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Mark Fernald: Trumpcare Hurts The Granite State

What Trumpcare Means for New Hampshire:  Thousands lose their health insurance, hospitals take a financial hit, and the wealthy get a tax cut.

The Congressional Budget Office has now officially ‘scored’ Trumpcare and has estimated that 23 million will lose their health insurance.

Medicaid expansion under the Affordable Care Act has made it possible for nearly 50,000 citizens of New Hampshire to get health insurance. The vast majority of these newly insured are the working poor.  Their employers offer no health insurance, and they could not afford health insurance on the private market.  People making $18,000 a year could not afford a $6,000 health insurance policy before the Affordable Care Act.

If the Republican healthcare plan becomes law, nearly all of the newly insured will lose their coverage.

The expansion of Medicaid in New Hampshire has brought over $100 million per year into New Hampshire.  That new money has flowed to the bottom line of our healthcare providers, primarily our hospitals, which bear huge burdens providing free care for people without health insurance.  One study concluded that Medicaid expansion has cut the cost of uncompensated care over 40% in those states that expanded Medicaid.

Under Trumpcare, New Hampshire healthcare providers would lose hundreds of millions of dollars over the next decade, jeopardizing the financial health of some of our hospitals.

At the heart of Trumpcare is a big tax cut for the wealthy.  The Affordable Care Act included the Net Investment Income Tax, a new 3.8% tax on unearned income (such as interest, dividends, and capital gains) received by couples with incomes over $250,000 a year.  Trumpcare would repeal this tax.

The Net Investment Income Tax corrected a flaw in the original financing of Medicare:  the system is funded by a payroll tax on the wages of working Americans, rather than by a tax on the incomes of all Americans.  Part of our paychecks supported Medicare, but dividends, interest, and capital gains did not.

The importance of this flaw cannot be overstated.  Medicare is a program that benefits Americans who reach the age of 65.  It makes sense to pay for it the way we pay for the rest of the federal government—based on our incomes, not just on our W-2 earnings.

(Social Security is different.  It is paid for with a payroll tax, and the benefits you receive depend upon how much you pay in.  With Medicare, your benefits are not based on the Medicare taxes you have paid.)

Warren Bufffet is paid a modest salary by his company. The vast majority of his income is dividends and capital gains that are not subject to the Medicare payroll tax.  Year after year, before the Affordable Care Act, Warren Buffett paid less in Medicare tax than many wage-earning Americans.

To his credit, Warren Buffet has spoken out against Trumpcare as a tax cut for people like him who do not need it.  According to Buffett, repealing the Affordable Care Act—and the Net Investment Income Tax—would have saved him about $680,000 in 2016.

Repealing the Net Investment Income Tax will cost the federal government about $60 billion a year.  Trumpcare offsets that revenue loss with huge cuts to healthcare spending.  Medicaid expansion would be phased out, while health insurance subsidies for the working poor would be eliminated.

Here in New Hampshire, if Trumpcare becomes law, the health of tens of thousands of our fellow citizens will decline as they lose their health insurance.  The financial health of our hospitals will also decline, as the number of uninsured people increases.

Republicans have spent years railing against “Obama tax hikes” without mentioning that the target of their wrath is a tax that corrected one of the great inequities in our tax system.  The health of millions will be harmed to benefit the wealthy few.

The Republican plan is now in the Senate, where it is being revised in secret. Most senators pay the Net Investment Income Tax, as they have large stock portfolios, and family incomes over $250,000.  We will see which senators vote to give themselves a tax cut—while taking health insurance away from millions—and which senators will vote against a personal tax cut and for affordable healthcare.

Mark Fernald is a former State Senator and was the 2002 Democratic nominee for Governor.  He can be reached at mark@markfernald.com.

850% Increase To Seniors Healthcare: NH Congressional Delegation Responds To New CBO Report

Yesterday the non-partisan, Congressional Budget Office (CBO) released their report on the American Healthcare Act of 2017 (AHCA) and the news is horrifying to seniors and low income families.

