Today, on the 10th anniversary of President Obama signing the Affordable Care Act into law and expanding access to quality, affordable health care for millions of Americans, Vice President Joe Biden sent a letter to President Trump, State Attorneys General, and Mississippi Governor Tate Reeves calling on them the drop the lawsuit against the landmark legislation, which would strip millions of their health insurance and gut protections for those with pre-existing conditions—during a global pandemic. Below is the text of Vice President Biden’s letter:
March 23, 2020
Dear President Trump, State Attorneys General, and Governor
Reeves,
All across this nation, Americans are anxious and afraid about the impact the
deadly COVID-19 pandemic is already having on their lives, their families, and
their ability to pay their bills. Individuals and families are stepping up to
do their part––staying home, taking individual precautions and implementing
social distancing, and making donations to support food banks and other vital
service providers, all to protect those most at-risk from the virus in our
communities. Their level of dedication should be matched by their elected
leaders.
At a time of national emergency, which is laying bare the existing
vulnerabilities in our public health infrastructure, it is unconscionable that
you are continuing to pursue a lawsuit designed to strip millions of Americans
of their health insurance and protections under the Affordable Care Act (ACA),
including the ban on insurers denying coverage or raising premiums due to
pre-existing conditions. No American should have the added worry right now that
you are in court trying to take away their health care. You are letting partisan rancor and politics
threaten the lives of your constituents, and that is a dereliction of
your sworn duty. I am therefore
calling on each of you to drop your support of litigation to repeal the ACA.
This Monday, March 23, marks 10 years since President Obama signed into law the
ACA. It was—and still is—a big deal for our country, because having
health insurance isn’t just about being able to access health care when you
need it, it’s about the peace of mind that comes from knowing that if your kid
gets sick, you will be able to get them the care they need, or that if you have
an accident, you won’t have to also worry about how to pay your medical bills.
During a public health crisis, it’s part of the assurance that you can seek the
treatment you and your loved ones need. I was proud to stand with President
Obama every day of our Administration, but no day more so than when he signed
the ACA, because of the real security it delivered for every day American
families.
Since 2010, 20 million Americans have gained access to health insurance
coverage. But the ACA also helps tens of millions more Americans across the
country. It is the reason 100 million people with pre-existing
conditions—including conditions like asthma and diabetes that make them at
higher-risk for adverse health impacts from the—don’t have to worry about being
charged more or denied coverage. It is the reason insurance companies can’t
tell patients that they’ve hit an annual or lifetime cap on care.
The litigation you are supporting—Texas
v. U.S.—jeopardizes every single one of those protections and
threatens the peace of mind and access to care for hundreds of millions of
Americans. There is no underlying constitutional flaw with the Affordable Care
Act. In fact, the Supreme Court twice upheld the constitutionality of the law.
The only reason this new case gained traction was because Congressional
Republicans decided to amend the law and zero-out the penalty for not being
insured, and legal experts from across the ideological spectrum have concluded
that this new argument—that this change invalidates the entire law—is legally
unsupportable.
The purpose of your suit is to destroy the ACA. Make no mistake: If the ACA did
not exist right now, in this public health crisis, tens of millions of people
would not have health insurance. 100 million would not have protections for the
kind of underlying conditions that make them even more vulnerable to the impact
of COVID-19. Insurance companies would be allowed to place caps on care
provided to individuals. And if you succeed in killing it next year, you’ll put
countless Americans at risk in the next pandemic.
If there was ever a moment to set aside politics, it is now. I have called for
making all testing, treatment, and any eventual vaccine free of charge,
regardless of whether an individual is insured. That is what is needed to
defeat this virus. The last thing we need right now is people avoiding seeking
care because they can’t afford it. But people will still have medical needs not
directly related to COVID-19, which is why every American needs access to
high-quality, affordable health insurance and the pre-existing condition
protections that the law guarantees.
You have in your power the ability to make life safer, healthier, and a little
bit easier for your constituents. All you have to do is drop your support for
this ill-conceived lawsuit, which is even more dangerous and cruel in this
moment of national crisis. History will judge all of us by how we respond to
this pandemic. The public health imperative we now face is bigger than
politics, and it requires all of us to summon the courage to lead and to do
what is right for the American people.
Joseph R.
Biden, Jr.
47th Vice President of the United States
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.
Vice
President Joe Biden, in the race for the Democratic nomination for President,
has staked out a position on improving on the Affordable Care Act (Obamacare)
as his solution to providing universal healthcare – essentially, enabling people keep their
private insurance but creating a new public option. That is more moderate than
the Democrats like Bernie Sanders and Elizabeth Warren who want a more extreme
Medicare for All that replaces private insurance (though it is unlikely that
there will not still be a market for supplemental private insurance, just as
there is now for Medicare). Here, is the Biden campaign’s description and
rationale for Biden’s plan to protect and build upon the Affordable Care Act: – Karen Rubin, News&
Photo Features
On March 23, 2010, President Obama signed the
Affordable Care Act into law, with Vice President Biden standing by his side,
and made history. It was a victory 100 years in the making. It was the
conclusion of a tough fight that required taking on Republicans, special
interests, and the status quo to do what’s right. But the Obama-Biden
Administration got it done.
But, every day over the past nine years, the Affordable Care Act has been under
relentless attack.
Immediately after its passage, Congressional Republicans began trying again and
again to repeal it. Following the lead of President
Trump, Republicans in Congress have only doubled down on this
approach since January 2017. And, since repeal through Congress has not been
working, President Trump has been unilaterally doing everything he can to
sabotage the Affordable Care Act. Now, the Trump Administration is trying to
get the entire law – including protections for people with pre-existing
conditions – struck down in court.
As president, Biden will protect the Affordable Care Act from
these continued attacks. He opposes every effort to get rid of this historic
law – including efforts by Republicans, and efforts by Democrats. Instead of
starting from scratch and getting rid of private insurance, he has a plan
to build on the Affordable Care Act by giving Americans more choice, reducing
health care costs, and making our health care system less complex
to navigate.
