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Rick Scott: Obamacare expanded the welfare state

Florida Gov. Rick Scott, who has asserted that he is helping President Donald Trump work on a replacement for “Obamacare,” made his feelings known about the Affordable Care Act again on Friday.

In an editorial on CNN‘s website, Scott made a number of points.

Among them, that the Affordable Care Act was nothing more than an expansion of the welfare state, and an usurpation of state’s rights when it comes to handling Medicaid.

“With Obamacare,” Scott writes, “President Obama enacted a massive expansion of the welfare state. And, not surprisingly, Obamacare has resulted in widespread increases in premiums and costs are expected to continue increasing.”

Scott’s preferred option — and likely the one the Trump administration will land on — block grants to the states for low-income health care.

“States can do a far better job administering the Medicaid program than the federal government can. If Florida is given the flexibility to run our own Medicaid program, we will be more efficient and less wasteful than the federal government,” Scott notes.

“Liberal Democrats,” asserts Gov. Scott, “have a game plan for America: everything for free, provided by the government, paid for with your tax dollars. There is a name for this approach, and it is called socialism. President Obama gave it a try, and in the process he proved what we already knew — it does not work.”

“Government assistance must be the last resort,” Scott adds, “not the first stop. This is no time for Republicans to go wobbly or get weak in the knees about repealing Obamacare. If we refuse to roll back the welfare state, what real purpose do we serve?”

With many people expecting Scott, termed out next year, to challenge Democrat Bill Nelson for his Senate seat, an oped like this serves multiple purposes.

It reminds national conservatives that, when it came to Medicaid expansion, the governor fought Washington and won.

It allows the governor to frame the current debate around what he has accomplished in Florida.

And, most importantly, it provides a framework for what might come out of Washington this year regarding reform of the current health care schematic.

Expect more op-eds like this in the weeks ahead.

Daniel Webster: Congress will not pull rug out on health care coverage

Whether or not congressional Republicans have a plan to replace Obamacare they are beginning to respond to voters concerns about lost coverage, and U.S. Rep. Daniel Webster has told his that “we do not intend to pull the rug out.”

In his newsletter to constituents of Florida’s 11th Congressional District, which includes much of Lake County and north Central Florida to the Gulf Coast, Webster pressed his assurances that the Affordable Care Act could be replaced.

He also made clear the laundry list of concerns that he and many other Republicans have been trying to raise for seven years, with a survey for his constituents, seeking responses.

“The House is working on a plan to provide Americans with the care they need, from the doctor they choose, at a price they can afford. We do not intend to pull the rug of coverage and care out from underneath anyone,” Webster insisted in a newsletter he sent out Tuesday night.

He asked voters to respond to him if they have experienced any of the following:

– An increase in premium costs.

– Lost health care coverage or reduction in plan benefits.

– Denied opportunity to get care from the doctor of choice.

– Increase in out of pocket expenses.

– Cut in work hours because an employer couldn’t afford to provide healthcare.

– The need to get a second or third job because work hours were cut.

– The need to adjust hiring practices because of the 30 hour “full time” standard.

He did not ask any constituents to respond about any potential positives in the ACA, such as if they were able to afford health care coverage for the first time, or if their Obamacare plan had provided them with valuable health care coverage they would not have had before the law was enacted.

A look at Obama’s legacy, foolish hope of ‘post-racial’ America

(Part 1 of two. Part two will deal with Obama’s political legacy)

The 2008 presidential campaign of Barack Obama focused on the theme of change. Obama promised to “restore our moral standing” and “focus on nation-building here at home.”

Obama, as a candidate, told audiences that “we are the ones we’ve been waiting for. We are the change we seek.” “Yes, we can” and “change you can believe in” became the campaign themes.

Obama promised to “make government cool again.” This would be achieved by an activist, expanding federal government. Obama seemed to be contradicting the message of the last Democratic president, Bill Clinton, who argued that “the era of big government is over.”

Although Obama viewed himself as a transformative president, much of his first year in office was spent stabilizing America’s collapsing economy and avoiding another Great Depression.

America was losing 700,000 to 800,000 a month with no let up in sight. Major banks and Wall Street brokers were declaring bankruptcy, and the American auto industry was on the verge of collapse.

