Trump's HHS still sabotaging Obamacare

The New York Times reporters Audrey Carlsen and Haeyoun Park exposed the ways in which the Trump administration continues to sabotage the Affordable Care Act in addition to the obvious political fight over its future.

"The Trump administration said in August that it would slash spending on advertising and promotion for the Affordable Care Act, but it has already been waging a multipronged campaign against it.

"Despite several failed efforts by Republican lawmakers to repeal it, the Affordable Care Act remains the law of the land.  But the Department of Health and Human Services -- an agency with a legal responsibility to administer the law -- has used taxpayer dollars to oppose it.

"Legal experts say that while it is common for a new administration to reinterpret an existing law, it is unusual to take steps to undermine it.  Here are three ways the health department has campaigned against Obamacare."

The uncertainty of whether the plan would be repealed -- as well as the reduced participation resulting from slashed budget for advertising and promotion - leave insurance companies unable to estimate their costs for the coming year.  So they jack up premiums to avoid losing money.  So Republicans saying costs are out of control -- and then sabotaging its success -- becomes a self-fulfilling prophecy.

This is a Republican strategy to try to make Obamacare fail, which they've been predicting ever since it became law.   Here are some other ways in which Team Trump is sabotaging the health care plan, as reported by the authors.

1.  "Redirecting Promotional Funding."  Instead of using its outreach budget to promote the ACA, the department made YouTube videos critical of the law.    The videos were testimonials of people who said they had been "burdened" by it.  One of them told reporters that he felt he was being pushed to "take a harder line against Obamacare."   The preponderance of negative reports in the department videos did not match the independent polls,

2.  "Attacking the Law."  The department targeted the ACA with a marketing campaign as Republicans in Congress tried to repeal the legislation.   During the period Congress was deliberating the law, Secretary of HHS Tom Price "sent out on Twitter 48 infographics advocating against" the program it is supposed to administer.  In addition, "the Trump administration ended $25 million worth of contracts that help people sign up for coverage."

3.  "Deleting Information Online.   The department removed useful guidelines for consumers about the ACA from its website."  Much of the information that the Obama administration had put online to help consumers learn about he ACA and how to obtain coverage is now gone, some of the basic links the very night of the inauguration.  It also erased positive personal stories about benefits people had received.

The authors conclude with a comment from the Center on Budget and Policy Priorities, a liberal think tank that said:   "It's these kinds of actions -- pulling back on outreach and enrollment, disseminating negative propaganda about the existing law -- those are the things that make the market implode."

And yet -- in spite of their best efforts, and in spite of lack of cooperation by a number of Republican governors in red states, and despite SCOTUS taking out one of the elements that made it work -- despite all that, Obamacare still lives.  And now a bipartisan group from the health committee in Congress is working to fix some of the problems that will make it work better, thanks to the leadership of Republican Lamar Alexander and Democrat Patty Murphy.

Ralph

PS:  On Tuesday this week, Sen. Bernie Sanders introduced his "Medicare for All" bill in the Senate.  In writing about this, Matthew Yglesias wrote on Vox.com that "By destabilizing ACA marketplaces, Donald Trump is leaving Democrats nowhere to go but left."   And he's still doing it, as described above.  Yglesias' point is that this commits Democrats to going the route of an all-government program, including phasing out the employer-based health insurance.   If instead Republicans had helped to improved Obamacare, the long-range solution could have developed in the direction of a private-insurance-based system, or at least some sort of a hybrid plan.    I'm not arguing that an all-government program is bad, but some people would.   The point is:  it's a more radical change than one involving private insurance.

PS#2:  In less than 2 weeks, insurance companies must lock in their premium rates for the coming year.  And Donald Trump still refuses to say whether he will continue paying subsidies to help make coverage affordable.   The insurers say, quite frankly, that it's this uncertainty that impels them to raise rates.   Meanwhile, the large insurance company Anthem has agreed to provide coverage in any county in the country.  So this eliminates the problem of places with no available exchange policies.

Trump seems to ease up on immigration; base goes ballistic.

It was bad enough when President Trump accepted the Democrats Schumer-Pelosi suggestion to pair a 90 day extension of the debt ceiling with funding for Hurricane Harvey relief. ["bad enough" = from the point of view of Trump's ultra-right political base.]

