The GOP Agenda Fuels An Epidemic of Hardship and Hunger

Food Bank line in Michigan.

The Covid-19 pandemic and the massive unemployment figures - more will be released today after yesterday's numbers brought the number of unemployed to over 30 million - have brought into focus the failed Republican policies which seek to leave the majority of Americans living in grim Dickensian like conditions while the wealthy suck up more and more of the nation's wealth.  Now, in this time of crisis, Congressional Republicans oppose more aid to those suffering.  Meanwhile, the Trump regime is before the U.S. Supreme Court seeking to end the Affordable Health Care Act which would leave millions more Americans with no health insurance. Cruelty is the hallmark of today's GOP and when has to wonder when its idiot supporters will stop allowing themselves to be played through racial resentment - the majority of those on welfare and unemployment are white, not black - and, of course pandering to Christian fanaticism.  A column in the New York Times looks at the GOP agenda that ought to have all but the wealthy running screaming from the GOP and its candidates.  Here are excerpts: 

Covid-19 has had a devastating effect on workers. The economy has plunged so quickly that official statistics can’t keep up, but the available data suggest that tens of millions of Americans have lost their jobs through no fault of their own, with more job losses to come and full recovery probably years away.

But Republicans adamantly oppose extending enhanced unemployment benefits — such an extension, says Senator Lindsey Graham, will take place “over our dead bodies.” (Actually, over other people’s dead bodies.)

They apparently want to return to a situation in which most unemployed workers get no benefits at all, and even those collecting unemployment insurance get only a small fraction of their previous income.

Because most working-age Americans receive health insurance through their employers, job losses will cause a huge rise in the number of uninsured. The only mitigating factor is the Affordable Care Act, a.k.a. Obamacare, which will allow many though by no means all of the newly uninsured to find alternative coverage.

But the Trump administration is still trying to have the Affordable Care Act ruled unconstitutional; “We want to terminate health care under Obamacare,” declared Donald Trump, even though the administration has never offered a serious alternative. Bear in mind that ending Obamacare would end protection for Americans with pre-existing conditions — and that insurers would probably refuse to cover anyone who had Covid-19.

Finally, the devastation caused by the coronavirus has left many in the world’s wealthiest major nation unable to put sufficient food on the table. Families with children under 12 are especially hard hit: According to one recent survey, 41 percent of these families are already unable to afford enough to eat. Food banks are overwhelmed, with lines sometimes a mile long.

But Republicans are still trying to make food stamps harder to get, and fiercely oppose proposals to temporarily make food aid more generous.

Attempts to restart the economy even though the pandemic is far from controlled will lead to many more deaths, and will probably backfire even in purely economic terms as states are forced to lock down again.

But we’re only now starting to get a sense of the Republican Party’s cruelty toward the economic victims of the coronavirus. In the face of what amounts to a vast natural disaster, you might have expected conservatives to break, at least temporarily, with their traditional opposition to helping fellow citizens in need. But no; they’re as determined as ever to punish the poor and unlucky.

What’s remarkable about this determination is that the usual arguments against helping the needy, which were weak even in normal times, have become completely unsustainable in the face of the pandemic. Yet those arguments, zombielike, just keep shambling on.

For example, you still hear complaints that spending on food stamps and unemployment benefits increases the deficit. Now, Republicans never really cared about budget deficits; they demonstrated their hypocrisy by cheerfully passing a huge tax cut in 2017, and saying nothing as deficits surged.

But what’s even worse, if you ask me, is hearing Republicans complain that food stamps and unemployment benefits reduce the incentive to seek work. There was never serious evidence for this claim, but right now — at a time when workers can’t work, because doing their normal jobs would kill lots of people — I find it hard to understand how anyone can make this argument without gagging.

So what explains the G.O.P.’s extraordinary indifference to the plight of Americans impoverished by this national disaster?

One answer may be that much of America’s right has effectively decided that we should simply go back to business as usual and accept the resulting death toll. Also, conservatives may worry that if we help those in distress, even temporarily, many Americans might decide that a stronger social safety net is a good thing in general. If your political strategy depends on convincing people that government is always the problem, never the solution, you don’t want voters to see the government actually doing good, even in times of dire need.

Whatever the reasons, it’s becoming increasingly clear that Americans suffering from the economic consequences of Covid-19 will get far less help than they should. Having already condemned tens of thousands to unnecessary death, Trump and his allies are in the process of condemning tens of millions to unnecessary hardship.

Medicare for All: Political Kryptonite

Giving away my age, I will admit that I like Medicare.  The coverage is far better than when I had private health care insurance and the premiums are considerably lower even when paying extra for supplemental and prescription drug coverage.  It also demonstrates how a public option for those who want it - something Pete Buttigieg is pushing in his campaign - could at last force serious competition on private health insurance companies which typically give would be subscribers arrays of plans that are near impossible to compare side by side but all of which are expensive and leave individuals choosing their preferred form of poison.  Medicare for those who want it also avoids potential political suicide for Democrats - something seemingly totally lost on Bernie Sanders and largely lost on Elizabeth Warren - why potentially paving the way toward a more expansive form of public option down the road.  Sometimes consistent evolution is far better than an overnight revolution.   Now, more Democrats seem to be waking to the reality that Sanders' and Warren's Medicare for all mantra could be pushing Democrats toward defeat in 2020 - something that I view as nothing less than a national catastrophe and the possible end of America's political system as we have known it.  A piece in the New York Times looks at this potential and why moderation is perhaps the best way to win in 2020.  Here are highlights:

Prominent Democratic leaders are sounding increasingly vocal alarms to try to halt political momentum for “Medicare for all,” opting to risk alienating liberals and deepening the divide in the party rather than enter an election year with a sweeping health care proposal that many see as a liability for candidates up and down the ballot.

From Michigan to Georgia, North Dakota to Texas, Democratic elected officials, strategists and pollsters are warning that the party’s commitment to the Obama-era Affordable Care Act — widely seen as critical to electoral gains in 2018 and 2019 — could slip away as a political advantage in 2020 if Republicans seize on Medicare for all and try to paint Democrats as socialists on health care.

