AR Law Requires Any Woman Seeking an Abortion to get Permission from the Man Who Impregnated Her

— by Julia Conley, staff writer at CommonDreams

Arkansas legislators have drawn harsh criticism from women’s rights groups after passing four new laws that would severely restrict abortion access. (Photo: Steve Rhodes/Flickr/cc)

A hearing is scheduled for Thursday in the American Civil Liberties Union’s suit to block several new anti-reproductive rights laws that have passed in Arkansas, which would impose severe restrictions on women’s abortion access in the state.

The group has joined with the Center for Reproductive Rights to keep the laws from going into effect, starting at the end of July.

“Instead of protecting women’s health, Arkansas politicians have passed laws that defy decency and reason just to make it difficult or impossible for a woman to get an abortion,” said Rita Sklar, executive director of the ACLU of Arkansas. “They’ve created burdensome bureaucratic hurdles that invade patient privacy.”

The Tissue Disposal Mandate, or H.B. 1566, will make it illegal for a woman to terminate a pregnancy without informing the man who impregnated her. During Arkansas’ legislative session, the provision was added to the state’s Final Disposition Rights Act of 2009, which mandates that family members must agree what to do with a loved one’s body after a death. The law would apply to women who become pregnant in cases of rape as well as women who have consensual sex.

The law also states that any man or woman must be over the age of 18 in order to seek an abortion. In the case of a 17-year-old girl who is impregnated by an 18-year-old, for example, the decision would be entirely up to the male.

In addition to H.B. 1566, Arkansas recently passed laws banning a medically safe and effective abortion method known as dilation and evacuation; restricting access to abortion based on the sex of the fetus; and requiring doctors to preserve fetal tissue and notify police after performing abortions on anyone under the age of 16. The ACLU and Center for Reproductive Rights have strongly condemned the laws.

“Arkansas politicians have devised new and cruel ways to rob women of their right to safe and legal abortion this year,” said Nancy Northup, president and CEO of the Center for Reproductive Rights. “The Center for Reproductive Rights will continue to use the full force of the law to ensure these rights are protected and respected for all women.”

In 2015, the Institute for Women’s Policy Research ranked Arkansas as one of the worst states for women’s reproductive rights.

Trump USA’s Fast-Forward Decline in the World

“Donald Trump has pressed ‘fast-forward’ on the decline of the United States.” – Chris Uhlmann

This is the most brutal and succinct analysis of Donald Trump, the man and the scripted, fake President*. Take 2 minutes and watch this. Then, pick your jaw up and wipe your tears.

Source:  Read the full article at Crooks & Liars

HUD Secretary Carson Removed LGBTQ Housing Discrimination Protections from Website

U.S. Senator Catherine Cortez Masto (D-Nev.) led 28 U.S. senators in a letter to Housing and Urban Development (HUD) Secretary Ben Carson, urging him to reinstate resources that protect LGBTQ people from housing discrimination. These resources, designed to help housing providers comply with HUD’s nondiscrimination rules, were removed from HUD’s website in recent months.

“It is concerning that HUD apparently removed these tools from its website, which are meant to assist grantees in meeting their underlying obligations under the law,” the senators wrote. “Without these training resources, housing service providers will face additional challenges in trying to understand how best to meet the needs of their clients.  The guidance resources that were withdrawn or removed are critical to ensuring nondiscrimination rules are fully and faithfully implemented.”

LGBTQ people across the country face unique housing challenges, with 40 percent of LGBTQ youth representing all youth experiencing homelessness and with nearly 1 in 3 transgender adults who report having experienced homelessness at some point in their lives. According to 2016 HUD data, Nevada has the highest rate of unsheltered, unaccompanied homeless youth in the nation, making guidance for Nevada housing providers especially important. The resources that were withdrawn from HUD’s website provide critical guidelines and information to ensure that housing providers comply with HUD policies that protect LGBTQ people.

