2020 will be The Health Care Election

In 2018 health care was the critical issue that allowed the Democrats to win the House.
If reality matters, then health care will be a much bigger issue in 2020 for multiple reasons. All but one of those reasons was caused/created by the GOP.

Let's start with what could be the biggest item of all - the court challenge to Obamacare.
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President Donald Trump told reporters Tuesday that the Republican Party "will soon be known as the party of health care – you watch."

In a letter filed Monday with the Fifth Circuit U.S. Court of Appeals, Justice Department attorneys said that a lower court’s ruling that the Affordable Care Act is unconstitutional should be affirmed and that the United States “is not urging that any portion of the district court’s judgment to be reversed.”

Last December, U.S. District Court Judge Reed O’Connor in the Northern District of Texas agreed with the GOP-led states' argument that the health law was unconstitutional.
The judge ruled that the requirement that people buy insurance or pay a penalty was no longer constitutional because Congress repealed the "individual mandate" when it passed the 2017 tax bill. O'Connor ruled that because that provision was so pivotal to the health law, the whole thing had to be tossed out.
...Without the health law, the Urban Institute estimates that 15.4 million low-income families and children would lose Medicaid and Children's Health Insurance Program coverage. Another 6.9 million Americans who buy ACA marketplace insurance also would lose health coverage, but some would get insured by an employer-sponsored plan, according to the Urban Institute.

If Trump wins this court case before the 2020 election, and I believe that he will, this will become the biggest shock to our health care system in memory.
Trump is right. The Republican Party "will soon be known as the party of health care", but not in the way he means.
You see, it isn't just the GOP assault on Obamacare (which I will get to in a minute). It's a systemwide, full-frontal Republican attack on all public health insurance for poor people.
A great example is this headline out of Tennessee the other day.
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Harrison is one of at least 128,000 children who, over a two-year span, were purged from TennCare or CoverKids, two Tennessee government health insurance programs for low-income families. It appears tens of thousands of these children have not acquired private insurance, so they likely joined the swelling ranks of the uninsured residents of Tennessee, already one of the unhealthiest states in the nation.
Programs dropped these children because they are no longer qualified or because their families did not respond to mandatory renewal forms that were mailed over the past three years. TennCare officials confirmed "many members" were disenrolled because they did not respond to renewal forms, but couldn't estimate how many were cut purely because of lack of paperwork.

Tennessee is hardly the only Republican state looking to drop coverage for poor people.
The primary method being used to prevent people from getting health care is Medicaid work requirements.

McGonigal — who had limited access to a computer and has trouble using them — didn’t realize he would have to report his hours every month, so when he went to pick up his prescription in October, he was told his medication would cost $800.

He hadn’t fulfilled the work requirement order, so he lost his insurance. Because he couldn't afford his medicine, his health worsened, he missed several days of work due to illness and Southwest Poultry fired him.

That anecdote leads the 35-page opinion that struck down Arkansas’ work requirements law last week, stymieing the legislation that had caused 18,000 Arkansans to lose health insurance over the past several months. About 2,000 were able to re-enroll after losing their coverage.

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All of this adds up to millions of people having lost health insurance since 2016.
How many millions? It depends on the survey.
The January 2019 Gallup National Health and Well-Being Index reported "a net increase of about seven million adults without health insurance."
The Centers for Disease Control and Prevention said the number of uninsured rose 1.3 million.
So no matter how you cut it the numbers are going in the wrong way, and are likely to accelerate.

Which brings us to Obamacare.
Obviously the Democratic establishment wants to believe that saving Obamacare is the winning political strategy. Just as obviously, that is not true.
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Forty-eight percent of respondents said the ACA had not impacted their monthly insurance premium costs, while 46 percent said their premiums were worse compared to before the law. Just 14 percent of respondents said they were better off.

When asked about the health care reform's effect on co-pay fees, 41 percent said they were worse off, and 35 percent said they were not impacted. Only 13 percent said the ACA improved those costs.

Forty-one percent said their access to medical service providers is the same as it was before the ACA, while 16 percent said it is better. Thirty-four percent said things are worse in terms of access.

The juicy bits of this poll are when you dig down in it.
It turns out that Democratic voters aren't in love with Obamacare either. It's not a partisan thing.

