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Congressional Republicans looking Out for Your Health, Healthcare Insurance, and Their’s Too . . .

One Happy Republican House Representative
invisible hand If you have not been paying attention, it looks like the Republicans are getting ready again to submit another version of a PPACA/ACA repeal bill. New Jersey Republican Representative Tom MacArthur is proposing an amendment allowing states to opt out of key PPACA requirements. For example:

– Preventative Care: The PPACA has 62 preventative measures or Essential Preventive Care benefits which are no cost to a patient. Cholesterol screening, Type 2 Diabetes screening various immunizations for adults and children, breast cancer screenings, hepatitis B screenings, HIV tests, lead screening for children, etc.

Community Rating: In the good old days when people had a heart attack , disorder, or illness; insurance companies would rate the individual and either insure them at a much higher rate or deny insurance to them. The PPACA acting like a true insurance pool spread the risk amongst the community adapting a more uniform rate for people. Two exceptions were smoking at 150% of the lowest cost individual and 300% for older people (Republicans wish to increase this to 500%). Where people with pre-existing conditions had to pay much higher rates or had no insurance, the PPACA established rates covering them and spreading the cost.

This new GOP amendment allows states to waive community rating. Insurers could again charge people based on their health and expected health care costs. The state would have to participate in the Patient and State Stability Fund (which would be underfunded) before it could waive out of Community Rating. The PSS is a pool of money in the AHCA that states can use to set up high-risk pools or shore up insurers that get stuck with really expensive patients (think of Corridor Risk and Reissuance programs which Republicans defunded).

Initially, the AHCA as proposed by Republicans would have resulted in an estimated 24 million people becoming uninsured over 10 years with a loss of 14 million in one year. We would be back to pre-PPACA with no single payer, universal, public option, Medicare-for-all in sight. The change in the Community Rating would target those with severe illness or disorders, the elderly, and those with pre-existing conditions. Removing the Preventative Care portion of the PPACA targets women and children and again patients would have to pay for them. There is just the healthy left or healthy today and the rest of the populations gets to fend for themselves. That would certainly lower healthcare insurance costs until the healthcare industry sucked it up in increasing prices. Not quite sure who the Republicans are tossing a bone to with this amendment, the healthcare industry or healthcare insurance companies?

As Vox’s Sarah Kliff points out; when the PPACA came into play, all Representatives and staffers had to purchase healthcare insurance on the individuals exchange. What was good for the gander was also good for the goose so to speak. I seem to remember differently; but, let’s go with this for now. There was quite a bit of grumbling going on in Congress when this was proposed.

invisible hand Fast forward to today’s amendment by New Jersey Republican Representative Tom MacArthur; it appears Congress now likes the PPACA when it comes to their healthcare insurance. If Representatives and staffers live in one of those states waiving out of Preventative Care and Community Ratings, Congress is exempt from the wavier. Looking at section 1312(d)(3)(D) of the amendment (sixth page) there is an exemption for those who will not be included in a state’s waiver. Senators, House Representative, their staffers and I am sure every other staffer in Washington, the Cabinet and their staffers, Bannon, etc. are all excluded from any state wavier on healthcare. I am glad they are looking out for us and the people who vote for them.

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7 Islands and 3 Branches

Jeff Sessions said “I really am amazed that a judge sitting on an island in the Pacific can issue an order that stops the President of the United States from what appears to be clearly his statutory and constitutional power,”

There has been considerable discussion of the phrase “an island in the Pacific”. With that phrase, Sessions made it clear that he considers Hawaii to be a second class state — not a real American state like Alabama. I have no doubt at all that he believes this largely because a majority of residents of Hawaii aren’t white. Our Attorney General is deeply racist and only sometimes able to hide this fact.

A Justice Department spokesperson added insult to insult by saying that Hawaii is indeed an island in the Pacific. This is true. Also Bora Bora is an Island in the Pacific. But Judge Watson didn’t issue his order while sitting on Bora Bora or the Island called Hawaii. he was sitting on Oahu, not Hawaii. The US State of Hawaii is an archipelago including 7 large islands only one of which is the island called “Hawaii” in the Pacific.

Sessions personally displayed spectacular geographic ignorance saying “I wasn’t diminishing the judge or the island of Hawaii, that beautiful place, give me a break.”

