CBO Scores American

Healthcare Act

The much awaited CBO calculation of direct spending and revenues of HR 1628 as passed by the House would ‘reduce the cumulative federal deficit over ten years by $119 billion.’

The calculation is based on the conclusion that ‘…provisions dealing with health insurance coverage would reduce the deficit, on net, by $783 billion; the non-coverage provisions would increase the deficit by $664 billion, mostly by reducing revenues.’ The difference, then, is $119 billion.

The savings largely come from the significant reductions in spending for Medicaid as the program was expanded under Affordable Care Act (ACA-Obamacare) to lower premiums for lower income people and removing the outlays for individual health insurance that, CBO says, would be replaced with tax credits for healthcare spending. The bill would increase spending for State programs that would be designed to cover individuals with preexisting conditions or other high healthcare problems who would likely not get insurance coverage or would pay a higher price for insurance.

Where the savings come from.

The bill gives up a great amount of revenues built into the ACA that paid its way from penalties on employers who’ do not offer insurance and on people who do not purchase insurance’. The largest increases in the deficit, CBO says, would come from repealing or modifying tax provisions in the ACA…such as ‘repealing a surtax on net investment income, repealing annual fees imposed on health insurers, and reducing the income threshold for determining the tax deduction for medical expenses.’ The also repeals the ACA tax on the sale of medical devices such as wheelchairs and other hard devices.

The results of the AHCA

CBO calculates that “14 million more people would be uninsured under H.R. 1628 than under (the ACA). The increase in the number of uninsured people relative to the number projected under current law would reach 19 million in 2020 and 23 million in 2026. In 2026, an estimated 51 million people under age 65 would be uninsured, compared with 28 million who would lack insurance that year under(the ACA).”

More specifically it is the ACHA’s approach to purchasing coverage and the assumption that people are better off buying coverage they think they need rather than purchasing plans with essential coverage that insurers must offer under the ACA. The idea is that it would lower premiums and would be accomplished in the ACHA through waiver options given to states.

“One type of waiver would allow states to modify the requirements governing essential health benefits (EHBs), which (under the ACA) set minimum standards for the benefits that insurance must cover. A second type of waiver would allow insurers to set premiums on the basis of an individual’s health status if the person had not (a lapse in continuous) coverage.”

Cost of Premiums

“H.R. 1628, as passed by the House, would tend to increase such premiums before 2020, relative to those under (the ACA)—by an average of about 20 percent in 2018 and 5 percent in 2019”

Leaving it to the states

“Although premiums would decline, on average, in states that waive Essential Health Benefits (EHB) some people enrolled in non-group insurance would experience substantial increases in what they would spend on health care. People living in states modifying the EHBs who used services or benefits no longer included in the EHBs would experience substantial increases in out-of-pocket spending on health care or would choose to forgo the services… Moreover, the ACA’s ban on annual and lifetime limits on covered benefits would no longer apply to health benefits not defined as essential in a state…some enrollees could see large increases in out-of-pocket spending because annual or lifetime limits would be allowed. That could happen, for example, to some people who use expensive prescription drugs. Out-of-pocket payments for people who have relatively high health care spending.

Read the full CBO report here

Trump Budget Revealed

The White House Office of Management and Budget (OPM) released the President’s FY 2018 budget described as a plan by OPM director Mick Mulvaney which is exactly what budgets are.. The plan, then aims to meet Trump’s various declared and undeclared policies both foreign and domestic and offers the industrious goal of balancing the budget in ten years; an accomplishment met only once in recent decades by Clinton and the US House managed by then Speaker Newt Gingrich turning a $300 billion  budget deficit into a $200 billion surplus when Clinton left office in 2000. Taken from Mulvaney’s and Trump’s comments the severe cuts in spending, and significant reductions in tax revenues are what is needed to stimulate the economy which, Mulvaney says has to increase to 3% or a balanced budget can never be met.

To those ends the bill sees only increases in spending for Defense, Veterans Affairs, and Homeland Security and plans significant cuts in domestic spending, particularly entitlement programs and the ending of many programs deemed in the budget as unnecessary or ineffective.

Defense spending would increase by 10.1% from $521 billion to $574 billion. VA spending would increase Nearly 6% from $74 billion to north of $78 billion and Homeland Security gains nearly 8% with an increase to $44 billion from the current $41.3 billion.

