Category: Health Care

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Some Questions About the Warren Plan for M4A

  By 2020, Elections, Health Care, Public Policy

This is the second of two post on the Warren plan to finance Medicare for All. The first dealt with why I think the time is ripe for M4A and especially for Warren’s version of it. This second post is about some questions that have been raised about Warren’s plan from the left. The Warren plan calls on businesses that have 50 or more employees and provide health insurance to them to pay a the federal government roughly 98% of what they pay for that insurance. A critique of the plan in Jacobin said that businesses would be able to escape from this requirement by reclassifying employees as independent contractors or by breaking themselves down into units with 49 or fewer employees. The whole question of reclassifying employees as independent contractor is not a new issue. There already are many incentives to do that. There are also business incentives to not… Continue reading

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The Warren Plan and the Prospects for Medicare for All

  By 2020, Elections, Health Care, Public Policy

I’ve been ambivalentabout the politics and policy of single-payer for a long time. That’s for three reasons First, while I by and large don’t think that a more left-wing program will hurt Democrats in the general election—just the opposite is true—there are certain ways it can hurt. The first is if we put forward plans that require tax increases on the working and middle classes. I do think that ultimately some of those tax increases will be necessary and that the benefits received in return for them will be greater than the costs of the tax increases. But it is a fundamental rule of politics that people are more agitated by what they are losing than what they are gaining. And talking about tax increases for future benefits is hard to explain and hard to defend especially because most Americans are not terribly well-informed about politics and public policy and… Continue reading

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“Work Requirements” and the Political Appeal of Cruelty

  By Medicaid, Work Requirements

From Third and State, April 17, 2018 We at PBPC are engaged in a major effort to push back against legislation in the PA General Assembly to create work requirements for Medicaid and SNAP. The new federal Farm Bill put forward by House Republicans, which authorizes the SNAP (Food Stamp) program, has similar provisions. We have been pointing out that the stereotypes used to justify work requirements are simply untrue. We show that stereotypes that justify harsh measures affecting those who are struggling with low incomes are based on falsehoods. The American social safety net almost entirely benefits people who cannot work — the elderly, ill, and disabled — or working Americans. It offers very little to able-bodied men and women who do not work. People who receive Medicaid and food stamps mostly work when they can find employment and are not ill, disabled, in school, or taking care of young children… Continue reading

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For Many Pennsylvanians, Insurance Premiums Increase Are Greater Than Tax Cuts

  By ACA, Federal Taxes, Health Care, PA Budget and Policy Center, PBPC Blog posts, Taxation

As we have pointed out previously, because it repeals the individual mandate, the Senate tax cut proposal will not only lead to 13 million fewer people having health insurance in the United States, but it will lead to much higher premiums for many who do purchase health insurance on the individual market. The CBO’s estimate was that premiums nationwide would increase by 10%. Last week we presented a very rough estimate of the impact of repeal of the mandate on the average cost of health insurance premiums in Pennsylvania and suggested that the average increase in premiums is likely to be higher than the average savings in taxes under the Senate plan. New research from the Commonwealth Fund provides more detailed information on the increase in premiums for Pennsylvanians at different ages. And their work reinforces our conclusion. In 2019, much of the benefit of the tax cut to middle… Continue reading

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Graham-Cassidy Repeal Bill — Just Plain Bad for Pennsylvania

  By ACA, PA Budget and Policy Center, PBPC Blog posts, US

As I write this, it is possible that the Graham-Cassidy bill to repeal the Affordable Care Act and make major changes to the traditional Medicaid program is already dying or dead. Two Republican members of the Senate, McCain of Arizona and Paul of Kentucky, have said they will vote against it. Senator Collins of Maine has announced that she is leaning against it. I’m hopeful that Senator Murkowski of Alaska will all announce that she is against it.  And when that happens, I expect a substantial group of Senators will join them because this bill is truly dangerous to every state and the only reason it is even being considered is that Senate Republicans fear the short-term political costs of disappointing their base voters and funders more than they fear the long-term costs of doing great harm to their constituents. Once it is clear that there is no path forward… Continue reading