“When you say Medicare for all, it’s a risk. It makes people feel afraid,” said Gov. Gina Raimondo of Rhode Island, . . . “We won in Kentucky and Louisiana, barely, in part, because we won on health care. I don’t think we can afford to lose on health care.”

While Democrats won the House in 2018 by decrying Republican efforts to undercut popular provisions in the Affordable Care Act, the Democratic presidential primary race has turned in large part on whether to replace that law with a more expansive, single-payer system, financed by higher taxes and linked to an end to private health insurance.

[M]oderate leaders in the [presidential nomination] race, like Joseph R. Biden Jr., the former vice president, and Pete Buttigieg, the mayor of South Bend, Ind., support adding a public health care option to the current law. While the primary race is fluid and unpredictable, Medicare for all has steadily driven much of the Democratic discussion of health care.

A determination to shift those conversations is now spurring top Democratic officials to speak out more forcefully against Medicare for all, playing to the anxieties of Democrats who fear their party could once more lose crucial Electoral College battlegrounds like Pennsylvania, Michigan and Wisconsin to Mr. Trump if they push for a nationwide overhaul of health care coverage and benefits.

Warnings are being issued at all levels of the Democratic Party, from union members who fear losing hard-won benefits, to candidates running in swing districts, all the way up to former President Barack Obama, who offered a pointed warning about the risks of overreach at a gathering of donors in Washington, D.C., this month.

Many are gravely concerned about the impact that having a presidential nominee who backs Medicare for all at the top of the ticket would have on the most vulnerable Democratic candidates.

[A]s the race moves closer and closer to the start of primary voting, other polling indicates that voters in key battleground states have grown more skeptical of implementing Medicare for all. A survey released this month by the Kaiser Family Foundation and Cook Political Report found that nearly two-thirds of swing voters in Michigan, Minnesota, Pennsylvania and Wisconsin rated a Medicare for all plan that would eliminate private insurance as a “bad idea.”

Internal polling conducted by the Democratic Governors Association in October found that Gov. John Bel Edwards of Louisiana tested 15 points higher on health care than his Republican challenger. Their polling found similar results in Kentucky, where Andy Beshear, the Democratic candidate and now governor-elect, polled 12 points higher than Gov. Matt Bevin, a Republican.

Even if Ms. Warren or Mr. Sanders fail to win the nomination, some Democrats from battleground and conservative states worry that the party has already damaged its brand heading into the general election.

“The politics are horrible for the Democratic Party, that’s my judgment,” said Ms. Heitkamp, who lost her seat representing North Dakota last year and is now heading up an effort to win rural voters. “We’re making the issue about our plan rather than what the president has or has not done.”

“Democrats need to start talking about the contrast with Trump on this,” said Mr. Brown, who has not endorsed a candidate in the primary race. “The conversation should not be Democrats fighting over the path to universal coverage.”

Congressional candidates are frequently asked whether they agree with the policy; candidates in all 10 of the most competitive Senate races have said they do not support it, preferring to keep their health care message focused on expanding Medicaid, protecting the Affordable Care Act and slamming repeal efforts by Republicans.

Other allies of Mr. Biden have begun speaking in increasingly apocalyptic terms about how a presidential nominee perceived as too far to the left — thanks to positions on issues like health care — would impact other candidates in competitive races.

“We’ve got to find ways that we can build on the success of the Affordable Care Act and ensure that everyone has coverage that works for them,” said Representative Chris Pappas, a New Hampshire Democrat elected last year. “Most of us who were recently elected to Congress, those who helped flip the majority in the House, really have a practical point of view of what’s actually going to deliver relief to families in our districts.”

Sadly, Sanders' and Warren's cult like followers appear blind to the reality that their candidates are pushing a plan too radical for a majority of voters at this point in time.  Winning in 2020 has to be the priority.  Without winning, no improvements can be made to the current system and, if Republicans retain control, continued efforts to destroy what has already been accomplished will increase. 

The Health-Care Crisis Has Spread to Employer Plans

America continues to have the most expensive, least efficient healthcare system - if one can even call it a system, given its fragmented nature - where people pay vastly more for the same procedures than people in Canada or Europe.  Add to that the ungodly high prescription drug costs that allow pharmaceutical companies in the USA to price gouge consumers, and it is a recipe for financial hardship for many who find themselves deferring care because they cannot pay policy deductibles.  While the focus of the Affordable Health Care Act was to bring insurance to the uninsured, a growing crisis is developing under employer based plans that are using ever increasing deductibles and prescription limitations as a means to cope with soaring costs.  It's little wonder that life expectancy is falling in the USA.  A piece in New York Magazine looks at the growing crisis.  Here are article excerpts:  

For most of this century, the big U.S. health-care policy issue has been providing insurance to the uninsured, including the uninsurable people with expensive health conditions. Yes, the majority of non-elderly Americans covered by employer-based insurance were affected by this debate insofar as sharing the costs of more universal coverage would increase their premiums and/or taxes. But for the most part, Americans were relatively happy with the insurance they got at work.

That’s changing, as is graphically illustrated by a major new survey conducted by the Los Angeles Times and the Kaiser Family Foundation that shows insurance deductibles, co-pays, and other “cost sharing” requirements by insurers are putting the squeeze on affected policyholders in a big way.

As the Times’ Noam Levy explains, the rise of deductibles has been dramatic:

In the last 12 years, annual deductibles in job-based health plans have nearly quadrupled and now average more than $1,300 [family coverage deductibles are far higher].

Yet Americans’ savings are not keeping pace, data show. And more than four in 10 workers enrolled in a high-deductible plan report they don’t have enough savings to cover the deductible.

One in six Americans who get insurance through their jobs say they’ve had to make “difficult sacrifices” to pay for healthcare in the last year, including cutting back on food, moving in with friends or family, or taking extra jobs. And one in five say healthcare costs have eaten up all or most of their savings.

