Archive for the ‘Congress’ Category
Either it was a cleverly engineered plan or some kind of cosmic joke: just as the confirmation hearing for Scott Pruitt, the climate denier who is Donald Trump’s nominee to head the Environmental Protection Agency, was getting under way Wednesday, on Capitol Hill, two federal agencies—the National Aeronautics and Space Administration and the National Oceanic and Atmospheric Administration—announced that 2016 was the warmest year since modern record-keeping began, in 1880. It was the third year in a row to smash previous records for warmth, a trend that prompted the Times to observe that “temperatures are heading toward levels that many experts believe will pose a profound threat.”
If Pruitt is confirmed, there will probably be no one in a better position to influence—or, more accurately, wreak havoc on—domestic climate policy. Central to the Obama Administration’s efforts to curb global warming has been a set of E.P.A. regulations limiting carbon emissions from power plants. Pruitt, as the Attorney General of Oklahoma, made his views on these regulations known by suing to block them. In the past six years, he filed more than a dozen lawsuits against the E.P.A., in many cases acting in concert with the very industries that the regulations were aimed at. Meanwhile, a super pac close to Pruitt, called Liberty 2.0, was collecting large contributions from these same industries; Murray Energy, the country’s largest coal company, for instance, gave fifty thousand dollars in August.
At confirmation hearings, nominees typically try to distance themselves from the more extreme positions they’ve held by suggesting that these were the equivalent of youthful indiscretions. But if that’s the strategy Pruitt was attempting on Wednesday, he failed. In his opening statement, Pruitt offered the following on climate change: “Science tells us that the climate is changing and human activity in some manner impacts that change. The human ability to measure with precision the extent of that impact is subject to continuing debate and dialogue, as well they should be.” The statement was clearly designed to be obfuscatory, but it was just comprehensible enough to also be clearly wrong. As the Times’ Coral Davenport put it on Twitter, “#Pruitt on #climate: ‘Science tells us climate is changing’ but says extent of human role is up for debate. False.”
Later in the hearing, Senator Bernie Sanders pressed Pruitt on his views about climate change. The exchange went, in part, like this:
Sanders: As you may know, some ninety-seven per cent of scientists who have written articles for peer-reviewed journals have concluded that climate change is real, it is caused by human activity, and it is already causing devastating problems in our country and around the world. Do you believe that climate change is caused by carbon emissions, by human activity?
Pruitt: As I indicated in my opening statement, the climate is changing and human activity contributes to that in some manner.
Sanders: In some manner? Ninety-seven percent of the scientists who wrote articles in peer-reviewed journals believe that human activity is the fundamental reason we are seeing climate change. You disagree with that?
Pruitt: I believe the ability to measure with precision the degree of human activity’s impact on the climate is subject to more debate on whether the climate is changing or whether human activity contributes to that.
The exchange—a bizarre riff on Pruitt’s opening statement—prompted Gizmodo to label the hearing “ a surreal nightmare.” It led Sanders to tweet: “We cannot have an EPA administrator who denies climate science. It is far too late for that.”
Pruitt has come under fire from some Republicans, including, most notably, . . .
An extremely ominous sign: Republicans are avoiding constituents angry about the Affordable Care Act repeal
When Congress actively avoids the people that members of Congress are supposed to represent and whose interests the member of Congress is supposed to protect, the government becomes separated from the people. It’s no longer government for the people, and it’s no longer government by the people. I suppose it’s still a government “of” the people, but only some of the people: the wealthy and powerful and corporate, whose interests are primary to many members of Congress, and much more important than the interests of their constituents.
Matthew Rozsa writes in Salon:
The same Republican politicians who are planning to repeal the Affordable Care Act are doing everything they can to avoid potentially embarrassing confrontations with their constituents who will be affected by their actions.
Although 10 Republican legislators have held in-person town hall meetings since the start of the year, only one — Rep. James F. Sensenbrenner, R-Wisconsin — has scheduled any events for the future, according to The Washington Post.
“In this day and age, real-life town halls are very dangerous for all but the most seasoned politicians,” John Feehery, a former senior House Republican leadership aide, told the Post. “I think John McCain can get away with it and a few others, but most should stick to office hours, really good constituent service or tele-town halls.”
There are already signs that Republican congressmen would experience a major backlash if they faced their constituents. Rep. Mike Coffman of Colorado had to exit an event on Saturday from a backdoor due to chanting protesters. Rep. Cathy McMorris Rodgers of Washington faced shouts of “save our health care” during an event in her district on Monday. And — perhaps most memorable — on Friday House Speaker Paul Ryan of Wisconsin was confronted on a national cable show by a cancer survivor who insisted that the Affordable Care Act had saved his life.