In Anticipation of Voter Suppression and Purges

— by Stephen Wolf and edited by David Nir. Daily Kos Elections Voting Rights Roundup email

In May, Donald Trump created a “Voting Integrity Commission” that we knew was purely a pretext to promote voter suppression nationwide. Now this panel has launched its opening salvo and confirmed its true purpose. The board is proposing to scrutinize each state’s voter registration records and intimidate the states into conducting voter purges—and it’s named America’s most prominent voter-fraud scaremonger to the commission itself. These actions are designed to give Trump and congressional Republicans an excuse to impose new voting restrictions at the national level.

Led by vice chair Kris Kobach, Kansas’ Republican secretary of state and one of the country’s foremost crusaders for voting restrictions, Trump’s commission has requested that every state send in its voter registration records in their entirety. For some states, these records would include voters’ names, addresses, birth dates, the last four digits of their Social Security numbers, party affiliation, the history of which elections they’ve voted in over the last decade, their registration status in another state, their military status, and whether they have felony convictions—in other words, quite a lot of personal information.

Although registration information is technically public, states have restrictions on with whom it can be shared and how, given the obvious privacy concerns with such sensitive data. While the federal government already has access to some of these statistics for every voter, the commission itself is required to make all documents it receives available to the general public, which would effectively defeat the attempts that the states have made to safeguard this information.

Kobach will likely abuse these registration records to demonstrate examples of the same person voting more than once in an attempt to claim that voter fraud is widespread. These examples will be bogus, though. Kobach has done this very same thing with his national “Crosscheck” system, which he’s convinced over 30 states to adopt. Crosscheck is notoriously riddled with inaccurate information, since it often compares just a few data points to suss out duplicate registrations, such as name and birthdate, leading to many false positives. (How many guys do you want to bet are named James Smith with a birthday of April 20? A lot, no doubt.) Election experts have estimated that Crosscheck could disenfranchise 200 valid voters for every one actual case of double registration that it eliminates.

Many Democratic state elections officials have refused Kobach’s request, while even a few Republicans have said they will only comply with the legal bare minimum and won’t submit private data. (Operative Matt Berg is keeping track of all the responses.) In a fitting ironic twist of incompetence, Kobach himself is unable to supply all of the requested information because of Kansas state law. Unfortunately, Kobach will likely enough get the information he needs from more pliant Republican officials in order to be able to falsely claim that voting irregularities are widespread.

Even if there were a legitimate reason to send the commission these records, Kobach was recently reprimanded by a federal court and fined $1,000 for “patently misleading representations” he made in a lawsuit over the contents of a document he was seen carrying that outlined proposed changes to federal voting laws. From the start, Kobach’s findings have been predetermined to support future voting restrictions.

As if Kobach weren’t awful enough, Trump also named Hans von Spakovsky to the commission. Spakovsky is perhaps the country’s most notorious promoter of the lie that voter fraud is widespread. As an attorney in the Justice Department’s Civil Rights Division under George W. Bush, Spakovsky played an instrumental role in politicizing the department to whip up the specter of voter fraud while greenlighting nascent Republican-passed voter restrictions like Georgia’s voter ID law over the objection of career DOJ employees. It’s really like they’re putting together the worst imaginable team of voter-suppression supervillains they possibly can.

Unfortunately, this commission is just one part of the Trump administration’s multi-pronged effort to impose new restrictions on voter registration. The Justice Department itself has played into this charade by sending a letter to the states warning them that it is “reviewing voter registration list maintenance procedures in each state” while querying them on how they plan to clean up their voting rolls. This action is another likely attempt at intimidation that will also encourage Republican-run states to purge their voting rolls, potentially disenfranchising many valid voters.

Meanwhile, congressional Republicans on the House Appropriations Committee have introduced a bill to eliminate the Election Assistance Commission; back in February, the House Administration Committee voted to do the same thing. This latest measure is part of the GOP’s budget proposal, which stands a good chance of passing. The EAC was created after the 2000 election debacle to help states run their elections, and it’s the only federal agency tasked with ensuring that voting machines aren’t vulnerable to hacking.

