Regulatory Action To Destabilize The Aca
When GOP lawmakers failed to repeal the ACA in 2017 , the Trump administration started looking for ways to chip away at the law via regulations instead. As mentioned above, the administration has opted to significantly reduce the federal funding that was being used to help people enroll in plans offered through the exchanges. But there have also been some regulations that have further undermined the ACA-compliant markets, mainly by making it easier for people to enroll in plans that dont meet the ACAs requirements for individual and small group coverage.
In June 2018, the Trump Administration finalized regulations that allowed self-employed people and small businesses to join association health plans without having a commonality of interest or a purpose for the association other than obtaining health insurance. This regulation has been struck down by a federal judge and although the case is being appealed, the Department of Labor has confirmed that association health plans based on the 2018 regulations cannot currently be marketed to sole proprietors and small businesses.
The Trump administration has issued regulations that allow employers to reimburse employees for the cost of individual market coverage. In addition, employers have the option of reimbursing employees for excepted benefits via an excepted benefits health reimbursement arrangement.
Eliminating Health Care Penalties
The Affordable care Act, required most Americans to be enrolled in Health Insurance since it was made affordable, otherwise a penalty would be induced. Effective 2017, congress attempted to eliminate financial penalties that were related to complying with the mandated law that every individual needs to be enrolled in Health insurance, this law however did not become effective until 2019. This policy is still valid, the penalty for having no health insurance was reduced to 0$. Individual mandates effects the decisions made by individuals regarding healthcare in that some people will not enroll since health insurance plans are no longer mandatory.
On March of 2020, the nation has undergone a global pandemic, however, several Republican-led states and the Justice Department are making the case for invalidating the ACA. This will cause at least 60 million people to not be able to afford being hospitalized, or treated which increased the number of COVID-19 cases nationwide.
A Final Vote Isn’t The Whole Story It’s Like Researching Your Ancestry And Going No Further Back Than Your Mother And Father
The day after she was one of three;Republican;senators to vote against;her party’s proposal to repeal chunks of the Affordable Care Act, Susan Collins of Maine posted a press release that said:;”Democrats made a big mistake when they passed the ACA without a single Republican vote. I don’t want to see Republicans make the same mistake.”
It was a nice nod in the direction of bipartisanship. But it also perpetuates a deceptive narrative, repeated often by Republicans,;that they were completely excluded from the process that resulted in Obamacare. While it is true that no Republican voted for the final bill, it is blatantly untrue that it contains no GOP;DNA. In fact, to make such an assertion is like researching your ancestry and going no further back than your mother and father.;
Not only were Republican senators deeply involved in the process up until its conclusion, but it’s a cinch that the ACA;might have become law months earlier if;the Democrats, hoping for a bipartisan bill, hadn’t spent enormous time and effort wooing GOP senators only to find themselves gulled by false promises of cooperation. And unlike Majority Leader Mitch McConnell’s semi-secret proceedings that involved only a handful of trusted colleagues, Obamacare, until the very end of the process, was open to public scrutiny.
More:Spare America a do-over on health care. Seize the bipartisan moment.
POLICING THE USA: A look at;race, justice, media
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Republicans Win Fewer Votes But More Seats Than Democrats
Republicans controlled the post2010 redistricting process in the four states, and drew new lines that helped the GOP win the bulk of the House delegation in each. Republicans captured 13 of 18 seats in Pennsylvania, 12 of 16 in Ohio, nine of 14 in Michigan, and five of eight in Wisconsin. Added together, that was 39 seats for the Republicans and 17 seats for the Democrats in the four proObama states.
The key to GOP congressional success was to cluster the Democratic vote into a handful of districts, while spreading out the Republican vote elsewhere. In Pennsylvania, for example, Republicans won nine of their 13 House seats with less than 60% of the vote, while Democrats carried three of their five with more than 75%.
One of the latter was the Philadelphiabased 2nd District, where 356,386 votes for Congress were tallied. Not only was it the highest number of ballots cast in any district in the state, but Democratic Rep. Chaka Fattah won 318,176 of the votes. It was the largest number received by any House candidate in the country in 2012, Democrat or Republican. If some of these Democratic votes had been unclustered and distributed to other districts nearby, the party might have won a couple more seats in the Philadelphia area alone.
The Closest House Races of 2012
NARROW DEMOCRATIC WINNERS
Vulnerable Gop Senators Vote To Protect Affordable Care Act From Trump Lawsuit
Six Republican senators, five of whom are up for re-election in 2020, sided with Democrats on Thursday in a procedural vote to block the Trump administration from supporting a lawsuit that would dismantle the Affordable Care Act.
Why it matters: The final vote on the motion was 51-43, failing to reach the necessary 60-vote threshold to pass. But the move by Senate Minority Leader Chuck Schumer forced several vulnerable GOP senators to go on the record on whether they support the lawsuit, which could strip protections from pre-existing conditions for millions of Americans.