For Biden, this is personal. He believes that every American has a right to the
peace of mind that comes with knowing they have access to affordable, quality
health care. He knows that no one in this country should have to lay in bed at
night staring at the ceiling wondering, “what will I do if she gets breast cancer?”
or “if he has a heart attack?” “Will I go bankrupt?” He knows there is no peace
of mind if you cannot afford to care for a sick child or a family member
because of a pre-existing condition, because you’ve reached a point where your
health insurer says “no more,” or because you have to make a decision between
putting food on the table and going to the doctor or filling a prescription.
In the coming months, Joe Biden will build on today’s plan by rolling out his
proposals to tackle some of our greatest public health challenges – from
reducing gun violence to curing devastating diseases as we know them like
cancer, Alzheimer’s, diabetes, and addiction.
I. GIVE EVERY AMERICAN ACCESS TO AFFORDABLE HEALTH INSURANCE
From the time right before the Affordable Care Act’s key coverage-related
policies went into effect to the last full year of the Obama-Biden
Administration, 2016, the number of Americans lacking health insurance fell
from 44 million to 27 million –
an almost 40% drop. But President Trump’s persistent efforts to sabotage
Obamacare through executive action, after failing in his efforts to repeal it
through Congress, have started to reverse this progress. Since 2016, the number
of uninsured Americans has increased by
roughly 1.4 million.
As president, Biden will stop this reversal of the progress made by Obamacare.
And he won’t stop there. He’ll also build on the Affordable Care Act with a
plan to insure more than an estimated 97% of Americans. Here’s how:
Giving Americans a new choice, a public
health insurance option like Medicare. If your insurance
company isn’t doing right by you, you should have another, better choice.
Whether you’re covered through your employer, buying your insurance on your
own, or going without coverage altogether, the Biden Plan will give you the
choice to purchase a public health insurance option like Medicare. As in
Medicare, the Biden public option will reduce costs for patients by negotiating
lower prices from hospitals and other health care providers. It also will better coordinate among
all of a patient’s doctors to improve the efficacy and quality of their care,
and cover primary care without any co-payments. And it will bring relief to
small businesses struggling to afford coverage for their employees.
Increasing the value of tax credits to
lower premiums and extend coverage to more working Americans. Today,
families that make between 100% and 400% of the
federal poverty level may receive a tax credit to reduce how
much they have to pay for health insurance on the individual marketplace. The
dollar amount of the financial assistance is calculated to ensure each family
does not have to pay more than a certain percentage of their
income on a silver (medium generosity) plan. But, these shares of
income are too high and silver plans’ deductibles are too high. Additionally,
many families making more than 400% of the federal poverty level (about $50,000 for a single person
and $100,000 for a family of four), and thus not qualifying for
financial assistance, still struggle to afford health insurance. The Biden Plan
will help middle class families by eliminating the 400% income cap on tax
credit eligibility and lowering the limit on the cost of coverage from 9.86% of
income to 8.5%. This means that no family buying insurance on the individual
marketplace, regardless of income, will have to spend more than 8.5% of their
income on health insurance. Additionally, the Biden Plan will increase the size
of tax credits by calculating them based on the
cost of a more generous gold plan, rather than a silver plan. This
will give more families the ability to afford more generous coverage, with
lower deductibles and out-of-pocket costs.
Expanding coverage to low-income
Americans. Access to affordable health insurance
shouldn’t depend on your state’s politics. But today, state politics is getting
in the way of coverage for millions of low-income Americans. Governors and
state legislatures in 14 states have
refused to take up the Affordable Care Act’s expansion of Medicaid eligibility,
denying access to Medicaid for an estimated 4.9 million adults.
Biden’s plan will ensure these individuals get covered by offering premium-free
access to the public option for those 4.9 million individuals who would be
eligible for Medicaid but for their state’s inaction, and making sure their
public option covers the full scope of Medicaid benefits. States that have
already expanded Medicaid will have the choice of moving the expansion
population to the premium-free public option as long as the states continue to
pay their current share of the cost of covering those individuals.
Additionally, Biden will ensure people making below 138% of the federal poverty
level get covered. He’ll do this by automatically enrolling these individuals
when they interact with certain institutions (such as public schools) or other
programs for low-income populations (such as SNAP).
II. PROVIDE THE PEACE OF MIND OF
AFFORDABLE, QUALITY HEALTH CARE AND A LESS COMPLEX HEALTH CARE SYSTEM
Today, even for people with health insurance, our health care system is too
expensive and too hard to navigate. The Biden Plan will not only provide
coverage for uninsured Americans, it will also make health care more affordable
and less complex for all.
The plan’s elements described above will help reduce the cost of health
insurance and health care for those already insured in the following ways:
All Americans will have a new, more
affordable option. The public option, like Medicare,
will negotiate prices with providers, providing a more affordable option for
many Americans who today find their health insurance too expensive.
Middle class families will get a premium
tax credit to help them pay for coverage. For
example, take a family of four with an income of $110,000 per year. If they
currently get insurance on the individual marketplace, because their premium
will now be capped at 8.5% of their income, under the Biden Plan they will
save an estimated $750 per month on
insurance alone. That’s cutting their premiums almost in half. If a family is
covered by their employer but can get a better deal with the 8.5% premium cap,
they can switch to a plan on the individual marketplace, too.
Premium tax credits will be calculated
to help more families afford better coverage with lower deductibles. Because
the premium tax credits will now be calculated based on the price of a more
generous gold plan, families will be able to purchase a plan with a lower
deductible and lower out-of-pocket spending. That means many families will see
their overall annual health care spending go down.
The Biden Plan has several additional proposals
aimed directly at cutting the cost of health care and making the health care
system less complex to navigate. The Biden Plan will:
Stop “surprise billing.” Consumers
trying to lower their health care spending often try to choose an in-network
provider. But sometimes patients are unaware they are receiving care from an
out-of-network provider and a big, surprise bill. “Surprise medical billing”
could occur, for example, if you go to an in-network hospital but don’t realize
a specialist at that hospital is not part of your health plan. The Biden Plan
will bar health care providers from charging patients out-of-network rates when
the patient doesn’t have control over which provider the patient sees (for
example, during a hospitalization).
