US Senate health care bill guts Medicaid, slashes taxes for the wealthy

 

By Kate Randall
23 June 2017

US Senate Republicans unveiled on Thursday the Better Care Reconciliation Act, their version of a plan to “repeal and replace” the Affordable Care Act (ACA), the Obama administration’s signature domestic legislation. The US House passed its own version, the American Health Care Act (AHCA), early last month.

Like the House plan, the Senate version guts Medicaid, the health insurance program for the poor and disabled jointly administered by the federal government and the states, slashing its funding by hundreds of billions of dollars. It would mark the effective end of the program, which currently covers 75 million Americans, as a guaranteed program based on need.

Better Care also repeals virtually all of the ACA’s taxes on wealthy individuals and corporations, effecting one of the largest redistributions of wealth from the poor to rich in US history. These tax cuts would be paid for by slashing health care coverage and raising costs for the vast majority of ordinary Americans, in particular targeting the poor, the elderly, the disabled, and those with preexisting conditions and disabilities.

The plan was drafted in secrecy by a “working group” of 13 senators, a process drawing criticism from both Republican and Democratic senators. As of Thursday evening, a group of four ultra-right Republican senators said they would not sign on to the bill, as it was not draconian enough, while other more moderate Senate Republicans said they needed to study the bill before making a decision.

However, it is likely that Majority Leader Mitch McConnell will be able to garner the votes of 50 out of 52 Republican senators to pass the legislation with a simple majority, counting on the vote of Vice President Mike Pence to break a tie. The bill would then be sent to a conference with the House, where a final version would be agreed, before being sent to President Trump to sign. Senate leaders hope to receive a scoring on the bill from the Congressional Budget Office (CBO) early next week and vote on it before the July 4 recess.

Medicaid

The Senate bill would convert Medicaid to a “per capita cap” funding system, in which states would get a lump sum from the federal government for each enrollee. States could also choose to receive a block grant instead, not tied to the number of Medicaid enrollees. This would effectively end Medicaid as an “entitlement” program, so-called because the funding is expanded automatically as people qualify on the basis of need.

The legislation would also change the way federal payments to Medicaid are calculated. The Senate bill would tether funding growth to the Medical Consumer Price Index plus 1 percentage point through 2025, then change over to the urban Consumer Price Index (CPI). This would amount to a funding cut to Medicaid, as the cost of health care typically goes up faster than the CPI.

The bill would also end the expansion of Medicaid under Obamacare by 2021. This extended coverage to an estimated 14 million people, mainly low-income adults earning below 138 percent of the poverty line (about $15,000 for an individual), in the 31 states plus the District of Columbia that opted to participate in the expansion.

Better Care defunds Planned Parenthood for one year, meaning Medicaid patients could no longer seek treatment of any kind at the nonprofit organization’s clinics. This will result in forgone screenings, less access to contraceptive and abortion services, and more unintended pregnancies, as well as maternal and infant deaths.

CBO scoring of the House bill, which makes similar cuts, estimated it would slash overall funding to Medicaid by $880 billion over a decade. The cutbacks would force states to remove people from Medicaid, reduce the range of services covered, and cut reimbursements to doctors, hospitals and drug companies.

Tax cuts

The Senate bill cuts taxes on net investment income for wealthy people, repeals an ACA Medicare tax on wealthy people, and eliminates taxes on health insurers, medical device companies and tanning salons.

Better Care repeals a 3.8 percent tax on net investment income (capital gains, dividends, etc.) for individuals making more than $200,000 a year or for couples making more than $250,000. In one of the bill’s most brazen giveaways to the rich, this repeal is not only immediate, but retroactive to capital gains made earlier this year.

The Tax Policy Center estimates that around 90 percent of the tax cuts will go to households with more than $700,000 in annual income, the top 1 percent, who will be freed from the 3.8 percent tax, along with a 0.9 percent payroll surtax on their salaries.

Smaller subsidies, skimpier coverage

The bill would make much less generous subsidies available to low- and middle-income people to purchase health insurance (people earning less than 350 percent of the poverty line, compared to the ACA’s 400 percent cutoff). Individuals earning less than $41,580 and families of four making less than $85,050 would be covered. However, the size of the tax credits would be tied to what it takes to purchase insurance with poorer coverage.

Insurance companies would be able to charge older adults not yet eligible for Medicare five times more than younger people, compared to three times more under Obamacare. The bill would also change the definition of “affordable” insurance. For example, a 60-year-old who earns $35,640 a year would be required to spend 16.2 percent of annual income, or $5,773, before receiving any assistance from the government. Overall, working-class families would pay higher premiums, deductibles and out-of-pocket costs for health insurance that covers much less.