Yet rather than protect the country’s elections infrastructure from the very real threat of intrusion, the GOP is whipping up hysteria over nearly nonexistent voter fraud. This fear-mongering will likely serve as a pretext to amend the 1993 National Voter Registration Act, or NVRA, and more popularly known as the “Motor Voter” law. This would be the logical culmination at the federal level of the wave of GOP-passed voting restrictions that have swept state governments in the last decade.

If Kobach gets his way, congressional Republicans will amend the NVRA to require proof-of-citizenship for all voter registrants. Kobach and his allies in fact tried to require citizenship documentation in Kansas, leading to the suspension of one in seven new voter registrations until a federal court intervened last year.

This requirement is a solution in search of a problem, since Kobach himself has only successfully prosecuted one non-citizen voter ever. Many citizens don’t have easy access to the kinds of documents necessary to prove citizenship, and the requirement would utterly destroy the ability of civic groups to conduct voter registration drives, since people don’t exactly walk around around with their birth certificates in their back pockets.

Trump’s voting integrity commission is an unmistakable witch hunt that no one who believes in representative democracy should normalize. Those who support free and fair elections should urge their elected officials to refuse to comply with the commission’s request for voter registration records. Furthermore, Democrats like New Hampshire Secretary of State Bill Gardner should end their participation on the commission, since their service only helps to legitimize a partisan effort to suppress votes in order to unfairly win elections.

Be Sure to Thank Sen. Dean Heller for NO Health Insurance Choices

— by Anjeanette Damon

News has broken that Anthem will stop offering health plans under the Affordable Care Act in nearly all of Nevada’s rural counties, specifically blaming the uncertainty caused by the Republican health care plan in the U.S. Senate. Roughly 8,000 rural Nevadans will lose their access to insurance, with no alternatives to buy a different plan on the exchange. Prominence also decided to pull out of the state’s exchange entirely.

From Stewart Boss, Nevada State Democratic Party spokesperson: “Nevada families are already feeling the harmful effects of the Republican health care agenda in Washington, and Senator Heller – who has voted 20 times to repeal or undermine the Affordable Care Act – is a major part of the problem. The uncertainty and instability caused by Dean Heller and Senate Republicans continuing their efforts to pass their toxic health care plan, combined with the GOP’s efforts to disrupt the exchanges, is now creating havoc in Nevada’s rural counties. The thousands of Nevadans who will lose their health care plans or lose access to health insurance through the exchange have Dean Heller and Donald Trump to blame for this turmoil.”

Reno Gazette-Journal: BREAKING: Rural Nevada to lose all Obamacare plans next year

 

Longer-Term Effects of the Better Care Reconciliation Act of 2017 on Medicaid Spending

Longer-Term Effects of the Better Care Reconciliation Act of 2017 on Medicaid Spending

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In CBO’s assessment, Medicaid spending under the Better Care Reconciliation Act of 2017 would be 26 percent lower in 2026 than it would be under the agency’s extended baseline, and the gap would widen to about 35 percent in 2036 (see figure below). Under CBO’s extended baseline, overall Medicaid spending would grow 5.1 percent per year during the next two decades, in part because prices for medical services would increase. Under this legislation, such spending would increase at a rate of 1.9 percent per year through 2026 and about 3.5 percent per year in the decade after that.

CBO and the staff of the Joint Committee on Taxation do not have an insurance coverage baseline beyond the coming decade and therefore are not able to quantify the legislation’s effect on insurance coverage over the longer term. However, the agencies expect that after 2026, enrollment in Medicaid would continue to fall relative to what would happen under the extended baseline.

On the basis of consultation with the budget committees, CBO’s just-released cost estimate for the bill measured the costs and savings relative to CBO’s March 2016 baseline projections, with adjustments for legislation that was enacted after that baseline was produced. For consistency, this longer-term analysis uses CBO’s extended baseline published in July 2016. CBO analyzed these longer-term effects at the request of the Ranking Members of the Senate Budget Committee and the Senate Finance Committee.