Republicans have a great deal to lose if they repeal the Affordable Care Act without setting up a replacement plan to protect the 22 million Americans who would otherwise lose their health insurance. There are 6.3 million people in Republican-led districts who enrolled due to the marketplaces established by the Affordable Care Act — compared with only 5.2 million enrollees who reside in Democratic-led districts. . .
Paul Krugman blogs at the NY Times:
Another week of complete chaos on the health reform front. Dear Leader declares that he’ll give everyone coverage; Republicans explain that he didn’t mean that literally. CBO says the obvious, that repealing the ACA would lead to immense hardship for tens of millions; Republicans declare that this is wrong, because they will come up with an alternative any day now — you know, the one they’ve been promising for 7 years.
I’ve written about all of this many, many, many times. The logic of Obamacare — the reason anything aiming to cover a large fraction of the previously uninsured must either be single-payer or something very like the ACA — is the clearest thing I’ve seen in decades of policy discussion. But I don’t know if I’ve ever written out the fundamental principles that lie behind all of this.
So here we go: providing health care to those previously denied it is, necessarily, a matter of redistributing from the lucky to the unlucky. And, of course, reversing a policy that expanded health care is redistribution in reverse. You can’t make this reality go away.
Left to its own devices, a market economy won’t care for the sick unless they can pay for it; insurance can help up to a point, but insurance companies have no interest in covering people they suspect will get sick. So unfettered markets mean that health care goes only to those who are wealthy and/or healthy enough that they won’t need it often, and hence can get insurance.
If that’s a state of affairs you’re comfortable with, so be it. But the public doesn’t share your sentiments. Health care is an issue on which most people are natural Rawlsians: they can easily imagine themselves in the position of those who, through no fault of their own, experience expensive medical problems, and feel that society should protect people like themselves from such straits.
The thing is, however, that guaranteeing health care comes with a cost. You can tell insurance companies that they can’t discriminate based on medical history, but that means higher premiums for the healthy — and you also create an incentive to stay uninsured until or unless you get sick, which pushes premiums even higher. So you have to regulate individuals as well as insurers, requiring that everyone sign up — the mandate, And since some people won’t be able to obey such a mandate, you need subsidies, which must be paid for out of taxes.
Before the passage and implementation of the ACA, Republicans could wave all this away by claiming that health reform could never work. And even now they’re busy telling lies about its collapse. But none of this will conceal mass loss of health care in the wake of Obamacare repeal, with some of their most loyal voters among the biggest losers.
What they’re left with is . . .
Jason Kottke blogs:
I posted earlier about Atul Gawande’s piece in the New Yorker on the importance of incremental care in medicine. One of the things that the Affordable Care Act did was to make it illegal for insurance companies to deny coverage to people with “preexisting conditions”, which makes it difficult for those people to receive the type of incremental care Gawande touts. And who has these preexisting conditions? An estimated 27% of US adults under 65, including Gawande’s own son:
In the next few months, the worry is whether Walker and others like him will be able to have health-care coverage of any kind. His heart condition makes him, essentially, uninsurable. Until he’s twenty-six, he can stay on our family policy. But after that? In the work he’s done in his field, he’s had the status of a freelancer. Without the Affordable Care Act’s protections requiring all insurers to provide coverage to people regardless of their health history and at the same price as others their age, he’d be unable to find health insurance. Republican replacement plans threaten to weaken or drop these requirements, and leave no meaningful solution for people like him. And data indicate that twenty-seven per cent of adults under sixty-five are like him, with past health conditions that make them uninsurable without the protections.
That’s 52 million people, potentially ineligible for health insurance. And that’s not counting children. Spurred on by Gawande, people have been sharing their preexisting conditions stories on Twitter with the hashtag #the27Percent.
The 27% figure comes from a recent analysis by the Kaiser Family Foundation:
A new Kaiser Family Foundation analysis finds that 52 million adults under 65 — or 27 percent of that population — have pre-existing health conditions that would likely make them uninsurable if they applied for health coverage under medical underwriting practices that existed in most states before insurance regulation changes made by the Affordable Care Act.
In eleven states, at least three in ten non-elderly adults would have a declinable condition, according to the analysis: West Virginia (36%), Mississippi (34%), Kentucky (33%), Alabama (33%), Arkansas (32%), Tennessee (32%), Oklahoma (31%), Louisiana (30%), Missouri (30%), Indiana (30%) and Kansas (30%).