All other government agencies face reductions, some significant but the cuts appear to be specific, not across-the-board cuts. Programs within agencies such as eliminating grants to Appalachian States for economic development projects in conjunction with abandoned coal mine land reclamation within the Department of Interior; eliminating  the Community Development Block Grants through HUD; eliminating the Low Income Home Energy Assistance Program under Health and Human Services; eliminating rural business and cooperative programs under the Department of Agriculture; and eliminating funding for the Corporation for Public Broadcasting (NPR, PBS)

Perhaps the most significant cuts are applied to the Environmental Protections Agency. the $54 billion cut reduces NOOA funding by $250 million and stops payments to climate change programs and ends up to 50 programs as reported by the Earth Island Journal.

Trump’s budget is seen by House Speaker Paul Ryan (R-WI) as right on track but many Members of congress see the plan as to severe and impossible for them to support. Democrats are certain oppose the plan without hesitation but many Republicans see the political third rail of the subway having to explain why they would support eliminating Meals on Wheels that provides balanced meals delivered to house-bound seniors. Other Republican’s have said, however, that the mandatory spending reductions in the budget are necessary to stimulate the economy.

It is the cuts to social and health safety nets that drew the most fire.

Trumps budget would remove $192 billion from the Supplemental Nutrition Assistance program (Food Stamps) over ten years, Medicaid that helps low income Americans pay for healthcare needs and supports seniors in nursing homes wold suffer $800 billion in cuts in addition  to the over $500 billion the American Healthcare Act would remove from that program and the Temporary Assistance for Needy Families would be cut $21 billion.

While the budget is not clear on how such cuts would impact the thousands of Americans getting by with help from those programs Mulvaney gave a generally specific explanation, ” We are no longer going to measure compassion by the number of programs or the number of people on those programs.” “We are going to measure compassion and success by the number of people we help get off of those programs and get back in charge of their own lives.”

Then there are the proposed tax cuts.

Based on the idea that reducing taxes on individuals and businesses will stimulate the economy thereby producing jobs and so taxes back to the Treasury to be used to reduce the public debt. That common philosophy appeared first with Ronald Reagan and went further with George Bush but both administrations left office with deficits; $300 billion after Reagan and $1 trillion after Bush. Trump proposes some $2 trillion in tax cuts which is, in federal budget terms, spending.


Human Trafficking and Child Protection

Rep John Ratcliff (R-TX-4)

Rep John Ratcliff (R-TX-4)

HR 1842 would include State crimes of violence as grounds for an enhanced penalty when sex offenders fail to register or report certain information as required by Federal law. Passed House

Rep. Moke Johnson (R-LA-8)

Rep. Moke Johnson (R-LA-8)

HR 1761 amends title 18, United States Code, to criminalize the knowing consent of the visual depiction, or live transmission, of a minor engaged in sexually explicit conduct.

Rep Susan Brooks (R-IN-5)

Rep Susan Brooks (R-IN-5)

HR 1973 would prevent the sexual abuse of minors and amateur athletes by requiring the prompt reporting of sexual abuse to law enforcement authorities’. Passed House.

Rep. Ann Wagner (R-MO-2)

Rep. Ann Wagner (R-MO-2)

HR 2473 aims to ensure compliance with the Justice for Victims of Trafficking Act of 2015, to make strides toward eradicating human trafficking. Passed House.

Rep. James Sensenbrenner (R-WI-5)

Rep. James Sensenbrenner (R-WI-5)

HR 1188 amends current law to require the Department of Justice to include additional data in its annual report on the enforcement of sex offender registration requirements. Passed House.

Rep Martha Roby (R-AL-2)

Rep Martha Roby (R-AL-2)

HR 1862 amends title 18, United States Code, to expand the scope of certain definitions pertaining to unlawful sexual conduct. Passed House.

Rep. Edward Royce (R-CA-39). HJRes 64 Sponsor

Rep. Edward Royce (R-CA-3)

HR 1625 amends the State Department Basic Authorities Act of 1956 to include severe forms of trafficking in persons within the definition of transnational organized crime. Passed House.

Rep. Adam Schiff (D-CA-28)

Rep. Adam Schiff (D-CA-28)

HR 695 mend the National Child Protection Act of 1993 to establish a national criminal history background check system and criminal history review program. Passed House.

HR 883 would provide a certification process for the issuance of nondisclosure requirements accompanying certain administrative subpoenas. Passed House.

HR 1808 updates the findings of Congress to reflect the awareness that a growing number of children are victims of child sex trafficking and sextortion. Passed House.

HR 1809 amends current law to modify and reauthorize juvenile justice  missing and exploited children programs. Passed House.