Twenty percent of Democrats said their premium costs have gotten worse under the health care law, with 36 percent saying they were the same. A minority, 32 percent, said they had seen an improvement. Twelve percent were unsure.

Similarly for co-pays, 16 percent said they had gotten worse under the Affordable Care Act, with 39 percent saying they were the same. Thirty-five percent said their situation with medical co-pays for visits had gotten better. Ten percent were unsure.

If Republicans hate Obamacare, and Democratic voters are generally indifferent to the ACA, then Thank Gawd for Bernie's Medicare For All, because otherwise this would be a missed opportunity.

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than when the U.S. healthcare system is brought up. It's simply indefensible, and the ACA with its roots in the fucking Heritage Foundation is a pile of steaming dung that had some glitter thrown on it.

@gjohnsit thank you for this post.

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The Liberal Moonbat's picture

@Le Frog ...it was actually a HUGE, and uncannily timely, help to my family and I. I'm aware I'm the exception to the rule that way (story of my life, after all).

I've been in regular psychotherapy since I was 6 years old, give or take. Shrink visits are just a normal part of my life - but shortly before HeriRomneBamaCare (gee, sounds like some kind of Hare Krishna chant) was passed, the insurance companies had decided that I'd reached a LIFETIME CAP on shrink visit coverage; I'd get no more from them, EVER AGAIN.

Just in the nick of time, however, the ACA stepped in and told the insurance companies "NOPE! Can't do that! Only patients get to decide when they've gotten what they need!"

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In the Land of the Blind, the one-eyed man is declared insane when he speaks of colors.

@The Liberal Moonbat

It will never sit right with me that right-wing dominance of the healthcare coverage conversation has shifted so far as to make Medicare for all be radical, unpalatable and simply incomprehensible.

If it's too unmanageable at the federal level, then the states can manage their own system (that's what we do here. In Ontario, our healthcare coverage is called OHIP). There are lots of models out there, that have been studied, but the American way seems to be that the only feasible system is one that handsomely enriches someone.

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The Liberal Moonbat's picture

@Le Frog Does that ever cause confusion with a certain pancake chain, or is it called something different up there?

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In the Land of the Blind, the one-eyed man is declared insane when he speaks of colors.

snoopydawg's picture

single payer or MFA wouldn't you? Surprise!?! Not so much. Why? Here's one reason:

I’m not a supporter of the DCCC, but this divisive diary neglects to the facts about whether MFA is popular or not. It is popular, but when people are told it means the end of private health insurance, it goes way down. Many people don’t want to change their insurance.

I personally favor fixing the ACA, expanding Medicaid in those resistant red states, creating a public option like a Medicare buy-in, and wean Wall Street off of health insurance over time.

The author is talking about how democrats are trying to disrupt the march for something better than the ACA. Nancy's top dawg that works on health insurance is doing all he can to keep single payer from happening. Remember when people once wanted that and elected someone who said that he's going to get it for us? And how disappointed they were when democrats created the turd called the affordable care act? Remember people hanging on Wendall Potter's every word? I sure do. BTW. The current MFA plan stinks. It's not really universal health care, it's universal health coverage. Or universal health insurance access.

Don't think it is as popular with voters, esp. voters in purple states, as diarist assumes. Tens of millions have fine employer- provided health plans for them and their families they do NOT want to replace with this ( or any other plan - don't fix what ain't broke). What is the cost to taxpayers will be a huge issue for most voters, and if the cost is easily susceptible to demogaguery by opponents, we'll lose even more seats over this than we did over Obamacare in 2010.
Pelosi is being prudent. Count me with Nancy.

Yeah Mrs. 'Impeachment is off the table' Pelosi doesn't want single payer or even MFA which is nowhere close to it. The true example of single payer is Medicaid. Not Medicare that has yuge holes in coverage and doesn't pay for everything. Let's just stick with the plan that keeps costing people everything they have through medical bankruptcy. Let's keep adding to the homeless population because this country can't offer what every sane country does. And keeping millions from getting medical treatment that costs hundreds of thousands of to die every year. Much better...

Hey. Remember when the Koch brothers did a study on MFA that Bernie first offered up?

