Got some time today? Just because there was no vote doesn’t mean our MoC (Rep. Keating) doesn’t need constituent feedback. Visit your MoC’s local office and let him know how you feel about his stance on TrumpCare. And let him know that you’re going to keep watching out for any new attacks on the ACA down the road. While Trump and Ryan have retreated “for the foreseeable future” (to quote Ryan again), this fight may not be over—stay tuned for more resources you can use to keep defending the ACA over the next congressional recess and beyond.
On Wednesday, April 5th, the Massachusetts Immigrant and Refugee Advocacy Coalition is holding its annual Immigrants’ Day at the State House in Boston. The formal events begins at 10 with a rally in the Hall of Flags. Before and after that constituents will be going to visit their own legislators to tell them how important it is to support the Safe Communities Act . The bill is now before the Joint Committee on Public Safety and Homeland Security. (S. 1305 and H. 3269).
Cape & Islands Stronger Together and the Barnstable Democratic Town Committee have chartered a bus so it will be easy for many of us to participate. The bus leaves the Barnstable Park & Ride at 7:15 am, it leaves the Sagamore Park & Ride at 7:40 am.
To check out the Boston event and information about the Safe Communities Act use this link. www.miracoalition.org
A donation of $15 is suggested as you board the bus (for those who are able). No one will be turned away if we have space!
If you have any questions please call or email Susan Truitt, Cape & Islands Stronger Together and Barnstable Democratic Town Committee, 774-327-7277 or firstname.lastname@example.org.
Bill #1275 Federal 115th Congress
Sponsors: Representative Pete Sessions (R-TX)
Passed by: The Budget Committee, Energy & Commerce Committee, and Ways & Means Committee
Summary: See Attached page
Where is it now? Scheduled to be on the House floor by March 24, 2017.
Stake Holders: All Americans.
Why do we care?
- Instead of subsidizing enrollees based on income, Trumpcare would provide refundable tax credits based primarily on age. (The G.O.P. plan would also account for no variation in costs between regional markets, which could disproportionately hurt rural consumers.)Vanity Fair 3/7/2017
- The G.O.P. plan offers tax credits ranging from $2,000, for individuals under the age of 30, up to $4,000 for people over 60. For individuals making more that $75,000 per year—and married couples who file jointly and make more than $150,000 per year—the tax credit would decrease by $100 for every $1,000 increase in salary.Vanity Fair 3/7/2017
- Because of differences in the tax-credit structure under the AHCA, older and poorer people would receive less assistance to gain access to care, according to analysis done by nonpartisan groups. Additionally, not every state would benefit in the same way. The Kaiser Family Foundation, a nonpartisan health-policy think tank, broke down the AHCA’s tax-credit structure compared with the Affordable Care Act’s. The key difference is that while the ACA adjusts for income level as well as the cost of living based on place of residence, the AHCA would give a flat credit based on age ranging from $2,000 annually for those under 30 to $4,000 a year for people over age 60. Based on Kaiser’s analysis, this would shift the cost of healthcare mostly for seniors and poorer Americans, who would see their insurance subsidies fall dramatically under the AHCA. Business insider. 3/14/2017
- Additionally, unlike the ACA, the AHCA does not adjust its tax credits based on the cost of living for the location where the beneficiary lives. Thus, rural areas where healthcare providers are limited and usually more expensive would see a bigger slash to benefits.
Based on an analysis by the Center for Budget and Policy Priorities of how states using the federal Healthcare.gov exchange could be affected by the new law, the biggest loser would be Alaska, with a tax-credit decline of $10,243 on average for individual insurance enrollees. Also, the individual enrollee’s tax credit in North Carolina, West Virginia, Oklahoma, Alabama, Nebraska, and Wyoming would decrease by more than $4,000 on average. Business Insider
- Estimates from congressional budget analysts and the White House’s Office of Management and Budget kept showing that the credits would be both too small to provide enough help to lower-income people and too expensive overall for a GOP determined to slash federal spending that the ACA has required. Washington Post 3/6/17
How does it meet our stated objective? The tax credit proposal seeks to lower federal spending on health care by capping individual subsidies through fixed-dollar insurance credits. This is a big change in federal health care and will especially affect poorer and older Americans. Speaker Paul Ryan and Republican congress is rushing this bill through to prevent any meaningful discussion on its many moving parts.
Local Impact: Cape Cod has an older population needing more healthcare but living on Social Security and pensions. Cape Cod is a rural area with a large seasonal economy and lower paying service level jobs making it difficult to pay for health insurance.
Bill #: H.R. 314
Bill Name: (short title) Health Care Choice Act of 2017
Summary: Repeals title I of the Patient Protection and Affordable Care Act (ACA) to amend the Public Service Act so that insurance companies licensed in one state can sell health insurances to residents of another state in which they are not licensed. Such insurance companies would be subject only to the regulations of the state they are licensed in; not the other states they are selling in.
