Its going to be a long ass proccess even if the repubs all agree ....
Every senator will get a chance to put changes up for a vote ... the dems will continue to be the obstructionist theta are ... its become very clear all the want to do is slow everything down ..
Like i said .. thats if the repubs can come up with something they all agree on ... ...
Sad part is .. oBUMa care is disenagrating right before our very eyes .. Anthiem left Indiana and Wisconsin yesterday ...
There's 18 counties in Ohio that will have no choices in 18 all ready ... and watch more drop out ... and there's a bunch of states with way more counties having ZERO choices ..
Its literally imploding before our eyes ... this is what the dems wanted all along since day 1 ... its always been about single payer and them (the gov't) getting more power and control ..
Its VERY SAD .. and i blame both sides of the aisle and oBUMa for this ...
It needs priced out, too, I believe. Must be some need or reasons for this secrecy.
Yes, the GAO must look it over first.
I understand the secrecy. Everything the Republicans try to do is immediately attacked when it isn't even completed. This secrecy is giving them the chance to work it up without distraction or disruption.
The GOP had how many years to come up with something better than the ACA?
And yet the only thing this bill accomplishes is a tax break for the rich, a kick in the face for everyone else.
So much for Trump's promise of making sure everyone is covered at a cheaper rate.
Conservatives said the ACA was a death panel.
Kicking 23 million people off insurance sounds like a death panel.
But if conservatives want to swing that far right on healthcare, then I'll swing far left. It's time to fight fire with fire.
I offficialy support single payer. Screw the conservative-led plan. It's nothing but another way to give rich people who don't even need the money more money.
Anybody who supports this must drop the idea that they are pro-life. Cause this crap is anything but.
“To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public.”
I doubt the senate bill is gonna be that much different.
That crap shouldn't have even made it out the house.
“To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public.”
Medicaid Cuts Taxes cut Planned Parenthood defunded for ONE YEAR, lol Does not repeal Obamacare, just changes structure Ends personal and business mandates McConnell trying to push it through by next week...
This will fail, either before it becomes law or after.
they don't need to read it .. remember Nancy's logic ... we need to pass it before we know whats in it .. pretty logical stuff .. putting the cart before the horse makes sense in their world ..
PS. Doesn't matter what it is .. ALL DEMS will just rip it cause its during the Trump presidency .. so whats the difference ... OBSTRUCT .. LIE .. RIP ... RIP .. LIE ... OBSTRUCT ...
OBUMa care is COLLAPSED all ready and its going to get worse ... yet the left just rips everything ..
Its not even broken anymore .. its well beyond repair ... INCREDIBLE .. .
But they don't care ... cause just like the goverment officials that don't have to abide by the laws they pass ... it doesn't affect them .. YET ... it will ..
Then they'll all be whining like the snowflakes they are ..
Lolololol. I'm laughing cause I don't know what else to do. The GOP is hellbent on screwing over the many for the very few.
“To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public.”
they don't need to read it .. remember Nancy's logic ... we need to pass it before we know whats in it .. pretty logical stuff .. putting the cart before the horse makes sense in their world ..
PS. Doesn't matter what it is .. ALL DEMS will just rip it cause its during the Trump presidency .. so whats the difference ... OBSTRUCT .. LIE .. RIP ... RIP .. LIE ... OBSTRUCT ...
they don't need to read it .. remember Nancy's logic ... we need to pass it before we know whats in it .. pretty logical stuff .. putting the cart before the horse makes sense in their world ..
PS. Doesn't matter what it is .. ALL DEMS will just rip it cause its during the Trump presidency .. so whats the difference ... OBSTRUCT .. LIE .. RIP ... RIP .. LIE ... OBSTRUCT ...
Thats all they got ...
I hope your right on the bill ... we'll see ...
They learned this well from the Republicans
"The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants." Thomas Jefferson.
