Tuesday, September 27, 2022

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Medicaid And Mental Health

The Trump Effect on Health Care

Trumps decision to reduce Medicaid will have a devastating effect on those who rely on it to provide treatment for mental illness or addiction. People are particularly concerned about the new healthcare bill and what it would mean amidst the opioid addiction epidemic that has taken over the country in recent years.

Medicaid is currently the single largest source of funding for mental health and substance abuse treatments. Much of the funding has been provided by Obamacare especially through its expansion to include low-income adults.

A significant portion of people with substance abuse and/or mental health issues have low incomes or are even homeless. Prior to the Affordable Care Act, most people with little income were ineligible for public insurance through Medicaid. Even those with lower middle class incomes who simply had inadequate insurance were unable to receive coverage for mental health until the ACA made significant expansions.

Sabotage Watch: Tracking Efforts To Undermine The Aca

President Trump said that, politically, the best thing to do would be to let the Affordable Care Act explode. This timeline tracked Trump Administration actions to sabotage the ACA by destabilizing private insurance markets or reversing the laws historic gains in health coverage.


For a graphic summarizing administration actions against the Affordable Care Act,

Shortly after President Trumps inauguration, he issues an executive order directing federal agencies to use their administrative powers begin dismantling the Affordable Care Act to the maximum extent permitted by law. The order instructs agencies, for example, to do what they can to grant exemptions or delay implementation of ACA provisions that impose a tax, fee, or other costs and to encourage development of a free and open market in health care services among states, while Congress works to pass repeal legislation.

The Administration announces that it will stop planned ads for the final week of open enrollment for marketplace health coverage.

After running ahead of 2016 enrollment totals through mid-January, final 2017 HealthCare.gov plan selections come in slightly below 2016.

Administrations first health care rule is billed as market stabilization, but would discourage enrollment and undermine market stability by making plans less affordable.


Health Plan Benefit, Rate Review, Management, and Oversight 51

The Archives Refers The Matter To The Justice Department

The archives tells the Justice Department that a preliminary review of the 15 boxes recovered in January indicated that they contained a lot of classified records, including highly classified records that were unfoldered, intermixed with other records and otherwise unproperly identified.

The next day, the House Oversight Committee announces an investigation into the records retrieved from Mar-a-Lago.

Spring 2022

Recommended Reading: Mossberg Patriot 10 Round Magazine

The Archives Recovers Sensitive Material From Mar

Officials from the archives retrieve 15 boxes containing presidential records and other sensitive material, along with various news clippings and other miscellanea. According to the Justice Department, the documents appear to contain national defense information, sometimes called N.D.I., which is protected by the Espionage Act.


The archives informs the Justice Department, which asks President Biden to request that the archives provide the F.B.I. with access to the boxes for examination. Later, when the Justice Department reviews the materials, investigators come to believe they have not recovered everything that Mr. Trump must return.

The One Way History Shows Trumps Personality Cult Will End

The CBO Bomb

An expert on autocracy assesses how far America has slipped away from democracy, and what it will take to get it back.

  • Link Copied

Michael Kruse is a senior staff writer at POLITICO and POLITICO Magazine.

In the summer of 2020, Ruth Ben-Ghiat was putting the final touches on her history of modern autocracy. She had to do it, though, without the benefit of knowing whether one of her most important subjects would remain in power come November.

But she wasnt exactly in the dark either.


She had seen enough of Donald Trumps behavior over the preceding five years to know how neatly he lined up with other strongmen she had studied and how his autocratic tendencies would influence his behavior whether he won or lost.

I just predicted that he wouldnt leave in a quiet manner, Ben-Ghiat, a professor of history and Italian studies at New York University told me recently. Hes an authoritarian, and they cant leave office. They dont have good endings and they dont leave properly.

