Category Archives: Affordable Care Act

As Mainers endorse expanding MaineCare, feds back LePage methods to shrink it | Bangor Daily News

On Tuesday, as thousands of Mainers supportedexpanding health care to an estimated 70,000 residents through Medicaid, the federal government signaled support for conservative measures that would likely constrict that access and give states greater control over the program.

The federal Centers for Medicaid and Medicare Services, or CMS, now aims to make it easier for states to customize their Medicaid plans, including changes such as monthly premiums and work requirements that some analysts say could drive down enrollments. Coming against a backdrop of conservative opposition to the Affordable Care Act and the provision that supports and funds the Medicaid expansion, the CMS announcement lends further uncertainty to the future of the voter-approved expansion in Maine.

In a speech Tuesday morning to state Medicaid directors gathered in Arlington, Virginia, CMS Administrator Seema Verma announced the agency’s commitment to working closely with states that seek to require more from “working-age, able-bodied Medicaid enrollees.” The change comes in response to the program’s growth in recent years, she said, and the need to “reset the federal-state relationship.”

Medicaid, known in Maine as MaineCare, is jointly run and funded by the state and the federal governments, providing health insurance to low-income residents.

Verma also said CMS would streamline the processing of state waiver applications designed to give states more flexibility in designing their Medicaid programs.

That’s good news for the LePage administration, which in August submitted its application proposing a monthly MaineCare premium of up to $40, $10 copays for some medical services, a 20-hour-per-week work requirement, and other measures. The application now awaits approval from CMS.

The Maine Department of Health and Human Services said in a statement on Tuesday afternoon that it was “encouraged” by Verma’s announcement.

“Through this waiver, it was the department’s intention to prioritize our limited resources for the Mainers who need them most, while promoting responsibility for one’s individual health and the cost of healthcare,” the statement read, in part. “We look forward to working with the administration to fulfill our shared objective of creating a sustainable Medicaid program through the promotion of individual accountability.”

But Mitchell Stein, an independent health policy consultant who advocates for policies expanding access to health care, said Wednesday that efforts to encumber MaineCare enrollees with work requirements, monthly premiums and other disincentives are intended to discourage enrollment and limit the provision of health services to vulnerable, low-income people.

“Most people on Medicaid who are able to work are already working,” he said. Nationwide, only 13 percent of adults included in the expansion population are able-bodied and not working, in school, or seeking work, Stein said, and of those, three-quarters are either actively looking for work or caring for family members.

“So, the idea that all these people are just sitting around not working is simply not true,” he said.

Read the rest of the story.

Advertisements

Susan Collins says Trump’s move to end Obamacare subsidies hurts ‘vulnerable people’ | Bangor Daily News

U.S. Sen. Susan Collins said Sunday that she is “very concerned” about President Donald Trump’s decision to stop payments to health insurers used to hold down insurance costs for low- and middle-income Americans.

“What the president is doing is affecting the ability of vulnerable people to receive health care right now,” Collins, the senior senator from Maine, said during a Sunday morning appearance on CNN’s “State of the Union.”

Trump announced Friday that he would “immediately” halt payments to insurers, known as “ cost sharing reductions,” under the Affordable Care Act, a move hailed by many conservative groups but criticized by health care and consumer groups.

Before his Friday announcement, Trump took to Twitter to blast the paymentsas “subsidies” to insurers: “The Democrats ObamaCare is imploding. Massive subsidy payments to their pet insurance companies has stopped. Dems should call me to fix!”

Collins challenged the president’s characterization of the payments as a “windfall” to insurers.

Read the rest of this story.

Our View: Collins’ presence needed to contain Trump’s chaos | Portland Press Herald

Sen. Susan Collins could not have picked a better moment to announce her decision to forgo a race for governor and continue serving in the United States Senate.

Just as she was walking the members of the Penobscot Bay Regional Chamber of Commerce in Rockport through her analysis of the problems in our health care system, President Trump was in Washington trying to make that system fail.

The contrast was stark. Collins was talking about ways to make the system better while Trump was looking for leverage, no matter who gets hurt along the way. It should be obvious to everyone why Maine and the nation need an independent-minded Republican like Collins in Washington to block the administration’s dangerous excesses and, when possible, forge pragmatic deals that keep the country moving forward.

Trump’s moves on health care last week expose his approach to policy-making and a shocking disregard for the millions of people who stand to lose health coverage because of his desire to put pressure on his opponents.