Legislature: U.S. House of Representatives
Sponsors: Blackburn, Gurthre, Olson, Black and Hudson
Where is it now? Referred to Committees on Energy and Commerce, Ways and Means, and Education and the Workforce, for a period determined by the Speaker such as needed for consideration of such provisions as fall within the jurisdiction of the committees.
Stake Holders: Insurance companies, insurance consumers especially the elderly & sickest, taxpayers, state insurance regulators, consumer protection agencies.
Why do we care? Currently health insurance companies must be licensed to sell insurance in a state in order to do so. As such, they must adhere to that state’s insurance regulations. Unlicensed, out-of-state insurance plans pose several problems: (1) In-state insurance plans have specific networks of doctors and hospitals. An out-of-state plan would not necessarily cover those health care providers. (2) State insurance regulations mandate levels of coverage. An out-of-state plan may not provide the level of coverage someone in another state might need. (3) Insurance companies could locate to states with the least regulation (“race to the bottom”) to sell low coverage/low cost plans. This could draw off (“cherry pick”) the healthiest individuals in other states leaving those states with an increased pool of high-risk people to insure resulting in higher rates for those people. (4) Consumers of out-of-state plans would not be backed by their state’s insurance regulations and suffer from a lack of consumer protection. (5) Allowing insurers to choose their regulator is the dynamic that led to the collapse of the financial sector.
How does it meet our stated objectives? Indivisible promotes inclusiveness, tolerance and fairness. This bill promotes exclusiveness by pitting the health against the unhealthy. It promotes unfairness by reducing regulatory consumer protection and allowing insurance companies to sell insurance in a state in which they are not licensed. Such unlicensed selling would otherwise be considered a criminal offense.
Local Impact? Massachusetts has quite strong insurance regulations. Should its citizens purchase health insurance from out-of-state companies, i.e., not licensed in Massachusetts, those regulations and the consumer protections that go with them would not apply. Also, purchasing out-of-state health insurance could decrease the pool of Massachusetts residents buying health insurance and force in-state insurance companies to raise rates due to a decreased number of subscribers. Increased rates could lead to non-coverage for those at highest risk which could result in death and/or use of more costly emergency room services.
Possible Action: Call representatives in the House to oppose. If passed in the House, the bill goes to the Senate where it will require 60 votes to pass because it is not part of the budget reconciliation process; call senators to oppose.
Sources: NAIC: The Center for Insurance Policy Research (“Interstate Health Insurance Sales: Myth vs. Reality”); Kaiser Health News; CNN Money; Business Insider; The Washington Post
Bill Name: FY 2018 Federal Budget
House: House and Senate
Where is it now? Submitted
Stake Holders: Environmental scientists, EPA staff, National Park Service, public health officials, public at large
Why do we care? The Trump Administration released a budget that will be welcomed by polluters slashing EPA’s ability to protect the environment and the public’s health. In order to fund a $54 billion increase in the military, many agency budgets are being cut, but the EPA stands out as the worst with a budget reduction of 31%, $2.6 billion. More than 3,200 EPA staff will lose their jobs. The Environmental Justice Department, a program that protects low-income communities from environmental hazards, is zeroed out. The Superfund for cleaning up toxic sites is eliminated. Almost no funding is left for air quality programs, clean energy or climate change research. Funding for enforcement of regulations or for emergencies as in Flint, Michigan, are also severely cut. The Washington Post says, “Almost no other federal department or agency is as much in the crosshairs as the EPA. Of all the destructive policies of Trump’s administration, the crusade against the environment may end up being the most disastrous – and the most irreversible.”
How does it meet our stated objective? Eliminating regulations, eliminating the EPA and catering to Big Oil were campaign promises made by Trump on the campaign trail. Like many of his promises, resistance is demanded by common sense, science and public health.
Local impact: In Massachusetts, the Sea Grant Fund that supports the Woods Hole Oceanographic Institute (WHOI), an independent institution focusing on climate change, would be eliminated. The Boston Globe reported (3/17/17) that Sen. Markey said, “He [Trump] is going to get the federal government out of the business of research, climate change and innovation, and wait for the private sector or the states to fill in the gaps.” There will also be a cut in the Community Block Grant to Massachusetts which provides many social services but also funds city efforts to clean up polluted sites.
Possible Action: Write or call Senators Warren & Markey, and Congressman Keating . Contact House Budget Chair, Diane Black (R-TN). Contact Bernie Sanders, Angus King, Tim Kane and Sheldon Whitehouse, all on the Senate Budget Committee. Contact local organizations such as the Association to Preserve Cape Cod, the Provincetown Center for Coastal Research and WHOI to ask how LCI could best help. An environmental event in Provincetown is being planned for April 29 in which LCI can participate and promote to members.
NOTE: HR 861 to terminate the EPA was included in a recent LCI alert but maybe should be repeated this week.
Sources: Earth Justice newsletter 3/17/17; Sheldon Whitehouse newsletter (D-RI); Boston Globe 3/17/17; Food & Water Watch, Democrats.com 3/17/17.