And that’s not even counting those who skip care they need because they cannot afford to pay their “share” of steadily rising medical bills.  When people don’t get essential care, of course, insurance has failed everyone other than the insurer itself. And while everyone was aware cost-sharing requirements were steadily increasing, it did sneak up on policy-makers whose attention was elsewhere:

The 2010 healthcare law — often called Obamacare — provided landmark protections to Americans once shut out of health coverage. But as Democrats and Republicans fought over the law, Altman said, neither focused on the rapid run-up in costs for people covered through work.

But this was by no means accidental. High-deductible insurance plans were promoted both by the industry and by conservative politicians: . . . . Backers of the high-deductible strategy nevertheless argued that patients, given “skin in the game,” would become active consumers who would force drugmakers, hospitals and other medical providers to rein in prices.

If that sounds familiar to consumers of political rhetoric, it’s because Republicans have long promoted patient-driven competition as a health-care cost panacea, usually through a combination of high-deductible insurance plans and tax-preferred health savings accounts designed to help consumers save for out-of-pocket costs.

Guess who got left holding the bag? That’s right, the employees, who were essentially victims of a bait and switch.  Now, suddenly, people with employer-sponsored health insurance have more to worry about than fighting managed care and/or maintaining the right to choose doctors

This shift in sentiment also helps explain why Medicare for All is so popular an idea. Yes, seamless universal coverage is attractive, but getting rid of deductible, co-pays, and even (in the more generous proposals) premiums could be an even bigger deal. It’s enough to make proponents of “skin in the game” nervous:

Even former Utah Gov. Mike Leavitt, a Republican who supported the move to higher deductibles as Health and Human Services secretary in the George W. Bush administration, acknowledged that adjustments may be needed, even if returning to the days of no-deductible coverage is not the solution.

“There needs to be a way to relieve the pressure,” Leavitt said. “Otherwise, people will feel like they have no insurance at all.”

Exactly.

Trump Hands Democrats a Gift with Effort to Kill Obamacare

I often make the statement that Trump and the Republican Party want to create a new Gilded Age where the wealth of the richest Americans soared to obscene levels - thinks of the Rockefellers, Goulds, Vanderbilts, etc. - while the majority of Americans struggled to survive.  One study found as follows as to what happened to life expectancy during the rise of the Gilded Age:

"an average white ten-year-old American boy in 1880, born at the beginning of the Gilded Age and living through it, could expect to die at age forty-eight. His height would be 5 feet, 5 inches. He would be shorter and have a briefer life than his Revolutionary forebears.” “Infant mortality worsened in many cities after 1880.”

Part of the problem of the Gilded Age was a lack of safety and environmental regulations - things that were eventually remedied.  Yet now, Trump and the GOP are steadily rolling back such regulations so that big business can reap larger profits. Now, Trump has declared war on the Affordable Health Care Act and seeks to deprive millions of access to healthcare.  Even before this latest action, as a Washington Post story reported, the USA was going backwards in terms of diminished life expectancy and infant mortality.  Here are excerpts:

The Centers for Disease Control and Prevention, for example, reported in November [2018] that life expectancy for the average American ticked downward for the third year in a row. The news attracted a storm of attention . . . . Other trends, however, passed by more quietly. In health care, for example, maternal deaths inched up slightly this year to 20.7 per 100,000 live births, according to data from the United Health Foundation. In fact, giving birth in the United States has become increasingly deadly over the past few decades, placing our country in the same category as developing nations such as Afghanistan and Swaziland. And the rates are even worse for mothers of color.

The latest CDC data released this year shows that U.S. infant mortality rates, after steadily falling over the past few decades, haven’t decreased significantly for five years. Today it stands at 5.9 deaths per 1,000 births, far higher than the average rate of 3.9 deaths for developed countries. Again, it’s even worse for infants of color.

Given these statistics, increasing access to health care would be the moral thing to do.  Sadly, to Trump and Republicans (and evangelical Christians), most of us simply do not matter.  Indeed, it appears that they'd prefer that Americans - especially minorities and the poor - simply die while the rich rake in an ever larger share of the nation's wealth. How else to explain the Trump administration's latest effort to destroy health care access for millions.  A piece in Politico looks at this disgusting development and the Democrat response to such immorality.  Here are highlights:

House and Senate Democrats on Tuesday seized on the Justice Department’s endorsement of a federal court ruling to eliminate Obamacare in its entirety, immediately renewing attacks on the GOP for trying to gut the law’s popular protections and rip health coverage from more than 20 million Americans.

The administration’s surprise decision — a shift from its prior stance that only parts of the Affordable Care Act should be thrown out — offered a unifying moment for Democrats still grappling with the news that Mueller would not charge President Donald Trump with any crimes and comes as the party readies a fresh legislative offensive on health care.

“It’s disgusting. It’s horrible,” said Rep. Ben Ray Luján of New Mexico, the No. 4 House Democrat. “It’s what they were trying to do during the repeal of the Affordable Care Act, it’s what Republicans were doing when they filed the lawsuit. The president’s been clear about his position the whole time.”

And even as Democrats decried the move, they also saw it as a political gold mine.

[L]awmakers were privately ecstatic about the Trump administration’s decision to essentially to trample all over its own good news cycle and turn the attention back to an issue that Democrats used to win back the House.

“It’s really outrageous. I don’t understand if Republicans weren’t present for the last election, but if there was an issue that was deeply critical, it was health care,” Rep. Pramila Jayapal (D-Wash.), co-chair of the Congressional Progressive Caucus, said after the meeting. . . . It’s “not only immoral, it’s a really bad political decision for them,” she added.

“We’re going to introduce a bill to protect and strengthen the ACA. That’s the responsible thing to do,” said Rep. Donna Shalala (D-Fla.). “They’re being irresponsible, and they’re putting 20 million people in this country at risk.”

Indeed, House Democrats had planned a pivot to health care even before the Trump administration late Monday announced its support for a federal judge’s December ruling that the entire ACA should be invalidated because Congress eliminated its individual mandate penalty in the GOP tax law.

Democrats are rolling out a wide-ranging Obamacare package aimed at shoring up the law’s benefits while reversing several of the Trump administration main health priorities — a bid to follow through on the campaign-trail vows that helped propel them into the House majority.

