Graham-Cassidy – R&R – Reachout and Rebuild

Zeldin Must Stand Up And Protect Long Island’s Health Care

David Posnett — Mon, 25 Sep 2017 17:27:26 +0000

Letter To Editor: Zeldin Must Stand Up And Protect Long Island’s Health Care

Published in “Smithtown Matters”, Friday, September 22, 2017 at 6:08PM

Dear Editor,

Next week, Senate Republicans will debate a cruel plan to take away health care from millions of Americans and tens of thousands of Long Islanders. Under the Graham-Cassidy bill, there would be a massive shift of federal support from “blue” states to “red” – especially from New York to Texas. In fact, New York could lose more than $45 billion dollars in federal funding. This would create enormous market uncertainty and devastate thousands of Long Islanders, particularly working families, the elderly, and the disabled.

Where is Rep. Lee Zeldin on the bill? Does he realize how much funding would be stripped from New York? Does he care? Even some New York Republicans, like Rep. Tom Reed and Rep. Peter King, have come out against Graham-Cassidy. I urge Rep. Zeldin – who voted to strip health care from millions of Americans earlier this summer – to stop playing politics with the lives of Long Islanders and oppose this bill for the good of his constituents.

Perry Gershon

Democratic candidate for New York’s 1^st congressional district

Also, check this out:

http://www.businessinsider.com/graham-cassidy-healthcare-bill-obamacare-insurance-2017-9

David Posnett MD

An Act of Mass Suicide

David Posnett — Sun, 24 Sep 2017 17:06:28 +0000

If the U.S. Adopts the G.O.P.’s Health-Care Bill, It Would Be an Act of Mass Suicide

By Atul Gawande

September 22, 2017

There is not a single metric of health or health care that the Graham-Cassidy plan—co-sponsored by Senator Lindsey Graham, of South Carolina—makes better.

Photograph by Mark Peterson / Redux

The fundamental thing to understand about Senate Republicans’ latest attempt to repeal Obamacare is that the bill under consideration would not just undo the Affordable Care Act—it would also end Medicaid as we know it and our federal government’s half-century commitment to closing the country’s yawning gaps in health coverage. And it would do so without putting in place any credible resources or policies to replace the system it is overturning. If our country enacts this bill, it would be an act of mass suicide.

In my surgery practice in Boston, I see primarily cancer patients. When I started out, in 2003, at least one in ten of my patients was uninsured. Others, who had insurance, would discover in the course of their treatment that their policies had annual or lifetime caps that wouldn’t cover their costs, or that they would face unaffordable premiums going forward because they now had a preëxisting condition. When he was governor of Massachusetts, it was Mitt Romney, a conservative, who brought Republicans and Democrats together to make a viable state system of near-universal coverage. That system then served as a model for the A.C.A. The results have been clear: increases in coverage have markedly improved people’s access to care and their health. For the last four years, health-care costs in Massachusetts have risen more slowly than the national average—while the national numbers themselves have been at historic lows. I have not seen a single uninsured patient—zero—in a decade. And now comes an utterly reckless piece of legislation that would destroy these gains.

To review how we got to this point: last spring, the House passed a health-care-reform bill that proposed to hollow out the A.C.A.’s funding, insurance mandates, and protections for people with preëxisting conditions. It was immensely unpopular with the public. The problem was not just that twenty-three million Americans would lose their health insurance if the bill becomes law but also the Republicans’ vision of a health system where insurance with deductibles of five thousand dollars and more, and little or no primary-care coverage, would become the norm. This summer, Senate Republicans failed to secure enough votes to pass a modified version of the House bill. Later, in a dramatic late-night session, the Senate also rejected, by a single vote, a “skinny” repeal bill. That bill would have repealed only the parts of the A.C.A. that required large businesses to insure their workers and all Americans to carry coverage. It would have resulted in a mere sixteen million more uninsured people, according to estimates.

