Anxiety over GOP health plan for those with severe illnesses
Unease and uncertainty are settling over Americans with serious illnesses as Republicans move closer to dismantling Democratic former President Barack Obama‘s health care system. A New Orleans attorney with multiple sclerosis fears he’ll be forced to close his practice if he loses coverage, while a Philadelphia woman with asthma is looking at stockpiling inhalers. The Republican health care bill pushed through the House on Thursday leaves those with pre-existing conditions fearful of higher premiums and losing coverage altogether if the Affordable Care Act is replaced. The bill sets aside billions of dollars more to help people afford coverage, but experts say that money is unlikely to guarantee an affordable alternative for people now covered under a popular provision of the existing law that prevents insurers from rejecting them or charging higher rates based on their health. What happens to those with pre-existing conditions under the Republican plan remains unknown. Several people unsettled by the prospects expressed these concerns. ___ FORMER UTAH CHEF Jake Martinez said he’s worried about getting health insurance in the future because he has epilepsy, considered a pre-existing condition by insurers. For the last several years, he, his wife and their three children have settled into a comfortable place using health insurance under the Affordable Care Act. But now the Murray, Utah, residents are worried about what may happen with this new health care bill. “Today, it really kind of sunk in that not only are we not going to potentially have health care coverage but that it was done as a political win rather than a well-thought-out plan,” said Martinez, a 32-year-old former chef who’s studying social work. “That’s what stings about it.” ___ KENTUCKY ATTORNEY Shortly after being diagnosed with type I diabetes, Amanda Perkins learned about the perils of pre-existing conditions when she starting trying to buy health insurance. Now she worries that protections under the Affordable Care Act that made sure certain essential health benefits, like insulin prescriptions, could be eliminated. The new Republican plan would let some states allow insurers to charge higher premiums for people with pre-existing conditions, but only if those people had a lapse in insurance coverage. Supporters say those states would need to have programs in place to help people pay for expensive medical treatments, including high-risk pools. But Perkins said Kentucky’s previous high-risk pool had a 12-month waiting period and was too expensive for her. “I bought a house just a couple of months ago. Will it come down to me paying my mortgage payment or paying my health insurance so I don’t have a lapse in coverage?” said Perkins, an attorney for a small firm in Lexington, Kentucky. ___ KANSAS GRAPHIC DESIGNER Janella Williams has a rare neurological disorder that forces her to receive expensive IV drugs every seven weeks. Without it, she would not be able to walk. Williams, who owns her own graphic design company in Lawrence, Kansas, pays $480 under an Obamacare plan. It keeps her out-of-pocket maximum at $3,500 a year and provides her coverage despite her pre-existing condition. “I’m terrified of becoming disabled. If I’m being completely honest, I’ve thought of ending my life if it comes to that,” she said. High-risk pools run by the state are not the answer, she says. The Republican plan would also bring back lifetime caps on coverage, which Williams says she would meet after only her first IV treatment. She and her husband both work full time, but wouldn’t be able to afford the roughly $600,000 a year her treatments cost once the cap is met. “I have really lost my faith in humanity,” she said. “It’s terrible how little we care for the sick.” ___ NORTH CAROLINA FINANCIAL ADVISER John Thompson credits his survival in large part because he bought a family insurance policy through the Affordable Care Act marketplace. Thompson, of Greensboro, North Carolina, was laid off in 2013, lost his employer-backed insurance and diagnosed with cancer during the year he was unemployed. If the House proposal allowing insurers to make coverage for pre-existing conditions unaffordable takes hold, he fears his cancer history will make him uninsurable if he would lose his current job as a retirement financial adviser. “Like many of us here, whether you have asthma or a heart condition or diabetes or like me, cancer, any type of pre-existing condition, you go back to the way it was before, you give insurance companies carte blanche to do their underwriting and to exclude you,” Thompson said. ___ FLORIDA MOM Shelby Jehlen, of New Port Richey, Florida, was diagnosed six years ago with leukemia and says she wouldn’t be able to afford insurance if she lost her roughly $400 a month subsidy. Jehlen saves about $1,000 every three months to see her cancer doctor under her Obamacare plan, but still pays about $1,500 for the check-ups. She was forced to quit work because of all the X-rays and other chemicals she was