A Plea for Saving the Children’s Health Insurance Program

In 1993, the late Governor Robert P. Casey Sr. signed the first Children’s Health Insurance Program into law in Pennsylvania, which later served as a model for the federal program Congress would enact a few years later. Westmoreland County’s then State Senator Allen Kukovich was instrumental in enacting this state program that he’s considered its founding father. Since 1997, the Children’s Health Insurance Program has provided matching funds to states for health insurance to children from families who can’t afford marketplace or employer insurance but earn too much to qualify for Medicaid. Sponsored by the late Senator Ted Kennedy in partnership with Senator Orrin Hatch and supported by then First Lady Hillary Rodham Clinton, it was the largest expansion of taxpayer-funded health insurance coverage for children in the United States President Lyndon B. Johnson established Medicaid in 1968. Today CHIP is a critical government program providing health insurance for nearly 9 million low-income kids as well as remains one of our nation’s most vitally important and widely supported programs. Thanks to CHIP, the United States enjoys has the highest rate of insured children in our nation’s history at over 95%.

On September 30, 2017, CHIP expired when lawmakers couldn’t agree on a 5-year reauthorization of the program. This puts millions of kids at risk of becoming uninsured, and in some cases, being denied the critical care they need to survive and thrive. Though states have remaining funds to keep their programs running for varying lengths of time, it’s an administrative nightmare for states that can’t plan ahead. But they may have to prepare for a possible shutdown of their CHIP programs well before they run out of money. As Alabama CHIP director noted, “This whole situation is causing chaos. We are causing confusion to families, stress and turmoil.” On December 15, Alabama officials were forced to announce that they’d stop taking new enrollees on New Year’s Day and the 84,000 kids (1/8 of the state’s children) currently in the program could lose coverage February 1. In my home state of Pennsylvania, the families of 174,000 children currently enrolled in CHIP are about to receive notices informing them that their insurance may be canceled while Colorado already has sent a letter back in September that their CHIP coverage will be canceled by the end of January. Utah has already submitted a request to the federal government to freeze their program’s enrollment. Some states such as Nevada, already have laws that force officials to freeze enrollment if federal funds decrease at all. By the start of 2018, more than half the states are projected to have used up their available funding. Across the country, families depending on CHIP are running out of time.

On December 21, 2017, Congress passed short-term legislation to fund CHIP until the end of March, which is said to cover an estimated 1.9 million children across 24 states and Washington D.C. which stood to lose coverage care like doctor visits and hospitalizations in January. But this temporary relief still leaves CHIP and the families who rely on it in uncertainty since as of December of 2017, there is no long-term fix in sight. As George Washington University professor Sara Rosenbaum told Bloomberg, “You can’t run an insurance program this way.” Essentially, lawmakers are forcing health officials running the program, “to go month-to-month.” Still, even with these short-term fixes, “there will be relief that the funding has been extended, but it will be combined with a lot of anxiety,” as Kaiser Family Foundation executive vice president Diane Rowland claimed.

Health coverage is critical for children to get a healthy start in life and high coverage rates mean more children have an opportunity to meet their potential. It is well understood that covering kids is an investment in our future since a child’s health, school performance, and future success are all linked. So it goes without saying that unhealthy children are at higher risk for school problems, failing, or dropping out. Children who have health insurance through CHIP or Medicaid have better access to healthcare and do better in school than their uninsured counterparts. And better school performance provides a foundation for future success in life. Thus, investing in children’s coverage programs means investing in not only children’s health, but also academic success and success later in life. CHIP is especially important to children with special health needs, children of color, children in working families, and children in rural communities. Without CHIP, there would be more uninsured children, increased healthcare costs and less access for kids with insurance, and great financial devastation for families with special needs kids. At any rate, losing CHIP will devastating to millions of families, which will mean uncertainty surrounding their children’s health, much higher healthcare costs and added financial burdens, for some, a complete loss in their children’s coverage.

There is no question that Congress must vote to continue funding CHIP or else coverage for the 9 million kids whose families depend on CHIP will be in jeopardy. Should federal CHIP funding end, states would need to adjust their budgets, either ending or significantly cutting back on existing CHIP programs. Options available to a state may depend on whether it operates a separate CHIP program or has CHIP as an expanded Medicaid one. Either way, children’s health coverage will suffer. Nevertheless, failing to fund CHIP will undo 20 years of progress as well as undermine our nation’s values. If we want our children to live and succeed in this country, then funding CHIP should be a top priority. As Americans, we have a moral, ethical obligation to take care of our children. But if we can’t protect children’s health insurance, what does it say about our values?

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Deliberate Sabotage

Since taking office, the Trump administration has already taken aim to sabotage the Obamacare marketplaces. First, they cut the Obamacare enrollment period from 90 days to 45. Second, they’ve cut the Obamacare advertising budget by 90% and reduced funding for in-person outreach by 40%. Nevertheless, this has caused Health and Human Services regional branches abruptly pulled out of outreach events they’ve participated in over the last 4 years. Third, they’ve shut down the Healthcare.gov website for maintenance. And finally, Trump has repeatedly threatened to end subsidies to insurance companies who cover the poor. Since Republicans have spent 7 years promising to repeal Obamacare, the healthcare law has become a political football. Recently Donald Trump has signed two executive orders sabotaging the Affordable Care Act. Both these executive orders could undermine President Obama’s signature domestic achievement sending insurance premiums skyrocketing and insurance companies fleeing from the ACA’s online marketplaces.

First, he ordered the government to allow associations of small employers or other membership groups band together and offer their own insurance that wouldn’t have to provide all the essential health benefits required under the law as well as be sold across state lines. The order also directed officials to loosen rules for low-cost, short-term health insurance. Trump claims these changes give consumers cheaper options. But health insurance (and basically everyone else) fear it could shift insurance markets back to their pre-ACA days when healthy people paid less but people with preexisting conditions often found coverage unaffordable.

According to the Brookings Institute, a version of these self-insured association plans first became widespread in the 1980s but they failed in droves because many were undercapitalized. Even worse, these earlier association plans had a history of becoming what the Labor Department referred to as, “scam artists.” And it’s known that some of these low-cost plans cover virtually nothing. The Government Accountability Office reported AHPs were “bogus entities [that] have exploited employers and individuals seeking affordable coverage.” In 1992, more than two dozen states found that these early association plans had committed fraud, embezzlement, and other criminal violations. AHPs also run a greater risk for insolvency when claims unexpectedly exceed their ability to pay and have a long history of financial instability. When a long-standing AHP covering 20,000 in New Jersey became insolvent in 2002, its outstanding medical bills totaled $15 million. Though employers paid their premiums, claims made by them and their workers remained unpaid. And it doesn’t help that even these plans’ strongest proponents want guardrails placed on what groups can qualify. For many associations offer health plans to just about anyone who needs insurance, not just small business owners. You don’t need to be a farmer to join the Farm Bureau and business associations can be open anyone filing a Schedule C tax form. Some even have skimpier qualifications that they’re criticized as “air breather” associations in which the only commonality among its members is need for air for breathing.

