Archive for the ‘Republicans’ Category

Why Georgia Republicans are nervous about House health plan – Atlanta Journal Constitution (blog)

U.S. Sen. Johnny Isakson, center, U.S. Rep. Doug Collins (back, left) and U.S. Rep. Tom Graves (back, center) at a rally in Marietta in November. Curtis Compton,ccompton@ajc.com

Georgia Republicans are sharply divided over the GOP proposal to replace the Affordable Care Act thats galloping through the U.S. House of Representatives, raising concerns about the lack of a cost estimate for the overhaul and its impact on the states budget as it moves through Capitol Hill.

As House lawmakers prepare to vote on the sweeping rewrite of health care policy, at least two GOP congressmen from Georgia said they wont support the measure in its current form. And Gov. Nathan Deal has raised concerns about how it will affect Georgia and other states that refused to expand Medicaid.

The fight over the plan is another stinging reminder of the challenges of making substantial changes to health policy even for Republicans who have long vowed to repeal the signature law of Barack Obamas presidency.

Under pressure from President Donald Trump, who has endorsed the plan, House GOP leaders have signaled they would make only minor changes to the proposal. Democrats, health care industry groups and other critics, meanwhile, are eagerly fanning the flames of a budding revolt. Conservative groups arent happy either, taking issue with the bills refundable tax credits that they say are akin to a new federal entitlement.

Before the measure was introduced, Deal recounted a call with fellow Republicans governors who he said took the bait and expanded Medicaid with the promise that the federal government would pick up the bulk of the bill.

I would remind Republican governors who expanded Medicaid that was part of Obamacare, said Deal. And now it could very well go away. I am sympathetic to what they did, but we dont want to be punished for what those states did.

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Why Georgia Republicans are nervous about House health plan - Atlanta Journal Constitution (blog)

Millionaires Will Get $157 Billion In Tax Cuts If Republicans Repeal Obamacare – Huffington Post

Repealing theAffordable Care Act is going to be a windfall for Americas wealthiest families, even as it wipes away programs that have allowed millions of poor and middle-class Americans to get health insurance.

A new government report shows just how big that windfall is.

According to that analysis, which the Joint Committee on Taxation prepared this week and which theNew York Timesobtained, shows households with incomes of more than $1 million will get tax cuts that, over the next decade, would add up to roughly $157 billion.

The money comes from two new closely related taxes that the Affordable Care Act imposed to help finance the laws coverage expansion. These taxes affect wealthy individuals and families exclusively they apply only to households with incomes above $250,000 for joint filers and $200,000 for individuals.

Previous estimates have suggested that 97 percent of Americans do not pay the tax at all, but that for the very wealthiest Americans, including those millionaires, it is worth quite a lot.

In fact, the richest 400 families in America would get an average tax cut of $7 million per year, according an analysis that the Center on Budget and Policy Priorities published in January, based on earlier projections of what those taxes cost now.

The GOP repeal legislation, which its sponsors have called the American Health Care Act, would not simply reduce taxes. It would also roll back the laws expansion of Medicaid and reorient its financial assistance, producing a massive shift of funds away from lower-income Americans.

Initial independent estimates suggest millions would lose insurance as a result. The Congressional Budget Office will release its official estimate next week.

Promoters of repeal legislation, including leaders of the Republican Party, have frequently said that repeal is necessary in order to rescue America from the Affordable Care Act. The 2010 law has raised premiums and forced coverage changes for some people, and in some states insurance markets are in trouble because the insurers are losing so much money.

But the markets in other states are fine, and the law has brought the number of uninsured Americans to an all-time low. Both access to care and financial security have improved overall, according to multiple studies.

House Speaker Paul Ryan (R-Wis.) was asked this week about cutting taxes for the wealthiest Americans at a time of so much inequality. Im not concerned about it because we said we were gonna repeal all the Obamacare taxes, this is one of the Obamacare taxes, he replied.