The package is largely a rehash of policies that Democrats pitched last year, like expanding the Obamacare subsidies meant to help Americans afford health coverage and restoring outreach funding that Trump slashed over the past two years. It would also rescind regulations expanding cheaper, skimpier health plans that the administration has touted for providing greater choice, but Democrats have derided as “junk” insurance.

Their plan gained new significance in the wake of the Trump administration’s legal action, providing vulnerable Democrats with concrete legislation to hype for their swing-district voters and a powerful tool to use against Republicans who refuse to endorse any Obamacare-related measures even as they insist they want to protect patients with pre-existing conditions.

For Republicans, meanwhile, the Justice Department’s move threatens to put them back on the defensive just days after what was arguably their biggest victory of the Trump era.

[M]ost Republicans have so far remained fairly quiet in the aftermath of the DOJ filing in a case that few view as politically advantageous — even as Trump appeared to celebrate the decision. . . . GOP lawmakers who did have an initial reaction expressed exasperation at the disconnect between the Trump administration and the Hill on health care.

[T]he issue is a new headache given the new Senate map: Democrats have gone from defending 10 states that Trump won in 2018 to launching campaigns against incumbents in places like Colorado, Iowa, North Carolina and Maine. Sen. Susan Collins (R-Maine) has been particularly outspoken in opposition to the administration’s support of the lawsuit.

[N]either the Trump administration nor Republicans in Congress have any ready replacement for Obamacare if it is ultimately wiped out. . . . with a serious battle for Senate control developing in purple and blue states, Democrats say they have the political upper hand on an issue their House counterparts used to devastating effect in 2018.

This move by the Trump administration to take away health care will prove far more detrimental to the administration and the Republican Party than any gains they might have made by the [findings] of Mr. Barr’s letter,” said Senate Minority Leader Chuck Schumer (D-N.Y.).

Even Doug Jones of Alabama, by far the most endangered Senate Democrat next year, was singing the same tune as party leaders. “I’m outraged. It’s going to hurt my state really bad if that were to go forward,” Jones said in an interview. “They couldn’t do in this chamber what they wanted to do, which is completely dismantle and disintegrate it. So they’re trying to blow it up in any way possible.”

Being a Republican and being a decent and moral person are becoming increasingly mutually exclusive.

Republican Appointees Are Corroding the Foundations of Democracy.

The main agenda of today's Republican Party is to retain power while thwarting the will of the majority of voters in the USA.  This agenda is being pushed in multiple ways, including voter disenfranchisement, gerrymandering and, increasingly, by politicizing the federal judiciary with unfit appointees who place political partisanship ahead above the U.S. Constitution and the rule of law.  Frighteningly, with the U.S. Senate controlled by Republicans - who seemingly hold as much regard for American democracy as the Vichy French did for maintaining the democracy of the French Third Republic - it is near impossible for Democrats to block these ideologues who are set on thwarting the will of the people. A column in the New York Times looks at this insidious assault of democracy itself and the ruling of GOP appointee U. S. District Court Judge Reed O'Connor who issued a ruling striking down the Affordable Health Care Act.  O'Connor has previously issued rulings (i) upholding anti-transgender "bathroom bills," (ii) barring same sex couples from family medical leave benefits and (iii) and allowing physicians to refuse to treat LGBT individuals.  Here are column highlights:

The midterm elections were, to an important extent, a referendum on the Affordable Care Act; health care, not Donald Trump, dominated Democratic campaigning. And voters delivered a clear verdict: They want Obamacare’s achievements, the way it expanded coverage to roughly 20 million people who would otherwise have been uninsured, to be sustained.

But on Friday, Reed O’Connor, a partisan Republican judge known for “weaponizing” his judicial power, declared the A.C.A. as a whole — protection for pre-existing conditions, subsidies to help families afford coverage, and the Medicaid expansion — unconstitutional. Legal experts from both right and left ridiculed his reasoning and described his ruling as “raw political activism.” And that ruling probably won’t be sustained by higher courts.

But don’t be too sure that his sabotage will be overturned. O’Connor’s abuse of power may be unusually crude, but that sort of behavior is becoming increasingly common. And it’s not just health care, nor is it just the courts. What Nancy Pelosi called the “monstrous endgame” of the Republican assault on health care is just the leading edge of an attack on multiple fronts, as the G.O.P. tries to overturn the will of the voters and undermine democracy in general.

Rule of law depends not just on what is written down, but also on the behavior of those who interpret and enforce that rule. If these people don’t regard themselves as servants of the law first, partisans second, if they won’t subordinate their political goals to their duty to preserve the system, laws become meaningless and only power matters.

And what we’re seeing in America — what we’ve actually been seeing for years, although much of the news media and political establishment has refused to acknowledge it — is an invasion of our institutions by right-wing partisans whose loyalty is to party, not principle. This invasion is corroding the Republic, and the corrosion is already very far advanced.

I say “right-wing” advisedly. There are bad people in both parties, as there are in all walks of life. But the parties are structurally different. The Democratic Party is a loose coalition of interest groups, but the modern Republican Party is dominated by “movement conservatism,” a monolithic structure held together by big money — often deployed stealthily — and the closed intellectual ecosystem of Fox News and other partisan media. And the people who rise within this movement are, to a far greater degree than those on the other side, apparatchiks, political loyalists who can be counted on not to stray from the party line.

Republicans have been stuffing the courts with such people for decades; O’Connor was appointed by George W. Bush. That’s why his ruling, no matter how bad the legal reasoning, wasn’t a big surprise.

[I]t’s not just the courts. Even as Trump and his allies spin fantasies about sabotage by the “deep state,” the reality is that a growing number of positions in government agencies are being occupied by right-wing partisans who care nothing, or actively oppose, their agencies’ missions. The Environmental Protection Agency is now run by people who don’t want to protect the environment, Health and Human Services by people who want to deny Americans health care.

The same takeover by apparatchiks is taking place in politics. Remember when the role of the Senate was supposed to be to “advise and consent”? Under Republican control it’s just plain consent — there is almost literally nothing Trump can do, up to and including clear evidence of corruption and criminality, that will induce [GOP] senators from his party to exercise any kind of oversight.

So how do people who think and behave this way respond when the public rejects their agenda? They attempt to use their power to overrule the democratic process.

