ACA 4

SEE ACA THREE

10/18 age of trump, documents gop efforts to finally kill it

MERRI OK

see govt shutdown 10 25

includes health care (reform)

includes pandemic

see medicare/aid expansion in states

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MMA

Right-wing media distract from GOP sabotage of the Affordable Care Act

Trump's media apologists praise his lackluster replacement health care proposal

Written by Zachary Pleat

Published 02/03/26

After Republicans let enhanced premium tax credits for Affordable Care Act Marketplace plans lapse at the end of 2025, health insurance premium costs for many Americans have risen significantly — and are projected to more than double for those who received those subsidies — and the number of signups has plummeted.

Now that Trump has announced his “Great Healthcare Plan” — a vague set of health care policies — and a rural hospital fund established by Trump’s tax cuts announced its first round of funding, right-wing media have jumped on board, ignoring Republicans’ long history of sabotaging the ACA in favor of claiming that the program is unaffordable and praising Trump’s policy ideas, which fail to address the problems he and Republicans helped to create.

Analyses predict massive spikes in insurance premiums and millions losing their insurance from the expiration of enhanced premium tax credits

• • AP on January 1: “Health subsidies expire, launching millions of Americans into 2026 with steep insurance hikes.” The Associated Press reported on January 1, “Enhanced tax credits that have helped reduce the cost of health insurance for the vast majority of Affordable Care Act enrollees expired overnight, cementing higher health costs for millions of Americans at the start of the new year. Democrats forced a 43-day government shutdown over the issue. Moderate Republicans called for a solution to save their 2026 political aspirations. President Donald Trump floated a way out, only to back off after conservative backlash. In the end, no one’s efforts were enough to save the subsidies before their expiration date.” The Associated Press, [1/1/26]

• • A September KFF analysis estimated that the expiration of the enhanced premium tax cuts would “more than double what subsidized enrollees currently pay annually for premiums—a 114% increase from an average of $888 in 2025 to $1,904 in 2026,” and approved rate changes show an average increase of 20% for all enrollees, more than double the increase for the previous year. An analysis by the Peterson-KFF Health System Tracker noted: “This is the largest rate change insurers have requested since 2018, the last time that policy uncertainty contributed to sharp premium increases.” KFF, [9/30/25; Peterson-KFF Health System Tracker, updated 1/15/26]

• • In June, the Congressional Budget Office estimated that 4.2 million people will become uninsured by 2034 from the expiration of the enhanced premium tax credits. The CBO also estimated that permanently extending these tax credits would increase the number of people with insurance by 3.8 million in 2035. Congressional Budget Office, [6/4/25, 9/18/25]

• • According to KFF, January data from the Centers for Medicare and Medicaid Services shows that ACA Marketplace sign-ups this year so far are “down by over a million people.” KFF cautioned that “these data may not fully show how much the expiration of the enhanced premium tax credits has affected enrollment in the Marketplaces. A better picture of the enrollment changes likely won’t be known until this summer, when effectuated enrollment data are typically released.” KFF, [1/29/26]

• ## As ACA tax credits lapsed, right-wing media criticized the ACA itself as unaffordable or blamed Democrats

• Right-wing media are claiming that the Affordable Care Act has caused Marketplace plans, which cover specific essential health benefits, to become unaffordable. Yet according to the Center on Budget and Policy Priorities, Marketplace costs are growing at similar rates as employer-sponsored health insurance, which is also heavily subsidized in that employer contributions are not taxed. And in fact, it was Republicans who controlled Congress and refused to extend the enhanced premium tax cuts before they expired, even though they extended Trump’s tax cuts for the rich before their scheduled expiration.

• • Fox contributor Dr. Nicole Saphier: “What happened is these insurance companies are being told that you have tvo cover all of these patients. You have all of these mandatory things you have to cover, which — that was a big flaw of the Affordable Care Act, which rose costs by essentially saying everything has to be covered.” Saphier continued: “Imagine if your car insurance covered your oil changes, covered everything about your car. That's not how insurance works. But the Affordable Care Act made that, which is why it got so expensive.” Saphier also said she was “frustrated” that “these politicians have failed” to extend the subsidies, even as she criticized the ACA. Fox News, *Fox & Friends*, [1/1/26]

• • Newsmax guest Jennifer Kelly: “The nightmare for Americans remains many still paying premiums higher than their own mortgage payment. And the blame for that falls squarely on Barack Obama and the Democrats’ shoulders. So the GOP should just keep pounding that message all the way to the midterms.” Newsmax, *Wake Up America*, [1/1/26]

• • Fox contributor Lisa Boothe called it the “Affordable Care Act that’s not affordable.”Fox News, *Outnumbered*, [1/1/26]

• • Fox host Julie Banderas: “Democrats, by the way, who backed Obamacare, … they are the ones that actually put a halt on Obama’s subsidies, which effectively are going to increase people’s medical care costs.” Conservative economist Stephen Moore replied, “What we don’t have in America today is affordable health care.” Fox News, *Fox News Live*, [1/1/26]

• • Newsmax guest host David Harris Jr.: “This is the real legacy of Obamacare, friends: skyrocketing prices, more government dependance, and a broken system that Democrats propped up with temporary handouts to mask the inevitable.” Newsmax, *The Chris Salcedo Show*, [1/1/26]

• • Fox Business host David Asman: “The premiums have not gone down. They have tripled. They have gone up three times with Obamacare. ... And now they're blaming Republicans for the rates going up.” Fox Business, *Kudlow*, [1/2/26]

• • Newsmax host Rob Astorino: “It’s not really debatable anymore that the so-called Affordable Care Act, aka Obamacare, has been a very expensive failure. And Democrats don't care how unaffordable or broken the system actually is. They just want to shovel more money into the pit and add more people to it.” Astorinio added: “Democrats created the mess. Republicans are going to get the blame.” Newsmax, *Saturday Agenda*, [1/3/26]

• • Fox contributor Mollie Hemingway: “This Obamacare has been a failure, Democrats know it but don’t want to deal with it, and Republicans, too many of them probably don’t have the courage to tackle it.” Fox Business, *Varney & Co.*, [1/8/26]

• • Newsmax senior political analyst Rick Santorum: The enhanced premium tax credits were “all a farce to keep the gravy train rolling.” Santorum also downplayed the loss of more than a million ACA enrollees compared to the previous year, saying that many people were fraudulently enrolled and “the quote dramatic increases actually didn’t affect very many people.” Newsmax, *The Record*, [1/16/26]

• • Fox Business host Dagen McDowell downplayed enrollment losses from the expiration of the enhanced premium tax credits. Citing conservative economist Stephen Moore, she said: “It was the fact that the number of people who dropped out of Obamacare was, for the current enrollment year, was incredibly small. And these super-sized subsidies going away had minimal impact on the number of people enrolling in Obamacare.” Fox Business, *The Bottom Line*, [1/16/26]

• • Fox Business host Elizabeth MacDonald: “Since Obamacare passed, insurance premiums have nearly tripled.” Fox Business, *The Evening Edit*, [1/19/26]

• • Heritage Foundation’s EJ Antoni onFox & Friends First: The premium increases from the lapsed tax credits are “once again exposing yet another lie of Obamacare, the so-called Affordable Care Act. Obviously it was the unaffordable care act.”Fox News, *Fox & Friends First*, [1/28/26]

• ## But Republicans have long been sabotaging the ACA in multiple ways

• Long before Trump’s second term tax cut for the rich further eviscerated the ACA, Republicans were sabotaging the health insurance expansion in numerous ways. This includes at least 70 separate attempts by Republicans in Congress to repeal or weaken the ACA, according to The Washington Post.

• • The first Trump administration undertook nearly 100 separate actions “to sabotage the ACA by destabilizing private insurance markets or reversing the law’s historic gains in health coverage.” The Center on Budget and Policy Priorities’ list of actions taken by the first Trump administration to sabotage the ACA spans from January 20, 2017, when Trump was first sworn into office, to January 19, 2021, his last full day in office during his first term. Center on Budget and Policy Priorities, [2/2/21]

• • In 2015, The New York Times described a Republican campaign against risk corridor provisions of the ACA as “legislative sabotage.” The Times called a successful effort led by then-Sen. Marco Rubio (R-FL) to limit funding to the “so-called risk corridor provision” of the ACA, which protected “insurance companies against financial losses,” “quiet legislative sabotage.” According to a later study published by the National Bureau of Economic Research, the insurers denied risk corridor payments in 2015 “had 7% higher premium increases over the next two years than did non-claiming insurers.” The New York Times, [12/9/15; Fierce Healthcare, 12/20/17]

• • In 2013, The Washington Post reported that Republicans promised to block any efforts to build a federal exchange and urged states to “refuse to build their own online insurance marketplaces.” The Washington Post, [11/2/13]

• • In 2013, Politico reported that “Republicans refused repeatedly to appropriate dedicated funds” for the ACA’s implementation. Politico noted that after “most Republican governors declined to create their own state insurance exchanges” and “congressional Republicans refused repeatedly to appropriate dedicated funds” needed for the federal government to “take at least partial responsibility for creating marketplaces serving [those] states.” Republicans’ stonewalling left “the Health and Human Services Department and other agencies to cobble together HealthCare.gov by redirecting funds from existing programs.” Politico, [11/1/13]

• • Many Republican-controlled states initially refused to participate in the ACA’s Medicaid expansion, leaving millions without insurance. The New York Times reported in 2013 that many states “largely controlled by Republicans … declined to participate in a vast expansion of Medicaid.” The New York Times, [10/2/13]

• ## Right-wing media have also heaped praise on Trump’s health plan and rural hospital fund

• Instead of calling on Congress to extend the expired tax credits, Trump announced his “Great Healthcare Plan” and a rural hospital fund created last year announced its first disbursements. Right-wing media endorsed both.

• • Fox contributor Dr. Nicole Saphier: The rural hospital fund is “going to help health care tremendously.” Fox News, *Fox & Friends*, [1/1/26]

• • Fox Business host Dagen McDowell: “The year of health care is here. Or hopefully fixing it. Supersized Obamacare subsidies have officially expired, and the Trump administration's sweeping changes to the industry are now taking effect.” Co-host Brian Brenberg added: “Beginning this month, all 50 states will receive a share of $10 billion in federal funding aimed at revitalizing and protecting rural health care systems.” Fox Business, The Bottom Line, [1/2/26]

• • Fox Business host Larry Kudlow introduced a segment by calling Trump’s plan “the greatest health care plan in the history of civilization.” Fox Business, Kudlow, [1/15/26]

• • Fox Business host Brian Brenberg: Trump’s health plan is “good economics” because it’s “getting consumers more in touch with the spending rather than all of the middlemen.” Fox Business, Kudlow, [1/15/26]

• • Newsmax host Katrina Szish: “The president putting decision-making power back into the hands of Americans. Seems practical to me.” Newsmax, Ed Henry: The Briefing, [1/16/26]

• • Newsmax host Shaun Kraisman called Trump’s plan a “new framework of ideas to revolutionize health care in America.” Newsmax, The National Report, [1/16/26]

• • Fox guest Steve Forbes: Trump’s plan “could cut out, over time, a trillion dollars [from] the cost of health care.” Fox Business, The Big Money Show, [1/16/26]

• • Newsmax White House correspondent Mike Carter: The rural hospital fund is “focusing on those folks, those Americans that live in more rural parts of the country, making sure they have great access to health care by funding rural hospitals.”Newsmax, Newsline, [1/16/26]

• ## Experts say Trump's plan will do little to improve health care affordability and will still result in millions losing their insurance

• The Washington Post described Trump’s plan as a “grab bag of initiatives” that “falls far short of President Donald Trump’s promises to deliver a replacement for the Affordable Care Act.” The Post continued:

Trump’s proposal includes a mix of initiatives that are already underway, such as Trump’s push to cut U.S. drug prices by linking them with the lower cost of drugs sold abroad, and some of his stalled ambitions, such as his desire to redirect billions of dollars in federal funding away from health insurers and toward average Americans. Trump also called to restore funding for the ACA’s cost-sharing reduction program, an insurance subsidy program that he ended in his first term, and to institute “maximum price transparency” by requiring hospitals and insurers to make more information available to consumers.

The proposal does not include new ideas to expand health coverage or simplify America’s often-byzantine health care system.

Additionally, other existing Republican policies stemming from their latest tax cut for the rich are estimated to cause up to 15 million Americans, and possibly more, to lose their health insurance. Other experts said Trump’s plans are so vague that it is unknown what effects they may have but they put people with preexisting conditions at risk and don’t reestablish the expired subsidies:

• • Trump’s plan to shift funds from subsidizing insurance plan premiums to health savings accounts is “a terrible approach for” the part of the population that needs assistance with expensive health care bills, according to Johns Hopkins University's Bloomberg School of Public Health health policy professor Gerard Anderson. Bloomberg, [1/23/26]

• • According to a December Cornell Health Policy Center survey of health care policy scholars, 70% “believed that depositing the value of a household’s enhanced premium tax credit into an HSA (rather than applying it directly to monthly premiums) would measurably worsen Marketplace affordability.” Health Affairs, [12/17/25]

• • KFF senior vice president Cynthia Cox: “The president’s plan is vague and, without knowing more, it is impossible to say what the implications would be for people with pre-existing conditions who rely on the ACA markets. The framework does not explicitly say people with pre-existing conditions are protected.” In a comment to NPR, Cox also said: “This looks much more like a compilation of Republican ideas, including some that are already in the Affordable Care Act. It doesn't appear to address the rising premium payments that we're seeing.” KFF, [1/16/26; NPR, 1/15/26]

• • Georgetown University McCourt School of Public Policy research professor Edwin Park: “The plan clearly opposes extension of the expiring ACA marketplace subsidies, without which roughly 4 million people will end up uninsured and many millions more will see their marketplace premiums double or increase by even more.” Park added that Trump’s plan also “appropriates the ‘cost-sharing reductions’ under the Affordable Care Act,” which he said would “have the effect of reducing premium tax credit amounts for those eligible for subsidies (while lowering unsubsidized premiums). The result would actually be more uninsured as low-income people see smaller subsidies and higher premiums they cannot afford.” The Guardian, [1/15/26]

• • University of Pittsburgh assistant professor Miranda Yaver: “The result would be inequity (and likely worse health outcomes) and further sabotage of the progress of the ACA.”She added that “it isn’t clear that the plans the Trump administration wants to help people to purchase would be ACA-compliant, which would mean that while healthy patients may enjoy cost savings, there won’t be remotely sufficient protection for the millions of Americans with pre-existing medical conditions.” The Guardian, [1/15/26]

• • NYU Grossman School of Medicine head of medical ethics Art Caplan: “It’s a broken plan and a broken idea.”He added: “The average consumer doesn’t really have time to go shopping when they need to go to the hospital for a premature birth or a car accident.” NBC News, [1/15/26]

• • Multiple studies have concluded that consumers simply don’t shop for cheaper health care.A 2018 New York Times report explained that even though “scholars have estimated that as much as 30 or 40 percent of care” is “shoppable,” studies show “very few people shop for this type of care.” It also covered a National Bureau of Economic Research working paper examining how people sought out nonemergency MRIs, which found that, “in the context of other studies … if people can’t shop for elective M.R.I.s, there’s hardly a chance they are going to do so with other health care procedures that are more complicated and variable.” A 2024 KFF analysis of Medicare beneficiaries also concluded that “the vast majority of the nation’s 67 million Medicare beneficiaries will not shop around among the coverage options for 2025 or switch plans,” even though it’s “a decision that could have a significant impact on enrollees’ coverage and costs.” The KFF analysis determined that “nearly 7 in 10 Medicare beneficiaries (69%) did not compare their Medicare coverage with other Medicare options during the program’s annual open enrollment period for coverage in 2022.” The New York Times, [7/30/18; KFF, 9/26/24]

• • KFF Medicare policy expert Juliette Cubanski: “Generally speaking, most people with insurance coverage will continue to be better off using their insurance to obtain medications rather than purchasing through the TrumpRx direct-to-consumer portal.” NBC News, [1/8/26]

• ## Trump’s rural hospital fund does not replace the rural medical funding he’s cut, and he’s using it to force states to adopt his policies

• The rural hospital fund was added to Trump’s tax cut bill for the rich to convince Republican holdouts to pass the law after they expressed concerns that the Medicaid cuts in the bill would devastate rural health care. The $50 billion fund doesn’t come close to replacing the rural Medicaid funding that was cut in Trump’s tax cut bill, and one state senator characterized it as a thinly disguised “sort of blackmail” given that it’s being used to coerce states into adopting Trump administration priorities and the money can be clawed back at a later date.