JCT prepared the analysis for the House Ways and Means Committee, which considered and approved repeal legislation this week. Neither JCT nor Ways and Means had made the report public.

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Millionaires Will Get $157 Billion In Tax Cuts If Republicans Repeal Obamacare - Huffington Post

When It Comes To Legislation, Sometimes Bigger Is Better – NPR

Printing out the new House Republican health care bill (L) kills way fewer trees than printing out Obamacare (R). But should that really be a selling point? Alex Wong/Getty Images hide caption

Printing out the new House Republican health care bill (L) kills way fewer trees than printing out Obamacare (R). But should that really be a selling point?

To President Trump, bigger is better.

He has inflated the size of his buildings (counting stories that aren't there). He exaggerated the size of the crowd at his inauguration (a million and a half it wasn't). And he, of course, famously lashed out when he was accused of having small hands. (If that implied something else must be small, he said during a nationally televised debate, "There's no problem. I guarantee you.")

But when it comes to the health care bill, the Trump administration believes smaller is better.

When House Republicans released their plan to repeal and replace Obamacare, press secretary Sean Spicer brought props to his daily briefing a table next to his lectern with the 123-page GOP bill, sitting next to a 974-page Affordable Care Act.

"As you'll see, this bill right here was the bill that was introduced in 2009 and 10 by the previous administration," Spicer said Wednesday. "Notice how thick that is."

He later went on to elaborate that the GOP replacement plan is even smaller than it looks.

"So far, we're at 57 for the repeal plan and 66 pages for the replacement portion," Spicer said. "We'll undo this. And remember, half of it, 57 of those pages, are the repeal part. So when you really get down to it, our plan is 66 pages long, half of what we actually even have there."

This tactic isn't new to the Trump administration; making page counts into a talking point has been a fixture of policy debates since at least the Reagan administration, particularly among conservatives. But a bill's length has very, very little to do with its quality. And experts say that keeping major legislation short is getting tougher.

Why all the hate for long bills?

Politicians have criticized long bills for decades, and that history shows a few reasons why people feel (or say they feel) that those bills are a problem.

For one, critics believe these lengthy bills are signs of legislative inefficiency. President Reagan in his 1988 State of the Union address gave a particularly memorable example of it.

"The budget process has broken down; it needs a drastic overhaul," he declared, shaming Congress for late and "monstrous" budget resolutions. And like Spicer this week, Reagan made his point with his own table piled high with paper (the relevant portion begins around 15:50 in the below video):

"Along came these behemoths. This is the conference report 1,053 pages, report weighing 14 pounds. Then this a reconciliation bill six months late that was 1,186 pages long, weighing 15 pounds. And the long-term continuing resolution this one was two months late, and it's 1,057 pages long, weighing 14 pounds. Now, that was a total of 43 pounds of paper and ink. You had three hours yes, three hours to consider each, and it took 300 people at my Office of Management and Budget just to read the bill so the government wouldn't shut down. Congress shouldn't send another one of these. No, and if you do, I will not sign it."

Reagan held up each of three different, massive budget bills, to laughter and applause from congressional members. He underlined his point by dropping each stack of papers with a theatrical thump. (He added a final flourish of shaking out his hand, as if he had injured it.)

A bill's length has also been taken as a sign that bills were simply unworkably byzantine. The Atlantic's James Fallows in 1995 cited the 1,342 pages of Hillary Clinton's health care overhaul as evidence that the bill was "fatally overcomplicated" and "impossible for anyone except the plan's creators ... to understand."

Yet another dimension to the fear of long legislation is the fear that it will contain buried, objectionable provisions that lawmakers won't find until it's too late.

After the George W. Bush White House passed its prescription-drug plan, for example, one Republican lawmaker told 60 Minutes that members of Congress weren't given enough time to understand the legislation.

"The bill was over 1,000 pages," North Carolina Rep. Walter Jones said. "And it got to the members of the House that morning, and we voted for it at about 3 a.m. in the morning."

This is a regular concern, said one former Hill staffer.

