U.S. Politics

Sanders: ‘If you don’t have the guts to face your constituents,’ you shouldn’t be in Congress


Sen. Bernie Sanders (I-Vt.) on Thursday blasted the GOP lawmakers who have refused to hold in-person town hall events due to a flurry of recent protests.

“If you don’t have the guts to face your constituents, then you shouldn’t be in the United States Congress,” Sanders said during an interview with CNN.

The former presidential candidate said the wave of angry of American voters greeting GOP lawmakers is a consequence of unpopular positions articulated by President Trump, including a call to repeal and replace the Affordable Care Act.

“And if you need police at the meetings, that’s fine, have police at the meetings, have security at the meetings. But don’t use that as an excuse to run away from your constituents after you support repealing the Affordable Care Act, throwing 20 million people off of health insurance, doing away with preexisting conditions,” he said.

“If you are going to do all those things, answer the questions that your constituents have.”

GOP members of Congress, including Majority Leader Mitch McConnell(Ky.) Sen. Tom Cotton (Ark.), Bill Cassidy (La.) and Rep. Jason Chaffetz(Utah), have been bombarded with protesters at home-town events over the week-long Presidents’ Day recess.

Trump claimed this week that many of the demonstrations were “planned out” by activists.

“The so-called angry crowds in home districts of some Republicans are actually, in numerous cases, planned out by liberal activists. Sad!” he tweeted on Tuesday.


U.S. Politics

Today in Obamacare: a quick primer on 3 new Obamacare replacement plans

Photo by Drew Angerer/Getty Images


Welcome to Today in Obamacare, Vox’s regular update on the battle over the Affordable Care Act, the changes a new president and new Congress might make, and what it means for the American people. Have a story you think should be here? Send me an email at sarah@vox.com.

Let’s explore some Republican health policy plans One of the biggest shifts this week — driven largely by President-elect Donald Trump and a handful of Republican senators — is one away from “repeal and delay” and toward “repeal and replace.”

That means now is as good a time as any to contemplate what replacement might look like. I’ve already written up a lot of Republican plans here, but there are some new ones in the mix that are worth taking a look at.

  • Sen. Lamar Alexander might leave those with tax credits in a lurch. On the Senate floor this week, Sen. Lamar Alexander (R-TN) released his three-point replacement plan — although calling this a plan is a bit of a stretch, given that it’s just four paragraphs. Alexander’s plan suggests, like other Republican replacement plans, getting rid of the law’s essential health benefits (like maternity care or prescription drugs) and giving insurers more flexibility around what they do and don’t cover. One surprising part of Alexander’s plan is that it will “eventually provide tax credits to help lower income Americans buy insurance” — suggesting those tax credits would not be available to start.
  • Sen. Bill Cassidy’s plan would allow the insurance markets to remain intact. Sen. Bill Cassidy’s (R-LA) Obamacare replacement bill continues to be one of the more interesting and surprising Republican offerings. It would allow states to automatically enroll uninsured people into low-cost health plans — a replacement for the individual mandate that would put the onus on the patient to opt out of coverage. Cassidy would also allow states that currently operate marketplaces to keep doing so, holding over a big element of the health care law. “I am almost agnostic as to what elements of Obamacare are in our plan or not,” he told me when we spoke last.
  • Rep. Phil Roe wants to give everyone the exact same health care deduction — Something notable about most Obamacare replacement plans offered by Republican congressional leadership, unlike the one from Rep. Phil Roe (R-NC), is that they maintain certain pillars of Obamacare, like tax credits to buy insurance or a mechanism to encourage people to buy coverage. They each make big changes to those policies, but at the end of the day, a recognizable version survives.

Roe’s policy, championed by the very conservative Freedom Caucus, is different. It includes no tax credits for the individual market and instead envisions giving every American, regardless of where they buy coverage, a standard deduction to offset the costs: $7,500 for individuals and $20,500 for families. Unlike Obamacare and some other Republican policies, these deductions wouldn’t get bigger for older people who typically have to spend more on insurance. They’d be the same for everybody — in that regard, it’s a huge shift from current policy.

