Team Trump knows exactly how politically dangerous their request that the courts invalidate the Affordable Care Act (a.k.a. Obamacare) is, so they’ve come up with some pretty obnoxious ways to try to avoid the consequences in 2020. They are currently preparing to ask a federal appeals court for a stay if the court rules Trump’s way, and “may try to delay a potential Supreme Court hearing on the matter until after the 2020 presidential election, according to current and former administration officials,” Joan McCarter noted at DailyKos (10/7)
They also say they “have some ideas for replacing parts” of the law. They don’t. Particularly for the parts that are most far-reaching, like the benefits of 133 million people with pre-existing conditions or the coverage of about 20 million previously uninsured people have secured. However the Fifth Circuit Court of Appeals—a notoriously conservative activist court—rules, the Department of Justice will try to delay the outcome. They’ll ask for a stay if the court rules for them and will delay an appeal to the Supreme Court if it rules against them. Anything to make sure that any final decision doesn’t come down before the 2020 election.
It’s also completely unworkable. Take just the example of the requirements for coverage of preventive care and prohibition of annual and lifetime benefit caps. These reforms apply to all insurance, including employer-provided insurance. How does a national company with employees in multiple states deal with that? The Employee Retirement and Income Security Act (ERISA), the federal law regulating employer-provided health benefits, is based on the principle that there can be no state-to-state variations in the law that governs employer’s health benefits. So this argument by the Barr team would contradict another standing law.
The administration’s ridiculous contortions on this shows a number of things. They know Trump’s and the GOP’s shrinking base is still going to demand the obliteration of Obamacare, so they’re trying to keep the issue alive. But they know that total repeal is going to destroy them politically, that it will drive an angry tsunami of people to the polls in November 2020 and bury them. It also demonstrates just how confident they are that the Supreme Court is now Trump’s. They expect it to destroy the law, they just want it to wait until it’s less politically inconvenient.
TRUMP’S MEDICARE ‘IMPROVEMENT’ SETS UP ITS DEMISE. Donald Trump signed an executive order (10/3) requiring the Centers for Medicare and Medicaid Services to propose ways to boost the Medicare Advantage program, which allows private insurance companies to get a cut of Medicare dollars.
Within the executive order, Charles Pierce noted at Esquire.com (10/4), is “a poison pill the size of a horse’s head.” Section 3 requires the Secretary of Health and Human Services to propose ways for Medicare to provide “more diverse and affordable plan choices,” such as “Medicare Medical Savings Accounts that promote innovations in supplemental benefits and telehealth services,” a payment model that allows Medicare beneficiaries to share in savings that result, and modifies regular Medicare fee-for-service to reflect prices paid for services in Medicare Advantage.
“That, dear friends, is pretty much the same plan that Paul Ryan, the zombie-eyed granny starver from the state of Wisconsin, spent years trying to slime into law. It is the first big step toward Ryan’s lifetime goal of privatizing the Medicare system, which, as someone who has enjoyed its benefits for almost a year, I can tell you is a terrible idea. Look at all the little buzzing land mines in there. ‘Competition.’ ‘Market pricing.’ This thing even expands Medical Savings Accounts, a terrible idea that emerged in the 1990s and that Bill Frist was going to ride into the White House in 2000.
“The president* is a blight and impeachment is the only cure, but the conservative project rolls merrily on. I’m not entirely sure he knew what he was signing, because he doesn’t know anything about anything, but the people who find him useful do, which is why he’ll be around for a while longer.”
TRUMP LETS TURKEY ATTACK KURDISH ALLIES OF US IN SYRIA. The White House announced late Sunday night (10/6) that Turkey had agreed to take responsibility for captured Islamic State fighters, who were captured in the war, which was largely fought by Kurds, with US advisers and air cover, to defeat the radical Islamic “Caliphate” in Syria and “will soon by moving forward with is long-planned operation into Northern Syria.” That is, Turkey will implement its plan to invade the Kurdish-majority region to establish what Ankara calls a “security zone” that will separate Syrian Kurds from Turkish Kurds. The following day, as US forces withdrew, the Turkish Air Force started offensives against Kurdish targets in northeast Syria.
Trump clearly signed off on the plan, apparently afraid to take Erdogan on, Juan Cole noted at JuanCole.com (10/7).
“Look, I am all for the US getting out of Syria. But it should be done in a way that ISIL doesn’t come roaring back and the Kurds who came to the defense of US interests aren’t hung out to dry. The US is an extremely wealthy and powerful player, and could make those arrangements if it wanted to,” Cole wrote.
“Trump doesn’t want to. He refused even to provide reconstruction aid to eastern Syria so as to ensure that people in the region did not turn back to ISIL out of desperation.
“Trump is the biggest disaster to hit US security since Benedict Arnold.