Essential benefits and preexisting conditions

The Senate bill would allow states to seek a waiver from ACA requirements for insurers to cover essential benefits, such as maternity care, prescription drugs, substance abuse and mental health services, emergency care, and other vital services.

While Senate Republicans claim their legislation keeps in place protections for those with preexisting conditions, in practice insurers would be able to skirt these protections by simply offering plans that don’t cover a range of preconditions, such as diabetes, cancer, prenatal care, etc.

Such waivers could also affect those with employer-sponsored insurance. For example, large employers in a waiver state could restrict services, impose lifetime limits on health care costs and eliminate out-of-pocket caps from their plans.

Better Care eliminates the individual mandate, which requires those without coverage from their employer or from a government program to purchase insurance or pay a tax penalty. Due to the “reconciliation” process, the bill cannot eliminate the mandate, but it reduces the penalty to zero. Employers with 50 or more employers would also not be penalized if they fail to provide insurance to their workers.

While gutting the mandates, the Senate plan keeps the insurance marketplaces set up under the ACA intact, but insurance will be more expensive and cover less.

While Republicans in both the Senate and House, as well as the Trump administration, have set as their goal repealing and replacing Obamacare, both the AHCA and the Better Care Reconciliation Act keep the ACA’s basic structure in place—all while repealing taxes for the wealthy, gutting Medicaid and raising costs and cutting services for working and middle-class people.

This is in part the result of the procedure chosen for repeal. Lacking the 60 votes to overcome a Senate filibuster, the Republican leadership chose to employ “reconciliation,” which is limited to a single bill each year, and requires only a simple majority. The rules governing reconciliation are arcane, and prevent changes in policy that have no fiscal impact, such as a ban on insurance companies covering abortion, which was dropped from the Senate bill.

But in the final analysis, there was no need to repeal Obamacare outright, since it accomplishes many of the goals agreed on by both capitalist parties. As the WSWS has maintained from the start, Obamacare was aimed at cutting costs for the government and corporations while rationing health care for the vast majority. Whatever version of “Trumpcare” eventually emerges from Congress for the president to sign will take the tendencies already present in the Affordable Care Act, then strip off the limited concessions it offered in the way of Medicaid expansion, essential services and other inadequate protections.

Obamacare took as its starting point the entrenched for-profit system of health care delivery in America, which is based on enriching the insurance companies, the pharmaceutical companies and the giant hospital chains.

With this as its basis, the ACA had as its aim the development of an even more openly class-based health care system than what previously existed, in which workers and their families are left with rising costs, cut-rate care, or no coverage at all, and the super-rich and privileged upper-middle-class layer avail themselves of the best medical care that money can buy.

As we wrote last year, through its tax credit system and marketplace exchanges, “[T]he ACA essentially establishes a voucher system, whereby minimal government subsidies are given to individuals to purchase private health insurance. It thereby serves as a model for the future privatization of the key government programs, Medicare and Medicaid, wrenched from the ruling class through bitter working class struggles in the last century.”

The Democrats have predictably denounced the Senate plan as a boondoggle for the rich, with House Minority Leader Nancy Pelosi and Senate Minority Leader Chuck Schumer railing against the tax breaks for the rich and the millions who stand to lose coverage.

But they have little to offer in way of an alternative, except the maintenance of the Obamacare status quo, or “working with” the Republicans to fix it. That is because they believe in the underlying premise that health care in America must remain at the mercy of the for-profit health care industry, and that the provision of health care must conform to the interests of the capitalist market.

As the WSWS wrote in July 2009, more than six months before the ACA became law, the Obama administration’s “drive for an overhaul of the health care system, far from representing a reform designed to provide universal coverage and increased access to quality care, marks an unprecedented attack on health care for the working population. It is an effort to roll back social gains associated with the enactment of Medicare in 1965.”

The Republicans’ attack on Medicaid, embodied in both the AHCA and the Better Care bill, marks a further step in this direction.

The Democrats’ fraudulent opposition to Trumpcare

By Kate Randall
21 June 2017

Senate Republicans are working feverishly to pass their version of a bill to “repeal and replace” the Affordable Care Act (ACA), having set themselves an arbitrary deadline of securing its passage before the July 4 congressional recess. Early last month, House Republicans passed the American Health Care Act (AHCA), celebrating in the White House Rose Garden with President Trump, who said of the bill, “It’s a great plan, and I believe it’s going to get better.”

A group of 13 Republicans senators is working behind closed doors on the Senate version of the legislation. Senate Majority Leader Mitch McConnell plans to push the legislation—which concerns one-sixth of the US economy, and which will affect the health and lives of tens of millions of Americans—with no committee hearings, no public mark-up (drafting and editing) of the bill, and only limited debate.