exposed to daily as a veterinary assistant and now cuts corners, sacrificing phones and school activities for her two teen daughters, to afford the monthly premiums. The stress has caused her to struggle with depression and anxiety. “Absolutely, I’m scared. I’m worried I’m going to have to figure out what I’m going to do with all my side effects with my leukemia if they take this away from me,” she said. ___ PHILADELPHIA BUSINESSWOMAN Adrienne Standley has been preparing for the possibility of losing her insurance since President Donald Trump took office. Three days after the inauguration, she set up an appointment for a birth control implant so she would be covered for four years, no matter what happens. The 29-year-old operations director at a start-up apparel business in Philadelphia also has asthma and attention deficit disorder. “I’m looking at stockpiling, making sure I have an inhaler,” she said. “I’m pretty scared to lose coverage.” ___ NEW ORLEANS ATTORNEY John S. Williams says he’ll be forced to close his practice and find a job with a group insurance
Americans offer hope, prayer in assessing Donald Trump’s 100 days
They are young and old: a high school student who can’t yet vote, a Vietnam vet who did so proudly. They hail from all corners of the United States and very different walks of life: a “downhome boy” from Kentucky, a third-generation Mexican-American from Texas, a stay-at-home mom in Pennsylvania, an Iranian immigrant in Los Angeles. Some oppose Donald Trump and all that he stands for, while others voted enthusiastically for him. Now, they are critiquing him. One hundred days into Trump’s presidency, The Associated Press returned to some of the everyday people interviewed these past months to ask them to write a letter to the president, evaluating the job he’s done so far and looking ahead to the months to come. One supporter tells the president he “might have fallen a little short” — on Obamacare, in particular — but he signs off “with hope.” A refugee implores Trump to “make America more friendly,” but finds optimism in the president’s reaction to this month’s chemical attack in Syria: “I hope this is a turning point.” A Trump objector calls his biggest accomplishment “waking up the public to fight.” She offers this advice: “Make decisions with your heart. It will give you wisdom.” ___ FROM RURAL AMERICA, A SUPPORTER SEES HOPE IN TRUMP’S PRESIDENCY Alan Halsey, 31, is a self-described “downhome boy” from Campton, Kentucky, who along with his wife owns and operates The Swift Creek Courier, a weekly newspaper, and Halsey’s Country Store, “a small business that is a chunk of 1950 set down in 2017.” He says he works seven days a week to try to provide for his family, but is struggling and tired of government regulation and red tape. He wrote: ” … I supported you quite strongly in the 2016 election, even to the point of hanging one of your signs on the front door of my business. I particularly related to your foreign policy of ‘America First,’ and your promise to bring business back to the United States. So far, I believe you’re heading in the right direction on that front, and I find a glimmer of hope in the future of the American economy. “Overall, I think you might have fallen a little short on your first 100 days, but I don’t put a lot of weight into a time frame that small. Provided you serve two terms, 100 days is about 4 percent of that. I still feel that something needs to be done with the Affordable Care Act, although I’m not certain exactly what. … I know many ACA recipients that visit a doctor more than once a week, while those that purchase their own insurance wait until a visit to a doctor is imperative to their survival. There must be a middle to that scenario. …” He signed his letter: “With Hope.” ___ CANCER SURVIVOR WORRIES OVER TRUMP’S PROPOSED BUDGET CUTS, BUT PRAYS FOR HIM Rebecca Esparza, 45, is a freelance writer in Corpus Christi, Texas, who didn’t vote for Trump. A cancer survivor, Esparza fears proposed budget cuts targeting the nation’s premier medical research institution, the National Institutes of Health, will hurt Americans who battle illness. She wrote: “. I cannot say I’m proud of your work so far. However, I have respect for the Office of the President, even if I disagree with your political aspirations. … I could write a dissertation on the many ways I disagree with your political ideals. I’m a third-generation Mexican-American, born and raised in South Texas. Your disdain for Mexico, its descendants and immigrants in general troubles me. Your plan to dismantle the Affordable Care Act, leaving millions of Americans with no other health insurance options, leaves me anguished. “But what distresses me most is your plan to cut nearly $6 billion in funding from the National Institutes of Health (NIH). On Thanksgiving Day in 2001, at age 30, I was diagnosed with ovarian cancer. … Cancer research saved my life. … The cuts you are proposing are disconcerting not only for cancer survivors, but for millions of Americans suffering from many types of chronic and rare diseases. … “I’ll