Representative Lee Zeldin should be ashamed of himself. That’s what his constituents declared back in May at their “Shame on Zeldin” protest on his AHCA vote.
And now, in the aftermath of the Las Vegas shootings, others have joined that chorus.
A recent editorial in The Forward shames Lee Zeldin—one of two Jewish Republican members of Congress—for accepting money from the NRA and voting so consistently with gun interests to have earned an A rating from the NRA. (In fact, Zeldin has accepted more money from the NRA than any other New York representative).
The editorial’s author, Jane Eisen, urges us not to let Zeldin off the hook:
“Don’t be distracted. My calls and emails to Zeldin’s and Kustoff’s congressional offices were not returned as of this writing. Contact them yourself. Let them know that they should be ashamed of accepting even a dime of this bloodied money.” (Emphasis added).
While the Secretary of the Interior is jetting around on our dime, and the head of the Environmental Protection Agency is slow-dancing with his longtime steadies in the extraction industries, the environment is apparently going into business for itself. From the NYT:
While not all algae blooms are toxic, they can produce a type of cyanobacteria called microcystis. These bacteria in turn, can produce neurotoxins and hepatotoxins, such as microcystin and cyanopeptolin that can cause serious liver damage under certain conditions. Dangerous levels of cyanobacteria caused Toledo, Ohio, to shut down the drinking water supply of a half-million residents for three days in 2014. In total, almost 3 million people get drinking water from the central basin of Lake Erie. Officials have been testing the intake points in the lake where towns draw water and report that the current toxin levels are low.
I will make the Toby Ziegler Wager—all the money in my pockets against all the money in yours—that nobody of any influence in this administration is aware in the least of this situation, much less how it’s caused, much less all of the contributing factors, much less what in the hell to do about it. I am willing to give them the benefit if the doubt as to whether anyone of influence in this administration knows of the existence of Lake Erie, but that is because I am a fair man that way.
The blooms are expected to grow more harmful as global warming changes rainfall patterns. According to local experts, storms have become more intense in the region, carrying more nutrients from the farmland into the lake.
Another study from the Carnegie Institution for Science shows that extensive algae blooms will continue to grow throughout the continental United States and around the globe, especially in Southeast Asia.
The mayor of Toledo, Paula Hicks-Hudson, wrote a letter to President Trump on Sept. 26, calling on the federal government to declare Lake Erie impaired, which would allow for the lake’s nutrient loads to be regulated under the Clean Water Act.
“There is something very wrong with our country when our rivers and lakes turn green,” Ms. Hicks-Hudson wrote in her letter. “As I look out my office at a green river, I can tell you one thing: The status quo is not working.”
The amount of things of which this government chooses consciously to remain ignorant about has to be something like a record by now, but its total disregard for anything resembling an environmental policy is going to be its longest lasting and most destructive legacy, and we know that already, and they haven’t been in office for a year yet. Well, that and Neil Gorsuch, who’s kind of an algae bloom on the Supreme Court.
In the developed world, these levels of gun violence are a uniquely American problem. Here’s why.
America is an exceptional country when it comes to guns. It’s one of the few countries in which the right to bear arms is constitutionally protected. But America’s relationship with guns is unique in another crucial way: Among developed nations, the US is far and away the most violent — in large part due to the easy access many Americans have to firearms. These charts and maps show what that violence looks like compared with the rest of the world, why it happens, and why it’s such a tough problem to fix.
1) America has six times as many firearm homicides as Canada, and nearly 16 times as many as Germany
Javier Zarracina/Vox
This chart, compiled using United Nations data collected by Simon Rogers for the Guardian, shows that America far and away leads other developed countries when it comes to gun-related homicides. Why? Extensive reviews of the research by the Harvard School of Public Health’s Injury Control Research Center suggest the answer is pretty simple: The US is an outlier on gun violence because it has way more guns than other developed nations.
2) America has 4.4 percent of the world’s population, but almost half of the civilian-owned guns around the world
Javier Zarracina/Vox
3) There have been more than 1,500 mass shootings since Sandy Hook
In December 2012, a gunman walked into Sandy Hook Elementary School in Newtown, Connecticut, and killed 20 children, six adults, and himself. Since then, there have been at least 1,518 mass shootings, with at least 1,715 people killed and 6,089 wounded.
The counts come via the Gun Violence Archive, which has hosted a database that tracks mass shootings since 2013. But since some shootings go unreported, the database is likely missing some, as well as the details of some of the events.
The tracker uses a fairly broad definition of “mass shooting”: It includes not just shootings in which four or more people were murdered, but shootings in which four or more people were shot at all (excluding the shooter).
Even under this broad definition, it’s worth noting that mass shootings make up a tiny portion of America’s firearm deaths, which totaled more than 33,000 in 2014.
4) On average, there is more than one mass shooting for each day in America
Whenever a mass shooting occurs, supporters of gun rights often argue that it’s inappropriate to bring up political debates about gun control in the aftermath of a tragedy. For example, former Louisiana Gov. Bobby Jindal, a strong supporter of gun rights, criticized former President Barack Obama for “trying to score cheap political points” when Obama mentioned gun control after a mass shooting in Charleston, South Carolina.
But if this argument is followed to its logical end, then it will never be the right time to discuss mass shootings, as Christopher Ingraham pointed out at the Washington Post. Under the broader definition of mass shootings, America has nearly one mass shooting a day. So if lawmakers are forced to wait for a time when there isn’t a mass shooting to talk gun control, they could find themselves waiting for a very long time.
Using data from a study in Pediatrics and the Centers for Disease Control and Prevention, Mother Jones put together the chart above that shows states with more guns tend to have far more gun deaths. And it’s not just one study. “Within the United States, a wide array of empirical evidence indicates that more guns in a community leads to more homicide,” David Hemenway, the Harvard Injury Control Research Center’s director, wrote in Private Guns, Public Health.
When economist Richard Florida took a look at gun deaths and other social indicators, he found that higher populations, more stress, more immigrants, and more mental illness didn’t correlate with more gun deaths. But he did find one telling correlation: States with tighter gun control laws have fewer gun-related deaths. (Read more at Florida’s “The Geography of Gun Deaths.”)
This is backed by other research: A 2016 review of 130 studies in 10 countries, published in Epidemiologic Reviews,found that new legal restrictions on owning and purchasing guns tended to be followed by a drop in gun violence — a strong indicator that restricting access to guns can save lives.
8) Still, gun homicides (like all homicides) have declined over the past couple decades
The good news is that all firearm homicides, like all homicides and crime, have declined over the past two decades. (Although that may have changed in 2015 and 2016, with a recent rise in murders nationwide.)
There’s still a lot of debate among criminal justice experts about why this crime drop is occurring — some of the most credible ideas include mass incarceration, more and better policing, and reduced lead exposure from gasoline. But one theory that researchers have widely debunked is the idea that more guns have deterred crime — in fact, the opposite may be true, based on research compiled by the Harvard School of Public Health’s Injury Control Center.
Although America’s political debate about guns tends to focus on grisly mass shootings and murders, a majority of gun-related deaths in the US are suicides. As Dylan Matthews explained for Vox, this is actually one of the most compelling reasons for reducing access to guns — there is a lot of research that shows greater access to guns dramatically increases the risk of suicide.
10) The states with the most guns report the most suicides
11) Guns allow people to kill themselves much more easily
Estelle Caswell/Vox
Perhaps the reason access to guns so strongly contributes to suicides is that guns are much deadlier than alternatives like cutting and poison.
Jill Harkavy-Friedman, vice president of research for the American Foundation for Suicide Prevention, previously explained that this is why reducing access to guns can be so important to preventing suicides: Just stalling an attempt or making it less likely to result in death makes a huge difference.
“Time is really key to preventing suicide in a suicidal person,” Harkavy-Friedman said. “First, the crisis won’t last, so it will seem less dire and less hopeless with time. Second, it opens the opportunity for someone to help or for the suicidal person to reach out to someone to help. That’s why limiting access to lethal means is so powerful.”
She added, “[I]f we keep the method of suicide away from a person when they consider it, in that moment they will not switch to another method. It doesn’t mean they never will. But in that moment, their thinking is very inflexible and rigid. So it’s not like they say, ‘Oh, this isn’t going to work. I’m going to try something else.’ They generally can’t adjust their thinking, and they don’t switch methods.”