None of this is very important. What is important is that Sessions challenges the authority of a judge to declare an executive order to be unlawful. ““I was just making the point that’s very real: one judge out of 700 has stopped the President of the United States from doing what he believes is necessary to protect our safety and security.” Sessions has abandoned his claim that his view of what appears statutory and constitutional should count for more than a judges — that an attorney should be able to over rule a judge. Now he claims that the President’s judgement should count more than any (single) judges view of what the law says.

Judicial proceedings start with a single judge (whose judgments can be appealed). Plaintiffs do not have direct access to panels of judges. As noted by Hobbes roughly 370 years ago, the law without a judge amounts to mere ink on paper. Sessions’ clearly stated view is that the President should not be subordinate to any law or statute whatsoever. If no single judge can even temporarily stop him, the law can’t stop him. If no single judge can issue a preliminary injunction or a decision, then no panel of judges can hear the case.

Sessions declares that the USA is, and should be, an absolute monarchy.

He is an enemy of the constitution.

However, he has not committed treason (which requires making war not just declaring it) and has not committed another impeachable offence (he did commit perjury during his confirmation hearings and, of course, should be impeached, convicted, removed from office and, I think, disqualified “to hold and enjoy any Office of honor, Trust or Profit under the United States”).

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A little bit about our supreme court and corporate power

In case you did not see this, it is my Senator’s opening comments at the Gorsuch hearings.  He sums up just what a 5/4 split court has been doing.

 

This is his discussion on Cspan about his book: Captured: The Corporate Infiltration of American Democracy

 

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Pence Makes Deciding Vote Allowing States to Defund Planned Parenthood

Second time Pence has cast the deciding vote in the Senate. Last VP to do so was Cheney in 2008.

VP Pence has made it no secret he is opposed to allowing women the right to decide on having an abortions. While in Congress, Pence sponsored the first bill to defund Planned Parenthood in 2007 and when it did not pass then he continued the effort until it did pass in the House in 2011.

More recently a Federal Court blocked a bill signed by then Indiana Governor Pence forcing women to have a funeral for the aborted fetus which would then go through a burial or cremation. The cost of the burial or cremation would have increased the cost of the abortion dramatically in Indiana. The court ruled Pence’s law would have blocked a woman’s right to choose.

If you remember VP Pence had used his tie breaker vote to approve Betsy DeVos as Secretary of Education. Today, VP Pence was again called upon to break a Senate tie involving the right of states to defund Planned Parenthood.

The Department of Health and Human Services under President Obama ruled organizations providing family planning and preventive health care services could not be barred by states from receiving Title X grant dollars for any reason other than those related to their “ability to deliver services to program beneficiaries in an effective manner.” It required states and local governments to distribute federal Title X funding for services related to contraception, fertility, pregnancy care and cervical cancer screenings to health providers without regard for whether those facilities also performed abortions outside of Title X. Title X funding covers services such as contraception, STD screenings, treatments and can not be used to pay for abortion services.

Weighing in after the tie-breaking vote to overrule President Obama’s Department of Health and Human Services, Senate Majority Leader McConnell had this to say:

“It was the Obama administration’s move that hurt ‘local communities’ by substituting Washington’s judgment for the needs of real people. This regulation is an unnecessary restriction on states that know their residents a lot better than the federal government.”

Not sure what needs McConnell’s real-people would have to block a woman’s decision to have an abortion which is not taken lightly by a woman and using it as an excuse to defund Planned Parenthood. It appears McConnell, Pence, and the Republicans are practicing a tyranny of a majority to disregard the rights of an individual in favor of their own views.

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Trump’s Cabinet Picks Are A Sorry Lot

Lifted from ataxingmatter from Jan 18:

by Linda Beale

Trump’s Cabinet Picks Are A Sorry Lot

As the Friday inauguration date draws near, most ordinary Americans who read, stay informed, pay attention to history and events, and engage in critical thinking are, understandably, aghast at the poor job Mr. Trump has done so far in putting together a workable Cabinet of high-level appointees with the expertise, experience and values that can lead the country.

