WTF Community

Health Care News, Analyses, and Updates Under Trump

General Discussion
#1

This topic is for discussing news and/or collecting resources pertaining to health care under the Trump Administration.

Examples of health-related subjects of interest: :mag_right: :hospital:

  • Existing health insurance laws and issues (Affordable Care Act / Obamacare, Medicare, Medicaid, etc.)
  • Local or federal congressional legislation (recently proposed, passed, or enacted bills) and legal challenges, public response, and implications
  • Fact-checking political claims about health care policies, laws, or related events
  • Evidence-based analyses or reports containing insightful stats and research data
  • Official statements (or tweets) by Trump, the White House, Department of Health and Human Services, National Institutes of Health, CDC, etc. and private sector or non-profit organizations and associations weighing in on those decisions or announcements
  • Major public health initiatives or changes in international assistance programs
  • Health policy goals or ideas (opinions and visions of problems, solutions, and future directions)
  • Specific themes (for example, focusing on the opioid epidemic, prescription drug costs, women’s health, etc.)
  • People’s personal stories, specifically in the context of how their lives or businesses are affected by health law or policy changes
  • America’s health care system in general (performance, cost, delivery, global standing and international comparisons, etc.)

Feel free to contribute by posting:

  • Mainstream news articles and your reaction to them
  • Institutional reports or expert commentary from think tanks, universities, or research groups
  • Educational materials explaining health industry terminology and health care concepts to further contextualize the news
  • Personal write-ups (either creating your own or linking to blogs, informed social media posts, etc.)
  • Helpful summaries

(Anything, really. These are just suggestions to get us started :slightly_smiling_face:)

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#2

Latest on Medicare for All
Bernie Sanders is introducing his Medicare for All bill tomorrow – Wednesday, 9/13 at 3pm EST. Currently, he has 9 co-sponsors – Ben Wikler from MoveOn.org has a running thread of all of them on Twitter: here. (Also, a great follow on Twitter for Healthcare.)

There is also Brian Schatz (D-HI)’s Medicaid as a public option plan and Chris Murphy (D-CT)’s Medicare as a universal public option plan, both which would be stepping stones to universal/single payer healthcare.

Hillary Clinton was on Pod Save America today and spoke about the concept Medicare for All concept briefly. Personally (bias aside – as I believe this for some time), I agree with her take that steps like a public option much like Schatz & Murphy’s plans would probably be the better route. Medicare for All is a great goal. However, our healthcare system is too complex for that type of change right now. Taking steps to improving the ACA and progressively working towards a Medicare for All system have much higher chances of passing in Congress, since there is intense public support for healthcare as a right, to get moderates on board from both sides of the aisle.

In additional news, Max Baucus (key architect of the ACA) now backs a single payer system – shocking many former Obama staffers, who worked with Obama during that time and many healthcare experts (notably, Sarah Kliff from Vox).

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Current Status: Where we're at with all the storylines
#4

The posts linked to this entry are a spin-off of what was initially supposed to be a brief health care update submitted to another thread.

They have since become longer write-ups on the recent history of Congress’ failed attempts to repeal and replace Obamacare, how the Affordable Care Act (ACA) has fared and weathered “sabotages” by Trump and Republicans since January 2017, and what is currently being debated and worked on in Congress after their return from summer recess.

(These overviews are by no means comprehensive and may contain inaccuracies. Please feel free to make suggestions, comments, and/or corrections.)

  • Undertaking Trumpcare: Legislative news and events from January–August 2017.¹
  • GOP Attacks Obamacare: The mandate, some myths, and a legend (to decode what’s up with the ACA nowadays).
  • An Act of Desperation: GOP bill and residual efforts to repeal ACA still underway (September 30 deadline), but main focus turns to stabilizing the Marketplace. Progressives also float the idea of a single-payer health system or “public option” to aim for universal coverage.

¹ Alternate title: “Lordy of the Circus Ring: You shall not pass terrible legislation.”

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Current Status: Where we're at with all the storylines
#5

Obamacare’s “navigator programs” for in-person outreach, education, and sign-up assistance begin to scale back or shut down after Trump’s 41% funding cut.

And a follow-up to Trump’s 90% funding cut to drop advertisements right before the ACA sign-up period in November.

