A Mile Wide, An Inch Deep

tl,dr: Yesterday was a huge victory for high quality, affordable health care in election after election. In exit polls nationwide, voters confirmed that health care was their top priority—and they punished those officials at every level of government who had sought to take it away. Even in races where health care proponents ultimately lost, the margin of victory was often significantly closer than anyone would have predicted two years ago in states won handily by Donald Trump—thanks to the power of health care voters. And, of course, a number of the Affordable Care Act’s harshest foes were forced to lie about their opposition to the law in a sweeping reversal of health care politics from previous election cycles. With Democrats taking control of the U.S. House of Representatives, the door has been firmly closed on further legislative attempts next year to repeal the ACA, gut Medicaid, block low-income patients from accessing care at Planned Parenthood, or cut Medicare to pay for t...

Omnibus, Poison Pills, and a Third Government Shutdown? This week, Congress is negotiating the last pieces of an omnibus spending package to fund the government through the end of the fiscal year. Current stopgap funding expires on March 23. Originally slated for a House vote this week, the timeline has been pushed to early next week. While most of the spending decisions have been finalized, big questions remain over more than a hundred controversial policy changes that Republicans hope to tie the bill. The package is likely one of the last big, must-pass bills Congress will take up before the election, making it the last chance for members of Congress to win legislative victories that they can take home. Anti-abortion conservatives, in particular, are clamoring for a win now that Republicans have given up on attempting a third reconciliation package, which would have let them once again try to force through attacks on Planned Parenthood and other abortion providers with just 50 s...

As January wraps up, it appears that Congress is still nowhere close to a deal on several major issues with significant implications for health policy. Four months into fiscal year 2018, Congress still can’t agree on FY 2018 funding levels or a budget deal to prevent sequestration — the deep, automatic, across-the-board cuts set to hit everything from the military to family planning and HIV/AIDS services to road and bridge safety. Hardline conservatives are happy to let sequestration hit non-defense priorities like health care, education, and infrastructure but are pushing for new spending for the Pentagon. Democrats have said that’s a non-starter. Meanwhile, there’s little evidence that Congress is any closer to a DACA deal for Dreamers, and there are significant concerns that, even if the Senate can pass something, Republican leadership in the House won’t bring it to a vote unless moderate Republicans face more public pressure. If there’s a silver lining to this madness ...

We drafted this for our interns based on a presentation I've been giving for years. Posting it here for anyone who might find it helpful while Congress debates the ACA's future. Health Insurance 101 Half of Americans get their health insurance through their employer The other half are insured through the government, through the individual market, or have no coverage at all You may have heard of terms like “socialized medicine” (Great Britain), “single payer” (Canada), and private health insurance. In the US, we have all three: Socialized health care: the government operates health care facilities and employs health care professionals. Examples include hospitals, clinics, and doctors that are owned, operated, or employed by the Indian Health Service, the Defense Department, and Veterans Affairs Single payer: health care services are provided by private businesses but paid for by the government. Examples include Medicare (seniors), Medicaid (low-income pati...

This week we’re on red alert in response to reports that Republican leadership is gearing up for a vote to repeal the Affordable Care Act (ACA) and gut Medicaid the week of September 25 , with a sham hearing possible before then. Now is the time to call, write, and rally to urge the Senate to reject this new threat and support a bipartisan package instead. The bill, known as Graham-Cassidy-Heller-Johnson for its sponsors Senators Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV), and Ron Johnson (R-WI), is being sold as a “compromise” and “non-partisan” solution—even though no Democrats support it. But not only is Graham-Cassidy not a compromise, it is the most radical proposal yet. And like the proposals that preceded it, the bill goes far beyond Republicans’ campaign pledge to repeal the ACA; it also attacks long-standing traditional Medicaid. Republicans only have two weeks to ram through repeal with just 50 senators and Vice President Mike Pence because on Sept...

Wondering what’s next after the Republican effort to repeal the Affordable Care Act (ACA) was dramatically stopped in its tracks last week ? This week has brought a new round of legislative threats and another promise from a petulant president to actively sabotage the law at the expense of millions of Americans who rely on it for their care. Radical bill from "moderate" senators This week, Senators Lindsey Graham (R-SC), Bill Cassidy (R-LA), and Dean Heller (R-NV) announced that they are working on yet another extreme GOP-only bill with the House Freedom Caucus to gut the ACA. The bill would repeal the ACA’s Medicaid expansion and its financial assistance to help low- and moderate-income households purchase private insurance. In their place, the bill would give states a block grant worth less than what the federal government would contribute under current law. Furthermore, the states that expanded Medicaid would be cut deeply while the 19 states that have refused to e...

If you're confused by the news reports and you're wondering how the pieces fit together and where things stand, I'll try to keep this page updated as events unfold. ACA repeal: what happens next? Politico reporter Dan Diamond posted this ACA repeal checklist on Twitter. I've modified it slightly to better reflect the full scope of what's happening when. But don't forget, "ACA repeal" in this context is only a partial repeal, which will set up a "death spiral" in health insurance markets and raise costs for all of us. (Read my backgrounders on what the GOP can and can't do through reconciliation here and on the politics of their replacement plans here .)   ☑  Senate vote-a-rama on amendments to budget outline   ☑  Senate passes budget outline   ☑  House passes budget outline   ☐  House drafts reconciliation bill repealing parts of the ACA, cutting taxes on the .01% wealthiest Americans, and blocking women with Medicaid from g...