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Don’t Take Skinny Repeal Lightly — The Dangers of the “Just Pass Something” Mentality

  By ACA, Health Care, PA Budget and Policy Center, PBPC Blog posts, Statements

As I write this, the Senate is moving in a somewhat haphazard way to a vote on what has been called a “skinny” repeal of the Affordable Care Act. Not only do we not know exactly what will be included in the skinny repeal, but we, like members of the Senate, are uncertain about the point of passing such a bill. Skinny Repeal as Trojan Horse Most observers of the Senate believe that the goal of enacting a skinny repeal bill is simply to keep the process of repealing, or repealing or replacing, the Affordable Care Act alive. If the Senate acts on some health care bill that is an amendment of the AHCA passed by the House, the next step will be a House-Senate Conference Committee, which would write a final bill that attempts to thread the very narrow needle between more moderate and more conservative Republicans in both… Continue reading

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Senate to Choose Between Health Catastrophe or Something Worse

  By ACA, Health Care, PA Budget and Policy Center, PBPC Blog posts

Mitch McConnell and his Republican allies have one more trick up their sleeves to try to get some health care bill through the Senate. This week they will seek a vote to proceed to debate on the bill passed in the House on the understanding that there will be a process, colloquially known as voterama, in which a series of votes on one or more substitutes to the bill, or amendments, will be introduced. That is, Senators are being asked to proceed to debate without any clear idea what final bill they will eventually vote on. I will say more about the process in a moment. But first I want to urge you to join the Insure PA / Protect Our Care phone bank to ask people in those states with Senators who are unsure about their position to call those Senators and ask them to vote no. (You can… Continue reading

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GOP health care bill kept private to avoid public criticism

  By Health Care, Public Policy

Originally published by The Morning Call on July 21, 2017 The effort that the Republican U.S. Senate leadership is making to hide the health care bill they will soon bring to a vote tells us just how bad that bill is likely to be. Recent reports indicate that the Senate leadership has been secretly sending pieces of their health care legislation to the Congressional Budget Office to secure the score necessary to pass the bill under rules that allow them to avoid a filibuster. They intend to bring a bill to the floor next week. They plan to replace that bill with the actual bill they intend to pass not much more than 24 hours before the final vote. This process is wrong. Democracy requires not just that we elect political decision-makers, but that they act transparently, in full public view. Long before a vote on complicated legislation like this,… Continue reading

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Statement on the CBO Score of BCRA–We Told You It Couldn’t Be Fixed

  By ACA, Health Care, My Work, PA Budget and Policy Center, Statements

Earlier this week we released a blog post and a long paper called, “It Can’t Be Fixed” that explained why the basic structure of all of the Republican “repeal and replace” necessarily leads to a health care system in which large numbers of Americans and Pennsylvanians lose insurance. The Congressional Budget Office (CBO) evaluation of the last version of the Senates’ Better Care Reconciliation Act (without the Cruz Amendment) released on Thursday confirms our argument once again. The CBO predicts that 22 million people will lose health insurance in the first decade. Our quick analysis of the impact on Pennsylvania shows that over one million will lose insurance in our commonwealth. The basic problem remains that the Republicans are determined to radically reduce federal spending on health care by $1.2 trillion over ten years (and more in the second ten years.). Any bill that aims to reduce spending at this… Continue reading

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It Couldn’t Be Fixed: Policy and Politics in the Republican Health Care Bill

  By ACA, Health Care, PA Budget and Policy Center, PBPC Blog posts

Now that the Senate Republican effort to repeal and replace the Affordable Care Act has failed, let’s take a step back and understand why no bill based on the Republican approach to health care could have been fixed enough to reduce the pain to levels acceptable to a majority of Republicans in Congress, let alone to the American people. The basic design of the bill was deeply flawed from the perspective of anyone who thinks that America has a responsibility to guarantee quality, affordable health care to all. The design only made sense if one, instead, seeks a politically palatable way to reject that responsibility and reduce federal health care spending in order to cut taxes on large corporations and the rich. What started as a bill to repeal the Affordable Care Act (ACA) became a bill to partly repeal the health insurance regulations and subsidies for insurance purchased in… Continue reading