It is no secret that the clandestine nature of the Senate “working group’s” negotiations is due to the AHCA’s wide unpopularity, with a recent poll showing that only 20 percent of Americans approve of it while 57 percent disapprove. The broad opposition is due to its draconian features, particularly the gutting of Medicaid, the social insurance program for the poor jointly funded by the federal government and the states. The AHCA would effectively end Medicaid as a guaranteed benefit based on need by placing a per-capita cap on overall spending.

The AHCA would slash $824 billion from Medicaid and would end the ACA’s expansion of Medicaid to low-income adults, causing 14 million newly insured people to lose their benefits over a decade. All told, the Congressional Budget Office estimates that 23 million people would become uninsured in 10 years under the AHCA. At the same time, the bill would slash taxes for corporations and wealthy individuals, while boosting the already multibillion-dollar profits of the health care industry.

McConnell has an additional reason for secrecy, since any divisions within the Republican caucus threaten passage of the bill, and concessions made to far-right senators like Ted Cruz and Rand Paul could provoke opposition from a group of “moderates” from states with large Medicaid populations, and vice versa.

Under the “reconciliation” process chosen for the health care legislation, the Republican leadership can push through the bill despite holding only a narrow 52-48 majority, providing they lose no more than two Republicans, with Vice President Mike Pence casting a tie-breaking vote.

Senate Democrats profess outrage over the closed-door nature of the Republicans’ deliberations. They staged a talk-a-thon on the Senate floor Monday night, stalling chamber proceedings through a series of parliamentary maneuvers. A few senators live-streamed their “search” for the elusive legislation, driving around the capital. All of these stunts amount to so much hot air. The Democrats are incapable of mounting a true opposition to the Republicans’ vicious assault on the health care of ordinary Americans because they share their class objectives.

Numerous media commentaries have pointed to the Democrats’ “powerless” position to oppose the Republicans’ plan, due to the Republicans’ 52-48 Senate majority. This is only valid in terms of parliamentary arithmetic: the vast majority of the American people oppose the House bill and will oppose the Senate bill once they learn its provisions. But the Democratic Party is unwilling and unable to mobilize this popular opposition.

Every Senate Democrat, including so-called independent and self-professed “democratic socialist” Bernie Sanders, portrays Obamacare as a progressive social reform, or at least a “step in the right direction,” concealing the reactionary and anti-working-class character of the Affordable Care Act.

Obamacare was aimed from the start at cutting costs for the government and corporations while rationing health care for the vast majority. In that sense, the Republicans have invented nothing new. Whatever version of “Trumpcare” eventually passes the Senate will only take the tendencies already present in Obamacare and make them worse: imposing more and more of the cost of health care on individual workers and their families.

The logic of this process, under both Democrats and Republicans, is the development of an openly two-class health care system: the best health care money can buy for the super-rich and a privileged upper-middle-class layer; and for the vast majority of the population, a cut-rate system, starved for funds and personnel, offering inadequate and overpriced care, if any at all.

In response to Trump and the Republicans’ howls that the ACA is “failing” and “imploding”—through rising premiums and deductibles and dwindling networks of insurers—the Democrats beg for a seat at the table to “fix” Obamacare. This is a euphemism for making further concessions to the demands of the insurance companies and other corporate interests by further restricting subsidies for low-income purchasers of insurance plans, cutting business taxes and implementing other regressive measures.

Any health care overhaul hatched in Washington will be based on the for-profit health care system, enriching the insurance companies, drug companies, hospital chains and medical device companies and the CEOs that run them.

Looking beyond the Democrats’ bluster, working people need to actually take stock of what is at stake in the Republicans’ plan. The most fundamental attack is the gutting of Medicaid, one of the last social reforms wrested from the ruling elite through working-class struggle. While limited in nature, Medicaid guaranteed the right to health insurance and medical services for the poor and for children and disabled people, and provided funding for nursing care for the elderly based on need. Medicaid emerged as part of the “Great Society” and “War on Poverty” under the Johnson administration, alongside landmark legislation such as the Civil Rights Act and the Food Stamp Act, both in 1964, and the Voting Rights Act of 1965.

The assault on health care exemplified by the Republicans’ reactionary legislation is of a piece with the ruling elite’s attack on all the social rights of the working class—the right to a job, education, decent housing, a secure retirement, access to the arts and culture, and a healthy and safe environment.

Congressional Democrats have chosen to oppose the Trump administration not over the destruction of social conditions, but over Trump’s alleged “softness” toward Russia. They are working in alliance with the dominant factions of the intelligence apparatus to whip up a war fever against Russia in an attempt to condition the public for an escalation of the wars in the Middle East as well as a military confrontation with Iran and nuclear-armed Russia. Incapable of opposing the most reactionary presidency in US history on anything resembling a progressive or democratic basis, they have positioned themselves to the right of Trump on issues of imperialist foreign policy.

