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ACA Repeal and Replace with American Health Care Act

Synopsis:

The repeal of the ACA will cut taxes on the wealthiest Americans as it increases the health care cost burden for poor and middle class. While some aspects of the ACA will remain in place, key elements such as mandatory penalties for not purchasing health insurance, taxes on device manufactures, health insurance companies, pharmaceutical companies and employers would all end, as would the expanded Medicare tax on wealthier Americans. Cutting new Medicaid recipients after 2020, along with less generous Medicaid support would lead to an estimated 24 million additional Americans without health insurance in 10 years and 14 million more uninsured by next year. The total savings, about $34 billion/yr is less than 1% of the current Federal budget of nearly $4 trillion/yr. Meanwhile tax credits would be extended to those more able to pay, will support is cut for those less able to pay for health care insurance.

Questions:

Do you support shifting the cost of health care from wealthier Americans onto Americans with far less resources?

  • The Republican health care bill would end Medicaid expansion in 2020.
  • Forty percent of American children depend upon Medicaid for their health care.
  • About 30% of Kentucky’s 4.4 million residents receive are from the state-federal program, most of them low-income or disabled.
  • Medicare covers the most medically vulnerable: children, elderly in nursing homes, disabled, and low income Americans.

If you do, please explain why do you believe the wealthiest Americans should have no responsibility or obligation to help the less well off in America to receive health care?

  • “The core values of the Patient Protection and Affordable Care Act (A.C.A.) are health (affordable coverage for everyone), financial security (coverage greatly reduces the risk of health-care bankruptcies) and peace of mind (families know they have coverage for high-cost health care).”
  • “The core values of the American Health Care Act (AHCA) are increasing the wealth of the wealthiest through tax cuts, leaving uninsured people to fend for themselves when they are most in need and cutting back care that most of us have been taught that our society should care for: seniors, children, the disabled, the mentally ill and those with chronic illness.”

If you don’t, will you promise to vote against the repeal effort and work to improve rather than replace the ACA?

In a Federal Budget now approaching $4 Trillion/yr, what is the problem with finding resources to cover a small deficit of $34 billion/yr in added health care insurance costs so more Americans can keep their health coverage under the ACA?

If average Americans had a problem paying for health insurance before, please explain how you think they will suddenly have the resources to pay of health insurance under the Republican plan?

  • Currently, 6.3 million people get deductible assistance.
  • AHCA will provide tax credits (subsidies) based on age rather than income. The highest tax credit will be $4000 per year, which will not cover the cost of insurance premiums.

Can you explain to older Americans how their paying more for their health care under the GOP plan is going to be beneficial and not detrimental to their living standards when they are on a fixed and often limited income?

  • Lower income and older Americans have higher premiums under the AHCA.
  • The AARP offers this example: A 60 year-old with an income of $30,000 could pay up to 25% of their income on insurance premiums.
  • Insurance companies would be allowed to raise their premium ratios for older Americans compared to younger, healthier Americans from the current 3:1 to 5:1.

Will you agree to quit using the term access in place of affordable coverage? People could care less about choices and access in health care if they can’t afford to purchase it.

Indivisible Bluegrass Team Research: ACA vs. AHCA Questions & Answers (3/16/17)

Deregulation

Synopsis:

Both Rand Paul and Andy Barr have supported the REINS ACT, sponsoring or co-sponsoring the bill.  The REINS ACT requires that every MAJOR regulation costing more than $100 million receive approval by Congress within 70 days before it can take effect.  The justification for this rule is to make government more accountable to the people instead of unelected bureaucrats and to help reduce the cost on business from a growing list of regulations. However, most regulations (with few exceptions for 8 Commissions run by political appointees and the Federal Reserve and its associated CFPB) must be shown to have a greater benefit than cost before they can be enacted. The Office of Management and Budget (OMB) has done two extensive reports on Federal regulations that shows the benefits of Federal Regulations outweigh their costs by 7 fold.  Only considering cost of regulations without considering their impact on society, environment, health and trust seems a one-sided view of the issue. Inserting Congress into a process often taking years of study, scientific and technical expertise to define, set guidelines and to assess public risks to health and the environment in areas where Congress has limited or no expertise inserts an unnecessary level of review more to hinder, rather than facilitate implementation of needed rules and regulations by government agencies. 

Questions: 

  1. Since Barr/Paul have supported and sponsored the REINS Act, could he please explain how his vote will improve the transparency of Federal regulations?
  2. Could Senator McConnell please provide his thoughts on either his support for or his disapproval of the REINS and similar acts attempt to insert greater Congressional input over Federal Regulations by the Executive Branch?
  3. How will Barr/Paul/McConnell guarantee their constituents their direct insertion into how regulations are put into effect, does not unduly increase the ability of business and lobbyist inappropriate influence over implementing needed regulations?
  4. With only a 70 day period to review EVERY Federal Rule and Regulation, could Barr/Paul/McConnell explain how Congress will judge regulations as acceptable or unacceptable when most members have a limited or no scientific or technical expertise to directly judge most of these regulations? 
  5. What assurances can Barr/Paul/McConnell make their constituents that their insertion into how regulations are implemented won’t place the public trust, public safety, public health and the environment at greater risk by hindering necessary regulations aimed at addressing these benefits to the public in a less coherent fashion?

Refugee Ban and Immigration

Synopsis:

President Trump has employed the selective use of information, the over statement of risk and the fear of terrorism to justify his refugee ban and immigration fears. Immigrants add billions of dollars to the US economy each year. There is only a net cost for the first generation of about $57 billion. The second generation of immigrant offspring generate $30.5 billion, while the third generation generates $223.8 billion for the US economy. There are not 2-3 million criminal illegal aliens in the US. Among the criminal element, illegal aliens make up only a very small percent of the total. Most of what Trump defines as criminal illegal aliens are here legally, have green cards or are in the US on legal temporary visas. As for foreign born terrorists, US immigration actions should reflect relative risk, not imagined risks. In the last 40 years, there has been a 1 in 3.6 million/yr chance of an American dying due to a foreign terrorist attack on US soil. During that same 40 year period, there were 768,000 murders. Or, 0.4% of all murders were by foreign terrorists, and no deaths were by any terrorists from any of the original seven or now six countries on the banned list.

Questions:

  1. Do you agree that fear mongering regarding terrorists from the banned countries does little to help the US image abroad and much to harm it among our allies and friends?
  2. If you agree, will you speak out against this ban by Trump?
  3. If you do not agree, please explain why based on the facts above.
  4. Will you speak out against the repeated use of exaggeration and fear to justify a wall on our southern border and excessive deportation of illegal immigrants from the US?
  5. If not, why not? What real risk do mostly law abiding even illegal immigrants pose to US security and safety if so few are committing crimes here?
  6. Please explain, who benefits either economically or in terms of security from this extreme rounding up of illegal immigrants from the US and the Gestapo like fear that it induces throughout the immigrant community?

Indivisible Bluegrass Team Research: Immigration Fact Checks