Monday, September 25, 2017

A healthcare homepage chorus screaming STOP at Senate Republicans

Last night I went to the American Medical Association website to retrieve the remarkable joint statement of the AMA, American Academy of Family Physicians, American Hospital
Association, Federation of American Hospitals, America’s Health Insurance Plans, and the
BlueCross BlueShield Association unequivocally calling on the Senate to reject Graham-Cassidy.  .

Though I had already absorbed the statement's stark assertions that the bill would "drastically weaken" individual insurance market, undermine safeguards for those with preexisting conditions, uninsure millions by kicking them off Medicaid, and force on states the "impossible task" of completely transforming their individual markets and Medicaid program in little more than a year, I was nonetheless a bit taken aback by the banner dominating the AMA home page

That led me to check out the American Hospital Association home page. And lo:

Next up, AHIP:

So there are the largest trade associations representing doctors, hospitals and insurers, not only issuing an unvarnished warning that Graham-Cassidy would be a national catastrophe, but highlighting that warning on their home pages. Well, what about nurses? The American Nurses Association is...adamant:

The National Association of Medicaid Directors home page links to its now-famous warning about Graham-Cassidy:

The statement itself, with the caveat that it represents the consensus of the NAMD Board of Directors but not the unanimous position of its 56 members, warns that "the envisioned block grant would constitute the largest intergovernmental transfer of financial risk from the federal government to the states in our country's history." Like AMA et al, NAMD warns that the scope of state-based transformation required by the bill is not doable within the time period allotted for "the vast majority of states." While stopping slightly short of absolute rejection, NAMD warns that a bill of this scope should not be voted on without due deliberation, including a full CBO score, which will not be forthcoming before the planned vote.

Another key set of stakeholders is represented by the National Association of Insurance Commissioners. The NAIC home page highlights a demand for a whole different focus:

That's in response to the HELP Committee hearings in pursuit of legislation to stabilize the existing individual market -- i.e., by funding CSR payments and reinsurance programs -- that HELP Committee chair Lamar Alexander put on ice last week to pursue Graham-Cassidy passage.

Home pages are just the top line, of course. At HuffPost, Jeff Young has a digest of the panoply of doctors' hospitals' insurers' groups that have issued statements against the bill.

Incapable of governing and destructive of past governing norms and standards as the Trump-era Republican party has proven itself, U.S. society has also shown on multiple fronts that it has strong antibodies. Dysfunctional though the U.S. healthcare system may be in many ways, it is no exaggeration to say that the entire system is blinking red in wholly rational fashion at Congressional Republicans. The opposition transcends partisanship, unites industry adversaries, and even extends across party lines among political appointees administering Medicaid and insurance. To defy industry consensus will require a massive dose of either hubris or cravenness to donors, or some odd combination of the two.

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