Whatever form it takes, the health care legislation that the Republicans are able to pass through Congress and place on the president’s desk to sign will be one of the most reactionary pieces of legislation in modern history. The ruling elite sees the attack on Medicaid as the first shot in their war on Medicare and Social Security and wants to see all of these social programs privatized or ended outright. In the final analysis, both big-business parties agree that health care must be limited to what is compatible with the profit interests of corporate America.

The working class must fight for its own class interests. The crisis in health care requires a socialist solution, which takes as its point of departure the needs of working people and society as a whole, not the wealth and profits of a tiny minority.

The establishment of a system of universal, free health care for all requires placing the entire health care system—the private insurers, pharmaceuticals, giant health care chains—under public ownership, managed democratically to serve human needs, not profit. Such a fight requires the mobilization of the working class as a revolutionary force, independent of and opposed to both the Democratic and Republican parties.

http://www.wsws.org/en/articles/2017/06/21/medi-j21.html

Senate Republican health plan could make deeper cuts to Medicaid than House version

By Kate Randall
20 June 2017

As the Senate Republican “working group” continues to craft its plan to “repeal and replace” the Affordable Care Act (ACA) behind closed doors, press reports suggest that in some respects the Senate bill will go even further than the House version in attacking working people and cutting health care for low income families.

Both the Senate bill and the American Health Care Act (ACHA) passed by the House would gut Medicaid, the health insurance program jointly administered by the federal government and the states. The Congressional Budget Office (CBO) has estimated that the AHCA would cause 23 million people to lose health insurance by 2026, mainly because the House bill would effectively end the ACA’s Medicaid expansion for low-income adults.

The AHCA would cut $800 billion from Medicaid over 10 years, by both ending the expansion of the program and placing a per capita cap on Medicaid spending overall. This would mark the end of the program as a guaranteed social benefit based on need, forcing states to cut back benefits and throw people off the rolls.

The Hill, citing lobbyists and Senate aides, now reports that an option being considered by the 13-member Senate working group would make even deeper cuts to Medicaid by changing the way growth in per-patient spending is calculated. While the proposal would start with the growth rate for the cap on Medicaid spending at the same levels as the House bill, beginning in 2025 it would drop it to a lower growth rate, the Hill’s sources say.

The AHCA would cap Medicaid’s per-patient spending and adjust it upward each year based on the CPI-M, the consumer price index for urban consumer medical care. It would add an extra percentage point each year for spending for the elderly and disabled. The Senate plan would use the same system initially, but beginning in 2025 it would adjust per-enrollee spending using the standard CPI-U, or prices paid by urban consumers for a representative basket of goods and services.

The change is not simply one of bookkeeping. Due to the rising cost of medical care relative to other consumer goods, the change would cripple Medicaid even further by decreasing the already restrictive spending cap and growth rate. To put this into perspective, since 2000, the CPI-M has grown about 41 percentage points more than the CPI-U.

According to the Hill, the “plan has been described as a ‘consensus option’” and has already been sent to the Congressional Budget Office for analysis. The Office of the Chief Actuary at the Centers for Medicare and Medicaid Services (CMS) recently estimated that the change in the consumer price index used would slash an estimated $64 billion from Medicaid funding over a decade.

While Senate Republicans are in the final stages of drafting the bill, without any public hearings or even a pretense of consultation, Senate Democrats are engaged in a political stunt that will do nothing to stop passage of the reactionary legislation.

The Democrats planned to disrupt Senate business by holding the floor all Monday night to protest the Republicans’ secretive proceduring, using parliamentary tactics to disrupt the ordinary business of the chamber.

While making speeches on the virtues of Obamacare—the Democratic program to cut health care costs for corporations and the government—the Democrats are making only a token gesture against the even more reactionary pro-business replacement plan being drafted by the Republicans.

The Democrats can offer no way forward for the millions of Americans who are currently struggling to obtain health care and pay their bills under Obamacare, and will fare even worse under the Republican replacement. That is because the Democrats share the same class objectives as the Republicans, to boost the profits of insurance companies, drug companies, hospital chains and medical device companies.

Senate Majority Leader Mitch McConnell has set a goal of pushing the legislation through before the July 4 recess, using the process known as “reconciliation,” which allows the bill to pass with a simple majority and exempts it from any filibuster. The main obstacle to passage is not any protest by the Democrats, which is only for public consumption, but differences within the Republican caucus in the Senate and between House and Senate Republicans.

Meanwhile, a new study also shows the potential ill effects of the House bill, the AHCA, on the US economy. The study by the Commonwealth Fund and George Washington University shows that while the economy would see a short-term boost from the repeal of the ACA’s taxes on the wealthy and corporations, in the long run the decrease in federal spending on health care would lead to the loss of almost 1 million jobs over a decade.