“Medicare for All” Would Cut Health Care Spending, Koch-Backed Think Tank Reports

Blahous’s paper, titled “The Costs of a National Single-Payer Healthcare System,” estimates total national health expenditures. Even though his cost-saving estimates are more conservative than others, he acknowledges that Sanders’s “Medicare for All” plan would yield a $482 billion reduction in health care spending, and over $1.5 trillion in administrative savings, for a total of $2 trillion less in overall health care expenditures between 2022 and 2031, compared to current spending.

The link goes to DK, but whoboy is it worth reading. I have extra gear if anyone wants to use it.

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“When police break the Law then there is no Law - just a fight for survival.” - Billy Jack

gulfgal98's picture

@snoopydawg

The current MFA plan stinks. It's not really universal health care, it's universal health coverage. Or universal health insurance access.

Health insurance is NOT health care. This is something most Americans do not understand. We have been conditioned to believe that we must have private health insurance in order to have health care. The private health insurance companies are simply a middle man who skims profits off the top and then regulates the amount of health care we are allowed to have.

This is not a right to health care. Every American should have the right to health care, not health insurance.

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"I don't want to run the empire, I want to bring it down!" ~ Dr. Cornel West

“Those who make peaceful revolution impossible will make violent revolution inevitable." ~ President John F. Kennedy

@gulfgal98

with this bull shit. My biggest fear is that the Democrats will screw up Medicare in the process of protecting their insurance companies.

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"Religion is what keeps the poor from murdering the rich."--Napoleon

@gulfgal98 all I could think was, "why are we still talking about insurance?"

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dfarrah

Pluto's Republic's picture

...as far as I'm concerned. After the Primaries, neither Party really wanted to debate issues of vital interest to the American people. The Republicans were not in touch with what those interests were, or had little constructive to say about them. Bernie Sanders kept them in constant focus, but the Democratic Party actively engaged in suppressing progressive ideas or ridiculing them as impossible dreams. Hillary, meanwhile, was intent on helping women and children and something, something rights. Also minorities.

When the election was down to Hillary Clinton and Donald Trump, there were no substantial discussions of the issues. There were word salads and bitter sparing, and stories of the victims of social injustice. But neither candidate really wanted to talk about health care, since Hillary ran against national health care in the Primaries and Trump had promised to make health care great again, but he had no plan at all. They couldn't talk about free trade agreements, or the expanding wars, or the out-of-control deregulated financial sector — because they were both on the same side of those issues. Discussing the impoverished middle class was, thus, inconceivable.

2020 will be The Health Care Election

Well, it should be. However, I've been visiting a few Democratic Party websites lately to look around, and these people seem to be gearing up to run against Donald Trump, again. That's their platform. To campaign against Trump's evil ways and to unite Party Members with a pledge to vote for the Democratic nominee, even if they don't like him or her. (The Democratic Party is dividing like a cell.)

They don't seem to agree on what to run for. In any event, with whom are they going to talk about health care? Each other? The Democrats will pitch health care to the People? Because the Republicans have pledged to not say another word about health care until after the 2020 election.

I think everybody could be in for a big surprise. This disconnect between the People and the Parties could make Brexit look like pre-school. And that is just one issue the political establishment doesn't want to talk about. By 2020, one-third of all student loans will be in default and the People's economic security will be shattered. Who knows? They may just want to talk about the fucking wars they can't afford. The People just had a big dose of the lying media and the mendacious intelligence agencies — and they are starting see the big picture.

Just sayin'

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I do not know if the people of the United States would vote for Enlightened Men — if they ran for public office — but there can be no doubt that such men do not run.
— Alexis de Tocqueville, Democracy in America

@Pluto's Republic

Democrat on the ballot for Pres is to vote for Trump for President and straight Dem below. Ensuring gridlock with a split government is the only way I can think of to try to stop them from further destroying us and the planet.

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"Religion is what keeps the poor from murdering the rich."--Napoleon

@dkmich If only it could be used as a defined threat. Dems respond to threats by wetting themselves. Otherwise it ends up everybody who voted for Trump is a racist.

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Wally's picture

@dkmich

. . . only coz I think D-Day and the Shootout in the OK Corral happen come High Noon Super Tuesday, March 3, 2020.