The state of play: Sens. Susan Collins , Joni Ernst , Cory Gardner , Martha McSally and Dan Sullivan all voted with Democrats and are facing close re-election fights. Sen. Lisa Murkowski also voted in favor.
- Sens. Steve Daines , Thom Tillis and David Perdue are facing tough re-election races, but voted against the motion.
Flashback: All six GOP senators who supported Thursday’s bill voted for the 2017 tax bill that set the latest Supreme Court challenge to the Affordable Care Act in motion.
Of note: Four of the Republicans to break rank were women nearly half of the nine female GOP senators in Congress.
- While Murkowski is not up for re-election until 2022, she opposed President Trump on quickly confirming a Supreme Court judge to replace the late Justice Ruth Bader Ginsburg and has publicly opposed the Trump administration on several occasions.
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Changes Required By The Affordable Care Act In 2011
- A provision goes into effect to protect patients choice of doctors. Specifics include allowing plan members to pick any participating primary care provider, prohibiting insurers from requiring prior authorization before a woman sees an obstetrician/gynecologist , and ensuring access to emergency care.
- Young adults can stay on their parents insurance until age 26, even if they are not full-time students. This extension applies to all new plans.
- All new health insurance policies must cover preventive care and pay a portion of all preventive care visits.
- A provision goes into effect that eliminates lifetime limits on coverage for members.
- Annual limits or maximum payouts by a health insurance company are now restricted by the ACA.
- The ACA prohibits rescission when a claim is filed, except in the case of fraud or misrepresentation by the consumer.
- Insurance companies must now provide a process for customers to make an appeal if there is a problem with their coverage. ;
NOTE: In January,;2011:;eHealth publishes 11 guides on the top;child-only health insurance coverage;that examined differences in implementation in numerous states.
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Poll Finds Startling Difference In Vaccinations Among Us Republicans And Democrats
A Washington Post-ABC News poll has found a startling difference between Democrats and Republicans as it relates to COVID-19;vaccination.;The poll found that while 86% of Democrats have received at least one COVID-19 vaccine shot, only 45% of Republicans;have.
In addition, the survey found;that while;only;6% of Democrats said they would;probably;decline;the vaccine, 47% of Republicans;said they;would;probably not;be inoculated.;
The poll also found that;60% of unvaccinated Americans believe the U.S. is;exaggerating;the dangers of;the;COVID-19;delta variant,;while;18% of the unvaccinated say the government is accurately describing the variants risks.
However, 64% of vaccinated Americans believe the government is accurately describing the dangers of the;delta variant.
Iran fighting COVID 5th wave The variant is having a;global impact.;Irans;President;Hassan Rouhani;has warned that the country is on the brink of a fifth wave of;a COVID-19 outbreak.;The;delta variant of the virus, first;identified;in India, is;largely;responsible;for the;rising number of hospitalizations and deaths in Iran, officials say.
All;non-essential businesses have been ordered;closed;in 275 cities, including Tehran, the capital.;Travel has also been restricted between cities that are;experiencing;high infection rates.
Reports say only about 5% of Iranians have been vaccinated.;
The Number Of Times Every Senate Republican Voted To Attack Preexisting Condition Protectionstheir Rushed Supreme Court Confirmation Will Be The Latest
The coronavirus has underscored how important it is that the American people have comprehensive, high-quality, and affordable health coverage.;More Americans than ever are;relying;on the Affordable Care Act for coverage; and yet, President Donald Trump and Republican attorneys general are suing to take away this critical lifeline in the middle of the pandemic. If the ACA is repealed, more than 20 million Americans could lose health coverage and 135 million could lose critical protections that prevent insurers from denying people coverage or charging them more for having preexisting conditions such as diabetes, cancer, and even COVID-19.
This case will be heard by the U.S. Supreme Court just one week after the election, which is why the president and Senate Republicans are rushing to install another rubber stamp for their political agenda following the passing of Justice Ruth Bader Ginsburgdespite just four years ago having opposed filling a Supreme Court vacancy during an election. This rushed confirmation push is;opposed;by the American people and comes while voting in the election is already underway.
This analysis provides a comprehensive look at how many times Senate Republican incumbents have voted to weaken the ACAs protections for preexisting conditions and makes clear why voters do not trust their efforts to push through a lifetime appointment that would put Americans health care at risk.
Table 1
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Opposition To Obamacare Becomes Political Liability For Gop Incumbents
In the 2014 elections, Republicans rode a wave of anti-Affordable Care Act sentiment to pick up nine Senate seats, the largest gain for either party since 1980. Newly elected Republicans such as Cory Gardner in Colorado and Steve Daines in Montana had hammered their Democratic opponents over the health care law during the campaign and promised to repeal it.
Six years later, those senators are up for reelection. Not only is the law still around, but its gaining in popularity. What was once a winning strategy has become a political liability.