Related CBO Publications:

Trump Can’t Put His Ego Aside, Declares Voter Fraud, Forms Unwarranted Commission at Taxpayer Expense

Trump may have won the electoral college, but he lost the popular vote by a historic margin.  That fact apparently insults his fragile ego to the effect that he’s now amplified his claims of voter fraud and formed a commission that will look for the equivalent of lightning repeatedly striking the same exact spot.  Heading that commission will be Kansas Secretary of State Kris Kobach who championed an illegal voter suppression technique called “caging” and launched a program called Interstate Crosscheck to compare voter registration data across states and ferret out evidence of double voting.  Crosscheck, in the 30 states that took up using it, flagged 7.2 million possible double registrants, no more than four have actually been charged with deliberate double registration or double voting.  Very few actual cases of fraud being referred for prosecution.

A new investigation from Rolling Stone raises fresh concerns about Interstate Crosscheck, finding that its methodology has a built-in racial bias that puts people with African-American, Latino and Asian names at greater risk of being wrongly accused of double voting.

The Washington Post actually did a deep dive into the 2016 election looking for voter fraud:

We combed through the news-aggregation system Nexis to find demonstrated cases of absentee or in-person voter fraud – which is to say, examples of people getting caught casting a ballot that they shouldn’t – during this election. This excludes examples of voter registration fraud – the filing of fraudulent voter registration information. Those aren’t votes cast – and given that organizations often provide incentives for employees to register as many people as possible, registration fraud cases (while still rare) are more common.

The found a grand total of only four documented instances of voters attempted to cast fraudulent votes. Not four percent, literally four individuals — and most of them were Republican voters.  There are no other documented cases of voter fraud in the entire country in 2016. These four represent 0.000002% of the ballots cast, and again, they weren’t actually included in any official tallies.

But for Trump, that’s just all “fake news” and he’s now formed his very own commission using taxpayer dollars to find that elusive voter fraud …. or is it to look for ways to suppress the vote nationwide to assure his re-election in 2020.  And, Kris Kobach has now lobbed his first volley in that effort:


I thought Republicans were supposed to be “States’ Rights” advocates.  This effort by President Trump through his minions Kris Kobach and AG Jeff Sessions looks like an attempt to federally take over our voting processes so as to make it easier to suppress the vote across the entire nation.  Do you really want to give all your personal and voting information to the Republicans who just left a database of voter information wide-open and unprotected for any and all to see, including the Russians?  If you read the letter above, he wants:

  • Your First and Last Name, including Middle Name and/or initials
  • Registration/Mailing Addresses
  • Your Date of Birth
  • Your Political Party
  • Your Last 4 digits of your Social Security Number
  • Your Voter history (elections voted in since 2006)
  • Your Voter Status (Active/Inactive/Cancelled)
  • Info whether you registered in some other state
  • Info regarding your military status
  • Info regarding whether you’re an overseas citizen

But it gets worse as he states:  “Please be aware that any documents that are submitted to the full Commission will also be made available to the public.”  Wonderful!  Are they planning to make it easy for hackers/criminals to use your personally identifiable information to commit identity theft as a means of voter intimidation and suppression?

Apparently Nevada’s Secretary of State has no problem with complying with the request, but will at least withhold Social Security Numbers, Driver’s License Numbers, DMV-ID Card Numbers and email addresses:

Related Articles:

Interested in Serving on a State Board/Commission?

Calling all Nevadans! Here’s your chance to have your say in how government operates in Nevada. The Governor will be appointing volunteers to serve on dozens of Nevada boards and commissions. The state is looking for folks who are interested in serving on everything from the Aging Commission to Wildlife Commissioners!

Governor Brian Sandoval is committed to building an efficient and responsive state government. The Governor believes that all citizens should have direct access to their government and have the right to help shape public policy. The Governor has the privilege and authority to confirm or appoint members to numerous boards and commissions. Most boards and commissions are created by federal law, state legislation, or executive order of the Governor. Each state board has a different role and membership requirements. The membership is outlined in the enabling document and is usually narrowly defined, often including requirements for political or geographic diversity.

