Keep up the pressure

Local media is covering the impact of the Senate Bill. Here in North Carolina is an extraordinarily detailed and humane look at the care that medically frail kids needs. It is a lot.

Among those who could be deprived of medical services are nearly 2,400 “medically fragile” children in North Carolina whose ventilators, oxygen tanks, feeding tubes, catheters and round-the-clock nurses are covered by a little-known Medicaid program available to middle-class families with private health insurance.

The program pays for services that private insurance doesn’t cover, allowing parents to work and the children to attend school….
Caring for one seriously ill child in the program costs an average of $80,000 a year in North Carolina, compared with $4,700 for a typical Medicaid beneficiary in the state. That could make the program an easy target for cost reductions, parents fear, because the amount of money required to treat one “medically fragile” child can be used to provide health care for 17 kids on Medicaid.

“Our kids aren’t cheap,” said Jenny Hobbs, a Pfafftown mom near Winston-Salem who works as an HR manager. Three of her four children are “medically fragile.”

Madison, 7, Meredith, 12, and Michael, 14, all have mitochondrial disease, a progressive disorder that can cause muscle weakness and pain, seizures, vision loss and hearing loss, learning disabilities and organ failure, among other complications. The condition has no cure. Last year, Madison was also diagnosed with melanoma. All three use feeding tubes for medications and supplemental feedings. Meredith and Michael need ventilators to help them breathe, while Madison requires an oxygen tank. All three have their own designated private duty nurse who accompanies them to school and cares for them overnight.

A block grant program creates a very strong incentive for states to minimize the amount of money that they spend on the highest cost cases. That means providing minimal or inadequate care to the kids who need the most help.

The local press is doing a good job of highlighting locally relevant stories.

Use these stories when you call your Senator this week.

What’s next

First thing, tonight, enjoy it.

If you like to partake in a recreational, legal intoxicant, enjoy one in moderation.

And then tomorrow get back on the phone and get back to pressuring the Senate.

The current Republican plan is to see what Senate Majority Leader can do to make the bill worse while giving non-Tea Party Republican hold-outs visible media wins with carve out cash and plus-ups for visible priorities. The plan is for him to release $20 billion dollars to opioid treatment so Senators Moore and Portman can claim a victory. He’ll authorize a plus-up for Medicaid reimbursement for Alaska and Montana and Idaho for $5 billion dollars. It will be the saddest show of an old man making it rain to buy attention for himself.

And then they’ll try to jam the bill through once they get back from the 4th of July recess.

So keep on calling tomorrow.

Call the Senate

Continue to call the Senate:

The ask is simple — no bill that leads to coverage losses.

Call the Senate & pessimism index update

Call the Senate.

Right now, it looks like the Senate’s plan is to make a few minor tweaks to the AHCA, and then dare half a dozen Repbulicans to vote no. It would be a rapid turn-around with votes in under a month from today.

Call the Senate. If you live in West Virginia, Alaska, and Nevada, call it twice.

Right now, my pessimism index has gone back to 80%. After the AHCA was introduced in March, I thought the chance of a bad healthcare bill passing and getting signed into law had dropped to about 65%. I was at 97% on November 9th.

So let’s call the Senate. And then start working on calling the House as they’ll have to revote on anything that the Senate passes or a conference report.

Time to call the Senate

We know the AHCA is horrendous policy.

We know the AHCA is extraordinarily unpopular.  We know that it is unpopular even among Republican voters.  We know that the Senate is far thinner margins than the House and we almost won there.  So the goal this week is to let your Senators know that this is a very bad bill with very real consequences for their constituents.

Medicaid in the President’s budget request

The Department of Health and Human Services accidentally leaked their own budget this evening. Bob Herman at Axios saved a copy. The biggest aspect of the budget is it laid out another $600 billion dollars in cuts to Medicaid and CHIP over ten years in addition to the $820 billion in Medicaid cuts in the AHCA.

Between these two documents Medicaid would lose 47% of its federal funding over a decade.

Loren Adler at Brookings thinks the cuts would be to tie the AHCA block grants to no more than inflation rate growth without regard to population or case mixture. As the Baby Boomers retire, more of them will require nursing home care that is currently paid for by Medicaid but there would be no federal money.

This is a budget wishlist that pits old people versus kids, the disabled against the pregnant and state budgets against upper income tax cuts in the federal budget.

Call Congress and give them an earful.

Some good news on voting rights

Some good voting rights news from Alabama:

“Many” Alabama felons will soon regain the right to vote if Gov. Kay Ivey signs a bill that landed on her desk Thursday morning, according to advocates.

The bill, called the Definition of Moral Turpitude Act, passed both houses of the state legislature Wednesday, a victory for backers who have sought for years to see it codified into law.

If Ivey signs it, the bill would more clearly define the term “moral turpitude” as it is used in the state constitution, which stipulates that “no person convicted of a felony of moral turpitude” may vote….

the term would refer to less than 50 specific “felonies that involve moral turpitude which disqualify a person from exercising his or her right to vote,” the legislation states.

By redefining “moral turpitude,” the bill would effectively restore “thousands” of felons’ right to vote.

The governor has indicated she will sign the bill this week.

Open thread