud: “But what I really think is, it should be like a corporation. You pay a million dollars in taxes, you get a million votes. How’s that?” Indeed.

This mentality is actually seeping down even into the disasters that have become all too common and catastrophic because of climate change: Freakonomics did a segment that a free market rather than anti-gouging laws should come into play after a disaster. A shopkeeper should be able to sell a bottle of water for $1000 to the father with a child dying of thirst if he wants to, because at $2 a bottle, someone will hoard. (The absurdity is that purchases are rationed for the rich and the poor.)

Another segment suggested that people should be able to pay their way (a premium) to jump a line – that’s okay for a themepark, but they are suggesting the same for access to life-saving organ donation.

Trump is the first president to dare do what the Republicans have been salivating over since the New Deal but dared not do. It’s not that the Republicans haven’t had their sights set on reversing every progressive policy since the 1860s. (Alabama Senate candidate, the defrocked judge Roy Moore, said that every Amendment after the 10th, the state’s rights one, should be abolished, including the 13th amendment ending slavery, 14th amendment giving due process, the 19th amendment giving women the right to vote. Meanwhile, the Republicans are about to cancel the 10th amendment’s State’s Rights provision in order to require New York State to accept Conceal Carry Reciprocity and overturn its own gun safety laws.)

You actually have Senator Chuck Grassley defending abolishing the estate tax which affects only a tiny fraction of the wealthiest families and was intended since the founding to prevent an institutionalized aristocracy, argue that the previous tax code favors poor and working-class Americans who were “just spending every darn penny they have, whether it’s on booze or women or movies.”

Utah’s Orrin Hatch, justifying shifting $1.5 trillion in tax breaks to the wealthy and corporations and slashing the social safety net, declared, “I have a rough time wanting to spend billions and billions and trillions of dollars to help people who won’t help themselves, won’t lift a finger, and expect the federal government to do everything.”

Merry Christmas? Bah humbug.

“And so how do we as Christians respond, who serve a God whose prophets call for welcoming immigrants (Deuteronomy, Leviticus), caring for the orphans and widows (Jeremiah, Ezekiel), establishing fair housing (Isaiah), seeking justice (Micah 6), and providing health care (Isaiah),” a twitter conversation between MSNBC’s Joy Reid and Susan Gilbert Zencka wrote.

“What you’re witnessing tonight in the United States Senate is the weaponization of pure, unmitigated greed,” Joy Reid wrote after the Senate’s adoption of its tax plan. “Lobbyists are writing the bill in pen at the last minute. And Republicans are no longer even pretending to care about anyone but the super rich,“ wrote Joy Reid.

The America that Trump and the Republicans envision is not one of an American Dream where anyone who has the ability and works hard enough can rise up, but one in which communities must beg billionaires for funding for a public school, a library, a hospital, and be very grateful for their charity.

Tell me how this is not a modern, nonfiction version of Dickens’ “Oliver Twist.”

“Please sir, I’d like some more.”

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

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

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

 

By Karen Rubin, News & Photo Features

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

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

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

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

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

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

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

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

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

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

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

Trump Declaring Women’s Health Week States ‘Ensuring Affordable, Accessible, Quality Healthcare is Critical to Improving Women’s Health’

Mother’s Day apparently begins Women’s Health Week, Donald Trump has proclaimed. But the Republican healthcare plan, TrumpCare, would make being a woman a pre-existing condition, make pre-natal and maternity costly add-ons, take Medicaid away from millions of women and children, and shut down access to Planned Parenthood clinics © Karen Rubin/news-photos-features.com

Who knew that Mother’s Day kicks off Women’s Health Week? In honor of the occasion, Donald Trump issued a statement that, like so many in TrumpWorld – like Orwell’s 1984 – bears little connection to reality:

Statement from President Donald J. Trump on Women’s Health Week

As we celebrate Women’s Health Week, beginning with Mother’s Day, we recognize the importance of providing women access to the best, evidence-based health information and care, and growing our medical knowledge through basic and applied research support.

Today, women are living longer, healthier lives than their mothers.  The number of women dying from heart disease and cancer – the top two killers of women in America – has been decreasing for decades.  Thanks to new breast cancer treatments, our health care professionals have saved lives and improved the quality of life for millions of women.  We must continue to foster an environment that rewards these needed advances in research.

Ensuring affordable, accessible, and quality healthcare is critical to improving women’s health and ensuring that it fits their priorities at any stage of life.  In particular, women should have access to quality prenatal, maternal, and newborn care.  Under the current healthcare system, however, the lack of choice in health insurance and in healthcare providers, along with skyrocketing premium and out-of-pocket costs, are failing our citizens, our families, and, in particular, our women.  Studies show that women are often the primary healthcare decision-maker for their family and they deserve better options.

I am committed to working with Congress to help mothers—and fathers—have paid family leave so that childcare is accessible and affordable, and to invest in the comprehensive care that women receive at community health centers.  Through these reforms, and my 2018 Presidential Budget, we will enable access to the critical healthcare services women need.