12) Programs that limit access to guns have decreased suicides
Estelle Caswell/Vox
When countries reduced access to guns, they saw a drop in the number of firearm suicides. The data above, taken from a study by Australian researchers, shows that suicides dropped dramatically after the Australian government set up a gun buyback program that reduced the number of firearms in the country by about one-fifth.
The Australian study found that buying back 3,500 guns per 100,000 people correlated with up to a 50 percent drop in firearm homicides, and a 74 percent drop in gun suicides. As Dylan Matthews noted for Vox, the drop in homicides wasn’t statistically significant. But the drop in suicides most definitely was — and the results are striking.
Australia is far from alone in these types of results. A study from Israeli researchers found that suicides among Israeli soldiers dropped by 40 percent — particularly on weekends — when the military stopped letting soldiers take their guns home over the weekend.
This data and research have a clear message: States and countries can significantly reduce the number of suicides by restricting access to guns.
13) Since the shooting of Michael Brown, police have killed at least 2,900 people
Since police shooting of Michael Brown in Ferguson, Missouri, on August 9, 2014, police have killed at least 2,902 people as of May 2017.
Fatal Encounters, a nonprofit, has tracked these killings by collecting reports from the media, public, and law enforcement and verifying them through news reports. Some of the data is incomplete, with details about a victim’s race, age, and other factors sometimes missing. It also includes killings that were potentially legally justified, and is likely missing some killings entirely.
A huge majority of the 1,112 deaths on the map are from gunshots, which is hardly surprising given that guns are so deadly compared with other tools used by police. There are also noticeable numbers of fatalities from vehicle crashes, stun guns, and asphyxiations. In some cases, people died from stab wounds, medical emergencies, and what’s called “suicide by cop,” when people kill themselves by baiting a police officer into using deadly force.
14) In states with more guns, more police officers are also killed on duty
Given that states with more guns tend to have more homicides, it isn’t too surprising that, as a study in the American Journal of Public Health found, states with more guns also have more cops die in the line of duty.
Researchers looked at federal data for firearm ownership and homicides of police officers across the US over 15 years. They found that states with more gun ownership had more cops killed in homicides: Every 10 percent increase in firearm ownership correlated with 10 additional officers killed in homicides over the 15-year study period.
The findings could help explain why US police officers appear to kill more people than cops in other developed countries. For US police officers, the higher rates of guns and gun violence — even against them — in America mean they not only will encounter more guns and violence, but they can expect to encounter more guns and deadly violence, making them more likely to anticipate and perceive a threat and use deadly force as a result.
15) Support for gun ownership has sharply increased since the early ’90s
Over the past 20 years, Americans have clearly shifted from supporting gun control measures to greater support of “protecting the right of Americans to own guns,” according to Pew Research Center surveys. This shift has happened even as major mass shootings, such as the attacks on Columbine High School and Sandy Hook Elementary School, have received more press attention.
16) High-profile shootings don’t appear to lead to more support for gun control
Although mass shootings are often viewed as some of the worst acts of gun violence, they seem to have little effect on public opinion about gun rights, based on surveys from the Pew Research Center. That helps explain why Americans’ support for the right to own guns appears to be rising over the past 20 years even as more of these mass shootings make it to the news.
17) But specific gun control policies are fairly popular
Although Americans say they want to protect the right to bear arms, they’re very much supportive of many gun policy proposals — including some fairly contentious ideas, such as more background checks on private and gun show sales and banning semi-automatic and assault-style weapons, according to Pew Research Center surveys.
This type of contradiction isn’t exclusive to gun policy issues. For example, although most Americans in the past said they don’t like Obamacare, most of them also said they like the specific policies in the health-care law. Americans just don’t like some policy ideas until you get specific.
For people who believe the empirical evidence that more guns mean more violence, this contradiction is the source of a lot of frustration. Americans by and large support policies that reduce access to guns. But once these policies are proposed, they’re broadly spun by politicians and pundits into attempts to “take away your guns.” So nothing gets done, and preventable deaths keep occurring.
After Las Vegas Shooting, Fake News Regains Its Megaphone
When they woke up and glanced at their phones on Monday morning, Americans may have been shocked to learn that the man behind the mass shooting in Las Vegas late on Sunday was an anti-Trump liberal who liked Rachel Maddow and MoveOn.org, that the F.B.I. had already linked him to the Islamic State, and that mainstream news organizations were suppressing that he had recently converted to Islam.
They were shocking, gruesome revelations. They were also entirely false — and widely spread by Google and Facebook.
In Google’s case, trolls from 4Chan, a notoriously toxic online message board with a vocal far-right contingent, had spent the night scheming about how to pin the shooting on liberals. One of their discussion threads, in which they wrongly identified the gunman, was picked up by Google’s “top stories” module, and spent hours at the top of the site’s search results for that man’s name.
In Facebook’s case, an official “safety check” page for the Las Vegas shooting prominently displayed a post from a site called “Alt-Right News.” The post incorrectly identified the shooter and described him as a Trump-hating liberal. In addition, some users saw a story on a “trending topic” page on Facebook for the shooting that was published by Sputnik, a news agency controlled by the Russian government. The story’s headline claimed, incorrectly, that the F.B.I. had linked the shooter with the “Daesh terror group.”
Google and Facebook blamed algorithm errors for these.
A Google spokesman said, “This should not have appeared for any queries, and we’ll continue to make algorithmic improvements to prevent this from happening in the future.”
A Facebook spokesman said, “We are working to fix the issue that allowed this to happen in the first place and deeply regret the confusion this caused.”
But this was no one-off incident. Over the past few years, extremists, conspiracy theorists and government-backed propagandists have made a habit of swarming major news events, using search-optimized “keyword bombs” and algorithm-friendly headlines. These organizations are skilled at reverse-engineering the ways that tech platforms parse information, and they benefit from a vast real-time amplification network that includes 4Chan and Reddit as well as Facebook, Twitter and Google. Even when these campaigns are thwarted, they often last hours or days — long enough to spread misleading information to millions of people.
The latest fake news flare-up came at an inconvenient time for companies like Facebook, Google and Twitter, which are already defending themselves from accusations that they have let malicious actors run rampant on their platforms.
On Monday, Facebook handed congressional investigators 3,000 ads that had been purchased by Russian government affiliates during the 2016 campaign season, and it vowed to hire 1,000 more human moderators to review ads for improper content. (The company would not say how many moderators currently screen its ads.) Twitter faces tough questions about harassment and violent threats on its platform, and is still struggling to live down a reputation as a safe haven for neo-Nazis and other poisonous groups. And Google also faces questions about its role in the misinformation economy.
Part of the problem is that these companies have largely abrogated the responsibility of moderating the content that appears on their platforms, instead relying on rule-based algorithms to determine who sees what. Facebook, for instance, previously had a team of trained news editors who chose which stories appeared in its trending topics section, a huge driver of traffic to news stories. But it disbanded the group and instituted an automated process last year, after reports surfaced that the editors were suppressing conservative news sites. The change seems to have made the problem worse — earlier this year, Facebook redesigned the trending topics section again, after complaints that hoaxes and fake news stories were showing up in users’ feeds.
There is also a labeling issue. A Facebook user looking for news about the Las Vegas shooting on Monday morning, or a Google user searching for information about the wrongfully accused shooter, would have found posts from 4Chan and Sputnik alongside articles by established news organizations like CNN and NBC News, with no obvious cues to indicate which ones came from reliable sources.
More thoughtful design could help solve this problem, and Facebook has already begun to label some disputed stories with the help of professional fact checkers. But fixes that require identifying “reputable” news organizations are inherently risky because they open companies up to accusations of favoritism. (After Facebook announced its fact-checking effort, which included working with The Associated Press and Snopes, several right-wing activists complained of left-wing censorship.) The automation of editorial judgment, combined with tech companies’ reluctance to appear partisan, has created a lopsided battle between those who want to spread misinformation and those tasked with policing it. Posting a malicious rumor on Facebook, or writing a false news story that is indexed by Google, is a nearly instantaneous process; removing such posts often requires human intervention. This imbalance gives an advantage to
The automation of editorial judgment, combined with tech companies’ reluctance to appear partisan, has created a lopsided battle between those who want to spread misinformation and those tasked with policing it. Posting a malicious rumor on Facebook, or writing a false news story that is indexed by Google, is a nearly instantaneous process; removing such posts often requires human intervention. This imbalance gives an advantage to rule-breakers, and makes it impossible for even an army of well-trained referees to keep up.