Nearly two years later after a riot, an impeachment, and a monomaniacal campaign to punish the Republicans who tried to hold him accountable Ben-Ghiat has ample proof of her thesis. And she professes even more concern that Trumps sway over the GOP has permanently transformed the partys political culture. Hes changed the party to an authoritarian party culture, she told me. So not only do you go after external enemies, but you go after internal enemies. Youre not allowed to have any dissent.

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The Cost Of Trumpcare

The Committee for a Responsible Federal Budget did a review of Trumps healthcare plan. The following article shows a breakdown of costs: MEASURING TRUMPS HEALTHCARE PLAN. The result is a cost of roughly $550 billion over ten years under conventional scoring and about $330 billion with dynamic scoring .


Note that this analysis does not include Mr. Trumps call to negotiate aggressively for Medicare drugs, a policy that is not listed on his website. He has previously claimed that $300 billion a year could be saved through negotiation, a claim we rated as false because Medicare will only spend an average of $111 billion each year on prescription drugs. Based on previous estimates by CBO, actual savings would likely be small or negligible.

NOTE: The plan assumes a full repeal of ObamaCare before replacing it. While this is possible given Trumps statements, it isnt necessarily what we would get from the future President Trump.

NOTE: Like him or hate him, Trump has mentioned some critical health policies like expanding Medicaid and debating drug costs for Medicare. These didnt make it into the Trump plan as written, but it would be a mistake to overlook the benefits of strategies like debating drug prices for Medicare.

10-Year Estimates of Healthcare Reform to Make America Great Again
Policy
$550 billion

Trump Didn’t ‘care’ Jan 6 Rioters Were Armed

STORY: “I was in the vicinity of a conversation where I overheard the President say something to the effect of ‘I don’t effing care that they have weapons…”

On January 6, 2021, then-President Donald Trump knew his supporters were armed, but he directed them to the Capitol anyway.

Thats the explosive testimony from Cassidy Hutchinson, a top aide to former White House Chief of Staff Mark Meadows, who on Tuesday provided the House select committee with a look at what was unfolding among the President and his top allies on the day of the Capitol riot.


Hutchinson said Trump expressed anger that the Secret Service was using metal-detecting magnetometers to keep armed people out of the fenced-off area where he gave his fiery speech.

“…because he wanted it full and he was angry that we weren’t letting people through the mags with weapons…”

CHENEY: “The select committee has learned about reports from outside the magnetometers and has obtained police radio transmissions identifying individuals with firearms, including AR-15s near the Ellipse on the morning of January 6th.”

Hutchinson, in a pre-recorded interview, said she was told there were knives, guns, spears and flagpoles among Trump supporters But Trump said: Something to the effect of, ‘Take the effing mags away, they’re not here to hurt me. Let them in, let my people in. They can march the Capitol after the rallies over. They can march from the Ellipse.”

The 7th public hearing is scheduled for July.


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Biden Likely To Help States Increase Health Care Access

More support expected for insurance navigators, Medicaid expansion.

All the exchanges used to provide navigators and engage in marketing to boost enrollment, especially in minority communities. But in 2018 the Trump administration eliminated almost all funding for Healthcare.gov navigators and marketing, so now only state-based exchanges have money for those functions.

The exchanges also determine eligibility for Medicaid, the public health plan for the poor. Consumers who qualify are enrolled or passed on to a state website where they can sign up.

The Trump option would strip down the exchanges to a basic listing of insurance plans and perhaps contact information for private brokers or insurance carriers. There would be no comparison of plans, no enrollment option and no guidance. Under this direct enrollment approach, brokers could limit options to the carriers they represent, instead of having to present all ACA-compliant plans.


Direct enrollment is already permitted in states that use Healthcare.gov. According to CMS, one-third of people enrolling in individual commercial plans do so through direct enrollment. Most enrollees prefer to use the exchanges.