Credit: Business Insider • Source: The Commonwealth Fund

The study writes of the AHCA: “It initially raises the federal deficit when taxes are repealed, leading to 864,000 more jobs in 2018. In later years, reductions in support for health insurance cause negative economic effects. By 2026, 924,000 jobs would be lost, gross state products would be $93 billion lower, and business output would be $148 billion less. About three-quarters of jobs lost (725,000) would be in the health care sector.”

The number of people working in the health care sector has risen in recent years due to the greater access to health care by people newly insured under Obamacare or through the expansion of Medicaid, as well as the aging of the population. The study notes that under the AHCA, cuts to Medicaid and federal subsidies for people to access health insurance would lead to fewer people using medical care and fewer jobs in the health care sector.

In other words, the estimated 1 million job losses would be a direct result of people being denied access to needed medical care, and those who are insured would have less money to put back into the economy in the form of consumer spending. The job losses would vary by state, according to the study, with many losing tens of thousands of jobs (see map).

http://www.wsws.org/en/articles/2017/06/20/heal-j20.html

Emails show extent of EPA head Scott Pruitt’s ties to industries he’s supposed to regulate: report

A disturbing report indicates that Scott Pruitt’s fossil fuel connections are taking advantage of the EPA head

A new report sheds light on how the man who President Donald Trump appointed to be head of the Environmental Protection Agency — and who shares the president’s unscientific views on man-made climate change — has a lot of connections to industries that have a vested interest in denying global warming.

More than 4,000 pages of emails from Pruitt’s days as Oklahoma’s attorney general reveal that the EPA administrator and his staff had dozens of meetings with coal, oil and gas executives and lobbyists, according to a report by the Associated Press.

One email from Pete Regan, executive director of the Domestic Energy Producers Alliance, urges Pruitt to meet an oil and gas lobbyist who he describes as “a gem of a dude. He serves on DEPA executive Comm w Harold Hamm. AG Pruitt was on multiple exec calls on 2015 giving updates re ‘sue and settle’, endangered species cases, etc. . . . Greg worked closely with Sen. Bob Dole and has great stories.”

Many of the items on Pruitt’s schedule were blacked out, which makes it more difficult for watchdog groups to ascertain the extent of his connections with the coal, oil and gas industries.

The emails were withheld from the public by Pruitt until a lawsuit by the liberal advocacy group Center for Media and Democracy convinced a judge to order their release.

Pruitt’s proposed budget cuts to the EPA have been so drastic that even many of his fellow Republicans have criticized them. Rep. Rodney Frelinghuysen of New Jersey told Pruitt during a congressional hearing on Thursday that “we are home to a historical background that shows us to have more Superfund sites than any other in the nation. I know there has been a proposal here to reduce substantial funding for this program.”

Similarly, Rep. David Joyce of Ohio asked, if Pruitt’s proposed cuts to the Great Lakes Restoration Initiative go through, “How will these functions be maintained if the GLRI is eliminated?”

Rep. Michael Simpson of Idaho pointed out that, because farmers in his state are dealing with new pests due to global warming, cutting EPA funding “leads to less timely reviews. The president’s budget will cut well below the minimum. The potato industry will not have access to the proper crop production tools.”

Matthew Rozsa is a breaking news writer for Salon. He holds an MA in History from Rutgers University-Newark and his work has appeared in Mic, Quartz and MSNBC.

US Senate health bill drafted in secrecy: A conspiracy against the health care of millions

Photo/J. Scott Applewhite)

By Kate Randall
16 June 2017

The US Senate is moving forward with its drafting of legislation to repeal and replace the Affordable Care Act (ACA) behind closed doors. Little information has been revealed about the contents of the bill being drawn up by the Senate’s 13-member “working group,” aside from several leaks to the media.

Senate Republicans plan to bring the legislation to a floor vote without a single committee hearing, and without a formal, open drafting session. They hope to pass the bill by an expedited reconciliation procedure, which requires only a simple majority and avoids the possibility of a filibuster by Senate Democrats.

Only a small group of senators know what is in the bill. Those being kept in the dark include not only Democrats, but Republicans who are not in the working group. An aide to one of those senators in the group told Axios that no draft would released because “we aren’t stupid,” an apparent allusion to the draconian features contained within it, including the gutting of Medicaid and its attack on the health care of millions of poor, older and sick Americans.

The apparent plan is to send the finalized Senate bill to the Congressional Budget Office (CBO) for scoring before it is then released to the press and the public, with a goal of a vote on the Senate floor before July 4.

The House Republicans’ bill, the American Health Care Act (AHCA), is deeply unpopular. Recent Public Policy Polling shows that only 24 percent of voters support the AHCA and 55 percent oppose it. Senate Republicans are well aware that a bill that bears any resemblance to the AHCA will face similar public opposition.

