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States that elected Donald Trump, including Florida, most affected by his health care decision

President Donald Trump‘s decision to end a provision of the Affordable Care Act that was benefiting roughly 6 million Americans helps fulfill a campaign promise, but it also risks harming some of the very people who helped him win the presidency.

Nearly 70 percent of those benefiting from the so-called cost-sharing subsidies live in states Trump won last November, according to an analysis by The Associated Press.

The subsidies are paid to insurers by the federal government to help lower consumers’ deductibles and co-pays. People who benefit will continue receiving the discounts because insurers are obligated by law to provide them. But to make up for the lost federal funding, health insurers will have to raise premiums substantially, potentially putting coverage out of reach for many consumers.

Some insurers may decide to bail out of markets altogether.

“I woke up, really, in horror,” said Alice Thompson, 62, an environmental consultant from the Milwaukee area who purchases insurance on Wisconsin’s federally run health insurance exchange.

Thompson, who spoke with reporters on a call organized by a health care advocacy group, said she expects to pay 30 percent to 50 percent more per year for her monthly premium, potentially more than her mortgage payment. Officials in Wisconsin, a state that went for a Republican presidential candidate for the first time in decades last fall, assumed the federal subsidy would end when they approved premium rate increases averaging 36 percent for the coming year.

An estimated 4 million people were benefiting from the cost-sharing payments in the 30 states Trump carried, according to an analysis of 2017 enrollment data from the U.S. Centers for Medicare and Medicaid Services. Of the 10 states with the highest percentage of consumers benefiting from cost-sharing, all but one — Massachusetts — went for Trump.

Kentucky embraced former President Barack Obama‘s Affordable Care Act under its last governor, a Democrat, and posted some of the largest gains in getting its residents insured. Its new governor, a Republican, favors the GOP stance to replace it with something else.

Roughly half of the estimated 71,000 Kentuckians buying health insurance on the federal exchange were benefiting from the cost-sharing subsidies Trump just ended. Despite the gains from Obama’s law, the state went for Trump last fall even as he vowed to repeal it.

Consumers such as Marsha Clark fear what will happen in the years ahead, as insurers raise premiums on everyone to make up for the end of the federal money that helped lower deductibles and co-pays.

“I’m stressed out about the insurance, stressed out about the overall economy, and I’m very stressed out about our president,” said Clark, a 61-year-old real estate broker who lives in a small town about an hour’s drive south of Louisville. She pays $1,108 a month for health insurance purchased on the exchange.

While she earns too much to benefit from the cost-sharing subsidy, she is worried that monthly premiums will rise so high in the future that it will make insurance unaffordable.

Sherry Riggs has a similar fear. The Fort Pierce, Florida, barber benefits from the deductible and co-pay discounts, as do more than 1 million other Floridians, the highest number of cost-sharing beneficiaries of any state.

She had bypass surgery following a heart attack last year and pays just $10 a visit to see her cardiologist and only a few dollars for the medications she takes twice a day.

Her monthly premium is heavily subsidized by the federal government, but she worries about the cost soaring in the future. Florida, another state that swung for Trump, has approved rate increases averaging 45 percent.

“Probably for some people it would be a death sentence,” she said. “I think it’s kind of a tragic decision on the president’s part. It scares me because I don’t think I’ll be able to afford it next year.”

Rates already were rising in the immediate aftermath of Trump’s decision. Insurance regulators in Arkansas, another state that went for Trump, approved premium increases on Friday ranging from 14 percent to nearly 25 percent for plans offered through the insurance marketplace. Had federal cost-sharing been retained, the premiums would have risen by no more than 10 percent.

In Mississippi, another state Trump won, an estimated 80 percent of consumers who buy coverage on the insurance exchange benefit from the deductible and co-pay discounts, the highest percentage of any state. Premiums there will increase by 47 percent next year, after regulators assumed Trump would end the cost-sharing payments.