Tackle market concentration across our
health care system. The concentration of market power
in the hands of a few corporations is occurring throughout our health care system,
and this lack of competition is driving up prices for consumers.
The Biden Administration will aggressively use its existing antitrust authority
to address this problem.
Lower costs and improve health outcomes
by partnering with the health care workforce. The Biden
Administration will partner with health care workers and accelerate the testing
and deployment of innovative solutions that improve quality of care and
increase wages for low-wage health care workers, like home care workers.
III. STAND UP TO ABUSE OF POWER BY
PRESCRIPTION DRUG CORPORATIONS
Too many Americans cannot afford their prescription drugs, and prescription
drug corporations are profiteering off of the pocketbooks of sick individuals.
The Biden Plan will put a stop to runaway drug prices and the profiteering of
the drug industry by:
Repealing the outrageous exception
allowing drug corporations to avoid negotiating with Medicare over drug prices. Because
Medicare covers so many Americans, it has significant leverage to negotiate
lower prices for its beneficiaries. And it does so for hospitals and other
providers participating in the program, but not drug manufacturers. Drug
manufacturers not facing any competition, therefore, can charge whatever price
they choose to set. There’s no justification for this except the power of
prescription drug lobbying. The Biden Plan will repeal the existing law
explicitly barring Medicare from negotiating lower prices with drug
corporations.
Limiting launch prices for drugs that
face no competition and are being abusively priced by manufacturers. Through
his work on the Cancer Moonshot, Biden understands that the future of
pharmacological interventions is not traditional chemical drugs but specialized
biotech drugs that will have little to no competition to keep prices in check.
Without competition, we need a new approach for keeping the prices of these
drugs down. For these cases where new specialty drugs without competition are
being launched, under the Biden Plan the Secretary of Health and Human Services
will establish an independent review board to assess their value. The board
will recommend a reasonable price, based on the average price in other countries
(a process called external reference pricing)
or, if the drug is entering the U.S. market first, based on an evaluation by
the independent board members. This reasonable price will be the rate Medicare
and the public option will pay. In addition, the Biden Plan will allow private
plans participating in the individual marketplace to access a similar rate.
Limiting price increases for all brand,
biotech, and abusively priced generic drugs to inflation. As
a condition of participation in the Medicare program and public option, all
brand, biotech, and abusively priced generic drugs will be prohibited from
increasing their prices more than the general inflation rate. The Biden Plan
will also impose a tax penalty on drug manufacturers that increase the costs of
their brand, biotech, or abusively priced generic over the general inflation
rate.
Allowing consumers to buy prescription
drugs from other countries. To create more competition
for U.S. drug corporations, the Biden Plan will allow consumers to import
prescription drugs from other countries, as long as the U.S. Department of
Health and Human Services has certified that those drugs are safe.
Improving the supply of quality
generics. Generics help reduce health care spending, but
brand drug corporations have succeeded in preserving a number of strategies to
help them delay the entrance of a generic into the market even after the patent
has expired. The Biden Plan supports numerous proposals to accelerate the
development of safe generics, such as Senator Patrick Leahy’s proposal to
make sure generic manufacturers have access to a sample.
IV. ENSURE HEALTH CARE IS A RIGHT FOR
ALL, NOT A PRIVILEGE FOR JUST A FEW
Joe Biden believes that every American – regardless of gender, race, income,
sexual orientation, or zip code – should have access to affordable and quality
health care. Yet racism, sexism, homophobia, transphobia, and other forms of
discrimination permeate our health care system just as in every other part of
society. As president, Biden will be a champion for improving access to health
care and the health of all by:
Expanding access to contraception and
protect the constitutional right to an abortion. The
Affordable Care Act made historic progress by ensuring access to free preventive care, including
contraception. The Biden Plan will build on that progress. Vice
President Biden supports repealing the Hyde Amendment because health care is a
right that should not be dependent on one’s zip code or income. And, the public
option will cover contraception and a woman’s constitutional right to choose.
In addition, the Biden Plan will:
1) Reverse the Trump Administration and states’
all-out assault on women’s right to choose. As president, Biden will work to
codify Roe v. Wade, and
his Justice Department will do everything in its power to stop the rash of
state laws that so blatantly violate the constitutional right to an abortion,
such as so-called TRAP laws, parental
notification requirements, mandatory waiting periods, and ultrasound
requirements.
2) Restore federal funding for Planned Parenthood.
The Obama-Biden administration fought Republican attacks on funding for Planned
Parenthood again and again. As president, Biden will reissue guidance specifying
that states cannot refuse Medicaid funding for Planned Parenthood and other
providers that refer for abortions or provide related information and reverse
the Trump Administration’s rule preventing
Planned Parenthood and certain other family planning programs from obtaining
Title X funds.
3) Just as the Obama-Biden Administration did, President Biden
will rescind the Mexico City Policy (also referred to as the global gag rule) that
President Trump reinstated and
expanded. This rule currently bars the U.S. federal government from supporting
important global health efforts – including for malaria and HIV/AIDS – in
developing countries simply because the organizations providing that aid also
offer information on abortion services.
Reducing our unacceptably high maternal
mortality rate, which especially impacts people of color. Compared
to other developed nations, the U.S. has the highest rate of
deaths related to pregnancy and childbirth, and we are the only country
experiencing an increase in this death rate. This problem is especially
prevalent among black women, who experience a death rate from complications
related to pregnancy that is more than three times higher than
the rate for non-Hispanic white women. California came up with a strategy
that halved the state’s
maternal death rate. As president, Biden will take this strategy nationwide.
Defending health care protections for
all, regardless of gender, gender identity, or sexual orientation. Before
the Affordable Care Act, insurance companies could increase premiums merely due
to someone’s gender, sexual orientation, or gender identity. Further, insurance
companies could increase premiums or deny coverage altogether due to someone’s HIV status. Yet,
President Trump is trying to walk back this progress. For example, he has proposed to once
again allow health care providers and insurance companies to discriminate based
on a patient’s gender identity or abortion history. President Biden will defend
the rights of all people – regardless of gender, sexual orientation, gender
identity – to have access to quality, affordable health care free from
discrimination.