So it’s no surprise that insurers and state-based regulators have criticized Donald Trump’s provision as a counterproductive step that could pave way for a new batch of flimsy, poor regulated health plans. states are often well positioned with broad enforcement authority to protect their residents by preventing or quickly identifying and closing down scam health insurance operators, many of whom have long used association health plans to sell fraudulent coverage to hundreds of thousands of unsuspecting consumers. However, unlike large employer plans and Obamacare, Trump’s executive order exempts AHPs from state authority. Thus, severely hurting the states’ ability to protect consumers. Instead, the US Department of Labor would primarily enforce AHPs but without the tools, resources, and culture to protect against fraud. As a result, con artists can potentially use existence of federally approved AHPs to so regulatory confusion in order to avoid state detection and shield themselves from law enforcement. So if you work for a small business that has an association plan, you may not be able to get help from your state insurance department if claims aren’t paid.
Though association plans may work great for small businesses with younger healthier workers, those with older, sicker workers will be charged higher premiums. Should one of these younger healthier employees experience a medical emergency, their insurance may not cover the care they need. In addition, small business owners might be incentivized to fire more medically costly employees to avoid premium increases. At any rate, a medical crisis could be potentially ruinous for small business employees under these plans, particularly if they become uninsured in the process. Furthermore, association plans might give small employers more incentives to reject certain applicants based on medical needs. Meanwhile, those on the Obamacare marketplaces will find their coverage less stable and secure if they have preexisting conditions since their insurance will be more expensive and consist of fewer people. Nevertheless, though association health plans may seem like affordable insurance, they’re actually poorly regulated inferior products that are only low-cost to consumers until something goes horribly wrong. But they also destabilize the insurance market which makes more viable small group and individual insurance more expensive and less accessible to those who need it the most. Such destabilization can result in higher medical costs, fewer options, and less healthcare access in the individual market.

When less regulated association health plans compete with fully regulated markets, they create an uneven playing field that can disrupt markets. People who don’t need to cover preexisting conditions or don’t want to pay community rates gravitate toward the better deals association plans offer, leaving sicker people in the regulated markets and having to pay higher costs. Thus, regulated market insurance prices increase, sometimes causing a death spiral that crashes the market and puts consumers at risk. Kentucky experienced this in the 1990s when it reformed its individual market but exempted association plans from the reforms. Association plan enrollment shot up while regulated market insurers pulled out. Within 2 years the state’s reforms were repealed. Though association plans were only a part of Kentucky’s failed market reforms, they’re still a major reason why the state’s health disaster now serves as a lesson for other states to avoid similar reforms.

Second, Donald Trump signed an executive order ordered the government to stop paying insurance subsidies that allowed low-income people to pay out-of-pocket medical expenses that could be as high as $7,150 for individuals and $14,300 for families. Known as cost-sharing reductions or CSRs, these subsidies drawn from a $7 billion fund had been embroiled in legal and political battles between President Barack Obama and congressional Republicans over whether Congress had authorized the president to pay for them. A recent poll from the Kaiser Family Foundation found that 60% of the public thought Congress should guarantee these payments continue. Most Republicans, however, consider them insurance company bailouts and wanted them to end.

Eliminating CSRs is an inherently unpopular policy does nothing but hurt people and waste money. Without subsidies, insurance markets could quickly unravel. Cutting them will result in insurers issuing premium increases as high as 20-25% by 2018-2020 for anyone using Obamacare. Furthermore, an already fragile Obamacare marketplace at greater risk of a last minute health plan exodus by those who assumed the government would pay these subsidies and feel they can’t take the significant financial losses. This can result in as many as 1 million Americans uninsured next year. As those insurance plans make double digit rate increases, the government will have to spend billions more on the other subsidies that 10 million Americans receive to purchase that coverage. According to the Congressional Budget Office, the move will ultimately cost the federal government $194 billion over the next decade. To put it this way, by eliminating CSRs, Donald Trump has enacting a policy where the government spends billions to insure fewer people. And therefore, one that helps nobody and hurts millions.

It’s very clear that Donald Trump’s presidential agenda is destroying Barack Obama’s legacy than trying to replace, fix, or improve his predecessor’s biggest accomplishments. Or perhaps help some of the very people who voted him into office. Though he and the Republicans see Obamacare as a political football, his actions will have immediate and very real consequences for Americans. Real people will be hurt by an administration that has actively decided to make a public benefits program function poorly. All these executive orders do is drain Obamacare of the resources it needs to deliver care to the many millions who’ve signed on to the program. Dividing the healthy from the sick in the name of allegedly expanding choice and driving up healthcare costs for sick people benefitting from Obamacare is an egregious idea that only ruins lives and helps nobody. Though the ACA isn’t a perfect and could use a few fixes, to let it fail simply out of spite is outright cruel.

Healthcare is a human right every American is entitled to and the federal government should guarantee access to all. Nobody should be turned away from the healthcare regardless if they can afford it or who has to pay for it. And if it’s taxpayers footing the bill, so be it. If a medical treatment should save a sick or injured person’s life, nothing else should matter. Because to deny medical care robs Americans of their dignity as well as their life, liberty, and their pursuit of happiness. The fact the United States has a for-profit healthcare system that discriminates against the poor is unconscionable for corporations, politicians, and employers shouldn’t decide who has access. It’s essentially indefensible that Donald Trump and the Republican Party not only think it’s okay to deny people medical care, but they’re also perfectly fine with throwing people off their health insurance. Furthermore, they don’t see any problem with letting the Children’s Health Insurance Program expire and jeopardizing healthcare coverage for 9 million kids. To believe only certain people should healthcare because you don’t want more government intrusion in your life and don’t want to pay for other people’s treatment is extremely selfish, degrading, and dehumanizing to the most vulnerable who need it. The fact the Republicans embrace such pathological ideology that government has no role to guarantee healthcare to its citizens is an absolute travesty. And it’s a viewpoint I find completely indefensible that I can’t respect it as an acceptable political opinion. In the United States, universal healthcare shouldn’t be controversial partisan issue but one every American should embrace wholeheartedly. After all, everyone needs healthcare and it’s the right thing to do. Because healthcare shouldn’t be about politics but people’s lives. Americans deserve a universal healthcare system that is of the people, by the people, and for the people. Not a pay to play system dominated by corporations.

The Scourge of Graham-Cassidy

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You’d think that Republican politicians at Capitol Hill would know by now that taking people’s healthcare away for whatever reason is as morally reprehensible as it is unpopular. But as soon as Congress is back in session, a group of Republican US Senators introduce this Graham-Cassidy legislation which is seen as the last Obamacare repeal bill left standing. The US Senate has until the end of the month to vote on this bill. In many ways, Graham-Cassidy is strikingly similar to earlier Trumpcare bills. But it’s also could be the most radical plan yet, drafted in secrecy without the usual committee hearings and markups. Senators Lindsey Graham and Bill Cassidy are rushing this legislation to the floor under the special “budget reconciliation which allows the bill to advance with only 51 votes instead of the usual 60. So far, it faces long odds that some of its backers said it would be almost impossible to get a massive rewrite of the healthcare system through the Senate within that period of time. And even if it passes, it could take the Congressional Budget Office could take several weeks to estimate Graham-Cassidy’s impact. That means we may have no idea how many Americans will lose their health insurance, how much premiums would increase, how much the deficit will increase, how much it will increase costs, and other impacts on the US economy. Still, keep in mind that it took only took 3 Republican US Senators to kill Obamacare repeal in July so anything’s possible. Even worse is that US Senator John McCain is open to supporting it. And remember, he was the deciding vote to sink Trumpcare back in July. Nonetheless, Graham-Cassidy’s impact can be potentially devastating to 1/6 of the US economy as well as millions of Americans.