We Americans share many values.  Among them has always been a view that those who are better off should help those who are less well off. We’ve done that in many ways, beginning with private charity (supported by our tax code) but going much beyond the soup kitchens and church support for a sick parishioner to include a progressive income tax, taxation of the estates of the wealthiest among us upon their deaths (since they were generally almost tax free in life), and the provision of many necessary services through public institutions.  The latter includes things that are important to the everyday life of all of us as well as the opportunities for better lives for those of us not born with a silver (or, in Trump’s case, golden) spoon:

  • a public right to decent health care, made real by the expectation that hospitals (whether for profit or nonprofit) will care for those who enter their emergency rooms in medical emergencies, even if the patients cannot afford to pay the going price for the service needed, and made more substantive by the passage of the Affordable Care Act which provided coverage for pre-existing conditions, allowed young people to remain on their parent’s insurance, and made market exchanges available to provide better to understand choices while providing a federal subsidy for those who otherwise couldn’t afford insurance;
  • public education from kindergarten through college, supported by federal and state funding, with reasonable rules that protect our children, such as not allowing private carrying of guns within protective zones around schools, and –in many states–rules that ensure that public support reaches poor districts as well as wealthy ones;
  • protection of the environment, from national monuments and parks to restrictions on dangerous fracking and oil drilling in sensitive areas (consider the Arctic National Wildlife Refuge), from ensuring that communities have clean water to drink through regulation of corporate waste to ensuring that children have safe homes through regulation of lead paint, from protecting the nation’s waterways so that individual owners and polluters cannot hoard or harm nationally important resources to protecting creatures large and small that represent the genetic diversity of this Earth
  • regulation of commercial enterprises, to ensure that they do not exploit their workers, through fair labor laws and hiring laws and workplace rules that prevent employers from being able to force individuals to work in dangerous conditions or without appropriate rest and meal breaks
  • regulation of financial enterprises, to ensure that those sophisticated ‘quants’ don’t take advantage of less sophisticated customers, to prevent discriminatory practices that disadvantage people of color, to ensure open and fair reporting of financial positions
  • regulation of the foods and drugs that enter our marketplace, to protect Americans, our children and our pets from the kind of pollution of food products that occurred when China’s unregulated marketplace allowed melamine (plastic) to be substituted for protein in pet foods that were exported abroad or the indiscriminate use of toxic pesticides without informing consumers so that we can make good decisions about products that we buy; and on and on

Trump’s appointees for many of the important Cabinet positions seem to be primarily wealthy crony capitalists with radical ideologies that are in direct conflict with the agency missions. Consider just the following three:

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PPACA Repeal and How to Make Reconciliation Work for You.

In this post, I am going to expand upon the impact of the new House Rules H. RES. 5 upon the Repeal of the PPACA. As I explained here Paul Ryan deliberately changed the House Rules and the Republicans following party line approved them with the exception of 3 who voted with the Democrats. The House Rules went from just this:

“The Director of the Congressional Budget Office shall, to the extent practicable, prepare an estimate of whether a bill or joint resolution reported by a committee (other than the Committee on Appropriations), or amendment thereto or conference report thereon, would cause, relative to current law, a net increase in direct spending in excess of $5,000,000,000 in any of the 4 consecutive 10 fiscal year periods beginning with the first fiscal year that is 10 fiscal years after the current fiscal year.”

plus this additional statement:

“This subsection shall not apply to any bill or joint resolution, or amendment thereto or conference report thereon—

(A) repealing the Patient Protection and Affordable Care Act and title I and subtitle B of title II of the Health Care and Education Affordability Reconciliation Act of 2010;

(B) reforming the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act of 2010.”

neatly hidden away on pages 25 and 26 of 115th Congress House H. RES. 5.

Ok, so the Republicans are up to their old craftiness of slipping it to the Democrats when they want to block something the Democrats have done in the past. There is reason to why Congressman wants to block the CBO from reporting on this. It deals with making it more difficult 10 years down the road to change the repeal.

If you remember, Bush’s tax cuts were passed using Reconciliation and the CBO did a cost analysis showing it would create a deficit. Using Reconciliation to pass a bill, the legislation passed and creating a deficit must expire in 10 years. Bush’s tax cuts did create a deficit and a big one much of which was reversed by Obama.

For sure, Congressman Paul Ryan knows the repeal of the PPACA will create a deficit and Republicans know the repeal will create a large deficit. To make sure no one else knows, Mr. Ryan has blocked the CBO from analyzing it before repeal. Also unbeknownst to many, if the CBO does not do its typical independent analysis of the costs (if any) created by the PPACA repeal and how much it increases the deficit, there is no requirement for the legislation to expire after 10 years. Republicans would have repealed the PPACA as they have wanted to do since 2010, and would have blocked it from ever coming back after 10 years.

Crafty little weasel that Mr. Paul Ryan!. Then too Mr. Rand Paul is ready to sell you his healthcare policy (Obamacare Replacement Act) which does cover pre-existing conditions up to a guaranteed two years. After two years, and miss a payment or your healthcare insurance lapses and the healthcare insurance company can charge you the going rate just like the good-old-days. Also keep in mind, “Americans will never learn how devastating the PPACA repeal will be to Medicare’s long term solvency that was extended a couple of decades because of the Affordable Care Act’s execution.”