If nothing else, Obama deserves credit for stabilizing the economy. His action plan included an unpopular stimulus program, a bailout of the auto industry that some described as socialism, and shoring up the big banks that were responsible for much of the economic instability with their risky loans.

As a result of President Obama’s efforts, an economic catastrophe was avoided. We have had eight consecutive years of economic growth, although critics pointed out the less than 3 percent growth rate was low. The economic programs, in part, lead to an 88 percent increase in the national debt and the loss of the United States AAA bond rating.

“Obamacare,” or the Affordable Care Act (ACA), was the primary domestic accomplishment of the Obama presidency. Young individuals could remain on their parent’s insurance until age 26, preexisting conditions would not disqualify you from coverage and 20 million more Americans received health care coverage.

The ACA was not without its critics. The plan did not control health care costs as promised, and Obama’s promise to Americans that “if you like your doctors, you can keep them” and “if you like your health care plan, you can keep it” proved not to be true. In fact, Politics-Fact labeled those promises the “lie of the year.”

The ACA was narrowly passed without a single Republican vote. That does not bode well for its long-term success. Major public policy change in the United States, to succeed, needs to be comfortably passed with bipartisan support. Civil rights legislation and Medicare are just two examples of that.

Democrats contend that Republicans were not going to vote for the ACA and give Obama a major political victory. Republicans argued that the president made no attempt to reach out to them and find common ground. The president has many tools available to curry support, most importantly, the power of persuasion. For whatever reason, the goal seemed to pass the ACA with or without Republican votes.

The election of Donald Trump now jeopardizes the ACA. Republicans must realize that if they attempt to “repeal and replace” Obamacare without Democratic support, their plan will fail just as Obama’s plan is likely to fail.

Obama, the nation’s first African-American president, was supposed to lead to a “post-racial America.” That was a foolish and unrealistic expectation.

During the 2008 campaign, Obama gave a speech on race in Philadelphia in an attempt to counter the negative public reaction to statements from Jeremiah Wright, the president’s longtime friend and minister. Wright attacked racism in America in many of his talks. The most explosive comment found Wright stating: “Not God bless America. God damn America!”

In his address on race, Obama said Wright was correct in talking about racism but wrong in speaking “as if no progress had been made.”

Almost as soon as he assumed the presidency, Obama dealt with one racial issue after another. In 2009, Obama said a police officer “acted stupidly” when he arrested Henry Louis Gates, a prominent black Harvard professor when Gates entered his home through a window after forgetting his house key. Obama quickly held a “beer summit,” inviting both Gates and the police officer to talk through their dispute.

In 2012, the nation was divided when a white neighborhood watch volunteer shot and killed a young black male named Trayvon Martin. Obama told reporters that “if I had a son, he would look like Trayvon Martin.” The white shooter was found not guilty.

A police shooting of another black teen in Ferguson, Missouri in 2014 led to criticism of Obama by both whites and blacks. Whites attacked the president for criticizing the police in “using excessive force” against protestors who were “lawfully exercising their First Amendment rights.” Blacks criticized the president for stating that there is “no excuse for violence against the police” or “those who would use this tragedy to cover for vandalism or looting.”

 In 2015, the nation was shocked by the brutal murder of nine black parishioners in Charleston, South Carolina by Dylann Roof, a young white male who had been invited to join the Bible study. The nation saw the moving acts of forgiveness as one relative after another of the victims said they forgave him. This act of grace led President Obama to conclude his remarks at the church by singing Amazing Grace.

Obama was widely criticized for his foreign policy actions or inactions. Critics blamed the early exit if American forces from Iraq as creating a vacuum which allowed ISIS to emerge. His nuclear pact with Iran was criticized by Republicans, the military, Israel and others who saw the act as creating a nuclear-armed Iran in the Middle East. The president’s failure to enforce his “red line” in Syria if chemical weapons were used by Bashar al-Assad, created an inroad for both ISIS and the Soviets to expand their role.

Like all presidents, Obama has a mixed bag of successes and failures as president. In his own analysis of his presidency, Obama praised his administration for stopping the economic crisis, saving the auto industry, creating the longest stretch of job creation, opening relations with Cuba, shutting down Iran’s nuclear program, passing national health insurance and securing marriage equality. “America is a better, stronger place than it was when we started.”