One Democrat down, seven Democrats to go Sen. Joe Manchin (D-WV) has expressed some openness toward working with Republicans on an Obamacare replacement plan. Earlier today, Politico reported that “Manchin has told GOP leaders that he’s ‘happy to sit down with you to see if we can find a pathway forward.’” But openness toward working with Republicans is still a far cry from actually voting with Republicans — a lesson that senators like moderate Republican Olympia Snow taught us during the original health law debate.

Kliff’s Notes: today’s top three health care reads

U.S. Politics

Here’s what Republicans voted for Wednesday night— $7 million for each of the 400 richest tax-payers

HOLLYWOOD, FL - APRIL 15:  Felue Chang who is newly insured under an insurance plan through the Affordable Care Act receives a checkup from Dr. Peria Del Pino-White at the South Broward Community Health Services clinic on April 15, 2014 in Hollywood, Florida. A report released by the Congressional Budget Office indicates that the Affordable Care Act will cost $5 billion less than originally projected for 2014.  (Photo by Joe Raedle/Getty Images)

attribution: Getty Images

And so it begins… (ks)


Sure, repealing Obamacare is about bringing “choice” back to Americans when it comes to their health insurance. That’s what Republicans say, right? That it’ll cost consumers less and be better and that’s all they want for the nation. How do you know that’s bullshit? Because of what repeal will really mean: massive tax cuts for the wealthiest tax-payers.

Urged on by Trump, the Senate overnight adopted a budget resolution that clears a path for eliminating the tax-and-spending provisions of the Affordable Care Act by simple majority vote — no Democratic cooperation required. That means repeal of two provisions targeted at high-income households: a 0.9 percent hospital insurance tax on earnings above $250,000 for couples and a 3.8 percent tax on capital gains, dividends and other nonlabor income above that same threshold.That would provide a tax cut averaging $7 million for each of the 400 highest-earning taxpayers, according to new calculations by the liberal Center on Budget and Policy Priorities using Internal Revenue Service data. That cut, the center estimated, would amount to $2.8 billion annually overall — or approximately the value of Obamacare subsidies for those with modest incomes in the 20 smallest states and the District of Columbia.

Overall, eliminating those two levies would represent a tax cut of roughly $346 billion over 10 years, according to the Congressional Budget Office. Households with million-dollar-plus incomes — a much larger group than the top 400 — would receive an average tax cut of $49,000 a year, the center says.

The only people Republicans are looking out for are the ones in Trump’s swamp.

Joan McCarter

U.S. Politics

Facebook Troll EXCITED For Obamacare Repeal Is On ‘Affordable Care Act’; Irony ABOUNDS (IMAGE)

Facebook Troll EXCITED For Obamacare Repeal Is On ‘Affordable Care Act’; Irony ABOUNDS (IMAGE)

Featured image via Giphy


It what can only be seen as a situation where you want to feel bad for a person, but really don’t, one supporter of repealing Obamacare just learned the hard way that they’re against their own healthcare.

All names have been blacked out, so pardon the anonymity. However, Helen Kennedy from Twitter seemed to get her hands on the really sad conversation.

It began with a post on Facebook from this someone who is against “Obamacare” and posted the vote and said:

“One step closer to fixing this mistake, and only a couple weeks left of Barry’s regime. 2017 is already looking up.”

This is when it gets sad. Someone pointed out that repealing the Affordable Care Act will strip health aid from those who desperately need it. This is when the person responds:

“… First we’re talking about Obamacare, not the ACA. Secondly, my health insurance is through the ACA, so I’m definitely not the kind of person to look down on others for needing help…”

This is when someone points out to this person that they’re on Obamacare, which is just another name for the Affordable Care Act.

This original posters replies:

“I’m not on Obamacare. My health insurance is through the ACA (Affordable Care Act), which was what they had to come up with after Obamacare crashed and burned as bad as it did. So I’m gonna be fine.”

Then response after response came in explaining that they are, in fact, the same thing. And as of the screengrab, the original poster hadn’t responded.

Here’s the tweet:

This makes you wonder how many people out there really don’t know that Obamacare and the Affordable Care Act are the same thing. And it’s actually kind of sad. They’ve been spoon fed lies by Republicans to hate the very thing they are now reliant on just by calling it another name that associates it with Obama. Which, by the way, is the only reason they want the repeal, so Obama doesn’t have the legislative victory.

This poor person. Hopefully, they change their stance sooner rather than later, but it seems their entire world has been rocked.