But just because the war against misinformation may be unwinnable doesn’t mean it should be avoided. Roughly two-thirds of American adults get news from social media, which makes the methods these platforms use to vet and present information a matter of national importance.
Facebook, Twitter and Google are some of the world’s richest and most ambitious companies, but they still have not shown that they’re willing to bear the costs — or the political risks — of fixing the way misinformation spreads on their platforms. (Some executives appear resolute in avoiding the discussion. In a recent Facebook post, Mark Zuckerberg reasserted the platform’s neutrality, saying that being accused of partisan bias by both sides is “what running a platform for all ideas looks like.”) The investigations into Russia’s exploitation of social media during the 2016 presidential election will almost certainly continue for months. But dozens of less splashy online misinformation campaigns are happening every day, and they deserve attention, too. Tech companies should act decisively to prevent hoaxes and misinformation from spreading on their platforms, even if it means hiring
The investigations into Russia’s exploitation of social media during the 2016 presidential election will almost certainly continue for months. But dozens of less splashy online misinformation campaigns are happening every day, and they deserve attention, too. Tech companies should act decisively to prevent hoaxes and misinformation from spreading on their platforms, even if it means hiring thousands more moderators or angering some partisan organizations.
Facebook and Google have spent billions of dollars developing virtual reality systems. They can spare a billion or two to protect actual reality.
In just a few hours, I’ll be arguing a critical case at the Supreme Court.Jennings v. Rodriguez will decide the fate of thousands of women and men who are languishing in immigration prisons across the country. It’s important – and I want to make sure you know what’s at stake.
At issue is the federal government’s practice of locking up immigrants who are challenging their deportation without the basic due process of a hearing to determine if their imprisonment is justified. Imprisoning people without a hearing is unconstitutional and un-American. We’ll prove that today in court.
This case is personal for me. I come from a family of immigrants. I was born here, but my parents are Sri Lankan Tamils. When civil war broke out in Sri Lanka, our extended family fled to live with us in the U.S and I saw first-hand the pain of displacement.
I think people looking at our immigrants’ rights work often don’t take the time to put themselves in the shoes of the people we represent. Many of our clients in this case are asylum-seekers, who have come to this country fleeing persecution from abroad. Others have lived here for decades. All deserve the basic humanity we grant American citizens.
Take our lead plaintiff, Alejandro Rodriguez. Alex was brought to the United States from Mexico by his parents as a baby. He grew up here, became a lawful permanent resident, and worked as a dental assistant to support his three children. He ran into legal trouble and was convicted of a minor drug possession offense. But since he was not a citizen, instead of being sent to a drug treatment program, Alex was imprisoned by immigration authorities for more than three years without ever receiving a bond hearing.
Through this case we got him out. Alex went on to win his immigration case and keep his lawful permanent resident status. He’ll never get back those three years away from his family, but he’s taking his fight to the Supreme Court to win justice for other immigrants. I’m proud to represent him, along with thousands of green card-holders and asylum-seekers locked up without due process.
That’s what I’m fighting for today. This case began ten years ago. It’s been a long road, and we’re finally here.
Thanks for your support,
Ahilan Arulanantham Legal Director at the ACLU of Southern California
Celebrities Come For Donald Trump On Twitter After He Knocked San Juan Mayor… Another day, another string of tweets from President Donald Trump. This time, celebrities lent their voices to the fray to defend the subject of Trump’s ire: San Juan Mayor Carmen Yulin Cruz. And Kim Kardashian shuts him down in fewer than 140 characters. Read more here.
“An entire N.F.L. football team (Pittsburgh Steelers) protesting the national anthem. These spoiled rich brats may think they are being cool and trendy, but they obviously have no true understanding what that anthem and flag mean to our service members, their families, and countless other Americans.”
No, Lee, you’re the one who does not understand. The flag is a symbol of our country, a country that has been degraded and divided by the bully-in-chief just about every day since he took office. Most Americans are horrified by the ignorance and petty vindictiveness of the president. One of the glories of this country is the freedoms it provides us, freedoms that include peaceful protest. (Perhaps it would have been more palatable for you if the players had been holding tiki torches?)
Why are you supporting an authoritarian wannabe who doesn’t understand the most basic tenets of our great democracy, let alone what it means to be a decent human being?
Letter to the East Hampton Star published Sep. 28, 2017
There is so much in the news today about oligarchs. Do most readers know who or what they are?
“Siri,” I asked into my iPhone, “what is the definition of oligarch?” Up popped the following screen:
1. a ruler in an oligarchy, and
2. (especially in Russia) a very rich businessman with a great deal of political influence.
Here in the U.S.A. we have our own oligarchs, such as the infamous Texas Koch brothers. And our oligarchs are not just businessmen, as the definition says, but women as well. Take Rebecca Mercer, who, with her extended Mercer family, contributes heavily to politicians, including our own congressman, Lee Zeldin.
How does it work here? To stay in their jobs, politicians have to spend an inordinate amount of time raising money — that’s our system. And what do these oligarchs get out of this; how do they rule? Well, for one, they get huge tax breaks.
I had to laugh when I got an email from Mr. Zeldin the other day, asking if I was in favor of tax reform. Who isn’t, but what kind? Giving tax breaks to the Mercers and their kind is not what I consider reform.
Has Mr. Zeldin been hoodwinked, or are we being hoodwinked? We need to pay taxes; the government can’t run on wind. And the rich should pay their fair share — period. The goodies that are supposed to trickle down from rich people’s tax savings are such a small trickle, if at all, that “trickle down” is a joke, a joke played on us.
I say no tax cuts for the rich, Mr. Zeldin; they are doing just fine. If you don’t believe me, ask Siri.
During the presidential campaign last year, we learned about Hillary Clinton’s income. Her $10,594,529 adjusted gross income (AGI) puts her in the top 1% of earners. Altogether, the top-earning 1% of taxpayers reported 20.6% of all AGI and paid 39.5% of total income taxes. Since President Trump never released his tax returns we dont know where he fits in. You can find out where you stack up on this site:
Posted on their website where you can also sign up in support. Here is the message from the National Physician’s Alliance:
We’ve been here before. Almost a year ago, we opposed the nomination of Dr. Tom Price for Secretary of Health and Human Services. As clinicians who put our patients first, today we call for Tom Price to resign.
A year ago, we were concerned that Dr. Price did not have a record of promoting policies that prioritized Americans’ health. As a legislator in the House of Representatives, he supported dismantling Medicaid, reducing funding for the Children’s Health Insurance Program (CHIP), and removing essential health benefits that would provide access to treatment for opioid use disorders, prenatal care, and contraception.
Prior to his confirmation, we learned that Dr. Price had traded stocks that stood to profit from his direct actions in the legislature, raising serious questions around his ethical conduct.
Regrettably, his tenure has only confirmed our fears.
In his confirmation hearings, Secretary Price recalled the lessons he learned as a practicing physician. One lesson he highlighted was that “many patients [he] knew or treated were never more angry and frustrated than when they realized that there was someone other than themselves and/or their physician making medical decisions on their behalf – when there was someone not involved in the actual delivery of care that was standing between them and their doctor or treatment.”
However, as Secretary of Health and Human Services (HHS) – that is precisely where Dr. Price has found himself: directly impeding patients’ ability to access treatment.
Worse, he has shirked his duties in office and wasted taxpayer dollars in the process.
His brazen decision to misspend over $400,000 by traveling needlessly on private jets is only the most recent offense to come to light. Records indicate that he used public funding to travel to luxury resorts, areas where he owned property, speaking events for friends, and lunch with his son. New reporting2 puts his travel costs at over $1 million in just 8 months; his recent decision to pay back only $52,000 of these costs only highlights his lack of accountability.
Beyond these questionable ethics, Dr. Price has eagerly advocated for legislation that would increase cost of health insurance and reduce access to care. These policies, according to multiple Congressional Budget Office (CBO) estimates, would create anywhere from 20 to 32 million additional uninsured and were universally opposed by patient groups, doctors, nurses, hospitals, health systems, and insurers.
