People like employer-based health insurance coverage because it’s the exact opposite of the kind of market Trumpcare creates. There’s no medical underwriting. Healthy people and sick people pay the same amount for their coverage. Paul Ryan is promising that they won’t be exposed to the every-man-for-himself principles that guide Republican policy on the individual market.  Ryan is lying.

As Stephanie Armour and Michelle Hackman reported in The Wall Street Journal earlier this month, the GOP health-care plan would actually jeopardize existing coverage for people who get insurance through their employer, not just the ones who get it from Medicaid and the individual market. The Republican plan would give states a waiver from Obamacare’s insurance regulations, which require that plans cover essential benefits and prevent them from putting lifetime caps on a person’s costs. And employers who shop for insurance can select a plan from any state.

That means every employer buying insurance could purchase plans that subject their employees to the kinds of price discrimination that Republicans want to impose on the individual market. People with preexisting conditions, or family members who have one, could suddenly find the workplace insurance they thought was totally safe now exposed them to massive new costs and the risk of medical bankruptcy.

According to Politico, Trump decided to abruptly terminate Obamacare Cost-Sharing Reduction subsidies to insurers, plunging markets into turmoil at the worst possible time.

Trump told aides in a Tuesday Oval Office meeting that he wants to end the payments to insurers, according to people familiar with his comments. Trump has previously expressed conflicting opinions on the issue. Insurers have been pressing for certainty as they plan for next year.

Estimated at $7 billion for this year, the payments go to insurance companies to reduce deductibles and other out-of-pocket costs for low-income consumers — an estimated 7 million people in 2017. Insurers are on the hook under the health law to keep paying even if the federal money stops.

Trump took CSR payments hostage in April, threatening to kill them if Democrats didn’t cooperate with his efforts to repeal and replace Obamacare.

Republican lawmakers should have the integrity to avoid sabotaging the current system until their own is in place (if that ever happens).  Intentionally destabilizing the insurance markets for millions would be an underhanded blow that should shame its perpetrators.

New York Magazine published an article by Jonathan Chait about Trump’s threats to the insurance industry.

One of the most plausible predictions of the kinds of long-term damage Donald Trump might do to the United States was written by Matthew Yglesias a week after the election. He described a scenario in which Trump used government power to coerce business to support him and his agenda. “Those who support the regime will receive favorable treatment from regulators, and those who oppose it will not,” in this haunting scenario, which resembles the nexus between business and government that prevails in Russia and other authoritarian capitalist states.

Noam Levey reports an example of this already happening. The thrust of Levey’s story is focused on the belief by insurers that uncertainty fostered by the Trump administration is killing health-care exchanges. Deep in the piece, Levey describes a Trump staffer threatening to withhold cost-sharing-reduction payments, called CSR, which are a vital part of making individual insurance profitable. “At one recent meeting, Seema Verma, whom Trump picked to oversee the federal Medicare and Medicaid programs, stunned insurance industry officials by suggesting a bargain: The administration would fund the CSRs if insurers supported the House Republican bill to repeal the Affordable Care Act,” reports Levey.

The Trump administration has pursued policies that are extremely friendly to incumbent businesses. But there is a discretionary quality to Trump’s governance that is ripe for abuse. Which firms will he call out for eliminating jobs? Which ones will he praise? Trump’s ability to hand out discretionary favors to pliant firms is a power to coerce large segments of the business community to endorse, or at least not oppose, his agenda.

 for New York magazine had an interesting article about Trump’s comments to Australian prime minister Malcolm Turnbull, Trump blurted out, “I shouldn’t say this to a great gentleman and my friend from Australia, because you have better health care than we do.”  This provoked a great deal of mockery, given that the country has a single-payer system.

The United States is the only industrialized democracy in the world that does not guarantee all its citizens access to medical care, while also spending a higher percentage of its economy on health care than any country in the world.

Trump took to Twitter to offer his own explanation. Yes, he really does think Australia has a better system than the United States. Indeed, he thinks everybody does:

“So, the only industrialized democracy in the world that does not have government-run health care also has the worst health care in the world, according to the Republican president of the United States. And that president is trying to strip back government involvement in health care while massively increasing the number of his citizens who will lack access to medical care. One might begin to suspect a minimal government role in health-care finance is a strategy that leads to bad health-care outcomes.”