The CBO Report is Out—We’re Still Screwed!

— as Posted at the Website of the Congressional Budget Office on June 26, 2017


View the full CBO Report Here


The Congressional Budget Office and the staff of the Joint Committee on Taxation (JCT) have completed an estimate of the direct spending and revenue effects of the Better Care Reconciliation Act of 2017, a Senate amendment in the nature of a substitute to H.R. 1628. CBO and JCT estimate that enacting this legislation would reduce the cumulative federal deficit over the 2017-2026 period by $321 billion. That amount is $202 billion more than the estimated net savings for the version of H.R. 1628 that was passed by the House of Representatives.

The Senate bill would increase the number of people who are uninsured by 22 million in 2026 relative to the number under current law, slightly fewer than the increase in the number of uninsured estimated for the House-passed legislation. By 2026, an estimated 49 million people would be uninsured, compared with 28 million who would lack insurance that year under current law.

Following the overview, this document provides details about the major provisions of this legislation, the estimated costs to the federal government, the basis for the estimate, and other related information, including a comparison with CBO’s estimate for the House-passed act.

Effects on the Federal Budget

CBO and JCT estimate that, over the 2017-2026 period, enacting this legislation would reduce direct spending by $1,022 billion and reduce revenues by $701 billion, for a net reduction of $321 billion in the deficit over that period (see Table 1, at the end of this document):

  • The largest savings would come from reductions in outlays for Medicaid—spending on the program would decline in 2026 by 26 percent in comparison with what CBO projects under current law—and from changes to the Affordable Care Act’s (ACA’s) subsidies for non-group health insurance (see Figure 1). Those savings would be partially offset by the effects of other changes to the ACA’s provisions dealing with insurance coverage: additional spending designed to reduce premiums and a reduction in revenues from repealing penalties on employers who do not offer insurance and on people who do not purchase insurance.
  • The largest increases in deficits would come from repealing or modifying tax provisions in the ACA that are not directly related to health insurance coverage, including repealing a surtax on net investment income and repealing annual fees imposed on health insurers.

Pay-as-you-go procedures apply because enacting this legislation would affect direct spending and revenues. CBO and JCT estimate that enactment would not increase net direct spending or on-budget deficits in any of the four consecutive 10-year periods beginning in 2027. The agencies expect that savings, particularly from Medicaid, would continue to grow, while the costs would be smaller because a rescinded tax on employees’ health insurance premiums and health plan benefits would be reinstated in 2026. CBO has not completed an estimate of the potential impact of this legislation on discretionary spending, which would be subject to future appropriation action.

Effects on Health Insurance Coverage

CBO and JCT estimate that, in 2018, 15 million more people would be uninsured under this legislation than under current law—primarily because the penalty for not having insurance would be eliminated. The increase in the number of uninsured people relative to the number projected under current law would reach 19 million in 2020 and 22 million in 2026. In later years, other changes in the legislation—lower spending on Medicaid and substantially smaller average subsidies for coverage in the non-group market—would also lead to increases in the number of people without health insurance. By 2026, among people under age 65, enrollment in Medicaid would fall by about 16 percent and an estimated 49 million people would be uninsured, compared with 28 million who would lack insurance that year under current law.

Stability of the Health Insurance Market

Decisions about offering and purchasing health insurance depend on the stability of the health insurance market—that is, on the proportion of people living in areas with participating insurers and on the likelihood of premiums’ not rising in an unsustainable spiral. The market for insurance purchased individually with premiums not based on one’s health status would be unstable if, for example, the people who wanted to buy coverage at any offered price would have average health care expenditures so high that offering the insurance would be unprofitable.