What's in the Senate proposal: Key provisions of Better Care Reconciliation Act of 2017
The Senate’s proposal to overhaul ObamaCare must be reconciled with the previously released House version before President Trump can sign a bill into law. While the Senate’s draft can be viewed in its entirety here, below are some of the key components being touted by Republicans in the Senate.
• Help stabilize collapsing insurance markets by creating a short-term stabilization fund to provide $15 billion per year in 2018 and 2019 and $10 billion in each of the next two years to address coverage disruption. It would also continue federal assistance to low-income Americans through 2019.
• End “onerous Obamacare mandates” by repealing individual and employer mandates.
• Improve the affordability of health insurance by expanding tax-free Health Savings Accounts, repealing ObamaCare taxes, implementing targeted tax credits and empower states to make changes in what markets are available to residents.
• Preserve access to care for Americans with pre-existing conditions, and allow children to stay on their parents’ health insurance through age 26.
• Strengthen Medicaid by giving states more flexibility while ensuring that those who rely on this program won’t have the rug pulled out from under them.
Kudos to them for adding the stabilization component and adjusting the pre-existing conditions that the House bill changed.
The little I've read about it, it seems to be much better than the house bill, but it doesn't seem to be a repeal and replace, more like a partial fix.
Question for you 40: Do you it enough to get the votes of some of the Rs that were leaning no based on the house bill? And, is it too much for the Rs that wanted to repeal or were more in line with the house bill?
Personally what I think is most of the objections by those 4 Senators is because they are getting some Press time for a future run at President and other career reasons.
There will be more negotiating to finish this up and then everyone is gonna pass it because they are sick of looking at it.
At a campaign rally in Iowa this week, Donald Trump boasted, "One by one we are keeping the promises we made to the people of Iowa and the people all over our country." That's hopelessly bonkers on a wide variety of fronts, but it's especially striking when it comes to health care.
The president promised the American public, "We're going to have insurance for everybody.... Everybody's going to be taken care of." He vowed his health care policy would offer "lower premiums" with "much lower deductibles." And perhaps most importantly, Trump swore, over and over again, in writing and in public remarks, that he would never cut Medicaid.
And yet, there was the Republican president yesterday, throwing his support behind a Senate GOP bill that won't cover everybody, would increase consumer costs, and cuts Medicaid by hundreds of billions of dollars. As NBC News' Benjy Sarlinexplained:
The Affordable Care Act gave states federal funding to expand Medicaid coverage to people whose incomes were between 100 percent and 138 percent of the federal poverty line.... But [the Senate Republicans' plan] would go a lot further than repealing Obamacare's changes. It would also cap the amount of funding states can get on a per-recipient basis rather than continue the current system, in which states decide how much to spend and then have the federal government match their contribution.
Starting in 2025, the plan would then grow those per-recipient caps at a rate that's unlikely to keep pace with increasing medical costs. A similar change in the House bill was projected to reduce Medicaid spending by $839 billion over a decade and cover 14 million fewer people. The Senate bill kicks in later, but its cuts would be even deeper than the House plan.
This is a profound betrayal to those Americans who actually believed Trump's assurances, and voted for him because they expected the Republican to honor his work.
What's the White House's explanation for the presidential perfidy? Trump's budget director recently questioned the importanceof the Medicaid promise, which probably won't offer much comfort to families poised to suffer.
What's more, it's not just Trump.
Sen. Dean Heller (R-Nev.) recently said, before he knew about his party’s plans to gut Medicaid, “We cannot pull the rug out from under states like Nevada that expanded Medicaid.” Sen. Lisa Murkowski (R-Alaska) has made similar comments, as have other GOP senators.
It’s against this backdrop that a Senate Republican quote to the Huffington Post yesterday stood out for me.
Although he didn’t formally endorse the legislation, it’s clear how Sen. Tim Scott (R-S.C.) would vote. Low-income people would have “more access” to health care because of the bill, he claimed. Asked how those sorts of people would have more access if the measure would result in Medicaid cuts, Scott offered a complete mischaracterization of the bill.
