Tag: house republicans
How House 'Opponents' Of Big Ugly Budget Bill Rolled Over For Trump

How House 'Opponents' Of Big Ugly Budget Bill Rolled Over For Trump

Early Thursday morning, July 3 — as House Speaker Hakeem Jeffries (D-NY) was laying out one reason after another why he considers President Donald Trump's "big, beautiful bill" a terrible piece of legislation — MSNBC reported that the megabill would soon be coming up for a full House vote and that Speaker Mike Johnson (R-LA) had secured enough votes to get it passed.

After the bill narrowly passed in the U.S. Senate, 51-50, Trump did everything he could to pressure House Republicans into voting "yes" as well. And according to Mychael Schnell and Mike Lillis, reporters for The Hill, that included a phone conversation in the wee hours with GOP lawmakers who were holdouts.

Schnell and Lillis report, "The phone call — which took place around 1 a.m. as holdouts huddled in a room off the House floor — came as a key procedural vote for the megabill remained open for almost four hours, with hardline conservatives and one moderate Republican hampering the legislation from moving forward. As of 2 a.m. on Thursday, the vote was 207 to 217, with five Republicans having voted 'no' and eight withholding their support. The combination has threatened to tank the rule, since Democrats are united against it, and a vote on the final package can't proceed without that rule."The GOP holdouts in the House, according to Schnell and Lillis, included Kentucky's Thomas Massie, Indiana's Victoria Spartz, and Indiana's Tim Burchett.

"During the conversation," the reporters explain, "Massie — who has been at odds with Trump over the megabill for weeks — suggested he was ready to drop his opposition and support the rule if Trump stops attacking him, The Hill has learned…. Trump and those in his orbit have gone after Massie in recent months after the Kentucky Republican voted against the House version of the megabill in May, and said the president's strikes on three Iranian nuclear facilities were 'not constitutional.'"

The journalists add, "A Trump-aligned super PAC, led by the president’s 2024 co-campaign manager, has rolled out ads bashing Massie as those in Trump World vow a primary challenger."

As the House vote was drawing closer on Thursday morning, Kentucky Gov. Andy Beshear, a centrist Democrat, appeared on MSNBC and said of the bill, "This is a huge betrayal…. A lot of jobs are going to be lost."

Reprinted with permission from Alternet

RNC Taking Unprecedented

It's Not Over: Now Is The Time To Pressure Vulnerable House Republicans

It was just under eight years ago that the nation nearly did what it is about to do and has never done before: Eliminate health insurance for millions of Americans.

I vividly recall how the last effort to repeal the Affordable Care Act ended. The entire newsroom of Modern Healthcare (the magazine I edited at the time) had gathered in front of a television monitor to watch the final Senate vote. President Donald Trump had strode into office promising repeal of the ACA. The House, with a large Republican majority, had voted in favor, but only narrowly. Twenty Republicans voted against scuttling a law that had succeeded in cutting the nation’s uninsured rate in half.

In the Senate, the decision came down to one man. Everyone stared as John McCain of Arizona, who was dying of brain cancer, strode across the Senate floor to cast the deciding vote. Republicans senators Lisa Murkowski of Alaska and Susan Collins of Maine had already voted no. As he approached the well where votes are cast, he stretched out his right arm. He had just held a brief phone conversation with the president. When his name was called, he held out his fist. With a quick flourish, he turned his thumb down. The gasp was audible.


The road to an inadequate system

Unlike every other country in the industrialized world, health insurance in the U.S. is not universal. Nor is it a right (despite the United Nations, the World Health Organization and a half dozen Democratic presidents declaring it so over the past 80 years). It is not even a guaranteed benefit for working under our employer-based health insurance system. There is no legal requirement that thousands of small businesses with tens of millions of workers offer coverage to their employees or that business, large or small, make it affordable when they do.

That’s why over the past century Congress has created an inadequate patchwork quilt of health insurance systems that to this day leaves 27 million people or 8.2% of the population uninsured. We have a government-run health care system for veterans (officially organized in 1921); a government-subsidized private insurance system paid for by employers (1940s); a government-run Medicare system for the old and disabled (1965); a joint federal-state Medicaid system for the poor (1965), subsequently expanded to include millions who work at low-wage jobs (20100; a government-run program for children who fall through the cracks (1997); and government-subsidized private health insurance for individuals who otherwise don’t have coverage (2010).

As Congress stitched each program onto the quilt, the share of the population without coverage fell. During recessions, the uninsured rate would sometimes rise temporarily, but the overall trajectory of the past century has been to move slowly, seemingly inexorably toward universal coverage.

We’re now on the verge of reversing progress for the first time. Donald Trump’s idea of making America great is to take us backwards to the time a little over a decade ago when fully 17% of the population was uninsured.