Public sentiment about the ACA, also known as Obamacare, has shifted considerably during the Trump administration after Republicans tried but failed to repeal it. Now, in the midst of the COVID-19 pandemic and the ensuing economic crisis, which has led to the loss of jobs and health insurance for millions of people, health care again looks poised to be a key issue for voters this election.
Reminder: Obamacare Passed Without A Single Republican Vote
Back in 2009 and 2010, Democrats controlled the White House and the U.S. House and U.S. Senate. President Obama, Senate Majority Leader Harry Reid and then House Speaker Nancy Pelosi rammed Obamacare through without a single Republican vote.
The Washington Post said of the Obamacare fight at the time It has inflamed the partisanship that Obama pledged to tame when he campaigned for the White House and has limited Congresss ability to pass any other major legislation.
In December 2009, the U.S. Senate voted 60 to 39 for Obamacare. The Washington Post reported The Senate bill passed without a single GOP vote.
In March 2010, the U.S. House voted 219 to 212 for Obamacare. 34 House Democrats and all of the House Republicans voted against Obamacare. The NO votes were the only bipartisan votes.
President Obama signed the Patient Protection and Affordable Care Act on March 23, 2010.
President Obama embraces HHS Sec Kathleen Sebelius and House Speaker Nancy Pelosi after signing the health insurance reform bill, March 23, 2010.
Democrats ignored the plans offered by Republicans at the time including the House GOP plan drafted by Rep. Tom Price and The Patients Choice Act of 2009introduced by U.S. Senators Tom Coburn, M.D. and Richard Burr and U.S. Representatives Paul Ryan and Devin Nunes .
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Isans Are Split On The Supreme Court Overturning The Aca
In June 2020, the Trump administration issued a brief asking the U.S. Supreme Court to overturn the ACA. The brief was filed in support of an ongoing challenge to the ACA by a group of Republican attorneys general in California v. Texas, a case that challenges the legality of the ACA in light of the zeroing out of the individual mandate penalty in the 2017 Tax Cuts and Job Acts. The death of Supreme Court Justice Ruth Bader Ginsburg on September 18 and the possibility of the Senate confirming a new Justice appointed by President Trump before the presidential election has brought heightened attention to the potential outcome of this case and the future of the ACA. In October 2020, a majority of the public said they do not want to see the Supreme Court overturn the 2010 health care law, and eight in ten said they do not want to see the ACAs protections for people with pre-existing conditions overturned. There are partisan differences on both questions, with the majority of Democrats and independents saying they dont want the Court to overturn the ACA or pre-existing condition protections. However, among Republicans, three-fourths say they want to see the ACA overturned, but two-thirds say they do not want to see pre-existing condition protections overturned.
Figure 2: Majorities Do Not Want Court To Overturn ACAs Pre-Existing Condition Protections, Republicans Want Entire Law Overturned
Russia Sanctions Headed To Trumps Desk Will He Sign
Some GOP senators worried the measure would go back to the House, where leaders would put it on the floor, pass it and send it to Trump who has said he would sign whatever lands on his desk when it comes to Republican-passed health care legislation.
Before the vote, at 10:43 p.m. ET, Trump was rooting them on in a tweet: Go Republican Senators. Go!
Afterward, it was a different story, with the president tweeting at 2:25 a.m. ET that those who voted no had let the American people down.
Its somewhat ironic that McCain was the one to derail what seemed like a sure Trump victory . After all, Trumps comments about the former prisoner of war were among the earliest to land the then-candidate in controversy.
Hes not a war hero, Trump said in 2015 of McCain. He was a war hero, because he was captured. I like people who werent captured. Hes been losing so long he doesnt know how to win anymore.
That was likely never lost on McCain.
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Actions To Hinder Implementation
Under both ACA and the AHCA, CBO reported that the health exchange marketplaces would remain stable. However, Republican politicians took a variety of steps to undermine it, creating uncertainty that adversely impacted enrollment and insurer participation while increasing premiums. Concern of the exchanges became another argument for reforms. Past and ongoing Republican attempts to weaken the law have included:
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Requirements For Health Plans And Insurers
Coverage
The Affordable Care Act prohibited individual market insurers from denying coverage to people with pre-existing conditions. This policy is known as guaranteed issue. Guaranteed issue regulations had already existed for insurers selling employer-sponsored health plans, and the ACA extended this rule to the individual market as well.
The law also required insurers to allow young adults to stay on their parents’ health insurance plans until age 26. Insurers were also required to allow people in the individual market to renew their health plans each year unless they did not pay their premiums.
Benefits
The ACA required individual and small group health plans that were offered both on and off the exchanges to cover services that fall into 10 broad benefits categories, called essential health benefits:
- Ambulatory patient services
- Rehabilitative and habilitative services and devices
- Prescription drugs
- Mental health and substance use disorder services, including behavioral health treatment
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
Premiums
The ACA placed restrictions on the way individual and small group insurers set a plan’s premiumThe amount a consumer is required to pay for a health insurance plan. Premiums are usually paid monthly, quarterly or annually.:
Medical loss ratio
Stabilization programs
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