Is This What You Want Your Government To Do? Current US House Bills (part 2)

Is This What You Want Your Government To Do?

A post is going around social media publicizing current House bills and asking people to call their officials to request they vote against the following bills. Today I am reporting on my continuing research into these bills.  See below the list for the current status of the bills, a summary of what each covers — and why you should care. Monday I reviewed the first four on the list in part 1, which you can read here. Today’s post covers 5 and 6, repeal of Obamacare and defunding Planned Parenthood. I plan to continue the review of the rest of the bills in the next few days.

  1. HR 861 Terminate the Environmental Protection Agency – referred to House Subcommittee on Environment
  2. HR 610 Vouchers for Public Education – referred to House Committee on Education and the Workforce
  3. HR 899 Terminate the Department of Education – referred to House Committee on Education and the Workforce
  4. HJR 69 Repeal Rule Protecting Wildlife – PASSED and sent to Senate
  5. HR 370 Repeal Affordable Care Act – see below
  6. HR 354 Defund Planned Parenthood – see below
  7. HR 785 National Right to Work (this one ends unions) – coming in the next blog.
  8. HR 83 Mobilizing Against Sanctuary Cities Bill – coming in the next blog.
  9. HR 147 Criminalizing Abortion (“Prenatal Nondiscrimination Act”) – coming in another
  10. HR 808 Sanctions against Iran – coming in another blog.
  1. HR 370 Repeal Affordable Care Act

The entire title of this bill is “To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010, and for other purposes.”  It has been referred to the following House committees: Energy and Commerce; Education and the Workforce; Ways and Means; Judiciary; Natural Resources; Rules; House Administration; Appropriations; Budget; and Subcommittee on Indian, Insular and Alaska Native Affairs. This sounds serious: most bills only go to one committee.

This bill would cancel the Patient Protection and Affordable Care Act, often called Obamacare. It also repeals the health care provisions of the Health Care and Education Reconciliation Act of 2010. The repeal would go into effect on January 1, 2020. The bill also states “Provisions of law amended by the repealed provisions are restored,” whatever that means.

Let’s try to figure out what those confusing words mean. The Senate Democrats wrote a “detailed summary” of the Affordable Care Act that simplifies the original bill.[1] Although ACA is imperfect and some people cannot afford medical insurance under ACA, millions of people have healthcare that previously did not. In addition to coverage of pre-existing conditions and chronic ailments, ACA stipulates that insurance companies must spend a minimum of 80% of the premiums on medical care. The HR 370 bill would repeal all of that as of 1/1/2020.

Let’s look at the other provisions of HR 370.  The Health Care and Education Reconciliation Act of 2010[2] (HR 4872) changed the financial provisions of ACA. This is a complicated bill. In addition to modifications to coverage of those on Social Security and changes to allowable fees paid to doctors, it reduced the percentage of insurance costs that an employer pays. It set up an increasing fine for people who did not obtain insurance coverage.  On the plus side, it set the maximum waiting period for coverage at 90 days, forbid dropping coverage except in cases of fraud, and required grandfathered medical plans to include coverage for dependents up to 26 years of age.

In addition, it changed the maximum Pell Grant amount that could be awarded beginning in 2013. Although it extended grants to minority institutions until 2019, it forbids the Secretary of Education from awarding those grants after FY2019. It also terminated unsecured Stanford loans for middle-income people.

Repealing would obviously remove health care coverage unless the government provides a replacement. In addition, it would remove the modifications set forth in Health Care and Education Reconciliation Act, and so, it would affect Pell Grants, Stanford loans, and grandfathered medical plans.  Not only would HR 370 remove those provisions and end ACA, it would rewrite Medicaid.

I’ll be honest: I have no idea what further changes would be enacted or restored with the passage of HR 370.  The original ACA bill[3] was a complex law encompassing 124 pages with 506 amendments, and HR 4872 added another 124 pages plus 165 amendments. [4]

On 3/6/2017, the Republican House replacement plan was announced. Despite 66 pages of text, it is incomprehensible and filled with references to other legal sections.[5]  As it was announced, it would provide tax credits for an individual or family to purchase insurance. It freezes Medicaid enrollment and puts an unspecified cap on state coverage. It removes requirements for employers to provide health coverage, removes subsidies for payment of insurance, adds a surcharge for people who have gaps in insurance coverage, and eliminates fines for individuals who do not obtain coverage. It prohibits funds to Planned Parenthood or any similar non-profit. It bans payments to any organization that provides abortion other than in cases of rape, incest or danger of death. States can remove coverage for some odd groups, such as people who receive large lottery winnings, and the state can recover any previous medical payments from that individual. Although it abolishes the Medicaid expansion coverage, which is scary, it does continue the Obamacare provision that stopped insurance companies from denying coverage for pre-existing conditions. However, cancelling Medicaid expansion removes coverage for more than 10 million people.

According to The New York Times, Medicare (including the expansion) currently insures 74 million people or “one in five Americans.”[6] Many of the replacement bill’s spending caps refer to money that finances Medicaid. Rather than reimburse states for actual Medicare costs, it would freeze funding for state medical health cost payments and tie increases to the Consumer Price Index. It seems odd — or immoral — that costs of health care would no longer be linked to patient needs. Instead costs would be linked to the economy.  Since health care needs tend to rise when the economy worsens, that seems barbaric.

Due to the Medicare changes, states could not institute new treatments. They might not manage to cover existing levels of medical coverage, for instance, if the medical needs of the state’s population were to change. One example would be public health care emergencies.