"What got snuck into there? What got airdropped into there in conference or whatever?" said Billy Pitts, a longtime GOP congressional aide, explaining a common reaction to long bills. "That's always the threat of a big, fat bill there's always something hidden inside of it."

That notion was hammered home for conservatives with Nancy Pelosi's infamous 2010 remark to the Legislative Conference for the National Association of Counties, that "we have to pass the bill, so that you can find out what's in it."

She has since said that that quote was taken out of context, but Republicans seized upon it as evidence of shady lawmaking. Right-leaning website the Daily Signal characterized its view of Pelosi's message as follows:

"What lurks within the House and Senate health care bills will be revealed in the fullness of time, and it's really good for us if we only knew better."

And finally, there is the symbolic argument perhaps the most common type of argument against long bills. It makes an intuitive sense that Republicans often lambast legislation for being lengthy.

"For conservatives, [long legislation] becomes a metaphor for complicated government," said Norm Ornstein, a resident scholar at the American Enterprise Institute, a right-leaning think tank. "You throw down 1,000 pages or 1,500 pages, and it looks like they're doing stuff that gets into every detail of everybody's lives."

Here's how bills get so long (and are getting longer all the time)

A thousand pages might sound insane to people who don't read legislation on a daily basis. But there are substantive reasons why bills can become so large.

The following three reasons explain why worries about lengthy bills are often overblown:

1. Making laws is harder than it looks

Interestingly, Spicer hinted at one of these reasons in his comments this week, when he said that repealing Obamacare itself took 57 pages. That's a lot of pages for doing something that can be explained in two words: "repeal Obamacare."

So while it might seem repealing a law would be simple say, writing a bill that says something along the lines of, "This bill will fully repeal the Affordable Care Act" it often instead requires making many, many changes to many, many different parts of different, specific and carefully crafted laws.

"The fact is even most aficionados could not read most bills and get anything out of them," Ornstein said of the desire to cut length, "which is why we have this army of people in the legislative branch, the Legislative Counsel's Office, to take policies and translate it into the gibberish."

2. Polarization means bills crammed full of things

Another reason why laws can get so long is that polarization has created gridlock that makes passing laws remarkably hard, said Sarah Binder, professor of political science at Georgetown University.

"Laws are long and probably longer today than in the past," she said in an email to NPR, "because the difficulty of legislating pushes lawmakers to craft new laws with big, multidimensional deals: Your team gets X; my team gets Y; we sew them up into one huge bill."

She added, "When you come up against a deadline, everything is multiple trains are leaving the station, and you put them all on the same track. And that's how you make deals."

To illustrate, she points to the fact that the number of bills passed keeps dropping but the length of those bills keeps rising.

In other words, less legislation (by number of bills) is getting passed, but each bill that's passed has way more legislation in it (by number of pages).

This means that the fear of surprise policies being shoehorned into a large bill makes some sense. But as Binder points out, cramming things into bills is also often the only option for passing legislation these days.

3. Some policy areas are just super complicated

Pitts emphasized to NPR the benefits of simple legislation: It's easier to understand, and it's easier to foresee its effects and how it will interact with existing laws.

However, it's also true that some legislation simply deals in complicated policy areas that can't be boiled down to a few dozen pages.

"What you have to keep in mind here in something like this area is you're talking about policy that affects close to one-fifth of the economy," Ornstein said. "And it gets into tax law; it gets into Medicare and Medicaid, which have grown greatly in complexity; it gets into divisions between the states and the federal government."

A similar principle applies to the tax code another area where the more-pages-is-bad argument is often made, as Ed Kleinbard, professor of law and business at the University of Southern California, told NPR last year.

"The tax code is thousands of pages long for a very simple reason: It is a model, in the economic sense, of all of economic activity," he said. "Most Americans don't spend a lot of time worrying about the taxation of cutting timber or of being crew on a tuna boat. But there are rules for that, and you may find the rules irrelevant to you, but the rules are complex for a reason."