The Republican bill currently being rushed to a vote was put forward by a group of senators led by Lindsey Graham, of South Carolina, and Bill Cassidy, of Louisiana. As has become the apparent rule for Republican health-care bills, there have been no hearings or committee reviews of the Graham-Cassidy bill. And, this time, lawmakers and the public do not even have a Congressional Budget Office analysis of the effects the bill would have on the budget, insurance costs, or the uninsured rate.

This is unprecedented: senators are moving ahead with a vote on a bill that would alter the health care of every American family and the condition of a sixth of our entire economy, without waiting to hear any official, independent estimates of the consequences. The irresponsibility is as blithe as it is breathtaking. Before becoming a senator, Cassidy spent twenty-five years working as a physician in hospitals devoted to the uninsured. I find it baffling that a person with his experience would not recognize the danger of this bill. But here we are.

The Graham-Cassidy bill goes even further than the bill passed by the House. It would bring to a virtually immediate end not only the individual and employer mandates but also the whole edifice of the Medicaid expansion, insurance exchanges, and income-based coverage subsidies set up under the A.C.A. Graham-Cassidy expects all fifty states to then pass, and implement, alternative health systems for tens of millions of people within two years—with drastically less money, in most states, than the current law provides. This is not just impossible. It is delusional.

Like the House bill, Graham-Cassidy would cut Medicaid payments for traditional enrollees—the elderly in nursing homes, pregnant women in poverty, disabled children, etc.—by a third by 2026. A portion of the money saved would go into a short-term fund for states to use for health-care costs. The rationale is that this would give states “flexibility” to design coverage for their residents as they see fit. But the amount of funding provided is, by multiple estimates, hundreds of billions of dollars below what the A.C.A. provides. The bill also nakedly shifts funds from Democratic-leaning states that expanded Medicaid under the A.C.A. to Republican-leaning states that didn’t. Analyses indicate that states like California, Massachusetts, and New York will receive block-grant funding anywhere from thirty-five to almost sixty per cent below the health-care funding their residents would receive under current law. Much of those missing funds would be transferred to states like Texas, Mississippi, and Wisconsin. And special deals to make further shifts from blue states to red states such as Alaska are being negotiated to win votes.

As for what states can do with the funds they do receive, they would not be allowed to use them to enroll people in Medicaid, or able to establish a single-payer system. And states would not be receiving enough to continue Obamacare on their own. The only options for spending are for commercial coverage. States will be permitted to let insurers bring back higher costs for people with preëxisting conditions and to reinstate annual and lifetime limits on coverage. And then, starting in 2026, the funding turns out to only be temporary. Under the bill’s provisions, unless further action is taken then, four trillion dollars will be removed from health-care systems over twenty years.

With these massive sums being flung around, it is easy to forget that this is about our health as human beings. The evidence is that health-care programs like the A.C.A. save lives. The way they do so is by increasing the number of people who have affordable access to a regular source of care and needed medications. Such coverage has been shown to produce a substantial and increasing reduction in mortality—especially among those with chronic illnesses, such as heart disease, cancer, or H.I.V.—in as little as five years.

Virtually all of us, as we age, will develop serious health conditions. A critical test of any health reform, therefore, is whether it improves or reduces our prospects of having the continuous care and medicines we need when we come to have a chronic illness. The Graham-Cassidy bill fails this test. It will terminate Medicaid coverage and insurance subsidies for some twenty million people. The entire individual-insurance market will be thrown into a tailspin. Federal protections for insurance coverage will be gone.

Every major group representing patients, health-care professionals, health-care institutions, and insurers has come out vociferously against this plan. Governors from Alaska to Ohio to Virginia have opposed the bill. In a highly unusual, bipartisan statement, the national association representing the Medicaid directors of all fifty states has also opposed the bill. The top health official in Louisiana, Cassidy’s home state, has opposed the new plan. There is not a single metric of health or health care that the Graham-Cassidy plan makes better. This bill is a national calamity. It should not even come to a vote.