The CBO reports:

  • An estimated 23 million people would lose healthcare coverage over the next ten years.
  • The cost of an individual plan would skyrocket by 20% in 2018, and an additional 5% in 2019.
  • Those 50-64 would be forced to pay drastically higher premiums, as much as 60% of their income.

VOX reports that this would be an 850% increase over what they would pay under the current ACA law.  You can see the breakdown of premiums based on 175% of the Federal Poverty Level ($26,500 per individual) and 450% of FPL ($68,200).

This new law makes healthcare completely unaffordable for millions of Americans, specifically older Americans.  These are just what people would be forced to pay to get “access” to healthcare. This does not include deductibles, co-pays, and co-insurance.   Nobody could possibly afford to pay 60% of their income to have the freedom to access healthcare.

“Today’s CBO report confirms that the Republican healthcare repeal bill is not only reckless, it would be devastating to Granite Staters’ health and wellbeing,” said Senator Jeanne Shaheen (D-NH).”Throwing 23 million Americans off their insurance is not a successful healthcare plan. The Republican leadership’s repeal bill would result in many patients paying more and receiving less coverage, while eliminating protections that prevent insurance companies from discriminating against patients with pre-existing conditions such as a history of cancer, heart disease, diabetes, or postpartum depression. The repeal bill would be particularly harmful to New Hampshire’s response to the opioid epidemic, eliminating Medicaid expansion that has helped Granite Staters get the substance misuse treatment they need. I urge my Republican colleagues to commit to working in a bipartisan manner to improve the Affordable Care Act and ensure that more Americans have affordable, accessible care.”

“The non-partisan Congressional Budget Office has confirmed what we already knew: Trumpcare would be devastating for hard-working people across New Hampshire and America, leading to higher costs for worse health coverage,” said Senator Maggie Hassan (D-NH). “If you buy your own health care, Trumpcare means you will face 20% higher premiums in 2018, with especially high premium hikes for older Americans. And if you have a pre-existing condition, which under Trumpcare includes cancer, asthma or diabetes, you could once again be discriminated against with higher costs. Trumpcare would also lead to 23 million more uninsured Americans, and it would undermine our efforts to combat the heroin, fentanyl, and opioid crisis – despite President Trump’s promises to take action against this crisis. I will continue to do everything in my power to stop this harmful Trumpcare bill.”

“Today’s estimate by the independent Congressional Budget Office confirms that the health care repeal bill Republicans pushed through the House earlier this month would kick a devastating number of Americans – 23 million people – off of their coverage, strip protections from people with pre-existing conditions, and raise their premiums,” said Congresswoman Carol Shea-Porter (NH-01) who voiced her opposition to this bill on the House floor.

“This estimate caps off a disturbing week where President Trump proposed devastating cuts to Medicaid, children’s health care coverage, and Social Security disability insurance, while continuing to destabilize insurance markets by denying insurers certainty about whether his Administration will honor its obligations. President Trump has broken his promise of ‘insurance for everybody,’” Shea-Porter added.

“This report affirms what we already knew, that the American Health Care Act would be a disaster for access to healthcare in New Hampshire and across the country,” said Congresswoman Annie Kuster (NH-02). “It would take away protections for those with preexisting conditions, allow Americans over 50 to be charged more, hurt access to healthcare for seven million veterans, and jeopardize our response the opioid epidemic. I urge my Republican colleagues to abandon this legislation and come to the table in good faith to work on bipartisan solutions to improve access to healthcare for all Americans.”

No doubt the Republicans will try to say that the CBO confirms that this new healthcare bill will save taxpayers “$116 billion dollars” over the next decade.  But at what cost?  They are gutting Medicaid upwards of $800 billion with an addition $276 billion in tax giveaways to wealthiest Americans.