Doubling America’s investment in
community health centers. Community health centers
provide primary, prenatal, and other important care to underserved populations.
The Biden Plan will double the federal investment in these centers, expanding
access to high quality health care for the populations that need it most.
In the months ahead, Biden will put forward
additional plans to tackle health challenges affecting specific communities,
including access to health care in rural communities, gun violence, and opioid
addiction.
SUPPORTING HEALTH, NOT REWARDING
WEALTH
Joe Biden believes in rewarding work, not just wealth – and investing in
hard-working Americans’ health, not protecting the most privileged Americans’
wealth. Warren Buffett said it best when he stated that he should not pay a
lower tax rate than his secretary.
The Biden Plan will make health care a right by getting rid of capital gains
tax loopholes for the super wealthy. Today, the very wealthy pay a tax rate of
just 20% on long-term capital gains. According to the Joint Committee on
Taxation, the capital gains and dividends exclusion is the second largest tax
expenditure in the entire tax code: $127 billion in fiscal year 2019
alone. As President, Biden will roll back the Trump rate cut for the
very wealthy and restore the 39.6% top rate he helped restore when he negotiated an end to the Bush
tax cuts for the wealthy in 2012.
Biden’s capital gains reform will close the loopholes that allow the super
wealthy to avoid taxes on capital gains altogether. The Biden plan will assure
those making over $1 million will pay the top rate on capital gains, doubling
the capital gains tax rate on the super wealthy.
WATCH: Joe Biden
talks more about the need to build on and protect ACA in THIS new video.
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.
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.
The Republican contrived American Health Care Act would repeal the Affordable Care Act (Obamacare) which made great strides in making access to health insurance more affordable for millions of Americans and slowing the annual increases in premiums which had been rising at rates 3 to 5 times faster than inflation. Obamacare was designed to work within the for-profit health insurance industry, rather than do what every other industrialized nation does and offer universal health care. Some continued to complain that premiums and deductibles were too high, but rather than solve that problem, Republicans have sought to repeal Obamacare 60 times, going so far as to shut down the government in 2013 rather than accept a budget that provided for the subsidies that make health insurance affordable for tens of millions of Americans.
Trump has made it a defining issue to get repeal, no matter the damage or loss of health insurance which is quite literally a life-and-death issue. But the AHCA is more than just a matter of Trump’s ego, it is also about reducing taxes for the wealthiest – who are assessed a small surcharge to fund ACA – and crucial to Trump’s other massive giveaway to the wealthiest and corporations, his tax “plan.”
It’s remarkable that this act, which would completely rework health care, representing one-sixth of the US economy and impacting every single person, is being pushed through without any hearings, input from medical professionals or even health insurance companies, without scoring from the Congressional Budget Office as to its true cost or how many people would find health insurance unaffordable or inaccessible.
But Governor Andrew Cuomo spells out how AHCA would affect millions of New Yorkers, and specifically attacks an amendment foisted by two New York Republican Congressmen that exclusively targets New York:
“The Republican health care bill is an assault on women and an assault on New York. It would allow insurance companies to discriminate against Americans based on pre-existing conditions, force millions of New Yorkers to lose coverage, and slash Medicaid by hundreds of billions of dollars.
“As a direct result of the amendment introduced by Congressmen Faso and Collins, this provision alone would cut Medicaid funding for New York by $2.3 billion and cripple hospitals, nursing homes, and assisted living facilities across the state.
“Most disturbingly, this bill penalizes New Yorkers because we believe in reproductive rights and ensure by law that medically necessary abortions are covered by insurance carriers. I’m calling on all of New York’s Congressional delegation—Republican and Democrat alike—to stand up for New York values and vote against this terrible bill.”
The American Health Care Act will be disastrous for New York:
The plan will leave 2.7 million New Yorkers without health care coverage
It will cut $4.7 billion from the state’s Medicaid budget.
It will put at risk 7 million people who rely on Medicaid services and other programs created under the Affordable Care Act
And it threatens the entire New York State health care system, which serves 19.5 million New Yorkers.
The Collins/Faso amendment, which targets only New York, stops counties from paying a share of Medicaid. It would have a devastating effect on New Yorkers:
It will cut $2.3 billion in Medicaid funding to the State. When added to the $4.7 billion cost of the ACHA over the next four years, the total cost to the State would rise to $6.9 billion
Steep cuts would force New York State to increase taxes, slash coverage to millions of New Yorkers, or devastate health care providers:
Nursing Home payments would be cut by $401 million
Home care payments would be cut by $360 million
Hospital payments would be cut by $355 million
The bill punishes New York for its support for women’s reproductive rights by threatening to take away citizens’ access to tax credits that are intended to make health insurance more affordable:
New York requires that all commercial insurance policies cover abortion services. In January, Governor Cuomo took new action to ensure that contraceptive drugs and devices are covered by commercial health insurance policies without co-pays, coinsurance, or deductibles
The Republican health care bill would prohibit the use of tax credits to support the purchase of insurance plans that cover abortion services.
As a result, the bill would effectively defund the Essential Plan, forcing 685,000 low-income people, half of whom are women, to lose their insurance and denying them $1.5 billion in tax credits.
In addition, roughly 143,000 lower-income New Yorkers whose income is just above the threshold for the Essential Plan, half of whom are women, would be denied $400 million more in tax credits that help them afford insurance.
This bill also includes an amendment that will enable insurers to charge more for people with preexisting conditions in some states, rolling back a key achievement of the Affordable Care Act.
In New York, 8.4 million people under the age of 65 have preexisting conditions.
The MacArthur amendment would allow states to opt out of provisions that restrict providers from raising prices on people with preexisting conditions.
Removing protections for people with pre-existing conditions will result in the sick paying high premiums and would force those who cannot afford it to lose coverage.
The health plan would also permit states to charge older people more, which would also force people who cannot afford it to lose coverage.
For those women who flexed their liberated muscles by opposing Hillary Clinton (because after all, what did they have to lose?), two stories from this week stand out:
Trump has not only set back American progress on every aspect of civil, environmental, economic and criminal justice a century to the Gilded Age, but threatens to do the same with women’s rights and standing in society. And I’m not just referring to the fact that he has made it okay to be a misogynistic, sexist, racist, xenophobic bit.