• • KFF explained that the rural hospital fund “provides $50 billion for state grants” over a five-year period, of which half is to be distributed “equally among all states with an approved application,” and the other half subject to the Trump administration’s discretion.KFF noted that “while the fund is described as a ‘rural’ program, the law appears to give states some ability to direct some of the dollars to urban and suburban areas, pending CMS approval.” KFF further noted that “while many of the major cuts related to Medicaid and the ACA Marketplaces under the law are not time limited, the rural health fund is temporary.” KFF, [8/4/25]

• • The reconciliation package also cuts an estimated $137 billion in rural Medicaid spending over 10 years. KFF explained that its estimate may undercount the lost funding for rural areas: “The analysis allocates each state’s estimated spending reductions from the KFF analysis of the reconciliation package to urban and rural areas using the percentage of Medicaid spending that paid for services used by rural enrollees within each state. The estimates may understate the effects on rural areas because they do not account for the full change in total Medicaid spending, which would include the federal spending reductions and the associated reduction in state Medicaid spending stemming from lower enrollment. The estimates also do not account for spending cuts related to Affordable Care Act (ACA) Marketplace coverage from the reconciliation bill, the expiration of enhanced ACA premium tax credits that were enacted during the COVID-19 pandemic, and the impact of proposed Marketplace integrity rules.” KFF, [7/24/25]

• • CBS News: An analysis from the University of North Carolina's Cecil G. Sheps Center for Health Services Research determined that 338 rural hospitals are at risk of closure due to the Republicans' cuts of Medicaid spending. The research was commissioned by Democratic senators. CBS News, [6/12/25]

• • AP: $12 billion of the fund is tied to “whether states are implementing health policies prioritized by the Trump administration’s ‘Make America Healthy Again’ initiative” and can be clawed back if “state leaders don’t pass promised policies.” This includes further restricting the types of food that Supplemental Nutrition Assistance Program funds could be used to purchase. The Associated Press, [12/29/25]

//

1. ### Fox misleadingly claimed that a government shutdown would impede relief for winter storms, glossing over the real threat to disaster-stricken communities

02/03/26 1:38 PM EST

2. ### Fox won’t tell viewers that the UAE bought off Trump

02/03/26 11:00 AM EST

3. ### Border Czar Tom Homan in resurfaced Fox interview: “We need a judicial warrant for a search”

02/03/26

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AN 12 25

Sarah Monroe once had a relatively comfortable middle-class life.

She and her family lived in a neatly landscaped neighborhood near Cleveland. They had a six-figure income and health insurance. Then, four years ago, when Monroe was pregnant with twin girls, something started to feel off.

“I kept having to come into the emergency room for fainting and other symptoms,” recalled Monroe, 43, who works for an insurance company.

The babies were fine. But after months of tests and hospital trips, Monroe was diagnosed with a potentially dangerous heart condition.

It would be costly. Within a year, as she juggled a serious illness and a pair of newborns, Monroe was buried under more than $13,000 in medical debt.

Part of the reason: Like tens of millions of Americans, she had a high-deductible health plan. People with these plans typically pay thousands of dollars out of their own pockets before coverage kicks in.

The plans, which have become common over the past two decades, are getting renewed attention thanks to President Donald Trump and his GOP allies in Congress.

Many Republicans are reluctant to extend government subsidies that help cover patients’ medical bills and insurance premiums through the Affordable Care Act.

And although GOP leaders have yet to coalesce around an alternative, several leading Republican lawmakers have said Americans who don’t get insurance through an employer should get cash in a special health care account, paired with a high-deductible health plan. In such an arrangement, someone could choose a plan on an ACA marketplace that costs less per month but comes with an annual deductible that can top $7,000.

“A patient makes the decision,” Sen. Bill Cassidy (R-La.) said at a recent hearing. “It empowers the patient to lower the cost.”

In a post on Truth Social last month, Trump said, “The only healthcare I will support or approve is sending the money directly back to the people.”

Conservative economists and GOP lawmakers have been making similar arguments since high-deductible health plans started to catch on two decades ago.

Back then, a backlash against the limitations of HMOs, or health maintenance organizations, propelled many employers to move workers into these plans, which were supposed to empower patients and control costs. A change in tax law allowed patients in these plans to put away money in tax-free health savings accounts to cover medical bills.

“The notion was that if a consumer has ‘skin in the game,’ they will be more likely to seek higher-quality, lower-cost care,” said Shawn Gremminger, who leads the National Alliance of Healthcare Purchaser Coalitions, a nonprofit that works with employers that offer their workers health benefits.

“The unfortunate reality is that largely has not been the case,” Gremminger said.

Today, deductibles are almost ubiquitous, with the average for a single worker with job-based coverage approaching $1,700, up from around $300 in 2006.

But even as high deductibles became widespread, medical prices in the U.S. skyrocketed. The average price of a knee replacement, for example, increased 74% from 2003 to 2016, more than double the rate of overall inflation.

At the same time, patients have been left with thousands of dollars of medical bills they can’t pay, despite having health insurance.

About 100 million people in the U.S. have some form of health care debt, a 2022 survey showed.

Most, like Monroe, are insured.

Although Monroe had a health savings account paired with her high-deductible plan, she was never able to save more than a few thousand dollars, she said. That wasn’t nearly enough to cover the big bills when her twins were born and when she got really ill.

“It’s impossible, I will tell you, impossible to pay medical bills,” she said.

There was another problem with her high-deductible plan. Although these plans are supposed to encourage patients to shop around for medical care to find the lowest prices, Monroe found this impractical when she had a complex pregnancy and heart troubles.

Instead, Monroe chose the largest health system in her area.

“I went with that one as far as medical risk,” she said. “If anything were to happen, I could then be transferred within that system.”

Federal rules that require hospitals to post more of their prices can make comparing institutions easier than it used to be.

But unlike a car or a computer, most medical services remain difficult to shop for, in part because they stem from an emergency or are complex and can stretch over numerous years.

Researchers at the nonprofit Health Care Cost Institute, for example, estimated that just 7% of total health care spending for Americans with job-based coverage was for services that realistically could be shopped for.

Fumiko Chino, an oncologist at the MD Anderson Cancer Center in Houston, said it makes no sense to expect patients with cancer or another chronic disease to go out and compare prices for complicated medical care such as surgeries, radiation, or chemotherapy after they’ve been diagnosed with a potentially deadly illness.

“You’re not going be able to actually do that effectively,” Chino said, “and certainly not within the time frame that you would need to when facing a cancer diagnosis and the imminent need to start treatment.”

Chino said patients with high deductibles are often instead slammed with a flood of huge medical bills that lead to debt and a cascade of other problems.

She and other researchers found in a study presented last year that cancer patients who had high-deductible health insurance were more likely to die than similar patients without that kind of coverage.

For her part, Monroe and her family were forced to move out of their house and into a 1,100-square-foot apartment.

She drained her savings. Her credit score sank. And her car was repossessed.

There have been other sacrifices, too. “When families get to have nice Christmases or get to go on spring break,” Monroe said, hers often does not.

She is thankful that her children are healthy. And she continues to have a job. But Monroe said she can’t imagine why anyone would want to double down on the high-deductible model for health care.

“We owe it to ourselves to do it a different way,” she said. “We can’t treat people like this.”

*KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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AN 1225

US Sen. Rick Scott, former CEO of the company that was at the center of the biggest Medicare fraud scheme in American history, has emerged as the most vocal Republican proponent of healthcare reform, warning his fellow GOP lawmakers that continued refusal to engage with the issue risks a “slow creep” toward single-payer healthcare.

On Thursday, according to Axios, Scott (R-Fla.) is “convening a group of House and Senate conservatives on Capitol Hill to pore over fresh polling to develop GOP alternatives to the Affordable Care Act.”

Late last month, Scott unveiled his own proposal titled the More Affordable Care Act, which would keep ACA exchanges intact while creating “Trump Health Freedom Accounts” that enrollees could use to pay for out-of-pocket costs. Scott’s plan, as the health policy group KFF explained, would allow enhanced ACA tax credits to expire and let states replace subsidies in the original ACA with contributions to the newly created health savings accounts.

“Unlike ACA premium tax credits, which can only be used for ACA Marketplace plans, the accounts in the Scott proposal could be used for any type of health insurance plan, including short-term plans that can exclude people based on preexisting conditions,” KFF noted. “States could also waive certain provisions of the ACA, including the requirement to cover certain benefits.”

“While ACA plans would still be required to cover people with preexisting conditions under the Scott proposal,” the group added, “it is likely that the ACA marketplace would collapse in states that seek a waiver under his approach.”

Last month, amid the longest government shutdown in US history, Scott leapt at the opportunity to champion possible Republican alternatives to the healthcare status quo, despite his ignominious record.

In 2003, the US Justice Department announced that the hospital chain HCA Inc.—formerly known as Columbia/HCA—had agreed to pay hundreds of millions of dollars in penalties and damages to settle what the DOJ characterized as the “largest healthcare fraud case in US history.”

Scott resigned as CEO of Columbia/HCA in 1997, days after federal agents raided company facilities as part of the sweeping fraud probe. The federal government and company whistleblowers said the hospital giant “systematically defrauded” Medicare, Medicaid, and other healthcare programs through unlawful billing and other ploys.

“In 2000, Scott invoked the Fifth Amendment 75 times in a deposition as part of a civil case involving his time leading the company,” Florida Phoenix reported last year. A former HCA accountant accused Scott, who was never directly charged in the case, of leading “a criminal enterprise.”

Scott later served two terms as governor of Florida and is now one of the wealthiest members of Congress, and he maintains he was the victim of a politically motivated DOJ investigation.

“The Clinton Justice Department went after me,” Scott complained during his 2024 Senate reelection campaign.

It’s unclear whether Scott’s healthcare ideas will gain sufficient traction with President Donald Trump and Republican lawmakers, who have seemed content to bash the existing system without proposing anything concrete or viable to replace it. Trump was supposed to unveil his own healthcare proposal last month, but the White House pulled the plug amid GOP pushback.

Some members of the Democratic caucus, meanwhile, are making the case for the very system Scott is warning his colleagues about.

“Let’s finally create a system that puts your health over corporate profits,” Sen. Chris Van Hollen (D-Md.) said earlier this week. “We need Medicare for All.”

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mma 10 25

Fox News propagandists are overwhelmingly backing the GOP’s bogus shutdown message that congressional Democrats are refusing to fund the government because they want to give health care to illegal immigrants. But every once in a while their masks slip, and they reveal that they oppose extending the crucial Obamacare subsidies at the heart of Democrats’ actual position, which would trigger drastic premium price hikes for millions of Americans.

A partial government shutdown began at midnight on Wednesday after both Republican and Democratic proposals to extend government funding failed to reach 60 votes in the Senate. CBS News reported that the Democrats’ “red line” was “a permanent extension of enhanced tax credits for Americans who purchase health insurance through the Affordable Care Act marketplace.” Those enhanced tax credits, authorized under the American Rescue Plan Act in 2021, are scheduled to expire at the end of the year.

That’s as it should be, according to some Fox pundits.

Fox host Sean Hannity complained on Wednesday night that Democrats had refused to fund the government in part because “they want to extend Biden COVID-era health care subsidies, which were supposed to be temporary. COVID is over.” But rather than explain the implications of allowing those subsidies to expire, Hannity pivoted away to his main gripe. “Don’t let the left fool you. This is also about your tax dollars funding health care for illegals,” he said, while airing B-roll from 2022 and 2023 of migrants crossing the U.S.-Mexico border. “Democrats have been lying, trying to deny it,” he added.

Video

Citation

From the October 1, 2025, edition of Fox News' Hannity

Earlier that day on The Five, after Democratic co-host Jessica Tarlov pointed out that the ACA subsidies are “the crux” of the dispute, Jesse Watters interjected that Democrats “juiced up the premiums for COVID-level spending” and Republicans simply “want to bring it back down to pre-COVID.”

Guest host and Fox contributor Paul Mauro chimed in that Democrats “used COVID to throw all of these subsidies in, and like any entitlement, when you go to take it away, people have strokes.”

“Right,” Fox host Greg Gutfeld interjected.

This position is wildly unpopular — polls show that supermajorities of Americans support extending the subsidies, with even Republicans and self-identified MAGA supporters backing it by a wide margin — and for good reason.

The 22 million Americans who benefit from those enhanced subsidies will face crushing increases in the cost of health insurance if those Fox hosts get their way and Republicans allow them to expire. According to CBS News:

The cost of premiums for people who buy their insurance through the ACA marketplaces could more than double, rising from an average of $888 in 2025 to $1,904 in 2026, according to a Sept. 30 analysis by KFF. About 4 million people would likely drop their insurance coverage if the credit is allowed to expire because they would't be able to afford the costs, the Congressional Budget Office has estimated.

That’s a huge potential impact for millions of people — but Fox’s mentions of these subsidies are breathtakingly rare.

Tarlov and other Democrats have used appearances on the right-wing network to try to warn its viewers, but Fox’s stars are far more blasé. They are relying on a typical page from Fox’s standard playbook: Mentions of the Obamacare subsidies and potential results of the policy they support are few and far between, as the hosts instead try to redirect the attention of their audience and stoke their rage over the prospect of undocumented immigrants receiving benefits.