This new healthcare bill is a complete disaster. The Senate is our only hope to somehow fix this.  If the Senate passes this bill as it is now, people will die.  People will no longer be able to afford healthcare and they will no longer be able to afford their medications and they will die.

HHS Secretary Tom Price Visit NH Trying To Peddle The AHCA

Today, Health and Human Services Secretary Tom Price came to New Hampshire to host a roundtable discussion on the American Health Care Act and it impact on access to healthcare and substance misuse treatment in New Hampshire.

The AHCA has very little support, except for those inside the Republican Party, for its cuts to programs designed to help states combat the growing opioid addition.  This include NH’s Governor Chris Sununu.

Over the weekend, Republican Governor Chris Sununu praised the recently passed Trumpcare bill, calling it a “great message” to the American people and saying he was “glad they pass something.” The governor also wanted to see Congress give him the power to opt-out of providing coverage for substance abuse treatment.

New Hampshire has the third-most per capita deaths by drug overdose and the Drug Enforcement Agency (DEA) called the state “ground zero” for the opioid epidemic. Sununu is welcoming Trumpcare architect, Health & Human Services Secretary Tom Price to the state on Wednesday to discuss the opioid crisis just days after the governor expressed interest in cutting off coverage for substance abuse victims.

“It’s a mystery what exactly made Governor Sununu throw his support behind the most recent and cruelest version of Trumpcare, but it could do with the amendments that allows states to deny coverage and hike up premiums for more Americans,” said NHDP Chair Ray Buckley. “Sununu’s idea to give states the option to deny coverage for substance abuse treatment is heartless. The governor’s purely ideological stance would weaken New Hampshire’s ability to combat our largest and most urgent issue.”

This weekend, the New Hampshire Hospital Association called the bill “a significant step backward.” New Hampshire Health Care Association said they couldn’t “imagine how care in New Hampshire ultimately survives this blow,” and the CEO of Catholic Medical Center said the bill would “result in dramatic increase in uncompensated care costs.”

Two new reports analyze ways in which Trumpcare would damage Granite Staters. Kaiser Family Foundation’s analysis of the AHCA found that a 60-year old in New Hampshire making $20,000 a year would pay 607% more in premiums than under the ACA. New Futures calculated the cost of substance abuse in New Hampshire as upwards of $2 billion annually, underscoring the need for federal assistance. Rather than increase federal money, Trumpcare would cut Medicaid by $880 billion and phase out Medicaid Expansion by 2020.

Sununu also asked for the power to opt-out of providing mental health coverage. The Trumpcare bill that just passed the House offers two key opt-out provisions. One provision would allow states to opt out of guaranteeing “essential health benefits” and the other would effectively allow insurance companies to charge an unlimited amount in monthly premiums to those with preexisting conditions.

In advance of Secretary Price’s visit, Congresswoman Annie Kuster wrote to the Secretary and inquired about the Trump Administration’s commitment to ensuring coverage for those with preexisting conditions, protecting rural hospitals, supporting treatment and recovery services for substance misuse, and avoiding cost increases for older Americans.

“I was glad to have the opportunity to express my concerns about the American Health Care Act with Secretary Price this afternoon,” said Congresswoman Kuster. “In New Hampshire, Medicaid expansion offered through the ACA has played an important role in getting thousands of Granite Staters seeking recovery services the treatment and care they need. Nearly every participant at today’s listening session highlighted the critical need to continue Medicaid expansion in our state. The Republican healthcare bill poses a serious threat to efforts to address the opioid crisis in New Hampshire and across the country. I hope that after hearing from people in New Hampshire, Secretary Price will have an appreciation for the importance of preserving access to treatment and recovery services that were established by the ACA. Rather than pursue partisan efforts to repeal the ACA, I urge my colleagues to come together in good faith to work to improve access to healthcare for all Americans.”

Senator Jeanne Shaheen said the AHCA “decimates Medicaid” and removes requirements for insurance companies to “cover substance misuse” treatments.