During this process, he provided at best, misinformation, and at worst, outright lies about the impact of the legislation he was promoting.
Most egregiously, Dr. Price has demonstrated dereliction of his duties at HHS, which has been used as a political tool for sabotage of the Affordable Care Act (ACA), rather than as an institution for policy implementation. Under his leadership, HHS has used funding that was earmarked to increase enrollment to run ads against the ACA. The ACA enrollment period has been reduced by 45 days; television advertising and patient navigators have been cut; and access to the health insurance portal has been reduced with unnecessary periods of website shutdown.
The uncertainty he has created over continuing the cost-sharing reduction payments mandated under law has only served to destabilize the insurance markets and increase premiums for patients.
Tom Price should never have been confirmed. His conduct prioritizes self-enrichment, and raises critical questions about his commitment to “improve the lives of the American people, to help heal individuals and whole communities.” He has advocated cuts to programs impacting the most vulnerable Americans, while simultaneously wasting taxpayer resources. Now almost one year later, we believe that his actions in office warrant resignation.
Sen. Bill Cassidy (R-La.) speaks as Sen. Dean Heller (R-N.V.) and Sen. Lindsey Graham (R-S.C.) listen during a news conference on health care September 13, 2017. Senators Graham, Cassidy, Heller and Johnson unveiled a proposed legislation to repeal and replace the Obamacare. (Alex Wong/Getty Images)
The latest GOP effort to “repeal and replace” the Affordable Care Act is getting a lot of attention, even if its passage seems unlikely. But there is far more to the measure than its changes to rules regarding preexisting health conditions.
In fact, the bill proposed by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) would disrupt the existing health system more than any of the measures considered so far this year, according to supporters and critics.
For backers of the bill, that disruption is a good thing. But others are appalled. As insurance industry analyst Robert Laszewski put it in a note to clients this week, “Would you rather lose your Republican Senate seat because you couldn’t pass an Obamacare repeal-and-replace plan or because you blew up the health insurance system?”
Some of those alterations have generated little discussion but would have major impacts. Here are four unheralded changes:
— The Bill Caps Federal Funding To Medicaid
Much focus has been placed on the bill’s funding formula, which would take money from states that expanded the Medicaid program for the poor. Less notice has been paid to the fact that this bill, like some other GOP options over the summer, would, for the first time, cap overall federal Medicaid funding. The federal government has provided an open-ended funding match since the program’s creation in 1965 — meaning the federal government has provided its share of whatever states spend to care for low-income children, pregnant women, seniors and people with disabilities. More than 70 million people are covered by Medicaid, including those added as a result of the ACA.
Republicans have been pushing unsuccessfully to limit the federal government’s funding of Medicaid to states since the 1980s.
State Medicaid directors — including both Republicans and Democrats — are alarmed at the idea that something of such magnitude could be done with so little debate or consideration. “Graham-Cassidy would completely restructure the Medicaid program’s financing, which by itself is three percent of the nation’s Gross Domestic Product and 25 percent of the average state budget,” said a statement from the group.
The Congressional Budget Office estimated in June that an earlier version of the cap would reduce federal Medicaid spending 35 percent by 2036. As a result, said CBO, states would “need to … decide whether to commit more of their own resources, cut payments to health care providers and health plans, eliminate optional services, restrict eligibility for enrollment, or adopt some combination of those approaches.”
“There won’t be enough money to do what’s authorized under current law,” said Jessica Schubel of the left-leaning think tank the Center on Budget and Policy Priorities.
— The Bill Gives Unprecedented Power To The Secretary Of Health And Human Services
Republicans complained bitterly about the power delegated by Congress to the secretary of Health and Human Services in the ACA. But conservative analyst Chris Jacobs pointed out that the Graham-Cassidy bill gives the HHS secretary more power still.
The bill creates a dizzyingly complex formula for the funds now being spent on the ACA, which is intended to draw money away from wealthier states (that mostly expanded Medicaid under the health law) toward poorer ones (that mostly did not). But there is a huge loophole, noted Jacobs. The bill gives the HHS secretary authority to change the formula on his or her own.
“That’s a trillion-dollar loophole that leaves HHS bureaucrats with the ultimate say over how much money states will receive,” Jacobs wrote.
And, he said, it’s the opposite of “federalism,” or giving states more authority, which the bill’s sponsors claim to be advancing.
“Draining the swamp shouldn’t involve distributing money from Washington out to states, whether under a simple formula or executive discretion,” he wrote. “It should involve eliminating Washington’s role in doling out money entirely.”
— The Bill Cuts Off All ACA Funding After 2026
The bill would lump together all funds being spent under the health law to help people pay premiums, out-of-pocket health costs and expand Medicaid to non-disabled adults and redistribute those funds to the states in the form of block grants. States could then use that money for almost anything health-related.
What few people have noticed, however, is that those block grants end abruptly after 2026. Originally, many thought this was because of congressional budget rules that limit new programs to no more than 10 years.
In fact, those rules only say that a program cannot add to the deficit after 10 years. The block grant is paid for by ongoing taxes generated from the ACA, so there is no budget requirement to end the block grant.
The reason seems to be a desire to require Congress to come back and revisit the program. A spokesman for Cassidy said the program “just has to be reauthorized in 2026 just like the CHIP program.” CHIP is the Children’s Health Insurance Program, also created in a budget bill in 1997. Congress was supposed to reauthorize that program by the end of September, although it looks as if lawmakers will miss that deadline, despite bipartisan support.
Others, however, worry that cutting the money off after 2026 means Congress could no longer use the current funding mechanism. Instead, lawmakers would have to come up with massive cuts to other programs or new tax increases if they wanted to continue providing the money for health care.
— The Bill Could Roil The Individual Insurance Market In Some States By Banning Abortion Coverage In Private Health Plans.
In keeping a promise to anti-abortion lawmakers, the bill would prohibit all private insurance plans receiving any federal funds from providing abortion coverage.
As part of a delicate compromise that got the ACA enacted in 2010, states were given the option to ban abortion coverage in plans on their health exchanges. Half of them did.
But some states, notably California, New York and Oregon require plans they regulate to offer coverage of elective abortions.
The problem is that the deadline for insurers to opt into coverage under the ACA is next Wednesday. If Congress were to pass the bill after that, it is unclear what would happen to those plans. In California, the requirement for abortion coverage is based on the state’s Constitution, so it would be possible that no plans could be offered to people who are eligible for federal help.
“There aren’t clear answers” to what would happen if the bill becomes law in its current form and takes effect in January, said Debra Ness, president of the National Partnership for Women and Families, a reproductive rights advocacy group. “I think it’s going to create chaos.”
Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.
Leland Melvin (ex-Astronaut & NFL Player) Wrote to Trump
And this is what he had to say:
To Donald Trump
I believe in the Declaration of Independence and the Constitution of this country even though at the time they were drafted, their tenets of life, liberty justice for all and eventual freedom of speech, religion, assembly, press and petition amendment ratified in Dec 1791, only applied to a select group of people and not ones that looked like me.
Donald Trump, I listened to your Alabama rally rant and could not believe how easily you say what you say.
We have become numb to your outlandish acts, tweets and recent retweet of you knocking down Hillary Clinton with a golf ball that you hit.
Donald Trump, your boorish and disgusting actions are not funny. They actually promote violence against women especially when your followers act out what you say.
I used to walk the grounds of UVA in Charlottesville, VA as a graduate student only to watch in horror as those same grounds became a battlefield being trod by Nazi and anti-Semitic worshippers armed with assault style weapons ready to fight to make America White again. (their words). You actually said there were nice people on both sides. People armed and ready to kill other Americans for the purpose of eradicating Blacks, Jews, Hispanics, Mexicans, Asians, Latinas and even the first real Americans, Native Americans to make America Great Again were “nice people”?
Comparing this to what you say in condemnation of an unarmed black man peacefully protesting by exercising his constitutional First Amendment rights by silently taking a knee is appalling, unnerving and reprehensible.
Today, you called Colin Kaepernick “a son-of-a-bitch.”
You said he should be fired.
You are calling his white mother a bitch.
The strong contrast in language for a black man and a Nazi is very telling. Do you have any sense of decency or shame in what you say to the American people that are part of your duty to serve respectfully with dignity, presidentially?