If Bernie doesn't pull it off then, I'm going to concentrate on enjoying my life quite hedonistically and selfishly, thank you.

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Unabashed Liberal's picture

@Pluto's Republic @Pluto's Republic

playbook for 2020 is slightly different, though.

You mention,

Because the Republicans have pledged to not say another word about health care until after the 2020 election.

My impression or understanding is that, no, they have no intention of presenting their own health care legislation. But, that's because they intend to attack MFA--and so-called socialism, in general. IOW, I've gotten the impression that they will have a lot to say about the MFA proposals. (Just not present their own solution(s).)

If DT had any message discipline--which he clearly doesn't--and, he/they were to point out the fact that Sanders' and Jayapal's MFA Bills will 'dismantle' the current (1965) Traditional/Original Medicare program, my guess is that Repubs might do what they did in 2008--garner the majority of the senior vote. After all, the evidence is in the legislation, itself. But, again, DT is so off-the-charts squirrelly and ignorant, he'll likely nullify the Republican lawmakers' messaging due to his constant drama queen antics.

Ran across a Kaiser Tweet yesterday--Dems are now going after Medigap, which I'll be posting about soon. Again, targeting seniors. Been following Kaiser Health folks for their expertise, and, because many of them are dog lovers--so, sorta hate to challenge their policy people, but, soon, may have no choice. The latest proposal would make Medigap premiums skyrocket--pricing it out of the reach of the majority of regular (senior) beneficiaries, I would think.

Have a good one!

[Edited: Deleted a signature line.]

Mollie

I think dogs are the most amazing creatures; they give unconditional love. For me they are the role model for being alive.
~~Gilda Radner, Comedienne

Dem Budget Committee Chair Yarmuth, December 13, 2018, "Newsmakers" -
"Ultimately, we are going to have to 'deal with' programs like Medicare, and Medicaid, and Social Security, and, ah, it's one of those things that's going to have to be done on a bipartisan basis, because "nobody wants to walk the plank on those."

Bad

Beware! Yarmuth wants to strike a so-called "Grand Bargain" with Republicans. See C-Span video, above.

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Everyone thinks they have the best dog, and none of them are wrong.

I was 32 in 1992 and there was this guy, James Carville, who came to fame helping Harris Wofford in PA run on a health care platform thing, and then Carville went to work for Clinton, B.

2008-2010 I was glued to dkos & clicking on all the stupid links to send letters to fucking lying scum like Baucus and Lieberman, imploring & begging them to NOT be fucking lying scum, all of which was written in code switch happy happy speak.

When the incumbents with over 4 or 6 years experience start bleating about health care, I will believe Very Very few of the lying assholes.

rmm.

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But then I sigh; and, with a piece of scripture,
Tell them that God bids us do good for evil:
And thus I clothe my naked villany
With old odd ends stolen out of holy writ;

orlbucfan's picture

@seabos84

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Inner and Outer Space: the Final Frontiers.

lotlizard's picture

@seabos84

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Jen's picture

I am one of those uninsured Tennesseans. I fear that if something doesn't change really quick, I will not live to see 50 (I'm almost 45 now).

I lost my insurance in May 2016. I don't know why. I'll assume because of the forms that were mentioned that renews insurance. I probably didn't get those forms because I've had to move so many times.

I used to get SSI when my kids were still minors, but now that they're grown I don't get anything at all. When they stopped my SSI about 6-7 years ago, I asked about my health insurance and they told me I would ALWAYS have mediCARE.

I had medicare because I am deaf and I received a cochlear implant in 2004. Medicare paid for everything - the surgery, the implant, the audiologist appointments. Let me just state that if I had known that one day I would be without insurance, I would NEVER have let them put this bullshit in my head.

The first implant failed (broke, suffered from planned obsolescence, stopped working) in 2013 right before the 10-year warranty ended. I still had insurance and after long consideration I decided to let them replace the broken implant with a "new and improved" implant. I honestly don't know if medicare or advanced bionics paid for the second surgery, the second implant was free because of the warranty on the first, medicare paid for the audiologist appointments again.

Now there is something wrong with the second implant. I tried to make an appointment with the same audiologist that has been my audiologist since I got the first implant and they told me I would need a referral. Thankfully I fixed that by contacting advanced bionics and complaining. But I would still have to pay for that audiologist appointment and I haven't even checked how much that will cost.