During the 2016 campaign, Obama stated: “My legacy is on the line.” By that standard, the public decided they wanted to move in another direction.

___

Darryl Paulson is Emeritus Professor of Government at the University of South Florida St. Petersburg.

Charlie Crist calls GOP Obamacare repeal without replacement ‘unacceptable’

With the Affordable Care Act — aka Obamacare — already beginning to be phased out by Republicans in Washington this month, congressional Democrats took to the streets in Florida and around the country Sunday afternoon.

Congressional representatives held rallies and press events featuring regular citizens whose lives have benefited by Barack Obama’s signature domestic achievement.

In South St. Petersburg, Charlie Crist held his own event, where he blasted congressional Republicans for having nearly seven years to provide an alternative to the ACA without doing so yet.

“In Washington D.C. I will do everything I can to prevent that from happening,” he said of the plans to repeal and replace.

And while that comment drew cheers from his supporters at the news conference held outside of Advantage Insurance Solutions on 22nd Street South, the fact is in the House at least, Republicans don’t necessarily need any Democrats to help them pass an alternative plan after they repeal the ACA.

“I think we need to keep it the way it is and try to improve it,” Crist said when asked if he would work with Republicans on a replacement.

“There are things that can be better about this act, no question about it,” he admitted, referring to ways to keep costs from escalating. But he said that repealing provisions of the law such as removing the ban on insurance companies being able to deny patients with pre-existing conditions was morally wrong.

“It would have to be something like Obamacare,” he said when asked by another reporter about what type of alternative he could stand behind. But the freshman Representative admitted that would be “challenging” considering that Republicans ran this fall on a platform of dismantling Obamacare.

“But anything worthwhile is not easy,” he said. “Just because it’s hard doesn’t mean it’s not worth fighting for.”

Terry Donald is the owner of We Haul Florida, a hauling and cleanup service in Pinellas County.  He calls his family’s health history “a nightmare” with high blood pressure and heart disease present in several members of his clan. He related an anecdote about how he received a staph infection after cutting his leg while mowing his lawn. “Had I not sought treatment, I would have lost my life,” he said starkly, referring to how he was treated by his doctors with an aggressive course of IV antibiotics.

“People ask me why this coverage is so important and I tell them I had insurance,” he said. “I knew it would be covered. I knew I wouldn’t go bankrupt for receiving the care that I needed.”

Gloria Campbell writes insurance policies as the owner of Advantage Insurance Solutions. She says before the creation of the ACA, nine out of 10 health insurance policies that she drew up for her clients were rejected because of her client’s pre-existing health conditions, or their families’ poor medical history.

Campbell says many of those people now on the ACA had never previously seen a doctor because they didn’t know how insurance worked.

“Now they own their own health care,” she said. “They talk about what kind of outcomes they want. Now people don’t rely on getting sick, they rely on staying well.”

“We have the technology to restart a heart, to 3D print organs and tissue, to save people from Ebola, but we lack the moral fiber and legislative stones to ensure that the American taxpayer doesn’t face lifelong financial ruin for the crime of surviving,” charged Jhavavi Pathak, who currently attends MIT and is the founder of The War on Cancer Foundation.

She told the story of her father, Yogesh, who in 2004 was diagnosed with Stage 4 kidney cancer which ultimately spread to his spleen, pancreas, lungs, leg, brain and skull. He’s had 14 major surgeries, including four on his brain, and is somewhat miraculously still alive. In the fall of 2013, he signed up to get on the ACA. “Every one of us is a single mishap or accident away from lifelong financial ruin,” she declared.

“It used to be people didn’t survive a serious medical issue,” Pathak said. “We just didn’t have the medical treatments or the scientific know-how. But now in 21st Century America, people simply can’t afford to survive a serious medical attention.”

While she and the other public speakers blasted the GOP for not having a replacement plan ready to insert as they begin to repeal the law, Kentucky Senator Rand Paul announced Sunday that he does have a replacement ready to go.

“Replacement should be the same day,” Paul said on CNN’s State of The Union, reiterating his critique of fellow congressional Republicans’ “repeal and delay” idea. “Our goal is to insure the most amount of people, give access to the most amount of people at the least amount of cost.”