Hillary Clinton in her campaign noted that it isn’t just “attitude” or “culture” that propagates bias, but systemic reinforcement in the economy, the tax code, the courts, the law, and most especially health care and reproductive rights, that, more than anything else for all practical purposes keep women down and lacking power.
The Affordable Care Act (Obamacare), explicitly reversed those impediments, which allowed insurance companies to make women pay higher premiums for their pre-existing condition of being a woman.
The health care “reform” that Republicans are trying to ram through would not only restore that ability of insurance companies to charge women more so that they couldn’t actually afford prenatal care, or for that matter a delivery, or the necessary care for their infant, especially one that is born without all the advantages of its mother having had access to prenatal care, but they propose to defund Planned Parenthood, used by 4 million people (52 million visits a year), resulting in 551,000 fewer unintended pregnancies, and of course, they intend to end women’s reproductive rights altogether.
After the Women’s March on Washington the day after inauguration, which brought out millions across the US and the world, I proposed that women should strike to demonstrate how essential to the economy women were. On March 8, International Women’s Day, there was just such a strike, “A Day Without Women.” But as the big day approached, I realized it had to fail because women predominate in jobs that are life and death – nurses, teachers, home healthcare and daycare providers, legal services (the list goes on and on and on).
“My babies,” is how a Great Neck kindergarten teacher described her students during a school board hearing on the proposed bond, noting that there is a significant difference in learning readiness for children who come to kindergarten with or without having attended pre-K, which follows through throughout their elementary schooling. They don’t catch up. I am quite sure she was in her classroom teaching instead of joining the “Day Without Women” strike.
Moreover, unless a woman worked for a sympathetic boss, she likely could not afford to lose pay, and possibly her job.
Consequently, the full impact of women on the economy, and in society – that women comprise half of the entire paid labor force for the first time in history, mothers are now close to 50 percent of all primary breadwinners, and women drive 70 to 80 percent of all consumer purchasing – went unnoticed, and women as a political force were pretty much told to sit down and shut up, as Senate Majority Leader Mitch McConnell told Senator Elizabeth Warren.
But, as ever, Senator Warren expressed best why “women’s issues are economic issues” and how the system is rigged against them:
Women are the main breadwinners, or joint breadwinners, in two-thirds of the families in America, she said, but:
Having a child is the single best predictor that a woman will end up in financial collapse.
Single moms are more likely than any other group to file for bankruptcy – more likely than the elderly, more likely than divorced men, and more likely than people living in poor neighborhoods.
Single moms who have been to college are actually 60% more likely to end up bankrupt than those with just a high school diploma.
“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.”
Warren noted:
Women struggle under the burden of student loan debt, child care costs that equal college tuition, make 78 cents to the dollar of her male colleague and can be fired just for asking what the guy down the hall makes (Republicans are blocking the Paycheck Fairness Act).
Mothers are 10 times more likely than fathers to take time off when their kids are sick, and 60% are not paid for that time off. Too many women fear losing their jobs because they are stuck having to choose between work or caring for someone they love. (Republicans won’t even let us have a vote on paid sick time and family leave, and Trump rolled back Obama’s executive orders on parental leave and overtime pay).
Two-thirds of minimum wage workers are women but the minimum wage hasn’t gotten a federal raise in seven years, and mothers of very young children disproportionately work low-wage jobs (Trump rolled back Obama’s executive order and Republicans have blocked every effort to raise it.).
Because women make less than men throughout their lifetimes, they receive, on average, about $4,000 less a year than men in Social Security benefits (as well as pensions). This really hurts because women are less likely to have other assets, so they rely more heavily on those Social Security checks to keep them out of poverty. Republicans still threaten to cut Social Security for women and families and raise the retirement age, while their health care plan would also increase the cost of having health care and likely toss off millions of women and children from any health care at all.
“Donald Trump was right about one thing: the game is rigged. It’s rigged for rich guys like Donald Trump. The system works great for those who can hire armies of lawyers and lobbyists, but it leaves women and families behind. A system in which Republicans work tirelessly to rip away health care from millions of women and defund Planned Parenthood health clinics, while giving away billions of dollars in subsidies to Big Oil. A system that cuts Head Start programs and NIH medical research, but protects tax breaks for billionaires and giant corporations,” Warren stated.
And no where is this “rigged system” more apparent than in the Trump/Ryan plan to repeal Obamacare and replace it with a plan that will strip health insurance from millions, raise the cost for women, for older people, for the poor and sick, in order to give the 400 richest Americans—who averaged incomes of $318 million in 2014—a tax cut of about $7 million a year, a windfall that they will happily reinvest in buying the election of candidates who will do their bidding. (Trump doesn’t pay taxes, so this wouldn’t benefit him.)
Indeed, as it turns out, there isn’t a single “Women’s Issue” but rather, a broad gamut of issues are central to women: climate change, nuclear nonproliferation, gun violence prevention, food, water and drug safety, education, workers rights, health care and public health; infrastructure and mass transportation; immigration rights, criminal justice reform, affordable housing. What is there about life that doesn’t concern women?
The fascinating thing about that ignorant lout who is unbelievably serving in Congress but can’t understand why a man should have to pay for prenatal care is that society has a collective interest in women’s health, and public health. If someone doesn’t go to the doctor and can’t afford to stay home from work, their communicable disease will spread. When people don’t go to the doctor for an early diagnosis, but only go when the condition becomes severe, society as a whole foots the bill for catastrophic care, and is deprived of that individual’s productivity.
Clearly, there should be a different sort of strike, one that would not require women to relinquish their work responsibilities: they should strike sex. Women are considered mere vessels to incubate an embryo (an elected official actually said that), a lesser person with fewer legal and political rights than a zygote. Women are singularly punished for having sex. Sex in Trump’s misogynistic RightWing America has come to mean enslavement. (And yes, I realize this sounds as crazy as Ben Carson, the neurosurgeon who has taken over Housing & Urban Development, who equated the slaves who were brought to the US in chains at the bottom of boats to “immigrants” with their high aspirations.)