36% uninsurable in West Virginia! You’ll note that all 11 of those states voted for Trump in the recent election and in West Virginia, Trump carried the day with 68.7% of the vote, the highest percentage of any state. The states whose people need the ACA’s protection the most voted most heavily against their own interest.
Oh and one last thing. . .
The authors of an excellent column in the Washington Post are:
Richard Painter, a professor of law at the University of Minnesota, was the chief White House ethics lawyer for President George W. Bush from 2005 to 2007. He is vice chairman of Citizens for Responsibility and Ethics in Washington.
Norman Eisen, a fellow at the Brookings Institution, was the chief White House ethics lawyer for President Obama from 2009 to 2011. He is chairman of Citizens for Ethics and Responsibility in Washington.
The column begins:
The latest front involves the Office of Government Ethics and its director, Walter Shaub Jr. , who has had the temerity to speak up against Trump’s plan to deal with his conflicts of interest as “meaningless.”
Both of us, former ethics counsels for Presidents George W. Bush and Barack Obama, respectively, have worked with Shaub, a career public servant who, in our experience, provided nonpartisan and wise advice. Now, Shaub is being pilloried — and may be at risk of losing his job — for doing just that, and asserting correctly that Trump’s approach “doesn’t meet the standards . . . that every president in the last four decades has met.”
How does the Trump plan fall short? The president-elect asserted that the conflicts laws don’t apply to him but ignored the most fundamental one of all: the constitutional rule that presidents may not accept cash and other benefits — “emoluments” — from foreign governments.
Trump’s lawyer then offered a porous and insufficient plan to address this problem: The Trump Organization will donate profits from foreign governments’ use of his hotels. But why only hotels? What about foreign sovereign payments to buy his condos or apartments, for use of his office buildings or his golf courses, not to mention his massive foreign government bank loans, and other benefits? And why only profits, when the Justice Department has long held that the emoluments clause covers any revenue from foreign governments — not simply profits?
For speaking up about the shortcomings of this plan, Shaub found himself in the Republican crosshairs. Rep. Jason Chaffetz (Utah), chair of the House Oversight and Government Reform Committee that has jurisdiction over the White House, demanded Shaub appear for a Star Chamber-style recorded inquisition and implicitly threatened to shut down the Office of Government Ethics if Shaub did not submit. Chaffetz ought to have been doing the exact opposite, supporting OGE and demanding documents from Trump about any financial ties to Russia or other foreign governments.
Then, just when we thought it couldn’t get worse, it did. The incoming White House chief of staff, Reince Priebus, went on national television to threaten Shaub. In a scene like something out of a gangster B-movie, Priebus warned the director that “he ought to be careful ” and gave his blessing to Chaffetz’s interrogation. Priebus’s glare of menace was unmistakable. The only thing he left out was cracking his knuckles.
Priebus went on to make assertions about Shaub that were false. For example, he claimed Shaub was “political” because he “may have . . . publicly supported Hillary Clinton,” which is simply untrue. Shaub has done no such thing. (Before becoming director, Shaub made modest political donations, as did his Republican predecessor.Indeed, both of us have also exercised this same First Amendment right.)
Priebus also attacked Shaub’s competence, and so his livelihood, questioning “what this person at Government Ethics, what sort of standing he has any more in giving these opinions.” In fact, the director is a dedicated and talented ethicist who has served Democratic and Republican presidents alike with distinction and without controversy for many years. He has already approved 54 percent of the Trump nominees who have submitted their paperwork to OGE, compared with just 29 percent at this point in the Obama transition eight years ago. If the White House chief of staff had made these kinds of threats against the head of OGE when we were serving in the White House, we would have resigned immediately. . .
So Cory Booker is another “Republican lite” Democrat, though in this case he seems quite heavy handed. Zaid Jilani and David Dayen report in The Intercept:
The policy has widespread support among Americans: one Kaiser poll taken in 2015 found that 72 percent of Americans are in favor of allowing for importation. President-elect Donald Trump also campaigned on a promise to allow for importation.
The Senate voted down the amendment 52-46, with two senators not voting. Unusually, the vote was not purely along party lines: 13 Republicans joined Sanders and a majority of Democrats in supporting the amendment, while 13 Democrats and a majority of Republicans opposed it.
One of those Democrats was New Jersey’s Cory Booker, who is considered a rising star in the party and a possible 2020 presidential contender.