Under Current Law. Although premiums have been rising under current law, most subsidized enrollees purchasing health insurance coverage in the non-group market are largely insulated from increases in premiums because their out-of-pocket payments for premiums are based on a percentage of their income; the government pays the difference between that percentage and the premiums for a reference plan (which is the second-lowest-cost plan in their area providing specified benefits). The subsidies to purchase coverage, combined with the effects of the individual mandate, which requires most individuals to obtain insurance or pay a penalty, are anticipated to cause sufficient demand for insurance by enough people, including people with low health care expenditures, for the market to be stable in most areas.

Nevertheless, a small number of people live in areas of the country that have limited participation by insurers in the non-group market under current law. Several factors may lead insurers to withdraw from the market—including lack of profitability and substantial uncertainty about enforcement of the individual mandate and about future payments of the cost-sharing subsidies to reduce out-of-pocket payments for people who enroll in non-group coverage through the marketplaces established by the ACA.

Under This Legislation. CBO and JCT anticipate that, under this legislation, non-group insurance markets would continue to be stable in most parts of the country. Although substantial uncertainty about the effects of the new law could lead some insurers to withdraw from or not enter the non-group market in some states, several factors would bring about market stability in most states before 2020. In the agencies’ view, those key factors include the following: subsidies to purchase insurance, which would maintain sufficient demand for insurance by people with low health care expenditures; the appropriation of funds for cost-sharing subsidies, which would provide certainty about the availability of those funds; and additional federal funding provided to states and insurers, which would lower premiums by reducing the costs to insurers of people with high health care expenditures.

The agencies expect that the non-group market in most areas of the country would continue to be stable in 2020 and later years as well, including in some states that obtain waivers that would not have otherwise done so. (Under current law and this legislation, states can apply for Section 1332 waivers to change the structure of subsidies for non-group coverage; the specifications for essential health benefits [EHBs], which set the minimum standards for the benefits that insurance in the non-group and small-group markets must cover; and other related provisions of law.) Substantial federal funding to directly reduce premiums would be available through 2021. Premium tax credits would continue to provide insulation from changes in premiums through 2021 and in later years. Those factors would help attract enough relatively healthy people for the market in most areas of the country to be stable, CBO and JCT anticipate. That stability in most areas would occur even though the premium tax credits would be smaller in most cases than under current law and subsidies to reduce cost sharing—the amount that consumers are required to pay out of pocket when they use health care services—would be eliminated starting in 2020.

In the agencies’ assessment, a small fraction of the population resides in areas in which—because of this legislation, at least for some of the years after 2019—no insurers would participate in the non-group market or insurance would be offered only with very high premiums. Some sparsely populated areas might have no non-group insurance offered because the reductions in subsidies would lead fewer people to decide to purchase insurance—and markets with few purchasers are less profitable for insurers. Insurance covering certain services would become more expensive—in some cases, extremely expensive—in some areas because the scope of the EHBs would be narrowed through waivers affecting close to half the population, CBO and JCT expect. In addition, the agencies anticipate that all insurance in the nongroup market would become very expensive for at least a short period of time for a small fraction of the population residing in areas in which states’ implementation of waivers with major changes caused market disruption.

Effects on Premiums and Out-of-Pocket Payments

The legislation would increase average premiums in the non-group market prior to 2020 and lower average premiums thereafter, relative to projections under current law, CBO and JCT estimate. To arrive at those estimates, the agencies examined how the legislation would affect the premiums charged if people purchased a benchmark plan in the non-group market.

In 2018 and 2019, under current law and under the legislation, the benchmark plan has an actuarial value of 70 percent—that is, the insurance pays about 70 percent of the total cost of covered benefits, on average. In the marketplaces, such coverage is known as a silver plan.

Under the Senate bill, average premiums for benchmark plans for single individuals would be about 20 percent higher in 2018 than under current law, mainly because the penalty for not having insurance would be eliminated, inducing fewer comparatively healthy people to sign up. Those premiums would be about 10 percent higher than under current law in 2019—less than in 2018 in part because funding provided by the bill to reduce premiums would affect pricing and because changes in the limits on how premiums can vary by age would result in a larger number of younger people paying lower premiums to purchase policies.