be praying for you, President Trump. … I pray you will carefully consider how your decisions have life or death consequences for hard-working Americans.” Read more about Esparza. ___ ONE-TIME OBAMA VOTER FEELS PRIDE IN TRUMP’S WORK Laverne Jones Gore, 60, owns an executive leadership development company in Cleveland and voted for Trump after previously supporting Barack Obama. Gore calls herself a “middle-class American who happens to be black” and says she felt uncomfortable voicing her opinion during the Obama years, but Trump has “made me proud to be an American again.” Part of a military family — her deceased husband was a Marine and a son graduated from West Point — Gore’s one hesitation these past 100 days is over Trump’s airstrike in Syria. She wrote: ” … Mr. President you have absolutely met my expectations. I actually believe you have shown a strength that I had not given to you, and I am surprised by your willingness to meet head on the challenges and resistance within your governing bodies. I don’t believe you have been afforded an opportunity to really show us what you have to offer in the form of leadership of our nation. “I have no issue with you as it relates to ‘Russians.’ I personally believe most of it was contrived. I have no issue with you as it relates to immigration. I think the issues were in need of control. … I have some reservations about your use of Twitter, but I understand the difficulty you have getting your intended message out. “Yes, you surprised me with the Syria strike and I am not certain how I feel about another war or thought of war. I am still contemplating your action and observing the responses to come from the world theatre as they absorb your full intent.” ___ ‘YOUR SIGNATURE CRUSHED MY FAMILY’ Marjan Vayghan, 32, an artist and writer
House Freedom Caucus chairman says there’s ‘no deal’ on the GOP health care legislation after White House meeting
The Latest on the upcoming health care vote in the House (all times local): 1:35 p.m. The chairman of the conservative House Freedom Caucus says there’s “no deal” on the GOP health care legislation after a meeting at the White House with President Donald Trump. The assertion from Congressman Mark Meadows of North Carolina throws plans for a vote on the bill later Thursday into doubt. Two dozen or so Freedom Caucus members have opposed the legislation pushed by GOP leaders, saying it doesn’t go far enough to repeal “Obamacare.” But the group had been negotiating directly with the White House in hopes of reaching agreement to eliminate additional requirements on insurers. Without a deal with the Freedom Caucus, and with moderate-leaning members defecting, it seems unlikely GOP leaders will have the votes they need to go forward with a vote later Thursday as they had planned. ___ 10:06 a.m. Former President Barack Obama is celebrating the seventh anniversary of his landmark health care law, saying in a statement on Thursday that “America is stronger because of the Affordable Care Act.” Obama does not directly address GOP efforts to repeal his law, which are coming to a head Thursday as House leaders push toward a vote on their repeal legislation. Republicans remain short of votes. The former president does say that if Republicans are serious about lowering costs and expanding coverage, and are prepared to work with Democrats, “That’s something we all should welcome.” But, Obama says, “we should start from the baseline that any changes will make our health care system better, not worse for hardworking Americans.” He notes 20 million Americans gained coverage under his law. ___ 9:40 a.m. President Donald Trump is urging people to call their lawmakers to express support for the Republican legislation to repeal and replace “Obamacare.” Trump posted a video on Twitter Thursday asking people to get behind the plan. He says that people were “given many lies” about the Affordable Care Act. Trump added that the legislation was “terrific” and “you’re going to be very, very happy.” The GOP legislation was on the brink hours before Republican leaders planned to put it on the House floor for a showdown vote. Trump was spending the final hours trying to close the deal with conservatives who have opposed the plan. ___ 9:00 a.m. The GOP’s long-promised legislation to repeal and replace “Obamacare” stands on the brink, just hours before Republican leaders planned to put it on the House floor for a showdown vote. The stakes are high, and Republicans are staring at the possibility of a failure that would throw prospects for their other legislative goals into uncertainty. Speaking to members of the conservative Freedom Caucus mid-day Thursday, Trump is pitching concessions to representatives who want to limit the requirement for health plans to include benefits including substance abuse and maternity care. But those changes appear to be scaring off at least some moderate Republicans. In a count by The Associated Press, at least 26 Republicans say they opposed the bill, enough to narrowly defeat the measure. Republished with permission of The Associated Press.