By Sarah

U.S. Politics

Trump ‘Not Even A Little’ Concerned That GOP Has No O’care Replacement Plan

Evan Vucci


Donald Trump said Monday that he was “not even a little bit” concerned that congressional Republicans have yet to put forth a replacement plan for the Affordable Care Act, even as they move forward with steps to repeal it.

“That’s going to all work out,” the President-elect told reporters in the lobby of Trump Tower.

Senate and House Republicans have started ringing alarm bells about the party’s long-stated plan to move forward with a prompt repeal of the healthcare law. Sens. Rand Paul (R-KY), Lamar Alexander (R-TN) and Susan Collins (R-ME) are among those calling for a replacement plan to be prepared before repeal is enacted to avoid throwing the insurance industry into chaos.

Asked Monday if a replacement plan would be ready by the time Obamacare is repealed, Trump said, “We’ll be talking about it on Wednesday.”

The President-elect is scheduled to hold his first press conference since July in Manhattan on Jan. 11. He is expected to address his plans for the Trump Organization and the role his son-in-law Jared Kushner will play in his administration, as well as Obamacare repeal.

Allegra Kirkland

U.S. Politics

As Obamacare Faces Repeal, Its Legacy Is Still Up In The Air


When President Obama took office in 2009, the U.S. was in trouble — 50.7 million people were uninsured, the largest number in history. Mortality rates were on the rise, even as health care spending grew faster than the nation’s economy. Obama was always going to address the situation through some type of health care reform, Jason Furman, chairman of the president’s Council of Economic Advisers, said recently. As the number of days left in Obama’s presidency approaches single digits, it’s clear that part of his legacy will be that his administration implemented the biggest health care overhaul since the creation of Medicaid and Medicare. What’s less clear is how those changes will be viewed years from now — and part of that depends on what happens next.

Republicans have tried to repeal the Affordable Care Act dozens of times since the law was pushed through Congress in 2010 without any support from GOP lawmakers. The party has pledged to immediately repeal the law (or, more likely, defund it) as the new session of Congress opens today, though they will likely delay the effects of the repeal and don’t yet have a replacement in place. When they do take action, lawmakers will have to contend with the massive changes the health system has already undergone as a result of Obama’s health care bill.

But understanding what changed in the U.S. under the ACA is no simple feat. We have plenty of numbers, sure, but part of the trouble is that assessing health care policy is a largely ideological affair — there are always winners and losers, and the trade-offs that seem reasonable to one group can look disastrous to another. And how Obama’s signature health legislation is viewed decades down the line will likely be informed as much by what happens next as what has happened so far. Still, a good place to start assessing the program’s likely legacy is by examining three metrics often used to judge health policy: coverage, cost and quality.

More people are insured

The ACA increased insurance coverage everywhere, among every demographic group, but just a quarter of the population knows that the uninsured rate is now at an all-time low. About 20 million people gained insurance as a direct result of the law, according to the Department of Health and Human Services.


But while the country has seen net gains in coverage, it has been a bumpy road for some. The group of people who are newly covered under the ACA includes about 16 million low-income people who gained Medicaid, which was expanded under the law to cover anyone with an income that is less than 138 percent of the federal poverty line. Not everyone in that group is now eligible for Medicaid, however. After a Supreme Court decision determined that states could decide whether to expand the program, 19 states opted not to, creating a deep geographical divide among low-income people. About 2.5 million people fall in this “coverage gap”: They live in a state that didn’t expand Medicaid, and their incomes are too low for them for them to qualify for federal subsidies in the ACA-created insurance marketplaces where people can buy private insurance.

Critics warned that the law, which required large employers to offer insurance to employees who worked a certain number of hours, would be a job-killer. They were also concerned that it would push people off of work-based insurance by leading employers to cut hours below the threshold where offering insurance was mandatory. While those doomsday predictions didn’t come to pass, it does appear that some employers limited the hours of workers who were already part-time.