In 2020, average premiums for benchmark plans for single individuals would be about 30 percent lower than under current law. A combination of factors would lead to that decrease—most important, the smaller share of benefits paid for by the benchmark plans and federal funds provided to directly reduce premiums.

That share of services covered by insurance would be smaller because the benchmark plan under this legislation would have an actuarial value of 58 percent beginning in 2020. That value is slightly below the actuarial value of 60 percent for “bronze” plans currently offered in the marketplaces. Because of the ACA’s limits on out-of-pocket spending and prohibitions on annual and lifetime limits on payments for services within the EHBs, all plans must pay for most of the cost of high-cost services. To design a plan with an actuarial value of 60 percent or less and pay for those high-cost services, insurers must set high deductibles—that is, the amounts that people pay out of pocket for most types of health care services before insurance makes any contribution. Under current law for a single policyholder in 2017, the average deductible (for medical and drug expenses combined) is about $6,000 for a bronze plan and $3,600 for a silver plan. CBO and JCT expect that the benchmark plans under this legislation would have high deductibles similar to those for the bronze plans offered under current law. Premiums for a plan with an actuarial value of 58 percent are lower than they are for a plan with an actuarial value of 70 percent (the value for the reference plan under current law) largely because the insurance pays for a smaller average share of health care costs.

Although the average benchmark premium directly affects the amount of premium tax credits and is a key element in CBO’s analysis of the budgetary effects of the bill, it does not represent the effect of this legislation on the average premiums for all plans purchased. The differences in the actuarial value of plans purchased under this legislation and under current law would be greater starting in 2020—when, for example, under this bill, some people would pay more than the benchmark premium to purchase a silver plan, whereas, under current law, others would pay less than the benchmark premium to purchase a bronze plan.

Under this legislation, starting in 2020, the premium for a silver plan would typically be a relatively high percentage of income for low-income people. The deductible for a plan with an actuarial value of 58 percent would be a significantly higher percentage of income—also making such a plan unattractive, but for a different reason. As a result, despite being eligible for premium tax credits, few low-income people would purchase any plan, CBO and JCT estimate.

By 2026, average premiums for benchmark plans for single individuals in most of the country under this legislation would be about 20 percent lower than under current law, CBO and JCT estimate—a smaller decrease than in 2020 largely because federal funding to reduce premiums would have lessened. The estimates for both of those years encompass effects in different areas of the country that would be substantially higher and substantially lower than the average effect nationally, in part because of the effects of state waivers. Some small fraction of the population is not included in those estimates. CBO and JCT expect that those people would be in states using waivers in such a way that no benchmark plan would be defined. Hence, a comparison of benchmark premiums is not possible in such areas.

Some people enrolled in non-group insurance would experience substantial increases in what they would spend on health care even though benchmark premiums would decline, on average, in 2020 and later years. Because non-group insurance would pay for a smaller average share of benefits under this legislation, most people purchasing it would have higher out-of-pocket spending on health care than under current law. Out-of-pocket spending would also be affected for the people—close to half the population, CBO and JCT expect—living in states modifying the EHBs using waivers. People who used services or benefits no longer included in the EHBs would experience substantial increases in supplemental premiums or 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. As a result, for some benefits that might be removed from a state’s definition of EHBs but that might not be excluded from insurance coverage altogether, some enrollees could see large increases in out-of-pocket spending because annual or lifetime limits would be allowed.

Uncertainty Surrounding the Estimates

CBO and JCT have endeavored to develop budgetary estimates that are in the middle of the distribution of potential outcomes. Such estimates are inherently inexact because the ways in which federal agencies, states, insurers, employers, individuals, doctors, hospitals, and other affected parties would respond to the changes made by this legislation are all difficult to predict. In particular, predicting the overall effects of the myriad ways that states could implement waivers is especially difficult.