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1. ### Right-wing media run wild with the blatantly false claim that Democrats are shutting down the government to secure “health care for illegals”

09/30/25 3:58 PM EDT

2. ### How Fox News is hiding the GOP’s brutal Medicaid cuts

06/26/25 9:28 AM EDT

3. ### Another massive Trump corruption scandal for right-wing media to bury

09/16/25

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an 10 25 reporter no ID

President Donald Trump has repeatedly — and falsely — claimed that Democrats want to shut down the federal government in order to obtain $1 trillion for health care for undocumented immigrants, who by law are not allowed to access programs like the Obamacare exchanges, Social Security, or Medicare.

Democrats are “threatening” to shut down the government “unless they can have over $1 Trillion Dollars in new spending to continue free healthcare for Illegal Aliens,” Trump alleged last week.

He also wrongly claimed Democrats want to “force Taxpayers to fund Transgender surgery for minors, have dead people on the Medicaid roles, allow Illegal Alien Criminals to steal Billions of Dollars in American Taxpayer Benefits, try to force our Country to again open our Borders to Criminals and to the World, allow men to play in women’s sports, and essentially create Transgender operations for everybody.”

READ MORE: ‘No More Dudes in Dresses’: Hegseth Targets ‘Woke’ Diversity, ‘Nordic Pagans’ and ‘Beardos’

In a rare moment, a reporter told the President that undocumented immigrants are not eligible for health care, and pressed him on what he meant.

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“They’re not eligible for the healthcare subsidies that Democrats are demanding,” the reporter said. “So can you clarify, what are you talking about when you say, Democrats want to protect their healthcare?”

“So,” Trump responded, seemingly unaware of the law, “when an illegal person comes in, a person who came into our country illegally, therefore, breaking the law, and — look, we all have big hearts, I have a bigger heart than you do — they’re all breaking the law, and they’re coming into our country, and we just, as a country, cannot afford to take care of millions of people who have broken the law coming in.”

“We want them to come into our country, but we want them to come and legally,” he claimed, before going off on a tangent about the border.

READ MORE: ‘Fascism as a Playbook’: Trump Ripped for Saying U.S. Is ‘Under Invasion From Within’

“I mean, we had a border that was reckless. We had a border that was a disaster. They were coming in by the millions. I say 25 million people, and you’re saying less, but I say 25 million people came in illegally.”

“And no system can take care of the healthcare of all of those people that came in our lifetime for that,” Trump added, again, apparently unaware that that is not what Democrats are asking for.

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The federal government is expected to shut down by midnight Wednesday morning, and health insurance premiums may be about to skyrocket — particularly in some of the reddest states in the country.

That's according to Sen. Tammy Duckworth (D-Ill.), who posted to her official X account on Tuesday that residents of several deep-red states could soon be in for serious sticker shock when shopping for health insurance. She wrote that monthly premiums are expected to jump as high as 346 percent in Alaska; 150 percent in Louisiana; 314 percent in Mississippi; 235 percent in South Dakota; 320 percent in Tennessee; 387 percent in West Virginia and 382 percent in Wyoming. All of those states are represented by 14 Republican senators.

"Republicans are fighting to make sure this happens to their own constituents," she wrote.

Duckworth's figures come from a Tursday report from the Kaiser Family Foundation (KFF), which recently broke down how much health insurance premiums would rise in each state if Affordable Care Act (ACA) subsidies expire at the end of the 2025 calendar year. Premiums could rise sooner than that, as health insurance companies are already calculating the cost of 2026 monthly premiums when the open enrollment period begins on November 1.

Those subsidies, which are formally known as "enhanced premium tax credits," were introduced in 2021 and later extended through the end of 2025 after former President Joe Biden signed the Inflation Reduction Act into law. Americans with incomes above 400 percent of the federal poverty level are eligible for the enhanced premium tax credits.

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"For example, with the enhanced tax credits in place, an individual making $28,000 will pay no more than around 1 percent ($325) of their annual income towards a benchmark plan," the KFF wrote in its report. "If the enhanced tax credits expire, this same individual would pay nearly 6 percent of their income ($1,562 annually) towards a benchmark plan in 2026."

"In other words, if the enhanced tax credits expire, this individual would experience an increase of $1,238 in their annual premium payments net of the tax credit," the report continued.

Democrats have been pushing Republicans to extend the tax credits in exchange for voting for the government funding bill currently being debated in Congress. So far, Republicans have refused to include an extension. President Donald Trump baselessly accused Democrats of wanting "free healthcare for illegal aliens," even after a reporter reminded him on Tuesday that undocumented immigrants are not eligible for the ACA subsidies Democrats want to extend.

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Expert warns 'gaslighting' Republican plan does 'much more harm' than just gutting Medicare

John Stoehr June 04, 2025

The Republican budget bill that recently passed the House adds onerous work requirements that would push millions of people off Medicaid. House Speaker Mike Johnson told “Meet the Press” over the weekend that they’d only lose their healthcare if “they choose to do so.” But that, according to Charles Gaba, is “gaslighting b-------.”

“The entire point of imposing work requirements,” Charles told me, “is to either discourage eligible people from enrolling or to make the requirements difficult to comply with, resulting in millions being kicked off the program even if they are working or volunteering.”

Charles Gaba is “the biggest powerhouse Democratic donor wrangler that nobody has ever heard of,” according toPolitico. As the editor and publisher of ACAsignups.net, he’s also one of the country’s leading authorities on Obamacare, Medicaid and healthcare policy, generally.

After the House Republicans passed their budget bill, I got in touch with Charles. I asked him straight up if the legislation guts Medicaid.

Yes, he said, but it does so much more harm than that.

If the congressional Republicans do not extend insurance subsidies passed during the pandemic, Obamacare enrollees will “face massive premium hikes – in many cases, three and four times higher than what they're paying right now,” he said. That’s impacting some 24 million Americans, most of them, Charles reminds me, residing in red states.

The following is a long interview, but vital to anyone with a stake.

Are the Republicans really going to gut Medicaid? Huge numbers of people who voted for and who support Donald Trump depend on it.

The version of the budget bill passed recently by House Republicans absolutely would, if implemented, gut Medicaid – particularly for around 20 million Americans who are currently enrolled in Medicaid via the Affordable Care Act expansion that’s in effect across 41 states.

Obviously, there will be changes made to it in the Senate, so we don't know what the final version of the bill will be, and even if it passes through both the House and Senate, and is signed into law by Trump, there will no doubt be legal challenges to some provisions within it.

But yes, the current version passed by House Republicans would be pretty devastating to both Medicaid as well as ACA exchange enrollees.

There has been less attention to those ACA exchange enrollees. What does the budget bill do to the Affordable Care Act? What do those changes say about Trump and the GOP’s plans for the safety net?

The first way the budget bill hurts the ACA is what it doesn’t include – extend the improved tax credit formula under the Inflation Reduction Act (IRA), which is scheduled to expire at the end of this year.

If the IRA subsidies expire this year, nearly all of the around 24 million Americans enrolled in healthcare coverage via the ACA exchanges will face massive premium hikes – in many cases, three and four times higher than what they're paying right now.

Millions will be priced out of being able to afford coverage at all, while most of the rest will have to either eat the higher premiums, downgrade to a lower-quality plan with higher deductibles, higher copays, a worse provider network or all of the above. Or they'll have to move to non-ACA coverage via so-called "junk plans," which have few if any of the patient protections required by ACA plans.

That’s what the budget bill doesn’t do to the ACA. What does it do?

It makes a bunch of changes to how ACA exchange enrollment and tax credit eligibility work. Some of these get pretty wonky, and some would "just" be codifying rules that are already being put into place by the Trump Administration, but the list includes things like:

Denying tax credits via ACA exchange plans to anyone who (ironically) gets kicked off of Medicaid for failing to meet the new "work reporting requirement" provisions.

Changing the ACA's formula for determining "maximum out of pocket" costs (MOOP), so that enrollees would face hundreds of dollars in higher deductibles and copays.

Weakening the ACA "metal level" rules to let insurance carriers make plans less comprehensive (ie, silver plans are supposed to cover around 70 percent of average enrollee costs; under the GOP changes, a silver plan cold cover as little as 66 percent.)

Cutting the open enrollment period nearly in half, from the current 76 days down to 45 days.

Mandating a $5 per month premium on some low-income enrollees who are currently eligible for $0 per month premiums.

Adding a whole bunch of extra red tape to millions of enrollees for them to remain eligible for tax credits.

All of this illustrates Trump and the GOP's disdain for and hatred of the social safety net as a whole: If they can't get rid of it outright, they'll deliberately make it too cumbersome and complicated to work, thus allowing them to claim government itself doesn't work.

:{Or,:{ as PJ O'Rourke once put it: The Republicans are the party that says government doesn't work and then they get elected and prove it}:

• YouTube

www.youtube.com

How are the Republicans going to justify taking health insurance away from people or making what they do have worse than it is?

GOP House Speaker Mike Johnson has repeatedly used the "lazy young men playing videogames" stereotype, as who he claims they want to force into "getting off the couch to get a job" etc, even though there's no evidence that a lack of healthcare coverage inspires young men to seek employment and plenty of evidence that providing healthcare coverage to people makes them more likely to get and keep a job.

They're also trying to claim that millions of undocumented immigrants are "stealing" healthcare even though federal dollars don't pay for Medicaid for any undocumented immigrants. There's a few states that pay for Medicaid for that population using 100 percent state dollars, which is entirely up to the voters of those states. Yet the House Republican bill tries to blackmail those states into not paying for Medicaid for undocumented immigrants by threatening to withhold federal dollars for US citizens and documented residents if they don't.

I'm going to be generous and say that Trump voters seem confused. A recent report by NPR suggested that they don't want Medicaid cuts for people they know, but do want cuts for some kind of makebelieve freeloader. This seems to me a recipe for continued support for Trump, even as he's hurting his own people. Thoughts?

Sadly, that sounds likely to be the case. I listened to and read the NPR piece you mentioned, and everyone who talked about "waste" or "abuse" spoke in very vague terms without ever specifying who exactly they think is "abusing" or "wasting" Medicaid dollars.

In addition, they seem to simply flat-out refuse to believe that Republicans and Trump will take away their healthcare, because "that wouldn't be right" and "I need it," regardless of what's in the bill.

I've even read other articles where Trump supporters shrugged off the potential loss of Medicaid/ACA coverage, because they figured that Democrats would stop or reverse the cuts from happening, which seems like a rather twisted sort of justification for supporting Republicans.

That seems to be happening in the interplay between the House and the Senate. Trump voters want cuts for "those people." So the House bill passed. They don't want cuts for themselves. So the bill is stalling in the Senate. I don't know what any Democrat could say to Trump voters when the point for them is theater, not solving problems.

I know that Missouri Senator Josh Hawley has been vocal about opposing any major cuts to Medicaid while Alaska Senator Lisa Murkowski has openly called for the IRA subsidies to be extended.

The House GOP bill does a lot to try to punish Democrats more than Republicans, but it would still be pretty devastating for millions of Republicans no matter what, making it difficult to square the circle.

While I noted there are more Medicaid expansion enrollees in blue House districts, there are more ACA exchange enrollees in red House districts, and even within those, there's still no way of knowing for certain whether a particular enrollees is a "one of their own" or not.

NOW READ: 'Watch carefully': Marjorie Taylor Greene doubles down in new 'warning' to lawmakers

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an 12 24

Florida leads the nation in Obamacare sign-ups as Republicans fight Medicaid expansion

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mike j jokes about ~ ACA

an 11 24

having secured control of both chambers of the U.S. Congress and the White House starting in January, Republicans are making no secret of their intention to pursue sweeping healthcare cuts that would raise costs and imperil insurance coverage for millions of people across the country.

Rep. Jodey Arrington (R-Texas), chairman of the House Budget Committee, told reporters earlier this week that the GOP is looking to use the filibuster-evading reconciliation process to pursue cuts to "mandatory programs"—a category that includes Medicare, Medicaid, and Social Security.

Bobby Kogan, senior director of federal budget policy at the Center for American Progress, noted in response to Arrington's comments that Republicans attempted to cut both Medicaid and Affordable Care Act (ACA) tax credits that help enrollees afford health insurance.

The Republican Study Committee, of which Arrington is a member, proposed eliminating the ACA tax credits in its 2025 budget proposal—a move that could result in around 4 million peoplelosing insurance.

:{The tax credits are set to expire next year, meaning Republicans could just do nothing and allow them to lapse.

Last time Republicans had a federal trifecta, they tried and failed to fully repeal the ACA—an effort that sparked a wave of civil disobedience on Capitol Hill.

Both President-elect Donald Trump and House Speaker Mike Johnson (R-La.) said on the campaign trail that they're looking to try again.

"We're going to replace it," Trump said during his lone debate with Vice President Kamala Harris in September—while admitting that he did not have a fully formed alternative plan.

Johnson, for his part, said during a campaign stop in Pennsylvania last month that "healthcare reform's going to be a big part of the agenda." When a voter posed the question, "No Obamacare?" Johnson replied in the affirmative, "No Obamacare."

"The ACA is so deeply ingrained, we need massive reform to make this work," he added, "and we've got a lot of ideas on how to do that."

Sarah Lueck and Allison Orris of the Center on Budget and Policy Priorities wrote Wednesday that Trump's return to the White House and the GOP's capture of both chambers of Congress poses "big risks to people's ability to access and afford health coverage in Medicaid and the marketplaces."

"While Republicans have moved away from talking about their plans for changing health coverage in the U.S. as 'repeal,'" Lueck and Orris added, "Trump's first term and Republicans' recently released policy agendas suggest they may pursue policies that would have much the same result: higher costs for people, reduced access to care for vulnerable groups, and more people who are uninsured."

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Vance's ACA remarks deserve more attention than they've gotten from top newspapers

JD Vance suggested a Trump administration would gut the Affordable Care Act. Only The Washington Post covered it.

Written by Harrison Ray

Research contributions from Rob Savillo & Tyler Monroe

Published 09/20/24

The Washington Post was the only paper out of five of the top newspapers to cover in print Sen. JD Vance’s (R-OH) indication that a second Trump administration would gut the Affordable Care Act, reversing protections for seniors and people with preexisting conditions.

There hasn’t been a single news article about Vance’s comments in the A sections of the five papers’ print editions in the time between when the senator’s comments aired on Sunday and 3 p.m. on September 20. The only print coverage of the comments came from 2 opinion pieces in The Washington Post.

• After praising former President Donald Trump's 2017 efforts to repeal Obamacare (which would have left 23 million Americans uninsured), Vance attempted to clarify the campaign's position on health care during a September 15 interview on Meet the Press, which he described as “deregulating the insurance markets”:

Think about it: a young American doesn't have the same health care needs as a 65-year-old American. A 65-year-old American in good health has much different health care needs than a 65-year-old American with a chronic condition. And we want to make sure everybody is covered.