In an executive order signed Thursday, Trump opened the door to insurance companies to sell low-cost plans across state lines. While that might sound good, it’s not. The premiums are less expensive because the plans don’t cover much. A young, healthy person who doesn’t expect to get sick or injured might be willing to take the risk, but these are exactly the people needed in the insurance pool to spread costs. If the only people who buy state-regulated health insurance are the ones who are most likely to make a claim, the premiums will go sky high, and many people will be forced to drop coverage. And to make sure that happens sooner, rather than later, Trump announced with a tweet that he would unilaterally end subsidies that help insurance companies cover out-of-pocket costs for lower-income plan members. That will also drive premiums up, and force people to drop coverage.

Creating chaos in the health insurance markets might deliver some short-term political advantage for Trump, but it won’t get more people covered by decent comprehensive health insurance.

Read the rest of this editorial.

Collins says Trump is keeping vulnerable Americans from getting health care | Portland Press Herald

Fresh from her announcement Friday that she intends to stay in the Senate and forgo a run for governor, Sen. Collins went on national television Sunday morning to continue to push her moderate stance on health care reform and advise President Trump to mind his words.

Collins made apperances on CNN’s “State of the Nation” news show  with host Jake Tapper and ABC’s “This Week” with George Stephanopoulos.

Seeming to take new relish in her role as the voice of the Republican moderate, Collins used her appearances to advise President Trump to be careful with his language and lend support for Trump’s decision not to re-certify the Iran nuclear agreement while tip toeing around other questions.

The CNN show focused on Trump’s attempts last week to undo two cornerstone policies of the Obama years, the Affordable Care Act and the Iran nuclear deal. She followed an appearance by Secretary of State Rex Tillerson who defended Trump’s decision not to certify the Iran agreement over nuclear arms development and throw the issue to Congress.

Read the rest of this story.

How Maine people moved Sen. Collins and stopped Trumpcare | Bangor Daily News

By Amy Fried

The stories we tell about politics have consequences, shaping how people and groups act in the future. Tales of courageous politicians, however uplifting, can overlook how citizens influenced them.

After the dramatic failure of the health care vote in the Senate, attention flowed to the three Republicans who broke with their party — Susan Collins, Lisa Murkowski of Alaska and John McCain of Arizona — each a protagonist in this drama.

What actually happened shows how much citizens mattered in the health care fight and provides lessons for democracy in the Trump era.

On health care, Collins did not start where she ended and she shifted after considerable grassroots action.

Moreover, confronting Collins meant challenging the most popular elected official in the state, who was used to highly laudatory press.

Using guidelines from the Indivisibles Guide, a document developed by former congressional staff that sparked people to form local chapters, Maine people repeatedly asked Collins to hold a town hall. She never did.

Constituents found her anyway, and spoke to her and her staff in Maine and Washington, D.C. All sides benefited from a Maine political culture that prizes civility. While confrontations could be intense, they were also courteous.

And so, coming out of a Bangor radio station one snowy February day, Collins faced something virtually unprecedented for her — public pressure. After one womanpolitely told her, “I would like to request a public access town hall, please,” the senator walked to her car.

Read the rest of this commentary.

Listening to real people trumps threats in ACA repeal battle | Bangor Daily News

There are many reasons that Republican efforts to repeal the Affordable Care Act, and to replace it with inferior plans that would have also gutted Medicaid, failed in Congress. One of the biggest reasons is that Republican leadership, especially in the Senate, tried to pass proposals that were hastily written, had no clear policy goals, and had no objective expert analysis. As a result, those proposals would have harmed millions of American people.

So, it is disheartening, but not surprising, that President Donald Trump is now trying to undermine the ACA through backdoor executive actions, which could have dire consequences for millions of Americans, rather than a bipartisan effort to fix what is really wrong with the health insurance law.

After the last attempt to repeal portions of the ACA, known as “skinny repeal,” failed last Friday morning, done in by “no” votes from Republican Sens. Susan Collins, Lisa Murkowski and John McCain, Trump said he’d let the insurance program fail, to make lawmakers more eager to reach a deal. “As I said from the beginning, let ObamaCare implode, then deal. Watch,” he posted on Twitter.

Trump has suggested that his administration will end payments to insurance companies that encourage them to take on lower-income subscribers by lowering their out-of-pocket costs such as co-pays and deductibles. Without the cost-sharing reduction payments, many insurers would likely increase premium costs and some would drop out of the ACA market.

The administration may also stop enforcing the individual mandate, a much maligned portion of the law, but one that is necessary to bring younger, healthier people into the market.