The National Association of Insurance Commissioners has estimated the loss of the subsidies would result in a 12 percent to 15 percent increase in premiums, while the nonpartisan Congressional Budget Office has put the figure at 20 percent. Experts say the political instability over Trump’s effort to undermine Obama’s health care law could prompt more insurers to leave markets, reducing competition and driving up prices.

In announcing his decision, Trump argued the subsidies were payouts to insurance companies, and the government could not legally continue to make them. The subsidies have been the subject of an ongoing legal battle because the health care law failed to include a congressional appropriation, which is required before federal money can be spent.

The subsidies will cost about $7 billion this year.

Many Republicans praised Trump’s action, saying Obama’s law has led to a spike in insurance costs for those who have to buy policies on the individual market.

Among them is Republican Rep. Andy Biggs of Arizona, a state Trump won. An estimated 78,000 Arizonans were benefiting from the federal subsidies for deductibles and co-pays.

“While his actions do not take the place of real legislative repeal and revitalization of free-market health care, he is doing everything possible to save Americans from crippling health care costs and decreasing quality of care,” Biggs said.

Republished with permission of The Associated Press.

Pam Keith gets backing from NOW in bid for congressional seat

Pam Keith, the former Navy JAG officer who finished third in 2016 ifor the Democratic nomination for the U.S. Senate, is getting the backing of the National Organization of Women in her bid to defeat Republican Brian Mast in Florida’s 18th Congressional District.

“Florida NOW considers Pam Keith a champion for women’s rights.  She will not let women or children fall to the wayside with bad legislation on healthcare or equal opportunity for women,” said Terry Sanders, Florida NOW President.

“Pam has long been an advocate for women’s rights.  Her legal background as judge advocate in the U.S. Navy and private practice in both Washington, D.C. and Chicago, as well as her experience in diplomatic arenas around the world, make her an excellent candidate for Congress,” added Joanne Sterner, Florida NOW political action director.

Keith is one of two Democratic challengers to emerge so far against Mast, an Army veteran who took back the Treasure Coast area seat for the Republicans in 2016. It had been held the previous four years by Democrat Patrick Murphy.

Palm Beach Gardens attorney Lauren Baer announced her candidacy for the Democratic nomination earlier this month. She served as a senior policy advisor to former U.S. Secretaries of State Hillary Clinton and John Kerry, as well as to Samantha Power, the U.S. ambassador the United Nations under Barack Obama.

“Women are the majority of our nation, women are the future of our nation, and I am gratified that NOW believes I am the best woman to lead our nation toward that future,” said Keith in a statement. “Brian Mast and Donald Trump have fought against the interests of women, from stealing our healthcare to endorsing sexist, hateful language in the workplace. Women are being undervalued at work, the system pays us less for the same work, ignores harassment and gave us a government that doesn’t even allow women to help write the legislation that affects so many of us. I’m going to Washington to put a stop to all that, to make women’s lives better. I joined this race to take my passion and skill to unite people of all genders, orientation, and color to fight this administration’s continual assault on women’s reproductive health. I’m glad that NOW recognizes that I am a strong ally and best advocate.”

Shad Khan slams ‘racist’ NFL owners, Steve Bannon, Donald Trump

Jacksonville Jaguars owner Shad Khan unleashed on “racist” NFL owners, offering some sharp critiques of President Donald Trump and his consigliere Steve Bannon Thursday in Chicago.

Quotes from Crain’s Chicago Business:

Khan’s description of NFL owners was so subversive and trenchant a player could have said it: “You’ve got a bunch of 85-year-old guys who don’t think they’re racist, but they are racist.”

Though Crain’s said a spokesman tried to ameliorate the impact of that quote, saying those were sentiments that were expressed to Khan or some such, rest assured that it will resonate with those who have watched a third of an NFL season and wondered why Colin Kaepernick couldn’t get a job despite his resume.

Khan, who played a crucial role of support in the Jaguars’ National Anthem protest in their London trip this year, spoke with great clarity and specificity about his issues with the Trump/Bannon axis — a remarkable move for a man who donated $1 million to Trump’s Inaugural Committee.