“Considering Secretary Price played a lead role in crafting the Republican leadership’s healthcare repeal bill, I hope that he will take to heart the significant concerns of Granite Staters who are extremely alarmed about the impact that this legislation would have on their lives,” said Senator Shaheen.

“Today, Secretary Price said the Trump administration’s focus is to provide coverage and care to every American, but his words don’t match the administration’s actions. The Republican leadership’s healthcare repeal bill decimates Medicaid, and eliminates the program’s expansion and the federal requirement that insurance plans cover substance misuse treatment.  Taken together, these policies would not only take a wrecking ball to our state’s progress to address the opioid epidemic, but put us in a far worse position than ever before. These tools are fundamental to New Hampshire’s efforts to provide treatment to Granite Staters who desperately need it. Needless to say, a listening tour would have been much more appropriate prior to pushing this healthcare repeal legislation through the House of Representatives without any hearings,” Shaheen added.

 

Senator Maggie Hassan is also opposed to the AHCA and is “deeply concerned” about the cuts to the office “tasked with coordinating the federal government’s response to the substance misuse crisis.”

“While I appreciate Secretary Price’s visit to New Hampshire to highlight the heroin, fentanyl, and opioid epidemic devastating our state, there remains a troubling disconnect between the Trump Administration’s words and its proposals, which would significantly harm our ability to combat this crisis. The Trumpcare proposal being pushed by Secretary Price would be devastating to those on the front lines of this crisis – from slashing the traditional Medicaid program, to ending New Hampshire’s bipartisan Medicaid expansion plan and undermining the requirement that insurance companies cover substance use disorder treatment. I am also deeply concerned by reports that the White House is considering effectively eliminating the office tasked with coordinating the federal government’s response to the substance misuse crisis.”

“I hope that Secretary Price listened closely and learned from the discussion in which participants largely focused on the importance of Medicaid expansion and the critical role it plays in our efforts to combat substance misuse and save lives.”

 

As the day moved on, Secretary Price continued his listening tour but decided to lock out local media outlets.

Congresswoman Carol Shea-Porter blasted them in her statement.

“If an HHS Secretary hosts a so-called ‘opioid listening tour’ and doesn’t allow the public or press to hear it, does it make a difference? People in New Hampshire are tired of hearing all talk on the opioid crisis and no action from Washington Republicans – and in fact, Secretary Price has spent the last few weeks pushing policies that would send us backwards in this fight. Perhaps Secretary Price kicked the press out of his roundtable because he knows his support for kicking millions off health care and ending key heroin-fighting programs is indefensible. Maybe he didn’t want to face the Granite Staters who now have access to treatment for opioid misuse, but who would lose coverage under the Republican health care bill, which repeals the Affordable Care Act’s Medicaid expansion. Or maybe he didn’t have an explanation for why just last week, the White House proposed drastic cuts to the Office of National Drug Control Policy, the office that has been coordinating the federal response to the opioid emergency, and proposed ending the award-winning New England High Intensity Drug Trafficking Area program. Secretary Price and the Trump Administration should get to work on concrete actions that show a real commitment to turning this tide, and to making sure nobody in New Hampshire loses their health care.”

The AHCA would kick an estimated 24 million off their healthcare. It would gut Medicare and give massive tax breaks to the ultra-wealthy.

 

Senator Hassan Joins Colleagues, Advocates for Disability Community in Speaking Out Against Trumpcare

Senator Highlights Devastating Impact Cuts to Medicaid Would Have on Critical Services for Granite Staters Who Experience Disabilities

WASHINGTON – Today, Senator Maggie Hassan (D-NH) joined Senators Bob Casey (D-PA), Senator Debbie Stabenow (D-MI), Senator Chris Van Hollen (D-MD), former Senator Tom Harkin, members of the disability community, and advocates for a press conference outside the U.S. Capitol highlighting the devastating impact Trumpcare would have on Granite Staters and Americans who experience disabilities.