For those part-timers and others, the process of buying insurance became easier with the advent of the insurance marketplaces, which allow people to compare plans. Still, of the 5 percent of Americans who bought plans outside an employer or a government program before the law passed, millions had their policies canceled, despite the Obama administration’s infamous promise that people who liked their health care plans could keep them. Those losses were partly the result of insurers phasing out plans that didn’t meet the new federal requirements for coverage — requirements that are controversial, because while they mean more comprehensive coverage, they can also mean higher premiums, which can be a turn-off for the young, healthy adults who are needed to balance out insurance pools. The Congressional Budget Office, a nonpartisan analysis arm of Congress, recently explained that at least some of the old, less-comprehensive plans would not count as insurance coverage because they don’t offer sufficient financial protection.

Among those who gained insurance were people with pre-existing health conditions. Before the ACA, insurance companies could choose to deny coverage to people on the private market, and they often did so for people who had diseases that are expensive to treat. The new law banned that practice. The Kaiser Family Foundation, which researches health care policy, recently estimated that 27 percent of adults younger than 65 would be uninsurable and that millions more could be denied coverage for specific health issues under pre-ACA, private-market norms. While many of those people have insurance through an employer or public program, they would previously have been left without options if they were to lose that insurance.

Despite challenges relating to cost and market participation from insurers, the insurance markets set up by the ACA are gaining steam. Approximately 6.4 million people have signed up for 2017 insurance coverage through the federally run marketplaces (even more have signed up on the state-run exchanges; 2017 numbers aren’t yet available, but more than 12.6 million selected a plan during the open enrollment period for 2016). That’s a record number, even as premiums increase by double-digit percentages in many places. About 85 percent of those people will receive federal subsidies that help offset the rising prices, but middle-class buyers can easily pay more than $1,000 per month.

But although the specifics of how people are covered have been shifting, the absolute increase in the percentage of people with health insurance is the blinking red data point that legislators will have to reckon with as they gear up to change, eliminate or replace the ACA under President-elect Donald Trump’s administration. Polls suggest that a growing number of people want to see the law scaled back, not repealed, and however unpopular the ACA is, taking away newly acquired insurance is likely to be controversial. Topher Spiro, vice president of health policy at the liberal think tank Center for American Progress, helped write the law. He said he thinks that because so many people are now insured, expectations regarding access to insurance have changed, which will lead to increased insurance coverage being part of Obama’s legacy, even though the GOP has pledged to repeal or defund the health care bill. “There’s no doubt in my mind that in the long term, there will be many more people insured as a result of the Affordable Care Act,” Spiro said. It’s impossible to know if he’s right, but the trepidation that some Republican legislators have recently expressed about repealing the law without a replacement plan in place suggests that he might be.


U.S. Politics

Trump’s Broken Promise Will Doom Thousands Of His Voters

Trump’s Broken Promise Will Doom Thousands Of His Voters


Not long ago, Americans learned that the average life expectancy for white people in this country — those most likely to have voted for Donald Trump — actually declined for the first time in many years. The pathologies and frustrations believed to have driven that decline may have motivated the tiny handful of votes that gave Trump his Electoral College victory.

But not long after their euphoria over his inauguration fades, they are going to learn why his administration is so likely to drive those statistics in the wrong direction. Despite his promise to protect Social Security and Medicare — and his vow to replace the Affordable Care Act with “something much better” — Trump’s cabinet appointees and his allies in Congress plan ruinous changes to those programs. And that will mean ruin, and in thousands of cases death, for the mostly white and working class people who depend so heavily on them.

Unless the Republicans come up with a plausible bill to replace Obamacare, which has eluded them since 2009, millions of their constituents will lose the health insurance they have only recently gained — and yes, thousands of those people will die next year.

Back when the president’s health reform plan first passed, Republicans and their media echoes warned loudly about mythical “death panels” embedded in his legislation. Now, the voters who believed that nonsense are about to meet the real death panel — led by House Speaker Paul Ryan, Senate Majority Leader Mitch McConnell, and Rep. Tom Price, the Georgia Republican slated to head the Department of Health and Human Services.

This is not hyperbole: Before the advent of Obamacare, tens of thousands of uninsured Americans died every year because they didn’t receive timely care. Eight years ago, one reputable study estimated that as many as 137,000 Americans had perished prematurely due to lack of health coverage — or more than twice as many as died in the Vietnam War — between 2000 and 2006 alone. The Institute of Medicine has estimated that uninsured adults are 25 percent more likely to die prematurely than those with coverage, with uninsured adults between 55 and 64 years old faring even worse. For them, being uninsured is the third most significant cause of death, behind only heart disease and cancer.