U.S. News reported that the Arkansas Supreme Court has allowed a class action on understaffing in nursing homes to proceed.  The state Supreme Court upheld a Pulaski County judge’s decision granting class-action status in all aspects of the case except negligence.

Andrew Phillips sued Michael Morton and Robinson Nursing and Rehabilitation Center in 2015, following the death of his mother, Dorothy Phillips, the Arkansas Democrat-Gazette reported. The lawsuit alleges understaffing at Defendants’ nursing home caused her decline and wrongful death.  Phillips filed a wrongful-death lawsuit against Robinson Nursing and Rehabilitation Center LLC, Central Arkansas Nursing Centers Inc., Nursing Consultants Inc. and Morton in 2015 over the death of Dorothy Phillips, who lived in the nursing home from Aug. 19, 2013, until her death Feb. 22, 2014.

The Supreme Court rejected the nursing home’s arguments that Phillips failed to prove some essential elements behind the class-action status on other points. The high court ordered the case back to Pulaski County with instructions to decertify the class solely on the negligence claim.

“Negligence requires an individual analysis of each plaintiff’s specific allegations,” Justice Karen Baker wrote. “The commonality requirement is clearly satisfied because Robinson’s act of understaffing, independent of any action by Phillips, establishes a common question relating to the entire class.”

After citing case law, Baker wrote, “Accordingly … as to the breach of contract, [the Arkansas Deceptive Trade Practices Act], and unjust-enrichment claims, we hold that the circuit court correctly found that the commonality and predominance requirements of Rule 23 had been met.”

Phillips’ attorneys had asked Justice Rhonda Wood to recuse from the case, but she declined. She ended up siding with Phillips’ attorneys on all class-action issues except for the negligence one.

The attorneys had cited campaign contributions Wood received from Morton and his businesses and noted that her name had come up in connection with an investigation involving Morton, lobbyist Gilbert Baker and ousted Circuit Judge Michael Maggio.

Maggio has pleaded guilty to a federal bribery charge but has appealed his conviction. Baker and Morton have not been charged with a crime. Maggio implicated them, though not by name, in his plea agreement. No one has accused Wood of criminal wrongdoing.

 

WJLA explains how TrumpCare’s Medicaid cuts will negatively affect nursing home residents.  According to the Congressional Budget Office, the American Health Care Act (AHCA) will cut Medicaid spending by $880 billion.  There are nearly 70 million Medicaid enrollees nationwide. The annual long-term service and support spending for Medicaid annually is $152 billion, according to Medicaid.gov.

Nursing facility care is a mandatory entitlement within the Medicaid program. All individuals who qualify financially for Medicaid and qualify by level of disability for nursing facility care must be allowed to receive nursing facility services.

If the cost for care rises or there are more enrollees in the Medicaid program in need of nursing facilities than the state could be without funds to provide nursing facilities to make these accommodations. This can create hurdles for Medicaid recipients currently in nursing homes if the cuts result reduced options for care or loss of care all together.

A report issued by the Henry J. Kaiser Family Foundation echoes that concern.

“States with costs that exceed the cap for their senior or disabled enrollees would need to find other revenues to maintain coverage, or reduce costs,” the report said.

“Republicans have now made the bill even more costly and cruel to American families, likely resulting in millions more Americans not being able to afford coverage. The American people have a right to know the full consequences of Trumpcare before their representatives vote on it,” House Minority Leader Nancy Pelosi said in a statement.

 

New York Attorney General Eric Schneiderman tells Erin Burnett he’s planning a lawsuit should the legislation be signed into law.

“If they pass the bill in the form the House passed it, it is unconstitutional,” he said on CNN’s “Erin Burnett OutFront.”
Calling it “bad public policy” that will ultimately “cost millions of people health care,” Schneiderman takes particular issue with the impact the bill will have on women. “This is an effort to cut off funding for breast cancer screenings, education on sexual-transmitted disease,” he noted, adding that “it imposes an undue burden on women’s constitutional rights.”

The state is now investigating a local nursing home days after a Channel 9 investigation exposed allegations of abuse. [Nursing home faces lawsuits after employee pleads guilty to sexually assaulting patient].

The Channel 9 investigation aired Thursday and by the weekend, state investigators were at Lake Park Nursing and Rehabilitation Center in Indian Trail. Eyewitness News anchor John Paul went back to the facility looking for answers.  Paul talked to new family members who said they’re concerned about some of the conditions they’ve witnessed there.