“Medicaid’s not actually being cut from our perspective,” he said.
I realize policymakers will have spirited conversations about the nuances of expenditure growth rates, but whether or not Medicaid is being “cut” isn’t exactly a matter of “perspective.” Either Republicans intend to spend less or they don’t. Opinions and debates over how many Medicaid patients can dance on the head of a pin aren’t altogether constructive.
And regardless of the right’s “perspective,” the pending Republican legislation would cut Medicaid dramatically, promises from GOP politicians notwithstanding.
Sen. Tim Scott (R-S.C.)... “Medicaid’s not actually being cut from our perspective,”
Sen. Tim Scott (R-S.C.)... Low-income people would have “more access” to health care because of the bill, he claimed.
The only way Trumpcare can be successfully sold to the American people is if the President and your GOP elected officials..LIE LIKE HELL, thinking their voters are too damn stupid to figure out when Trump and the GOP are conning you.
It does not matter if your GOP, Dem or Independent everyone will get hurt by the GOP/Trump healthcare con.
If this passes, if the GOP can ram this through while they have control, the GOP is going to come back and go after other entitlements..medicare and social security.
Those of you who believe this won't touch you...think again.
Efforts in Congress to cut Medicaid jeopardize a critical source of health coverage for veterans. Approximately 1.75 million veterans—nearly 1 in 10—have Medicaid as a source of coverage.1 This coverage ensures that veterans get the primary and specialty health care they need when they need it.
About 340,000 veterans nationally receive coverage through the Affordable Care Act’s (ACA) Medicaid expansion.2 Most of these veterans would likely lose that coverage if Congress passes the Republican proposal to slash funding for the Medicaid expansion.
Republicans in the House of Representatives have also proposed to radically change the structure of the Medicaid program by capping and cutting funding—a blow to the Medicaid program that would put the health care of 1.75 million veterans at risk.
Not all veterans can get health care through the VA Not all veterans qualify to receive health insurance through the Department of Veterans Affairs (VA). Eligibility relates to a variety of factors, including minimum service requirements as well as disability and discharge status.3 According to the Veterans Administration, in 2014 only 40 percent of all veterans were enrolled in the VA health care system.4 Furthermore, veterans’ family members rarely qualify for VA assistance.5
Approximately 1.75 million veterans rely on Medicaid. Many of these veterans have extensive health care needs. High-cost enrollees, such as veterans who require intensive care for conditions like traumatic brain injuries and musculoskeletal disorders, are at particular risk if the program is cut. Efforts to cap and cut Medicaid risk the health and security of veterans most in need.Additionally, not all veterans enrolled in the VA can easily use VA services. One-third of veterans enrolled in the VA did not use a VA service in 2014.6 Many enrolled veterans do not live near a VA provider. Transportation issues can make it impractical or impossible for veterans to use the VA as a source of care. This is particularly true for the millions of veterans who live in rural areas.7
Nearly 1 in 10 veterans relies on Medicaid In 2015, roughly 1.75 million veterans (ages 18 and older)—nearly 1 in 10—had Medicaid coverage (see Table 1). In many cases, Medicaid supplemented VA or other coverage like Medicare for veterans who were older than 65. About half of Medicaid-enrolled veterans are aged 18-64 and ineligible for Medicare. Forty percent of these 913,000 working-age veterans (18-64) with Medicaid had no other source of health coverage. Without Medicaid coverage, they would be uninsured. Medicaid is their only way to reliably get access to needed care.
Medicaid is also an important source of coverage for veterans’ family members, who rarely qualify for veterans benefits to help cover health care costs. In 2015, more than 660,000 veterans’ spouses were enrolled in Medicaid.
The ACA and the Medicaid expansion have improved veterans’ access to health coverage Since the implementation of the ACA, the number of veterans without health insurance has declined.8 The ACA’s Medicaid expansion, which extended Medicaid coverage to more working-age veterans, has helped to increase veterans’ access to health coverage.