Those estimates don’t include the victims of insurance company profiteering who will die if the repeal of Obamacare undoes its protection of patients suffering from “previously existing conditions.” Exposed to the tender mercies of corporate actuaries, thousands of them will lose their coverage, watch their families driven to destitution, and many of them will die, too.

That isn’t supposed to be what happens under President Trump, who declared in many interviews and debates his determination to provide better and cheaper health insurance “for everybody, let it be for everybody.” But by appointing a far-right ideologue like Price to run health policy, Trump effectively violated that promise before even taking his oath of office. Working with Ryan and the Republican majority in both houses of Congress, Price means to destroy Obamacare, slash Medicare, and decimate Medicaid.

The truth about the current incarnation of the Republican Party, which voters ought to have learned long ago, is that its attitudes toward working Americans of all descriptions range from careless to merciless. If not every Republican shares the “let ‘em die” position on health care screamed by a GOP debate audience in 2012, all too many believe that government has no role in ensuring that every American is insured — even though that would save money as well as lives.

However ridiculous most of Trump’s commitments may seem, his promise to protect Americans who depend on Obamacare, Medicare, and Medicaid is a matter of life or death. Unless he changes course now, we may see a lot of red caps at funerals for people who lost their health insurance, and died much too soon.

U.S. Politics

New Study Shows Why Major Insurers Hate The ACA – It Actually Forces Them To Help Sick People

Getty Images


Major insurers everywhere have dumped massive cash into lobbying against the ACA. Their corporate-owned Republicans have insisted it would destroy America in any number of strange and unusual ways. Now a new study reveals why they say helping sick people afford to see a doctor is bad for the country.

Data has become available for 2014 and 2015 enrollees to Blue Cross and Blue Shield, who were picked up through the Affordable Care Act’s health insurance exchanges. It shows that the people who the ACA was specifically created to help are actually going to the doctor and using medical services . Huge shock, right? The entirety of the Republican and corporate establishment’s opposition to the ACA resides in a single thing — money. More for them, and none for regular people. If the poor and middle class suffer and die needlessly, that’s just their cost of doing business.

People who got back into the insurance market, thanks to the ACA, were shown to have a 22 percent higher medical cost than those with employer-based coverage in 2015. The average monthly spending numbers for the new enrollees was $559 in 2015 compared to $457 for group members who had it through an employer. The same new enrollee segment increased from $501 in 2014 to the previously mentioned $559 in 2015.

The irony of the situation is that the very corporations who are whining about having to pay the bills of sick people were the primary engineers of their own self-imposed disaster. These are the same corporations that spiked health insurance costs, causing people to be unable to afford it. They are also the same corporations that outright refused to sell people coverage, because of “pre-existing conditions.” Pre-existing conditions that could be literally anything they wanted them to be. After sometimes decades of unmanaged health issues, these new enrollees are consuming services at elevated rates. Insurers basically screwed themselves for short-term profits, and now they have to pay some of it back. Pardon me if I am less than sympathetic towards them.

This shows just how desperately needed the ACA is, and how incredibly dishonest health insurers are about their business model. The fact insurance payouts rose as much as they did in as short a time is proof just how many Americans were suffering without need. That is where the darker truth of the health insurance industry comes into plain view. These companies are still wildly profitable . They just want to keep more money for themselves. Simply put, they’ve become a caricature of their own greedy reputations.

The tragedy of this all is that the same data showing how desperately needed the ACA is, also is being used as misinformation to completely lie to America about how bad it is for the country. The only tidbit being presented is that it is increasing costs to insurance companies, which does mean their premiums might go up. However, the overall increase in premiums is at a slower rate than before Obamacare became law, even with the increased payouts for more consumption of services.

Right wingers and unscrupulous insurance companies are taking the very truth about why it is a good law, and perverting it into a lie about how it is bad by purposefully omitting all context until the “truth” is whatever they want it to be. If you add in the fact that initial expenditures are going to be higher until we catch up with decades of a lack of care, you can argue a case that premiums would have actually dropped if all other things were equal, due to massive amounts of new customers spreading out the cost burden.

As more new data becomes available, and initial over-consumption tapers off, the last arguments to be made against the law will ultimately boil down to profit over people. If anything will prove how obsolete the American health insurance industry is, and why single-payer is needed, that will be it.