But then Wednesday night, over a White House dinner with Schumer and Pelosi, Trump apparently agreed with them again, this time on legislation that would save the DACA Dreamers from deportation, with a path to citizenship, paired with increased money for border security.

The Dems say it was also agreed that the funding for border security could not be used for building a wall.   The White House pushed back on the last point, first saying that was not part of the deal;  then later, saying "there was no deal" at all. Another source said that the president would continue to press for the wall in other avenues.

Either way, Trump's key ultra-right, anti-immigration supporters went ballistic.   Thanks to HuffPost's Willa Frej for this reporting:

"Far-right news outlet Breitbart News ran with the headline, 'Amnesty Don.'"  That was followed by this:  "President Trump signaled a full-fledged cave on the issue of giving amnesty to nearly 800,000 illegal aliens currently protected by an Obama-created executive immigration program."

Best Bud Sean Hannity, Fox News star who usually sides with Trump -- and sometimes leads him -- declared that "it's over" for the president if he abandons his hardline immigration stance.

Iowa's Rep. Steve King, a Trump stalwart in Congress, tweeted that "If AP is correct, Trump base is blown up, destroyed, irreparable, and disillusioned beyond repair.  No promise is credible."   Former Illinois congressman Joe Walsh said that Trump has "screwed his base."

Thursday morning, Trump tweeted out a defensive reminder that the Dreamers were here "through no fault of their own."   Conservative firebrand Ann Coulter fired back:   "Who DOESN'T want Trump impeached?"

Whew !   This is immediate, extremely harsh, and utterly complete.   Trump has a choice.   Work with Democrats and get something half-way responsible done -- or face war and abandonment from the shrinking base he has left.

At least that is the vocal, media or media-friendly opinion shapers on the far-right.   Let's see what the average far-right voters say in a few days.

And, of course, what Trump does now matters.   Will he try to back out?    Or might he really pivot now toward the Democrats?    I occasionally had the fantasy that this least-ideological, most-malleable president could possibly abandon the right-wing and realign himself with a Democrat/Moderate Republican coalition.

Ralph

PS:  As the furor has grown throughout the day on Thursday, Trump has given conflicting statements, denying that any deal was made, insisting he would not do anything without funding for a wall, etc.   Typical chaos of the man who occupies the Oval Office.   He's fast losing the position of "most powerful man in the world," as his word becomes completely unreliable.   Who can trust him?  Now, even his solid base is learning that they can't either.  With this hit-you-in-the-face betrayal, they may start to notice how many other promises he has failed to keep.

Understanding Hillary Clinton and politics

Hillary Clinton's new book What Happened arrived in the book stores on Tuesday, and she has already been very busy giving interviews, signing books and explaining how she understands the 2016 campaign and her electoral loss, among other aspects of her life in politics.

People are taking different views of this -- from "Why doesn't she just go away?" --  to "At least let her write a book -- to "What a tragedy that we didn't elect her instead of you-know-who."  I read what I think is the best, in depth, understanding of Clinton, the person, as well as her place in politics and government.   It's based on an hour-long interview of Clinton by Ezra Klein, one of the smartest guys around news analysis and one of the founders of the Vox.com "explaining the news" site.

Ezra's introduction to the transcript is informative:

"What Happened has been sold as Clinton’s apologia for her 2016 campaign, and it is that. But it’s more remarkable for Clinton’s extended defense of a political style that has become unfashionable in both the Republican and Democratic parties. Clinton is not a radical or a revolutionary, a disruptor or a socialist, and she’s proud of that fact.

She’s a pragmatist who believes in working within the system, in promising roughly what you believe you can deliver, in saying how you’ll pay for your plans. She is frustrated by a polity that doesn’t share her “thrill” over incremental policies that help real people or her skepticism of sweeping plans that will never come to fruition. She believes in politics the way it is actually practiced . . . .

"This makes Clinton a more unusual figure than she gets credit for being: Not only does she refuse to paint an inspiring vision of a political process rid of corruption, partisanship, and rancor, but she’s also actively dismissive of those promises and the politicians who make them.