When Democrats win despite election rigging, they strip the offices Democrats win of power, as they did in Wisconsin. When Democratic policies prevail despite all of that, they use apparatchik-stuffed courts to strike down legislation on the flimsiest of grounds.

As David Frum, the author of “Trumpocracy,” warned a year ago: “If conservatives become convinced that they cannot win democratically, they will not abandon conservatism. They will reject democracy.” That’s happening as we speak.

So Pelosi was right about Reed O’Connor’s ruling being a symptom of a “monstrous endgame,” but the game in question isn’t just about perpetuating the assault on health care, it’s about assaulting democracy in general. And the current state of the endgame is probably just the beginning; the worst, I fear, is yet to come.

Don't Fall for GOP Claims on Protections for Preexisting Conditions

At times I am amazed at how stupid Republicans think the public is when it comes to believing their lies.  True. with Trump supporters, especially evangelical Christians who tend to be the least educated segment of society, there is a high level of stupidity, some fueled by intellectual laziness and some spurred by racism to which the GOP has played ever since the rise of Richard Nixon's "southern strategy."  But when it comes to health care - especially maintaining protections for preexisting conditions - anyone paying any attention can see that the rhetoric that one is hearing from Republican congressional candidates is 180 degrees the opposite of the votes and actions over the last two years.  For example, how can one be a champion of protecting preexisting conditions (as claimed by Republican Senate candidate Josh Hawley who hopes to unseat Democrat Claire McCaskill) while in charge of a state filed lawsuit seeking to end those very protections.  Locally, the same holds true for Rep. Scott Taylor who is singing one line now, but voted very differently.  A piece in the Washington Post looks at GOP lies which are in high gear as election day approaches.  Here are excerpts:

What began over the summer as a halfhearted attempt by Republicans to push back against Democratic attacks on the issue of health care has exploded into a full-throated reversal of their positions, particularly on protections for sick Americans.

In Missouri, Republican Senate candidate Josh Hawley has been hammered by the woman he hopes to unseat, Democrat Claire McCaskill, for being among the attorneys general who have asked a federal court to render unconstitutional the Affordable Care Act, or Obamacare, which compelled insurance companies to cover those with preexisting conditions.

“You don’t go to court and get rid of important protections when there is no backup, when people will be in a free fall,” McCaskill said in a debate Thursday night.

In Texas, where he is trying to beat back a well-financed challenge by Democratic Rep. Beto O’Rourke, Sen. Ted Cruz said in a debate Tuesday that he would “protect preexisting conditions.” Cruz forced a government shutdown in 2013 over his effort to repeal Obamacare. In a House race in California, Republican Rep. Dana Rohrabacher is, like Hawley, using his child’s illness to attest to his embrace of protections for preexisting conditions, even though he repeatedly voted to quash the Obamacare bill that first secured them.

Democrats and health-care specialists say that the proposals being put forward by Republicans contain exemptions that mean the sick would not be fully protected or would be charged exorbitant rates for coverage, as they were before the ACA became law.

Still, the sudden scramble by Republicans underscores the speed with which voters have also reversed themselves on the most popular provisions of the act, even as Republicans worked relentlessly to repeal them. It also raises a political irony: The same issue that gave birth to the tea party and propelled Republicans to power in the 2010 midterm elections could cost them dearly eight years later.

Republicans appeared to have been caught flat-footed about the change in voter opinion about insurance coverage, which has been cited by voters in multiple polls this year as the issue they care most about.

[A]s the GOP shifted its focus to tax cuts — which have not gained traction among voters — Democrats built an entire midterm campaign strategy around preserving the law’s most popular provision.

The actions of Republicans, including the president, before this election year have not matched their rhetoric over the past few weeks.  For more than eight years, their greatest and most unifying party rallying cry has been repealing Obamacare.

Trump also has bragged repeatedly about his administration’s many steps to undermine the law and water down protections, even as his administration has refused to defend any part of the law against the lawsuit filed by Republican attorneys general. “I think the big issue is the brazenness [with] which this mantle is being put on to say this is something they’ve always supported,” said Sabrina Corlette, professor of health policy at Georgetown University.  Most health-policy experts say the Republican position is contradictory because without a replacement plan in place, people with past or existing illnesses would lose the protections they have now.

“The irony is that what allowed the House to pass [the repeal bill] was a proposal to weaken protections for preexisting conditions. This was not an obscure part of the debate,” said Larry Levitt, senior vice president for health reform at the Kaiser Family Foundation.

If you care about health care coverage - and Social Security and Medicare - the only option is to vote Democrat on November 6, 2018.  Do not fall for the GOP lies.  

Republicans Continue to Undermine Pre-Existing Condition Coverage

Missouri Republican Senate candidate Josh Hawley apparently has taken the Hypocrite's oath.

America continues to have the most costly and inefficient health care systems in the world.  It literally costs multiples of what other nations with national systems are paying and it costs lives because many who need health care cannot afford it.  If Republicans have their way, health care insurance will become even more expensive and those with pre-existing conditions may find themselves un-insurable.  This from the party that claims to uphold "Christian values" even as it seeks to slash social programs to cut a deficit cause by a massive tax cut give away for the extremely wealthy and large corporations which have not reinvested their huge windfall in increased employee wages or massive capital investments.  It's little wonder Millennials are walking away from the GOP - and religion. A column in the New York Times exposes the Republican hypocrisy.  If you care about health care, vote Democrat in every race on November 6, 2018.  Here are column excerpts:

On graduation, most medical students swear some version of the ancient Hippocratic oath — a promise to act morally in their role as physicians.

When it comes to how political figures deal with health care, however, we’ve come to expect the opposite, at least on one side of the aisle.  It often seems as if Republican politicians have secretly sworn a Hypocrite’s oath — a promise to mislead voters to the best of their ability, to claim to support the very protections for the sick they’re actively working to undermine.

To see what I mean, consider the case of Josh Hawley of Missouri, who is running for the Senate against Claire McCaskill.

