Republicans renew attempts to repeal Obamacare

Amanda Michelle Gomez

Amanda Michelle Gomez Health Reporter, Think Progress

A group of Republicans and Washington D.C. think tanks released a proposal Tuesday that aims to resurrect Obamacare repeal. The consistent chatter around the proposal has drawn ire from the White House and GOP leadership, as the midterms are just months away, and repeal efforts haven’t proved to be winning strategies.

The seven-page whitepaper titled “The Health Care Choices Proposal: Policy Recommendations to Congress” asks lawmakers to scrap the Affordable Care Act (ACA) and replace it with block grants. In other words, the bill would eliminate Obamacare subsidies and Medicaid expansion, and give states a fixed dollar amount so they can set up their own health system.

“But Obamacare is broken, can’t be fixed, and continues to do great harm. What’s needed is a fresh approach — one that gives Americans more choices of private, affordable coverage while making sure the most vulnerable are protected,” the proposal reads.

The “fresh approach” resembles the Graham-Cassidy bill, one of six failed GOP health bills from last summer that effectively deregulated the insurance market. “States decide how much insurers can charge people who are sick, required benefits, and cost-sharing,” Kaiser Family Foundation’s Larry Levitt said last September of the bill. Had it been enacted, millions of additional people would be uninsured, according to the Congressional Budget Office.

Last year’s Graham-Cassidy bill didn’t even make it to a floor vote, as there were too many Senate hard “no’s” against Obamacare repeal. It’s hard to see how this proposal is any different.

Should Obamacare repeal efforts return, the group of think tanks (including the Heritage Foundation, American Enterprise Institute, Galen Institute, and Manhattan Institute) led by former Republican Sen. Rick Santorum (PA), will likely give Democrats another health issue with which to campaign on.

The ACA is fairly popular, but it’s even more popular when it’s under attack. And health care ranks higher as a campaign issue for Democrats, mobilizing them to the polls. The Trump administration already handed Democrats a strong campaign weapon when they argued in court that protections for people with pre-existing conditions are unconstitutional.

“All these people out there not responsible for elected real-life senators don’t seem to realize there are consequences for failed votes,” one top Senate GOP aide recently told the Daily Beast. “We experienced them last summer. I don’t understand why we would want to have that again.”

When Republicans talk health care — particularly those who face tough midterm races — they usually bring up less contentious issues like opioid bills they’ve sponsored. And Obamacare repeal could be disastrous for people with substance use disorder, as Medicaid expansion helps cover a lot of people who need addiction treatment.

Graham-Cassidy 2.0

A major difference between the latest Republican proposal and that of last year’s is that the recent one does not significantly cut Medicaid. Under Graham-Cassidy 2.0, states have to offer “premium assistance” to people enrolled in Medicaid insurance. “Allowing people to cash out their Medicaid benefit in a world [with] no [pre-existing] protections likely raises federal costs significantly, as we would expect only the healthier Medicaid beneficiaries to take advantage,” tweeted Brookings Institution’s Loren Adler. In other words, the federal government will likely have to foot the bill for the sicklier Medicaid crowd.

Last year’s Graham-Cassidy bill was also criticized for using a formula that penalized states who expanded Medicaid. In this proposal, these states are still losers, tweeted Levitt.

As the think tanks try to encourage lawmakers to undo the Obama-era health law, people who purchase insurance on the individual market stand to lose. For states to receive block grant funding, they don’t have to require insurers to provide all 10 essential health benefits afforded under the ACA. And insurers can charge older people significantly more.

States and insurers have to follow some rules. For example, under the proposal, no health plan can cover abortion. While federal funding is already prohibited from directly funding the procedure, ACA health plans can cover abortion using other dollars; some 28 states provide some or all coverage for elective abortions.

Graham-Cassidy 2.0 may very well go nowhere, but it’s hardly the only way conservatives are trying to skirt health law. The Trump administration is expected to finalize a proposal Tuesday afternoon to free up association health plans. Small businesses and self-employed businesses can band together and buy insurance that do not comply with ACA rules. The plans are not, for example, required to cover maternity care or addiction treatment.


Reposted from Think Progress

Posted In: Allied Approaches

Union Matters

Get to Know AFL-CIO's Affiliates: National Association of Letter Carriers

From the AFL-CIO

Next up in our series that takes a deeper look at each of our affiliates is the National Association of Letter Carriers.

Name of Union: National Association of Letter Carriers (NALC)

Mission: To unite fraternally all city letter carriers employed by the U.S. Postal Service for their mutual benefit; to obtain and secure rights as employees of the USPS and to strive at all times to promote the safety and the welfare of every member; to strive for the constant improvement of the Postal Service; and for other purposes. NALC is a single-craft union and is the sole collective-bargaining agent for city letter carriers.

Current Leadership of Union: Fredric V. Rolando serves as president of NALC, after being sworn in as the union's 18th president in 2009. Rolando began his career as a letter carrier in 1978 in South Miami before moving to Sarasota in 1984. He was elected president of Branch 2148 in 1988 and served in that role until 1999. In the ensuing years, he worked in various roles for NALC before winning his election as a national officer in 2002, when he was elected director of city delivery. In 2006, he won election as executive vice president. Rolando was re-elected as NALC president in 2010, 2014 and 2018.

Brian Renfroe serves as executive vice president, Lew Drass as vice president, Nicole Rhine as secretary-treasurer, Paul Barner as assistant secretary-treasurer, Christopher Jackson as director of city delivery, Manuel L. Peralta Jr. as director of safety and health, Dan Toth as director of retired members, Stephanie Stewart as director of the Health Benefit Plan and James W. “Jim” Yates as director of life insurance.

Number of Members: 291,000 active and retired letter carriers.

Members Work As: City letter carriers.

Industries Represented: The United States Postal Service.

History: In 1794, the first letter carriers were appointed by Congress as the implementation of the new U.S. Constitution was being put into effect. By the time of the Civil War, free delivery of city mail was established and letter carriers successfully concluded a campaign for the eight-hour workday in 1888. The next year, letter carriers came together in Milwaukee and the National Association of Letter Carriers was formed.

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There is Dignity in All Work

There is Dignity in All Work