Our National Anthem has been edited to try not to offend, because when Francis Scott Key penned the song he watched freed slaves fighting for the British and wrote this stanza:
“And where is that band who so vauntingly swore,
That the havoc of war and the battle’s confusion
A home and a Country should leave us no more?
Their blood has wash’d out their foul footstep’s pollution.
No refuge could save the hireling and slave
From the terror of flight or the gloom of the grave,
And the star-spangled banner in triumph doth wave
O’er the land of the free and the home of the brave.”
I guess if I were a slave back then I probably would have done anything to obtain freedom from my American oppressors who were whipping, killing, raping, dismembering, hanging or releasing the dogs on people like me all under our Constitution.
In 1814 former slaves fought with the British for their freedom from their American enslavers.
Key witnessed a battle from a ship off the Maryland shore at Fort McHenry, which inspired him to write what became our National Anthem.
I served my country not in the military, but as 1 of 362 American Astronauts that have explored the universe to help advance our civilization. Not just Americans, but all humans. I also was briefly in the NFL and stood for the National Anthem with my hand over my heart. What makes us great is our differences and respecting that we are all created equally even if not always treated that way.
Looking back at our planet from space really helps one get a bigger perspective on how petty and divisive we can be. Donald Trump, maybe you should ask your good friend Mr. Putin to give you a ride on a Soyuz rocket to our International Space Station and see what it’s like to work together with people we used to fight against, where your life depends on it. See the world and get a greater sense of what it means to be part of the human race, we call it the Orbital Perspective.
Donald Trump, please know that you are supposed to be a unifier and a compassionate and empathetic leader. If you can’t do the job then please step down and let someone else try. I pray that you do the right thing.
Published in “Smithtown Matters”, Friday, September 22, 2017 at 6:08PM
Dear Editor,
Next week, Senate Republicans will debate a cruel plan to take away health care from millions of Americans and tens of thousands of Long Islanders. Under the Graham-Cassidy bill, there would be a massive shift of federal support from “blue” states to “red” – especially from New York to Texas. In fact, New York could lose more than $45 billion dollars in federal funding. This would create enormous market uncertainty and devastate thousands of Long Islanders, particularly working families, the elderly, and the disabled.
Where is Rep. Lee Zeldin on the bill? Does he realize how much funding would be stripped from New York? Does he care? Even some New York Republicans, like Rep. Tom Reed and Rep. Peter King, have come out against Graham-Cassidy. I urge Rep. Zeldin – who voted to strip health care from millions of Americans earlier this summer – to stop playing politics with the lives of Long Islanders and oppose this bill for the good of his constituents.
Perry Gershon
Democratic candidate for New York’s 1st congressional district
Offshore wind farms are becoming increasingly common in our oceans. In Europe, the goal is for them to supply over 4 percent of the continent’s electricity by 2030. And that’s triggering a wind power boom—the amount of electricity they generate is expected to increase 40-fold by 2030.
Offshore wind turbines are huge—much bigger than their land-based counterparts. They can be over 200 meters tall—twice the height of the Big Ben clock tower in London—and generate up to nine megawatts of power. But most of their mass is in the concrete and steel bases that sit underwater.
Naturally, these bases become home to complex ecosystems. In the North Sea, where most of the European farms are being built, these ecosystems are dominated by blue mussels. These feed by filtering phytoplankton from the water. Mussels are also a food source for other marine animals, such as fish and crabs, and this has the potential to significantly alter the food web.
The geography of offshore wind farms in the North Sea.
And that raises an important question. How are offshore wind farms, and the new colonies of blue mussels they support, changing the oceans?
Today we get an answer thanks to the work of Kaela Slavik at the Helmholtz Centre for Materials and Coastal Research in Germany and a few pals, who have investigated the impact of offshore wind power on marine ecosystems for the first time. Their conclusions are stark—they say offshore wind platforms are changing the nature of marine ecosystems in complex, unanticipated, and beneficial ways.
The team’s method is straightforward. Their goal is to measure the current changes in the marine ecosystems caused by offshore wind farms and then create a computer model that they can use to predict future changes.
The team starts with measurements of the biomass of blue mussels that a typical wind turbine can support—some four metric tons of the shellfish. Using maps of current and planned windfarms in the North Sea, it’s then straightforward to estimate the total mass and distribution of blue mussels supported by wind farms now and in 2030.
That gives an interesting result. Mussel beds are currently concentrated around the coast, but wind farms are offshore. “Once all the planned wind farms are in operation, they will provide habitat for mussels that are equal to 20 percent of the current stock from natural mussel beds along the coast,” say Slavik and co.
The next steps are harder. An important question is how the new mussel colonies will change phytoplankton levels in the ocean. Slavik and co investigate this using water and satellite measurements. But this is complex data that varies significantly from year to year.
Beyond that, the team studies the simulated effect of blue mussels as “ecosystem engineers”—how they support other species in the North Sea.
Their conclusions make for interesting reading. Slavik and co say one important effect of offshore wind farms is that they act as marine preservation areas, because fishing and bottom trawling is not allowed for safety reasons. So these areas can support greater biodiversity than unprotected areas.
Blue mussels themselves also significantly change this environment. They support other species, since their shells and shell litter are habitats for other creatures. The way blue mussels filter feed makes water clearer, and they concentrate nutrients for other species. This increases “the degree of habitat complexity, encouraging a higher level of species richness,” say the team.
One unanticipated consequence of all this is that these new ecosystems can support alien species which would not otherwise be able to gain a foothold. One example is the marine splash midge, which is native to Australasian waters and transported on the hulls of ships. “It has been observed at offshore wind farms in Denmark and along the Swedish Baltic coast,” say Slavik and co.
But the long-term consequences of this change in biodiversity is unknown. “Through these changes in biodiversity, offshore wind farms could shape the marine ecosystem beyond their physical boundaries,” say the researchers.
Mussels are also food for larger species such as crabs and certain fish, which are themselves prey for seals. So it’s no surprise that seals have already begun to migrate to off shore wind farms off the coast of Denmark.
For the most part, Slavik and co are cautiously positive about the changes that offshore wind farms cause, but they are quick to point out that the longer-term effects are still unknown. “Many of the ecosystem feedbacks and hence changes to ecosystem services are yet unknown and need to be studied both in situ and in future system-wide synoptic studies,” they say.
So more work is obviously needed, particularly in other areas where offshore wind farms are planned. The ecosystems that the North Sea support are obviously different from those in other oceans. Just how the platforms will change ecosystems in other parts of the world isn’t clear.
But this study shows for the first time that offshore wind farms are changing our oceans. Clearly, we need to know more about how this will happen.
Ref: arxiv.org/abs/1709.02386: The Large Scale Impact of Offshore Windfarm Structures on Pelagic Primary Production in the Southern North Sea
There is not a single metric of health or health care that the Graham-Cassidy plan—co-sponsored by Senator Lindsey Graham, of South Carolina—makes better.
Photograph by Mark Peterson / Redux
The fundamental thing to understand about Senate Republicans’ latest attempt to repeal Obamacare is that the bill under consideration would not just undo the Affordable Care Act—it would also end Medicaid as we know it and our federal government’s half-century commitment to closing the country’s yawning gaps in health coverage. And it would do so without putting in place any credible resources or policies to replace the system it is overturning. If our country enacts this bill, it would be an act of mass suicide.
In my surgery practice in Boston, I see primarily cancer patients. When I started out, in 2003, at least one in ten of my patients was uninsured. Others, who had insurance, would discover in the course of their treatment that their policies had annual or lifetime caps that wouldn’t cover their costs, or that they would face unaffordable premiums going forward because they now had a preëxisting condition. When he was governor of Massachusetts, it was Mitt Romney, a conservative, who brought Republicans and Democrats together to make a viable state system of near-universal coverage. That system then served as a model for the A.C.A. The results have been clear: increases in coverage have markedly improved people’s access to care and their health. For the last four years, health-care costs in Massachusetts have risen more slowly than the national average—while the national numbers themselves have been at historic lows. I have not seen a single uninsured patient—zero—in a decade. And now comes an utterly reckless piece of legislation that would destroy these gains.