"On Tuesday morning, I sat down with Clinton for an hour. . .  It is a cliché that stiff candidates become freer, easier, and more confident after they lose . . . but it is true for Clinton.   Jon Stewart used to talk of the “buffering” you could see happening in the milliseconds between when Clinton was asked a question and when she answered; the moments when she played out the angles, envisioned the ways her words could be twisted, and came up with a response devoid of danger but suffused with caution. That buffering is gone.

[And I (RR) would add a description of this from a media person who wrote that Clinton 'measures her words by the teaspoon and then sprays them with disinfectant.'   Sorry I've lost the name to be credited with that metaphor.]

"In our conversation, she was as quick and confident as I’ve seen her, making the case for her politics without worrying too much about . . . the possible lines of offense. . . . In our discussion, she lit into Bernie Sanders’s single-payer plan, warned that Donald Trump is dragging us down an authoritarian path, spoke openly of the role racism and white resentment played in the campaign, and argued that the outcome of the 2016 election represented a failure of the media above all. This was Clinton unleashed, and while she talked about what happened, it was much more interesting when she talked about what she believed should have happened."

 A transcript edited for length and clarity can be read at:

https://www.vox.com/policy-and-politics/2017/9/13/16298120/hillary-clinton-what-happened-interview

I highly recommend it, not only for understanding a woman who almost broke the ultimate glass ceiling, but for a better understanding of our whole political process as it has come to be.  You're not likely to find a better delineation of the difference between pragmatism and idealism in politics.

Ralph

Bannon seems worried about what Mueller will find on Trump

Former White House Chief Strategist Stephen Bannon, who left that job in August -- gave a television interview with Charlie Rose that was revealing.  Bannon sees himself as "going to war" for President Trump's agenda (aka Bannon's agenda) -- but now from the outside.

He plans to go after Republicans who did not support Trump;  and the litmus test, as he says, will be  whether or not they supported candidate Trump when the Billy Bush tape came out  -- you know, the shocking audio recording of Trump's "locker room" talk about how he could just grab women "by the p--sy, because when you're a star, they let you do it."  

Wow -- that's a shockingly low bar by which to judge a man's qualifications for the presidency.  But then Bannon, though a surprisingly well read and educated man in some areas, is not known as a paragon of moral principles, even in the low-bar world of politics.

Here's the "reveal" I alluded to in the headline.  Bannon says that Trump's firing of James Comey was the biggest mistake in modern politicsl history. . . .  I don't think there's any doubt that if James Comey had not been fired, we would not have a special counsel. . . .  We would not have the Mueller investigation in the breadth that clearly Mr. Mueller is going."

So, I read this to mean that (1) he thought that Comey's investigative scope was more limited than Mueller has been given, or (2) Trump could have intimidated Comey into not going  . . .  somewhere Trump doesn't want exposed.

Bannon also seems to imply that he knows what Mueller will find and that it will be highly damaging to Trump's presidency, if not to him personally.

This rules out, in my thinking, the obstruction of justice charge, since that did not come up until Comey was fired.  I'm guessing what Bannon has in mind must be either (1) the Russian collusion or (2) business/financial crimes.

It's interesting to speculate what Bannon will do if he himself is called to testify by Mueller.   He obviously knows a lot of damaging information.  Would he betray his boss/puppet?   Take the 5th?   Would Trump pardon him?

Ralph

Quote of the Week

Some wisdom from Henry Ford:

"Whether you believe you can do a thing, or not,

You are right."

Where are the climate deniers now?

I haven't heard any arguments coming from climate deniers in the past week trying to tell us that Hurricanes Harvey, Irma, Jose, and Katia -- all coming so close together is just a matter of coincidence and has nothing to do with warmer sea water and higher sea levels.

Nevertheless, Neil deGrasse Tyson, astrophysicist, author, director of the Hayden Planetarium and the American Museum of Natural History, shot down one of their favorite arguments anyway:   that scientists are in cahoots with each other to make up this story about global warming.   And they find a few odd outliers to quote that make a name for themselves by questioning the consensus findings.

Tyson's tweet:   "Anyone who thinks scientists like agreeing with one another has never attended a scientific conference."

What deniers fail to understand is that, for scientists to agree as much as they do on climate change (like 97%), is phenomenal and rare.   It's almost in the realm with believing in gravity.  Tyson has taken on the argument before, just recently over the total eclipse.