So putting too much stock in the length of the bill often makes little sense. This may be something repeal proponents will want to keep in mind in the coming weeks, because this bill is just the first part of a three-part plan.

"One of the reasons that this bill is shorter at this point," Ornstein points out, "is they're taking on only parts of the Affordable Care Act and making changes.

"If they manage to do all these things, and you look at the nature of the regulations and then you do a third bill, it's probably going to be about as long as the Affordable Care Act."

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When It Comes To Legislation, Sometimes Bigger Is Better - NPR

Trump And Republicans Expect You To Die, Joe Public – Huffington Post

Are you Joe Public? One of Americas more than 94 million permanently unemployed? A doctor, truck driver, or other worker at risk of technological unemployment? Then you, Joe, had best learn a new word: Democide.

Whats democide? Its the killing of people by a government most often based on their socioeconomic status.

The Republican healthcare plan, the AHCA dubbed Trumpcare earlier this week, is more than mean-spirited. It is madness. It is that pure evil that oozes up from the cracks of greed, selfishness, and self-entitlement.

Is it outside the realm of possibility for that small sect of the wealthiest Social Darwinists, who believe that the rich and powerful are the product of natural selection, and their well-paid Republican think tanks and politicians, to entertain the notion of thinning the herd?

What has their agenda been in Trumps first 50 days? Keep more poor people from entering the country. Thin the herd. Deport the working poor. Thin the herd.

You dont have to have a Paul Ryan Powerpoint presentation to figure out that Trumpcare, which proposes moving millions of people from Medicaid to tax credits, isnt just an accounting sleight of hand to have the government pay for healthcare without really calling it a social program. It is a reverse redistribution of wealth, back to the haves, that can only have one absolute effect.

If that sounds like the premise for some cheesy Hollywood future Nazi flick, think again. Democide is not uncommon in human history. Simple starvation is usually the class weapon of choice. The Irish famine killed an estimated million people, and Stalins starvation of the USSR, most notably Ukraine, sent as many as 49 million people to their deaths.

There are 94.7 million Americans who are considered not in the labor force, not even seeking a job, a number which jumped again another 664,000 in 2016, CNBC reports.

Out of 209 million working-age Americans, thats a staggering 45 percent of the workforce, which may explain why Democratic tone-deafness to their plight pushed ballots for Trump in key rust belt states.

While the GOP distracts us with border walls, and pits poor and threatened middle class whites against equally struggling minorities and immigrants, two forces are at work, which conservatives assiduously avoid discussing, that have huge ramifications to every American and most of the economies of the planet.

Automation and global warming.

Automation affords us all kinds of wonders. Instant global communications, cool games, amazing images, better cars, new medicines. Used properly, it can bring humanity greater prosperity, health, and well being. That is, if, of course, you believe that all human beings have equal worth, and, freed of work by the machines, can be equally supported, along with the rich and powerful, by the technology that takes them out of the working world.

Republicans, of the Social Darwinist/Randian selfish stripe, though, hold a darker world view of that automation, rooted in their selfish dogma. They arent just rethinking your right to healthcare. Theyre mulling over how many of us are really all that necessary in this brave new world.

The assembly line, the warehouse of the 21st century, doesnt use sweatshop labor. Robots in a warehouse dont eat, sleep, drink, need breaks, have family problems, or health issues.

If you are a college-educated professional smugly thinking that you arent vulnerable like your blue collar brethren, think again.

IBMs Artificial Intelligence program, Watson is beginning to outthink physicians in diagnostics, and radiology and pathology to the point that many types of medical jobs in those fields will go away soon. Robotic surgery reduces error and improves patient outcomes. One estimate is that 80 percent of doctors will be unnecessary by the mid-century.

Uber is already replacing humans with pilotless cars. Mercedes, amongst others, is well on the way to delivering pilotless trucks to the worlds highways. So shed another estimated 4.8 million professional drivers from the workforce. Recalling antiques like land-line telephones, if people just start using cars by calling them up on their apps and just paying by the ride, rather than owning one, kiss 1.4 million auto dealership jobs goodbye, and perhaps 600,000 independent mechanics who wont be working on fleet pilotless cars. In all, more than a third of the population could find itself jobless as a result of automation in this century.