Paul praised the good intentions of the designers of the Affordable Care Act but said it includes too many mandates and has “broken the insurance model” in the individual market. Among other changes, his plan would remove some insurance coverage mandates that drive up premium costs to “legalize the sale of inexpensive insurance.”

 

Marco Rubio votes to repeal Affordable Care Act

U.S. Senator Marco Rubio has cast his vote to repeal the Affordable Care Act, commonly known as Obamacare.

Early Thursday morning, the Senate GOP took a first step towards a repeal of the law – which they’ve long said was a goal of theirs and which President-elect Donald Trump made a campaign promise to do. In a marathon voting session, they approved a budget resolution that would speed through the repeal of the law.

Rubio was right on board with that.

“ObamaCare has led to rising premiums, a collapse of the individual insurance market and fewer choices for patients,” Rubio said. “The law is an absolute failure, and its proponents insist it must be salvaged with a taxpayer-funded bailout of health insurance companies. We’ve now taken an important first step to repeal this law and replace ‎it with a patient-centered approach that expands access to providers and lowers costs of care.

“It is my hope and expectation that the transition to a replacement program can be done relatively seamlessly and minimize disruptions to patients.”

Opponents of the measure say a repeal of the Affordable Care Act would be disastrous and leave many people without health care, as well as leaving people with pre-existing conditions unable to find coverage.

The GOP and Trump say they’ll work towards implementing a replacement for the law that will be better, though no details on what that plan will be have surfaced.

Survey finds bipartisan divide on ACA but bipartisan support for key provisions

The Affordable Care Act has a clear partisan divide but individual, key provisions have broadly bipartisan support, the Pew Research Center is reporting Monday.

Pew found that the partisan divide that began immediately in 2009 when Congress was debating President Barack Obama’s health care bill that got dubbed “Obamacare” remains a gulf – with more than 70 percent of Democrats wanting to keep the law and more than 85 percent of Republicans wanting to scrap it, as the now solidly-Republican led Congress and president-elect Donald Trump intend to do as soon as possible.

But individual provisions? Pew cited a Kaiser Family Foundation survey that shows that’s where the challenge is for Republicans pledging a repeal-and-replace plan.

Kaiser asked people about ten specific ACA provisions: nine of them got overall 60 percent support, and eight of them even got 60 percent support from Republicans.

The only provision Kaiser inquired about that clearly lacks support is the one requiring people to pay tax fines if they don’t sign up for a health insurance plan. Only 21 percent of Republicans support the idea, and only 35 percent of all Americans surveyed support it. Democrats still favor it, with 57 percent support.

Otherwise, Americans like the provisions in Obamacare:

– Overall, 85 percent of Americans surveyed said they like that young adults can stay on their parents’ policies through the age of 26, and that rule also got an 82 percent approval rating among Republicans.

– 83 percent of Americans said they like that there’s no out-of-pocket expenses for preventative-care medicine, and that includes 77 percent of Republicans surveyed.

– Closing the Medicare prescription drug “donut hole;” creating insurance exchanges for small businesses; providing subsidies for low- and moderate-income people to buy coverage; and giving states the option to expand Medicaid to cover uninsured; all got approval from at least 80 percent of Americans and at least two-thirds of Republicans.

– Preventing insurance companies from refusing coverage because of pre-existing conditions; and increasing the Medicare payroll tax on upper-income Americans; both got 69 percent overall approval and 63 percent approval among Republicans.

The only other provision Republicans rebelled against besides the fines for uninsured is the requirement that businesses with at least 50 employees provide health insurance. Just 45 percent of Republicans liked that, though overall 60 percent of Americans like it.

Democrats pretty much liked everything, giving 75 percent approval ratings for all the provisions Kaiser, asked about except the fines for uninsured people.

“Regardless of what they would like to see happen with the law, a growing share of Americans – across partisan lines – now see a dim future for the law’s major provisions. Roughly half of U.S. adults (53 percent) expect that its major provisions will probably be eliminated, while 39 percent say they are probably here to stay,” reported Pew authors Kristen Bialik and Abigail Geiger.

 

Rick Scott to US House Majority Leader: ‘repeal and replace Obamacare’

On Monday, Florida Governor Rick Scott sent a letter to the United States Congress majority leader calling for the body to “repeal and replace” Obamacare.