Here’s How Donald Trump Says He’d Replace Obamacare

Trump Tries To Kill Obamacare During Pandemic

Senior Reporter, HuffPost

WASHINGTON — Republican front-runner Donald Trump, who has vowed to scrap the Affordable Care Act and replace it with “something terrific,” finally provided a rough idea of what he thinks terrific looks like.

The bullet points published on the billionaire businessman’s website Wednesday night don’t amount to a detailed plan to overhaul the health care system, but they’re about as specific as is typical for a presidential campaign and in line with the vague proposals touted by rivals Sen. Ted Cruz and Sen. . It’s certainly more than the Republican Congress has managed to produce in the six years since the ACA became law. And, yes, Trump calls it “Healthcare Reform to Make America Great Again.”

It’s notable that Trump unveiled his proposal the night after his Super Tuesday triumph over Cruz and Rubio and the night before another Republican debate. It also comes as he maneuvers toward a general election campaign against whoever wins the Democratic nomination, former Secretary of State Hillary Clinton or Sen. Bernie Sanders .


So what does Trump want to do on health care? Of course, the first order of business is to entirely get rid of Obamacare and its individual mandate that nearly everyone get health coverage or face a fine . There’s a bunch of stuff on his website complaining about Obamacare, which gives Trump something in common with the congressional Republican leaders he likes to insult.

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Learn More About Medicare And Compare Medicare Supplement Plans

Are you concerned about how federal health care changes could affect your Medicare coverage?

Are you approaching Medicare eligibility at age 65 and curious about your plan options?

1 Pear, R., and Haberman, M. Trump Retreats on Health Care After McConnell Warns It Wont Happen. . New York Times. Retrieved from www.nytimes.com/2019/04/02/us/politics/obamacare-donald-trump.html.

2 Congressional Budget Office. American Health Care Act of 2017. . Retrieved from https://www.cbo.gov/publication/52752.

Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.

The Justice Department Visits Mar

Jay I. Bratt, the Justice Departments chief of counterintelligence, visits Mar-a-Lago accompanied by F.B.I. agents. Mr. Trump greets them in the dining room. According to Mr. Trumps lawyers, the former president says: Whatever you need, just let us know.

Mr. Bratt inspects a storage room. Christina Bobb, another of Mr. Trumps lawyers, signs a written statement asserting that to the best of the lawyers understanding, they have turned over the remaining classified material from the White House boxes, satisfying the subpoena, according to several people briefed on the statement.

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Past Updates On Trumpcare

The next section includes some past updates on TrumpCare so you can get a sense of what was promised or tried in the past and compare that to what is happening now. A lot of small changes have happened very quickly so forgive the notes.

UPDATE: Trump and Republicans in Congress had stated that they would seek to repeal ObamaCare within Trumps first hundred days in office. True to their word the process of repeal has begun. Trump has signed an executive order on ObamaCare. The American Health Care Act is on the table. After a meeting with President Obama, President-elect Trump suggested he would either amend ObamaCare or repeal and replace it, not just repeal it, and would keep key provisions like guaranteed coverage for preexisting conditions and allowing kids to stay on their plans until 26. More recently, Trump promised simultaneous repeal and replace,insurance for everybody, and he doubled down on his longstanding promise of negotiating with drug companies. Unfortunately, after a meeting with drug companies, Trump backed away from allowing negotiations.

TIP: The GOP forever altered the lexicon when they called the Patient Protection and Affordable Care Act ObamaCare. With this in mind, Trumps healthcare plan has been unofficially dubbed TrumpCare. This is true even though no formal plan is on the table yet.

When Does Trumpcare Take Effect

Trump

The ACHA first had to pass a vote in the House of Representatives, which it did so on May 4 by a margin of 217-213.1 The bill will still need to pass a vote in the Senate before it can be signed into law by President Trump.

Despite passing the House, the bill has stalled at the Senate level, as many GOP senators have balked at approving the ACHA as it was originally written. A committee of senators has been formed to draft a new version of the bill. There is no deadline for this new version, and no date has been set for a vote.