The Medicaid expansion extended coverage to millions, including hundreds of thousands of veterans. Congressional efforts to end the expansion, whether through a freeze in enrollment or a phase-out of federal funding, pull the rug out from under veterans who gained coverage.In 2015, more than 913,000 veterans between the ages of 18 and 64 were enrolled in Medicaid, and about 340,000 veterans received Medicaid because of the Affordable Care Act’s Medicaid expansion. That represents a significant increase in the Medicaid enrollment of working-age veteran from 2013, the year before the ACA went into effect (see Table 2). While the number of veterans covered by Medicaid increased across most states when the ACA was implemented, it was significantly greater among states that expanded Medicaid.9
Changing the structure of the Medicaid program or ending the Medicaid expansion would hurt veterans and their families Veterans and their family members depend on Medicaid. Sometimes it supplements VA or other coverage; for many, it is their only source of coverage.
Veterans are at a higher risk than most for unique and sometimes serious or complicated health care issues as a result of their service. These health conditions might include musculoskeletal conditions, traumatic brain injuries, and post-traumatic stress disorder.
Congressional actions such as capping and cutting Medicaid or ending or phasing out the Medicaid expansion would make it harder for veterans to get the health care they need. This is a disservice to those who have served our country.
Congress should be taking steps to make it easier, not harder, for veterans to access the health care they need when they need it. Voting to end the Medicaid expansion or to cap or cut Medicaid is a vote against veterans and their families.
SUMMARY:
Republican efforts to cut Medicaid or roll back the Medicaid expansion do not honor the service of America’s veterans. 1.75 million veterans, many of whom have no other source of coverage, will see their coverage weakened. 340,000 of those veterans who are covered by the Medicaid expansion will have their coverage dropped altogether. Ending the Medicaid expansion would hurt veterans and their families.
TABLE 1:
Total number of veterans (18 and older) covered by Medicaid (2015)
State Number of Veterans Alabama 28,000 Alaska 3,700 Arizona 45,000 Arkansas 27,000 California 183,000 Colorado 41,000 Connecticut 18,000 Delaware 6,000 District of Colombia 3,000 Florida 119,000 Georgia 50,000 Hawaii 8,000 Idaho 9,000 Illinois 60,000 Indiana 29,000 Iowa 19,000 Kansas 13,000 Kentucky 36,000 Louisiana 31,000 Maine 15,000 Maryland 32,000 Massachusetts 51,000 Michigan 72,000 Mississippi 32,000 Minnesota 17,000 Missouri 27,000 Montana 7,000 North Carolina 54,000 North Dakota 3,000 Nebraska 9,000 New Hampshire 8,000 New Jersey 27,000 New Mexico 19,000 Nevada 18,000 New York 93,000 Ohio 71,000 Oklahoma 19,000 Oregon 36,000 Pennsylvania 82,000 Rhode Island 8,000 South Carolina 29,000 South Dakota 4,000 Tennessee 43,000 Texas 105,000 Utah 8,000 Virginia 32,000 Vermont 8,000 Washington 56,000 Wisconsin 35,000 West Virginia 15,000 Wyoming 3,000 U.S. Total* 1,764,000 *Totals may not add due to rounding.
Anyone in your family have Alzheimer’s disease? Your grandmother or grandfather?...maybe your great grandmother or father?...maybe a loved one hit with a disabling disease that strikes at a younger age?
Many want to remain in their homes and hope to never see a nursing home. I have a relative who says, don't ever put me in a nursing home because I will die.
You think that these Trumpcare cuts won't affect you or anyone in your family?...read on!
Aging At Home Will Be Harder With Medicaid Cuts
Next Avenue, Contributor By Beth Baker, Next Avenue Contributor link
MAY 17, 2017 @ 01:27 PM
In 2012, Ti Randall of New York City, who has Alzheimer’s disease, had run out of savings. His Social Security and a veteran’s pension helped cover his basic living expenses. But it took Medicaid to provide Randall with other services he needed in order to remain at home.