“Trumpcare hurts people who experience disabilities with drastic cuts to the traditional Medicaid program,” Senator Hassan said to advocates outside the Capitol. “This plan changes Medicaid into per capita caps or a block grant system – and that is just code for a massive cut to the federal support states receive…[If Trumpcare passes], states will be faced with cutting services that people with disabilities depend on, such as personal care, prescription drugs, and rehabilitation services.”

“We can’t afford to go back to the days where we marginalize or don’t assist some of our most vulnerable people, so I’ll will stand strong with the people of New Hampshire, and my colleagues in fighting against this dangerous bill that would pull us backward,” Senator Hassan added.

Senator Hassan emphasized the importance of building a stronger, more inclusive society where all citizens can be engaged and active in our economic and civic life. The Senator also urged attendees to continue speaking out against Trumpcare, underscoring the importance of advocacy efforts in impacting real change on a local and federal level.

Watch video of the press conference here.

On The House Floor, Shea-Porter Pushes Amendment To Require Insurance Coverage Of Opioid Use Disorder Treatment

As Congress Debates Health Care Legislation, Congresswoman Highlights New Hampshire Heroin, Fentanyl, and Prescription Opioid Crisis 

WASHINGTON, DC Congresswoman Carol Shea-Porter (NH-01) today offered and the House voted on a Motion to Recommit that would require association health plans to provide coverage for substance use disorder treatment. As Congress this week considers the American Health Care Act, which would cause 24 million Americans to lose their coverage, Shea-Porter called on her colleagues to work together to improve access to quality, affordable health care.

“Today, Members of Congress can say to my constituents in New Hampshire and their constituents across this great nation: we hear you. We know your sons and daughters, your nieces and nephews, your neighbors and friends are struggling, and we have your back,” said Shea-Porter. “We believe all Americans deserve good health insurance they can count on when they need it most. We aren’t going to pull the rug out from under people who are about to turn their lives around.”

Shea-Porter’s remarks highlighted the fact that much-needed treatment facilities, such as Hope on Haven Hill in Rochester, which she recently visited, have been able to open because more Americans now have insurance that covers treatment thanks to the Affordable Care Act and its Medicaid expansion. 

177 Democrats and 2 Republicans voted for Shea-Porter’s motion.

SHEA-PORTER’S FULL HOUSE FLOOR REMARKS

“I rise today on behalf of the families and communities across this nation that are confronting a public health threat of our time: the heroin, fentanyl, and prescription opioid crisis. 

“This motion would simply ensure that the health insurance plans that today’s bill would permit must still cover substance use disorder treatment, including for opioids, as an essential health benefit.

“Under current law, we require insurers to cover this treatment. Before the Affordable Care Act, many insurers either didn’t cover treatment at all or imposed onerous requirements that blocked people from getting needed care.

“H.R.1101 would roll back that guarantee. It would allow association health plans to return to the kind of skimpy coverage that left so many people struggling with an opioid disorder in dire straits at critical moments. We know there’s often a narrow window of opportunity — after an overdose, for example — for someone to commit to treatment, and these are the moments when being able to make a single phone call can make all the difference. 

“This week’s debate about health care is extremely important. Will we decide to work together to improve the American people’s access to quality, affordable health care or weaken benefits and kick 24 million or more of our constituents off their plans? We all need to speak up on behalf of those whose lives have been turned around because they can now access care.

“As I talk to families, medical professionals, and law enforcement officials in my district, I hear stories that highlight the dramatic impact that improved access to coverage has had in making treatment a real option for people with substance use disorder.

“This week, we see that base of coverage is under serious threat. In fact, experts estimate that repealing the Affordable Care Act’s coverage provisions would cause about 2.8 million Americans with a substance use disorder to lose some or all of their coverage.