Governors’ Letter Opposing the Graham-Cassidy Bill

David Posnett — Wed, 20 Sep 2017 13:46:19 +0000

September 19, 2017

The Honorable Mitch McConnell Majority Leader
United States Senate
317 Russell Senate Office Building Washington, D.C. 20510

The Honorable Charles E. Schumer Minority Leader
United States Senate
322 Hart Senate Office Building Washington, D.C. 20510

Dear Majority Leader McConnell and Minority Leader Schumer:

As you continue to consider changes to the American health care system, we ask you not to consider the Graham-Cassidy-Heller-Johnson amendment and renew support for bipartisan efforts to make health care more available and affordable for all Americans. Only open, bipartisan approaches can achieve true, lasting reforms.

Chairman Lamar Alexander and Ranking Member Patty Murray have held bipartisan hearings in the Senate’s Health, Education, Labor and Pensions (HELP) Committee, and have negotiated in good faith to stabilize the individual market. At the committee’s recent hearing with Governors, there was broad bipartisan agreement about many of the initial steps that need to be taken to make individual health insurance more stable and affordable. We are hopeful that the HELP committee, through an open process, can develop bipartisan legislation and we believe their efforts deserve support.

We ask you to support bipartisan efforts to bring stability and affordability to our insurance markets. Legislation should receive consideration under regular order, including hearings in health committees and input from the appropriate health-related parties. Improvements to our health insurance markets should control costs, stabilize the market, and positively impact coverage and care of millions of Americans, including many who are dealing with mental illness, chronic health problems, and drug addiction.

We look forward to continuing to work with you to improve the American health care system.

Sincerely,

John Hickenlooper Governor
State of Colorado

Bill Walker Governor State of Alaska

John Kasich Governor State of Ohio

Steve Bullock Governor
State of Montana

Tom Wolf
Governor
State of Pennsylvania

John Bel Edwards Governor
State of Louisiana

Charles D. Baker Governor
State of Massachusetts

Terence R. McAuliffe Governor
State of Virginia

Brian Sandoval Governor
State of Nevada

Phil Scott Governor
State of Vermont

Jimmy Kimmel Shreds the Graham-Cassidy Bill

David Posnett — Wed, 20 Sep 2017 13:15:35 +0000

From his monologue:

“I know you guys are going to find this hard to believe. But a few months ago, after my son had open heart surgery … a senator named Bill Cassidy from Louisiana, was on my show and he wasn’t very honest,” Kimmel said, kicking things off. Here’s a transcript of most of Kimmel’s remarks, which got heated, especially toward Cassidy — and he had a few choice words for people who will criticize him for politicizing his son’s health problems.

It seemed like [Cassidy] was being honest. He got a lot of credit and attention for coming off like a rare, reasonable voice in the Republican Party when it came to health care for coming up with something he called — and I didn’t name it this, he named it this — the Jimmy Kimmel test, which was in a nutshell: No family should be denied medical care, emergency of otherwise, because they can’t afford it. He agreed to that. He said he would only support a health-care bill that made sure a child like mine would get the health coverage he needs no matter how much money his parents make.

And that did not have annual or lifetime caps. These insurance companies, they want caps, to limit how much they can pay out. So for instance, if your son has to have three open heart surgeries, it can cost hundreds of thousands of dollars apiece. If he hits his lifetime cap of, let’s say, a million dollars, the rest of his life, he’s on his own.

Our current plan protects Americans from these caps and prevents insurance providers from jacking up the rates for people who have preexisting conditions of all types. And Sen. Cassidy said his plan would do that, too. He said all of this on television many times.

(Clip of Sen. Cassidy on CNN saying, “I ask, does it pass the Jimmy Kimmel test? Would the child born with a congenital heart disease be able to get everything she or he would need in the first year of life? I want it to pass the Jimmy Kimmel test.”)