“You have to give Trump credit, people are confused on the First Amendment versus patriotism, that if you exercise your First Amendment, you’re not a patriot, which is crazy … People are confused on it, (Trump) knew he could hit on it and take advantage. I think what we’re seeing is the great divider overcoming the great uniter.” Khan said.

“What (Trump) has done is shown leadership as the great divider, not [a] uniter. We are used to being warm and fuzzy and cuddled. Well, it’s a different time,” Khan said.

That division is part of the Steve Bannon strategy, Khan offered.

“Steve Bannon or whoever is analyzing the data realizes, ‘How do I get elected?’ I get elected by dividing this person or this group against this group. What are the worst fears, phobias somebody has, how do I tap that button and get them with my people? There’s a lot of predictive behavior here,” Khan asserted.

Khan, as is widely known, is a frequent contributor to Republican pols such as Gov. Rick Scott and Mayor Lenny Curry.

Yet even before his comments on Trump, Khan has played a unique role in social commentary in Jacksonville — providing a centrist perspective on hot-button issues.

There are those in Khan’s orbit who say that a key factor toward Jacksonville expanding the Human Rights Ordinance to include LGBT people was Khan deciding to weigh in on the issue in an unambiguous way in 2017.

In fact, Khan’s position was consistent with the one he had expressed in 2016.

“It’s like civil rights,” Khan said. “It’s so late that it’s not even worth talking about.”

Khan is noted, likewise, for pithy quotes that seem to enrage people.

“A homeless guy in Detroit has more mojo than a millionaire in Jacksonville,” Khan said in 2014.

‘Morning Joe’ host Joe Scarborough officially leaves GOP

MSNBC host and former Republican Congressman Joe Scarborough has made his departure from the GOP official.

The “Morning Joe” anchor said on Twitter on Thursday that he became an independent and he added a picture of himself with an elections official in New Canaan, Connecticut, smiling while holding a form.

Scarborough announced that he would leave the party in July and accused Republicans of abandoning their fiscal principles. Scarborough has been a fierce critic of President Donald Trump, who has targeted Scarborough and his fiancee and co-host Mika Brzezinski on Twitter.

Scarborough was elected to four U.S. House terms from Florida starting in 1994.

Republished with permission of The Associated Press.

Can Matt Gaetz get through big tax increase on NFL?

Progressives have an opportunity to get behind a bill that would end certain tax exemptions for a group they would normally refer to as “fat cats.”

One Member of Congress went on television this week promoting a bill that targets the corporate headquarters for wealthy business owners, saying it’s time for them to pay up.

“The current millionaires and billionaires associated with professional sports leagues, including the NFL, have a tax exemption,” the member said. “They don’t have to pay taxes. That’s special treatment that is not afforded to just regular folks (who I represent) or the small businesses on Main Street throughout America.”

That sounds like something House Minority Leader Nancy Pelosi of San Francisco might say, or ultra-progressive Massachusetts Sen. Elizabeth Warren; or Weston Democrat Debbie Wasserman Schultz.

In reality, it was said by conservative Republican Rep. Matt Gaetz of Fort Walton Beach.

Gaetz is now the lead sponsor of a bill originally filed in January by the now-retired Utah Republican, Jason Chaffetz. The PRO Sports Act would end a sports league’s 501(c)(6) tax exemption (as a non-profit) if they generate more than $10 million each year. He links the bill to the actions of NFL players “taking a knee” or sitting during the national anthem.

This is good politics for two reasons. For Gaetz and the conservative First Congressional District, it’s a slam dunk, or touchdown, if one prefers.

On the other hand, the left can, and will, make the free speech argument in siding with the protesters. But wouldn’t most of their constituents want the “tax breaks for the wealthy” to go away whether players stand or kneel?

Gaetz is rallying support. The quote above was uttered during an interview Monday night on Fox News.