To review how we got to this point: last spring, the House passed a health-care-reform bill that proposed to hollow out the A.C.A.’s funding, insurance mandates, and protections for people with preëxisting conditions. It was immensely unpopular with the public. The problem was not just that twenty-three million Americans would lose their health insurance if the bill becomes law but also the Republicans’ vision of a health system where insurance with deductibles of five thousand dollars and more, and little or no primary-care coverage, would become the norm. This summer, Senate Republicans failed to secure enough votes to pass a modified version of the House bill. Later, in a dramatic late-night session, the Senate also rejected, by a single vote, a “skinny” repeal bill. That bill would have repealed only the parts of the A.C.A. that required large businesses to insure their workers and all Americans to carry coverage. It would have resulted in a mere sixteen million more uninsured people, according to estimates.
The Republican bill currently being rushed to a vote was put forward by a group of senators led by Lindsey Graham, of South Carolina, and Bill Cassidy, of Louisiana. As has become the apparent rule for Republican health-care bills, there have been no hearings or committee reviews of the Graham-Cassidy bill. And, this time, lawmakers and the public do not even have a Congressional Budget Office analysis of the effects the bill would have on the budget, insurance costs, or the uninsured rate.
This is unprecedented: senators are moving ahead with a vote on a bill that would alter the health care of every American family and the condition of a sixth of our entire economy, without waiting to hear any official, independent estimates of the consequences. The irresponsibility is as blithe as it is breathtaking. Before becoming a senator, Cassidy spent twenty-five years working as a physician in hospitals devoted to the uninsured. I find it baffling that a person with his experience would not recognize the danger of this bill. But here we are.
The Graham-Cassidy bill goes even further than the bill passed by the House. It would bring to a virtually immediate end not only the individual and employer mandates but also the whole edifice of the Medicaid expansion, insurance exchanges, and income-based coverage subsidies set up under the A.C.A. Graham-Cassidy expects all fifty states to then pass, and implement, alternative health systems for tens of millions of people within two years—with drastically less money, in most states, than the current law provides. This is not just impossible. It is delusional.
Like the House bill, Graham-Cassidy would cut Medicaid payments for traditional enrollees—the elderly in nursing homes, pregnant women in poverty, disabled children, etc.—by a third by 2026. A portion of the money saved would go into a short-term fund for states to use for health-care costs. The rationale is that this would give states “flexibility” to design coverage for their residents as they see fit. But the amount of funding provided is, bymultipleestimates, hundreds of billions of dollars below what the A.C.A. provides. The bill also nakedly shifts funds from Democratic-leaning states that expanded Medicaid under the A.C.A. to Republican-leaning states that didn’t. Analyses indicate that states like California, Massachusetts, and New York will receive block-grant funding anywhere from thirty-five to almost sixty per cent below the health-care funding their residents would receive under current law. Much of those missing funds would be transferred to states like Texas, Mississippi, and Wisconsin. And special deals to make further shifts from blue states to red states such as Alaska are being negotiated to win votes.
As for what states can do with the funds they do receive, they would not be allowed to use them to enroll people in Medicaid, or able to establish a single-payer system. And states would not be receiving enough to continue Obamacare on their own. The only options for spending are for commercial coverage. States will be permitted to let insurers bring back higher costs for people with preëxisting conditions and to reinstate annual and lifetime limits on coverage. And then, starting in 2026, the funding turns out to only be temporary. Under the bill’s provisions, unless further action is taken then, four trillion dollars will be removed from health-care systems over twenty years.
With these massive sums being flung around, it is easy to forget that this is about our health as human beings. The evidence is that health-care programs like the A.C.A. save lives. The way they do so is by increasing the number of people who have affordable access to a regular source of care and needed medications. Such coverage has been shown to produce a substantial and increasing reduction in mortality—especially among those with chronic illnesses, such as heart disease, cancer, or H.I.V.—in as little as five years.
Virtually all of us, as we age, will develop serious health conditions. A critical test of any health reform, therefore, is whether it improves or reduces our prospects of having the continuous care and medicines we need when we come to have a chronic illness. The Graham-Cassidy bill fails this test. It will terminate Medicaid coverage and insurance subsidies for some twenty million people. The entire individual-insurance market will be thrown into a tailspin. Federal protections for insurance coverage will be gone.
Every major group representing patients, health-care professionals, health-care institutions, and insurers has come out vociferously against this plan. Governors from Alaska to Ohio to Virginia have opposed the bill. In a highly unusual, bipartisan statement, the national association representing the Medicaid directors of all fifty states has also opposed the bill. The top health official in Louisiana, Cassidy’s home state, has opposed the new plan. There is not a single metric of health or health care that the Graham-Cassidy plan makes better. This bill is a national calamity. It should not even come to a vote.
The gift of a brilliant actor, great con man, or devious traitor is to be able to hold the facade of normalcy, courage, integrity, or our other higher virtues up to the world and convince it for a time to see the face they want it to see. For the actor, it’s to inhabit the character on stage or screen until the curtain call comes or the credits roll. For the con man, it’s to take that last dollar from the victim of a long con. For the traitor, it’s to pass that last tranche of intelligence on to his handlers from a foreign government.
No matter how skilled their performances, the essential nature of a man’s character is always there, waiting to be revealed in times of stress or challenge. People living a lie are always, as Aristotle reminds us, “… at war with and in opposition to themselves.” In the end, there’s always a tell and always a glimpse behind the mask, and stress is what reveals it.
No institution in the world stresses a man like the American presidency. That glorious burden and singular honor tests, ages, and wears on every person who carries it. The incumbent’s true character, good and bad, is revealed to the world.
Before this week, the essential character of Donald Trump wasn’t a secret—he was always a flamboyant liar, a raging narcissist, and a man driven by impulse and expedience—but to the victims of the biggest political con in American history those were part of his roguish charm. He was always an actor, playing the successful dealmaker and negotiator.
Trump voters are world-champion rationalizers. They knew he was a bastard, but he was their bastard. They knew he was a lying, amoral, narcissistic snake, but by God, he was their snake. American conservatives who knew better sold their virtue, ideology, and principles once Trump won the White House, nodded sagely and intoned, “But Gorsuch.” The last two weeks have been a delicious comeuppance for all of them, as Trump has burned them to the ground by forging a new alliance with the Democratic leadership of Congress and leaving his Republican frenemies in the dirt.
Trump’s fans love his attacks on the GOP. Regardless of the eventual consequences for the party, they defend Trump’s erratic behavior and Russia ties. The Charlottesville disaster was a heavy burden. The blame game from Trump’s failure to sell Congress on an Obamacare repeal raised the tensions. The attacks on GOP senators set teeth on edge. The first flirtation with Chuck Schumer and Nancy Pelosi over the debt ceiling was like a slap.
Then Trump’s full-fledged triple backflip on DACA and the wall struck like a political earthquake. The sense of shock and betrayal in his base is magnificent. They foolishly believed Trump would never betray them on immigration, despite his lifetime of serial lying and deception.
The clickservative media and Trumpsplainers on the right have demanded since the election that we listen to the Trump voters, and that we understand their economic anxiety and the sense that Washington betrayed them over the decades. These may all be true and explicable motivations for their choice of Trump, but those normalizing Trump tend to elide and dismiss the centrality of anti-immigration hysteria and racial animus in Trump’s campaign.
Was every Trump voter motivated by a xenophobic fury at brown people coming here to live a better life? Of course not, but all voters motivated by a xenophobic fury at brown people coming to live here were Trump voters, and he shamelessly, consistently, and viciously played that card.
There’s a popular argument among Trump apologists that the wall, deportations, and DACA weren’t linchpins of Trump’s campaign rhetoric. This is cheap and sloppy historical revisionism. He opened his campaign with an attack on Mexicans. At Trump rallies, “build the wall” was the tentpole of his speeches and central to the crowd’s Pavlovian call-and-response. His attacks on Marco Rubio, Jeb Bush, and the rest of the 2016 primary field were predicated in large measure on their alleged weaknesses on immigration. Anti-immigrant rhetoric was the hot wire connecting more traditional working-class Republican and Reagan Democrat voters who remain firmly convinced that Mexicans took their jerbs after the passage of NAFTA. It was also a talisman among the alt-righters, who believe that allowing immigration (legal and otherwise) “browns” their desired lily-white America.