The secrecy surrounding the bill has been bolstered by a significant curtailing of on-camera interviews within the Capitol. According to the Washington Post, the prohibition of televised interviews was issued Tuesday at the point when senators were reportedly going to be informed about some of the features of the bill at a luncheon on Capitol Hill. The prohibition apparently came from the Senate Rules Committee.

At a closed-door White House lunch Tuesday with 15 Republican senators, President Trump reportedly referred to the House plan as “mean,” and according to sources said he wants the Senate version to be “more generous.” This seemingly bizarre statement by Trump—after praising the AHCA as “a great plan” at a White House Rose Garden celebration last month—is an indication of the perceived unpopularity of the Republicans’ planned “repeal and replace” of the bill popularly known as Obamacare.

The ACHA builds on the free-market foundations of the ACA, which gives the for-profit health care industry free rein to charge as they see fit for premiums and to pull out of markets that they find unprofitable. As a former Medicare administrator in the Obama administrator admitted recently about the ACA, “We elected to have a system that is completely market-based so companies get to make individual decisions.”

The Senate plan, like the Republican, takes its cue from the central features of Obamacare, which cuts costs for the government and corporations while rationing and degrading health care for the vast majority of Americans.

The gutting of Medicaid

The biggest change in the AHCA is the gutting of Medicaid, the health care program jointly administered by the federal government and the states. The CBO estimates that the AHCA would cause 23 million people to lose health insurance by 2026, mainly because the House bill would effectively end the ACA’s Medicaid expansion for low-income adults.

The Senate plan reportedly maintains the AHCA’s per capita cap or block granting of federal Medicaid funds, which would effectively end Medicaid as a guaranteed program based on need. It would also put an end to the expansion of Medicaid under the ACA, but would allow a longer phase-out of the expansion, possibly up to seven years, i.e., prescribing a slow death as opposed to the House plan’s quicker demise.

According to a new report by the Center on Budget and Policy Priorities (CBPP), coverage losses under the AHCA would affect people of all ages and income levels, including families with children, seniors, and people with disabilities. It would also sharply cut government subsidies for individual market coverage, and allow insurers to charge sharply higher premiums to people with preexisting conditions.

About 3 million children would lose coverage, CBPP says, increasing the uninsured rate for children by about 50 percent. Another 6.4 million young adults (age 19-29) would lose coverage, or about one in eight people in this age group. This runs counter to claims that the House bill would favor younger, healthy people.

More than 8 million people, age 30-40, would lose coverage, increasing their uninsured rate by a staggering 84 percent. About one in five of this age group would be uninsured, compared to one in 10 under current law, according to CBPP.

The uninsured rate for older adults (age 50-64) would more than double under the AHCA, reflecting the fact that the bill would allow individual market insurers to charge older people premiums five times higher than for younger people. While the Senate plan reportedly will offer some additional premium assistance to this age group, it will be inadequate to make a significant difference.

The majority of those losing coverage under the AHCA would have low incomes. Some 14.7 million adults with incomes below 200 percent of the poverty level (about $50,000 for a family of four) would become uninsured. But 5.1 million adults with incomes above 200 percent of the poverty level would also lose coverage.

Preexisting conditions

While Trump has claimed that people with preexisting conditions would be “taken care of” under any final Republican health care bill, this is not the case. The Senate bill, unlike the AHCA, would not allow states to obtain waivers to deny coverage to people with preexisting conditions. However, it would maintain the AHCA provision allowing states to waive coverage of essential health benefits.

Topher Spiro, vice president for health policy at the Center for American Progress, writes in the Washington Post that maintaining the waivers for essential benefits will have the effect of denying coverage for people with preexisting conditions.

Allowing states to ditch coverage of essential services such as hospitalization, and emergency care, maternity care, substance abuse treatment, mental health care and prescriptions drugs would also allow waivers of the ACA’s ban on lifetime and annual limits on coverage related to the essential health benefits.

Also, Spiro notes, if insurers cannot markup premiums for people with preexisting conditions, they could alter their benefits packages to screen out sick people by excluding the benefits they need. The list of possible benefits they could drop from coverage is vast, including treatments for cancer, diabetes and heart conditions. Simply being a woman puts a person at a disadvantage, as prenatal and maternity care, contraception and abortion services could be excluded.

According to the CBO, about 19 million people are enrolled in the individual market nationwide, and about half of them live in states that would seek essential benefits waivers. As about 55 percent of individual market enrollees have a preexisting condition, this means about 5.3 million people with preexisting conditions could see their coverage severely deteriorate and their premiums skyrocket.

While congressional Democrats have made some noise about the secrecy surrounding the Senate deliberations on the health care bill, there has been virtually no comment on the reactionary content of the legislation.