On Tuesday, he wrote to House Ways and Means Committee Chairman Kevin Brady, formally asking the committee to consider ending the exemptions. Protesters, he wrote, “have every right to do so, but they should do it on their own time and on their own dime.”

This week, Gaetz picked up his first two co-sponsors with Alabama Republican Mo Brooks and Texas Republican Blake Farenthold signing on. Is all of this getting the attention of NFL Commissioner Roger Goodell? Lagging attendance and dropping television ratings certain are.

While polls do not show strong majorities for either side, people are voting with their feet. Attendance is lagging and television ratings are going down.

This week, Goodell wrote to all 32 NFL teams saying “Like many of our fans, we believe that everyone should stand for the national anthem.” While offering respect to the players, he also wrote: “We need to move past this controversy, and we want to do that together with our players.”

In the meantime, another weekend of games will take place before owners gather next week for their fall meetings. Thursday night’s Eagles vs. Panthers game in Charlotte saw no kneeling, just two Philadelphia players conducting symbolic gestures while standing.

If an understanding soon develops between players and owners, perhaps with locking arms replacing the kneeling, Gaetz’ bill may well wither on the vine. Even President Donald Trump gave the thumbs up for that gesture.

Goodell could only hope for such an occurrence. If controversy continues, look for more of Gaetz in the media and more co-sponsors for his bill.

It might actually get a hearing.

 

John Ward announces run for Ron DeSantis’ seat

A Republican Florida businessman isn’t waiting for Republican U.S. Rep. Ron DeSantis to make up his mind about his political future before running for his seat.

John Ward announced Thursday he’s running for DeSantis’ seat as the incumbent decides whether to run for governor or seek a fourth term.

Ward, a business investor and Navy veteran, is running as a pro-President Donald Trump candidate and an outsider who’s frustrated with business as usual in Washington.

He’s a multi-millionaire who plans to combine traditional fundraising with his own wealth to pay for the campaign, pledging to have at least $1 million in his account by January.

Democrat Nancy Soderberg, who once served as ambassador to the United Nations, is also running for the seat in the northeast Florida district that favors Republicans.

Gus Bilirakis ‘thrilled’ with Trump’s new health care executive order

President Donald Trump took the first steps toward fulfilling his vow to dismantle Obamacare, and Tarpon Springs Republican Gus Bilirakis is thrilled.

Trump signed an executive order Thursday that calls on his administration to develop policies to increase health care competition and choice with the intent of improving the quality of health care and lower prices.

Specifically, the president’s order directs the Labor Department to study how to make it easier for small businesses, and possibly individuals, to join together and buy health insurance through nationwide association health plans, CNN reported. The department could give employers in the same industries more flexibility to offer group coverage across state lines, providing them with a broader range of policies at lower rates.

Virginia Democratic Senator Tim Kaine tweeted that the executive order might be complicated, so he’d break it down in simpler terms.

“It’s sabotage,” he tweeted, adding later that “it would allow cheap low-quality plans onto the market that could discriminate against people with pre-existing conditions, seniors,” ultimately pushing healthy people onto “junk plans,” which leave only the sick or at-risk on the Affordable Care Act, essentially destroying the insurance market.

Bilirakis, on the other hand, applauded what he termed the President’s “bold action.”

“This is great news, especially since the Florida Office of Insurance Regulation recently announced that individual health insurance plans available on the Florida exchange are likely to increase by an average of 44.7 percent, effective January 1, 2018,” Bilirakis said. “Additionally, there will only by 9 companies participating in the Florida exchange next year, with 42 out of 67 counties only having one provider, Florida Blue.”

Bilirakis added that he’s always been a proponent of allowing individuals to purchase health insurance across state lines and expand the reach of Association Health Plans, “because I believe it will drive down prices through increased competition.”

Earlier this year, Bilirakis held three town hall meetings on health care in his district, by far the most by any Republican in the Tampa Bay area. Angry Democrats dominated all three, demanding he does not support dismantling the Affordable Care Act.