But the best way to do that is to actually promote some more choice in our healthcare system and not have a one-size-fits-all approach that puts a lot of people into the same insurance pools, into the same risk pools, that actually makes it harder for people to make the right choices for their families.

Vance doubled down during a rally in North Carolina, explaining the policy in more detail:

If you only go to the doctor once a year, you're going to need a different health care plan than somebody who goes to the doctor fourteen times a year because they've got chronic pain or they've got some other chronic condition.

That's the biggest and most important thing that we have to change. Now, what that will also do is allow people with similar health situations to be in the same risk pools.

As Jonathan Chait explained, “The Trump plan, according to Vance, is to permit insurance companies to discriminate against people with preexisting conditions.” Which in essence means “Vance is advocating a partial or complete return to the system that existed before Obamacare."

• Media Matters reviewed print articles in the A sections of five of the top U.S newspapers for coverage of Vance’s comments and found that only 2 opinion articles in The Washington Post mentioned them. The Los Angeles Times, USA Today, The New York Times, and the Wall Street Journal all failed to cover Vance’s comments on the ticket’s health care plan.

In The Washington Post’s coverage, a piece from the editorial board noted the Trump/Vance plan “could explode costs for older Americans or those with preexisting conditions.” The other opinion piece clearly explained the stakes:

Vance is referring to letting insurance companies offer different plans and pricing based on whether patients have preexisting conditions or might need more medical care because of their age, health status, gender, etc., or perhaps even their genetic profile. Rather than spreading the insurance risk around to a larger group of people who to some extent cross-subsidize one another, Vance wants to segment riskier patients into their own “pools.” Sicker, higher-risk, more expensive people can “choose” to go into one pool; healthier, less risky, cheaper-to-insure people can “choose” to land in another.

The Washington Post also had a news article about Vance’s comments in its online edition.

• As the health care research organization The Commonwealth Fund explained the last time Trump tried to repeal the ACA:

The reality is that high-risk pool coverage was prohibitively expensive and there is little evidence to suggest that the existence of such pools made coverage less costly for others in the individual insurance market. Without substantially more federal funding than currently proposed, these facts are not likely to change. People with preexisting conditions may have “access” to coverage, but most will not be able to afford it and those who can will face limited benefits and extremely high deductibles and out-of-pocket payments.

With American voters consistently rating health care as a top election issue, these newspapers must do a better job of informing readers about the stakes of the race: If Trump and Vance repealed the ACA, it would be disastrous for those who need care the most.

• ## Methodology...

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How the GOP plans to make us sicker

Rep. Marjorie Taylor Greene (R-GA) flexes her muscles during a Bikers for Trump campaign event held at the Crazy Acres Bar & Grill on May 20, 2022 in Plainville, Georgia. (Photo by Joe Raedle/Getty Images).

Dan BenbowMay 13, 2024

The Republican Party has a knack for keeping America sick.

In 1994, when virtually every other developed country had universal healthcare, Republicans and their medical-industrial complex allies used a flood of disinformation to kill President Bill Clinton’s healthcare reform bill.

For 16 long years after, Republicans blocked structural reform, with predictably grim results. By 2010, 49 million Americans lacked coverage. Medical bills accounted for 62 percent of U.S. bankruptcies (up from 8 percent in 1981). Tens of thousands of Americans a year died from a lack of healthcare coverage.

ALSO READ: 16 worthless things Trump will give you for your money

Summarizing a 2010 Commonwealth Fund report, science writer Maggie Fox said that “Americans spend twice as much as residents of other developed countries on healthcare, but get lower quality, less efficiency and have the least equitable system.”

Just months earlier, Democrats had overcome a Republican filibuster to pass the Affordable Care Act (ACA), but the law hadn’t taken effect yet.

Several frivolous court challenges and then-Sen. John McCain’s act of political courage later, the ACA has achieved a number of big things. They’ve made us healthier. And they’re worth listing individually:

The ACA, colloquially known as Obamacare, currently provides healthcare to 40 million Americans.

The U.S. now has its lowest uninsured rates in modern history. If not for state-level GOP resistance to Medicaid expansion, the number would be even higher — an estimated 2.3 million additional Americans would have healthcare coverage.

The number of Americans under the age of 26 who receive coverage through their parents’ policies has more than doubled, according to the Centers for Disease Control and Prevention.

Americans with pre-existing conditions (including “up to 86 percent of people ages 55 to 64” who are not yet Medicare-eligible) are no longer at the mercy of healthcare industry greed.

Americans aren’t necessarily bound to toxic employers for their healthcare coverage, since they can sign up for the ACA if they leave a job with benefits. This is especially beneficial to the self-employed.

Americans who experience traumatic, life-changing events won’t be gouged due to caps on annual out-of-pocket costs and the end of insurance company limits on payouts for a given patient.

The ACA uses rate review to make insurance companies spend at least 80 percent of their budget on direct care, rather than on expenses which have no value to patients—marketing, advertising, profit margins, lavish CEO compensation and the inflated administrative costs that come with privatization and multiple billers.

Closing the health gap

Despite these big steps forward, four decades of Republican obstruction has ensured that the United States still has a long way to go before it catches up to its peers.

Unique among developed countries, the United States still fails to cover tens of millions of its citizens, which contributed to hundreds of thousands of deaths during the COVID pandemic.

Millions with employer-based coverage self-ration their care to avoid exorbitant co-pays and deductibles.

Relative to other developed countries, America still has far more medical bankruptcies, far higher infant mortality rates, far higher maternal mortality rates, and higher avoidable mortality rates.

Our fragmented healthcare system contributes to by far the highest rates of childhood deaths of any industrialized country, and our life expectancy is lower than some developing countries.

Because of GOP hostility to government price regulation (a component of all universal health systems), Americans continue to pay by far the most for healthcare and prescription drugs among our advanced economy peers.

To the extent he has been able — despite senators Joe Manchin and Kyrsten Sinema and unified Republican opposition — President Joe Biden has ameliorated these problems.

His American Rescue Plan Act increased ACA subsidies for millions, decreased income requirements for ACA eligibility, and lured additional states into Medicaid expansion with increased subsidies. Thanks to Biden, new ACA enrollments hit a record high this year.

The Inflation Reduction Act keeps ACA subsidies in place through 2025. It caps costs for insulin and other drugs covered under Part D of Medicare and will limit out-of-pocket prescription drug expenses to $2,000/year for Medicare beneficiaries in 2025. It also forces prescription drug companies to negotiate the costs of the 10 most expensive drugs (a number that will rise to 20 drugs annually.)

When blocked by Congress, Biden has used executive actions. Biden expanded postpartum Medicaid eligibility and open enrollment periods for the ACA and increased funding for navigators that assist Americans signing up for ACA coverage. He reformed Title X to extend family planning access to women who’d had it stripped away by the Trump Administration. He also fixed the “family glitch,” which kept family members of people with overpriced employer-based coverage from getting coverage through the ACA.

Biden also took a number of steps to shore up the Children’s Health Insurance Program (CHIP) and increase funding for the Maternal, Infant, and Early Childhood Home Visiting Program, which provides health benefits for Alaska Native and American Indian families and pays for itself many times over.

Your health is on the ballot

If given another term, and a Democratic Congress, Biden would continue improving the nation’s healthcare system, as reflected in his most recent budget.

Biden would expand care to the uninsured, improve coverage and lower drug costs in the CHIP program, Medicare and Medicaid.

He would try to extend ACA subsidies beyond 2025 and increase ACA subsidies to lower premiums.

He would raise the number of drugs Medicare negotiates to 50 annually, expand the $2,000 annual prescription drug cap to private plans and limit co-pays for generic drugs.

He would try to make Big Pharma pay rebates if the cost of a specific drug goes up more than inflation. His agenda also includes expanded home care services, improved access to mental health care, and increased research in women’s health.

He would continue to work on lowering maternal mortality rates and improving neonatal care. He could revive policies blocked by Congress during his first two years — such as a Medicare buy-in for Americans 50 and older and a national public option, which has lowered patient costs at the state level.

ALSO READ: How Trump could run for president from jail

By contrast, Donald Trump, the former president and presumptive 2024 Republican nominee, shows little interest in healthcare reform. His website is conspicuously light on healthcare policy. He rarely talks of it on the campaign trail.

In a nod to his old-and-white constituency, he promises to take on Big Pharma, but Biden is already doing this and congressional Republicans have actually considered a repeal of the pricing curbs that Biden established.

Trump’s site makes a vague statement about appointing a panel to review childhood illnesses, Washington-speak for kicking the can down the road.

His public statements offer mixed messages on the big issues. Would he try to repeal the Affordable Care Act? Would he protect Medicare, privatize it or cut funding? Would he maintain protections for people with pre-existing conditions or allow them to go without coverage by leading an effort to repeal the ACA, as he has threatened to do?

Given Trump’s prior record — his lack of clarity about future plans, his habit of lying consistently, the 88 felony counts pending against him across four separate criminal court cases — healthcare advocates have no good reason to trust him.

In fact, if Trump serves a second term with Republican majorities in Congress, the GOP would almost certainly make our healthcare system more expensive and less responsive to the average citizen’s needs.

ALSO READ: Trump vs. history: Former presidents typically implode on their comeback tours

The recent House Republican Study Committee budget proposal slashes Medicaid, as did the House Republicans’ 2023 budget proposal. These cuts would be devastating to the poor, the disabled, special needs children, and millions of elderly Americans (Medicaid funds over half of America's long-term care.)

The United States, alone among its developed world peers, has 5 million children with no healthcare. GOP plans to gut Medicaid and the CHIP (Children’s Health Insurance Program) could cause millions more to lose coverage.

GOP repeal of the Affordable Care Act — which Republicans have attempted before and Trump and congressional Republicans remain open to — could have catastrophic consequences.

Up to 30 million Americans could lose their coverage, including many of our most vulnerable citizens. Up to 129 million Americans with pre-existing conditions could again be at the mercy of healthcare industry profiteers. Medical debt and bankruptcies could skyrocket. Millions of Americans could lose access to no-cost preventive services.

Women would bear the brunt of this, stuck with co-pays for (or simply foregoing) mammograms, cervical cancer screenings, pregnancy-related services, contraception, and Pap smears. Their children would lose vital pediatric immunizations.

Due to his unholy alliance with extreme-right, self-proclaimed Christians, Trump would likely exhume his policy to cut off funding for Planned Parenthood and other family planning organizations, thereby taking away birth control from millions of cash-strapped women and exacerbating America’s contraceptive desert crisis.

He would probably re-start his “final conscience rule,” which allows healthcare entities to deny reproductive healthcare to women for religious reasons.

His Justice Department would either support or (at best) present no legal challenges to red state abortion restrictions so ambiguously worded that they actually threaten certain forms of birth control.

He would pack the federal courts with anti-abortion judges such as Matthew Kacsmaryk, the Trump appointee who recently ruled to outlaw mifepristone, an FDA-approved medication used to end early-term pregnancies since 2000.

He would hamper fetal tissue research and undermine the National Institutes of Health and the Centers for Disease Control and Prevention. Again.

ALSO READ: Trump’s Manhattan trial could determine whether rule of law survives: criminologist

In effect, Republicans could inflict the worst of all worlds: big steps backward toward the highly dysfunctional healthcare system we had pre-ACA, with its higher costs, fewer benefits, and more uninsured Americans. They would handcuff groundbreaking health research for American women.

We could expect less healthcare security, more anxiety about keeping our coverage (and our family’s coverage), more rationing due to prohibitive for-profit mark-ups, children not getting basic needs met, low-income disabled and elderly Americans going without and more back-alley abortions.

American lifespans, which already trail other highly developed nations by several years and have significantly regressed since their 2014 peak, will get shorter yet.

The 2024 presidential election will determine if the U.S. continues to gravitate toward the humane and effective healthcare models that exist everywhere else in the developed world or wins a race to the bottom with itself.

Dan Benbow has been an online political features writer since 2003. His work has appeared at Raw Story, the Miami Herald, the New York Daily News, Salon, Truthout and the Progressive. He is currently seeking representation for his first novel and can be reached at benbowauthor@gmail.com or followed @danbenbow on X.

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On Super Tuesday, voters in North Carolina picked their gubernatorial nominees to succeed term-limited Gov. Roy Cooper: State Attorney General Josh Stein on the Democratic side, Lt. Gov. Mark Robinson on the GOP side.

Stein's campaign has a lot of political ammunition to use against Robinson, a far-right Holocaust denier and Christian nationalist who is stridently anti-gay, has called Dr. Martin Luther King Jr. a "communist," and believes that women should not have been given in the United States.

Likely 2024 GOP presidential nominee Donald Trump has endorsed him, and Democratic strategists are hoping that having someone as extreme as Robinson on North Carolina's ballot will benefit President Joe Biden in the swing state.

READ MORE:['Cowardly': NY Times pummeled for ignoring NC GOP nominee’s Hitler and Holocaust remarks

In an article published on March 11, the Daily Beast's Dan Merica stresses that the Stein campaign has another issue to use against Robinson: health care.

Democrats have been slamming Trump for promising to overturn the Affordable Care Act of 2010, a.k.a. Obamacare, if he returns to the White House in January 2025. But Merica points out that Robinson is even to the right of Trump on the ACA, which he considers a plot to "enslave everybody."

"Democrats are eager to focus the race on health care in the southern state, hoping to use Robinson's opposition to the Affordable Care Act and his more recent antipathy to the state expanding Medicaid as a focal point of attacks against the Republican, employing a similar strategy that worked for the party in 2018," Merica explains. "Robinson's particular complaint about the health-care law, signed by President Barack Obama in 2010, was against one of the most popular provisions: the ability for children to stay on their parents' health-care plans until they turned 26 years old."

Trump had high hopes for abolishing Obamacare when the America Health Care Act passed in the U.S. House of Representatives in 2017, but the bill failed in the U.S. Senate. And in the 2018 midterms, health care was a strong issue for Democrats — who didn't retake the U.S. Senate that year but recaptured the U.S. House of Representatives in a big way.

"Robinson, with his history of bombastic comments, has even argued for a more conservative position on health care than Trump, who made repealing Obamacare a focal point of his successful 2016 campaign and attempted to do just that when he took office in 2017," Merica recalls. "Trump, in a bid to assuage critics who worried that taking away health care with no replacement would be politically detrimental to Republicans, often said he would replace the Affordable Care Act 'with reforms that expand choice, freedom, affordability'…. He ultimately got on board with a Republican alternative that was projected to kick 23 million people off health insurance, significantly raise prices for people with pre-existing conditions, and send health insurance markets — according to the nonpartisan Congressional Budget Office — into an 'unsustainable spiral.'"