"I don't see people objecting to it.  I don't see people in denial of it.   Yet methods of science predict it," Tyson said on "The Daily Show."  So when the same methods and tools of science predict an eclipse, which people believe, but reject the same methods and tools about climate change, it doesn't add up.

Another, earlier tweet from Tyson:  "I'm so disappointed that the country that I grew up in -- that put men on the moon, that developed the internet, that invented personal computers and smartphones -- that people are debating what is and what is not scientifically true."

And, even more recently:   Most people listened to weather news to learn from scientists when and where -- and which -- hurricane was going to come their way.

I think the answer is pretty simple.   The eclipse was an event that would soon be over and would not require a great expenditure to do something about.   The inventions Tyson mentioned are conveniences that people are willing to spend money on personally for their personal convenience.  It doesn't require an act of congress or tax money.

But climate change is a calamity that we have to do something about -- and it is going to be very expensive, at least initially.  And it involves special interests of some very wealthy people (the oil and petrochemical industry) that are going to have to accept change.

The consequences of not doing anything are simply unthinkable.

Ralph

Learning from experience: from Katrina to Harvey and Irma

The disaster response to Katrina was itself a disaster.  But thankfully our governments and other organizations have used the experience to learn from the mistakes of 2005.

The New York Times' Dave Phillips describes the "stumbling leadership and lack of preparation that contributed to the estimated 1,800 deaths in Hurricane Katrina."   Houston has been a different story, and Phillips lists seven key changes that have made all the difference.

1.  Completing paperwork in Advance:  In New Orleans in 2005, it took four days to get approval from federal authorities to send in military help, as no one knew quite the proper protocol and what level of command had to approve the decision.  Now, they pre-approve such requests.    When it came from Houston, the response was quick at the battalion commander level:  "Go save lives;  we've got your back."

2.  Better Plans and More Training:  Reform mandates by Congress require that communities "create a workable disaster plan and train local officials to work with state and federal officials when disaster strikes.   FEMA has spent $2 billion to train and prepare local authorities.

3.  Responders Work Off the Same Playbook:   During Katrina, according to the press secretary for the Louisiana governor:  "We wanted soldiers, helicopters, food and water. . .  They wanted to negotiate an organizational chart."    The difference now, as Phillips says, is that:  "Local and federal authorities now go through the same disaster training and largely work from the same playbook, which means they speak a common language and can work together."

4.  Early Delivery of Emergency Supplies:   During Katrina, debris and flood waters kept trucks with supplies from getting through to the emergency shelters. Now, supplies are pre-delivered where they will be needed.

5.  Hospitals Better Equipped to Evacuate:   This was a big problem during Katrina when a hospital needed to be evacuated, after power and back-up generators had failed.   Bed-ridden patients had to be carried down flights of stairs;  vital life-support devices lacked electricity to operate.    In 2016, Congress instituted a requirement that hospitals that take Medicare and Medicaid patients must have emergency plans and train for them.

6.  Mandatory Experience for FEMA Chief:   I well remember during FEMA the outrage when we learned that President George W. Bush had appointed a crony who had no experience whatsoever in disaster management or even in heading a large organization.   Following that, Congress passed a law requiring the the Director of FEMA must "have years of management experience in the field, so that political appointees with no disaster experience , , ,  could never lead the agency again."   One of the FEMA commanders said last Friday:  "We plan for the worst of the worst, the biggest of the big, and it has served us well."

7.  Enlisting the Public's Help:   In the past, the tendency was to turn away volunteer help because of the fear of liability lawsuits if something went wrong.   That thinking has been abandoned in favor of an attitude of using "citizens as an untapped emergency force" when disasters overwhelm the plan.    In Houston, they put out a call for "anyone with a boat" to come help in the rescue effort.  "The ragtag flotilla that formed has been credited with rescuing thousands of people."   The CEO of Harris County (Houston) said, "I got pushback on the boat decision. . . I violated almost every bureaucratic rule in the book this week.   But I think the decision saved many, many lives."

A retired FEMA official summed it up:  "The realization [is] that disaster response is not just governmental response;  it is a societal response.  The federal government has a role, and so does everybody else."

Man, doesn't it feel good when our government does something RIGHT?  As I write this, Irma is wrecking its havoc on Florida on both coasts.   Such a big storm, such a narrow state.   The entire state has been designated as on hurricane alert. Let's hope that the Florida emergency forces learned their lessons well.