Regardless of you think, it is morally unconscionable to introduce legislation designed to take away people’s healthcare for any reason, especially politics. Every Republican plan to repeal and replace the Affordable Care Act has meant higher costs, millions of hard-working Americans losing their insurance, and key protections gutted with devastating consequences for anyone with pre-existing conditions. Should Graham-Cassidy be made law, millions will lose their insurance, thousands will face bankruptcy and loss in quality of life, hundreds of jobs will be lost, hospitals and medical facilities will close, costs will rise, and many will die from not getting the treatment they needed to save their lives. There will be more abortions, more maternal and infant deaths, more deaths and disabilities from gun violence, more ravaged communities, and more opioid overdose deaths. Most of all, it will threaten the health security for every American. This isn’t the kind of healthcare future most Americans want to live in and I will absolutely not stand for it.

The fact my access to Medicaid in the next decade may depend a few GOP Senators’ votes just scares the living shit out of me. It’s appalling enough that I have to live under a for-profit healthcare system I strongly believe has no moral right to exist. If I lose my Medicaid coverage, it’s very likely I may never be able to get health coverage that’s just as good or at all. Why the hell should I have my healthcare taken away from me just so some rich guy can enjoy some massive tax cut he doesn’t even need? I can’t live with that. I shouldn’t have to live with that. I shouldn’t have to lose my healthcare just so the Republican Party can satisfy their donors and voters. My healthcare shouldn’t be sacrificed to fulfill some market-based conservative vision that won’t benefit me. My autism shouldn’t reduce my own humanity to a financial risk. I’d rather pay taxes for someone else’s healthcare treatment I may not even need than be dropped from my coverage due politicians’ selfish interests.

As I’ve said before, the Republicans’ war on Obamacare must end. Graham-Cassidy is just mere malicious cruelty that robs Americans of their dignity and possibly their life, liberty, and the pursuit of happiness. Healthcare is a fundamental right the federal government should protect for all Americans. Corporations, politicians, and employers shouldn’t decide who has access to healthcare, especially Republicans on Capitol Hill. Nobody should be denied treatment if they’re sick or injured regardless of whether they can afford it or who has to pay for it. If a medical treatment can save someone’s life, then nothing else should matter. If you believe otherwise, then you can just go to hell for all I care.

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What Graham-Cassidy does:

1. Shift Medicaid funding and insurance subsidies to a block grant system: Instead of determining the federal government’s share of funding for Obamacare’s Medicaid expansion and individual insurance subsidies, states would receive large chunks of money up front and determine what to do with it. For instance, they could spend it on providing insurance, fund high risk pools, or pay bills for patients with high medical needs. But there is no accountability for how this money is spent, won’t adjust based on need or higher costs, nor requires offering low and moderate income individuals coverage or financial assistance. Nevertheless, this system literally takes money from states that expanded Medicaid and gives it to states that didn’t. For those that did, their block grant funding could be anywhere from 35-60% below what they’d receive in the Medicaid expansion and/or marketplace subsidy funding under the current law. It would also would make it much more expensive for states to continue Obamacare if they like it. In fact, most states if not all would have to use the bill’s so-called “flexibility” to eliminate or cut coverage and financial assistance to low or moderate income people. Many states would likely do one or more of the following: cap enrollment; offer very limited benefits; charge unaffordable premiums, deductibles, and co-payments; redirect federal funding from providing coverage to other purposes, like reimbursing hospitals for uncompensated care; and limit assistance to fixed dollar amounts that put coverage out of reach for most low- to moderate- income people. Millions would lose coverage. Rural hospitals that receive more of their income from the ACA and Medicaid will be disproportionately hurt. In addition, to get this money, states would have to kick in some of their funds, too. And that block grant funding will end in 2026.

2. Convert Medicaid’s current federal-state partnership to a per-capita cap: This could cut Medicaid per-beneficiary funding for seniors, people with disabilities, and families with children. This could result in states having to raise taxes, cut other budget priorities like education, or make severe cuts to eligibility, benefits, and provider payments. Home- and community- based services allowing people needing long term services and supports to remain in their homes rather than move to an assisted living facilities could be cut in many states. These and other “optional” benefits to states under federal law could be at greatest risk. Moreover, the gap between federal funding under the per-capita cap and states’ actual funding needs would grow even larger if Medicaid costs grow more quickly than expected in ways the cap doesn’t account for. Over time, this will not only leave Medicaid underfunded and way less responsive to low-income people’s health needs.

3. Allow states to adjust the essential health benefits: Currently the federal government mandates that all plans sold on the Obamacare exchanges cover 10 basic types of care, including maternity care, emergency room visits, prescription drugs, mental health coverage, rehabilitative services, and substance abuse treatment. Under this proposal, states could significantly pare back their insurance coverage to cover less expensive benefits. We should not that before the ACA, 75% of all individual market plans excluded maternity coverage, 45% excluded substance abuse treatment, and 38% excluded mental health care. This could lead many people without access to the healthcare they need, especially if they have a pre-existing condition. According to the CBO, states accounting for half of the nation’s population would choose to let insurers exclude essential health benefits. People needing these services could face increased out of pocket costs that could amount to thousands of dollars per year.

4. Eliminate or weaken protections for people with pre-existing conditions by allowing states to waive the ACA’s underwriting prohibition: Underwriting allows insurance plans to charge premiums to expected health costs of a specific patient. Thus, resulting in low premiums for the young and healthy and high premiums for those sicker or older. Obamacare bans varying premiums by health status and required all individuals to be charged the same. Because before the ACA, insurers could charge unaffordable premiums to those with pre-existing conditions which effectively resulted in coverage denial. In the US, 52% of adults under 65 have a pre-existing condition. According to the CBO, states accounting for 1/6 of the nation’s population would let insurers charge higher premiums based on health status. In those states, less healthy individuals and people with pre-existing conditions would be unable to purchase comprehensive coverage with premiums close to those under the current law and might not be able to purchase coverage at all.

5. Eliminate the individual and employer mandate: People who don’t sign up for insurance won’t face a tax under the plan and companies can’t be compelled to offer coverage. This can result in hundreds of Americans losing their employee health benefits at work. Not to mention, destabilize and risk collapse of the individual market.

6. Creates a state reinsurance fund: Allocates a certain amount of money to insurers to offset greater losses from insuring a sicker pool of people. This is known as a high-risk pool which will most likely be underfunded, charge expensive coverage, and provide terrible coverage for low-income people with pre-existing conditions.

7. Bars states from reimbursing Planned Parenthood for Medicaid enrollees for a year: Thus, preventing Medicaid recipients from accessing preventative health and family planning services. This will leave millions of Americans without access to critical services, particularly low-income women. Of course, you probably saw this coming since many Republicans are staunchly anti-abortion. Still, one’s abortion stance shouldn’t prevent women from getting a pap smear, breast cancer screening, or contraceptives, especially if Planned Parenthood is the only provider in town.

8. Lifts prohibition against annual and lifetime limits on benefits: This can be particularly devastating to premature babies, those with disabilities, the rare disease community, and cancer patients.

9. Allows states to institute work requirements for Medicaid: Studies have shown instituting work requirements for benefits doesn’t alleviate poverty. In fact, work requirements exacerbated it. Stable employment among recipients subject to work requirements proved the exception, not the norm. In addition, most recipients with significant barriers to employment never found work even after participating in work programs otherwise deemed successful. This is especially the case when such programs don’t support efforts to boost beneficiaries’ efforts and skills. Nevertheless, voluntary employment programs could significantly increase employment without the negative impacts ending basic assistance for individuals unable to meet mandatory work requirements.