READ MORE:[John Oliver smacks down Holocaust-denying GOP candidate and 'racist' Trump

Merica adds, "Robinson, however, advocated for full repeal of the Affordable Care Act with no replacement — an even bleaker alternative."

Merica points out that Stein's campaign is already attacking Robinson on Obamacare.

Elisabeth Greenleaf, campaigns director for Progress North Carolina and a Robinson critic, told the Daily Beast, "I can only imagine he will continue to double down on this stance. And our work is educating voters on the impacts of that. It's going to be a big issue in this race."

READ MORE:**Trump’s call to repeal Obamacare blasted as 'outlandish' as signups hit new record high

*Read The Daily Beast's full report at this link (subscription required).

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Trump’s call to repeal Obamacare blasted as 'outlandish' as signups hit new record high - Alternet.org

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TV news coverage since Trump threatened to repeal the ACA mostly failed to mention these critical stakes | Media Matters for America

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AN 11 23

For a brief moment in the summer of 2023, the surprise No. 1 song “Rich Men North of Richmond” focused the country’s attention on a region that often gets overlooked in discussions of the U.S. economy. Although the U.S. media sometimes pays attention to the rural South — often concentrating on guns, religion and opioid overdoses — it has too often neglected the broad scope and root causes of the region’s current problems.

As economic historians based in North Carolina and Tennessee, we want a fuller version of the story to be told. Various parts of the rural South are struggling, but here we want to focus on the forlorn areas that the U.S. Department of Agriculture refers to as “rural manufacturing counties” — places where manufacturing is, or traditionally was, the main economic activity.

You can find such counties in every Southern state, although they were historically clustered in Alabama, Georgia, North and South Carolina, and Tennessee. And they are suffering terribly.

Yes, the South is actually in crisis

First, let’s back up. One might be tempted to ask: Are things really that bad? Hasn’t the Sun Belt been booming? But in fact, by a range of economic indicators — personal income per capita and the proportion of the population living in poverty, for starters – large parts of the South, and particularly the rural South, are struggling.

Gross domestic product per capita in the region has been stuck at about 90% of the national average for decades, with average income even lower in rural areas. About 1 in 5 counties in the South is marked by “persistent poverty” — a poverty rate that has stayed above 20% for three decades running. Indeed, fully 80% of all persistently poor counties in the U.S. are in the South.

Persistent poverty is, of course, linked to a host of other problems. The South’s rural counties are marked by low levels of educational attainment, measured both by high school and college graduation rates. Meanwhile, labor-force participation rates in the South are far lower than in the nation as a whole.

Unsurprisingly, these issues stifle economic growth.

Meanwhile, financial institutions have fled the region: The South as a whole lost 62% of its banks between 1980 and 2020, with the decline sharpest in rural areas. At the same time, local hospitals and medical facilities have been shuttering, while funding for everything from emergency services to wellness programs has been cut.

Less wealth, less health

Relatedly, the rural South is ground zero for poor health in the U.S., with life expectancy far lower than the national average. So-called “deaths of despair” such as suicides and accidental overdoses are common, and rates of obesity, diabetes, hypertension, heart disease and stroke are high – much higher than in rural areas in other parts of the U.S. and in the U.S. as a whole.

Manufacturing counties in the rural South are particularly unhealthy. Residents there die about two and a half years younger than the average American, which to demographers is a staggeringly high differential.

These things, of course, didn’t happen in a vacuum. The Obama-era Affordable Care Act encouraged states to expand Medicaid coverage, but Southern states largely refused to do so. That left large portions of the low- and lower-middle-income population in the rural South uninsured. This has pushed many medical facilities in the region into a death spiral, as their business models — predicated on governmental insurance of one kind or another — became untenable.

Given all this, is it any wonder that rates of upward mobility in the rural South are among the lowest in the country? Alas, probably not — certainly not to residents of rural North Carolina, a state where more than half of its counties lost population between 2010 and 2020.

It wasn’t always this way

Although some people think that these areas have forever been in crisis, this isn’t the case. While the South’s agricultural sector had fallen into long-term decline in the decades following the Civil War — essentially collapsing by the Great Depression — the onset of World War II led to an impressive economic growth spurt.

War-related jobs opening up in urban areas pulled labor out of rural areas, leading to a long-delayed push to mechanize agriculture. Workers rendered redundant by such technology came to constitute a large pool of cheap labor that industrialists seized upon to deploy in low-wage processing and assembly operations, generally in rural areas and small towns.

Such operations surged between 1945 and the early 1980s, playing a huge role in the region’s economic rise. However humble they may have been, in the South — as in China since the late 1970s — the shift out of a backward agricultural sector into low-wage, low-skill manufacturing was an opportunity for significant productivity and efficiency gains.

This helped the South steadily catch up to national norms in terms of per-capita income: to 75% by 1950, 80% by the mid-1960s, over 85% by 1970, and to almost 90% by the early 1980s.

Although today the rise of the Sun Belt is often associated with, if not attributed to, climate, low housing costs and the growth of the South’s booming metropolitan areas, all those rural sweatshops and humble-looking processing sheds opening up in the early postwar era mattered a lot. They elevated the living standards of countless once-desperate and impoverished farmers.

The origins of the rural crisis

By the early 1980s, however, the gains made possible by the shift out of agriculture began to play themselves out. The growth of the rural manufacturing sector slowed, and the South’s convergence upon national per capita income norms stopped, remaining stuck at about 90% from then on.

Two factors were largely responsible: new technologies, which reduced the number of workers needed in manufacturing, and globalization, which greatly increased competition. This latter point became increasingly important, since the South, a low-cost manufacturing region in the U.S., is a high-cost manufacturing region when compared to, say, Mexico.

Like Mike Campbell’s bankruptcy in Hemingway’s “The Sun Also Rises,” the rural South’s collapse came gradually, then suddenly: gradually during the 1980s and 1990s, and suddenly after China’s entry into the World Trade Organization in December 2001.

Between 2000 and 2010, for example, manufacturing employment in North Carolina, one of the South’s leading manufacturing states, fell by about 44%. Starting a bit earlier — in 1998, when the Asian currency crisis squeezed Southern manufacturers — we find that the Tar Heel State lost 70% of its manufacturing jobs in textiles and 60% in furniture between then and 2010.

Other states in the South’s “manufacturing belt,” such as South Carolina and Tennessee, lost about 40% of their manufacturing jobs between 2000 and 2010. Although they have recouped some jobs since then, not one Southern state has as many manufacturing jobs as it did a generation ago. And most of the job growth in the southern manufacturing sector in recent decades has taken place in or near big cities.

The proportion of craftsmen and factory workers in the rural Southern labor force fell from 38% in 1980 to a little over 25% by 2020 — a trend that was particularly striking in rural manufacturing counties.

Factory jobs there increasingly gave way to low-level service-sector gigs, which generally paid less. As a result, median income per capita in rural manufacturing counties in the South has stagnated and is much lower than in rural manufacturing counties elsewhere in the U.S.

The first step is recognizing there’s a problem

Those parts of the rural and small-town South that were once heavily involved in manufacturing are in economic crisis today.

One might argue that the current mess is a legacy effect of the South’s historical dependence on a low-skill, low-cost growth “strategy” — beginning with slavery — that privileged short-term economic gains over patient investment in human capital and long-term development. That’s a big claim about a larger, more complex story.

For now, our aim is simply to call attention to the problem. One must first acknowledge it before there can be any hope of a remedy. Until then, the inhabitants of such areas will remain feeling, as the Southern writer Linda Flowers vividly put it, “throwed away.”

Peter A. Coclanis, Professor of History; Director of the Global Research Institute, University of North Carolina at Chapel Hill and Louis M. Kyriakoudes, Director, Albert Gore Research Center and Professor of History, Middle Tennessee State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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https://www.alternet.org/2022/09/house-republican-gop-repeal-obamacare/

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miissouri judge sides with GOP governor to block Medicaid expansion and override the will of voters

https://www.alternet.org/2021/06/medicaid-2653529375/

In 2020, voters in Missouri approved a ballot measure that called for Medicaid expansion in the midwestern state. But on June 23, a judge ruled that the voter was unconstitutional.

If the expansion went through on July 1, it would expand Medicaid to roughly 275,000 adults in the Missouri. But Republican Gov. Mike Parson, in May, announced that the expansion wouldn't be funded, and Missouri Democrats slammed Parson for defying the will of the voters. A lawsuit was filed on behalf of three Missouri residents with chronic health conditions who cannot afford treatment.

But Judge Jon Beetem of the Cole County Circuit Court sided with Parson, ruling, "The court concludes that the state's refusal to enroll plaintiffs and other eligible individuals in the MO HealthNet program is not unlawful. Notwithstanding a majority vote of the people, an initiative which does not comply with the limits of the Constitution cannot stand."

According to CNN reporter Tami Luhby, Chuck Hatfield — an attorney representing the three plaintiffs in the lawsuit — said he plans to appeal Beetem's ruling all the way to the Missouri Supreme Court.

When Parson announced, in May, that the Medicaid expansion lacked funding, the Republican governor said, "Although I was never in support of MO HealthNet expansion, I always said that I would uphold the ballot amendment if passed. However, without a revenue source or funding authority from the (Missouri) General Assembly, we are unable to proceed with the expansion at this time and must withdraw our State Plan Amendments to ensure Missouri's existing MO HealthNet program remains solvent."

In the United States, millions of people who are either self-employed or do not have health coverage through their jobs have obtained health insurance through the Affordable Care Act of 2010, a.k.a. Obamacare. But Luhby notes that some uninsured Americans find themselves in a "coverage gap" — a problem the Medicaid expansion in Missouri was designed to address.

Luhby explains, "More than 2 million uninsured adults fall into the 'coverage gap,' meaning their incomes were too high to qualify in their states but too low to make them eligible for Affordable Care Act premium subsidies, which are open only to those earning more than 100% of the poverty level in non-expansion states."

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Conservatives backed the ideas behind Obamacare, so how did they come to hate it?

Christopher Robertson, Boston University and Wendy Netter Epstein, DePaul University

Republicans have attacked the Affordable Care Act since it became law 10 years ago, yet Republicans were the ones who came up with the blueprint for the law. How did this twist happen?

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justice Department and 11 states sue Google in antitrust case: 'Long overdue'

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https://www.alternet.org/2020/10/trumpcare-doesnt-exist-but-that-doesnt-stop-nevertheless-facebook-and-google-cash-in-on-misleading-ads-for-garbage-health-insurance-h1/

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an 1020

https://www.alternet.org/2020/10/expert-uber-funded-ballot-measure-in-california-would-create-permanent-underclass-of-workers/

no lnx (bad code?)

Expert: Uber-funded ballot measure in California would create 'permanent underclass of workers'

Angry young man driver, pissed off shaking hands and shrugging shoulders, has problems with the car. Displeased perplexed guy has a road accident. Traffic jam rush hour.

Nicole Karlis October 03, 2020

Those who took high school civics may recall that our democracies lives on fractions. A majority vote — one-half plus one — is what it takes to pass a bill in most legislative bodies. The constitution requires a "supermajority," meaning two-thirds of a governing body, for only the most important and crucial matters: to override a presidential veto, or remove an officer via impeachment, say.

If two-thirds seems like a high threshold for a congressional body, what about seven-eighths? That's the super-duper-majority that would be required to overturn Proposition 22 — the Uber- and Lyft-funded ballot measure that will appear on California ballots this November — should it pass this fall.

You read that right: the astroturf ballot measure written by some of Silicon Valley's biggest corporations, which is written to keep these companies' contractors from achieving benefits or a stable, salaried job, would require a seven-eighths majority of state legislators in both state chambers in order to be overturned — such a difficult threshold to meet that experts say it would be effectively permanent.

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The origin of Proposition 22

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It all goes back to California's Assembly Bill 5, which went into effect on January 1, 2020. The impetus for AB5 was to make gig economy work into more stable and reliable work, and reduce worker exploitation; currently, driver-contractors like those who work for Uber or Lyft are not guaranteed health care of any other benefits if they work more than 40 hours a week, as they are legally contractors rather than employees.

Likewise, such drivers and deliverypersons often make less than minimum wage after their own expenses are accounted for. AB5, which put into place a "test" to determine whether someone is a contractor or employee, was designed to lift these kinds of workers out of poverty.

Yet since AB5 passed through California's state legislature, Uber and Lyft have refused to comply; instead, they chose to pour over $180 million into the astroturf campaign for Proposition 22. Similar gig worker-reliant companies have chipped into the campaign, too. DoorDash has donated $47.5 million; Instacart has donated $27.5 million, and Postmates has contributed a little over $10 million.

According to Ballotpedia, Proposition 22 is the most expensive ballot measure contest in California, and the United States — and if it passes, it will set an example for the corporations that funded it that they could use as a model in other states. Indeed, the companies are funneling so much money into this campaign because there's a lot at stake. For example,Los Angeles and San Francisco are two of the five largest markets for Uber, which has stated in financial disclosures that new regulations in major metro areas could negatively affect their financials. Many of their workers have criticized these companies for pouring so much money into a campaign as they struggle to receive basic support, like personal protective equipment and hand sanitizer, from their employers during the pandemic.

Proposition 22 is more than just a determination of classification, though. Labor experts fear it will be a major setback for labor rights, the community at large, and that it will send the wrong signal to other states who have been exploring ways to regulate these companies.

"They have basically operated as though the law does not apply to them," Ken Jacobs, the chair of the UC Berkeley Center for Labor Research and Education, told Salon. "And I think that signals to other states around the country, 'Don't try to enforce your laws because we have the political power and resources to defeat you if you do.'"

We spoke to experts about the fine print of Proposition 22, and how it will affect Uber and Lyft drivers in the state of California if passed.

1. Very few drivers will actually qualify for health insurance benefits

Uber and Lyft have positioned Proposition 22 as a "third way" solution to provide more benefits to drivers. The campaign states on its website that voting "yes" on Proposition 22 will provide drivers with "new benefits and protections in these tough economic times including a minimum earnings guarantee,access to health care benefits and insurance against illnesses and injuries acquired on the job."

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Yet this depends on a driver's "engaged time," according to the proposition, meaning the time between accepting a ride and completing the ride. This doesn't factor the time a driver is waiting in between drives. For drivers who average 25 hour per week of engaged time during a calendar quarter, Uber and Lyft will provide "subsidies equal to 82% the average California Covered (CC) premium for each month." For those who average between 15 and 25 hours of "engaged time" each quarter, the companies will provide healthcare subsidies equal to 41 percent the average CC premium for each month.

"They purport to have a healthcare reimbursement piece here, but it's very weak and very few drivers would qualify, or at least qualify for the larger amount of it," Jacobs said.

Rey Fuentes,Skadden Fellow at the Partnership for Working Families, told Salon that drivers would essentially have to drive 40 hours a week to get that 25 hours of engaged time to qualify for the best offer. In a report Fuentes co-authored, he notes a second way in which drivers will be essentially cheated of quality healthcare options. "By using the definitions section to ensure that the maximum benefit is actually 82 percent of an average premium payment for the lowest-cost healthcare plan on the Covered California insurance exchange, not a worker's actual premium expenses," the report states.