Before this investigation, two lawsuits were filed on behalf of residents who are now deceased. The suits alleged sexual assault, poor treatment and untimely death.

According to Nursing Home Compare on the Medicare website cms.gov, Lake Park is a one-star facility owned and operated by PRINCIPLE LONG TERM CARE, INC tha tis on the Special Focus facility watch list. On January 15, 2016, the facility was fined $132, 600 and then again on November 2, 2016 for $277,052.

Vox reported that Health and Human Services Secretary Tom Price gave multiple interviews defending the Republican plan to repeal and replace Obamacare.

He repeatedly lied and made false promises about what the American Health Care Act would do.  He told CNN that the bill would “absolutely not” result in millions of Americans losing Medicaid.  (The Congressional Budget Office evaluated a previous version of the bill and estimated that it would cut $880 billion from the Medicaid program.)
He told NBC that the goal of the Republican plan is to “make certain that every single person has health coverage.”  (The CBO also estimates that the AHCA would cause 14 million people to lose their Medicaid coverage by 2026.)
He has described it as protecting people with preexisting conditions and reducing deductibles, while it does neither of those things. (Most midlevel plans sold on the marketplace have significant deductibles, which can be as high as $6,000.)

Nonpartisan analysis of the bill shows that none of these claims is true. The Republican plan would result in millions of Americans losing Medicaid coverage. Passing the bill would reduce rather than increase how many people have coverage.

The most recent CBO estimate predicts that 24 million Americans would lose coverage under AHCA. The majority of those people losing coverage would be Medicaid enrollees, but 2 million Americans would also lose individual plans. An additional 7 million Americans would lose coverage, as the CBO expects the Republican plan would encourage some workplaces to drop their offerings.

Conservative writer Andrew Sullivan’s reaction to Trumpcare in New York Magazine was excellent.

“A word on Obamacare. I relied on it until just recently when I joined New York’s staff and went on an employer’s plan, and, to tell the truth, part of me didn’t even want to make the change — even though it will obviously save me a lot of money. What Obamacare did for me, living with the preexisting condition of HIV, was, first of all, give me far more independence and freedom. It gave me the confidence to quit a previous job and start my own little media company — my blog, the Dish. It gave me peace of mind when I subsequently shut that business down and was able to stay on the same plan. It allowed me to be a freelance writer without fear of personal bankruptcy. I got no subsidy, but I was glad to pay the premiums for me and my husband because it gave me a sense of control over our finances and our future. I knew I wouldn’t suddenly find myself facing soaring health-care costs or no health care at all — and the premium actually went down a smidgen last year.

The TrumpGOP’s attempt to abolish it is therefore, to my mind, neither conservative nor decent.

You might think Obamacare would violate my generally conservative principles, but it didn’t. In fact, it seemed to me to be an effective marriage of conservative principles and, well, human decency. The decency part comes from not blaming or punishing the sick for their condition. The conservative part comes from the incremental nature of the reform, and its reliance on the private sector to provide a public good. For good measure, it actually saved the government money, and it slowed soaring health-care costs. The exchanges, with predictable early hiccups, largely worked — a case study in the benefits of market competition. The law allowed for experiments to test how efficient health care could be. It even insisted on personal responsibility by mandating individual coverage. And the concept of insurance is not socialism; it’s a matter simply of pooling risk as widely as possible. If any European conservative party were to propose such a system, it would be pilloried as a far-right plot. And yet the Republican Party opposed it with a passion that became very hard for me to disentangle from hatred of Obama himself.

The Trump GOP’s attempt to abolish it is therefore, to my mind, neither conservative nor decent. It’s reactionary and callous. Its effective abandonment of 95 percent of us with preexisting conditions will strike real terror in a lot of people’s hearts. Its gutting of Medicaid will force millions of the poor to lose health care almost altogether. It will bankrupt the struggling members of the working and middle classes who find themselves in a serious health crisis. It could hurt Republicans in the midterms —though that will be cold comfort for the countless forced into penury or sickness because of Trump’s desire for a “win.” But it’s clarifying for me. It forces me to back a Democratic Party I don’t particularly care for. And it destroys any notion I might have had that American conservatism gives a damn about the vulnerable. It really is a deal-breaker for me. I hope many others feel exactly the same way.”