10. Nearly doubles maximum contributions to Health Savings Accounts: Called HSAs, these are tax advantaged accounts for those enrolled in a high deductible healthcare plan. Proponents think HSAs encourage consumers to make more cost-effective and responsible healthcare decisions. However, they may actually worsen healthcare in the US since people may hold back spending that would be covered, or spend it unnecessarily just because it has accumulated to avoid the penalty taxes for withdrawing it. Not to mention, it’s widely believed they only benefit young, healthy people with money and make healthcare more expensive for everyone else. They’re particularly bad for those with chronic health problems with predictable costs. Besides, low-income people often don’t enough to from the tax breaks HSAs offer. To make matters worse, the FDIC doesn’t insure them since HSAs are subject to market risk. And a lot of surveys found that HSAs recipients are significantly less satisfied with most of its aspects than those with more comprehensive health plans.

To the Honorable United States Senator Pat Toomey of Pennsylvania

Dear Senator Toomey:

I am writing to you today to strongly urge you to oppose the Better Care Reconciliation Act which will gut the Affordable Care Act, slash Medicaid by $800 billion, leave 22 million uninsured, and roll back protections for those with pre-existing conditions. Drafting of the BCRA was conducted through a highly partisan, secretive, and undemocratic process despite being one of the most consequential pieces of legislation. There is no state where a majority support it. Healthcare is a fundamental right which the federal government should guarantee to all Americans. Legislation to deprive people of healthcare and lower their quality of life is unconscionable. To vote for such an atrocious bill that will only hurt most Pennsylvanians on so many levels. Your unwillingness to even meet with your constituents on the BCRA only highlights your cowardice on this piece of legislation. You can say that recent Medicaid growth is unsustainable (it’s not). You can claim that the ACA is collapsing (contrary to what most experts believe). But even if both were true, to support the BCRA is inherently inexcusable regardless what you believe in.

Senator Toomey, I know your mind is made up and you will more than likely vote for this morally indefensible healthcare bill. After all, you have never been keen on government intervention in providing healthcare for all Americans. I agree the Affordable Care Act does not cover everyone and does not do enough to make healthcare more affordable. But there is no doubt that the ACA has expanded coverage to 20 million more Americans and improved coverage for millions more. It has also saved lives. The BCRA does nothing to fix the ACA’s flaws and even significantly weakens many of the law’s provisions such as essential health benefit requirements, a ban on pre-existing conditions, and barring lifetime or annual caps. Furthermore, the bill would drastically reduce Medicaid funding and other subsidies. All of this will significantly raise premiums, deductibles, and out of pocket costs as well as leave millions of Americans with no access to adequate care. In addition, these provisions will lead to almost a million Americans losing their jobs, medical facility closings, and widespread economic ruin in communities nationwide. Statewide 731,000 Pennsylvanians will lose their insurance while countless more will be left with more expensive but inferior coverage. Without the coverage they have, thousands will die because they couldn’t receive the care they needed including the elderly, children, people with disabilities, the chronically ill, women, veterans, substance abusers, the mentally ill, and the poor. Many of them are Medicaid recipients who may not be able to get coverage through their employer or the individual market. And despite what you think about it, it’s an indispensable program and possibly their only lifeline. Nobody should be denied healthcare regardless of who they are, especially if receiving medical treatment is a matter of life or death. And for many, without healthcare, they may be able to get a job or live an independent life with dignity.

Senator, you were elected to the US Senate to represent the interests of your constituents first and foremost. But your recent cowardly behavior suggests you’re more willing to throw Pennsylvanians under the bus for the good of the party. If you’re willing shut people out of a town hall for fear of your constituents protesting over legislation that will have a damaging impact on their lives, then perhaps you shouldn’t be a US Senator. You have a duty to vote against a wretched healthcare bill that most people in your state don’t want and will certainly ravage the state. People will die. People will lose their jobs. People will get sicker. Hospitals will close down and put communities in economic ruin. Our state’s problem with opioid addiction will exacerbate because more people won’t be able to afford treatment. Vote for the BCRA with your party and I guarantee you will have blood on your hands if it ever becomes law. I sincerely hope your name is dragged through the mud for your advocacy and support for the BCRA which will only provide worse care for Americans or no care at all. And I hope that Pennsylvanians will remember what you did within the next 5 years so they can kick you out of office by the time your term is up.

I absolutely do not care what your or your party’s views on healthcare are. Nor do I care about your negative perception of the ACA as an extension of big government. Because despite what you think, for profit healthcare is an American travesty that discriminates against the poor and must die. There is nothing you can do to convince me that free market healthcare is the best system since I’ve known countless cases where it has failed. And as someone on the autism spectrum, I will cling to my Medicaid coverage so tight that you’ll have to pry it from my cold dead hands. To support such a system that denies people access to the healthcare they need is inherently morally indefensible and violates Americans’ right to life, liberty, and the pursuit of happiness. And all that matters much more to me than any of your free market ideas you prize most highly. Well, your free market praises can go straight to hell for all I care. It deeply horrifies me that politicians like you could ever craft, let alone campaign for legislation that consists of nothing but heartless cruelty to those most vulnerable. And in the least transparent as well as most partisan and undemocratic way possible, I might add. I’d like to think my government representatives would at least have a heart not to play politics with mine or anyone else’s healthcare, especially a sick child’s. But I know full well, it’s certainly not the case. And I know it’s not the case with you which is a shame. However, if you are willing to support legislation that will only lead to pain and suffering, then may that be on your soul for the rest of your days. And may your vote for the BCRA ruin your career and reputation. Because I don’t think you’d deserve nothing less.

The Republicans’ War on Obamacare Must End Once and for All

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As Donald Trump’s Russian investigation circus dominates the headlines and airwaves, Senate Republicans are secretly working on their bill to repeal and replace the Affordable Care Act also known as Obamacare. So far on what we heard, it’s said to be quite similar to the dreaded American Healthcare Act that passed in the US House of Representatives back in early May save for a seven-year Medicaid expansion phase out. But it’s possible that the US Senate can vote on this bill before the 4th of July recess. Though we may not know what’s in the GOP Senate bill, we need to understand that the Republicans’ vision on healthcare is fundamentally unpopular and has more to do with implementing a massive tax cut for their rich donors and their free market ideology into federal policy. They GOP establishment doesn’t think it’s the government’s job to make sure everyone has healthcare and that publicly funded healthcare expands government power. And they’re keeping their bill a secret in order to keep their healthcare vision pure. But whatever their healthcare bill is, it’s clear it would likely lead to fewer Americans having health insurance and billions being cut from Medicaid. Should the Senate GOP come to a vote in the coming weeks, then resisting such travesty can’t be more important than now. And it’s paramount that Americans speak up against the GOP effort to repeal Obamacare before it’s too late since healthcare touches all our lives.