The Great Recession was the Great Realignment by Americas corporations, paper pushers made obsolete by the first major wave of automation by personal computers in the office space. Electronic documents and cloud computing will continue that downward trend in basic office jobs. CEOs earned huge bonuses for firing people who had been technologically unemployed but still working at Americas corporations, for years.

Robots will soon drive, lift, nail, climb fearful heights, fix broken sewage pumps in toxic conditions, and a host of other jobs better, longer and cheaper than humans in North America.

Millions of Americans are just, frankly, unnecessary as labor. As automation continues, millions more will be displaced, and no one, Republican or Democrat, is talking about what we do to restructure a society where work no longer defines us.

The second 400-pound elephant of the Republicans quiet agenda is Global Warming.

We know that folks like the Kochs want to protect their big oil business and deforestation. Even though they wont allow state and Federal agencies to even talk about the rising temperatures, the people paying for stupid arent stupid. They know that with a temperature increase, the prospect of famines in the land of plenty grow. They, the chosen, must survive.

This is why Trumpcare can be viewed as its own more subtle variation of Final Solution. If you think thats hyperbole, consider outcomes.

A fast-food worker with Type II diabetes, who makes $22,000 a year, gets an estimated Trumpcare tax credit of $700. That leaves them $500 or more short of their health insurance premium costs alone, and thousands of dollars short of paying high insurance co-pays and non-covered expenses of thin Trumpcare insurance. People do not seek care that they cant afford. Diabetics, and millions of others with chronic illness, or long-term disability, will die younger.

Trumpcare, which would allow insurers to raise rates on the elderly by 30 percent, and knock 4 to 6 million Medicaid recipients off of state rolls by 2024, leads to state-sponsored killing of the poor for being poor. Meanwhile, under Trumpcare, as proposed, the wealthy will get a big tax rebate. Why? It maintains the income inequality that only further accelerates the weeding out process.

In a time where medicine and science have largely rid the world of plagues, world population is on the rise and resources, like food and timber, thanks to global warming, are threatened. Make healthcare unaffordable, and people die.

There is no Republican rhetorical ruse that works around that.

The irony is that Trump supporters most at-risk, nibbling on his blue rat pellet promises of making America great again, are the ones that are most targeted by the weeding.

All regimes that engage in this type of madness hold out the hope of salvation through their strong hand, only to crush the weak where it suits them, when it suits them.

Trumpcare is a plot worthy of another orange-haired villain, Auric Goldfinger:

Goldfingers parting words to the hero, James Bond, I want you to die, are easily envisioned to be the parting words to you, Joe.

Joe Public: How do you expect me to function if Im not healthy enough to work? If there is no job for me?

Auric Trump: No, Mr. Public. I expect you to die! You are a drag on the economy, and on the food supply that, with the damage we do to the planet, will be shrinking, bigly. I dont need as many of you as consumers. You threaten dwindling resources, and theres nothing that you can do to make us wealthier.

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Trump And Republicans Expect You To Die, Joe Public - Huffington Post

House Republicans would let employers demand workers’ genetic test results – PBS NewsHour

Swab containing a DNA (Deoxyribonucleic acid) human sample with genetic testing results. Photo via Getty Images

A little-noticed bill moving through Congress would allow companies to require employees to undergo genetic testing or risk paying a penalty of thousands of dollars, and would let employers see that genetic and other health information.

Giving employers such power is now prohibited by legislation including the 2008 genetic privacy and nondiscrimination law known as GINA. The new bill gets around that landmark law by stating explicitly that GINA and other protections do not apply when genetic tests are part of a workplace wellness program.