2. Drivers won't be guaranteed paid leave or paid sick days

Under the current California state and federal law, app-based workers are required to have a minimum of eight weeks of paid family leave, and three days of paid leave for illness or care of a family member. None of this is part of Proposition 22. In the report Fuentes co-authored, the researchers call this omission "glaring," especially in the pandemic, in which many rideshare and delivery drivers are considered to be "essential workers."

"Although some app-based companies have created limited sick leave benefits to respond to this crisis, these plans are voluntary and temporary, and cannot be added to this initiative before voters can weigh in on the ballot measure," the authors write.

Fuentes says there are many drivers who drive to make money to help support a sick family member.

"They're doing it because they're caring for individuals who have illnesses and families, or they have an illness themselves that they can't have traditional employment because your work arrangements are precarious," Fuentes said. "That's why it's actually more important that those workers get things like paid sick leave or paid family leave."

Since drivers have to work at least 40 hours a week to reach 25 hours of "engaged time," taking a vacation will likely affect whether they qualify for healthcare benefits.

3. Drivers won't be able to unionize

This year, more drivers have been organizing to protest unfair labor practices and the lack of protections during the pandemic. However, if Proposition 22 passes, drivers won't be able to unionize and leverage the power of collective bargaining. Under federal law, according to the National Labor Relations Board (NLRB), app-based drivers are said to lack benefits of collective bargaining because they're more like "entrepreneurs," legally speaking. While the legality of this is disputed by various labor organizations, Fuentes said this leaves an opening for states to "establish a separate organizing statute that gives workers the lawful ability to form a union under state law."

"The ballot initiative, however, would prevent the state legislature from ever considering a collective bargaining regime unless it gets a 7/8ths vote of the state legislature, which is an impossible threshold," Fuentes said.

4. Proposition 22 reverses key worker benefit if there's a car accident

"From a driver's perspective this is actually one of the things we think is so harmful about the ballot initiatives," Fuentes said. "California provides workers compensation protection to drivers injured on the job, and that benefit is covered through what is called no-fault coverage."

Even if they are at fault for the accident or contributed to it, all workers in California are covered by the workers compensation statute. Fuentes said Proposition 22 "reverses that."

"This suggests to us very clearly that workers could be denied coverage if they're even partially at fault, which is not something that should ever happen with a workers compensation scheme," Fuentes said. "And the broader part is that workers who are seriously injured and partially disabled or permanently disabled, you can access that up to a lifetime benefit through California's Workers Compensations Temporary Disability Program, but the ballot initiative capped at two years."

5. These reversals and precedents will be most likely permanent

Most astonishing is that Proposition 22, if passed, will be very difficult to amend, since that would require a seven-eighths (87.5%) vote in each chamber of the California State Legislature. Fuentes said this will "lock in" a "permanent underclass of workers."

"All the historic workplace safety protections that California has enacted to protect workers, all of those things are still vitally necessary and even more so now during COVID-19," Fuentes said. "From an abstract perspective, the idea that some of the richest companies in the world are passing a ballot initiative that would exempt their workers from basic labor protections is just, I think beyond the pale."

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https://www.alternet.org/2020/09/experts-lawsuit-heading-to-supreme-court-would-lead-to-massive-transfer-of-wealth-from-middle-class-to-richest-americans/

Republican lawsuit that seeks to strike down the Affordable Care Act would save the richest one-tenth of 1 percent of Americans an average of $198,000 per year, according to an analysis by the Center on Budget and Policy Priorities.

The case, which was initiated by 18 state attorneys general and backed by the Trump administration, is scheduled to be heard by the Supreme Court a week after the November election. A Texas judge ruled in 2018 that the entire Obamacare law was unconstitutional, after the Republican-led Congress eliminated the individual mandate penalty in its 2017 tax bill and an appeals court then sent the case back for the judge to decide whether the entire law needed to be struck down.

Legal experts have called the idea that the individual mandate rendered the entire law unconstitutional “ridiculous” and a “mockery of the rule of law.” But conservatives currently hold a 5-3 majority on the Supreme Court, which could soon swell to a 6-3 majority if President Trump successfully replaces the late Justice Ruth Bader Ginsburg, putting the fate of the law and health coverage and protections for tens of millions of Americans in doubt.

Repealing Obamacare would be a boon for the richest Americans, however, because of the taxes imposed by the law. Obamacare imposed a 0.9% tax on earnings over $200,000 for individualsand $250,000 for couples, along with an additional 3.8% tax on unearned income like capital gains and royalties. The analysis also includes other Obamacare revenue streams, like a$2.8 billion annual fee on pharmaceutical companiesand the law’s employer mandate. These taxes were used to cover the cost of the Medicaid expansion and subsidies for those buying health care on the exchanges created by the law.

The top 0.1% of earners, who make more than $3 million per year, would see a tax savings of about $198,000 per year, according to the CBPP analysis. Households earning more than $1 million per year would get tax cuts of about $42,000 per year.

Households in the bottom 80% would see average tax cuts of less than $80 a year. The top 0.1% would receive 42% of the tax benefits from the law’s repeal.

Tax cuts for households with incomes above $200,000 per year would cost the government about $30 billion per year, enough to cover the cost of the Medicaid expansion for more than 4 million people, according to the analysis.

“In effect, the Administration and the state attorneys general are seeking a massive transfer of resources from low- and moderate-income people to those at the top of the income scale,” the CBPP researchers wrote. “The lawsuit would also widen racial gaps, with Black and Hispanic people disproportionately likely to lose health coverage and the overwhelming share of the tax cuts flowing to white people.”

Based on estimates from the Urban Institute, the analysis found that nearly 10% of non-elderly Black people and 10% of Hispanic people would lose health coverage if the law were repealed. About one of every 16 white people would also lose coverage.

“Meanwhile, the tax cuts that would result from striking down the law would flow disproportionately to white households, which are three times likelier than Black or Hispanic households to be in the top 1 percent of the income scale,” the researchers wrote.

The lawsuit was filed after Senate Republicans unsuccessfully tried to repeal Obamacare despite campaigning on the issue for years.

“Repealing ObamaCare has always been about tax cuts for the rich,” Steve Wamhoff, the director of federal tax policy at the left-leaning Institute on Taxation and Economic Policy, wrote in an op-ed during the repeal push.

An ITEP analysis also found that if Congress had repealed the law’s 3.8% tax on unearned income in 2016, about 90% of the benefits would have gone to the richest 1% of households.

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photo op reality TV performance pseudo-event

trump mocked for finally releasing ‘health care plan’ — which is really a ‘toothless’ executive order

David Badash / The New Civil Rights Movement  September 25, 2020

For at least four years President Donald Trump has been promising the American people a health care plan. He famously sat for the “60 Minutes” cameras just days after the…

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an 920

even Trump’s own health care advisers know nothing about the ‘mythical’ health care plan he brags about: columnist

Alex Henderson

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https://www.alternet.org/2020/08/economist-paul-krugman-lays-into-the-clueless-gop-s-on-california/

no twt charts

California was a red state before the 1990s, but it has become increasingly Democratic since then and is now one of the states far-right Republicans love to demonize. A resident of the East Coast, liberal economist and New York Times columnist Paul Krugman lays out some of the reasons why Republicans are clueless about California in an informative Twitter thread posted on August 31.

Krugman posted the thread in response to a Politico article that was written by journalist Carla Marinucci and published on August 30. Marinucci’s piece outlines some of the ways in which “California-bashing” is part of the GOP’s strategy this election year — for example, trying to vilify the California native who 2020 Democratic presidential nominee Joe Biden chose as his running mate: Sen. Kamala Harris, who served as California’s attorney general before becoming a U.S. senator.

“Not that rationality has anything to do with this, but the GOP attack on CA really involves denial of plain facts,” Krugman tweets. “The state has problems — but not the ones conservatives claim.”

While Republicans often attack California from a health care standpoint, Krugman points out that California has been “an enthusiastic and effective adopter of Obamacare, sharply cutting its number of uninsured.” And the economist backs that up with hard data, posting a graph that shows the number of Californians who lack health insurance compared to other states. Way too many Americans still lack health insurance, but as Krugman demonstrates, California’s willingness to fully embrace the Affordable Care Act of 2010, a.k.a. Obamacare, is why, per capita, it has more people with health insurance than other states.

In other words, California still has a long way to go before it measures up to France, Germany or Italy in terms of access to health care, but it is way ahead of red states like Alabama and Mississippi.

Krugman, however, criticizes California for its lack of affordable housing, but argues that a Trump-like approach would make the crisis even worse.

“CA’s biggest policy problem is housing unaffordability, which can be traced to NIMBYism and hence restrictive zoning,” Krugman writes. “But those are exactly the policies Trump insists we keep, to preserve the Suburban Lifestyle Dream!”

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// attempt pvt USPO?  what happned to maralogo VA scam?

an

https://www.alternet.org/2020/08/trumps-defense-secretary-wants-to-privatize-military-healthcare-using-budget-cuts/

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is it as simple as, dems won on this in 2018 so i'll just co-opt it, tho central to aca which raga and doj actively constantly trying to kill for year? ppl lose healthcare w/ jobs, so helps the, how?

https://www.alternet.org/2020/08/trump-campaign-thought-their-huge-news-on-pre-existing-conditions-had-democrats-cornered-but-it-backfired-spectacularly

During a bizarre Friday evening press conference at his private golf club in New Jersey, President Donald Trump vowed to protect Americans with pre-existing conditions.

Of course, Trump does not need an executive order to accomplish such a goal, as it is already federal law in the Affordable Care Act, that was passed a decade ago by congressional Democrats and then-President Barack Obama.

Trump campaign advisors soon took to Twitter to praise Trump’s promise as “huge news.”

“Huge news just now – [Trump] announces upcoming EO to cover pre-existing conditions. Big, big, big news,” campaign senior advisor Jason Miller tweeted.

Campaign advisor Boris Epshteyn believed it was such “HUGE NEWS” that he tweeted it between to flashing red sirens.

There was just one problem, which was pointed out by trial lawyer Max Kennerly, who pointed out it conflicted with a brief the administration recently filed with the U.S. Supreme Court.

Here’s what others were saying:...

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is this why continue to try to kill aca in middle of pandemic when poor white rural ppl need rx? mos before elextion?! Okla approved narrowly medicaid expansion?!

https://www.alternet.org/2020/07/of-course-theres-a-massive-tax-cut-for-the-super-rich-included-in-trumps-obamacare-lawsuit/

There’s a dollop of cream on top of the shit sandwich that is the Trump-backed lawsuit in front of the Supreme Court to overturn the Affordable Care Act (ACA). That’s of course the big sweetener for the people who matter most to Republicans: the Uber Rich. It’s not just taking health care away from the plebes, as satisfying as that would be for Republicans.No, it has to come with a hefty tax cut for the wealthiest—and of course it does.

The highest income 0.1% of households—those making more than $3 million annually—will get tax cuts to the tune of $198,000 if the law is completely overturned, the Tax Policy Center estimates. Now, $200,000 to someone making more than $3 million is more or less couch change, but you can bet they won’t turn it down. It’s not just the richest among us who gain. Those making over $1 million a year would see about $42,000 back in tax cuts. The total loss of revenue should the law be overturned would be about $30 billion in 2020. That itself would pay for Medicaid coverage for more than 4 million people, just for some perspective. (By the way, if the law goes down, Medicaid expansion goes with it.)

The taxes involved are mostly on high earners in their Medicare taxes. The ACA has a a 0.9% tax on earnings over $250,000 for couples ($200,000 for single filers), with the revenue going to the Medicare Trust Fund. So the repeal would also destabilize Medicare, which is a side bonus for Republicans. The law imposed a larger, 3.8% tax on unearned income (capital gains, dividends, taxable interest, and royalties) for couples with incomes over $250,000 ($200,000 for single filers). The loss of various other revenue generators in the law—a $2.8 billion annual fee on pharmaceutical companies, limits on contributions to medical Flexible Spending Accounts, and the ACA employer mandate requiring large employers to provide health care to workers—all contribute to the overall losses.

Which means, as the Center on Budget and Policy Priorities (CBPP) spells out, a decision by the Supreme Court to destroy the law (and at least part of the intent of Trump and the Republican attorneys general pushing the case) would “transfer billions of dollars each year from low- and moderate-income people (who would lose subsidized health coverage) to high-income households and corporations (which would receive large tax cuts).” They calculated those numbers all the way down the tax rates, with the vast majority of Americans who make less than $250,000 getting $100 or less. The people at the very top, those in the top 1%, would get more than two-thirds of the total cuts. They could spend all that money on their gold-plated health care.

the CBPP also points out that the end of Obamacare would result in even wider health and income gaps for people of color, citing an Urban Institute analysis from before the coronavirus pandemic. It projects that the loss of the law “would cause nearly 1 in 10 non-elderly Black people, and 1 in 10 Hispanic people, to lose coverage, compared to about 1 in 16 white people.” In addition, the tax cuts “would flow disproportionately to white households, which are three times likelier than Black or Hispanic households to be in the top 1 percent of the income scale.”

That, of course, is baked into the entire calculation behind getting rid of Obamacare. Racism is a component of pretty much everything Republicans do.

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https://www.washingtonpost.com/opinions/2020/05/05/why-william-barr-wants-gop-stop-trying-destroy-obamacare/

The Plum Line

Opinion

Why William Barr wants the GOP to stop trying to destroy Obamacare

By

Paul Waldman

Opinion writer

May 5, 2020

You know what you don’t hear many people saying lately? That everyone loves their private health insurance, and that’s why we can’t have health-care reform that gives too many people coverage through the government.

The idea was always absurd, since not wanting to lose your coverage is very different from loving it. (And you don’t understand the true nature of private insurance until you’ve had to fight with an insurance company over a bill it didn’t want to cover.) But the coronavirus pandemic could transform the way we think about health care, among many other things.

That’s why this report from CNN is rather interesting:

Attorney General William Barr made a last-minute push Monday to persuade the administration to modify its position in the Obamacare dispute that will be heard at the Supreme Court this fall, arguing that the administration should pull back from its insistence that the entire law be struck down.

With a Wednesday deadline to make any alterations to its argument looming, Barr made his case in a room with Vice President Mike Pence, White House counsel Pat Cipollone, members of the Domestic Policy Council, press secretary Kayleigh McEnany and several other officials. The meeting ended without a decision and it was not immediately not clear if any shift in the Trump administration’s position will emerge.

This lawsuit, initiated by multiple Republican states, seeks to have the entire Affordable Care Act struck down, which would immediately cost 20 million people their health coverage and mean that somewhere between 50 million and 130 million would lose protections for preexisting conditions, among other things.