The glorious, Fatal Attraction-level bonkers fury of Ann Coulter and the rest of Trump’s true believer cohort over his DACA flip produced an ocean of furious MAGA tears, incoherent rage, and promises to walk away from Trump if he didn’t get back on his wall-building, kid-deporting rhetoric of 2016. The Breitbart comments section, always a perfect focus group of what the Trump base believes on any given day, turned ugly, and for once it wasn’t directed against the Republican Party, but against Trump himself. At best, Trumpsplainers evoked the hoary Trump-fan trope of “You don’t understand Trump’s 87-dimensional quantum chess game, man.”
The Republican leadership learned last week when he rolled them on the debt ceiling that Trump is an honorless man. This week, Trump’s most passionate supporters saw him throw away their signature issue for a pat on the head from two of the most liberal Democrats in the political universe. Schumer and Pelosi got more than they would have in the hated Gang of Eight agreement with a little well-timed flattery. Trump’s fans get red hats, attacks on the media, and open borders, amnesty, and Dreamers.
As members of the reviled Never Trump movement, it’s not just an end-zone celebration play to say we warned you. We warned you over and over that Trump’s brand isn’t success; it’s betrayal. We warned you that he believes in nothing, and so he will break any promise, shaft any ally, and abandon any position. Hate us all you want, but if you think this is the last time he’ll shank his faithful, you might want to review the last 40 years of his personal and business behavior.
Actors act. Con men con. Traitors betray. It’s what they do. This week was just the latest example from the Conman-in-Chief.
Republican efforts in Congress to “repeal and replace” the federal Affordable Care Act are back from the dead. Again.
By Julie Rovner
Sen. Lindsey Graham (right), stands with Sen. Bill Cassidy (left), Sen. Dean Heller and Sen. Ron Johnson (second from right), as well as former senator Rick Santorum (center), to announce their legislation to repeal and replace Obamacare through block grants. (Jim Watson/AFP/Getty Images)
While the chances for this last-ditch measure appear iffy, many GOP senators are rallying around a proposal by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), along with Sens. Dean Heller (R-Nev.) and Ron Johnson (R-Wis.)
They are racing the clock to round up the needed 50 votes — and there are 52 Senate Republicans.
An earlier attempt to replace the ACA this summer fell just one vote short when Sens. Susan Collins (R-Maine), Lisa Murkowski (R-Alaska) and John McCain (R-Ariz.) voted against it. The latest push is setting off a massive guessing game on Capitol Hill about where the GOP can pick up the needed vote.
After Sept. 30, the end of the current fiscal year, Republicans would need 60 votes — which means eight Democrats — to pass any such legislation because special budget rules allowing approval with a simple majority will expire.
Unlike previous GOP repeal-and-replace packages that passed the House and nearly passed the Senate, the Graham-Cassidy proposal would leave in place most of the ACA taxes that generated funding to expand coverage for millions of Americans. The plan would simply give those funds as lump sums to each state. States could do almost whatever they please with them. And the Congressional Budget Office has yet to weigh in on the potential impact of the bill, although earlier estimates of similar provisions suggest premiums would go up and coverage down.
“If you believe repealing and replacing Obamacare is a good idea, this is your best and only chance to make it happen, because everything else has failed,” said Graham in unveiling the bill last week.SIGN UP
Here are five things to know about the latest GOP bill:
1. It would repeal most of the structure of the ACA.
The Graham-Cassidy proposal would eliminate the federal insurance exchange, healthcare.gov, along with the subsidies and tax credits that help people with low and moderate incomes — and small businesses — pay for health insurance and associated health costs. It would eliminate penalties for individuals who fail to obtain health insurance and employers who fail to provide it.
It would eliminate the tax on medical devices.
2. It would eliminate many of the popular insurance protections, including those for people with preexisting conditions, in the health law.
Under the proposal, states could “waive” rules in the law requiring insurers to provide a list of specific “essential health benefits” and mandating that premiums be the same for people regardless of their health status. That would once again expose people with preexisting health conditions to unaffordable or unavailable coverage. Republicans have consistently said they wanted to maintain these protections, which polls have shown to be popular among voters.
3. It would fundamentally restructure the Medicaid program.
Medicaid, the joint-federal health program for low-income people, currently covers more than 70 million Americans. The Graham-Cassidy proposal would end the program’s expansion under the ACA and cap funding overall, and it would redistribute the funds that had provided coverage for millions of new Medicaid enrollees. It seeks to equalize payments among states. States that did not expand Medicaid and were getting fewer federal dollars for the program would receive more money and states that did expand would see large cuts, according to the bill’s own sponsors. For example, Oklahoma would see an 88 percent increase from 2020 to 2026, while Massachusetts would see a 10 percent cut.
The proposal would also bar Planned Parenthood from getting any Medicaid funding for family planning and other reproductive health services for one year, the maximum allowed under budget rules governing this bill.
4. It’s getting mixed reviews from the states.
Sponsors of the proposal hoped for significant support from the nation’s governors as a way to help push the bill through. But, so far, the governors who are publicly supporting the measure, including Scott Walker (R-Wis.) and Doug Ducey (R-Ariz.), are being offset by opponents including Chris Sununu (R-N.H.), John Kasich(R-Ohio) and Bill Walker (I-Alaska).
On Tuesday 10 governors — five Democrats, four Republicans and Walker — sent a letter to Senate leaders urging them to pursue a more bipartisan approach. “Only open, bipartisan approaches can achieve true, lasting reforms,” said the letter.
Bill sponsor Cassidy was even taken to task publicly by his own state’s health secretary. Dr. Rebekah Gee, who was appointed by Louisiana’s Democratic governor, wrote that the bill “uniquely and disproportionately hurts Louisiana due to our recent [Medicaid] expansion and high burden of extreme poverty.”
5. The measure would come to the Senate floor with the most truncated process imaginable.
The Senate is working on its Republican-only plans under a process called “budget reconciliation,” which limits floor debate to 20 hours and prohibits a filibuster. In fact, all the time for floor debate was used up in July, when Republicans failed to advance any of several proposed overhaul plans. Senate Majority Leader Mitch McConnell (R-Ky.) could bring the bill back up anytime, but senators would immediately proceed to votes. Specifically, the next order of business would be a process called “vote-a-rama,” where votes on the bill and amendments can continue, in theory, as long as senators can stay awake to call for them.
Several senators, most notably John McCain, who cast the deciding vote to stop the process in July, have called for “regular order,” in which the bill would first be considered in the relevant committee before coming to the floor. The Senate Finance Committee, which Democrats used to write most of the ACA, has scheduled a hearing for next week. But there is not enough time for full committee consideration and a vote before the end of next week.
Meanwhile, the Congressional Budget Office said in a statement Tuesday that it could come up with an analysis by next week that would determine whether the proposal meets the requirements to be considered under the reconciliation process. But it said that more complicated questions like how many people would lose insurance under the proposal or what would happen to insurance premiums could not be answered “for at least several weeks.”
That has outraged Democrats, who are united in opposition to the measure.
“I don’t know how any senator could go home to their constituents and explain why they voted for a major bill with major consequences to so many of their people without having specific answers about how it would impact their state,” said Senate Minority Leader Chuck Schumer (D-N.Y.) on the Senate floor Tuesday.
The Trump Administration continues to govern with a blind eye toward inconvenient facts and analyses.
Stephen Miller, Trump’s top white nationalist advisor in the White House, reportedly rejected a study proving refugees contribute significantly more to U.S. revenue than they cost. From TheNew York Times:
Trump administration officials, under pressure from the White House to provide a rationale for reducing the number of refugees allowed into the United States next year, rejected a study by the Department of Health and Human Services that found that refugees brought in $63 billion more in government revenues over the past decade than they cost.
The draft report, which was obtained by The New York Times, contradicts a central argument made by advocates of deep cuts in refugee totals as President Trump faces an Oct. 1 deadline to decide on an allowable number. The issue has sparked intense debate within his administration as opponents of the program, led by Mr. Trump’s chief policy adviser, Stephen Miller, assert that continuing to welcome refugees is too costly and raises concerns about terrorism.
The leaked study showed refugees hugely contribute to the U.S. economy:
The internal study, which was completed in late July but never publicly released, found that refugees “contributed an estimated $269.1 billion in revenues to all levels of government” between 2005 and 2014 through the payment of federal, state and local taxes. “Overall, this report estimated that the net fiscal impact of refugees was positive over the 10-year period, at $63 billion.”