“And the quality of that coverage is also at risk. Thanks to the Affordable Care Act, insurance now must cover treatment for behavioral health and substance use disorder, just the same as it would cover any other medical service. These parity protections mean insurers must cover treatment for substance use disorder with comparable cost-sharing — no more surprises, like annual visit limits, higher copays, or frequent pre-authorization requirements and medical necessity reviews.

“Badly needed facilities are opening because plans now cover these services. I recently visited a recovery home for pregnant women and new mothers that was able to open its doors this year in my hometown only because it could rely on Medicaid expansion. Legislation like H.R.1101 would cause fewer people to have this coverage, meaning fewer facilities can open.

“Many of you know that my home state of New Hampshire is on the front lines of the heroin, fentanyl, and prescription opioid crisis. Our communities are struggling, and helping people get treatment is key to turning the tide. I have met the people who couldn’t be in a recovery facility without Medicaid expansion. 

“Today, Members of Congress can say to my constituents in New Hampshire and their constituents across this great nation: we hear you. We know your sons and daughters, your nieces and nephews, your neighbors and friends are struggling, and we have your back. We believe all Americans deserve good health insurance they can count on when they need it most. We aren’t going to pull the rug out from under people who are about to turn their lives around.

“I urge my colleagues to support this motion, which would not delay passage of the underlying bill. Thank you.”

Shaheen Blasts Trumpcare As “Out of Touch” With Stories From Working People In NH

On Senate Floor, Shaheen Shares Stories of Granite Staters Who Rely on the Affordable Care Act, Calls Trumpcare
“Totally Out of Touch” With Lives of Working Americans
 

(Washington, DC) — U.S. Senator Jeanne Shaheen (D-NH) spoke on the Senate floor today to share the stories of Granite Staters who have been helped by the Affordable Care Act (ACA), also known as Obamacare, and against President Trump and Republican leadership’s proposed repeal bill. Shaheen highlighted her conversations with Granite Staters across New Hampshire whose lives have been saved thanks to the ACA and Medicaid Expansion. “For ordinary people in New Hampshire and across America, repealing the Affordable Care Act isn’t about politics, it’s about life and death,” said Shaheen. “It’s about people being cut off from treatment for substance use disorders.  It’s about cancer patients being turned away from life-saving therapies.  It’s about children with serious preexisting conditions being denied health coverage.”

During her remarks, Shaheen said Republican leadership’s legislation to repeal the Affordable Care Act “would have catastrophic consequences” for New Hampshire. “It is especially distressing that Trumpcare would roll back expansion of the Medicaid program, which has been an indispensable tool in our efforts to combat the opioid epidemic,” Shaheen said. That “could terminate treatment for hundreds of thousands of people across America who are recovering from substance use disorders.”

Shaheen went on to share stories of Granite Staters who are getting treatment for substance use disorders with help from the ACA. One letter that Shaheen read was from Nansie Feeny of Concord, NH, who wrote: “[My son] Benjamin went to Keene State College with the same hopes and dreams many have when building their American dream.   While there he tried heroin.  Addiction overcame him… It was due to Obamacare that we were able to get him insured so that he could get the proper help he needed and [into] a suboxone program that assisted him with staying ‘clean.’  In April it will be a year for Ben in his recovery. Without Obamacare this would not have been possible.”

Shaheen urged her Senate colleagues to “come together to repair the flaws in this landmark law and ensure that it works even better for all Americans.”

During her remarks, Shaheen also voiced her concerns about Seema Verma, President Trump’s nominee to serve as administrator of the Centers for Medicare and Medicaid Services, and said that she will vote against her confirmation. “Ms. Verma made it clear that [prenatal care and maternity coverage] should be strictly optional – and women should pay extra for it if they want it,” said Shaheen. “The American people do not want drastic cuts to Medicaid – cuts that will threaten coverage for children, seniors, people with disabilities, and patients receiving treatment for substance use disorders.”

 

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