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Inside The Failed Mission To Get Trump To Care About Afghanistan

In the months leading up to Gen. John W. Nicholsons departure from Afghanistan in September, his top advisers and staffers set out on an unusual mission, one that took place not in the foothills of the Hindu Kush but inside a compound in Kabul.

Their goal: Find a way to convince President Donald Trump and members of Congress to support troops staying on the ground in the 17-year-long war, according to three individuals involved in the discussions. It was the summer of 2018, public support for U.S. troop presence in Afghanistan had waned, and the president was again threatening to pull the plug on the U.S. mission. Nicholson and his team feared that the American public, too, no longer understood why troops needed to stay.

The goal, one of Nicholsons top staffers said, was to get people to care again. And to do so, they sought to better publicize how the U.S. was increasingly involved in monitoring the growing peace protests across the country and hoped to capitalize off the movement to broker talks between the Taliban and the government.

There was a massive push to get people to understand that there was still work to dopeace talks to finish, the source said.

Nearly three months after Nicholsons departure, however, it seems that his mission has at least partially failed. Gen. Austin S. Miller was installed in place of Nicholson and Zalmay Khalilzad was appointed U.S. special adviser for the country and is currently leading the peace talks.

READ THIS LIST

The Archives Publicly Criticizes Trumps Destruction Of Documents

The archives makes a public statement about Mr. Trumps record-keeping practices, noting that some of the records it received at the end of his administration included paper records that had been torn up by former President Trump.

About a week later, the archives issues another public statement about retrieving documents from Mar-a-Lago, asserting that Mr. Trump still has presidential records that should have been turned over to the archives at the end of his time in office.

What we consider before using anonymous sources.How do the sources know the information? Whats their motivation for telling us? Have they proved reliable in the past? Can we corroborate the information? Even with these questions satisfied, The Times uses anonymous sources as a last resort. The reporter and at least one editor know the identity of the source.

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Secretary Of Health And Human Services Tom Price

  • During an interview on March 12, 2017, NBC’s Chuck Todd asked Price if the AHCA “which leaves much of the Obamacare architecture in place, is an acknowledgement that the health care system cant be run by the free market alone.” Price replied, “No, not at all. And obviously this is a transition that we’re going through, but the important thing is to appreciate that the market as it is right now is failing. Obamacare, the ACA, has failed. Youve got premiums going up, you’ve got deductibles where people have an insurance card but they don’t have any coverage, got a third of the counties in this nation that only have one insurer offering coverage, five states with only one insurer offering coverage. That’s not a choice nor is it responsible to the individuals who are going to be selecting the coverage. So what we need to do is to fix this, to move in a direction that puts patients and families and doctors in charge of their health care, and not Washington, D.C.”
  • In 2015, Price said, It needs to be fully repealed, because the first step out of the gate for Obamacare is a step in the wrong direction and that is for government control over every aspect of health care, so it’s hard to fix the system that they have put in place without ending that premise that government ought to be running and controlling health care.

What About ‘medicare For All’

White House Reverses Trump Ban on LGBT Health-Care Protection

Growing numbers of liberal Democrats are coalescing around a universal healthcare plan proposed by Democratic presidential candidate Bernie Sanders.

He advocates expanding Medicare, the US government’s medical coverage programme for pensioners, to all Americans.

Mr Sanders’ idea – Medicare for All – would provide healthcare for everyone free of charge. He says it would be funded by higher taxes.

Conservatives say the idea would bankrupt the country, but supporters say Americans would save by avoiding the opaque medical fees they currently face, such as insurance premiums, co-payments, deductibles and other out-of-pocket expenses.

A study by the free-market Mercatus Center found Medicare could cost the federal government more than $32tn over the course of a decade.

The same research also estimated the plan could save the country $2tn over the same period – but only if healthcare providers accepted a 40% drop in payment rates.

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