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As a Catholic and a liberal, I’ve always believed that for-profit health insurance is inherently wrong since it makes money on people’s misery and discriminates against the old, sick, disabled, and poor. Nobody should be denied healthcare for any reason. I passionately believe that healthcare is a fundamental right that nobody can take away. As someone on the autism spectrum who’s on Medicaid, I consider such service a godsend and liberating. I’m not ashamed for relying on Medicaid since it government medical assistance has greatly helped me throughout my life. And I’m perfectly fine with my tax dollars paying for other people’s medical treatments, especially if they’re much more disadvantaged than me. Though finding a decent dentist who takes my plan is a pain in the ass, it at least provides the healthcare access I need so finding a job with health benefits isn’t a matter of life and death. If my job doesn’t provide health benefits, then I can purchase a subsidized plan on the individual market thanks to the Obamacare exchanges and the Medicaid expansion. And thanks to Obamacare, I won’t have to worry about lifetime caps or my autism being a preexisting condition. Still, while I don’t think Obamacare goes far enough and would prefer a single payer US healthcare policy, I strongly think that it’s a step in the right direction and improves healthcare access drastically. To repeal and replace it with a healthcare plan that takes healthcare away from people who benefit from Obamacare like myself is malicious and cruel. To me healthcare isn’t about government, money, or whether we should pay for other people’s treatment. It’s an issue of human dignity as well as a matter life and death. The idea of the GOP healthcare becoming law scares the hell out of me. And I’m very afraid I’ll lose my Medicaid and may never be able to get health insurance that’s just as good, or at all. I shouldn’t have to lose my healthcare just so some rich guy can have a massive tax cut he doesn’t even need. Nor should anyone else. I strongly wish the Republicans give up trying to repeal Obamacare once and for all because politicians, corporations, and employers shouldn’t decide who should have access to healthcare. If someone gets sick or injured, they should receive the best care they need without breaking the bank. And I don’t care who that person is, whether they can afford it or who has to pay for their treatment. Because if their life depends on receiving care, then nothing else should matter. And I think it’s an appalling shame that too many people in this country don’t agree with me on that.

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Here is a list of reasons why we need to stop the Republicans from repealing Obamacare and replacing it with a cruel substitute that nobody wants.

 