“He needed companionship and assistance,” says Ann Burgunder, 69, his long-time partner and caregiver. Burgunder, meanwhile, wanted and needed to continue working.
Randall’s needs have since grown. Now, at 93, he must have help bathing, dressing, cooking and toileting. At this point, “he couldn’t be left alone at all,” says Burgunder, who works as a coordinator for New York University's Alzheimer's Disease and Related Dementias Family Support Program. Through Medicaid, Randall has the services of home-care aides 12 hours a day Monday through Friday and half the day on Saturday. Medicaid also pays for his incontinence supplies, which cost more than $300 a month.
Proposed cuts to Medicaid under the American Health Care Act passed by the House recently could change life for Randall and many others. Medicaid is not only an insurance program for low-income people. It’s a lifeline for older adults like Randall who need supportive services to stay at home. At-home services are a lifeline for Medicaid as well, which would otherwise be paying for more expensive care in an institutional setting.
Many Never Expected to Need Medicaid
“A lot of formerly middle-income people have the misfortune of getting the wrong disease and they use up all their money on long-term care,” says Howard Gleckman, resident fellow of the Urban Institute and author of Caring for Our Parents. “They find themselves in old age doing something they never expected, which is ending up on Medicaid.”
Unlike Medicare, Medicaid covers long-term care for at least 2 million older adults. It has long been the payer of last resort for those who live in nursing homes. But increasingly, Medicaid’s focus has shifted to giving people want they want — help to keep living at home.
A tipping point came in 2014, when for the first time in the program’s history, more than half of Medicaid funding for long-term care, 53%, was spent on home- and community-based services aimed at keeping people of all ages out of institutions.
The cost of care at home is usually significantly lower than in an institution. In 2016, the national median cost of a shared nursing home room was $82,125 annually. The median cost of a home health aide was $46,332 annually for 44 hours of support each week.
“The vast majority of people in nursing homes do not need to be there, they just need some home supports,” says Leonardo Cuello, director of health policy for the nonprofit National Health Law Program, a nearly 50-year-old organization that advocates for access to health care for low-income people. “Across the country, state Medicaid programs are figuring out creative ways to get people those services in their home.”
Many of the innovative programs Medicaid has developed to cover home- and community-based services grew out of grants through the Affordable Care Act and their future is now uncertain. Unlike nursing home costs, which the federal government requires states to cover, these services are considered optional. This makes them particularly vulnerable to the billions of dollars of cuts to Medicaid included in the American Health Care Act.
High Risk of Nursing Home Admission
The eligibility criteria for receiving Medicaid-covered home- and community-based services vary by state. Generally they are based on people’s income, assets and need for help with activities of daily living — in other words, their risk of needing nursing home care.
Many who qualify for such services are among the 11 million older adults who are “dual eligible,” covered by both Medicare and Medicaid. Most of them do not yet need age-related long-term care, but dual-eligibles tend to have significantly more chronic conditions than those on Medicare alone. According to areport by the Kaiser Family Foundation, 61% of dual-eligibles need at least limited help with activities of daily living compared to just one-third of people who are only on Medicare.
In addition to home care, Medicaid — depending on the state — may cover in-home physical and occupational therapy, telehealth consults, adult day care and day health-care services, medical and nonmedical transportation, emergency call systems (e.g. Lifeline pendants) and respite for family caregivers, as well as incontinence products, shower benches, wheelchairs and other equipment including the cost of home adaptations for people with mobility challenges.
Some states have long waiting lists of eligible people wanting to receive home- and community-based services.
“All of those services make the difference between living at home — having an independent life with dignity and maximizing quality of life — and living in an institution,” says Cuello.
Medicaid helps low-income people stay independent in another way. For those living at the federal poverty level, it often pays for the Part B individual share of Medicare, now $134 a month.