And then I have to ask myself if it's worth it. I have needed to see a doctor for my heart for at least 2 years. My sister is 7 years older than I am and she needs a heart transplant. She has had a pacemaker for about 7 years. Some days I wonder if I'll see the next day. I know something is wrong, but even if I paid to see a doctor to find out what is wrong, I could never afford heart medication, much less a pacemaker or heart transplant.

And I don't even know how to try to get my medicare back. I don't even know where to start. It's not like I can pick up the phone and make some calls and even if I could, who would I call? And all this irritates me so much and makes my blood pressure rise which makes the situation even worse.

Oh, and the implant, it makes noise - like an electronic bird or like a creaking door - it's so very annoying. The sound processor stopped working last year - I don't know if it's the cord or something else. The cord costs $125 and I don't want to buy a cord if the implant inside my head is dead or dying. So advanced bionics agreed to have an agent present at my audiologist appointment (if I ever make one) to find out if a new cord will fix the sound processor problem.

Sorry for rambling. I hope I made some sense. I've always said I don't want to die in Tennessee.

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Is it great yet?

@Jen

You deserve better.

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ggersh's picture

@Jen It's quite the travesty what the politicians
and oligarchs have done to this country and
everyday people like you.

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Buy a Bible don't read it and you'll be a Catholic
Buy a Bible read only what suits you and you'll be an Evangelical
Buy a Bible read it fully, analyze it, reason it and you will be
an Atheist

Pluto's Republic's picture

@Jen

They can straighten out the Medicare or tell you what happened to it. And you can tell them what is happening to you.

Best wishes.

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I do not know if the people of the United States would vote for Enlightened Men — if they ran for public office — but there can be no doubt that such men do not run.
— Alexis de Tocqueville, Democracy in America
Jen's picture

@Pluto's Republic The SS office was the first place I tried since they were the ones that told me I'd "always" have insurance. They just looked at me like I was crazy and told me they couldn't help me. I could not even find out from them where to go that would help me.

Thank you for all the comments.

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Is it great yet?

Azazello's picture

The Red Team says get rid of the ACA. The Blue Team says we must fight to keep it, hoping that they can rally the troops behind Pelosi and RomneyCare. The real battle is within the Democratic Party: Jayapal Confronts Top Pelosi Aide for 'Inappropriate' Effort to Undermine Medicare for All

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It didn't have to be this way.

There are 2 groups of people, people who see all the things they cannot afford because they have to pay ACA premiums (things like a home, a retirement fund, blood pressure pills, a brake job...) and people who benefit from the ACA.
The first group is huge, and they vote.
The second is nowhere near as large, and they vote less often.

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A PROUD Hillary hater since 1993

@doh1304 They took from those over the poverty line, from the near poor to the upper middle class and gave it to the poor. Those people now have high deductible, high priced junk insurance with high co pays while the upper class skate, and the poor (Some,at least) have something. Thank the democrats and their willingness to compromise with our healthcare and make sure everyone under a certain income has shitty insurance.

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Anja Geitz's picture

There is some really good information. I definitely agree that the primary issue in this country should be the healthcare system. Having seen it up close and personal when my Sister went through cancer treatment last year, the commodification of healthcare is, if you'll pardon the pun, sickening. Doctors pushing treatments and drugs that may harm patients because the pharmaceutical companies have such an influence in the market is truly a grotesque manifestation of capitalism.

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There is always Music amongst the trees in the Garden, but our hearts must be very quiet to hear it. ~ Minnie Aumonier

I wrote this yesterday and put it in draft.

In the wee hours of the morning, trying to escape my very bad thoughts, I switched to C-SPAN seeking diversion. There was a panel made up of former HHS Secretaries and John Kasich. Kathleen Sibelius stated that Obama wanted to include in the ACA, the repeal of Medicare Part D that forbid the Administrator from negotiating lower drug prices, but Democrats refused to vote for it. The way she said it seemed like she found that astounding.

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It's simply too painful to acknowledge, even to ourselves that we've been taken. Once you give a charlatan power over you, you almost never get it back. Carl Sagan