Scott’s position on what he calls the “excessive overreach” of Obamacare is not necessarily a surprise, given his historic opposition to the president’s approach to the Affordable Care Act.

However, it is newly salient in light of Republican control of the executive and legislative branches.

“For far too long, it has been fashionable in Washington to say Obamacare can only be tweaked. We have seen debate after debate in Washington about this bad law but nothing has been changed. It has to be completely overhauled and now is the time to do it. We cannot let the usual political games or partisan gridlock of Washington get in the way of immediately repealing and replacing Obamacare with a plan that actually works,” Scott noted.

“The impact of Obamacare has been devastating in Florida and our nation. Obamacare was sold on a lie from the very start. Costs are skyrocketing, people have not been able to keep their doctors and many people have fewer doctors to choose from. The increases in health care costs are at a 32-year high and are expected to continue increasing in the coming months. Recent news of Obamacare rates rising 25 percent is absurd and families simply cannot afford it. We can do better and the families and businesses footing the bill deserve better,” Scott added.

In the five-page letter, Scott advocated for “state flexibility,” rather than a “one size fits all” approach to the replacement.

“Specifically,” Scott wrote, “our state needs the greatest possible amount of flexibility from Washington … without creating a massive government program that makes promises to patients that we could never afford to keep.”

Scott’s letter laid out the governor’s suggestions for replacement.

One suggestion: to repeal the individual and employer mandates, allowing people to choose to deposit funds into a health savings account instead of giving the money to an insurance company.

Scott also urged the allowance of insurance companies to sell across state lines, which currently isn’t an option.

Scott also backs greater flexibility in packages sold, and allowing families to opt for a single plan for the entire family, rather than one plan for children and another for adults.

Regarding the state’s needs, Scott told the House Majority Leader that he’d like Florida to have “flexibility to run our own Medicaid program that uses the state’s successful managed care model.”

Scott would also like to see the elimination of “burdensome” Obama regulations, such as the Managed Care Rule, the Access Rule, and the Outpatient Drug Rule, examples of “intensive but often purposeless federal micromanagement” that privileges federal bureaucracy at the expense of the state process.

If Republicans have a better idea to replace Obamacare, let’s hear it

I have a friend who has owned a small restaurant in Tampa for decades. He voted for Donald Trump for two important reasons: Trump isn’t Hillary Clinton, and he hates Obamacare.

Let me rephrase that: He doesn’t like Hillary, but he loathes Obamacare with unyielding venom. Keeping up with its requirements, he said, has been an expensive nightmare. He wants it gone.

Today.

This is a kind and decent man who is all-in on goodness. He is charitable, law-abiding and is happy to lend a hand. So, over several plates of bacon and eggs at his joint, I have deduced that his position can best be summed up like this: He wants his employees and anyone in need to have access to health care, but he despises the bureaucracy and costs imposed by Obamacare.

It looks like he is going to get his way as the Republican-controlled Congress is tripping over itself to defund, defeat and dethrone the signature accomplishment of President Barack Obama’s administration. But then what?

Well, to borrow the infamous quote from House Speaker Nancy Pelosi from 2010 when the Affordable Care Act was coming to life, “We have to pass the bill so that you can find out what is in it, away from the fog of the controversy.”

That quote was taken out of context and fed to Pelosi for breakfast, lunch and dinner, along with Obama’s vow that people could keep the doctors they liked. That became the rallying cry for opponents, but Trump now basically is saying the same thing – promising Americans that law will be replaced with something great.

While we wait for greatness, consider these Florida statistics from a recent federal Health and Human Services report.

— An estimated 132,000 young Floridians have been able to keep insurance by the provision allowing them to stay on their parents’ policies until age 26.

— It claims premiums grew 1.3 percent annually from 2010-2015, far less than the 8.2 percent of the previous decade.

Hold on just a minute there.

The HHS apparently forgot to include the estimated 25 percent premium hike for Floridians this year. There are many factors for that, especially the fact that far fewer people enrolled in Obamacare than the government projected and fewer insurers are offering coverage now that federal backstops against financial losses have been phased out.

All this sets up as a trap for Republicans in their zeal to end the program, though.