In a statement to the media after the vote, Booker’s office said he supports the importation of prescription drugs but that “any plan to allow the importation of prescription medications should also include consumer protections that ensure foreign drugs meet American safety standards. I opposed an amendment put forward last night that didn’t meet this test.”
This argument is the same one offered by the pharmaceutical industry. The Pharmaceutical Research and Manufacturers of America (PhRMA), which lobbies against importation, maintains that it opposes importation because “foreign governments will not ensure that prescription drugs entering the U.S. from abroad are safe and effective.”
The safety excuse has long been a refuge for policymakers who don’t want to assist Americans struggling with prescription drug costs. Bills to legalize importation passed in 2000 and 2007, but expired after the Clinton and Bush administrations refused to certify that it would be safe. The Obama administration also cited safety concerns when opposing an importation measure in the Affordable Care Act.
A second amendment Wednesday, authored by Democratic Sen. Ron Wyden, would have allowed importation pending a safety certification, just like the previous laws passed on the subject. It also failed. Sen. Bob Casey, D-Pa., used that amendment to claim on Twitter that he voted “to lower drug prices through importation from Canada,” and Booker referred to the Wyden amendment in his statement as well. This is a well-worn tactic from opponents of importation to mislead their constituents, as they know such certification will never occur.
The safety excuse is mostly a chimera, as most of the drugs that would be imported from Canada were originally manufactured in the United States; they’re just cheaper there, because the Canadian government uses a review board and price negotiation to make drugs more affordable.
“My first response to that is show me the dead Canadians. Where are the dead Canadians?” former Minnesota Gov. Tim Pawlenty, a Republican, once asked during his own push to allow for importation.
Democrats blocked importation from becoming part of the Affordable Care Act in 2009, with over 30 votes in opposition, because they feared it would have pushed the pharmaceutical industry to oppose the underlying legislation. They also voted in large numbers to oppose importation as part of an FDA bill in 2012. . .
As noted at the link, Booker gets loads of cash from pharmaceutical companies, and he delivers good value for their money. This is not how Congress should work.
Paul Waldman looks back down memory lane:
At his CNN town hall yesterday, Paul Ryan met a man named Jeff Jeans, a lifelong Republican and small business owner who not long ago got a cancer diagnosis. He didn’t have insurance at the time and was told that without treatment he’d have only six weeks to live.
“Thanks to the Affordable Care Act, I’m standing here today alive,” he said. “I want to thank President Obama from the bottom of my heart, because I would be dead if it weren’t for him.”
Let’s not mince words: If Paul Ryan and the rest of the Republicans in Congress get their way, people like Jeff Jeans will die.
That sounds like hyperbole, like unnecessarily inflammatory rhetoric. But it’s the truth. These are literally life-and-death questions Congress is deciding.
There are a lot of reasons why repealing the ACA is going to be a disaster. But for now I want to focus on just one: what’s going to happen to the estimated 52 million Americans who have pre-existing conditions, like Jeff Jeans?
To begin, let’s remember what it was like before the ACA was passed. When you applied for insurance, you had to give a detailed accounting of every major medical procedure you’d ever had, every serious condition you’d ever had, every time you had sought treatment for anything for years prior. The insurer would comb over your application to see if there was any grounds on which they could reject you. That didn’t just apply to people with chronic conditions like diabetes or a major illness like cancer. In the bad old days, insurers could deny you coverage for anything. Tore some cartilage in your knee on the basketball court a few years ago? Denied. Had sinus problems? Denied. Carpal tunnel? Denied. If you were lucky, they’d cover you but just refuse to pay for anything remotely related to your old condition or that particular body part.
And when you did get sick, they’d sometimes undertake a “recission,” in which they went back through your records to see if there was any excuse they could use to cancel your policy now that you were going to cost them money. Check out this account from journalist Xeni Jardin, who was diagnosed with breast cancer before the ACA took effect. During one chemotherapy session, someone from the billing department pulled her aside and told her, “Your insurance company has opened a fraud investigation because they believe you had cancer as a pre-existing condition.” Imagine dealing with that while you’re fighting for your life.
Now here’s how getting insurance works today, with the Affordable Care Act in effect, if you have a pre-existing condition. See if you can follow along, because it’s pretty complicated:
You buy coverage. The insurer doesn’t ask you about your medical history. It’s covered. That’s all.
Here’s a list of some things that will return once they repeal the ACA: . . .
Continue reading. It’s pretty horrifying. And do read the whole thing. There’s quite a bit more.