 

Victor Torres blasts federal response, Donald Trump tweets on Puerto Rico

Declaring that “Americans are dying as we speak,” state Sen. Victor Torres blasted the Puerto Rico federal disaster relief efforts in an impassioned call at the Florida Capitol Thursday.

Torres, an Orlando Democrat who’s been active in the Florida-side of the relief efforts since Hurricane Maria devastated the island three weeks ago, also criticized President Donald Trump‘s Thursday tweet that had declared federal relief agencies cannot stay in Puerto Rico forever.

He joined key members of the Florida House Democratic Caucus including state Reps. John Cortes of Kissimmee and Carlos Guillermo Smith of Orlando.

Torres, a former Marine who is Puerto Rican, blamed a lack of coordination between the U.S. Military, working with FEMA and government officials in Puerto Rico in transporting and delivering the relief supplies, and called the preparation and response to the disaster by the federal government “inadequate.”

“Americans are dying as we speak,” Torres said. “While fellow Americans have generously rallied to donate relief supplies and money to support recovery efforts in Puerto Rico, the federal government has been too slow to respond to this disaster and there is a total failure of coordinated relief efforts to provide supplies and support to the island.

“There are tons of donated supplies like food, water, medicine and other vital resources that are either sitting in warehouses here on the mainland waiting to be sent to Puerto Rico, or even worse, containers of supplies sitting in the seaports and airports on the island that are not being distributed to people who are in desperate need.”

Torres noted that 80 percent of Puerto Rico still is without power and nearly half the island has no drinking water or functioning sewer services.

And then Thursday came Trump’s latest tweets, which also quoted journalist Sharyl Attkisson declaring that Perto Rico survived the Hurricanes and “now a financial crisis looms largely of their own making.”

“A total lack of accountability says the Governor. Electric and all infrastructure were disaster before the hurricanes. Congress to decide how much to spend,” Trump tweeted.

“We cannot keep FEMA, the Military & the First Responders, who have been amazing (under the most difficult circumstances) in P.R. forever!” Trump tweeted.

“Just this morning, the president tweeted that Puerto Ricans cannot expect relief workers to stay there forever,” Torres replied Thursday. “No one expects FEMA to be there indefinitely, but we should all expect and demand them to stay until they complete their job of aiding fellow Americans.”

‘LIP’ money falls short of initial estimates

At the height of a budget showdown earlier this year, Gov. Rick Scott boasted that his friendship with President Donald Trump‘s administration would result in Florida getting $1.5 billion to help the state’s hospitals.

But months later, the final amount will be considerably smaller, a top state Medicaid official said Wednesday. Instead the state will have about $790.4 million in supplemental Medicaid funds to spend this year.

Beth Kidder, a deputy secretary at the state Agency for Health Care Administration, told the Senate Health and Human Services Appropriations Subcommittee that the agency has $303 million in funding commitments from counties to help fund the Low-Income Pool. The money will be used to draw down $487 million in federal Medicaid dollars bringing the total available to just more than $790 million for the supplemental program widely known as LIP.

“The $1.5 billion is not $1.5 billion,” Senate Health and Human Services Appropriations Chairwoman Anitere Flores, a Miami Republican, said.

Kidder told the panel that the size of the Low-Income Pool has always been contingent on the receipt of matching local dollars to fund it. While the state in the past has been able to fully fund the program, the federal government has changed its expectations on how money can be spent. For instance, money can no longer be used to help offset losses hospitals incur while treating Medicaid patients. Under the new rules, only charity care can be considered for reimbursement.

The restrictions, Kidder said have made it “onerous and difficult for funders” to agree to provide the required local matching dollars. She also noted that the state didn’t get final approval of what is known as a Medicaid 1115 waiver and accompanying special terms and conditions until August, after local governments had already prepared budgets. The Medicaid 1115 waiver gives the state the authority to operate its mandatory Medicaid managed-care program as well as the LIP program.