Let’s not forget that passage of the ACA took place against a backdrop of private insurance rates skyrocketing to pay for the uncompensated care given to the desperately ill people who showed up on hospitals’ doorsteps. It was also a time when tens of millions of people lacked access to routine health care, especially among the poor and poorly paid working class. That led to the gross disparities in life expectancy, infant and maternal mortality, and chronic disease incidence and deaths, which still bedevils this country.

Meanwhile, Robert F. Kennedy Jr., the Trump-appointed head of the Health and Human Services Department, is presiding over the dismantling of our world-class medical research system. He’s organizing sharp reductions in childhood vaccination programs and has little to say about the budgetary evisceration of our public health infrastructure. He makes loud pronouncements about the low quality of our food supply, yet says nothing about legislation that will literally rip food out of the mouths of children. Make America healthy again? Make America unhealthy again is more like it.

There’s still hope

Despite Trump’s threat to deploy the MAGA hordes to destroy the careers of Republican Congresspersons who go against his wishes, there’s still hope that the One Big Ugly Bill can be stopped. It only takes five Republicans in the House to vote no with the 212 Democrats who will be solidly against the legislation. The Senate version that passed Tuesday sharply reduces federal support for hospitals in nearly every jurisdiction in the country in addition to maintaining massive cuts in the core Medicaid program. Its aid for rural hospitals doesn’t begin to cover the losses most will absorb.

That’s the main reason the bill barely squeaked by in the upper chamber. GOP Sens. Thom Tillis of North Carolina and Susan Collins of Maine, who couldn’t stomach the Medicaid cuts, were joined by Sen. Rand Paul of Kentucky, who didn’t think its cuts went far enough. Alaska’s Sen. Lisa Murkowski, whose largely rural state would be harmed by the bill, could have been the deciding vote by said ‘yay’ despite what she said were grave misgivings. “We do not have a perfect bill by any stretch of the imagination,” she told reporters. “My hope is that House is going to look at this and recognize that we’re not there yet.”

The reality is that had she voted no, the bill as presently constructed would have died. That would have opened the Senate up for another round of deliberations where she would have wielded enormous influence.

“This fight’s not over”

The next battleground is the House, where Speaker Mike Johnson (R-LA), who represents another district heavily dependent on Medicaid, faces a difficult choice. He could call for a conference with the Senate, which could become a long and messy negotiation between budget hawks like Paul and those pleading for special bailouts like Murkowski and Collins.

Or, he could take the politically risky path of calling for a vote on the Senate bill, which would test Trump’s power. That opens the door for citizen activists, advocates for the poor, and the hospital and physician lobbies to put maximum pressure on Republican legislators, particularly those from swing districts that will suffer greatly from reduced support for Medicaid.

That work is already underway. Hundreds of people recently showed up on a rainy night in Omaha to pressure Rep. Don Bacon (R-NE), a former Air Force general. The Nebraska Hospital Association has warned his district faces at least six hospital closings should the bill pass. Last year, he narrowly won a district that supported Kamala Harris in the presidential race. After voting for the House version of the One Big Beautiful Bill, he announced his retirement.

“Nebraskans want no cuts to Medicaid,” Kelsey Arends, a staff attorney for Nebraska Appleseed, said at a press briefing organized by Families USA, which is just one of many groups organizing protests across the country. “340,000 people here rely on it.” Voters passed a referendum in 2018 expanding Medicaid under the ACA. In 2020, there were widespread protests that succeeded in stopping the Republican governor from instituting work requirements. “Rep. Bacon vowed to protect (Medicaid), but these bills are taking it away,” she said.

Similar local organizing campaigns are taking place in all the districts where Republican won House seats by thin margins, often riding into office on Trump’s coattails. Now they’re telling their constituents that they want to protect Medicaid and keep rural hospitals open.

“This fight’s not over,” Families USA executive director Anthony Wright said. “If these members mean anything that they said, they should not vote for this bill.”

Merrill Goozner is a former editor of Modern Healthcare, where he wrote a weekly column. He is also a former reporter for The Chicago Tribune and professor of business journalism at New York University.

Reprinted with permission from Gooz News.

How Trump's 'Big Beautiful' Medicare Cuts May Harm Your Health Care

How Trump's 'Big Beautiful' Medicare Cuts May Harm Your Health Care

I’m no defender of the cruel and unusual punishment inflicted on the American people by the House Republicans’ “One Big Beautiful Bill” passed late Tuesday night. And it’s important to understand that Medicare as well as Medicaid will take a major hit, nearly $500 billion in cuts over the next decade, according to the Congressional Budget Office.

But the political impact will be far less than the cuts to Medicaid, food stamps, reproductive health, environmental and other program contained in the bill. That’s why I’m interrupting my travels this morning to offer this explainer because how defenders of Medicare and Medicaid talk about these Medicare cuts matters.