John Oliver, in his summation of International Women’s Day on Sunday’s episode of Last Week Tonight, said: “Every year, the best way of gauging not just how far women have come, but perhaps how far they still have to go, is by watching powerful men around the world trip over their dicks while talking about the day.”
He highlighted Vladimir Putin, who told his nation, “Women give us life and perpetuate it in our children. We will do our utmost to surround our dear women with care and attention, so that they can smile more often.”
Women in Congress (still only 20%) wore white to Trump’s joint address, to symbolize the suffragettes of a century ago and show solidarity.
“We wear white to unite against any attempts by the Trump Administration to roll back the incredible progress women have made in the last century, and we will continue to support the advancement of all women,” Rep. Lois Frankel, D-Fla., the chair of the party’s Women’s Working Group, said in a statement.
Governor Andrew Cuomo, in response to a question posed by Mark Halperin on MSNBC, said:“Obviously the consequences for a state like New York could be devastating. Depending on what they do, you have 3 million people who are insured under Obamacare. What are you going to do with the 3 million people? Medicaid is a big piece of our budget. They talk about block grants, turning it over to the state. That sounds great. The question is when they block grant it, do they actually transfer the money? Remember the old expression, passing the buck without passing the bucks. Governor of New York, my fear is the rhetoric of give it back to the states sounds great, but if they give it back to the states and they cut the funding, you put the states in a really terrible situation. So I get the political appeal of repeal Obamacare, but you know, be careful what you ask for and I think this is the dog that chases the car. What are they going to do? And you have millions and millions of people who are affected and you could devastate the budget. I just did my budget. I said, “Look, I don’t have a contingency plan.” Because I don’t know what they’re going to do, and frankly, they could take an action for which there is no contingency plan. There are rumors that they could cut the state of New York 2, 3 billion dollars. I can’t make up 2, 3 billion dollars. It would wreak havoc in this state. So it’s their move and I want to see what they come up with.”
Lt. Governor Kathy Hochul, commenting on a proposed amendment from Congressman Collins (R-NY), said:
“Our Founding Fathers warned us this day would come. Partisan politics would overtake good government for the people. The Medicaid changes being proposed in Washington would cut taxes for wealthy special interests while devastating New York State’s finances and all but eliminating health care for the most vulnerable New Yorkers.
“What’s worse, a New York Republican Congressman, Chris Collins is offering an amendment that would wreak havoc on the state. While I understand that the Democrats in Washington are attacking Collins on ethics issues and are having a heated political fight, they shouldn’t be played out at the expense of everyday New Yorkers.
“Here are the facts: The overall Medicaid plan would cost the state billions of dollars of lost federal funds and jeopardize hospital stability. As if that were not enough, Rep. Collins would have the state assume the counties’ share of Medicaid expenses outside of New York City. The current breakdown is 13 percent county, 36 percent state, and 51 percent federal. This ill-conceived plan would cost his home state approximately $2.3 billion. Unbelievably, that’s on top of the cost of the Republican Affordable Care Act repeal plan – another $2.4 billion.
“Translation: Rep. Collins is proposing a tax increase on New Yorkers to the tune of $4.7 billion. This one-two punch would destroy all the hard work the Governor and Legislature have accomplished in the last six years to lower taxes across the board and achieve the lowest spending increases in recorded history. New Yorkers will be at risk of losing their healthcare, hospitals will be forced to lay off workers, and our vulnerable elderly will find it much harder to afford nursing home care.
“On the merits, the counties have no right to claim this is an undue burden. They paid a percentage of health care costs even before Medicaid – and in fact, currently have a more favorable agreement than in decades.
“In 1960 – well before New York State and most counties had any sales tax revenue to pay for it – Congress passed the Kerr-Mills Act, which created a national role in funding health care for the elderly. Under this program, the counties in New York paid approximately 44 percent of the cost of care, the state paid about 38 percent, and the federal government paid around 18 percent.
“In 1965, Medicaid replaced that program and the counties paid 25 percent. That same year, the state began giving counties the option of collecting sales tax on their behalf. Every county in New York has subsequently agreed to this option. Many counties in the nation don’t get sales tax, and most of those receive less than our counties. Moreover, the state recently agreed to give the counties additional help – after hearing the counties’ complaints of the growing Medicaid costs, the state has held them harmless for any increases since 2011.
“As a result, the counties’ share for Medicaid is down from 25 percent to 13 percent, and the state assumed this cost while still living within the 2 percent spending cap, and all while cutting taxes. The state is not asking the counties to do anything more than we have done ourselves. In fact, the state has done far more. If the Collins amendment passed, the state would need to raise income taxes or the counties would have to forego their share of sales tax in exchange for the state picking up the additional Medicaid costs.
“In short, Rep. Collins’ amendment and the Affordable Care Act repeal would transfer $4.7 billion in costs to the state which would translate into a new tax for New Yorkers. I know firsthand that the people of the 27th Congressional District face enough challenges in their lives – they don’t need to worry about increasing health care costs or new taxes.
“Rep. Collins should stop prioritizing his wealthy friends and start helping his home state by protecting the most vulnerable from losing their healthcare and putting the state budget at risk. Remember, as my mentor Sen. Daniel Patrick Moynihan used to always point out, New York is a donor state – we pay more in federal taxes than we receive back.
“Mr. Collins, try practicing good government rather than partisan politics.”
Donald Trump and Mike Pence are only courting right-wing conservatives on policies that impact all Americans’ lives, including health care and women’s reproductive health.
The only ones the Trump/Pence/Ryan/McConnell Administration care about, speak to are the ultra-rightwing conservatives. This from the White House, Friday, March 10:
READOUT OF THE VICE PRESIDENT’S LISTENING SESSION WITH CONSERVATIVE LEADERS
Vice President Mike Pence and Secretary of Health and Human Services Tom Price assembled dozens of conservative leaders today at the White House to discuss the multi-faceted effort to repeal and replace Obamacare. The Vice President and the Secretary highlighted the work being accomplished through legislative and regulatory efforts to end Obamacare’s government takeover of healthcare and provide market-based reforms that will lower costs and provide more choice to Americans. They also invited conservative groups to continue offering their ideas for improving healthcare in America and agreed to keep communication channels open as the President and Congress work to fulfill the promise of repealing and replacing the flawed Obamacare law.