This is not a new position for Barr, who may be a Trump lickspittle but has enough political sense to realize what a catastrophe it would be for the GOP if the lawsuit succeeds. It does not appear that the rest of Trump’s crackerjack team of political savants agrees, even in the midst of a pandemic. The prospect of striking down the ACA is too enticing.

This lawsuit was a humanitarian disaster in the making before, but consider what it means now. By some estimates, as many as 35 million Americans could lose their employer-provided health coverage in this recession. While some of those will become eligible for Medicaid and some may be able to get coverage on the Obamacare exchanges, there will without a doubt be millions of people added to the ranks of the uninsured.

And Republicans still want to take away coverage from even more people?

It was an interesting coincidence that on “Fox & Friends” Tuesday morning,Kellyanne Conway repeatedly referred to Trump as “this health-care president,” which is kind of like calling him “this environmental president” or “this immigration president” or “this modesty and sensitivity president.” Maybe she’s already getting worried about how the issue will play in November.

And the lawsuit could — and should — be an issue, one made particularly vivid by the pandemic.

The case could be heard by the Supreme Court this fall, though the decision wouldn’t come until after the election. Republicans may already be afraid that the pandemic will make people even more angry at the prospect of tossing out the ACA, and even more receptive to new reforms that expand the number of people with more secure government coverage, especially when you throw in the fact that health insurance premiums are likely to spike next year.

Which is why I suspect that the pandemic will make it even more likely that Chief Justice John Roberts will once again step in to save the Republican Party from itself by voting with the liberals and saving the ACA.

Imagine it’s January 2021, and there’s a Democratic president and a Democratic Congress. Even if the pandemic is under control, the memory of all that death and sickness will still be with us, as will the terrible economic consequences. Were the court to strike down the ACA, the upheaval and suffering would be so enormous that it would immediately become likely that Congress would pass a dramatic new health reform. Perhaps not single-payer, but certainly a public-option plan that provided millions more with the security that comes with government coverage, and that you can’t get with insurance that you lose if you lose your job.

This is just one area among many in which Democrats have policy ideas that could address gaps and weaknesses in our system that the pandemic revealed and exacerbated — family leave, higher wages, stronger labor protections, and automatic stabilizers to react quickly to downturns without political wrangling, to name a few. In the wake of this crisis, it’s going to become even harder for Republicans to resist at least some of them, especially if moderate Democrats who would hold the balance of power decide that a more robust system of social supports is exactly what the public now wants and expects.

That’s not to say some kind of new New Deal is a guarantee if Democrats are in control, but it has certainly become more likely. The opportunity is there, if they decide to take it.

And if Trump wins in November? He’ll keep trying to get the ACA overturned, probably with continued promises that if he’s successful, Republicans will replace it with “something terrific.” We’ll probably see more iterations of the pattern in which Trump announces that a spectacular new GOP health-care plan is in the works, then everybody pretends he never said any such thing and he forgets all about it.

And Republicans will go right back to saying that government is the problem and we should put our faith in the wisdom of the market. That’s an argument that may sound even more hollow than it did before.

Read more:

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medicare for All is cheaper: Multiple studies say M4A is more cost-effective than a public option

Igor Derysh / SalonFebruary 22, 2020

Two new studies found that the Medicare for All plan proposed by candidates like Sen. Bernie Sanders, I-Vt., and Sen. Elizabeth Warren, D-Mass., would cost less than the public option…

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what Happens When Sheriffs Release Violent Offenders to Avoid Paying Their Medical Bills

Sheriffs regularly release sick and injured inmates to avoid paying their hospital bills. But in Alabama, some defendants charged with violent offenses like murder have been let out. And some have gone on to commit new crimes.

120 propubl

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an 1219

‘People have died as a result’: Residents of rural Missouri are furious with greedy corporation for closing their only hospital

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an 1219

...... no lnx

Repealing two major Obamacare taxes

While Republicans have consistently failed to repeal and replace Obamacare, they were finally able to thwart — with the help of some Democrats — three significant taxes that were enacted under the law.

Under the newly passed package, Congress has gotten rid of the so-called “Cadillac Tax,” which penalizes extremely generous health insurance plans,a broader tax on insurance premiums, and a tax on medical devices. The Washington Post editorial board noted that the repeal of these taxes will add to the federal deficit. But their repeal also undermines a goal that, at least in theory, lawmakers almost universally see as worthwhile: restraining the growth of health care costs and spending.

5. Money to research gun violence

Democrats got a significant win in the spending package in the fight against gun violence, as Politico explained:

The deal would provide federal funding for gun violence research for the first time in over 20 years, marking a majority victory for Democrats and gun control groups that have long lobbied Capitol Hill on the issue. It would designate $25 million for research at the Centers for Disease Control and Prevention and the National Institutes of Health to study gun violence — a field that has largely been stymied since the 1990s, when Congress began using spending bills to bar taxpayer funding for such work.

Given the salience of gun safety to the Democratic Party — and the backlash the issue can inspire on the right wing — it’s remarkable that this development has been barely noticed.

6. Border wall

Congress approved $1.375 billion in funding for work on Trump’s border wall, well below the $5 billion he requested and far short of the estimated $25 billion the entire project could require. However, Trump may still try to use military funds not specifically allocated for physical barriers to fulfill his major campaign promise. Some of these efforts are facing court challenges.

Given that a dispute over the border wall funding fueled a month-long government shutdown at the beginning of 2019, it’s notable that there was relatively little consternation about these provisions now. One implication is that Trump learned his lesson last time — forcing the government to shut down will not help him get his way.

7. Increased funding for science and research[guns]

Congress and American media severely neglect the topic of government funding of science, which, in light of the extreme challenges climate change and other hazards pose to human wellbeing, falls drastically short of what would be desirable. But there are some significant signs that spending is moving in the right direction on this front in the new package, as Science Magazine explained:

The National Institutes of Health (NIH), for example, will receive a 7% boost, or $2.6 billion more, to $41.7 billion. The National Science Foundation (NSF) was given an additional $203 million, a 2.5% increase that lifts its budget to $8.28 billion. The budget of the Department of Energy’s Office of Science will grow by $415 million, or 6.3%, to exactly $7 billion, and space science at NASA will rise by 3.4%, or $233 million, to $7.14 billion.

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someone said case pushed down to prevent scotus in 2020 election

https://www.alternet.org/2019/12/the-warped-and-twisted-logic-republicans-are-trying-to-use-to-rip-health-care-away-from-millions/

no lnx

The warped and twisted logic Republicans are trying to use to rip health care away from millions

Written by Cody Fenwick December 19, 2019

To understand the stakes and debates around the current fight to tear down the Affordable Care Act — otherwise known as Obamacare — you must be able to wrap your head around the twisted the logic that Republicans are using in court.

At the center of the legal battle is the infamous “individual mandate,” the piece of Obamacare that required Americans to purchase health insurance. Advocates for the law backed this provision because of a collective action problem. They feared that without the mandate, too many people would opt to go without health insurance and make the system worse for everyone.

Some claimed this provision was unconstitutional. But in the Supreme Court case National Federation of Independent Business v. Sebelius, Chief Justice John Roberts concluded in an opinion for the majority that the mandate was a permissible application of Congress’ taxing power. If you didn’t get insurance under Obamacare, you had to pay several hundred dollars extra in your taxes — that’s how the mandate was enforced. Roberts decided this was legitimate.

If the question has been settled by the Supreme Court, why is it back at the center of a new lawsuit? That’s where things get really warped.

In 2017, the Republican-led Congress was unable to get the votes to repeal either all of Obamacare or the mandate itself. However, because of technical rules in the Senate, they were able to set the penalty for not complying with the mandate to zero. On Roberts’ understanding of the mandate, it has been effectively repealed. If the federal government passed a lot setting all income taxes to zero, no one would argue that there was a still an income tax.

Legal scholar Eric Segall, a professor at Georgia State University, told me simply that the 2017 change “makes the Constitutionality of the mandate/tax irrelevant. Since that Congress didn’t repeal the rest of [Obamacare], neither should the Court.”

But Republicans argue the opposite. They say that since the law still requires Americans to buy insurance without a penalty, it can no longer be considered a tax. Therefore, to their minds, since it can no longer be upheld as constitutional under Congress’s taxing power, and it should be struck down.

It gets even worse and more bizarre.

The Republican state attorneys general who brought the case, as well as the Justice Department, have argued that the mandate should be struck down — and the rest of the Obamacare should fall with it. Judge Reed O’Connor, a federal judge in Texas, agreed and did just that, sending the case to the Fifth Circuit. His ruling stunned even many conservative legal commentators.

Obamacare is a vast and complex law, and knocking it down would be monumentally disruptive. Tens of millions of people get their health care through its provisions — largely through its expansion of Medicaid and through the private health insurance marketplaces the law set up. Knock down the law, and many people could find themselves without coverage. Even for those who retain coverage, the consequences to the change in the law would be unpredictable, because there’s no telling how insurers would react to the shift.

On Wednesday, the Fifth Circuit upheld O’Connor’s finding that the mandate is unconstitutional — but it sent the case back to him to re-examine the question about whether the mandate could be “severed” from the rest of Obamacare. If he determined that the mandate could be severed, he would be able to strike the mandate from the books, but it would have few if any practical implications.

Nicholas Bagley, a law professor at the University of Michigan, warned that observers shouldn’t be reassured by the court’s new ruling.

“Yes, the court remanded without deciding how much of the ACA had to go. Yes, the court said it’s possible that the mandate could be fully severed,” he said in a tweet. “But don’t buy it. The writing is on the wall.”

He continued: “The court could easily have said that the mandate is fully severable, if it thought it was. But it didn’t. The court could have announced that only community rating and guaranteed issue have to go. But it didn’t.”

His conclusion? The circuit court is “perfectly OK if Judge O’Connor strikes down the most significant parts of the ACA.”

Of course, if that happens, the Supreme Court will almost certainly take up the case eventually. There’s one benefit for Republicans, though, of the case being sent back down to the O’Connor. It stretches out the timetable for coming to a resolution. That may mean the final decision isn’t made — and the disruption of the health care markets doesn’t emerge — until after the 2020 election. If, for example, the Supreme Court were to knock down all of the ACA in the summer of 2020, it would likely be a devastating blow to President Donald Trump’s re-election campaign. The disruption in health are would almost certainly be blamed on Republicans. If the decision can be put off, Trump stands a better chance of retaining power.

It’s not certain, though, that even if the circuit court and O’Connor decide to strike down much of the law that the Supreme Court will concur. While four of the conservatives on the high court might be inclined to gut Obamacare, Roberts has repeatedly been willing to save it before. It would be surprising, then, if he took this opportunity to throw the law out, especially when such a ruling would be in obvious tension with his previous conclusions about the validity of the mandate. And the justification needed to strike down the rest of Obamacare requires some additional and extreme mental gymnastics.

But this is, in many ways, the conservative vision. The reason they care so much about stacking the courts with conservative judges and justices is so they can knock down laws that Republicans hate, even if they’re popular with voters. And it’s even better if, as may be happening now, they can time the most significant rulings to avoid an extreme electoral backlash for the GOP.

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Bezos abruptly cuts health benefits for nearly 2,000 part-time Whole Foods workers: ‘This is disgusting’

Eoin Higgins / Common Dreams

Amazon founder Jeff Bezos on Thursday cut benefits for part-time workers at his grocery chain Whole Foods.

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Thousands of poor patients face lawsuits from nonprofit hospitals that trap them in debt

Maya Miller, Beena Raghavendran / ProPublica

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https://www.alternet.org/2019/08/republican-attacks-on-the-social-security-2100-act-are-an-assault-on-public-health/

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CMD Wins Reversal of Restrictive DOJ Public Records Policy

By ExposedByCMD Editors (Press Release) — Group obtains more than 3,000 records relating to former Attorney General Schimel’s war on the Affordable Care Act.

Read more >>

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big week for barr, squelch mueller (recall 19 pp audition memo, unitary exec BS can not obstruct just by def then walk back, then try kill ACA

https://www.alternet.org/2019/03/republicans-want-to-do-vast-harm-on-health-care-because-its-only-a-right-for-the-rich/

This week, U.S. Attorney General William Barr, a Republican, announced that his predecessor, Jeff Sessions, just hadn’t gone far enough when he asked a federal judge to kill the Affordable Care Act’s (ACA) protections for people with pre-existing medical conditions—that is, stuff like asthma, diabetes and high blood pressure.

Barr told an appeals court that he does not want it to merely murder that one provision but, instead, will insist that it massacre the ACA’s entire 1,990 pages—death to every clause protecting patients from insurance company abuses, every portion devoted to containing costs, every phrase extending health care to the nation’s young adults and working poor.

It is essential, Barr contends, that the court rip insurance from 21 million people covered by the ACA health insurance marketplaces and Medicaid expansion; that the court deny insurance to 2 million young adults covered by their parents’ plans; that the court foreclose substance abuse treatment to 800,000 Americans suffering opioid addiction.

It is critical, Barr insists, to deprive the ACA’s guarantee of medical insurance access to133 million Americans with pre-existing conditionsand toincrease medication and premium costs for 60 million senior citizens on Medicare. Also, of course, Barr says, the court must restore the medical insurance caps that bankrupted and killed Americans who suffered diseases that are expensive to treat, like cancer, or whose babies were born prematurely requiring costly long-term care.

Barr is not an outlier. He is the face of a Republican Party that has done everything in its power to rob Americans of ACA benefits every minute of the nine years that the law has existed. GOP governors have vetoed the ACA extension of Medicaid, denying insurance to millions of low-income working people. When the U.S. House was controlled by the GOP, it voted more than 50 times to repeal all or parts of the ACA. Twenty GOP state attorneys general asked a federal judge to overturn the law after Congress zeroed out its tax penalties for people who refuse to get insurance.

All of this is blatantly mean-spirited because the GOP never produced a plan to replace the ACA health insurance guarantees. In medical terms, it is the opposite of the physician mission to heal. It is Republican machination to harm.

People who drive a Mercedes, spend half a million bucks to get their children into high-status universities and lull away weekends at $3 million Nantucket beach homes will always have health care. The price is irrelevant to them. Even if denied insurance, they can afford chemotherapy, or the monthly bill for insulin or the cost of a leg broken in a sail-boating accident.

For everyone else, for coal miners and code writers, for registered nurses and Starbucks baristas, for Amazon warehouse workers and independent truck drivers, health insurance is vital. Workers, whether low-income or middle class, don’t have hundreds of thousands sitting around for a heart transplant or repeated cancer treatments or neonatal care.

Before the ACA, health insurance corporations took advantage of this situation. They raised premiums at twice the rate of inflation. They refused to insure sick people—the people who desperately need insurance, people with inherited conditions and chronic illnesses. Even some employer-based insurance plans excluded coverage for certain medical conditions. Insurers dropped coverage when people got sick. They capped coverage—so that if $1 million or $2 million—or some other random amount—was spent to save the preemie’s life in the first 18 months, the still-fragile baby was uninsured after that.

