Frustrated by Congress, Trump signs order to weaken Obamacare

Agencies
October 13, 2017

Washington, Oct 13: President Donald Trump on Thursday signed an order to make it easier for Americans to buy bare-bones health insurance plans, using his presidential powers to undermine Obamacare after fellow Republicans in Congress failed to repeal the 2010 law.

Trump issued the executive order aimed at letting small businesses band together across state lines to buy cheaper, less regulated health plans for their employees with fewer benefits. Such new insurance options, however, may not be available until 2019, and the order could face legal challenges from Democratic state attorneys general. It was Trump’s most concrete step to undo Obamacare since he took office in January promising to dismantle Democratic former President Barack Obama’s signature domestic policy achievement.

Senate Democratic leader Chuck Schumer accused Trump of “using a wrecking ball to single-handedly rip apart our healthcare system.”

Later on Thursday, Politico reported that Trump plans to cut off subsidy payments to insurers selling Obamacare coverage, citing two people familiar with the matter. Trump has repeatedly threatened to stop the payments, which are made directly to insurance companies to help cover out-of-pocket medical expenses for low-income Americans enrolled in individual healthcare plans under Obamacare.

The payments are estimated at $7 billion in 2017. If Trump does eliminate the subsidy payments, premiums for many customers on the Obamacare individual insurance markets would be 20 percent higher in 2018, the nonpartisan Congressional Budget Office has said.

The White House did not immediately respond to a Reuters request for comment. Republicans call Obamacare, which extended health insurance to 20 million people, a government intrusion into Americans’ healthcare, and have been promising for seven years to scrap it. Trump’s order aims to give people more access to cheaper plans, which do not cover essential health benefits such as maternity and newborn care, prescription drugs, and mental health and addiction treatment. Obamacare, known formally as the Affordable Care Act, requires most small business and individual health plans to cover those benefits.

“DESTROYING EVERYTHING”

“The cost of the Obamacare has been so outrageous, it is absolutely destroying everything in its wake,” Trump said at a White House signing ceremony.

Trump’s order was aimed at making it easier for small businesses to join together as associations across state lines.

Unlike large employers that can create their own health plans because their work forces are big enough to spread risk – mitigating the effect of individuals with serious illnesses – small employers have few options to offer reasonably priced health coverage. Allowing small employers to band together in associations is meant to give them options similar to larger companies. The White House also said the associations would give employers more leverage to negotiate with insurance companies in purchasing health insurance plans for employees.

Some of the business groups that the order is aimed at, including franchise organizations and retailers – which generally have a large number of hourly employees – said they are interested and want to be part of the rule-making process at the Department of Labor, but cautioned that there are many details to tackle.

“It’s not something we’ll be able to open a suitcase tomorrow and be in business with. There are a lot of issues to be worked out and to consider,” said Neil Trautwein, vice president of health care policy at the National Retail Federation.

A spokesman for the National Federation of Independent Business, the largest small-business association in the country, said it would be watching to see “how the regulatory architecture develops” and make a determination in the future.

Small businesses have been among the biggest critics of Obamacare.

The order also sought to change an Obama-era limit on the time span that people can use short-term health insurance plans, which are cheaper but cover few medical benefits. Those plans are currently limited to three months.

Joseph Antos, a healthcare expert at the conservative American Enterprise Institute think tank, said he did not believe the order would have much of an impact because employers from regions with lower healthcare costs, like Iowa, would not want to join up with those from regions with higher costs.

Experts also questioned whether Trump has the legal authority to expand association health plans.

Democratic state attorneys general have said they will sue if Trump tries to destroy Obamacare. California Attorney General Xavier Becerra said Trump’s executive order is just another step toward imploding the Affordable Care Act.

“It should come as no surprise that California is prepared to fight in court to protect affordable healthcare for its people,” Becerra said.

The association health plans could attract young, healthy people and leave a sicker, more expensive patient pool in the individual insurance markets created under Obamacare, driving up premiums. The American Hospital Association said Trump’s order “could destabilize the individual and small group markets, leaving millions of Americans who need comprehensive coverage to manage chronic and other pre-existing conditions, as well as protection against unforeseen illness and injury, without affordable options.”

Small health insurers and state insurance regulators also criticized Trump’s move. Hospital stocks edged lower in Thursday trading, with HCA Healthcare Inc down 1.7 percent and Tenet Healthcare Corp down 4.4 percent. Medicaid insurers also fell with Centene Corp off 2.5 percent.