The following individuals participated:
Thomas Binion, Heritage Foundation
Melissa Ortiz, Able Americans
Mia Heck, ALEC
Jason Pye, FreedomWorks
Brian McManus
Matthew Schlapp, American Conservative Union
Nan Swift, National Taxpayers Union
Richard Manning, Americans for Limited Government
Grace Turner, Galen Institute
Kenneth Cuccinelli, Senate Conservatives Fund
Jennifer Butler, State Policy Network
Daniel Schneider, American Conservative Union
John McKechnie, ABA Health Savings Account (HSA) Council
Stephen Keen, National Federation of Independent Business
Lisa Nelson, ALEC
Jennifer Hatten, ABA Health Savings Account (HSA) Council
David Bozell, ForAmerica
Phil Kerpen, American Commitment
Peter Sepp, National Taxpayers Union
Timothy Chapman, Heritage Action
Bradley Close, National Federation of Independent Business
Kent Lassmam, Competitive Enterprise Institute
Jennifer Martin, Tea Party Patriots
Shonda Kalra, Tea Party Patriots
Amanda Moorhead, National Federation of Independent Business
Bill Pascoe, Tea Party Patriots
Christopher Jacobs, Texas Public Policy Foundation
Adam Brandon, FreedomWorks
Michael Cannon, CATO
Bob Carlstrom, Association of Mature American Citizens
Andy Roth, Club for Growth
Heather Curry, CATO
During the Presidents Week recess when Congressmembers are supposed to meet with constituents, I attended two jam-packed rallies focused on saving Obamacare (this followed the rallies held coast-to-coast in the days before the inauguration). In each of these, desperate people (dismissed by Republicans as “paid professional agitators”) stood up to preserve the Affordable Care Act.
While not perfect (after all, how could it be when Obama had to thread a ridiculously tiny needle to get anything passed the Republican wall of opposition), Obamacare has brought coverage to 20 million previously uninsured people, reducing the percentage of uninsured Americans to a historic low of 8.6%, allowed children up to age 26 stay on their parents’ plan, mandated coverage for preexisting conditions, ended lifetime caps, capped the amount of premium that for-profit insurance pocketed for non-patient purposes at 20% (versus 97% that Medicare spends on patient care ), instituted basic standards of coverage that included, for the first time, wellness visits, coverage for certain regular tests (mammograms, colonoscopy).
The secret sauce? Mandating coverage or else pay a penalty, but if you didn’t earn enough to pay, you would be able to get subsidies from the government Why? Because the whole thing revolved around the idea that young and healthy people would pay into the system, bringing down the insurance premium for everyone. And every policy would cover certain basics, like child birth and prostate cancer, mammogram and colonscopy (ending the higher premiums for a woman).
And it was working: in the first place because if people can go to their doctors earlier, get diagnostic tests and catch illnesses earlier, they are less expensive to treat, let alone reduce the amount of suffering while increasing a person’s productivity during their prime years.
Let’s review: before Obamacare, nearly 50 million people were without health insurance and tens of thousands of families were losing health insurance as they were losing their jobs (and homes) to the Bush/Cheney Great Recession. 20,000 people a year were dying needlessly simply for lack of access to affordable health care.
And, for years, for-profit insurance companies, with a 33% margin, were raising premiums at three to five times the CPI each year; routinely dropping doctors, denying coverage, throwing people off for “preexisting conditions.” Companies were dropping health benefits for employees.
“Preexisting condition? Life is a preexisting condition, resulting from sexual contact and will invariable end in death,” Dr Martha Livingstone, vice chair of Physicians for a National Health Program, told an overflow audience at the Universalist Unitarian Church in Huntington. “We all have a preexisting condition. We all need health care because we are human beings. How we will get it?”
Congressman Tom Suozzi, who stood in front of SRO town hall at the JCC in Plainview, and again at the Huntington health care rally, and back in January, with Kathleen Rice, at a massive health care rally, said about Obamacare, “Mend it. Don’t End it.”
The key problems with Obamacare, people complained, are high deductibles (for the cheapest plans), that premiums rose significantly (after rising at the slowest rate of increase in 50 years and mainly because of the Republican sabotage that prevented the full implementation), and that doctors, and even insurers would change (which happened before, as well).
What Republicans are proposing now, though, doesn’t “fix” any of these problems. In essence, the Republican plan favors the healthy and the wealthy, shifting the burden of payment while providing fewer benefits onto working people, low-income people and the elderly, while – and here is the added bonus – exploding the budget deficit. Millions will lose insurance; costs will skyrocket, and Republicans are ramming it through without “scoring” its impact on the budget or people.
They concocted the bill in secret, are ramming it through without proper analysis, scrutiny or debate, or even “scoring” by the Congressional Budget Office, and here’s the added subterfuge: they are repealing the elements in stages: by 2018 for the first parts (to minimize impact on midterm elections) and by 2020 for the complete repeal (to ease the way for Trump’s reelection).
The Republican plan begins with ending that “freedom killing” mandate, which is the hinge upon which access to affordable health care rests, because by requiring everyone – young, healthy people who might otherwise defray health insurance costs – to purchase, the pool is large enough to keep premiums down for everyone, while covering everything from child birth to mental health to pre-existing conditions.
Instead of a mandate, enforced with a modest tax penalty, to insure that enough healthy, young people are in the pool to lower everyone’s premium while expanding care and access even if there is a pre-existing condition, the Republican plan provides for a 30% “surcharge” if you have let insurance lapse more than 60 days. So if you have lost your job, and therefore your health insurance, and can’t pay, you will only get further and further behind.
Instead of subsidies for people who don’t earn enough to purchase health insurance, Republicans want to give tax credits, which only are beneficial if you earn enough to pay. What is more, they want tax credits not to be based on income at all, but on age, so a 60 year old would get $4000 in tax credits while a 30-year old minimum-wage worker would get $2000 –still only a fraction of the cost of a minimally basic health plan – up to $14,000 in credits for a family.