The NYT reports it’s not clear who rejected the report, but it has Stephen Miller’s xenophobic, anti-immigrant, white nationalist fingerprints all over it:
It was not clear who in the administration decided to keep the information out of the final report. An internal email, dated Sept. 5 and sent among officials from government agencies involved in refugee issues, said that “senior leadership is questioning the assumptions used to produce the report.” A separate email said that Mr. Miller had requested a meeting to discuss the report. The Times was shown the emails on condition that the sender not be identified. Mr. Miller personally intervened in the discussions on the refugee cap to ensure that only the costs — not any fiscal benefit — of the program were considered, according to two people familiar with the talks.
Earlier this year, The Business Insider published data supporting the rejected administration report. A new working paper from the National Bureau of Economic Research shows refugees provide a net contribution to the economy through the taxes they pay over time, countering the notion that they are a drag on the economy due to a reliance on social benefits.
The report from Notre Dame economists William Evans and Daniel Fitzgerald finds that “over their first 20 years in the United States, refugees who arrived as adults aged 18-45 contributed more in taxes than they received in relocation benefits and other public assistance.” The Notre Dame study drew on State Department data to create a sample of 20,000 refugees who entered the country between 1990 and 2014.
The authors also find that “the younger the refugees were when they resettled in America, the more likely they were to catch up with their native-born peers educationally and economically.”
This chart captures their findings, showing that refugees on average cross the threshold from net beneficiaries to net contributors around the 9th year after migration.
NBER
The research also found that refugees who arrived before the age of 14 had, by ages 19-24, graduated from high school at the same rates as American youth. By ages 23-28, those refugees displayed the same college graduation rates as the US-born population.
“Refugees who arrived as children of any age have much higher school enrollment rates than U.S.-born respondents of the same age,” the research finds.
The US spends an average of $15,148 in relocation costs and $92,217 in social benefits over an adult refugee’s first 20 years here, the NBER said, citing the Notre Dame report. Over that period, the average adult refugee pays $128,689 in taxes — $21,324 more than the benefits received.
The Honorable Mitch McConnell Majority Leader
United States Senate
317 Russell Senate Office Building Washington, D.C. 20510
The Honorable Charles E. Schumer Minority Leader
United States Senate
322 Hart Senate Office Building Washington, D.C. 20510
Dear Majority Leader McConnell and Minority Leader Schumer:
As you continue to consider changes to the American health care system, we ask you not to consider the Graham-Cassidy-Heller-Johnson amendment and renew support for bipartisan efforts to make health care more available and affordable for all Americans. Only open, bipartisan approaches can achieve true, lasting reforms.
Chairman Lamar Alexander and Ranking Member Patty Murray have held bipartisan hearings in the Senate’s Health, Education, Labor and Pensions (HELP) Committee, and have negotiated in good faith to stabilize the individual market. At the committee’s recent hearing with Governors, there was broad bipartisan agreement about many of the initial steps that need to be taken to make individual health insurance more stable and affordable. We are hopeful that the HELP committee, through an open process, can develop bipartisan legislation and we believe their efforts deserve support.
We ask you to support bipartisan efforts to bring stability and affordability to our insurance markets. Legislation should receive consideration under regular order, including hearings in health committees and input from the appropriate health-related parties. Improvements to our health insurance markets should control costs, stabilize the market, and positively impact coverage and care of millions of Americans, including many who are dealing with mental illness, chronic health problems, and drug addiction.
We look forward to continuing to work with you to improve the American health care system.
“I know you guys are going to find this hard to believe. But a few months ago, after my son had open heart surgery … a senator named Bill Cassidy from Louisiana, was on my show and he wasn’t very honest,” Kimmel said, kicking things off. Here’s a transcript of most of Kimmel’s remarks, which got heated, especially toward Cassidy — and he had a few choice words for people who will criticize him for politicizing his son’s health problems.
It seemed like [Cassidy] was being honest. He got a lot of credit and attention for coming off like a rare, reasonable voice in the Republican Party when it came to health care for coming up with something he called — and I didn’t name it this, he named it this — the Jimmy Kimmel test, which was in a nutshell: No family should be denied medical care, emergency of otherwise, because they can’t afford it. He agreed to that. He said he would only support a health-care bill that made sure a child like mine would get the health coverage he needs no matter how much money his parents make.
And that did not have annual or lifetime caps. These insurance companies, they want caps, to limit how much they can pay out. So for instance, if your son has to have three open heart surgeries, it can cost hundreds of thousands of dollars apiece. If he hits his lifetime cap of, let’s say, a million dollars, the rest of his life, he’s on his own.
Our current plan protects Americans from these caps and prevents insurance providers from jacking up the rates for people who have preexisting conditions of all types. And Sen. Cassidy said his plan would do that, too. He said all of this on television many times.
(Clip of Sen. Cassidy on CNN saying, “I ask, does it pass the Jimmy Kimmel test? Would the child born with a congenital heart disease be able to get everything she or he would need in the first year of life? I want it to pass the Jimmy Kimmel test.”)
So last week, Bill Cassidy and Sen. Lindsey Graham proposed a new bill, the Graham-Cassidy bill. And this new bill actually does pass the Jimmy Kimmel test, but a different Jimmy Kimmel test. With this one, your child with a preexisting condition will get the care he needs — if, and only if, his father is Jimmy Kimmel. Otherwise, you might be screwed.
Now, I don’t know what happened to Bill Cassidy. But when he was on this publicity tour, he listed his demands for a health-care bill very clearly. These were his words. He said he wants coverage for all; no discrimination based on preexisting conditions; lower premiums for middle-class families; and no lifetime caps. And guess what? The new bill? Does none of those things.
Coverage for all? No. Fact, it will kick about 30 million Americans off insurance. Preexisting conditions? Nope. If the bill passes, individual states can let insurance companies charge you more if you have a preexisting condition. You’ll find that little loophole later in the document after it says they can’t. They can, and they will.
But will it lower premiums? Well, in fact, for lots of people, the bill will result in higher premiums. And as far as no lifetime caps go, the states can decide on that, too, which means there will be lifetime caps in many states. So not only did Bill Cassidy fail the Jimmy Kimmel test, he failed the Bill Cassidy test. He failed his own test. And you don’t see that happen very much.
This bill that he came up with is actually worse than the one that, thank God, Republicans like Susan Collins and Lisa Murkowski and John McCain torpedoed over the summer. And I hope they have the courage and good sense to do that again with this one, because these other guys who claim they want Americans to have better health care — even though eight years ago they didn’t want anyone to have health care at all — they’re trying to sneak this scam of a bill they cooked up in without an analysis from the bipartisan Congressional Budget Office.
They don’t even want you to see it. They’re having one hearing. I read the hearing’s being held in the Homeland Security Committee, which has nothing to do with health care. And the chairman agreed to allow two witnesses, Bill Cassidy and Lindsey Graham, to speak.
So, listen, health care is complicated. It’s boring. I don’t want to talk about it. The details are confusing, and that’s what these guys are relying on. They’re counting on you to be so overwhelmed with all the information you just trust them to take care of you, but they’re not taking care of you. They’re taking care of the people who give them money, like insurance companies. And we’re all just looking at our Instagram accounts and liking things while they’re voting on whether people can afford to keep their children alive or not.
Most of the congresspeople who vote on this bill probably won’t even read it. And they want us to do the same thing, they want us to treat it like an iTunes service agreement. And this guy, Bill Cassidy, just lied right to my face.
(Clip of Kimmel and Cassidy’s interview from May — Kimmel: “Do you believe every American regardless of income should be able to get regular checkups, maternity care, etc., all of those things, that people who have health care get and need?” Cassidy: “Yep.”)
So “yep” is Washington for “nope,” I guess. And I never imagined I would get involved in something like this, this is not my area of expertise. My area of expertise is eating pizza, and that’s really about it. But we can’t let them do this to our children, and our senior citizens, and our veterans, or to any of us.
And by the way, before you post a nasty Facebook message saying I’m politicizing my son’s health problems, I want you to know: I am politicizing my son’s health problems because I have to. My family has health insurance, we don’t have to worry about this. But other people do, so you can shove your disgusting comments where your doctor won’t be giving you a prostate exam once they take your health-care benefits away.
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R&R - Reachout and Rebuild 