So last week, Bill Cassidy and Sen. Lindsey Graham proposed a new bill, the Graham-Cassidy bill. And this new bill actually does pass the Jimmy Kimmel test, but a different Jimmy Kimmel test. With this one, your child with a preexisting condition will get the care he needs — if, and only if, his father is Jimmy Kimmel. Otherwise, you might be screwed.

Now, I don’t know what happened to Bill Cassidy. But when he was on this publicity tour, he listed his demands for a health-care bill very clearly. These were his words. He said he wants coverage for all; no discrimination based on preexisting conditions; lower premiums for middle-class families; and no lifetime caps. And guess what? The new bill? Does none of those things.

Coverage for all? No. Fact, it will kick about 30 million Americans off insurance. Preexisting conditions? Nope. If the bill passes, individual states can let insurance companies charge you more if you have a preexisting condition. You’ll find that little loophole later in the document after it says they can’t. They can, and they will.

But will it lower premiums? Well, in fact, for lots of people, the bill will result in higher premiums. And as far as no lifetime caps go, the states can decide on that, too, which means there will be lifetime caps in many states. So not only did Bill Cassidy fail the Jimmy Kimmel test, he failed the Bill Cassidy test. He failed his own test. And you don’t see that happen very much.

This bill that he came up with is actually worse than the one that, thank God, Republicans like Susan Collins and Lisa Murkowski and John McCain torpedoed over the summer. And I hope they have the courage and good sense to do that again with this one, because these other guys who claim they want Americans to have better health care — even though eight years ago they didn’t want anyone to have health care at all — they’re trying to sneak this scam of a bill they cooked up in without an analysis from the bipartisan Congressional Budget Office.

They don’t even want you to see it. They’re having one hearing. I read the hearing’s being held in the Homeland Security Committee, which has nothing to do with health care. And the chairman agreed to allow two witnesses, Bill Cassidy and Lindsey Graham, to speak.

So, listen, health care is complicated. It’s boring. I don’t want to talk about it. The details are confusing, and that’s what these guys are relying on. They’re counting on you to be so overwhelmed with all the information you just trust them to take care of you, but they’re not taking care of you. They’re taking care of the people who give them money, like insurance companies. And we’re all just looking at our Instagram accounts and liking things while they’re voting on whether people can afford to keep their children alive or not.

Most of the congresspeople who vote on this bill probably won’t even read it. And they want us to do the same thing, they want us to treat it like an iTunes service agreement. And this guy, Bill Cassidy, just lied right to my face.

(Clip of Kimmel and Cassidy’s interview from May — Kimmel: “Do you believe every American regardless of income should be able to get regular checkups, maternity care, etc., all of those things, that people who have health care get and need?” Cassidy: “Yep.”)

So “yep” is Washington for “nope,” I guess. And I never imagined I would get involved in something like this, this is not my area of expertise. My area of expertise is eating pizza, and that’s really about it. But we can’t let them do this to our children, and our senior citizens, and our veterans, or to any of us.

And by the way, before you post a nasty Facebook message saying I’m politicizing my son’s health problems, I want you to know: I am politicizing my son’s health problems because I have to. My family has health insurance, we don’t have to worry about this. But other people do, so you can shove your disgusting comments where your doctor won’t be giving you a prostate exam once they take your health-care benefits away.

Letter to Sen. McCain

David Posnett — Tue, 19 Sep 2017 18:50:08 +0000

From Max Plesset MD (Springs, East Hampton)

Dear Senator McCain,

I have always respected your independence, judgement and thoughtful decision making. Now you have a serious malignancy and I am sorry for that. Undoubtedly you are receiving the best of care that the American health system has to offer. However, it is clear that the Graham-Cassidy bill will jeopardize the kind of care you are getting for a large number of our citizens and your constituents in Arizona. By transferring most if not all of the current federal health care dollars to block grants to the states many people, especially medicaid patients, will be at the mercy of the state spending priorities. Please uphold your integrity as you did before by voting no on this bill. Thank you for considering my email.

to send email to Sen. McCain:

https://www.mccain.senate.gov/public/index.cfm/contact-form