Hawley is one of 20 state attorneys general who have brought a lawsuit attempting to repeal a key provision of the Affordable Care Act — the provision that protects people with pre-existing medical conditions, by requiring that insurance companies cover everyone of similar age at the same rate regardless of medical history. Kill that provision, and millions of vulnerable Americans will lose their insurance.

But here’s the thing: Protecting coverage for pre-existing conditions is overwhelmingly popular, commanding majority support even among Republicans. And McCaskill has been hammering Hawley over his role in that lawsuit.

So Hawley has responded with ads claiming that he, too, wants to protect those with pre-existing conditions, as supposedly shown by his support for a bill that purports to provide such protection.

I have to say, you almost have to admire the sheer brazenness of the dishonesty here. For the bill Hawley touts is a fraud: It’s full of loopholes allowing insurers to discriminate in ways that would end up making essential health care unaffordable for those who need it most. For example, while it would require that they offer insurance to, say, cancer patients, it would allow them to sell policies that don’t cover cancer treatment — which would mean that policies that did cover such treatment would become prohibitively expensive.

And the fraudulence of this bill aside, even serious, nonfraudulent regulation of insurance companies isn’t enough in itself to provide affordable coverage for pre-existing conditions.

That was New York’s experience: Before the A.C.A., it had strong regulations on insurers, but high premiums meant that only people with health problems bought insurance on the individual market (as opposed to getting it from their employers), and this in turn kept premiums high.

To make regulation work, you have to back it up with incentives for healthy people to sign up, including subsidies that help lower-income families afford insurance. In other words, if you really want to make essential care available for pre-existing conditions while continuing to rely on private insurance companies, you need a system that looks a lot like … Obamacare. Indeed, New York premiums dropped in half when the A.C.A. went into effect.

Hence the Hypocrite’s oath. Republicans hate the idea of guaranteeing that all Americans receive essential health care, and they really, really hate the taxes on high incomes that help pay for Obamacare subsidies. And you can imagine an alternative political universe in which the G.O.P. openly admitted its true goals, justifying them on the basis of economic freedom, or something.

But in this universe, Republicans have decided that they must conceal their intention of taking health care away from those who need it most. So they’re doing what Hawley is doing: resorting to a combination of sabotage and smoke screen. On one side, they’re hacking away at the edges of the Affordable Care Act in the hope that it will implode. On the other, they’re pretending to want the very things — like guaranteed coverage of pre-existing conditions — they’re trying to destroy.

[T]his is why many Democrats are talking about Medicare for all. Obamacare was a market-friendly health insurance reform designed in part to mollify conservatives; their response was scorched-earth opposition, followed by a series of attempts to exploit public confusion about how the Affordable Care Act works and what it will take to sustain it. So there’s something to be said for a simpler system that would be harder to game politically.

[P]olls show that Democrats hold a large edge over Republicans on the question of which party people trust more on health care. But that gap would surely be even bigger if more voters realized what the G.O.P. is actually trying to do.

So let’s be clear about this: If you or anyone you care about suffers from a pre-existing medical condition, Republicans are trying to take away your insurance. If they claim otherwise, they’re lying.

I truly believe the rise of deliberate and blatant dishonesty of the GOP directly tracks with the rise of Christofascists in the party base and party bureaucracy.  No one is more dishonest.

Is Some of Trump's Base Waking to the Fact It Has Been Conned

One of the ironies of Donald Trump's base of support - and the Republican Party in general - is that it is made up of aging, uneducated, evangelical Christian whites for whom Trump and the GOP establishment hold nothing but contempt when not speaking into microphones at rallies and political events.  Yet through appeals to racism, religious based ignorance, fears of lost white privilege and appeals for hatred against those deemed "other" Trump and the GOP have induced members of this base to vote against its own best economic interest as GOP policies have looted the nation to benefit the wealthy.  Touring Versailles a week ago I could not help but see parallels between the detachment of the French nobility from the reality of their subjects and today's plutocrat loving GOP.  Sooner or later the masses wake up to the reality that they are being deliberately screwed over.   As a column in the New York Times reviews, at least a few in the Trump/GOP base may be slowly awakening to the fact that they have been conned and callously played for fools.  Here are column excerpts:

Dogs, though known for their loyalty, can take only so much from one abusive human. Alas, the same cannot be said for the aging, white, rural and southern people who make up Trump’s base. He can lie to them, hurt them with tariffs, make a mockery of their values, suck up to freedom-hating dictators they once distrusted, and they’ll stick with him. Cult 45 is thought to be impermeable.

But surprise — a raft of new polls show that some of the most hard-core Trumpsters are starting to get a clue. I know, hold your applause. It’s like discovering that climate change is not a hoax when your town is under water, and all your commander in chief can do is throw you a roll of paper towels. And the woke among the true believers is small.

I think Trump’s base is showing some erosion because his followers feel he finally crossed a line: He’s now insulting them.

It didn’t go over well in Alabama that Trump reportedly called his ’Bama-bred attorney general, Jeff Sessions, “a dumb Southerner” and ridiculed his accent. Trump has denied the account from Bob Woodward’s new book, “Fear.”

Trump has used the regional dis before, calling the family of another ex-wife, Marla Maples, “dumb Southerners” and “hillbillies,” as one reporter recalled. Last week, the longtime Trump confidant Roger Stone trashed Sessions as an “insubordinate hillbilly” — expressing a double dose of hick hatred. It’s in Trump’s character to deride those without gold-plated bathroom fixtures as inferior. His people, as he said in a North Dakota non sequitur, have the best apartments and the nicest boats. But you don’t need what comes out of his mouth as proof of his class disdain. Look at the two biggest policy initiatives of his presidency. He has tried mightily to destroy Obamacare and all the lives dependent on it. He’s still pushing a repeal plan that would leave upward of 18 million people without health care. And who are those people? His supporters, mostly.

Working-class whites, particularly in the old Rust Belt, were the main beneficiaries of the expansion of health care under President Barack Obama. . . . . And if the president’s party succeeds in choking the last life out of Obamacare, these Trump voters stand to lose the most.

As noted, some of them are catching on. A Quinnipiac poll out this week showed that even among non-college-educated whites — the strongest demographic holdout for Trump — a plurality now say they’d like to see Congress be more of a check on the president. Since his election, he’s down 14 points among the “poorly educated” that Trump once professed to love, a CNN poll found.