Uninsured people died of treatable conditions because they couldn’t afford care. Inadequate insurance bankrupted families. Americans worried incessantly about whether they would be able to afford to maintain their insurance or whether an illness would cost them their coverage.

The ACA cured many of these problems in addition to lowering the rate at which the cost of health insurance rose. As it accomplished those things, it became more popular. Its approval rating rose from around 40 percent initially to 51 percent now. That’s not great, but it sure as hell is better than the way people felt about insurance before the ACA.

The position of Republicans, however, is that some people just don’t deserve health insurance. It’s similar to saying some children just don’t deserve an education. Or some families just don’t deserve to have a fire department respond to a blaze at their home.

Republicans’ first effort to thwart the ACA was a lawsuit challenging its constitutionality.The U.S. Supreme Court ruled that most of the law complied but that the federal government could not force states to expand Medicaid. Under the ACA, the federal government initially paid 100 percent, and later 90 percent, of what it cost states to extend Medicaid coverage to people who earned up to 138 percent of the federal poverty threshold, which is about $17,000 for an individual or $35,000 for a family of four.

As a result, Republican governors and lawmakers denied Medicaid to millions of eligible low-income working people and their families.Some Republican governors went so far as to defy the will of the people of their states. In Maine, for example, voters approved expanding Medicaid in 2017 in a binding referendum by 59-to-41 percent after the Republican governor five times vetoed Medicaid expansion proposals. Even after the referendum and a court decision ordering expansion, the Republican governor refused to do it. Not until a Democrat took the governor’s seat this year did it happen. Similarly, Virginia and Kansas got Medicaid extensions only after they elected Democratic governors.

In Idaho and Utah, just like Maine, Republicans are defying the will of the people in their states who passed referendums to extend Medicaid. In Idaho, the Republican-controlled House decided to require those to whom Medicaid would be extended to buy insurance on the ACA exchanges instead. The Republican-controlled legislature in Utah voted to expand Medicaid only to people earning up to 100 percent of the poverty threshold, instead of 138 percent, and, at the same time, demanded that the federal government reimburse Utah at the 90 percent rate as if the state had properly expanded Medicaid.

In addition, in Idaho, the GOP-controlled House voted to require Medicaid recipients to prove they are working to qualify. Arkansas was the first state where Republicans imposed this demand, and quickly 18,000 residents lost their insurance, either because they didn’t report work or failed to follow complicated rules, which include providing an email address in a state where less than half of residents of some counties have internet access.

Fourteen other states have imposed work requirements or want to, but a federal judge this week told Arkansas and Kentucky to stop it.

They probably will appeal—at the same time Republican Attorney General Barr is trying to blow up the entire health care law. The message is clear: to Republicans, health care is a right only for the rich; the rest can suffer and die. The GOP Hippocratic oath is: Do vast harm.

This article was produced by the Independent Media Institute.

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• Judge Strikes Trump Rule Allowing Employers to Circumvent Obamacare

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https://www.alternet.org/2019/03/economist-paul-krugman-proves-just-how-badly-west-virginians-screwed-themselves-by-voting-for-trump/

Trump promised to bring back coal, an energy source that’s becoming increasingly less viable by the day. And largely because of this, he won West Virginia in a landslide.

Of course, in the long run, the coal industry is screwed. Renewables are getting cheaper and cheaper, so even if you don’t force coal companies to pay for the negative externalities they create (like pollution and health care costs related to dirty air and occupational hazards), coal will be unable to compete in the long run.

But facts have never stopped Trump or his supporters.

Enter Paul Krugman, who recently made a handy little chart showing just how bad a bargain voting for Trump was, even — or especially — for West Virginians:

[twit] 145K ppl will lose healthcare"]

chart: big bar vs tiny one https://twitter.com/paulkrugman/status/1110568596558807040/photo/1

With the new Trump effort to destroy the ACA, I’m thinking about West Virginia, where a lot of people gained insurance under the Medicaid expansion, but voted for Trump because he promised to bring back coal. So I made a little chart pic.twitter.com/UrtIIXHn4v

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https://www.alternet.org/2019/03/ohios-republican-attorney-general-is-going-to-war-with-trump-to-try-and-save-obamacare/

Trump is forcing his Justice Department, over the objections of his own attorney general, to support the position of a coalition of right-wing states suing to strike down the Affordable Care Act, aka “Obamacare” in its entirety.

But at least one GOP state attorney general is among those fighting back. According to the Cincinnati Enquirer, Ohio’s Dave Yost is advising a federal court to throw out the lawsuit:

Yost said in an interview he agrees that the individual mandate to buy health insurance is unconstitutional but disagrees that the rest of the law is also therefore invalid.

Yost plans to file a friend-of the-court brief in the5th Circuit Court of Appeal. The brief will argue the individual mandate can be removed from the law without eliminating protections for pre-existing conditions, insurance caps and other parts of the law. About 1.9 million non-elderly Ohioans have pre-existing conditions, according to the Kaiser Family Foundation.

The lawsuit is rooted in the GOP tax bill passed at the end of 2017, which among other things eliminated the ACA’s individual mandate, and in the Supreme Court’s 2012 decision in National Federation of Independent Businesses v. Sebelius, which said the mandate was constitutional under Congress’ power to tax. Since the mandate no longer exists, the lawsuit argues, it is no longer a tax, and therefore the entire law — pre-existing conditions, community rating, insurance exchanges, essential benefits, tax credits, Medicaid expansion, Medicare reforms, all of it — must be struck down.

• The lawsuit is broadly considered ridiculous even by conservative experts — most of the law’s provisions have nothing to do with the individual mandate, and when Congress eliminated the mandate while keeping everything else, they were clearly establishing the mandate is severable from the rest of the law. Nevertheless, the lawsuit found sympathetic ears in Judge Reed O’Connor, an extremely partisan federal judge in Fort Worth with ties to Sen. John Cornyn (R-TX). O’Connor ruled in favor of the lawsuit, but his ruling is on hold and under review by the Fifth Circuit — and Trump’s DOJ is trying to persuade them to uphold it.
• 20 GOP state attorneys general, led by Texas AG Ken Paxton, initially brought the lawsuit, but Ohio was never among them. Despite being firmly in Republican control for nearly a decade, the state has benefited hugely from the ACA — it adopted the Medicaid expansion, and relies heavily on ACA programs to keep rural hospitals afloat and combat the opioid crisis. Losing all these programs would be a disaster for Ohio, and Republicans there know it.
• In addition to Yost’s brief, over a dozen Democratic state attorneys general led by California’s Xavier Becerra are mounting a defense of the ACA.

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key issue in 2018

ere are five deceitful Republican candidates in key races who been campaigning on protecting Americans’ health coverage while fighting relentlessly to take it away.

1. Arizona Senate Candidate Martha McSally

In the Arizona Senate race, Democratic candidate Kyrsten Sinema has been attacking her GOP opponent, fellow congresswoman Martha McSally, nonstop over health care—stressing that McSally would gladly throw Americans with pre-existing conditions to the wolves. And McSally has responded by insisting that protecting them is a high priority for her. But McSally showed her true colors when, in late October, she snapped at a reporter and asked, “Can we please talk about the things that matter to most voters, instead of repeating the Arizona Democrat Party press releases? Do you have anything to talk about, like the caravan or job opportunities?” And McSally also showed her true colors when, in 2017, she voted for the GOP’s American Health Care Act, which would have repealed the ACA and allowed insurance companies to charge much higher premiums for Americans with pre-existing conditions.

2. Wisconsin Gov. Scott Walker

In Wisconsin, Republican Gov. Scott Walker has been running ads insisting that he will protect Americans with pre-existing conditions if reelected. But when Obama was in Milwaukee recently stumping for Walker’s Democratic opponent Tony Evers, he pointed out that Walker has signed on to a GOP lawsuit that seeks to end those protections (Texas v. Azar). Evers has been calling for Walker to drop Wisconsin from the lawsuit—which, of course, he hasn’t done. When Walker insists that he is looking out for cancer patients or diabetics who are worried about keeping their health coverage, he is—as Obama asserted in Milwaukee—flat out lying.

3. Texas Sen. Ted Cruz

In 2018, incumbent Sen. Ted Cruz has received a surprisingly strong challenge from Democrat Beto O’Rourke in the Texas Senate race—and health care is one of the issues that O’Rourke has been campaigning on aggressively. Cruz has maintained that protecting Americans with pre-existing conditions is a priority for him, but his record says otherwise. Cruz once helped shut down the federal government over his demand that the ACA be reversed, and he happily voted for the American Health Care Act in 2017.

4. California Rep. Dana Rohrabacher

In 2017, incumbent Republican Rep. Dana Rohrabacher voted for the American Health Care Act. But in 2018, the California congressman has had the audacity to campaign on protecting Americans with pre-existing conditions—and his Democratic challenger, Harley Rouda, has been calling him out. While Rouda has described the ACA as a “great program,” Rohrabacher has called it “disastrous.” In other words, Rohrabacher is much more interested in playing partisan politics than protecting Americans who have had the misfortune of suffering from cancer, heart disease and other illnesses that insurance companies consider pre-existing conditions.

5. Florida Gov. and U.S. Senate Candidate Rick Scott

Florida’s two-term Republican governor, Rick Scott, is term-limited in the Sunshine State and has been trying to capture Democrat Bill Nelson’s seat in the U.S. Senate. It’s been a tight race, with some polls showing Scott slightly ahead and others showing Nelson slightly ahead—and Scott has been running ads asserting that if he is elected to the U.S. Senate, he will help protect Americans with pre-existing conditions. But Scott’s record shows that he is lying.

Scott has repeatedly called for a full repeal of the ACA, and he is among the 20 GOP governors who has signed on to the Texas v. Azar lawsuit. In contrast, Nelson voted for the ACA in 2010. And Florida’s Democratic gubernatorial candidate, Andrew Gillum, is a strong opponent of Texas v. Azar.

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krugman/cody f

...For those of us who have long covered health care policy, it's been a mind-boggling turn of events. Republicans, who have always played a losing hand by arguing for the unpopular and wrongheaded idea that there should be more free-market principles applied in health care, are now literally saying one thing and doing the other.

Many GOP candidates are insisting — vociferously — that they are in favor of protecting people with pre-existing conditions — even while the party does its best to dismantle all the protections for people with pre-existing that are at the core of Obamacare.

"Indeed, 20 Republican state attorneys general filed a lawsuit trying to eliminate protection for pre-existing conditions, and the Trump administration has declined to oppose the suit, in effect endorsing it," Krugman noted. "Now, you might imagine that Republicans would respond to the manifest unpopularity of their health care position by, you know, actually changing their position. But that would be hopelessly old-fashioned. As I said, what they’ve chosen to do instead is lie, insisting that black is white and up is down."

He continued:

Thus Josh Hawley, as Missouri’s attorney general, is part of that lawsuit against Obamacare’s regulation of insurers; but in his campaign for the Senate, he’s posing as a defender of Americans with pre-existing conditions. Dean Heller, running for re-election to the Senate in Nevada, voted for a bill that would have destroyed Obamacare, including all protection for pre-existing conditions; but he’s misrepresenting himself just like Hawley is.

And they aren’t just lying about their own position. They’re also lying about their opponents’. Incredibly, Republicans have spent the years since passage of the A.C.A. accusing Democrats of wanting to destroy Medicare.

And of course, this week saw the publication of Trump's op-ed attacking Medicare-for-All, in which, as the Washington Post explained, “Almost every sentence contained a misleading statement or a falsehood.”

If they wanted to, Republicans could try to convince the American people that their view that the health insurance industry should be less regulated, not more, is correct. Or they could, in the face of the facts and the wild unpopularity of their position, either change their minds or simply leave the issue alone and focus on other topics they care about.

But they've realized Trump has had a lot of success lying to voters faces while stabbing them in the back. And, to top it off, he gratuitously smears Democrats with obvious falsehoods.  That's been his consistent strategy, and now the whole party has adopted it as its own.

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https://www.exposedbycmd.org/2018/09/24/attorney-general-schimel-withholds-documents-related-his-legal-war-against-affordable-care-act

Center for Media and Democracy (CMD) filed suit today against Wisconsin Attorney General Brad Schimel and the Department of Justice (DOJ) for refusing to disclose public records related to his high-profile legal war against the Affordable Care Act (ACA).

In February of this year, Schimel and Texas Attorney General Ken Paxton filed a lawsuit,joined by 18 other Republican AGs designed to do what Congress couldn’t — kill the Affordable Care Act. The suit seeks to strike down the law’s individual mandate and would eliminate coverage for preexisting conditions, the ACA’s most popular provision.

CMD submitted an open records request on August 3, 2018 for internal records and communications from the offices of Attorney General Schimel and the Solicitor General regarding the ACA. CMD limited the request to records between January 1, 2018 and August 3, 2018.

On August 20, 2018, the DOJ identified 1,940 relevant emails, but denied CMD’s request outright by claiming it would be “excessively burdensome” to review and redact them.

“Schimel’s case against the Affordable Care Act is of significant public interest. Why he would deny the public information about this controversial suit, which may ultimately be decided by the U.S. Supreme Court, is unknown. But the citizens of the state deserve answers,” said CMD Executive Director Arn Pearson.

“Wisconsin’s Open Records Law has a strong presumption of public access,” said Pines Bach attorney Christa Westerberg, who is representing CMD. “The Department’s denial is a burden on the public’s right to know on a matter of obvious public concern.”

If successful, Schimel’s ACA suit could result in 17 million people losing their health insurance. Insurance companies could be allowed to reject those with pre-existing conditions or jack up their rates.

Congress attempted to repeal and replace the ACA in 2017, but ultimately could not muster the votes in the Senate. Now Republican attorneys general are using their 527 political organization, the Republican Attorneys General Association (RAGA), to coordinate attacks on the ACA to weaken it and, with the latest suit, upend it.

Two of RAGA’s top donors, the billionaire Koch brothers, have spent hundreds of millions on the ACA repeal effort since the law was enacted. Koch Industries has contributed close to half a million to RAGA over the last year and a half and $10,000 directly to Schimel’s reelection campaign.

RAGA, in turn, has pumped $44,000 into Schimel’s campaign and has a $2.5 million ad buy praising the Attorney General running statewide.

“It is puzzling that Attorney General Brad Schimel, the man who created Wisconsin’s Office of Open Government, would deny a reasonable records request that clearly meets the criteria of Wisconsin’s Open Records law,” said David Armiak, a researcher with CMD.

The Center for Media and Democracy is a non-profit investigative watchdog group. Our reporting and analyses focuses on corporate influence and money in politics. We publish ExposedbyCMD.org, PRWatch.org, SourceWatch.org, and ALECExposed.org.

The complaint can be accessed on our website here.

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