The other big idea to “afford” health care is the Health Savings Account, which Republicans have wanted forever – another scheme to bolster Wall Street donors, and provide yet another device for the wealthiest to shield income from tax. The flaw is that you need to have enough money to stash away in HSA to begin with. But suppose you get a cancer diagnosis or are hit by a car before you have accumulated sufficient funds? Or you contract some illness that blows through your HSA? Tough luck.
The GOP plan would end the Medicaid expansion – when the federal government paid 90% instead of 50% of the state’s Medicaid cost — which will result in 10 million people in 31 states losing health insurance.
Another keystone of the GOP health care con is to give states block grants – a fixed amount that has no correlation to actual need. The interesting thing is that Governors tend not to use the money for its purpose (health care for the poorest residents), but for pet priorities like lowering taxes for businesses.
The Republicans say they want to shift “power” back to the states. But states always had the ability, before, to devise their own health care plan, as long as it met basic standards of the Affordable Care Act. What states want is the ability –and the excuse – not to provide universal coverage.
Republicans will claim that their plan will continue to cover pre-existing conditions. But their idea is to stick people with pre-existing conditions into high-risk pools, which could put the cost out of reach.
Indeed, no one has bothered to mention that Obamacare capped the amount that the for-profit insurance companies could charge for non-patient services – it was at 33% (versus a 3% administrative budget for Medicare) before the ACA, which required 80% of the premium to go to patient services. That is out the window.
An added zinger, just for good, is that the plan ends federal funding for Planned Parenthood. Gotcha!
Trump proposes to cure the cost problem making it possible to buy insurance across state lines, without saying how that would actually reduce the cost of the premium, under the pretext that “competition” will lower the cost. Except that the same few companies dominate the market in most states, and like airlines, can just raise premiums as they like. Also, this would negate New York’s ability to set standards on insurance companies. And wouldn’t it also mean that New Yorkers would pay the higher premium for Southern obesity?
Most of the changes are phased in – they don’t get implemented until after the 2018 midterm elections, and Obamacare is not completely repealed until after the 2020 elections.
But what Republicans claim is the “unsustainability” of Obamacare is the result of Republicans efforts to sabotage it from day 1. And the first thing that Trump did? Ended enforcement of the mandate and issue a proposal to cut next year’s enrollment period in half allow insurance companies to easily raise deductibles, limit patients’ choice of doctors, and restrict others from getting covered mid-year — even if they have a child or lose their employer-based insurance. Insurance companies are pulling out because the Republicans are intentionally making it impossible for them to do business.
By immediately repealing the mandate as well as the taxes that support Obamacare, it is truly unsustainable and more insurance companies that are planning premium rates and participation now, will either pull out or hike up premiums to ridiculous levels because essentially, they are only insuring sick, older people.
The taxes that pay for the Obamacare health care benefits are also being immediately repealed which will explode the budget deficit, which somehow, Republicans only care about when a Democrat is in the Oval office.
And here is the stunner: the Republicans, who have worked this up in secret, without any debate or public commentary (they dismiss the millions who have come out to town halls, rallies and protests as “paid professional agitators” instead of people with real concerns), plan to shove the legislation through without even scoring by the Congressional Budget Office. They can’t say how much health insurance will cost in TrumpWorld, or how many people will wind up losing health insurance or who wind up being woefully uninsured because they can only afford a minimal policy that doesn’t actually cover anything. They can’t say how many more employers (only about half were offering health insurance benefits before ACA) will simply stop providing any health care benefit at all. That’s Freedom! That’s Choice!
“Do we want people to have socialized medicine or individual accountability, personal choice, where businesses decide?” Congressman Chris Collins (R-NY) asked hypothetically.
Obamacare did not just benefit the 30 million people who were able to afford health insurance, 20 million of them for the first time. It benefited every American who also has insurance, and every American who has Medicare, as well. And remember the complaints with Obamacare? That deductibles were too high; premiums went up significantly from the first year (except they had traditionally gone up at 3 to 5 times the CPI, without any limits). That doctors left the plan or insurance companies changed the plan to exited the exchanges? The Republican plan does not improve any of this. Instead, it returns health care to the total control of for-profit companies, who can raise premiums at will, drop doctors at will, set lifetime caps or refuse to cover certain procedures.
Health care should be a right, not a privilege reserved with the means to pay for it. But the Republican mold would create a system of unequal protection throughout the land. If you happen to live in New York State, you are likely to have better access to life saving, life-affirming care for your family than if you live in Texas.
The Republican plan is a prescription for sicker people who don’t get the checkups, early diagnosis and wellness care to prevent more serious (and costly) and deadly maladies. But they don’t care. Indeed, the rightwingers like Freedom Caucus who are howling mad at the American Health Care Act are upset that it is not draconian enough, that it is “Obamacare Light”.
In TrumpWorld, people are back at the mercy of the for-profit health insurance and health care industry, back under the thumb of employers and abusive spouses. Now that’s freedom-killing, as much as it is a death penalty.
It is as Alan Grayson said early in the Obamacare debate: “The Republican health care plan: don’t get sick. The Republicans have a back-up plan in case you do get sick … Die quickly!”
Rightwingers, conservatives don’t hate Obamacare because it smacks of “socialized medicine.” They hate it because they believe when everyone is entitled to health care, there will be a shortage of doctors, of hospital beds. They will have to wait for appointments. They fear “rationing,” not caring that to avoid that feared scenario, it means that 50 million people will be excluded from health care system altogether.
The solution to having truly universal health care is to reform the health care system – more physicians assistants, nurse practitioners, online diagnosis and triage, more early diagnosis and wellness care.
Contrary to the rightwing hysteria (death panels!) Obamacare is not socialized medicine because it bent health care into a pretzel in order to retain for-profit health insurance entities as the gatekeeper between patients and health care. But the epic failure of the Republican plan, which more than restores ultimate control over people’s lives and quality of life to for-profit companies and employers and abusive spouses, will likely result in a true universal, Medicare-for-All, single-payer system.
Trouble is, that won’t happen for decades more, and not until after hundreds of thousands of people have suffered miserably, died needlessly, prematurely, for lack of access to timely, affordable, quality health care.