In West Virginia, where Trump could shoot the Mountaineer mascot and still walk at the head of a parade, attacks on Obamacare are killing Republican chances of taking down Senator Joe Manchin.

The other signature issue is the tax cut. Remember how Treasury Secretary Steven Mnuchin, another plutocrat who has trouble hiding his contempt for flyover country, described it last year? “Not only will this tax cut pay for itself,” he said, “but it will pay down the debt.”

We’ll soon be running a trillion-dollar deficit, up 32 percent this fiscal year, thanks to the tax cut. . . . .The collapse in revenue will hurt Trump supporters in other ways. One is the paucity of federal dollars for investment — in community colleges, roads, opioid treatment, Pell grants for students, ultimately even Social Security or Medicare. Another is that, by forcing borrowing costs up, the Trump deficit contributes to rising interest rates. That makes it much harder for working families to buy homes.

In truth, economics will probably not move Trump supporters. Their vote for him was more about status anxiety in a changing nation than about financial uncertainty. They’ll stay with him only so long as they allow themselves to be easy marks for the insulting con of this presidency.

GOP Message to Most Americans: Get Sick, Go Bankrupt and Die

Liar and modern day Pharisee, Mike Pence.

Sitting in Le Marais area of Paris as I type this post, several things come to mind.  One is that the French truly have a love of life and, unlike Americans work to live rather than live to work.  Another is that they are free from the constant fear of that one major illness or pre-existing medial condition that could wipe them out financially,  Why this freedom of such fear?  It's simple: France's healthcare system, rated by many as the best and most cost effective in the world. Yes, the French pay higher taxes, but walking around the city one sees few signs of poverty and an enviable lifestyle.  The contrast could not be greater compared to America where health care cost remain a continued concern for all but the very wealthy.  Indeed, the message the Republican Party seemingly sends to millions of Americans is like the caption of this post: get sick, go bankrupt and die.  This from the political party that pretends to embrace "Christian values"  and that now finds it strongest support from evangelical Christians and white supremacists (in my view, the two are increasingly synonymous).  A column in the New York Times looks at the menace of the GOP towards millions of Americans:  Here are excerpts:

Despite his reputation as a maverick, John McCain spent most of his last decade being a very orthodox Republican . . . . But he redeemed much of that record with one action: He cast the crucial vote against G.O.P. attempts to repeal the Affordable Care Act. That single “nay” saved health care for tens of millions of Americans, at least for a while.

But now McCain is gone, and with him, as far as we can tell, the only Republican in Congress with anything resembling a spine. As a result, if Republicans hold Congress in November, they will indeed repeal Obamacare. That’s not a guess: It’s an explicit promise, made by Vice President Mike Pence last week.

In the case of health care, however, there’s an even deeper problem: The G.O.P. can’t come up with an alternative to the Affordable Care Act because no such alternative exists. In particular, if you want to preserve protection for people with pre-existing conditions — the health issue that matters most to voters, including half of Republicans — Obamacare is the most conservative policy that can do that. The only other options are things like Medicare for all that would involve moving significantly to the left, not the right.

Health economists have explained this point many times over the years; but as always, it’s difficult to get a man to understand something when his salary depends on his not understanding it.

If you want private insurers to cover people with pre-existing conditions, you have to ban discrimination based on medical history. But that in itself isn’t enough, because if policies cost the same for everyone, those who sign up will be sicker than those who don’t, creating a bad risk pool and forcing high premiums. That was the case in New York, where premiums for individual policies were very high before the A.C.A. For what Obamacare did was provide incentives to get healthy people to sign up, too. On one side there was a penalty for not having insurance (the individual mandate). On the other, there were subsidies designed to limit health expenses as a share of income. Republicans have tried to sabotage health care by doing away with the mandate, and have succeeded in driving premiums higher; but the system is still standing thanks to those subsidies.

The point, again, is that Obamacare is the most conservative option for covering pre-existing conditions, and if Republicans really cared about the scores of millions of Americans with such conditions, they would support and indeed try to strengthen the A.C.A.

Instead, they’re going to kill it if they hold on in two months. But covering pre-existing conditions is popular; therefore, they’re pretending that they’ll do that, while offering proposals that would, in fact, do no such thing.

Do they imagine that voters are stupid?  Well, yes. In recent rallies Donald Trump has been declaring that Democrats want to “raid Medicare to pay for socialism.”

But the more important target is the news media, many members of which still haven’t learned to cope with the pervasive bad faith of modern conservatism.

Sadly, when it comes to the GOP base, they are stupid.  Or, in the alternative, are so motivated by their racial hatreds that they blinded to the reality that they are voting against their own interests in most instances. 

Trump’s War On Pre-Existing Condition Protections

As noted in the prior post concerning suicide, Trump and the GOP, but Trump in particular, is waging a war to kill the pre-existing condition provisions of the Affordable Health Care Act.  If successful, this will mean many Americans will lose coverage completely or face skyrocketing premiums.  Oh, and did I mention that almost anything can be deemed a pre-existing condition by insurance carriers who only want to accept premium payments but never have to pay out to their insureds?  With fewer and fewer Americans receiving health insurance through their jobs, this is a big deal and will cause significant harm to many already beleaguered individuals and families - especially among the GOP base.  Belatedly, some in the GOP are waking up to the danger of their handiwork in the lead up to November 218.  A piece in Talking Points Memo looks at the issue.  Here are excerpts:

Republicans were already worried that the nation’s health care woes could sink them in 2018. Now they feel like the Trump administration just tossed them an anvil.

The Department of Justice’s announcement Thursday night that it will take aim at Obamacare’s most popular provisions — a ban on insurance companies discriminating against people based on pre-existing conditions, and limits on how much insurers can hike premiums for older Americans — will be ammunition Democrats can use this November.

The long-shot lawsuit from 20 conservative states, now endorsed by the DOJ, argues that because Republicans repealed the Affordable Care Act’s individual mandate penalty as part of their tax overhaul, the mandate itself can no longer be considered a tax — the basis on which the Supreme Court upheld it in 2012. And, the DOJ added, since the ACA’s rules on pre-existing conditions are “closely intertwined” with the mandate, they too must be struck down.