Christian Drake

U.S. Politics

Obamacare Helped The Sickest Americans Gain Insurance, Huge Study Confirms



A new report released Tuesday from the Blue Cross and Blue Shield Association underscores the need for the Affordable Care Act’s reforms, finding evidence that the health law effectively expanded coverage to America’s most vulnerable citizens.

According to the data, Obamacare’s newest policyholders were more likely to have a variety of significant health problems — in other words, reasons that insurers might have denied them coverage before the Affordable Care Act was passed.

Newly enrolled policyholders were twice as likely to have diabetes, twice as likely to have Hepatitis C, and three times as likely to have HIV. They also had higher instances of high blood pressure, diabetes, depression, and coronary artery disease. Hospital admission rates were 84 percent higher for these policyholders, and the frequency of their doctor and specialist visits were 26 percent higher.

“It’s no surprise that people who newly gained access to coverage under the Affordable Care Act needed health care. That’s why they were locked out of coverage before,” Ben Wakana, a spokesman for the Department of Health and Human Services, remarked.

The Blue Cross and Blue Shield Association study is significant due to the sheer size of claims data analyzed. Since Blue Cross and Blue Shield plans are purchased across the country, researchers had access to claims for 4.7 million people. About one-third of those studied had been continuously enrolled since 2013; the others signed up in 2014 or 2015.

The report also found that the influx of sicker, previously uninsured patients into the health insurance system is contributing to a rise in insurance premiums nationwide. The increased need for care is driving insurance costs up, even as many people are receiving better care.

Thanks to Obamacare, Americans now have greater access to private health insurance plans through the law’s new individual marketplaces, as well as protection against insurance companies denying them coverage based on pre-existing medical conditions.

Since the passage of the Affordable Care Act in 2010, the percentage of uninsured citizens has dropped considerably. Nearly 9 in 10 American adults now have health insurance, and the law has helped to close the health insurance gap between low-income people and wealthier Americans.

U.S. Politics

Supreme Court Trashes Latest Legal Attack On Obamacare

DON RYAN/ASSOCIATED PRESS – Yes, the Affordable Care Act is still constitutional.


The justices already ruled the law constitutional. They’re done for now.

WASHINGTON — The U.S. Supreme Court has snubbed yet another Obamacare case.

The justices on Tuesday declined to take up the latest legal challenge to the Affordable Care Act — a quirky lawsuit that sought to invalidate the law on the grounds that it violates the Origination Clause of the U.S. Constitution.

Under the clause, “all bills for raising revenue” — read: taxes — must “originate” in the House of Representatives. But Matt Sissel, the man behind the case, argued that must mean the health care law is unconstitutional because, in his view, the legislation originated in the Senate.

“The reason the Constitution requires all bills for raising revenue to originate in the House is to keep the taxing power — of which the founders were justly suspicious — in the hands of the most democratic branch of the federal government,” said Sissel’s appeal to the Supreme Court.

That argument was a response to the court’s decision in NFIB v. Sebelius, which in 2012 upheld the law on the basis that its so-called individual mandate — the requirement that every American carries health insurance, or else pay a penalty — constitutes a “tax on going without health insurance.”

But Sissel, an artist, challenged that requirement, noting in court papers he’d much rather “devote his resources to building up his art business rather than buying health insurance.”

Even though two lower courts rejected his arguments, he nonetheless pressed on with his appeal to the Supreme Court. What may have prompted Sissel to take his case all the way to the top was a lengthy rejection issued by an appeals court last summer — essentially telling him that his constitutional argument was meritless, but in which four conservative judges said that the case underscored “the importance of this issue to our constitutional structure and to the individual liberty protected by that structure.”

But even those judges, in the end, couldn’t bring themselves to rule that the challenger had a winning case, and concluded that the Affordable Care Act properly originated in the House of Representatives.

“To read my opinion so far, you might wonder whether I think the world will end not in fire, or in ice, or in a bankruptcy court, but in an Origination Clause violation,” wrote U.S. Circuit Judge Brett Kavanaugh for himself and the three other judges. “This case is not Marbury v. Madison redux. But the case is still quite important.”

Apparently not important enough for the Supreme Court to get involved.