Congress must quickly step in to stop such disastrous moves. The Senate Health Care Committee announced Tuesday that it will begin holding hearings early next month on how best to stabilize the individual health insurance market. Congress must also appropriate the funds to continue the cost-sharing reduction payments, which are necessary to keep health insurance affordable for many lower-income Americans.

Read the rest of this editorial.

George Mitchell blasts LePage for attacks on Susan Collins, Angus King | Bangor Daily News

Former Democratic U.S. Sen. George Mitchell defended Maine’s current U.S. senators Thursday for their votes regarding the Affordable Care Act in response to Gov. Paul LePage’s prolonged criticism of their positions.

LePage has used his public speaking engagements in recent days to lambaste Republican U.S. Sen. Susan Collins and independent Sen. Angus King for their votes against repealing and replacing the Affordable Care Act.

Since Saturday, LePage has rallied supporters at a Somerset County GOP eventagainst Collins, ripped her and King in two radio interviews, penned a scathing commentary against them in the Wall Street Journal and targeted them in this week’s radio address.

“U.S. senators like Sens. Susan Collins and Angus King are enjoying Cadillac health insurance plans while they are mandating Americans ride a moped,” said LePage in the latter. “They are so busy seeking the national limelight, they are ignoring the people in their own state.”

Members of Congress and their staffs can purchase health insurance through the Affordable Care Act exchanges, with the bulk of their premiums covered by the government. King’s and Collins’ staffs did not immediately respond to Bangor Daily News questions about their specific health care plans and whether they had contacted LePage or his staff to ask him to correct his assertion that they have “Cadillac plans.”

In a statement to reporters on Thursday, Mitchell took umbrage with LePage’s assertions.

“I respectfully but strongly disagree,” he said. “Sens. Collins and King did in fact represent the best interests of the vast majority of Maine people.”

Read the rest of this story.

Collins, King offer alternative to executive-level lunacy | Bangor Daily News blog

By Lance Dutson

The contrast couldn’t be more striking.

On one hand, there is the imagery of Anthony Scaramucci, President Donald Trump’s short time communications director, hair slicked back, reaching into a female reporter’s personal space over and over as he desperately attempted to bully a series of lies into reality.

On the other, there is Maine’s senior senator, Susan Collins, unassumingly returning home to the Bangor airport Friday morning where a small crowd of Mainers erupted into spontaneous applause, earnestly thankful for the battle she had just waged on their behalf.

This contrast — between pettiness and earnestness, between the honorable and the base — has been a cornerstone of Maine’s sense of political self for decades.

Our federal government just had one of its most embarrassing weeks ever. Republican leadership tried and failed to ram a deeply flawed and unvetted healthcare overhaul bill through the U.S. Senate in the dead of night. Trump abruptly proclaimed a ban on transgendered people serving in the military through his Twitter account. The White House communications director went on an on-the-record, profanity-laced tirade to a reporter, calling Trump’s chief of staff a “f*** paranoid schizophrenic” and claiming Chief Strategist Steve Bannon was fellating himself. Threats were made via Twitter about staff members having the FBI investigate other staff members. And the president fired his own chief of staff, Reince Priebus, leaving Priebus alone in a black Suburban on the tarmac next to Air Force One, as the rest of the motorcade pulled away.

Read the rest of this commentary.

Lipstick on a Health Bill | The New York Times

Susan Collins, the Maine Republican, got straight to the point in describing the new Senate health care bill: “Still deep cuts to Medicaid in Senate bill. Will vote no,” she tweeted yesterday. “Ready to work w/ GOP & Dem colleagues to fix flaws in ACA.”

Rob Portman, the Ohio Republican and another potential swing vote, was less straightforward. “I opposed the last draft of the Senate health proposal because I had concerns about the measure’s Medicaid policies,” Portman said in a statement. Later, he followed up saying that he was undecided about whether he would support this bill.

Here’s the problem for Portman: Collins is right. The Medicaid policies are virtually identical between the revised Senate bill and the previous bill. If Portman opposed the last bill because of how it would harm Medicaid recipients — and he did — he would logically need to oppose this one, too.

Read the rest of this commentary.

Both Maine Senators Say They Will Vote ‘No’ on Latest GOP Health Care Bill | Maine Public

The latest attempt by the US Senate to repeal and replace the Affordable Care Act has failed to garner support from Maine’s senators. Though the bill does eliminate some unpopular provisions from earlier versions, the changes aren’t enough to gain traction with Senators Collins and King, and Maine health providers.

