Healthcare confusion is a good excuse to take care of yourself
The Short Version
After a party-line vote during a late-night session of Congress allowed for the complete dismantling of the Affordable Care Act, the non-partisan Congressional Budget Office, joined by Congress’ Joint Committee on Taxation, released a statement yesterday saying that repealing the healthcare law without a replacement would result in 18 million more uninsured Americans. However, that assessment was made on previous legislation. No new legislation has been submitted yet and the president-elect has promised “universal coverage.” With all the confusion, the best advice, for now, is to take care of yourself and not expect anything from Congress.
A Little More Detail
Congress scared a lot of people last week when it passed a bill changing the rules for repealing the Affordable Care Act. The vote was largely along party lines, 51-48, and came in the wee hours of Thursday morning while most Americans were sound asleep. At first, because a protective clause regarding pre-existing conditions and other coverage was removed from the nonbinding resolution, many people were under the impression that coverage for pre-existing conditions had been removed. It hadn’t. All the resolution did was make it easier for Congress to repeal existing healthcare legislation by allowing the Senate to pass such a bill with a simple majority rather than the 60 votes currently required.
Still, mention healthcare and one suddenly has the attention of millions of Americans who would not have any insurance coverage without the Affordable Care Act. So, the Congressional Budget Office and the Joint Committee on Taxation took a look at the last bill in which Congress attempted to repeal the Affordable Care Act and calculated the cost. Their determination was that should Congress follow a similar pattern and repeal the law without any replacement, insurance costs would soar and 18 million people who currently have coverage would lose it within the first year. Were no replacement offered, the number of uninsured Americans would swell to 56 million by 2026. One has to admit those are pretty scary numbers.
However, there is currently no serious bill before Congress that would gut the Affordable Care Act. At this point, the House of Representatives is still arguing over smaller, more petty details and the Senate is fully consumed in hearings for Cabinet appointees. Any omnibus bill that would completely repeal the Affordable Care Act with any hope of receiving the president’s signature is still several months away.
Add to that the promise of GOP leaders to retain the pre-existing condition coverage and the president-elect’s promise for universal coverage and the waters get even more muddy. If the incoming president is going to hold out for a replacement plan that covers everyone, then Congress has to dramatically alter its approach away from anything they proposed last year. This could potentially set the stage for disagreement between the president and congressional leaders, further delaying any kind of repeal and replace legislation.
At this point, there is absolutely no certainty of any kind as to how Congress might actually handle changes to the healthcare laws. The confusion is frustrating and leaves millions of Americans in limbo regarding long-term healthcare.
Time To Self-Medicate
Given all the confusion and uncertainty regarding the healthcare laws, doctors are taking a more cautious approach and advising patients to maintain current medication and to take more responsibility for their personal health where it is reasonable to do so. Here are some of the recommendations being offered:
- See your physician for a regular checkup, making sure prescriptions and treatment plans are up-to-date.
- Make sure all scheduled vaccinations are up-to-date.
- Maintain a healthy diet that is appropriate to both your age and physical needs. Not everyone should eat the same things.
- Stay active with an appropriate exercise plan that does not present a high level of risk.
- Avoid high-risk activities where possible. Now is not the time to undertake something that might leave one in need of long-term healthcare.
- Stay away from unproven forms of “alternative” medicines that could complicate healthcare.
- Those in high-risk categories, such as the very young and very old, should avoid contact with highly infectious environments and limit some public activities during high-risk seasons.
In short: don’t get sick. There is no promise that anyone will be covered for any form of healthcare in the future, regardless of what Congress and the president-elect might say. Taking responsibility for your own healthcare and that of your children is something we all should be doing anyway. It probably doesn’t hurt to start a savings account to use in the event of a medical catastrophe, such as a car accident or a rabid squirrel attack if you can afford to do so.
We’ve not lost everything yet, but to the degree we can prepare for the worst we are better off.
Pardon Me
Or at least commute my sentence
The Short Version
President Obama pardoned 64 and commuted the sentences of over 200 people yesterday in one of the largest groups of commutations by any president. Included in this list was Chelsea Manning, the transgender former Army analyst convicted of leaking top secret material to WikiLeaks in 2009 and former Marine general James E. Cartwright who plead guilty to making false statements to the FBI. Many people are upset by Ms. Manning’s sentence commutation while others are wondering if this may open the door for prosecution of WikiLeaks founder Julian Assange.
Matters Of Distinction
Right off the bat, we need to make a couple of points clear. A presidential pardon largely removes one’s crime and its effects. All rights are restored and the legal record of the conviction is expunged. Commuting a sentence, however, does not remove the conviction nor many of the penalties related to that conviction. All commuting a sentence does is let a person out of jail sooner. They are still subject to reporting laws, may not regain the right to vote, and cannot be considered for any form of federal employment. All pardons and commutations are permanent and cannot be undone.
A Little More Detail
President Obama had already surpassed the record for the number of people he has pardoned or for whom he has commuted sentences. Mr. Obama has long considered the imprisonment of non-violent drug offenders to be a matter of injustice and the majority of his pardons and commutations have been focused toward releasing non-violent drug offenders from jail. Not a lot has been written or said about any of these actions, though they’ve been ongoing for quite a while.
What got everyone’s attention yesterday was the commutation of the 45-year sentence given to Chelsea Manning. Speaker of the House, Paul Ryan called the act “just outrageous,” saying that ” “Chelsea Manning’s treachery put American lives at risk and exposed some of our nation’s most sensitive secrets.” Ms. Manning, who was known as Bradley at the time of arrest, has presented some interesting problems for the federal prison system, however. Being held in the men’s facility at Leavenworth Federal Penitentiary subjected Ms. Manning to severe abuse and mistreatment from other prisoners. At the same time, the system was unable to provide the transitional medical care Ms. Manning needed. She had attempted suicide twice in the past year.
Chase Strangio, an American Civil Liberties Union attorney representing Ms. Manning, said that Obama’s action could “quite literally save Chelsea’s life.”
In addition to Ms. Manning and General Cartwright, President Obama pardoned San Francisco Giants Hall of Famer Willie McCovey and hotelier Ian Schrager, both of whom were convicted of tax evasion, as well as commuting the sentence of Puerto Rican nationalist Oscar Lopez Rivera, an ultranationalist who, at age 74, is no longer considered a threat and would have otherwise likely died in prison.
The White House also announced that several more pardons and commutations would be announced on Thursday, the last day of President Obama’s administration. However, most of those will, again, be centered around drug offenders and no “big names” are expected.
Not For Everyone
What’s worth noting is who is not on any of the lists for pardons or sentence commutation. Edward Snowden, who, like Manning, leaked top-secret information to WikiLeaks, is not on the list. The White House has said that Snowden has not applied for clemency.
Also missing from the list is Native American activist Leonard Peltier, who was convicted and sentenced to two consecutive terms of life imprisonment for first-degree murder in the shooting of two Federal Bureau of Investigation agents during a 1975 conflict on the Pine Ridge Indian Reservation, has widely been considered to have been convicted unjustly. Yesterday, James Reynolds, the federal prosecutor responsible for Peltier’s conviction, published a letter in the Chicago Tribune urging Peltier’s release saying “The government has gotten almost 41 years, and 41 pounds of flesh; Peltier is old and sick, and in my opinion, any more time served would be vindictive.” However, the White House has not responded on the matter.
There is also some speculation as to whether Ms. Manning’s clemency opens the door for some action against WikiLeaks founder Julian Assange. However, again, there is no official word from the Justice Department regarding those rumors. Given the timing and transition about to take place, it is unlikely that the Justice Department would initiate any new activity that would require completion by the new administration.
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