CBO and JCT’s projections under current law itself are also uncertain. For example, enrollment in the marketplaces under current law will probably be lower than was projected under the March 2016 baseline used in this analysis, which would tend to decrease the budgetary savings from this legislation. However, the average subsidy per enrollee under current law will probably be higher than was projected in March 2016, which would tend to increase the budgetary savings from this legislation. (For a related discussion, see the section on “Use of the March 2016 Baseline” on page 15.)

Despite the uncertainty, the direction of certain effects of this legislation is clear. For example, the amount of federal revenues collected and the amount of spending on Medicaid would almost surely both be lower than under current law. And the number of uninsured people under this legislation would almost surely be greater than under current law.

Intergovernmental and Private-Sector Mandates

CBO has reviewed the non-tax provisions of the legislation and determined that they would impose intergovernmental mandates as defined in the Unfunded Mandates Reform Act (UMRA) by preempting state laws. Although the pre-emptions would limit the application of state laws, they would impose no duty on states that would result in additional spending or a loss of revenues. JCT has determined that the tax provisions of the legislation contain no intergovernmental mandates.

JCT and CBO have determined that the legislation would impose private-sector mandates as defined in UMRA. On the basis of information from JCT, CBO estimates that the aggregate cost of the mandates would exceed the annual threshold established in UMRA for private-sector mandates ($156 million in 2017, adjusted annually for inflation).

Resources and Related Links

Al Franken Speaks: It’s Simple, If AHCA Passes—People Are Going to Die

Sen. Al Franken discusses how dangerous Trumpcare actually is:

 

The GOP’s AHCA, if enacted, will strip people of their protections, not so much in the language as written striking those protections directly, but through the granting of “waivers.”  Various states, specifically “red” states, want to be able apply for waivers such that they don’t have to provide healthcare plans that provide coverage for any “essential healthcare benefit” identified in the ACA that they don’t particularly like.  That means MEN in GOP-dominated legislatures who don’t think “maternity care” should be an essential benefit because MEN don’t get pregnant, can seek waivers for having to provide plans that cover maternity care.  The same might hold true for those opposing inclusion of Emergency Room care, or prescription drugs, or 1st-day expenses associated with a hospital admission (the most expensive day), or cancer screenings, etc. Similarly, waivers could be sought regarding annual or lifetime limits of coverage.  We already know that they’re seeking an amendment that would block all coverage for 3-months should someone come up short after getting fired from a job and miss a payment to their healthcare insurer.

If the AHCA passes in the Senate and goes back to the House for a vote, the House could choose to short-circuit the process and end their struggle to “repeal and replace” by merely voting to accept the Senate-passed bill and it would head to interloper in the White House’s desk for his glorious 2″ tall signature in some binder he can hold up for all to see.

One thing all of us need to understand is that enactment of the AHCA will be the first step in the race to the bottom for ALL of us (not just those on medicaid or those buying insurance via exchanges) — even those who currently have employer-based insurance will be dramatically impacted.  You see, employers already buy insurance “across state lines” because they typically have plans that insure employees in multiple states.  That means, they’ll be looking at which states sought waivers and for what type of coverage they sought waivers that will drive their cost of insuring their workforce down.  When they start buying insurance from waivered-state insurance providers, those essential health benefits you’ve become accustomed to having and using are going to start disappearing.  Your costs/cost-sharing/deductibles/etc. are all going to dig deeper into your pockets, and that’s before all those age-rated factors start kicking in, or your workplace becomes too hostile for you to tolerate any more as they lean on you more heavily attempting to get you to leave so they can hire a less expensive to insure younger employee.

Those of us who live in rural America already know how hard it is to obtain services or to even find a healthcare insurer … at any price.  Corporations have no interest in doing business in rural America where doctors are fewer, where hospitals and clinics serve smaller populations and where serious emergency cases have some seriously high transportation costs associated with getting them to the nearest trauma center.  It can only get worse for us.

Bottom-line?  People are going to lose their ability to afford insurance.  AND … people are going to needlessly die early deaths.