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#6

Nice summary of some of the broader changes that could potentially be expected for certain groups under a Medicare-for-All system:

Helpful resource with detailed information for every health insurance exchange by state:

Two-thirds of Virginia was recently at risk of having no insurer in the Marketplace next year. They are now covered (again), but the effect Trump has had on insurance premium rates is readily apparent.

For example, in Virginia:

  • CareFirst Blue Choice rates for 2018 will now increase 49% (up from 16%) on the assumption Obamacare’s individual mandate will not be enforced under Trump.
  • Health Keepers (Anthem) will go from a 38% to 56% increase assuming Trump doesn’t pay cost-sharing reductions (CSRs).
  • Kaiser Foundation Health Plans will increase rates from 24% to 35% due to no CSRs.
  • Optima Health rates will jump from a 19% to 73% increase due to no CSRs and in anticipation of other major insurers dropping out of their service regions.
  • Piedmont HMO rates will go from a 10% to a 42% increase due to no CSRs.
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#7

The latest Graham-Cassidy (GC) bill for health care reform has gained more momentum than previously anticipated. They only have to secure 3 or so additional votes to reach 50.

It’s less likely Murkowski or Collins (Alaska & Maine) will vote “yes” because most of the same problems they cited before still exist. The bill also drains some funds from their states (along with 32 others), but there is some discussion of giving Alaska special treatment
with 48% more funds per person (although still a funding cut compared to current law).

I want to believe McCain would vote against the bill, but the governor of Arizona has come out strongly in support of it.

Yet, many of the same medical associations, patient advocacy groups, hospitals, and insurers from before have publicly denounced this bill too.

One thing GOP has on their side is sheer desperation and a deadline by next Wednesday to pass something (anything) to repeal Obamacare, especially because Republicans promised to do so for the past 7 years. The biggest motivator, however, is probably from donors who have threatened to withhold funds until GOP passes a major piece of legislation.

This week, Republican leadership even tried to sideline a separate bipartisan effort designed to help stabilize the ACA.

To top things off, an official CBO budget score for the bill won’t be available by next week.

A couple independent but unofficial analyses have already contradicted some of Senator Cassidy’s claims.

#8

All 50 members of the Board of the National Association of Medicaid Directors issued a statement coming out against the Graham-Cassidy Obamacare repeal bill.

Other major health organizations and groups that disapprove:

  • American Medical Association (AMA)
  • American Pediatrics Association (APA)
  • Association of American Medical Colleges (AAMC)
  • America’s Health Insurance Plans (AHIP)
  • American Heart Association (AHA) + 16 more patient advocacy groups
  • Blue Cross Blue Shield Association (BCBSA)
  • Planned Parenthood (PP)
  • American Association of Retired Persons (AARP)
  • HIV Medicine Association
  • Alzheimer’s Association
  • American Cancer Society (ACS)
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#9

I’m fucking shocked, but McCain is apparently a “no” vote on Graham-Cassidy. Sen Collins probably is as well, and I can’t wait to hear which way Sen Murakowski goes.

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#10

HHS is still hard at work at killing the ACA, from the inside.

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#11

HHS unexpectedly told states their regional directors will not be partnering or coordinating with them to educate and sign people up during open enrollment.

Much like the ACA navigator program and advertisement budget (promised to them just a few weeks before cuts) & much like DACA (promised DREAMers they didn’t need to worry about being deported), HHS reassured advocacy groups their staff would assist (until they dropped out a week before scheduled events).

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#12


I’m not sure how recent these events are, but evidently, HHS has said they will not investigate claims of transgender healthcare rights violations, and Trump plans to remove those regulations.

:persevere:

#13
#3

My thoughts align with this article from a couple weeks ago providing “lessons learned” from GOP’s inability to come to a consensus and their failure by taking on too much at once.

  • Do it step by step w/ incremental bills and a narrower scope.
  • Parties must decide what they want (otherwise they become too fragmented).
  • Details matter: Bill should go through hearings. The less complex it is, the easier it’ll be to get other people on board.
  • Bipartisanship/compromise is required: Unilateral changes will just be undone or undermined when majority party in Congress switches.
  • Ditch slogans: Get realistic and specific.
  • Don’t overpromise.
  • ACA will be changed, but Republicans can’t get rid of it altogether.

I doubt we’d get to universal coverage or single-payer within the next couple major election cycles, but I agree single-payer is a good goal to aim for. The earlier we get the word out, the more people get used to the idea and improve upon current proposals.

Also, guess which states would likely benefit the most from a public option?

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