Insurers Come Out Swinging Against New Republican Health Care Bill
September 21, 2017 by admin
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Senate Republicans are already under pressure from 11 governors — including five fellow Republicans and a pivotal Alaskan independent — who this week urged the Senate to reject the last-ditch repeal effort.
The two major trade groups for insurers, the Blue Cross Blue Shield Association and America’s Health Insurance Plans, announced their opposition on Wednesday to the Graham-Cassidy bill. They joined other groups fighting the bill, such as the American Medical Association, the American Hospital Association, AARP and the lobbying arm of the American Cancer Society.
“The bill contains provisions that would allow states to waive key consumer protections, as well as undermine safeguards for those with pre-existing medical conditions,’’ said Scott P. Serota, the president and chief executive of the Blue Cross Blue Shield Association. “The legislation reduces funding for many states significantly and would increase uncertainty in the marketplace, making coverage more expensive and jeopardizing Americans’ choice of health plans.”
America’s Health Insurance Plans was even more pointed. The legislation could hurt patients by “further destabilizing the individual market” and could potentially allow “government-controlled single payer health care to grow,” said Marilyn B. Tavenner, the president and chief executive of the association. Without controls, some states could simply eliminate private insurance, she warned.
Insurers had been reluctant to speak out against the Republicans’ previous proposals in hopes that the White House and Congress would agree to stabilize insurance markets by providing critical funding for subsidies aimed at low-income Americans. But with hopes of securing that money before they finalize their rates virtually extinguished, insurers have less to lose by coming out against the proposal.
And many within the industry are worried that the next two years will be chaotic, with little support for the current market while states scramble to come up with a new way for individuals to buy policies.
“It’s just basically injecting chaos in 50 state capitals for the next two years,” said Sabrina Corlette, a research professor at Georgetown University.
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At this point, Republicans have not secured the 50 votes they would need to pass the bill, with help from Vice President Mike Pence to break a tie. But President Trump, in New York for meetings with world leaders at the United Nations, said he thought the health care bill had “a very good chance’’ of passing.
It has “tremendous support from Republicans — certainly we’re at 47 or 48 already,’’ he said, and “a lot of others are looking at it very positively.’’
“A great Bill,” Mr. Trump concluded on Twitter later Wednesday.
I would not sign Graham-Cassidy if it did not include coverage of pre-existing conditions. It does! A great Bill. Repeal Replace.
—
Donald J. Trump (@realDonaldTrump)
Sept. 20, 2017
The latest Republican drive to repeal the Affordable Care Act has created painful choices for Republican senators from states that stand to lose money under the legislation.
The bill would eliminate penalties for people who go without insurance, and it would funnel federal funds to states in the form of block grants for health care or coverage. States could decide how to spend the money, which is now being used for the expansion of Medicaid and for subsidies to help low- and middle-income people buy private insurance.
State officials were racing to try to figure out the impact, looking to experts to help them do the calculations.
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“States such as Alaska, Connecticut, Delaware, New Hampshire, New Mexico, New York, Oregon, Vermont and Washington would see reductions of 25 percent or more over the 2020 to 2026 period,” compared with what they would receive under current law, said a monograph issued on Wednesday by Manatt Health, a unit of Manatt, Phelps Phillips, a national law firm that advises many states on health care issues.
Among the Republicans agonizing over how to vote is Ms. Murkowski, who has said the bill’s effect on her state will be her paramount consideration.
Becky Hultberg, the president and chief executive of the Alaska State Hospital and Nursing Home Association, said on Wednesday that the cuts in the bill could have a “huge impact” on Alaska.
“The cuts could be devastating to our health care system, including rural and frontier hospitals that operate on razor-thin margins,” Ms. Hultberg said in an interview. “These hospitals are often accessible only by airplane or ferry, so the loss of a hospital means an expensive and disruptive medical evacuation out of the community.”
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“Ultimately,” Ms. Hultberg said, “patients will bear the consequences, through reduced access to health care and lost insurance coverage.”
The authors of the new repeal bill, Mr. Graham and Mr. Cassidy, say decisions about health care are best made at the local level.
Mr. McCain is a close friend of Mr. Graham, but is still studying the bill and has not said how he would vote.
The other Republican senator from Arizona, Jeff Flake, had no such hesitation. “Given the choice between Arizona or Washington deciding how federal health care dollars are spent in the state,’’ he said, “I’ll take Arizona every day of the week.’’
The Manatt study said Arizona would lose money under the bill, and a study by Avalere, a health policy consulting company, reached a similar conclusion. Both studies indicated that Tennessee would gain money.
Senator Bob Corker, Republican of Tennessee, said he liked the latest repeal bill. “I’d be ecstatic if we could finally make something happen on health care’’ by passing it, he said, adding: “I’m a states’ rights kind of guy. Our state has been well run for a long time. To know that our state would have the flexibility to carry out the program with more money than it now has could be a real win for us.’’
The studies by Manatt and Avalere suggest that West Virginia would lose money under the bill. Ms. Capito “is still evaluating the proposal,” said her spokeswoman, Ashley Berrang.