“That goes a long way toward being able to afford rent and groceries,” says Stacy Sanders, federal policy director of the Medicare Rights Center, which runs a free help line and an interactive website for consumers.
For Caregivers, Costs Add Up Quickly
John Schall, CEO of the nonprofit Caregiver Action Network, says for the nation’s 90 million family caregivers like Burgunder, “Medicaid and home- and community-based services can make all the difference.” Out-of-pocket expenses can quickly add up, often reaching $10,000 a year for caregivers, he says.
Medicaid is funded half by the federal government and half by the states. If the American Health Care Act becomes law, it will slash the federal contribution to Medicaid by $839 billion over the next decade and cap the support to each state. Under such cuts, according to a March analysis by the Congressional Budget Office (CBO), Medicaid spending by 2026 will be 25% less than it would have been under current law. Under the House bill, the CBO estimates, 5 million fewer people annually would be covered by Medicaid than under Obamacare. The CBO will soon update its analysis to reflect the version of the bill the House passed in May.
Proponents of that bill have said their aim is to give states more flexibility in shaping their Medicaid programs. “But flexibility in the absence of dollars doesn't mean more benefits for people,” Sanders says. “The funding has to be there to support the flexibility.”
Sharp cuts would force states to make tough choices, Sanders and other experts say. They could result in tightening eligibility for Medicaid, removing people who have coverage, cutting services or reducing Medicaid’s payments to service providers, including home care agencies, many of which already pay aides minimum wage. The proposed cuts to Medicaid would accelerate over time, with most going into effect beginning in 2020, just as many boomers will likely begin to need home- and community-based services.
“What does this mean for the 70 to 80 million people over 65 who will be relying on these programs in 2030?” Sanders asks. “This is absolutely the wrong time to be pulling back on some of these investments.”
Keeping Support Is Already a Battle
Burgunder says she’s worried what the proposed Medicaid cuts would mean for her and Randall. “I got a taste of the coming reductions in Medicaid if current thinking continues,” she says. In April, the Medicaid Managed Long-Term Care program that administers Randall's coverage told her that based on their most recent assessment of his needs, his covered care hours would be decreased by more than half, to 22 hours a week.
“I can only tell you I was apoplectic,” Burgunder says. She contacted Randall’s doctors and social worker, the Medicaid nurse, the Medicare Rights Center — everyone she could think of. With their help, she was able to get the decision reversed.
“If they had reduced those hours, I could no longer work. He can’t be alone,” she says. “I’m working partly because I enjoy it and partly for my own financial well being.”
She doubts she could care for Randall full-time. He would likely end up in a nursing home, with Medicaid covering the cost.
Somebody is going to have to tell me why I should support the healthcare bills as they are currently written and being discussed in the house and senate. I know it could be tweaked and modified over the next few weeks before they come up with a final product... but somebody is going to have to sell me on why I should support it. And "It's not Obamacare" isn't a good enough sales pitch. I don't like Obamacare but so far, I fail to see how this is an improvement... but I'm willing to listen.
I don't like Obamacare but so far, I fail to see how this is an improvement... but I'm willing to listen.
DC...EXACTLY!
This far too important and will affect many more families than the American people realize...veterans, grandma, grandpa, sick, disabled.
Too important to ram through on a political vote..details must be addressed..each and every detail.
Then there is the reason WHY we are even talking about this issue...it's all tied to more Trickle Down economics and tax cuts for those who need the cuts the least.
Address the shortcomings of the present healthcare system and make it better. Take the savings and pay down the debt.
And so far, I've heard a lot of what sounds seriously flawed. Something to the effect of, "Well Obamacare is dying so we have to do something."
There's no doubt that Obamacare has its problems and needs to be fixed, but that's no excuse to pass a crappy deal. What they're doing is taking over 800 billion from medicaid and giving that money out in tax cuts. That's not a healthcare plan. That's a tax cut plan.
Intoducing for The Cleveland Browns, Quarterback Deshawn "The Predator" Watson. He will also be the one to choose your next head coach.
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