Kidder tried to remain optimistic, though. She told the committee that the $790.4 million in LIP funds for fiscal year 2017-2018 is more than the $590 million Florida had for the program last year. Additionally, she reminded lawmakers that the Trump administration agreed to keep available a $1.5 billion LIP program for the next five years.

“It’s out there, it’s a target,” she said of the $1.5 billion annual commitment.

Under the approved waiver, three groups of providers can tap into LIP funds: hospitals, medical school faculty and federally qualified health centers. All of them must agree to certain requirements to get the money. For instance, hospitals must agree to sign contracts with at least half of the standard Medicaid health plans that operate in their regions.

Meanwhile, the Agency for Health Care Administration posted details on how it plans to distribute the $790 million in LIP funding. More than $654 million is being directed to 204 hospitals, $85 million is being directed to eight medical faculty teaching practices and another $50 million is allocated to federally qualified health centers.

The federally qualified health centers, though, say they have problems with a provision in the Medicaid 1115 waiver’s special terms and conditions that requires all reimbursements to the clinics to be made by managed-care organizations, rather than the state paying bills directly.

Kidder told lawmakers that the agency has met with the federally qualified health centers to discuss the concerns, including a meeting Wednesday.

Florida Association of Community Health Centers President Andy Behrman told senators that the Wednesday meeting with state officials was a “good move forward” and that there may be a way to solve some of his members’ concerns.

He said the clinics don’t want to walk away from $50 million but that they need to be protected.

The state has asked counties contributing matching dollars to the LIP program to send signed letters of agreement to the state by Nov. 15 and to send the funds to the state the following month.

After the state receives the funding, Kidder said, it will submit a proposed budget amendment to legislative leaders for approval. The budget amendment will include a 2017-2018 LIP distribution model that shows the government entities that contributed the funds as well as the funding distribution by provider.

The amendment will be approved within 14 days of submission unless the chair and vice chair of the Joint Legislative Budget Commission or the Senate president and speaker of the House of Representatives oppose the amendment in writing.

Republished with permission of the News Service of Florida.

Gwen Graham vows to enact clean power plan

With President Donald Trump‘s announcement Monday he would be ending the federal clean-power plan initiated by his predecessor, Democratic gubernatorial candidate Gwen Graham vowed she would enact a “Florida clean power plan” to continue to seek carbon reductions and increase renewable energy.

Graham and her Democratic rivals, Tallahassee Mayor Andrew Gillum and Winter Park businessman Chris King all have previously vowed to resist attempts to role back carbon emissions plans, and to pursue clean energy in Florida, and in particular to support and promote expansion of solar power in the Sunshine State.

Now Graham says she’ll specifically stick to the goals former President Barack Obama had set with his federal order, to work toward a 32 percent reduction in carbon emissions by 2030, compared with what Florida was producing in 2005. That would require significant decreases in coal-fired power. She said that would save the average consumer $85 a year in power bills.

“Donald Trump and the politicians in Tallahassee have their heads in the sand. Our state is already feeling the effects of climate change and sea level rise — a single hurricane just destroyed countless homes, took dozens of lives and knocked out power across our entire state,” Graham stated in a news release issued by her campaign. “I was proud to support President Obama’s Clean Power Plan in Congress, and, as governor, I will fight for Florida to enact a clean power plan to meet those goals.”

Arguing that an aggressive and comprehensive renewable energy policy would combat climate change, protect clean air, create jobs, and lower energy prices, she added, “Florida can’t afford to wait for the federal government to act. As governor, I will implement a renewable energy standard, cut carbon emissions and create clean energy jobs.”

According to the Energy Information Administration, renewable energy accounts for less than 2.5 of Florida’s energy portfolio, the news release stated.

“As governor, I will work with Democrats and Republicans to cut the regulatory red tape that prevents homeowners from purchasing solar energy and I will appoint PSC commissioners who understand the threat of climate change and the need to support clean energy,” Graham said. “It’s not just crucial to combating climate change, it makes economic sense. We can protect our beaches from oil drilling, our water from fracking and make the Sunshine State the Solar State, all while creating good paying jobs.”

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