Trump has taken a number of other steps to weaken or undermine Obamacare. He has not committed to making billions of dollars of payments to insurers guaranteed under Obamacare, prompting many to exit the individual market or hike premiums for 2018. The administration also halved the open enrollment period, which begins Nov. 1, slashed the Obamacare advertising and outreach budget, and allowed broad religious and moral exemptions to the law’s mandate that employers provide coverage for women’s birth control.

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News Network
April 16,2020

Islamabad, Apr 16: The number of coronavirus cases in Pakistan topped 6000 while the death toll due to the virus has reached 117, Dawn reported citing official data on Wednesday.

Over 1,446 people have recovered in the country from the deadly virus that has killed over 1.3 lakh people worldwide.

The total number of cases in the country has reached 6297 with Punjab being the worst affected province with 3,016 cases. Meanwhile, Sindh has 1,688 cases of the deadly virus.

Khyber Pakhtunkhwa has reported 47 new cases of the coronavirus, taking the provincial total to 912. Most of the new cases are of Tableeghi Jamaat members who have travel history.

Balochistan has reported four new cases of COVID-19, taking the provincial total to 281 according to provincial government spokesperson Liaquat Shahwani.

On Tuesday, Prime Minister Imran Khan had announced the extension of the nationwide lockdown with relaxation to some sectors.

Addressing the media in Islamabad on Tuesday, Khan said, "We made the hard decision of imposing lockdown in the country which was very well implemented due to cooperation of the people."

The countrywide lockdown was imposed last month in a bid to stem the spread of coronavirus. Later, a two-week extension was announced in the restrictions until April 14.

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News Network
February 26,2020

Feb 26: China’s massive travel restrictions, house-to-house checks, huge isolation wards and lockdowns of entire cities bought the world valuable time to prepare for the global spread of the new virus.

But with troubling outbreaks now emerging in Italy, South Korea and Iran, and U.S. health officials warning Tuesday it’s inevitable it will spread more widely in America, the question is: Did the world use that time wisely and is it ready for a potential pandemic?

“It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen — and how many people in this country will have severe illness,” said Dr. Nancy Messonnier of the U.S. Centers for Disease Control and Prevention.

Some countries are putting price caps on face masks to combat price gouging, while others are using loudspeakers on trucks to keep residents informed. In the United States and many other nations, public health officials are turning to guidelines written for pandemic flu and discussing the possibility of school closures, telecommuting and canceling events.

Countries could be doing even more: training hundreds of workers to trace the virus’ spread from person to person and planning to commandeer entire hospital wards or even entire hospitals, said Dr. Bruce Aylward, the World Health Organization’s envoy to China, briefing reporters Tuesday about lessons learned by the recently returned team of international scientists he led.

“Time is everything in this disease,” Aylward said. “Days make a difference with a disease like this.”

The U.S. National Institutes of Health’s infectious disease chief, Dr. Anthony Fauci, said the world is “teetering very, very close” to a pandemic. He credits China’s response for giving other nations some breathing room.

China locked down tens of millions of its citizens and other nations imposed travel restrictions, reducing the number of people who needed health checks or quarantines outside the Asian country.

It “gave us time to really brush off our pandemic preparedness plans and get ready for the kinds of things we have to do,” Fauci said. “And we’ve actually been quite successful because the travel-related cases, we’ve been able to identify, to isolate” and to track down those they came in contact with.

With no vaccine or medicine available yet, preparations are focused on what’s called “social distancing” — limiting opportunities for people to gather and spread the virus.

That played out in Italy this week. With cases climbing, authorities cut short the popular Venice Carnival and closed down Milan’s La Scala opera house. In Japan, Prime Minister Shinzo Abe called on companies to allow employees to work from home, while the Tokyo Marathon has been restricted to elite runners and other public events have been canceled.

Is the rest of the world ready?

In Africa, three-quarters of countries have a flu pandemic plan, but most are outdated, according to authors of a modeling study published last week in The Lancet medical journal. The slightly better news is that the African nations most connected to China by air travel — Egypt, Algeria and South Africa — also have the most prepared health systems on the continent.

Elsewhere, Thailand said it would establish special clinics to examine people with flu-like symptoms to detect infections early. Sri Lanka and Laos imposed price ceilings for face masks, while India restricted the export of personal protective equipment.

India’s health ministry has been framing step-by-step instructions to deal with sustained transmissions that will be circulated to the 250,000 village councils that are the most basic unit of the country’s sprawling administration.

Vietnam is using music videos on social media to reach the public. In Malaysia, loudspeakers on trucks blare information through the streets.