Where are the Democrats in all of this?

GOP Prohibits CBO From Reporting How Much ACA Repeal Blows Up the Deficit RMuse, Politicus usa January 11, 2017

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Constitutional Crisis ?

To Recap what everyone knows now (in case anyone reads this months from now)

On January 27th Donald Trump signed an executive order suspending the refugee admission program for 120 days and blocking US entry for citizens of 7 countries for 30 days.
The order was written without input from the Justice, Homeland Security, State and Defence departments. As written it banned entry for legal permanent residents (with green cards) who were travelling abroad when it was issued. It also banned entry for people who were on airplanes flying to the USA when it was signed.

On January 28th dozens (to hundreds ?) of people were detained in Airports. Tens of thousands of ordinary Americans went to the airports to protest the new policy (there is hope). Also hundreds of lawyers spontaneously went to airports to attempt to represent (pro bono) the people who were detained and at risk of being put on planes returning to the foreign point of departure.

Early January 29, some aspects of the execution of the executive order was temporarily stayed by a judge

Judge Ann Donnelly of the U.S. District Court in Brooklyn granted a request from the American Civil Liberties Union to stop the deportations after determining that the risk of injury to those detained by being returned to their home countries necessitated the decision.

3:00 AM January 29th, the Associated Press reported — something. It is not clear to me if the recent event is a constitutional crisis or just an absurd lie alternative fact.

The Ap reported

Stephen Miller, a senior adviser to the White House, said that nothing in the judge’s order “in anyway impedes or prevents the implementation of the president’s executive order which remains in full, complete and total effect.”

If Miller meant what he said, he has declared that the Trump administration will order the executive branch to ignore the stay (that is the only way the order could remain in “total effect”. If so, there would no longer be rule of law in the USA. There would only be Trump’s orders and the decision by people in uniforms whether to obey them.

I am fairly confident that the US is still a nation of laws. I think that Miller’s statement is a simple blatant lie not the declaration of a coup. I think he is sayign that the Judges order would have no effect even if it were obeyed. I am pretty sure Miller is insisting that Donnelly didn’t order what Donnelly ordered.

In contrast the more official response by the DHS noted that the stay applies only to people in the USA or in the air at the time it was granted.

Also the DHS didn’t mention legal permanent residents. It is very clear that the DHS can’t block their entry to the USA. In fact, it is known that the DHS argued this immediately and was over-ruled by White House staff. The application of the order to legal permanent residents is very clearly blatantly illegal. Arguably, the executive order is completely illegal, but to ignore green cards is very clearly illegal.

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Election Integrity

From the beginning of this election cycle President-Elect Trump claimed the system is rigged, millions of illegal voters voted, the dead have voted, etc. That is until he won and then it was I also won the popular vote as millions voted illegally for Clinton. Historically, voter fraud has hardly been an issue and it has been measured in the tens of thousands of 1%. What is claimed to be voter fraud is usually voting irregularities or issues with the procedures and process of voting. Even though there is no evidence of wide spread voter fraud, it has not stopped states from putting in place new laws to supposedly safe guard the vote and at the same time making it more difficult to vote. Amongst those states who have installed new requirements to vote or register are “9 of the 15 previously covered in whole or in part by Section 5 of the Voting Rights Act because of a state’s history of preventing minorities from voting.

The Electoral Integrity Project is an independent academic project at Harvard University and the University of Sydney. It is directed by Harvard University Professor Pippa Norris and governed by an International Advisory Board. Using 726 political scientists based in local universities in each state, the EIP evaluated the process and procedures of voting in each state using 49 core indicators which were then grouped into 11 ranking categories. The highest attainable ranking in any one category is 100 points. The project reviews the entire electoral cycle from the pre-election stage, the campaign itself, the actual polling day, and the aftermath. The results of the 2016 election and the corresponding state rankings are in Figure 1 (click on the picture for a larger version).

invisible hand

In speaking for the SCOTUS majority vote of 5, Chief Justice John Roberts repealed Section 5 of the Voting Rights Act claiming things had changed dramatically since the 1960s. Congress could no longer require states and counties to get the approval of the Department of Justice to change plans or put in place requirements for minorities to vote. The thought was the additional approval and supervision by the DOJ was no longer needed as these jurisdictions could be trusted to treat minorities fairly going forward.