But the state’s senior senator, Joe Manchin III, a Democrat, said, “The numbers do not work at all for West Virginia, with an older, sicker population and an opioid addiction problem.”
“As a former governor, I like the concept of block grants because they give you flexibility,” Mr. Manchin said. “But the cuts are deeper than the needs we have, and our needs are greater than the money we would have under the bill.”
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At Mexican School Hit by Quake, Heartbreak and Dwindling Hope
September 21, 2017 by admin
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Many did, having rushed out before tumbling walls could trap them. Passers-by had also raced to the school immediately after the quake to pluck students from the cavities and openings of the buckled structure.
But as the day and night wore on, mostly lifeless bodies were pulled from the wreckage, their names recorded by an army of volunteers keeping lists of the dead. By Wednesday night, five people were known to be still missing, including one student who officials said was alive but trapped as rescuers tried frantically to reach her. Hope was dwindling that any more children would be found alive.
“To see a parent carry their own dead baby is something I will never forget,” said Elena Villaseñor, a volunteer whose own home was badly damaged. She held a sheaf of papers with the names of children on them, written large enough for parents to see them from a distance.
Her own daughter was safe, she said, having been at a different school that did not collapse. But she could not sit idle while others suffered, and so she raced to this school to help however she could.
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Miguel Tovar/Associated Press
The death toll across the country — in Morelos, Mexico State, Puebla and Mexico City — climbed to 217 people less than 24 hours after the earthquake struck. The number is expected to rise even higher, as the rescue efforts slowly transition into recovery efforts, and more of the missing are marked as dead.
Watching that number climb, hour by hour across the city and the broader earthquake zone, is a nation already in mourning. Two weeks earlier, the largest earthquake in a century hit Mexico, killing at least 90 people in the south of the country and offering a grim foreshadowing of the hardship still to come from this one.
Perhaps nowhere was the suffering more concentrated than at the collapsed school. The smell of gas, sweat and earth filled the air overnight as people yelled their messages into megaphones. At first, the lights from police cars and emergency vehicles lit the rescue. Later, a generator was brought to the scene to power floodlights.
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Of the 400 students who attend the school, it was unclear exactly how many were there when the earthquake struck on Tuesday afternoon and made it out of the building. The injured, more than 60 of them, were sent to area hospitals, while traumatized parents whisked others to safety.
At least three parents at the site of Enrique Rebsámen, a Mexico City private school, had been communicating with their children trapped inside. They managed to reach them through the messaging service WhatsApp, begging their children to give them details, like how far from the main door they were when the building collapsed, to help the search efforts.
One of the many volunteers, seated at a makeshift desk on Tuesday night, helped keep a list of the injured and the dead; it included at least five adults. Residents donned red vests and formed human chains to remove the chunks of concrete from the school’s broken edifice. Giant piles of water, medicine, blankets and even baby formula hugged the periphery, brought by neighbors who carted it in by the armful.
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The solidarity in the aftermath of the quake has been repeated at collapsed buildings across Mexico, a quiet but resolute determination to help. Strangers spending hours clearing debris, medics and construction workers plunging into the bowels of broken buildings, students and even children bringing water and food.
At the school, the blitz of activity continued all night and into morning. Someone yelled for medicine: “We need clonazepam, insulin, anesthetics, antihistamines and oxygen tanks.” Workers wore helmets and face masks. Bulldozers and excavation machines went in and out of the disaster site.
Everyone found something to do, passing water, coffee or medicine to those who needed it. Volunteers called for baby bottles to feed the children still trapped in the wreckage.
Every so often, amid the piercing noise of raised voices, grumbling machinery and the whine of ambulances, a volunteer’s arm would rise and others would follow. An odd silence would settle over the gathered.
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Carlos Jasso/Reuters
A name would be called.
“Sara Ledesma! Where are her parents?” a paramedic screamed. No one appeared, and the masses voiced her name in somber chorus.
Her parents were nowhere to be found.
In the frantic confusion of the rescue operation, the crosscurrents of hundreds of well-meaning personnel sometimes led to frightening miscommunication.
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After toiling for hours sifting through the rubble, Florentino Rodríguez García was given a sudden ray of hope: His 9-year-old grandson, José Eduardo Huerta Rodríguez, was supposedly fine.
A medic told him that the boy had been taken to a hospital for injuries. But after hours of hunting, Mr. Rodríguez could find no trace of the boy.
He headed back to the school and was approached by a nurse this time. She took him by the hand. She told him the medic had been mistaken. José, she said, was still trapped inside.
“Please don’t tell me that,” Mr. Rodríguez screamed, collapsing into hysterics. “They told me he was out! This can’t be true!”
“We just celebrated his birthday this past Sunday,” he told the woman, who listened quietly. “He is such a smart little boy!”
He melted back into the crowd of anguished parents congregated outside of the school — and waited.
And then, an hour later, an arm was raised, followed by others. Silence.
“José Eduardo Huerta Rodríguez,” the crowd began to chant.
The boy had been pulled out. He was still alive, a rescue worker said.
But several hours later, a family member emailed to say that in the chaos, the rescuer had been mistaken. José Eduardo, the relative said, had died before his body was recovered.
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