Previous proposals to repeal and replace the Affordable Care Act have included tax breaks for high income earners. Those tax breaks have been scaled back in the latest version of the Senate bill, called the Better Care Reconciliation Act. There’s also more funding included to fight the opioid epidemic: $45 billion over the next decade. But one big problem remains: cuts to Medicaid. Senator Susan Collins tweeted that’s the reason she can’t support this latest proposal. Neither can Vanessa Santarelli, CEO of the Maine Primary Care Association.

“The deep cuts to the Medicaid program could be really damaging, particularly to a state like Maine and to our community health centers,” Santarelli says.

Read and listen to the story.

Senate GOP leaders abruptly delay vote on healthcare bill until after July 4th recess | Los Angles Times

Facing resistance from their own party, Senate Republican leaders said Tuesday they would postpone a vote on their healthcare bill until after the July 4th recess.

Senate Majority Leader Mitch McConnell wants to provide more time to make changes to the bill to try to convince reluctant GOP senators to vote for the measure.

“We’re going to press on,” McConnell said, adding he remains optimistic. “We’re continuing to talk.”

Since the nonpartisan Congressional Budget Office said the bill would leave 22 million more Americans without insurance after 10 years, several Republicans senators had said they would not even support allowing the bill to be brought to the Senate floor for a vote.

Meanwhile, President Trump invited all GOP senators to the White House for a meeting Tuesday afternoon.

But Sen. Susan Collins (R-Maine), a moderate who has expressed serious doubts about the bill, questioned whether revisions would make a difference.

“I have so many fundamental problems with the bill, that have been confirmed by the CBO report, that it’s difficult to see how any tinkering is going to satisfy my fundamental and deep concerns about the bill,” Collins said on CNN.

Read the rest of the story.

Sen. Susan Collins Will Vote No On Health Care Bill: Her announcement is a significant blow to Senate Republicans | Huffington Post

Sen. Susan Collins (R-Maine) said on Monday she would not vote for the Senate’s controversial health care bill, despite urging from fellow Republicans to pass the legislation as soon as this week.

In a series of tweets, Collins cited a Congressional Budget Office report released Monday that found the new bill would cause 22 million people to lose their insurance over the next 10 years. The Senate’s bill would also dramatically undercut federal funding for Medicaid and financial assistance for low- and middle-income people, all facts Collins said wouldn’t “fix ACA problems for rural Maine,” referring to the Obama administration’s Affordable Care Act.

The announcement is a significant blow to Senate Republicans, particularly Majority Leader Mitch McConnell (R-Ky.), who has scrambled to garner support for the bill, which could come up for a vote as early as Thursday.

Read more of this story and view images of Sen. Collins’ tweets and a table that shows the differences between the Affordable Care Act and the two GOP versions to repeal and replace ACA.

 

Maine health care providers urge Sen. Susan Collins to oppose health care bill | Bangor Daily News and Maine Public

Maine health providers from across the state spoke in Lewiston on Friday to denounce the Senate health care bill and urge Sen. Susan Collins to oppose it.

Portland family physician Dr. Sam Zager said the Senate bill will cut off care for patients.

“I think this gets to the core of what it means to have a civilized society,” he said. “Are we going to turn people out? Are we going to toss them off the ship and let them drown at sea? Or are we going to acknowledge that we have a responsibility for the welfare of those around us?”

The Senate bill would partially cut funding for the Medicaid program, which pays for the majority of long-term care costs for seniors and people with disabilities.

Read the rest of the story.

Our View: Sen. Collins should fight Senate health care bill | Portland (Maine) Press Herald

Sen. Susan Collins says she will spend the next few days carefully reviewing the new Affordable Care Act repeal proposal, taking a hard look at an upcoming analysis by the Congressional Budget Office and considering what she has learned from her conversations with constituents in Maine.

We admire her diligence, but we think Collins already has enough information to know what she should do. This bill would be bad for Maine and bad for America, and the senator should speak out against it as forcefully as possible.

Collins’ voice has never been more important. Because of the way parliamentary rules are being applied, the 52 Republicans in the Senate are the only ones who get to make a meaningful impact in this debate. If only three Republican senators refuse to sign on, the bill will have to be renegotiated. Just hours after details of the bill were revealed, four hard-right senators said they might scuttle it if the cuts to health care aren’t even deeper than proposed.

Read more of the editorial in the Portland Press Herald.