As their attention is focused on the Trump-Russia connection and investigation of the president on obstruction of justice, there is general disinterest by politicians of both big business parties in legislation that will eviscerate Medicaid and leave 23 million more people uninsured and at the mercy of the health care giants and their profits, leading to unnecessary suffering and increased deaths.

Jacob Leibenluft of CBPP commented in an interview in the Post on the lack of congressional hearings and coverage in the media on the Senate bill, “I hate to think that looking back on this period, we’ll realize that the most regressive piece of social legislation in modern American history was passed, and no one was paying attention.”

http://www.wsws.org/en/articles/2017/06/16/sena-j16.html

Why Is PBS Airing Right-Wing-Sponsored School Privatization Propaganda?

A new documentary aims to drum up public support for Betsy DeVos’ proposed voucher system.

Photo Credit: YouTube Screengrab

Secretary of Education Betsy DeVos and her department have pushed for an expansion of privatized school choice programs in the proposed budget for fiscal year 2018, particularly in the form of private school vouchers. Now a propagandistic three-part documentary series called School Inc. will help DeVos in her efforts to gain public support for expanded private school choice options. The series has already aired on PBS stations in some markets and will be shown on more this month.

majority of people across the partisan spectrum oppose private school vouchers, programs that redirect public education money to pay for private school tuition. Vouchers are problematic for many reasons, including their history of allowing for discrimination against LGBTQ, disabled, and special education students, their impact on reducing public education funding, and their ineffectiveness in boosting academic achievement.

Despite these problems, private school vouchers are a long-standing priority of the corporations and right-wing funders backing the education privatization movement. The late Andrew Coulson, long-time head of the Cato Institute’s Center for Educational Freedom, was the driving force behind School Inc. The Cato Institute is a right-wing, libertarian think-tank that calls for the elimination of public schools in support of greater “educational freedom” to choose from a free market of privately run schools.

In addition to School Inc.’s roots in the radical, libertarian Cato Institute, education historian and former U.S. Assistant Secretary of Education Diane Ravitch found that the film was funded by a number of arch-conservative foundations with ties to the “dark money ATM” DonorsTrust and the Ayn Rand Institute. Ravitch has prescreened School Inc. and provided this scathing review to The Washington Post:

This program is paid propaganda. It does not search for the truth. It does not present opposing points of view. It is an advertisement for the demolition of public education and for an unregulated free market in education. PBS might have aired a program that debates these issues, but “School Inc.” does not.

Why would a public broadcast channel air a documentary that is produced by a right-wing think tank and funded by ultra-conservative donors, and that presents a single point of view without meaningful critique, all the while denigrating public education? PBS responded in part with a statement to the Post, saying, “PBS and local member stations aim to offer programs that reflect diverse viewpoints and promote civic dialogue on important topics affecting local communities.”

However, as Ravitch notes, when a documentary fails to objectively present information about a topic that may not be well understood by the general public, the result is unlikely to “promote civic dialogue.” And when major media outlets uncritically provide a platform to right-wing ideologues, they further misinform and polarize the debate around important issues such as public education.

 

http://www.alternet.org/media/why-pbs-airing-right-wing-sponsored-school-privatization-propaganda?akid=15747.265072.VfPhWx&rd=1&src=newsletter1078406&t=16

Donald Trump in Wonderland

Literally everything our president says and does reflects the opposite of reality

Monday’s fawning Cabinet meeting was just the latest example of a doomed presidency driven by dangerous fictions

Early on Monday a colleague of mine messaged me with a link to a Politico article detailing how Russian intelligence has allegedly gathered “kompromat” on about 2,300 well-known American media personalities and politicians, apparently in conjunction with Vladimir Putin’s ongoing effort to subvert American democracy.

My political writer friend added, “This is scary. What do you think will happen?”

“Nothing,” I wrote back. “Not as long as Trump insists this is nothing more than a scam by the Democrats because Hillary lost.”

We can’t repeat this enough: The United States and our democratic institutions were attacked by a hostile foreign power, yet President Donald Trump refuses to do a damn thing about it. Not only is he still infuriatingly chummy with the Russians, gifting them (without reciprocation) classified intelligence inside the Oval Office and reopening housing compounds that serve as bases for Russian spies. He won’t even acknowledge as legitimate the very basic nut of the story, that Russia hacked the 2015-16 election cycle. Never mind the question of possible collusion for now. The Russians attacked us and there’s copious evidence to prove it.

Imagine if, in the wake of 9/11, the George W. Bush White House had refused to accept that the attack even occurred. The entire world would have thought Bush had lost his mind or that our entire nation was caught in the grip of mass delusion.