The bill, HR 1313, was approved by a House committee on Wednesday, with all 22 Republicans supporting it and all 17 Democrats opposed. It has been overshadowed by the debate over the House GOP proposal to repeal and replace the Affordable Care Act, but the genetic testing bill is expected to be folded into a second ACA-related measure containing a grab-bag of provisions that do not affect federal spending, as the main bill does.

What this bill would do is completely take away the protections of existing laws, said Jennifer Mathis, director of policy and legal advocacy at the Bazelon Center for Mental Health Law, a civil rights group. In particular, privacy and other protections for genetic and health information in GINA and the 1990 Americans with Disabilities Act would be pretty much eviscerated, she said.

Employers say they need the changes because those two landmark laws are not aligned in a consistent manner with laws about workplace wellness programs, as an employer group said in congressional testimony last week.

Employers got virtually everything they wanted for their workplace wellness programs during the Obama administration. The ACA allowed them to charge employees 30 percent, and possibly 50 percent, more for health insurance if they declined to participate in the voluntary programs, which typically include cholesterol and other screenings; health questionnaires that ask about personal habits, including plans to get pregnant; and sometimes weight loss and smoking cessation classes. And in rules that Obamas Equal Employment Opportunity Commission issued last year, a workplace wellness program counts as voluntary even if workers have to pay thousands of dollars more in premiums and deductibles if they dont participate.

Despite those wins, the business community chafed at what it saw as the last obstacles to unfettered implementation of wellness programs: the genetic information and the disabilities laws. Both measures, according to congressional testimony last week by the American Benefits Council, put at risk the availability and effectiveness of workplace wellness programs, depriving employees of benefits like improved health and productivity. The council represents Fortune 500 companies and other large employers that provide employee benefits. It did not immediately respond to questions about how lack of access to genetic information hampers wellness programs.

Rigorous studies by researchers not tied to the $8 billion wellness industry have shown that the programs improve employee health little if at all. An industry group recently concluded that they save so little on medical costs that, on average, the programs lose money. But employers continue to embrace them, partly as a way to shift more health care costs to workers, including by penalizing them financially.

READ NEXT: Do workplace wellness programs improve employees health?

The 2008 genetic law prohibits a group health plan the kind employers have from asking, let alone requiring, someone to undergo a genetic test. It also prohibits that specifically for underwriting purposes, which is where wellness programs come in. Underwriting purposes includes basing insurance deductibles, rebates, rewards, or other financial incentives on completing a health risk assessment or health screenings. In addition, any genetic information can be provided to the employer only in a de-identified, aggregated form, rather than in a way that reveals which individual has which genetic profile.

There is a big exception, however: As long as employers make providing genetic information voluntary, they can ask employees for it. Under the House bill, none of the protections for health and genetic information provided by GINA or the disabilities law would apply to workplace wellness programs as long as they complied with the ACAs very limited requirements for the programs. As a result, employers could demand that employees undergo genetic testing and health screenings.

While the information returned to employers would not include workers names, its not difficult, especially in a small company, to match a genetic profile with the individual.

That would undermine fundamentally the privacy provisions of those laws, said Nancy Cox, president of the American Society of Human Genetics, in a letter to the House Committee on Education and the Workforce the day before it approved the bill. It would allow employers to ask employees invasive questions about genetic tests they and their families have undergone and to impose stiff financial penalties on employees who choose to keep such information private, thus empowering employers to coerce their employees into providing their genetic information.

If an employer has a wellness program but does not sponsor health insurance, rather than increasing insurance premiums, the employer could dock the paychecks of workers who dont participate.

The privacy concerns also arise from how workplace wellness programs work. Employers, especially large ones, generally hire outside companies to run them. These companies are largely unregulated, and they are allowed to see genetic test results with employee names.

They sometimes sell the health information they collect from employees. As a result, employees get unexpected pitches for everything from weight-loss programs to running shoes, thanks to countless strangers poring over their health and genetic information.

This article is reproduced with permission from STAT. It was first published on March 10, 2017. Find the original story here.

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House Republicans would let employers demand workers' genetic test results - PBS NewsHour