State wide voting restrictions directed at minorities were viewed as a problem of the past when discrimination was blatant. With the passing of decades it was felt these States had outgrown past biases with minorities and could be allowed to govern voting rules and regulation on their own by SCOTUS. Evidence of such was not so positive and recent reviews show the states in the South had the weakest electoral performance overall in 2016. The newly passed North Carolina GOP State House laws to restrict the power of Democrat Governor Roy Cooper before he takes office suggest such thoughts of fairness were optimistic. The Rust Belt ‘Blue Wall’ states of Ohio, Michigan, Pennsylvania, and Wisconsin were also problematic. By contrast, the quality of elections in the Pacific West and New England were viewed positively.

Figure 2 shows the ranking of each state amongst the other states for “perceptions of Electoral Integrity” from the highest Election Integrity at 1 (Vermont) to the lowest Election Integrity (Arizona) at 51 (Click on the picture for a larger version).

invisible hand

Vote counting, the Voting Process, and the role of Electoral Authorities were shown to be less problematic than Congressional Voting District Boundary Delineation, State Electoral laws, Campaign Media, and Political Money in the Electoral process. North Carolina comes in at #1 followed by Wisconsin, Ohio, Pennsylvania, Michigan, Texas, and South Carolina for Congressional Voting District Delineation. The aggregate for Congressional Voting District Delineation is 33 and is the lowest of the 11 categories with Electoral Laws (Voting IDs, Early Voting, Provisional Ballots, etc) being next.

It is no secret, delineation of state Congressional Districts has led to additional Congressional Representatives of a political party being sent to Congress. As an example, Michigan has had a greater than 50% Democrat majority vote since 1992 and its Congressional delegation to the House has been less than 50% Democrats. This is the result of Congressional redistricting after every Census by a Republican majority in the state. As it now stands, changes to Congressional Districts will not happen until 2022 and only if the Democrats can take back state legislatures or if courts overrule the Congressional District delineation in place now or created in 2022 after the next Census. There is a far greater issue with Republican drawn districts than Democrat.

Other issues which need sunlight and additional discussion are Campaign Media, the lack of substantive Policy Discussion during the campaign, the False Equivalency Standards of Journalism, and the overwhelmingly Negative Tone of news coverage.

If one were to compare states by political control using this data, Democrat – Controlled states showed greater “Electoral Integrity than Republican – controlled states. Figure 3 shows in the aggregate assessments of each of the eleven stages during the electoral cycle compared with which party controlled the State House. With the exception of “Reporting Results” across all the remaining stages, “the gap was substantial and statistically significant on the issues of gerrymandered district boundaries, voter registration, electoral laws, and the performance of electoral officials.” Democrat controlled states out performed Republican controlled states in Electoral Integrity.

invisible hand

Taking into consideration the substantial gap and statistically significance issues of gerrymandered congressional district boundaries, voter registration, electoral laws, and the performance of electoral officials” (Figure 3), there was a clear tendency for Trump to also win more states (Figure 4) exhibiting these weaknesses. The evidence is not so clear as to state Trump won these states solely due to these issues; however, the correlation and direction pointed is clear. Perhaps as Trump claimed the election was rigged; but, it was not rigged in the manner he claimed.

There is little or no evidence there was voter fraud or votes cast illegally in 2016 as President – Elect Trump has claimed before, during, and after the election. However taking a broader vision of Election Integrity and with a review of this study, “one could arrive at the conclusion US elections suffer from several systematic and persistent problems. Donald Trump and the Republican party appear to have done well in states with the most problems.”

invisible hand

It is not only the 2016 election which has had its issues. As EIP and Professor Norris have shown in other studies, there have been issues with the 2012 and 2014 elections as well. When compared to other countries, the United States has scored the worst in Election Integrity amongst similar Western Countries given the culture and history the US represents. “The US also ranks 52nd out of all 153 countries worldwide in a cross-national Electoral Integrity survey. The comparison is even worse when the issue of Congressional District boundaries ate considered as the U.S. score is the second lowest in the world.

References:

Why it’s Not About Election Fraud, Its Much Worse. Electoral Integrity Project; Pippa Norris, Holly Ann Garnett, Max Grömping

Study: Clinton-Trump Coverage was a Feast of False Equivalency, Erik Wemple

“North Carolina Is No Longer Classified as a Democracy”, Andrew Reynolds

The Truth About Voter Fraud”, Justin Levitt

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