Republicans had begun growing hopeful that good economic news and some improving poll numbers might save them in the midterms. But they now fear that Trump has handed voters proof positive that his party doesn’t care about those with preexisting conditions.

“This is definitely the most popular aspect of the Obamacare legislation, and it clearly creates an opening for Democrats going into the final months of the election year,” GOP strategist Ken Spain, a former communications director at the National Republican Congressional Committee, told TPM.

Poll after poll has found that protecting people with pre-existing conditions is the most emotionally potent health care argument for voters. A survey conducted by the Democratic firm Hart Research Associates for Protect Our Care this past January and shared with TPM on Friday found that the issue was one of the most effective in the healthcare debate: 63 percent of voters had “very major concerns” and another 20 percent had “somewhat major concerns” with the GOP’s efforts to repeal pre-existing condition protections. Among independents, that number rose to 73 percent with “very major concerns.”

Now, thanks to the Trump administration, the issue is poised to come back into the headlines at the worst possible time for Republicans. Most insurers inform their customers about their new insurance rates in October, just weeks before voters go to the polls. Insurance rates were already set to rise next year, in large part because of Republicans’ repeal of the individual mandate, and insurers say Trump’s latest move could push premiums higher still.

“Removing those provisions will result in renewed uncertainty in the individual market, create a patchwork of requirements in the states, cause rates to go even higher for older Americans and sicker patients, and make it challenging to introduce products and rates for 2019,”America’s Health Insurance Plans (AHIP), health insurers’ major lobbying group, warned in a Friday statement.

Now, a year later, after receiving significant political blowback for these repeal attempts, GOP lawmakers are once again in the hot seat as the Trump administration tries to use the courts to get rid of the ACA protections they were unable to abolish through Congress.

“If I were a House Republican I would have woken up to my morning newspaper and thrown it against the wall. He just made clear the thing they’ve done their best to hide from,” said Democratic strategist Jesse Ferguson.

As Republicans squirm, Democrats are pouncing on the administration’s attempt to have the ACA’s most popular protections ruled unconstitutional. By Friday morning, candidates in competitive House and Senate races were blasting out statements on the legal filing and attacking their GOP opponents for siding with President Trump on health care policy.

With their eyes on retaking at least one, if not both chambers of Congress this fall, national Democratic groups are confident that the issue will be a major political liability for the GOP.  

“No issue is more personal than health care, and this is a perfect storm of two of the most personal aspects of health care coming together: skyrocketing premiums and the loss of protections for people with pre-existing conditions,” Tyler Law, the national press secretary for the Democratic Congressional Campaign Committee (DCCC), told TPM.

“Whoever tends to be disruptive on healthcare tends to get punished,” former Rep. Tom Davis (R-VA), a former NRCC chairman, told TPM. “When Republicans come in and try to undo Obamacare, they’re being disruptive.”

Medicaid Expansion Approved by Virginia General Assebly

Ralph Northam on inauguration day 2018.

In a major triumph for Governor Ralph Northam and Virginia Democrats - not to mention the tens of thousands of working Virginians who will benefit - the Virginia General Assembly has approved Medicaid expansion.  The move will end Virginia's export of taxes that have accrued to adjoining states which previously embraced Medicaid expansion, an aspect of the Affordable Health Care Act which Congressional Republicans have worked to kill with no regard for the millions of Americans who will be harmed through either a loss of health insurance coverage or significantly increased health insurance premiums all so the 1% could reap obscene tax cuts.   Many of Virginia's rural hospitals, especially in Southwest Virginia where bigotry and religious extremism make it difficult to attached a new industrial base, that have been teetering on bankruptcy  or closure, will be among the big winners on this development.   Here are highlights from the Virginian Pilot:

The Republican-controlled Virginia General Assembly gave final approval Wednesday evening to a state budget expanding Medicaid coverage to the state's poor, acting swiftly after the Senate broke years of partisan gridlock on the issue.

The House of Delegates voted Wednesday only about an hour after the state Senate voted in favor of expansion. Several Republicans in both chambers joined with Democrats to support Medicaid expansion.

The House had previously endorsed expansion, while the Senate had held out in opposition until Wednesday.

Democratic Gov. Ralph Northam is expected to sign the budget in coming days that continues the plan. Expanding Medicaid was a key provision of then-President Barack Obama's health care overhaul, and a tally from the Kaiser Family Foundation shows Virginia will become the 33rd state to approve Medicaid expansion.

Senate passage came by a 23-17 vote with four Republicans joining Democrats for passage. The House quickly followed about an hour later with a lopsided 67-31 final endorsement.

Wednesday's voting marked the end of a more than four-year battle over whether Virginia should expand the publicly funded health care program for the poor. 

Virginia Democrats have pushed for years to expand Medicaid, saying their state should not pass up the roughly $2 billion in extra federal funding the program would bring to the state.  Sen. Ben Chafin, a Republican lawmaker from Virginia's economically depressed southwest coal country, announced his support for expansion on the Senate floor. He said his rural area needed expansion to help bolster its hospitals and provide care for constituents in need.  "I came to the conclusion that no just wasn't the answer anymore," Chafin said.

Expanding Medicaid to cover more low-income families was a key provision of the Affordable Care Act secured by then-President Barack Obama.

A federal-state collaboration originally meant for poor families and severely disabled people, Medicaid has grown to become the largest government health insurance program, now covering 1 in 5 people. Obama's health care overhaul gave states the option of expanding Medicaid to cover more low-income adults.

The GOP-controlled General Assembly's support for Medicaid comes despite Trump administration rejections.

Last year, Virginia saw its state legislature reshaped by an anti-Trump wave as Democrats made unexpectedly large gains in the state House. And a failure by the GOP-led Congress to repeal and replace the health law helped spur several of Virginia's Republican state legislators to flip positions.

Democrats campaigned heavily on expanding Medicaid last year and some House Republicans were eager to take the issue off the table before next year's election, when both House and Senate seats are up.