Some health experts worry that over time, states would be unable to respond to changes in the health care needs of their population unless they use their own money, potentially risking the survival of a program that has been a critical source of health coverage for the poor. … The Republican plan would set different spending targets for different types of Medicaid beneficiaries, like older Americans, the blind and disabled, children and adults.[7]

We will need to pay vigilant attention to what happens with these interlocked bills in the future.

  1. HR 354 Defund Planned Parenthood

To many Republicans, Planned Parenthood has become scapegoat for what they perceive as society’s evils. Based on that belief, the bill would prohibit any federal funding for one year unless all of the clinics associated with Planned Parenthood certify that they will not perform an abortion during that year.  There is an exception to the abortion provisions of the bill in the case of rape, incest or endangerment of the woman’s life. Since Planned Parenthood offers many more services than abortion, this is a way to blackmail the organization. Although Republican politicians claim they want to give families more power, HR 354 wants to remove decisions about family planning from women and from couples.

In addition, it instructs the Department of Health and Human Services and the Department of Agriculture to obtain repayment of funding if the terms are violated at one of the locations nationwide.  It would remove funds from all clinics associated with Planned Parenthood if one location was determined to be at fund. The bill does not state who would make the determination. It also does not explain if the money would be sent to Planned Parenthood after a year of defunding.

Money already budgeted for Planned Parenthood would go to existing community public health as set forth in section 330 of the Public Health Service Act.  Public health centers are wonderful providers, but they do not cover the same population. That act sets up public health programs for specific “medically underserved” populations. The Public Health Service Act covers programs for the homeless, residents of public housing, and seasonal agricultural workers.[8]  That is not the population served by Planned Parenthood.  This is beginning to sound like a shell game.

Again, federal funds do not currently cover abortions. Planned Parenthood does provide sex education (focused on prevention of pregnancy), [9]  Pap tests, breast exams, cancer screenings, treatment of sexually transmitted diseases, birth control, family planning services, and education on health and safety.[10] Essentially, this bill threatens to take all medical treatment away from Planned Parenthood populations.

HR 354 claims that people could go to other clinics instead of Planned Parenthood.  However, Planned Parenthood serves millions of people who don’t have another clinic, who don’t have a doctor, and do not have insurance. Planned Parenthood serves low-income people who aren’t on welfare; it serves the working poor, middle-income people, and young people who have no other means to medical treatment.  Last year, millions of men and women went there for information, medical services, and medical treatments.

Recently, I had a conversation with a doctor at a low-cost clinic; she told me that she had never received birth control training in medical school because it was affiliated with a Catholic hospital. Think of all of the religious hospitals and how many doctors are doing residency there. If regular doctors don’t know about birth control, what will happen if people don’t have insurance and cannot turn to Planned Parenthood?

HR 354 has been referred to the House Energy and Commerce committee and the Subcommittee on Health for review.

 

—- Footnotes—-

[1] Responsible Reform for the Middle Class “The Patient Protection and Affordable Care Act Detailed Summary”  Democrats.Senate.Gov/Reform (2010)  https://www.dpc.senate.gov/healthreformbill/healthbill04.pdf

[2] “H.R.4872 – Health Care and Education Reconciliation Act of 2010” Congress.Gov (2010) online at https://www.congress.gov/bill/111th-congress/house-bill/4872 (3/6/2017).

[3] “H.R.3590 – Patient Protection and Affordable Care Act”  Congress.Gov (2010)  online at https://www.congress.gov/bill/111th-congress/house-bill/3590/text (3/6/2017).

[4] “H.R.4872 – Health Care and Education Reconciliation Act of 2010” Congress.Gov (2010) online at https://www.congress.gov/bill/111th-congress/house-bill/4872 (3/6/2017).

[5] For example,  section 302 reads (in part): “Notwithstanding section 504(a), 1902(a)(23), 1903(a), 2002, 2005(a)(4), 2102(a)(7), or 2105(a)(1) of the Social Security Act (42 U.S.C. 704(a), 1396a(a)(23), 1396b(a), 1397a, 1397d(a)(4), 1397bb(a)(7), 1397ee(a)(1)), or the terms of any Medicaid waiver in effect on the date of enactment of this Act …”

[6] “Republican Changes to Medicaid Could Have Larger Impact Than Its Changes to Obamacare” The New York Times (2017) https://www.nytimes.com/interactive/2017/03/07/us/politics/medicaid-reform-impact-on-states.html?rref=collection%2Ftimestopic%2FHealth%20Insurance%20and%20Managed%20Care (3/7/2017).

[7] “Republican Changes to Medicaid Could Have Larger Impact Than Its Changes to Obamacare” The New York Times (2017) https://www.nytimes.com/interactive/2017/03/07/us/politics/medicaid-reform-impact-on-states.html?rref=collection%2Ftimestopic%2FHealth%20Insurance%20and%20Managed%20Care (3/7/2017).

[8] “42 USC 254b: Health centers” (2017) online at http://uscode.house.gov/view.xhtml?req=(title:42%20section:254b%20edition:prelim) (3/8/2017).

[9] “Planned Parenthood at a Glance” Planned Parenthood (2017) https://www.plannedparenthood.org/about-us/who-we-are/planned-parenthood-at-a-glance (3/7/2017).

[10] Debra Goldschmidt and Ashley Strickland  “Planned Parenthood: Fast facts and revealing numbers” CNN http://www.cnn.com/2015/08/04/health/planned-parenthood-by-the-numbers/

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About Lillith ThreeFeathers

Lillith ThreeFeathers is a shamanic healer, author, medium, and priestess.
This entry was posted in Medicine & Health, Politics, Society and Civilization and tagged , , , . Bookmark the permalink.

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