With lower enrollments than expected and the end to the safety net for insurance companies, any plan Republicans pass to replace the ACA probably will come up short of what Obamacare offered.

I can see the attack ads now when congressional seats are up for grabs in two years.

Incoming HHS head Tom Price of Georgia, a ferocious critic of Obamacare, has proposed a plan that would include a series of tax credits, health savings accounts, state grants and so on. Analysists have said Price’s proposal, if adopted, could mean reduced coverage and much higher premiums, especially for older Americans.

Republicans have the votes, for now, to move ahead with something. What that is, though, is anyone’s guess – especially Republicans. After barking their hatred for Obamacare for six years, they have, in the words of Senate Minority Leader Chuck Schumer, become “the dog that caught the car.”

Now what?

I know my friend would say to get rid of Obamacare and we’ll out the consequences later.

My take is a little different. I know this makes some people cringe, but I think health care is a right in a civilized society. It’s not something only those who can afford it should have. If Republicans have a better idea, let’s hear it.

After all, as Schumer said, they caught the car. They need to do more than just pee on the tires.

 

Health insurance board bracing for Donald Trump, Congress, to act on Obamacare

Members of a state insurance advisory panel called Friday for legislation fixing a regulatory “family glitch” that can make health insurance unaffordable to dependents of employees of small businesses.

The Florida Health Insurance Advisory Board declined additional proposed recommendations, however — in part because of uncertainty about what Donald Trump and the Republican Congress would do about the Affordable Care Act.

Board member Bill Herrle, Florida director of the National Federation of Independent Business, asked Insurance Commissioner David Altmaier, who chairs the panel, to begin bracing for whatever changes might be in store.

Herrle noted suggestions that Congress might set the ACA, sometimes referred to as “Obamacare,” to expire following the 2018 elections, and come up with a replacement plan in the interim.

“While that sounds like a long time, that could leave Florida with potentially only one legislative session in which to account for these changes,” Herrle said.

“Many of which may be ministerial, but some of which will not be as simple as going back to pre-ACA Florida statutes and plugging them back in. The market has changed very much.”

Altmaier agreed, saying his Office of Insurance Regulation has already started studying the situation.

“I think it would be prudent on the board’s part to initiate some of these dialogs,” Altmaier said.

The panel advises state leaders about health insurance matters and includes representatives of the industry, business interests, and state agencies. It needs a consensus to send recommendations to the Legislature.

Members agreed only once Friday: On the family glitch.

Louisa McQueeney, who manages an ACA navigator project for Florida CHAIN in Boynton Beach, argued that small group plans sometimes don’t cover employees’ family members. Depending on how much the family earns, the dependents might not qualify for ACA premium subsidies.

Other proposals failed, including to make health savings accounts available through high-deductible plans requiring policyholders to pay high out-of-pocket expenses; and to repeal a state law offering coverage through small-group plans to employees’ dependents until age 30. The ACA covers them until age 26.

Another idea that didn’t get off the drawing board involved improving coverage for sufferers of “maple syrup urine” disease, a genetic malady. State law mandates coverage through age 24 — a level established years ago when patients frequently died young.

Now they can live much longer, but have trouble paying for the expensive drugs that help keep them alive.

Often, board members cited uncertainty about what Republicans in Washington would do to the health insurance market.

“There are undoubtedly going to be some changes, maybe some substantial changes to the marketplace and how it functions, said John Matthews, southeastern general counsel for UnitedHealthcare.

“I question the wisdom of us making firm statutory mandate recommendations in light of what could be rather substantial changes to the ACA in general,” Matthews said.

Nearly 880,000 Floridians sign up for Obamacare

Nearly 880,000 Floridians have signed up for health coverage on President Obama‘s federal marketplace so far this year.

The deadline to enroll was Thursday for those seeking coverage starting on January 1. More than 4 million Americans chose plans on healthcare.gov this year. The figures were released by federal health officials and include both new and returning consumers who are updating or switching plans. Federal health officials say most consumers can find plans for less than $75 a month.

The robust enrollment comes amid uncertainty about the health care program as President-elect Donald Trump repeatedly promised to repeal it during his campaign. Few details about a replacement plan have been released and changes could take months or years to unfold.

No changes are expected next year for the more than 10 million people covered.

Republished with permission of the Associated Press.

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