Ralph

A mix of trivia & important odds and ends

Photo by MOAA showing three hurricanes coexisting from Mexico to the Carribean area:  Katia over Mexico, Irma over Cuba heading to Florida, and Jose over the Carribean.

1.  Mega-hurricane Irma set a record Thursday by maintaining wind speeds of at least 185 mph for a period of 37 hours -- the longest time at such a speed ever recorded anywhere.  And 6.3 million people -- 1/3 of our third most populous state -- have been told to evacuate.   Irma is devastating Florida just two weeks after Harvey did the same in Southeast Texas.   Katia, downgraded to category 1, hit Mexico's Gulf coast two days ago, and Jose, a category 4 hurricane, is following Irma's early pathway through the Carribean's Barbudo and St. Martin islands.

Is nature trying to tell us something about the effects of global warming?  Isn't it time we listen?

2. During Katrina, thousands of people refused to evacuate without taking their dogs and cats.   So Congress passed a law requiring that emergency disaster-management plans include provisions for pets.

3.  Senator Bob Menendez (D-NJ) is on trial for bribery and corruption.   He is accused of pulling strings in Washington to benefit his good friend, a wealthy Florida physician who bestowed Menendez with lavish gifts, luxurious travel accommodations, plus over half a million in campaign contributions, often in close time relation to some problem the friend wanted fixed, or some regulation he wanted changed.   The doctor has also been accused of Medicare fraud, and Menendez is alleged to have tried to intervene on his behalf with the Secretary of HHS.

Beyond the individual guilt or innocence is the fact that, if Sen. Menendez is found guilty, he will likely have to resign, or be expelled, from the Senate.  And his replacement -- if it occurs before January -- would be named by New Jersey's Republican governor, Chris Christie.   That would flip a seat in the Senate -- and conceivably make a difference in some close bills -- including, if the close vote on the ACA came up again, would go the other way, assuming everyone else voted as they did before.

4.  "Hamilton," the hit Broadway hip-hop musical about the Founding Fathers creating our nation, is opening in London this fall.   Tickets are in such demand, some people have paid as much as $ 3,300 for a ticket.

5.  FEMA has instituted a "rumor control" page on its website to debunk false rumors about the hurricane and relief efforts.   For example, it is true that emergency shelters are required to accommodate pets (see #2 above), but it is not required of hotels.   The site also warned people about scams, where people posing as FEMA officials ask for personal information (like social security numbers, immigration papers, etc.)  The only think FEMA actually requires for stay in a shelter is identification -- as most hotels now routinely do.  Homeland Security has explicitly announced that their ICE personnel, when assisting in rescue work, will not be questioning people about their immigration status.

6.   I had not realized how much Prince Charles' and Diana's marriage was an arranged one.   A new source has said that they had been in each other's presence only 13 times before the wedding.

7.  Based on background check records, the sale of guns has declined from 2.2 million in July 2016 to 1.7 million in July 2017.   Experts explain it thus:   There is typically a surge in gun sales when either of two events occurs:  (1) when a Democrat presidential candidate wins;   or (2) after there is a mass shooting.   The explanation seems to be that gun sales go up when there is a fear that future sales are going to be restricted.  People "stock up" out of fear that "they'll take away our guns."  With Trump in the White House, that fear is minimal.

8.  Years ago, end-zone celebrations after a touchdown had gotten so elaborate that the NFL decided to crack down and imposed rules, with infractions resulting in a team penalty.  As players became more creative with ways to get around the rules, the NFL rules became ever more restrictive and convoluted.  In fact, as the New York Times reports, here's what it had come to:  One rule said that a player could do a backflip with no penalty -- if he landed upright.   But, if he fell to the ground, there would be a penalty.

Finally, everyone agreed that this had become ridiculous.  So the NFL has relaxed it's rules on end-zone TD celebrations.  Now they have decided to just focus on players not delaying the game.   Let's see how that works out.   Or, rather, you guys see how it works out.   I don't watch pro football:  (1) because it just doesn't interest me;  and (2) because I do not want to contribute, as a another fan, to perpetuating a game that results in so much previously unrecognized brain injury from cumulative effects of repeated concussions.

Ralph