“Why does it matter to the United States? In 2015, when Washington was looking around for someone to fight ISIL on the ground while the US gave close air support, only one Middle Eastern player stepped up. It wasn’t Israel, which talks a good game about helping US security but has been almost entirely useless in every US-Mideast conflict since the Iran-Iraq War. It wasn’t Turkey, which is a NATO member and which, you know, you might expect to be at least a little afraid of a terrorist cult on its borders, which pulled off several major bombings inside Turkey. But no. It wasn’t Saudi Arabia, which was bogged down in its Yemen quagmire.
“The only group that heeded the call was the Kurds of northern Syria, who are the ones who defeated the maniacal ISIL in eastern Syria, with US air support and with the tactical and strategic advice of 2,000 US special forces personnel embedded among them.”
Turkey’s center-right pro-Islam government sees the Syrian Kurds and their Democratic Union Party (DUP) as no different from the Kurdistan Workers Party (PKK), which has attacked Turkish (i.e. NATO) security personnel in Turkey, so Washington considers it a terrorist group. In fact, the DUP does not have a reporting line to the PKK, Cole noted. “Both Kurdish organizations are post-communist collectivist organizations, and the anarchist secular left is about as contrary to Erdogan’s ideology of Malls-and-Islam as you could get.”
Erdogan’s solution is to invade Syrian Kurdish territory and drive the Kurds away from the Turkish border, and then to settle in their villages and homes some of the 2.5 million Arab Muslim refugees currently displaced to Turkey by the Syrian civil war, Cole noted.
“So the US used the Kurds and will now meekly turn them over to the tender mercies of Mr. Erdogan. Will the Green Berets and Navy Seals have to flee with their tails between their legs?
“So of course Mr. Tough Guy Trump has something to say about all this, right?
“Wrong.
“Crickets.”
Not quite. After Trump got up Monday morning to bipartisan complaints that he was abandoning US-allied Kurdish fighters to the mercy of the Turkish military, he tweeted, “As I have stated strongly before, and just to reiterate, if Turkey does anything that I, in my great and unmatched wisdom, consider to be off limits, I will totally destroy and obliterate the Economy of Turkey (I’ve done before!).”
The Pentagon issued a statement that it was not endorsing any Turkish operation against the Kurds. That’ll show them!
WHICH SENATORS APPEAR VULNERABLE HEADING INTO 2020? Republicans now hold a 53-47 majority in the Senate, so Democrats need to flip at least three Senate seats now held by Republicans to regain control of the Senate. The least popular Republican senator up for election in 2020, according to Morning Consult’s state tracking polls through June 30, is Thom Tillis of North Carolina, with a 33% approval rate and 35% disapproval, and Trump was three points “under water,” with 47% approval and 50% disapproval Sept. 1, so he won’t be much help.
“Moscow Mitch” McConnell has a 36% approval rate and 50% disapproval in Kentucky, but Trump was still relatively popular, with a 56% approval and 41% disapproval rate; Cory Gardner had 37% approval, 37% disapproval in Colorado, and he’ll get little help from Trump who is underwater, 41-56; Martha McSally had 40% approval, 37% disapproval in Arizona, where Trump is blowing bubbles, 47-50; Cindy Hyde Smith had 42% approval and 35% disapproval in Mississippi, but Trump is still popular, 59-38; Joni Ernst had 42% approval and 38% disapproval in Iowa, where Trump is down 42-55; John Cornyn had 43% approval and 25% disapproval in Texas, where Trump is barely ahead, 49-47; Susan Collins had 45% approval and 48% disapproval in Maine, where Trump is down, 42-55; and David Perdue had 48% approval and 26% disapproval in Georgia, where Trump is basically deadlocked, 49-48. Georgia, Kansas, Tennessee and Wyoming also will have open seats now held by Republicans while a New Mexico Sen. Tom Udall (D) is retiring, opening that seat, which Democrats should be able to keep.
Doug Jones is probably the most vulnerable Dem, with 39% approval and 37% disapproval in Alabama, but Trump is up 22 points, 59-37. Otherwise vulnerable Democratic senators up for re-election include Gary Peters, who has 34% approval and 27% disapproval in Michigan, where Trump is down 10 points, 43-53, and Tina Smith, who has 43% approval and 27% disapproval in Minnesota, where Trump is down 12 points, 43-54.
TRUMP SEES FLORIDA CHANCES DIM. Donald Trump is seeing his support in Florida slowly disappear which could cripple his chances of winning re-election in 2020, Politico reported (10/7).
At issue for the president — who has made attacks on people of color a central theme of his administration — is the fact that new voter sign-ups in the state are overwhelming non-white and the president’s rhetoric is not helping him sway them.