In Europe, portable pods set up at United Kingdom hospitals will be used to assess people suspected of infection while keeping them apart from others. France developed a quick test for the virus and has shared it with poorer nations. German authorities are stressing “sneezing etiquette” and Russia is screening people at airports, railway stations and those riding public transportation.

In the U.S., hospitals and emergency workers for years have practiced for a possible deadly, fast-spreading flu. Those drills helped the first hospitals to treat U.S. patients suffering from COVID-19, the disease caused by the virus.

Other hospitals are paying attention. The CDC has been talking to the American Hospital Association, which in turn communicates coronavirus news daily to its nearly 5,000 member hospitals. Hospitals are reviewing infection control measures, considering using telemedicine to keep potentially infectious patients from making unnecessary trips to the hospital and conserving dwindling supplies of masks and gloves.

What’s more, the CDC has held 17 different calls reaching more than 11,000 companies and organizations, including stadiums, universities, faith leaders, retailers and large corporations. U.S. health authorities are talking to city, county and state health departments about being ready to cancel mass gathering events, close schools and take other steps.

The CDC’s Messonnier said Tuesday she had contacted her children’s school district to ask about plans for using internet-based education should schools need to close temporarily, as some did in 2009 during an outbreak of H1N1 flu. She encouraged American parents to do the same, and to ask their employers whether they’ll be able to work from home.

“We want to make sure the American public is prepared,” Messonnier said.

How prepared are U.S. hospitals?

“It depends on caseload and location. I would suspect most hospitals are prepared to handle one to two cases, but if there is ongoing local transmission with many cases, most are likely not prepared just yet for a surge of patients and the ‘worried well,’” Dr. Jennifer Lighter, a pediatric infectious diseases specialist at NYU Langone in New York, said in an email.

In the U.S., a vaccine candidate is inching closer to first-step safety studies in people, as Moderna Inc. has delivered test doses to Fauci’s NIH institute. Some other companies say they have candidates that could begin testing in a few months. Still, even if those first safety studies show no red flags, specialists believe it would take at least a year to have something ready for widespread use. That’s longer than it took in 2009, during the H1N1 flu pandemic — because that time around, scientists only had to adjust regular flu vaccines, not start from scratch.

The head of the World Health Organization, Tedros Adhanom Ghebreyesus, said the U.N. health agency’s team in China found the fatality rate between 2% and 4% in the hard-hit city of Wuhan, the virus’ epicenter, and 0.7% elsewhere.

The world is “simply not ready,” said the WHO’s Aylward. “It can get ready very fast, but the big shift has to be in the mindset.”

Aylward advised other countries to do “really practical things” now to get ready.

Among them: Do you have hundreds of workers lined up and trained to trace the contacts of infected patients, or will you be training them after a cluster pops up?

Can you take over entire hospital wards, or even entire hospitals, to isolate patients?

Are hospitals buying ventilators and checking oxygen supplies?

Countries must improve testing capacity — and instructions so health workers know which travelers should be tested as the number of affected countries rises, said Johns Hopkins University emergency response specialist Lauren Sauer. She pointed to how Canada diagnosed the first traveler from Iran arriving there with COVID-19, before many other countries even considered adding Iran to the at-risk list.

If the disease does spread globally, everyone is likely to feel it, said Nancy Foster, a vice president of the American Hospital Association. Even those who aren’t ill may need to help friends and family in isolation or have their own health appointments delayed.

“There will be a lot of people affected even if they never become ill themselves,” she said.

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News Network
March 2,2020

Paris, Mar 2: A global agency says the spreading new virus could make the world economy shrink this quarter, for the first time since the international financial crisis more than a decade ago.

The Organization for Economic Cooperation and Development says Monday in a special report on the impact of the virus that the world economy is still expected to grow overall this year and rebound next year.

But it lowered its forecasts for global growth in 2020 by half a percentage point, to 2.4 per cent, and said the figure could go as low as 1.5 per cent if the virus lasts long and spreads widely.

The last time world GDP shrank on a quarter-on-quarter basis was at the end of 2008, during the depths of the financial crisis. On a full-year basis, it last shrank in 2009.

The OECD said China's reduced production is hitting Asia particularly hard but also companies around the world that depend on its goods.

It urged governments to act fast to prevent contagion and restore consumer confidence.

The Paris-based OECD, which advises developed economies on policy, said the impact of this virus is much higher than past outbreaks because "the global economy has become substantially more interconnected, and China plays a far greater role in global output, trade, tourism and commodity markets."

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