Under the bill, Medicare will be subjected to sequestration under the 1997 Balanced Budget Act. Sequestration is an across-the-board cut in government programs that Congress can impose if a spending bill increases the deficit.

Not all programs are affected. Medicaid, Pell Grants, and Social Security benefits are exempt. Medicare, Head Start, housing assistance, public safety grants, and transportation, among many, are not. In theory, defense spending should also be cut, but it was increased under this bill.

CBO estimates this bill’s limited sequestration will impose a four percent across-the-board cut in Medicare funding. This would include payments to both providers (boo!!) and Medicare Advantage plans sold by insurers (yay!!). Since MA plans now cover over 51 percent of seniors and are paid somewhere between 8-20 percent more on average per beneficiary than traditional Medicare, insurers will get hit with most of the cuts.

Now, if this were targeted just at MA plans along with new requirements on how they spent the money (like raising the mandatory medical loss ratio to 90 percent from 85 percent), and the money saved was targeted to preserve Medicaid as it now is (the $500 billion would cover most of the proposed cuts to that program), I might be cheering this aspect of the bill.

But as it stands, this is how MA plans and providers in traditional Medicare will likely respond to sequestration should it make it into the final bill:

  • They will reduce access. MA insurers will impose more stringent prior authorization rules, increase claims denials, and impose reductions on the amounts they pay hospitals, doctors and other providers;
  • Physician practices will impose limits on patient access for non-essential and less remunerative services like wellness visits and preventive care. Private equity, insurer and some hospital-owned physician practices will speed up the treadmill that already has a typical office visit down to 13 minutes or less;
  • Fewer doctors in many areas of the country will accept new Medicare patients, resulting in longer wait times and more difficulty finding providers, especially specialists; and
  • Some of those extra benefits in MA plans will disappear or be made more difficult to use. Many plans may impose higher out-of-pocket costs; and
  • The cuts will be especially damaging in rural areas already suffering from hospital closures and physician shortages. Seniors and the disabled will have to travel farther for care.

CBO estimated Congress could save nearly $1 trillion over the next decade by simply cutting MA plan payments down to the same amount providers would have received had their beneficiaries remained in traditional Medicare. Instead, they crafted a sequestration that will make it harder and more expensive for seniors and the disabled to access care.

It is the ways that will affect beneficiaries is what the general public needs to hear about as the bill now moves to the Senate — not the top line dollar number for the cuts.

Reprinted with permission from Gooz News.

House Republicans Urge New Social Security Chief To Act With 'Caution'

House Republicans Urge New Social Security Chief To Act With 'Caution'

After financial services executive Frank Bisignano was confirmed this week to lead the Social Security Administration (SSA), a group of 15 House Republicans is now urging him to seriously address some of the lingering issues within the agency — including problems exacerbated by President Donald Trump's administration.

The Arizona Republic recently reported that a group of 15 House Republicans who are predominantly from swing districts co-signed a letter to Bisignano about their "concerns" with the SSA following his Tuesday confirmation vote. In the letter — which the Republic's Laura Gersony observed "alternated between praise and polite uneasiness" — the lawmakers told Bisignano that they hoped he would use his time as commissioner to focus on improving the SSA's increasingly poor customer service.

"We commend and support the continued efforts to make our bloated bureaucracy more efficient for the American people," the 15 Republicans wrote. "However, we must use caution and consider the impact any changes would have so there are no disruptions in services for our seniors and disabled who depend on the Social Security Administration to receive retirement benefits and supplemental security income."

The letter comes on the heels of a statement by former acting SSA commissioner Leland Dudek, who led the SSA after former acting commissioner Michelle Wolf resigned in February after she clashed with Department of Government Efficiency (DOGE) representatives. Dudek acknowledged the long wait times and packed lobbies that have long plagued retirees — but blamed them on former President Joe Biden's administration "advancing radical DEI [diversity, equity and inclusion] and gender ideology over improving service for all Americans."

Dudek also spearheaded an effort to downsize the SSA's 57,000-member workforce, and convinced roughly 3,000 of them to take buyouts. Last month, the SSA announced that all official communications would be done exclusively through X (which is owned by DOGE co-founder and Tesla CEO Elon Musk) rather than issue press releases. DOGE also cancelled leases for SSA offices in multiple rural communities, meaning that retirees and disabled people who depend on Social Security now have to drive for several hours to their nearest office just to have basic questions answered.

Advocates warned that those measures could result in eligible recipients losing benefits they are entitled to through no fault of their own, given that many beneficiaries are elderly and may not have the ability to use new technology or leave their home to travel to an SSA office.

""I wish I had a better answer for people, but this is going to end in checks not going out, the money that we have earned not getting into our hands," Social Security Works executive director Alex Lawson told MSNBC host Rachel Maddow in April. "And I believe strongly that that's the point. The cuts they've made have no other rhyme or reason except to literally destroy the system."

Reprinted with permission from Alternet.

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