  1. The Republican Healthcare Plan to Repeal and Replace Obamacare is being comprised in secret and is being rushed to passage violates legislative due process.– Regardless of what you think about Obamacare, the process to pass the Affordable Care Act was lengthy, thorough, and transparent. In the House the ACA, received 79 hearings with 181 witnesses and 121 amendments as well as took over a year to pass. By contrast, Trumpcare has been rushed as well as negotiated in backrooms without input from experts, stakeholders, or the public. In the House, the AHCA received literally no hearings, no witnesses, and no substantive amendments and the Republicans passed it less than 2 months after revealing it. As of now, a group of 13 GOP Senators are deciding the future of the American healthcare system without following formal processes or seeking public input. Republican senators are now cutting deals on Trumpcare through informal working groups aimed at getting support for their healthcare plan from any holdouts. These working groups don’t include a single female Senator-Republican or Democrat. The Senate hasn’t held any public hearings or listening sessions on Trumpcare. Nor have they asked for feedback from any of the key stakeholders such as the public, children’s or disability rights groups providers, nor small business owners. Nevertheless, on such a major piece of legislation like Trumpcare, public debate is essential since it promotes accountability by leaving a public record of how a law came to be. And hearings give lawmakers the chance to hear from experts on what the bill would do. These GOP procedural shortcuts are the height of hypocrisy and set a dangerous precedent.
  2. The Republican Healthcare Plan to Repeal and Replace Obamacare is highly favorable to conservative free market ideology.– One of the main reasons for all the secrecy for the GOP drafting their healthcare legislation in secret is that Republicans want their plan to be as conservative ideologically pure as possible. Sure they want to scrap Obamacare but not because it doesn’t cover enough people and rising premiums. But they want to do so because they don’t believe the government should have to provide healthcare or regulate the healthcare industry. Nor do they believe that taxpayers should pay for other people’s healthcare. The GOP isn’t interested in the opinions of families or healthcare providers who will live out the consequences of their decisions every day. What most Americans want more government intervention in healthcare as well as expand coverage and access. The AHCA does the opposite of that which is what the Republicans want, which at its core is to redirect money spent to buy insurance for the poor to $600 billion tax cuts for the rich.
  3. The Republican Healthcare Plan to Repeal and Replace Obamacare is an unacceptable moral travesty.– Knowing what’s in the American Healthcare Act, it’s very clear that the GOP Senate’s healthcare plan would be no different from this one. A healthcare policy that denies health insurance to millions of Americans isn’t just horrifically unpopular and unsustainable, it’s also inherently cruel. Healthcare is a right that should never be denied to anyone in need of it. A bill that takes away healthcare from millions of people is unacceptable. Denying a poor person lifesaving medical care is not only a death sentence, but also undermines their humanity by reducing them to a financial risk. It also deprives them of a right to live or that their life doesn’t matter. Unfortunately this is the norm in the US healthcare system even with Obamacare though at a smaller scale. And if Trumpcare becomes law, expect such atrocities to happen more often. If we value human life and dignity, then we should make sure that nobody has the right to people’s access to healthcare. Whether this means more government intervention or a taxpayer funded healthcare system shouldn’t even matter.
  4. The Republican Healthcare Plan to Repeal and Replace Obamacare is wildly unpopular.– There is not a majority supporting the GOP healthcare plan in a single US state. Not one. Less than 20% of Americans Trumpcare. Most American healthcare establishment has condemned it. The reason why GOP Senators are now crafting healthcare legislation in secret is because they know the public doesn’t want it. And they know voting for such a plan could politically cost them big time come 2018. But at the same time, they don’t want to alienate their base and donors who want Obamacare repealed as soon as possible. Though it would be better for Republicans politically as well as the nation, if they just give up trying to repeal Obamacare and leave it alone.
  5. The Republican Healthcare Plan to Repeal and Replace Obamacare threatens health security for every American.– Unless you’re young, rich, and/or relatively healthy, Trumpcare could determine whether millions of Americans will have health coverage. The healthcare system touches all our lives and a GOP plan to repeal Obamacare could leave millions of Americans uninsured, which can be a matter of life or death to thousands of them. Not to mention, it’s greatly apparent that most of the American public and the healthcare industry don’t want the GOP’s healthcare plan. That doesn’t even get to the fact that the House passed the American Healthcare Act with no input from experts, stakeholders, or the public. Nor did the AHCA received any hearings, witnesses, or substantive amendments to the actual legislation accepted in committee. They tried to pass it 17 days after revealing it and were able to do so in less than 2 months. Surely any major piece of legislation that threatens at least your healthcare security shouldn’t be rushed through a very undemocratic process.
  6. The American Healthcare Act takes away healthcare from 23 million Americans.-According to nonpartisan estimates by the Congressional Budget Office (CBO). This will result in 24,000-44,000 more Americans dying every year from lack of insurance along with medical bankruptcies, lost wages, untreated illnesses, and others.
  7. The American Healthcare Act hikes deductibles by $1500 on average.– Trumpcare pushes Americans into low quality, high cost-sharing health insurance by providing meager tax credits compared to the Affordable Care Act. This is the opposite of what Trump promised in his campaign. This will have particular negative impact for those least able to pay them.
  8. The American Healthcare Act ends federal protections for people with pre-existing conditions.– TrumpCare incentivizes states to drop consumer protections, meaning insurance companies will be able to charge people with pre-existing conditions more. 130 million Americans have a pre-existing condition. Insurers in states that adopt opt-out waivers on ACA protections could charge people with pre-existing conditions 10 to 20 times more than others. And the CBO estimates that 1 in 6 people in the country would live in such a state. People could face premiums well over $100,000. Though Republicans are trying to make the case that high-risk pools will protect people with pre-existing conditions, they’ve been tried before and don’t work. And they usually have significantly higher premiums, lifetime limits, enrollment caps, waiting lists, and lock-out periods.
  9. The American Healthcare Act allows insurance companies to charge older Americans significantly more their healthcare.– A single, 64-year-old adult making 26,500 a year would have to pay between $13,600 and $16,100 in annual premiums, depending on whether they live in a state that sought a waiver from consumer protections. Compare this to the $1,700 the same person would have to pay under the current law, that’s a 950% increase.
  10. The American Healthcare Act cuts $834 billion from Medicaid, a program that more than 70 million Americans, half of which are children, rely on.– Medicaid is the largest health insurance provider in the United States and is funded by the government. Trumpcare cuts federal funding for the program which will result in states having to ration care and cut the quality of services. This could be devastating for the elderly, people with disabilities, the chronically ill, the mentally ill, addicts, children, and low income families. And many of these people would end up uninsured and unable to get health insurance anywhere else, especially if they have pre-existing conditions or if their employer doesn’t provide it. Under Trumpcare, Medicaid for kids, elderly, and the disabled is radically transformed into a system where states get fixed funding, regardless of their healthcare needs and unexpected disasters like Zika or opioid addiction spikes that drive up the cost of services. It’s estimated that under Trumpcare, 14 million will lose their Medicaid coverage.
  11. The American Healthcare Act puts lifetime and annual benefit caps on the table for even those with employer coverage.– This means a baby with a serious medical condition could use up its lifetime limits in the first month of life under Trumpcare.
  12. The American Healthcare Act makes women pay more for health insurance than men.– Because insurance companies could charge more for pre-existing conditions like breast cancer or assault survival and because pregnancy care no longer would be a required benefit, women would once again pay more for healthcare than men. The CBO estimates that woman wanting maternity care will have to add $1000 a month to her premiums.
  13. The American Healthcare Act defunds Planned Parenthood.– Nearly 3 million Americans, especially women and families receive affordable healthcare services annually at Planned Parenthood facilities. Trumpcare prohibits funding from going to these clinics.
  14. The American Healthcare Act harms children with special needs by cutting Special Education funds for schools.– Medicaid funds a large portion of education for students with a variety of disabilities. Buried in this bill is a provision that no longer recognizes schools as required Medicaid providers, on top of massive cuts to the program.
  15. Under the American Healthcare Act, health insurance companies can cover fewer essential health benefits even under employer plans.– Under Obamacare, insurance companies are required to cover a list of 10 essential health benefits including doctors’ services, inpatient and outpatient care, prescription drug coverage, pregnancy and childbirth, mental health services, and more as well as limits out of pocket costs. States under Trumpcare allows states to opt out of essential benefit requirements which will mean higher premiums and more out of pocket costs.
  16. The American Healthcare Act eliminates the employer mandate for large companies which will result in 7 million American workers losing employer coverage.– Under Obamacare, businesses with at least 50 employees are required to offer health insurance to their full time workers. Trumpcare eliminates this mandate which will result in large businesses dumping people off their employee-sponsored insurance. This will be particularly devastating to low income workers who may be able to afford purchasing healthcare on the individual market, especially if they have pre-existing conditions and higher premiums. And many will certainly not have the Medicaid expansion to fall back on.
  17. And the American Healthcare Act does all this to pay for $600 billion in tax breaks for the wealthy and corporations.– Providing a massive tax cut to the rich and corporations is no justification for denying millions of people healthcare. I don’t care what your political beliefs are. Still, if you want to finance healthcare access to people who can’t afford it, other people have to pay for it. And for rich people and corporations, that price is relatively small compared to what most Americans have to put up with if they don’t pay the bill.
  18. The American Healthcare Act will result in more abortions as well as maternal and infant deaths.– Because that’s what happens when you defund Planned Parenthood, cut $834 billion from Medicaid, no longer have pregnancy care as a required benefit, designate pregnancy and disabilities as pre-existing conditions, and cut access to healthcare entirely for millions of women. Lack of access to healthcare is a major reason why a lot of women terminate their pregnancies and why maternal deaths in the US are so high right now. Because when a pregnant woman doesn’t have healthcare access, having an abortion isn’t much of a choice. Because Texas refused to expand Medicaid and has taken great lengths to close its abortion clinics, it now has the highest maternal mortality rate in the entire developed world. Many of these women who die from pregnancy-related complications are poor and uninsured. Not to mention, before Obamacare, it’s widely noted that that insurance companies forced women to abort if their unborn babies had birth defects. A bill funding abortions on demand upholds the sanctity of human life far more than Trumpcare ever could, especially if a poor woman’s alternative is death. If we’re a society who values life and wants to save unborn babies, then ensuring that their mothers have access to healthcare is absolutely vital.
  19. The American Healthcare Act will exacerbate the opioid crisis.– Under the ACA, substance abuse treatment is considered an essential health benefit health insurance companies are required to cover. Many Americans also depend on Medicaid to pay for their substance abuse treatment as well. While the opioid crisis is devastating at epic proportions, it had existed long before Obamacare was made into law. Yet, if it wasn’t for Obamacare, the opioid crisis would’ve been much worse since many addicts would’ve not had access to treatment. This is especially the case for low income Americans who’ve suffered the most. Trumpcare could deny these people the very treatment they need to get their lives back on track which will result in more overdose deaths, family tragedies, and ravaged communities. Furthermore, under Trumpcare, insurance companies can deny or limit care to opioid addicts since substance abuse has often been seen as a pre-existing condition.
  20. The American Healthcare Act will result in more lives more deaths and disabilities from gun violence.– Another major public health crisis in the US is gun violence which kills nearly as many people as opioid addiction and costs American taxpayers $229 billion or over $700 per American annually. The total cost of gun violence amounts to more than the total cost of obesity and almost as much as the annual price tag for the entire Medicaid program. This includes at least $8.6 billion in direct expenses such as for emergency and medical care, which can include follow-ups, readmissions, disability, home medications, extended treatments like physical therapy, mental health services, and loss of work. From 2006-2014, the annual cost for initial hospitalizations for firearms injuries averaged $734.6 million per year. Medicaid paid about 1/3 of the costs, the largest proportion while insured patients accounted for over a quarter since most gun victims are young men from low income areas. For every one person who dies from a gunshot, there are 3 or 4 who usually survive. Individuals hospitalized for firearm injury were 30 times more likely to be re-hospitalized for another gun injury and 11 times more likely to die from gun violence within the next 5 years. A gunshot wound can wreck a person’s whole life if they don’t seek proper medical treatment as soon as possible. Many poor people either die or become permanently disabled from gunshot wounds, because they can’t afford the emergency room bill which amount to thousands of dollars. Yet, many suffer with long term physical, mental, and financial problems. And gunshot wounds often drive up US medical costs. Should Trumpcare become law, expect more gun victims leaving hospitals without adequate medical care and more uninsured victims. Not to mention, higher medical costs for the rest of us.
  21. The American Healthcare Act will result in more preventable deaths.– Despite what one Republican Idaho congressman might tell you, people have died because they were uninsured. Before the American Healthcare Act was passed, a 2009 study in the American Journal of Public Health found that lack of health insurance was associated with 45,000 deaths per year. The study’s author reported that lack of healthcare access contributed to one person dying every 12 minutes. If Trumpcare becomes law, it’s estimated that 22,000 – 44,000 will die a year due to lack of health insurance.
  22. The American Healthcare Act will hurt the US economy.– The Commonwealth Fund estimates that Trumpcare can cost over 1.8 million jobs. Not to mention, since it will certainly result in higher healthcare costs, expect job loss and hospital closings in the healthcare industry, especially in poor and rural areas. We should remember the healthcare industry accounts for 1/6 of the US economy, employs 19 million people. Also, high premiums, healthcare costs, and lack of affordable options might lead many people to reconsider quitting their jobs to start their own business, a concept known as “job lock.”
  23. The American Healthcare Act will hurt communities.– Since Trumpcare will make healthcare less affordable, this will leave many hospitals and medical facilities vulnerable to closing, particularly in rural and impoverished areas. Hospitals provide a critical function in local communities. A hospital closing not only costs jobs and revenue, but also cuts healthcare access to the people who live there, forcing them to seek medical care farther away. This can be especially devastating in impoverished and rural areas.
  24. The American Healthcare Act will hurt Americans’ quality of life.– While Obamacare has its faults, it at least provided millions of Americans with adequate healthcare coverage and options to meet many people’s needs and don’t break the bank. Thanks to the ACA, more people are covered and are more willing to visit a doctor. Not to mention, more people are able to depend less on employee-sponsored health benefits and are able to leave their job to start a business, raise a child, or retire early. And if you can’t find a job or lost one for reasons beyond one’s control, then it’s not the end of the world if your state has the Medicaid expansion. Trumpcare can have devastating implications on people’s lives, especially if they’re unable to get treatment for chronic pre-existing conditions. Many already employed may be forced to return to the workforce and to jobs they despise. Those who can’t find a job would be under increased pressure to find one while those who’ve lost theirs can lose their benefits. But both would be unable to find an affordable healthcare plan on the individual market, especially if they have a pre-existing condition. Same goes for those who lose their healthcare due to divorce or death of a spouse. People in abusive relationships could end up staying with their abusive partners. Those struggling with addiction and mental illness may not be able to seek treatment. Those who can’t work due to illness may end up unable to afford coverage and be forced to postpone treatment, which can make them even sicker. And it increases the possibility for people’s medical treatments driving them to bankruptcy.
  25. The American Healthcare Act is fundamentally Un-American.– If patriotism should mean anything to us, then it means sacrificing for the common good. Under the ACA, healthier and wealthier Americans pay a little more so sicker and poorer Americans don’t die. A for-profit healthcare system where people are seen to deserve the best deal they can get for themselves just doesn’t deliver that promise. Most Americans know that very well and are perfectly willing to subsidize poorer and sicker people under Obamacare, especially if it means better coverage for them. The Republican passage of the American Healthcare Act in May is a major betrayal to American values. In addition, it’s undemocratic to fast-track a major piece of legislation that would affect people’s lives every day without even consulting them, especially if it’s a policy the public doesn’t want at all.