As Politico’s Marc Caputo, writes, “He publicly doubted Hurricane Maria’s death toll in Puerto Rico and spread conspiracy theories about it. He reportedly called Haiti a ‘sh*thole.’ He balked at the idea of allowing Bahamians displaced by Hurricane Dorian into the US, explaining that it risked bringing in ‘some very bad people.’ Since taking office as president, Donald Trump has alienated what looks like a mini-United Nations of voters with deep connections to other countries, tens of thousands of whom live in the state that’s essential to his re-election — Florida.”
The report goes on to note that the new voters are overwhelmingly registering as Democrats and that “42% of the new voters who have registered are nonwhite. For the same period in the last presidential cycle, the percentage was 38.”
One demographic is particularly bad news for the President — Haitian Americans.
“Trump’s support among Haitian Americans has also taken a beating since he last campaigned in their community in 2016 and pledged: ‘I want to be your greatest champion.’ Instead, Trump has threatened to remove the Temporary Protected Status, commonly called TPS, of 56,000 Haitian immigrants who came to the US after a 2011 earthquake rocked the country. And he allegedly called Haiti a ‘ sh*thole’ behind closed doors,” the report states.
According to one activist, Trump comments and actions have not gone unnoticed.
“Bad words are bad words. Nobody likes to hear their home country called a sh*thole,” explained Hans Mardy, a Republican Haitian-American activist. “As a Republican, I would like to see a better collaboration with our government.”
University of Florida political science professor Dan Smith said Trump’s actions are definitely problematic, saying, “Haiti-born Florida voters turned out in 2018, higher than any other naturalized citizens. Probably didn’t really care for their country being called a sh*thole.”
Trump also is facing problems with Floridians of Venezuelan descent, who applauded his criticism of President Nicolas Maduro but see little action, as well as Bahamians and Puerto Ricans who fill out the voter rolls.
A Morning Consult tracking poll in Florida (9/1) showed Trump approval at 48% and disapproval at 49%.
WORKERS PAY THE PRICE AS GE FREEZES PENSIONS. General Electric announced it was freezing the pensions of roughly 20,000 employees with salaried benefits. The company is also offering a lump sum payout option to approximately 100,000 workers who’ve not yet begun taking pension payments, Andrea Germanos reported at CommonDreams (10/7).
The changes become effective January 1, 2021. At that point, affected workers will neither accrue additional benefits nor be able to contribute to the plan.
“Returning GE to a position of strength has required us to make several difficult decisions,” said GE’s chief human resources officer Kevin Cox, “and today’s decision to freeze the pension is no exception.”
GE closed its pension to new entrants in 2012, adding to a trend of companies shifting away from traditional pensions. It’s a shift progressive observers say bolsters the case for expanding Social Security.
72% OF RURAL HOSPITAL CLOSURES ARE IN STATES THAT REJECTED MEDICAID EXPANSION. Roughly 20% of Americans live in rural areas, including more than 13 million children, according to the last US census. And, according to research and reporting by the Pittsburg Morning Sun and its parent company, GateHouse Media, those people have been steadily losing access to hospitals for years, Luke Darby reported in GQ (7/30).
In Oklahoma, Georgia, South Carolina, and Mississippi, at least 52% of all rural hospitals spent more money than they made between 2011 to 2017. In Kansas, it’s 64%, and five hospitals there shut down completely in that time. Since 2010, 106 rural hospitals have closed across the country. (Another 700 are “on shaky ground,” and about 200 are “on the verge of collapse,” according to Gatehouse.) Of those 106 that closed, 77 were in deep red states where local politicians refused the Obama administration’s Medicaid expansion that came about as a result of the Affordable Care Act.
In short, the federal government provided funds to expand coverage for Medicaid, a program that helps pay for health care for low income patients. But the expansion was optional, and 14 Republican-controlled states rejected the money.
Just refusing the Medicaid expansion alone doesn’t completely account for the hundreds of rural hospital closures across Republican-controlled states. For one thing, medical treatment and technology has gotten more advanced. Dr. Nancy Dickey, president of the Rural and Community Health Institute at Texas A&M, told Gatehouse, “Most of what we knew how to do in the 1970s and 1980s could be done reasonably well in small towns. But scientific developments and advances in neurosurgery, microscopic surgery and the like required a great deal more technology and a bigger population to support the array of technology specialists.”
As a result, the number of services that rural hospitals offered started to shrink, while at the same time rural populations dwindled as both jobs and young people moved away. What’s left were older, poorer populations that needed more medical care and had less money to pay for it. In that situation, hospitals can’t generate enough revenue to stay open, let alone enough to pay the salaries of even new doctors, who carry an average of $200,000 in student debt.
Still, if the state legislatures and governors had accepted the money, billions of dollars could have gone to improving insurance coverage and propping up the hospitals’ bottom lines. In a health-care industry where the average CEO pay is $18 million a year, hospitals have to produce a lot of money to justify their existence to shareholders. The Medicaid expansion was one of the few lifelines available to rural Americans, and their politicians snubbed it.
From The Progressive Populist, November 1, 2019
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