Either way, Trump is behaving as if a series of ongoing events that were palpably real weren’t so at all. Those of us who have followed Trump’s ridiculousness since the 1980s know that he’s perpetually full of crap. For example, you may recall his yarn: “Trump Steaks are the world’s greatest steaks and I mean that in every sense of the word.” But as a presidential candidate, and subsequently as the country’s chief executive, his world of make believe is unparalleled. Everything orbiting in Trump’s universe — a universe that includes his 62 million voters along with Fox News — is a fantasy.

Everything that’s real is fake and everything that’s fake is real.

Trump held a Cabinet meeting on Monday morning where he asked his department-level secretaries to offer allegedly unsolicited praise for him and to express effusive gratitude for the honor of serving Trump personally. The usually stoic CNBC reporter John Harwood described the meeting by saying, “Honestly this is like a scene from the Third World.” Indeed. Vice President Mike Pence said serving Trump was “the great honor of [his] life.” (Pence has three children, by the way, whose births must be way down on the list of honors.) Chief of staff Reince Priebus, who’s fighting for his job, said, “Thank you for the blessing you’ve given us.” Yes, I’m sure it’s quite a blessing to be in charge of scooping the rhetorical feces from the cage of a clownish supervillain who needed four tries to correctly spell “hereby.”

The Cabinet’s gooey, over-the-top praise was cloying and artificial, but in Trump’s world of make believe the president and his disciples were sufficiently fluffed, injecting every word of the Cabinet’s Eddie Haskell-ish ass kissing into the news cycle. Insofar as perception is reality, we can assume it worked on the faithful. If all these serious people think Trump is the greatest president God ever created, then it must be true!

Likewise, Trump expects everyone to believe there might be tapes of his one-on-one meetings with former FBI Director James Comey. Knowing Trump and the mendacity of his online blurtings, it’s safe to say there aren’t any tapes even though (to coin a phrase), “Lordy, I hope there are tapes.” If the tapes exist, he’d release them. But releasing the tapes is irrelevant because as long as his base believes Comey is what Trump claimed — a crazy, cowardly grandstander who’s obviously lying about the meetings — then pretending that such tapes might exist is enough for the voters who matter.

What else?

Contrary to Trump’s world of make believe, there weren’t 3 million illegal Hillary Clinton voters, nor did former President Barack Obama have Trump’s “wires tapped.” The tax reform bill Trump says is being negotiated doesn’t actually exist. The American Health Care Act (also known as “Trumpcare”) will not provide health insurance to more people and will ultimately leave tens of millions of people with no coverage, among other terrible things. His tweets about the “travel ban” won’t help his chances in court and only make matters worse for the future of his executive order.

Meanwhile, Trump praised his record on jobs so far: While 1.1 million new jobs have been created since Election Day, 1.3 million jobs were created during the previous seven months during former President Barack Obama’s administration. (Trump has also forgotten about the supposedly “real” unemployment rate he mentioned so often during the campaign.) Trump insists the Democrats are feckless, rudderless failures who can’t get anything done yet they’re also effectively obstructing his entire agenda despite the fact that the GOP controls everything. And sorry, James Comey is telling the truth.

I could do this all day. Nothing Trump says is real or accurate — nothing. Even discussing his statements as if they’re mere off-the-shelf political lies serves to only normalize him when, in fact, what he’s doing is galactically destructive. The world has lost faith in America’s leadership or is losing it fast. Nearly 6 in 10 Americans believe Trump has gone bye-bye. Why? Because his fictitiousness is so completely obvious that we have no choice but to wonder whether he’s mentally fit to lead. (He’s not.) He seems to sincerely believe that his kooky outbursts and cartoonish threats sound legitimate when anyone with a brain knows he’s tilting at windmills — even some of his core supporters.

Congressional Republicans are excusing Trump’s loony behavior, for the moment, as the consequences of his being “new to the job,” arguing that his rookie stature is the source of his nonstop flailing. I’m all in favor of any excuses that underscore the president’s massive incompetence, thanks. But the GOP seems to forget that Trump has acted like this for his entire career. He sculpts his own reality to compensate for his endless roster of inadequacies.

But before too long — and I hope this is true — the president and his supporters will be blindsided by reality. Sometime soon, Trump will be fully exposed for his part in the Trump-Russia attack whether as a willing participant or a conspirator after the fact, orchestrating the cover-up. No fairy tales from his Twitter feed will dig him out. The story has to end this way. Trump and all Trump’s men have to be held accountable, otherwise we might as well resign ourselves to believing our democracy is owned and operated by the Kremlin. We can’t allow Trump’s delusions to become American delusions. The bedtime story Trump is telling has to end and end the right way — or else.

Bob Cesca is a regular contributor to Salon.com. He’s also the host of “The Bob Cesca Show” podcast, and a weekly guest on both the “Stephanie Miller Show” and “Tell Me Everything with John Fugelsang.” Follow him on Facebook and Twitter.