To the Honorable United States Representative Tim Murphy of the Pennsylvania 18th District

Note: I was going to e-mail this to my congressman on his website as a way to express my righteous indignation at his voting for the monstrosity known the American Healthcare Act. But since it’s rather long and the language is so colorful and direct, I thought it would be better to publish this piece on my blog and open to the public. Of course, this is probably not a good way to treat a US Congressman. However, in my defense, he pretty much deserves to be humiliated as much as any of the 217 Republican Congress responsible for passing this morally reprehensible bill. Even more so if that particular congressman is none other than House Speaker Paul Ryan. As a citizen, I believe it is our duty to hold any Republican who supported the AHCA accountable. Since I can’t write 217 blog posts for each GOP congress member who did, then I hope my piece to Murphy sets an example. A legislator voting to deny Americans healthcare is inherently unacceptable and there is no justification for it. People’s lives are at stake depending on whether it becomes law and we cannot let that happen. The AHCA is an absolute moral disgrace and any legislator who supported it must never live it down.

Dear Congressman Murphy:

I am writing to you to express my seething moral outrage and disgust on your vote in favor of the American Healthcare Act on May 4, 2017. You claim you voted but repeal the Affordable Healthcare Act in order to save Southwestern Pennsylvania. But in reality, you voted for a bill casting tens of millions of people off their health insurance, slash hundreds of millions from Medicaid, and send premiums through the roof for older and poorer Americans. The AHCA is a bill of unspeakable cruelty as well as a policy depicting nothing but appalling disdain for the human dignity among the most vulnerable and a flagrant violation of this nation’s ideals.

Voting in favor of such morally indefensible legislation virtually destroys your credibility among your constituents as their US representative. Your support for this bill expresses that you would put the interests of your party, your donors, and your career over those of the very people you were elected to represent. It absolutely horrifying that you could even think your vote in favor of the AHCA was your way of rescuing Southwestern Pennsylvania from the ACA when the AHCA is significantly worse. The AHCA is not an important first step to fixing our nation’s broken healthcare system. But it breaks it down even further by making healthcare even more unaffordable and inaccessible for Americans. And it undoes many of the ACA regulations and consumer protections that have significantly improved and increased healthcare coverage for millions of Americans. I understand that the ACA needs fixed since it does not lower healthcare prices nor cover everyone. However, any ACA replacement bill that does away with these protections as well as deny and worsen coverage for Americans like the AHCA is absolutely unacceptable. Your vote for the AHCA did not rescue Southwestern Pennsylvania. But instead you condemned and sold out Southwestern Pennsylvania. If this bill is ever made into law, people will die and blood will be on your hands.

Looking at your website, I see headlines of articles regarding your advocacy for people suffering from disabilities, drug addiction, and the mentally ill. Under the AHCA, states can apply for waivers to opt out of ACA regulations and protections, allowing insurance companies to deny the very care these people need. They can eliminate required coverage for mental health services, substance abuse treatment, and prescription drugs. They can offer policies with annual and lifetime limits. They can deny coverage to those with preexisting conditions like mental illness and disability. It even sabotages Medicaid which a lot of the people you claim to champion depend on. It is a disgrace that the Schizophrenia & Related Disorders Alliance of America recognized you as “Exceptional Legislator.” It is an appalling shame that the National Association of Psychiatric Health Systems recognized you as “Mental Health Champion.” Your vote for the AHCA was a profound betrayal to these people since they are among the most vulnerable in society. It is deeply cruel of you to call yourself their champion but are willing to throw them under the bus. Well, you can consider yourself their champion no longer. If you truly are, you would have vehemently opposed this legislative travesty in the first place. As a “Mental Health Champion,” you should have voted against it even at the expense of your career. Twenty-one of your fellow congressional Republicans were willing to do just that. Sure you may claim that you secured $15 billion for mental health and addiction treatment in the AHCA, but that is a very empty gesture. Nor does it shield anyone suffering from addiction or mental illness from being turned away from the very treatment they need. You have lost any semblance of credibility in order to be a “Mental Health Champion.” Now you are just another lapdog for the Trump administration.

I do not care what you believe in or why you voted for the American Health Care Act. What your views makes no difference to me, especially in matters of life or death. Even as a Republican congressman, your support for the American Healthcare Act is completely inexcusable on so many levels. As a lawmaker, you were charged with representing your constituents’ interests, which the AHCA completely goes against. Most Americans do not want it especially if it puts their healthcare access in jeopardy. Practically every organization in the medical establishment condemned it. The AHCA is a vicious piece of legislation threatening people’s access to healthcare which is irresponsible, inexcusable, and dangerous. This goes especially for an “Exceptional Legislator” and a “Mental Health Champion” like you, which you completely failed to live up to when voting for that morally indefensible bill. Twenty of your colleagues from your own party understood that, including four from Pennsylvania. They may not be in good shape in 2018 but they are significantly better people than you will ever be.

Whether you like it or not, your vote for the American Healthcare Act illustrates that you advocate a healthcare vision that demeans human life and is indifferent to human suffering. May you never be allowed to forget it and may you have to live with your vote for the AHCA for the rest of your days. I sincerely hope you are held responsible for what you have done, especially if the wretched bill becomes law. Let your name be dragged through the mud wherever you go. May the disabled, addicted, and mentally ill spit on you for selling them out. And may your constituents greet you with the anger and revulsion over your betrayal that you deserve. As my congressman, I have lost all respect for you and nothing else on your record could ever change that. There is nothing you can do to redeem yourself for not even Jesus could ever forgive what you did. If you have to support legislation threatening Americans’ access to affordable healthcare, then you are not worth the blood that flows in your veins.