House GOP health bill facing fresh House committee test
The White House and Republican leaders are talking to rank-and-file lawmakers about revising the GOP health care overhaul, hoping to keep a rebellion by conservatives and moderates from snowballing and imperiling the party’s showpiece legislation. Four days after a congressional report projected the bill would pry coverage from millions of voters, signs of fraying GOP support for the legislation were showing. The measure would strike down much of former President Barack Obama‘s 2010 overhaul and reduce the federal role, including financing, for health care consumers and is opposed uniformly by Democrats. In a fresh test of Republicans’ willingness to embrace the legislation, the House Budget Committee was considering the measure Thursday. Republicans expressed confidence the bill would be approved, but the vote could be tight. The panel can’t make significant changes but was expected to endorse non-binding, suggested changes to nail down votes. The bill would eliminate the tax penalty that pressures people to buy coverage and the federal subsidies that let millions afford it, replacing them with tax credits that are bigger for older people. It would cut Medicaid, repeal the law’s tax increases on higher earning Americans and require 30 percent higher premiums for consumers who let coverage lapse. Overt GOP opposition grew after the nonpartisan Congressional Budget Office projected Monday that the legislation would push 24 million Americans off coverage in a decade and shift out-of-pocket costs toward lower income, older people. Obama’s law has provided coverage to around 20 million additional people House Speaker Paul Ryan, R-Wis., told reporters Wednesday that leaders could now make “some necessary improvements and refinements” to the legislation. But he declined to commit to bringing the measure to the House floor next week, a schedule Republican leaders have repeatedly said they intended to keep. At a late rally in Nashville Wednesday, President Donald Trump said: “We’re going to arbitrate, we’re all going to get together, we’re going to get something done.” Vice President Mike Pence met with House GOP lawmakers and pressed them to unite behind the legislation. “‘It’s our job to get it out of here and get it to the Senate,’” Pence told Republicans, according to Rep. Dennis Ross, R-Fla. That would let Trump pressure “Democrats in these red states to come on board,’” Ross said, referring to Republican-leaning states where Democratic senators face re-election next year. But insurgents still abound. Conservatives want to end Obama’s expansion of Medicaid to 11 million additional low-income people next year, not 2020 as the bill proposes. They say a GOP proposed tax credit to help people pay medical costs is too generous, and they want to terminate all of Obama’s insurance requirements, including mandatory coverage of specified services like drug counseling. Rep. Mark Meadows, R-N.C., head of the hard-line conservative House Freedom Caucus, continued pushing for changes. He claimed at least 21 members of his group would oppose the measure as written; the bill would fail if 22 Republicans join all Democrats in opposing it. But underscoring the push-pull problem GOP leaders face in winning votes, moderates feel the tax credits are too stingy, especially for low earners and older people. They oppose accelerating the phase-out of the Medicaid expansion and are unhappy with long-term cuts the measure would inflict on the entire program. Terminating the Medicaid expansion in 2020 and not 2018 “is sacrosanct to me,” said moderate Rep. Tom MacArthur, R-N.J. In a new complication, Sen. Charles Grassley, R-Iowa, said the measure lacked the votes to pass in the Senate, where Republicans hold a precarious 52-48 majority. That left House members angry over being asked to take a politically risky vote for legislation likely to be altered. Moderates “don’t like the idea of taking a vote in the House that may go nowhere in the Senate,” said Rep. Charlie Dent, R-Pa. Amid the maneuvering, a federal report said more than 12 million people have signed up for coverage this year under the very statute that Republicans want to repeal. That figure underscored the potential political impact of the GOP’s next move. Republished with permission of The Associated Press.
18M more Americans would be uninsured under 2016 GOP repeal
Insurance premiums would soar and some 18 million Americans would lose health coverage if Republicans partially repeal President Barack Obama‘s health care law without a replacement, Congress’ nonpartisan budget office estimated Tuesday. The Congressional Budget Office analyzed a GOP 2016 repeal measure, which Republicans have cited as a starting point for their 2017 drive to dismantle and replace Obama’s health overhaul. Premiums for policies bought from online marketplaces established by Obama’s law would rise up to 25 percent a year after enactment of repeal. They’d about double by 2026, the report estimated. There’d also be 18 million more uninsured people a year after enactment and 32 million more by 2026, the report projected. The numbers served as a flashing yellow light for this year’s effort by President-elect Donald Trump and congressional Republicans to annul Obama’s law and — in a more complex challenge — institute their own alternative. While Republicans have produced several outlines for how they’d recraft Obama’s 2010 statute, they’ve never united behind one plan despite years of trying and there are many unknowns about what will happen in insurance markets while the GOP effort is underway. The report also became immediate political fodder for both sides in what is expected to be one of this year’s premier battles in Congress. Trump seemed to complicate that fight over the weekend when he told The Washington Post that a forthcoming GOP plan would provide “insurance for everybody.” In contrast, some congressional Republicans have used a more modest description, saying the plan will offer “universal access.” The 2016 bill that CBO analyzed did not replace Obama’s law with a GOP alternative, which Republicans have insisted will be an integral part of their health care drive this year. Because of that omission, Donald Stewart, spokesman for Senate Majority Leader Mitch McConnell, R-Ky., said the report “assumes a situation that simply doesn’t exist and that no one in Congress advocates.” AshLee Strong, spokeswoman for House Speaker Paul Ryan, R-Wis., called the estimates “meaningless” because they ignored plans for legislation and regulatory actions by the incoming Trump administration aimed at revamping how people could obtain coverage. Even so, Republicans have cited last year’s bill — which Obama vetoed — as a starting point for their 2017 drive to erase his law. Finding unity among Trump and GOP lawmakers on what a new plan should look like is expected to be a challenging task Democrats used the report as ammunition to assail the Republican health-care push. “Nonpartisan statistics don’t lie: it’s crystal clear that the Republican effort to repeal the Affordable Care Act will increase health care costs for millions of Americans and kick millions more off of their health insurance,” Senate Minority Leader Chuck Schumer, D-N.Y., said in a written statement that used the law’s formal name. Republished with permission of The Associated Press.