Veterans Matters

Rep. Martha McSally (R-AZ-2)

Rep. Martha McSally (R-AZ-2)

HR 2052 makes the wrongful broadcast or distribution of intimate visual images a court marshal offense. Passed House.

rep-jackie-walorski-r-in-2HR 467 ensures that  each VA medical facility  certifies it is  in full compliance with all provisions of law and regulations relating to scheduling appointments. Passed House.

Rep Lee Zeldin (R-NY-1)

Rep Lee Zeldin (R-NY-1)

HR 1005 provides agreement with state homes to pay for adult healthcare for veterans who are eligible. Passed House

Rep. Stephen Knight (R-CA-25)

Rep. Stephen Knight (R-CA-25)

HR 1162 directs the Secretary of VA to carry out a pilot program to provide access to magnetic EEG/EKG-guided resonance therapy to veterans. Passed House.

Rep. Mike Bost (R-IL-12)

Rep. Mike Bost (R-IL-12)

HR 1329 would increase Cost of Living Adjustments paid to veterans  to match any COLA given to Social Security recipients next year. Passed House.

Rep. Mike Bost (R-IL-12)

Rep. Mike Bost (R-IL-12)

HR 2288 reforms the rights and processes relating to appeals of decisions regarding claims for benefits under the laws administered by the VA. Passed House.

HR 1545 clarifies the authority of the Secretary of Veterans Affairs to disclose certain patient information to State controlled substance monitoring programs. Passed House.

Rep Tim Walz (D-MN-1)

Rep Tim Walz (D-MN-1)

HR 1725 VA must accept a medical exam from a private physician when establishing a veteran’s disability benefit. Passed House.


Resolution on Turkey

Turkish Embassy Personnel Attacks on US Protestors Condemned

Erdogan

Erdogan

Three Key House Legislators introduced H.Res. 354, a resolution condemning  the  violence  against  peaceful  protesters  outside  the  Turkish  Ambassador’s  residence  on  May  16,  2017.

Two dozen protestors who gathered outside the Turkish embassy in Washington DC to protest Turkish government policies under President  Recep  Tayyip  Erdogan considered brutal while President Trump met with the Turkish president at the Waite House.

The same incident happened later outside of the home of Erdogan reportedly with Erdogan looking on after stepping out of his limousine.

“violence  erupted  when  pro-Erdogan  supporters  and  individuals  from  the  Turkish  Embassy  grounds  pushed  past  District  of  Columbia  police  officers  to  brutally  attack  the  demonstrators” the resolution states as seen on various news channels and Youtube. ” this  is  the  third  instance  of  violence  perpetrated  by  members  of  Turkish  President  Erdogan’s  security  detail  in United States territory”  the resolution says.

Embassy officials have diplomatic immunity such that they can not be prosecuted for any crime committed on US soil. The resolution insists ‘Department of State should immediately request  the  waiver  of  immunity  of  any  Turkish  security  detail  official  engaged  in  assault  in  the  United  States  prior  to  release  of  that  individual  from  custody.’ Video on this country

EPA Rule Opposed

Rep. Bob Gibbs (R-OH-7)

Rep. Bob Gibbs (R-OH-7)

H.R. 953 would prohibit the Environmental Protection Agency (EPA) and states authorized to issue permits under the National Pollutant Discharge Elimination System (NPDES) from requiring a permit for some discharges of pesticides. Passed House.

*****

Improved DHS Program

Rep Michael McCaul (R-TX-10)

Rep Michael McCaul (R-TX-10)

HR 1370 amends the Homeland Security Act of 2002 to require the Secretary of Homeland Security to issue Department of Homeland Security-wide guidance and develop training programs as part of the Department of Homeland Security Blue Campaign. Passed House.

Social Security Card Fraud

Under HR 624 no department or agency of the Federal Government may include the social security account number of any individual on any document sent by mail unless the head of such department or agency determines it  is necessary.’ Passed House.

*****

Govt. Employee Use Time

Rep. Dennis Ross (R-FL-15)

Rep. Dennis Ross (R-FL-15)

H.R. 1293 requires the Office of Personnel Management, in consultation with the Office of Management and Budget, to submit an annual report to Congress relating to the use of “official time” by federal employees. Passed House.


SENATE

Amul R. Thapar, of Kentucky, to be United States Circuit Judge for the Sixth Circuit.    The nomination was confirmed by a vote of 52-44.

John Sullivan to be Deputy Secretary of State.  The nomination was confirmed by a vote of 94-6.

Terry Branstad to be Ambassador Extraordinary and Plenipotentiary of the United States of America to the People’s Republic of China. The nomination was confirmed by a vote of 83–12