A Letter on the American Health Care Act

The United States House of Representatives has just passed the phenomenally unpopular American Healthcare Act which is nothing but a complete travesty and a moral disgrace. The bill in question will repeal the Affordable Care Act as well as institute a healthcare policy that would take away or worsen coverage from millions of Americans, especially those on Medicaid and/or with preexisting conditions. In addition, the AHCA would allow states to apply for a waiver to opt out most of the regulations and consumer protections Obamacare gives. Under these waivers, states could allow insurance companies to charge older people 5 times more than the young for the same policy. They can eliminate required coverage called essential health benefits such as maternity care, mental health care, emergency services, hospitalization, preventive care, substance abuse treatment, and prescription drugs. And they can charge more or deny coverage to those with preexisting conditions like cancer, diabetes, or arthritis. Not to mention, these waivers can also impact those with employer-based health insurance because they’d allow insurers to offer policies with annual and lifetime limits that the ACA bans. And some companies may choose those policies for their workers to lower their premiums. Never have I seen any form of legislation emanating such disdain for the most vulnerable suffering among us. And what horrifies me more is that these 217 Republicans would proudly cast their vote for such appalling disrespect of human dignity. This is a moral outrage and there’s absolutely no justification for it. These 217 Republicans don’t deserve any respect or recognition as decent human beings. Because no principled legislator, Democrat or Republican, would vote for a horrendous bill like this or celebrate taking healthcare away from their constituents afterwards.

For Republicans to craft such policy in the first place is nothing but monstrous cruelty. So it goes without saying that the AHCA is a bill that nobody asked for and nobody wants. The whole healthcare industry and medical establishment virtually condemned it. Countless polls show that the overwhelming majority of Americans hate it for very good reasons. Experts tore it to shreds. But 217 Republicans voted to pass this wretched AHCA anyway despite such strong objections, including from their own constituents who elected them. Congressional Republicans just moved this travesty to the floor with no Congressional Budget Office Score, no committee hearings, no studies, and very few public discussions. It was all put to the floor in secrecy and haste. And Republicans tried to sell this bill with a campaign of flat-out lies and deceit. Cheeto Head has promised to cover everyone, even those who can’t afford healthcare. Republicans repeatedly promised that the AHCA would give Americans more choice and lower premiums and deductibles. Even House Majority Leader Kevin McCarthy swore that nobody would have their Medicaid taken away from them. But they’ve opposed any specific healthcare plan that does these things and refuse to defend their policy outcome their actual position would bring about. What’s in the AHCA clearly reflects this.

I can’t think of anyone in their right mind who’d support this nightmare bill that is nothing but a disaster to all Americans. The American Healthcare Act is just a $1 trillion tax cut scheme to benefit their selfish donors who don’t want to pay for someone else’s medical treatment. But it’s a scheme that would cause tens of millions to lose coverage, slash hundreds of millions of dollars from Medicaid, and send premiums skyrocketing for older and poorer Americans. If it becomes law, the consequences will be absolutely devastating. The AHCA will kill significant numbers of Americans. Some will lose their Medicaid, won’t go to the doctor, and will wind up finding out too late that they’re sick. There will also be some whose serious conditions will put up against lifetime limits or render them unable to afford what’s on offer in the high-risk pools and suddenly can’t get treatment. Families will go bankrupt due to high medical bills. Such notions aren’t abstractions or exaggerations but the reality. To millions of Americans, whether the AHCA became law isn’t just a matter of politics or even morality. It’s a matter of life or death.

What the AHCA vote to pass it shows that 217 congressional Republicans don’t think their lives matter and are indifferent to their suffering. And it’s even worse that they celebrate their morally abominable actions with carts of booze and liquor rolling in to the chambers. Now they have blood on their hands. These people must be held to account as well their decision can and should be a career-defining vote for every member of the House. No congressman voting for such vicious legislation should ever be allowed to forget it. Angry and betrayed constituents should make their intensity and revulsion of what their representatives had done clear. And these reps should be challenged about it at every townhall meeting, at every campaign debate, in every election, and every day with letters and phone calls. Even if this malicious bill never becomes law and its potential harm averted, it still doesn’t excuse its supporters’ moral responsibility. The AHCA is one of the most critical moments of American history and an act of unspeakable cruelty that should haunt those who supported it to the end of their days.

As a Catholic, liberal, and American, I believe that healthcare is a fundamental human right that should be guaranteed for all. To me, a for-profit market healthcare system the United States currently has simply shouldn’t exist. Nobody should be denied healthcare, especially when they need it. To deny a sick person needed care for whatever reason is nothing short of discrimination at best and a human rights violation at worst. Your access to healthcare shouldn’t be determined by what job you have or whether you got one, how much money you make, whether you have a preexisting condition, whatever health plan you have, how sick you are, who your parents are, where you live, or whatever else. All Americans are entitled to seek the medical treatment they need without breaking the bank. And nobody should die for being denied a medical treatment that would’ve saved their life.

Unfortunately, much of the country doesn’t see it that way since the for-profit healthcare is what dominates the US medical system which I strongly believe is discriminatory, costly, and unsustainable. Though Obamacare has significantly expanded coverage for millions of Americans as well as achieved significant progress, there’s still a long way to go. It may not cover everyone nor is it perfect, but the fact it has improved and increased healthcare coverage for millions of Americans who’d otherwise wouldn’t have makes it worthy to uphold for the time being. If Obamacare should be repealed and replaced, then it might as well be in favor of a single payer system or at a plan that at least fixes its problems. Any healthcare plan that provides anything less is unacceptable. Any plan that takes coverage away from any Americans and makes healthcare even more unaffordable is morally reprehensible. And anyone in Congress who supports a healthcare plan like the AHCA doesn’t stand for their constituents’ interests. Sure they may not believe healthy people shouldn’t pay for sick people’s care. But such constructs are utterly indefensible when American lives are at stake. Besides, the idea of healthy people paying for the sick is how health insurance works. It’s not anyone’s fault for getting sick, injured, mentally ill, or having a disability. So why should they be punished for not pulling their weight if they can’t afford treatment? There’s no reason for it because they certainly don’t deserve to die.

As the American Healthcare Act moves to the Senate, the lives and futures of Americans are now at stake. People are deeply terrified of this bill becoming law. Regardless of party affiliation, the US Senate must do everything it can to make sure the AHCA dies and never becomes law. The fight for affordable healthcare in America isn’t a matter of political football. It’s a matter of life or death. To support the AHCA is to defend the indefensible. To threaten access to people’s healthcare is irresponsible, inexcusable, and dangerous. And it flagrantly violates our nation’s values. Clearly, Americans deserve a better healthcare plan than this utter monstrosity. And they deserve better representatives with the 217 Republicans who just sold their souls. There’s nothing decent about the AHCA and no lawmaker should ever vote for it. And its passage in the House of Representatives doesn’t reflect the will of the American people at all nor brings credit to our nation’s ideals. The last thing the United States needs right now is to return to the horrors of the pre-Obamacare system which the AHCA seeks to bring back. For the love of God, I plead to my fellow Americans to not have us go through that hell again. And if it becomes law, I will absolutely not stand for it. Enough is enough and we can’t allow this catastrophe. The AHCA must die for the sake of the nation. These are the times that try men’s souls as now is the winter of our discontent. And we do what we can until the AHCA is completely dead before it ever gets to Trump’s desk. Because if it gets there, we’re all fucked.