Supporters of Medicaid enlargement have fun their victory, Tuesday, Nov. 7, 2017, in Portland, Maine. (AP Photo/Robert F. Bukaty)
Here’s the health-care takeaway from Tuesday’s elections: Voters throughout two states resoundingly sided with Medicaid enlargement, sending a transparent rebuke to Republicans who spent the previous yr attempting to whittle down spending on this system.
Up in Maine, voters mentioned “heck, yeah,” to rising the low-income medical insurance program, making their state the first within the nation to embrace through the poll field Obamacare’s imaginative and prescient of Medicaid protection for Americans incomes barely above the federal poverty line.
And throughout the river in Virginia — a state the place the GOP-led House of Delegates had for years blocked Medicaid enlargement regardless of efforts by Gov. Terry McAuliffe (D) — voters overwhelmingly sided with an entire slate of Democratic candidates who pressed for lastly adopting that a part of the Affordable Care Act.
“All the folks who fought me on Medicaid expansion, they all got blown out,” McAuliffe mentioned on the election-night social gathering for Gov.-elect Ralph Northam, who promised all through his marketing campaign to steer the state in increasing this system.
Maine Gov. Paul LePage (R) has vowed to throw roadblocks in the way in which as a lot as he’s in a position, and there’s nonetheless an opportunity Republicans will have the ability to stymie Democrats if they maintain a slim majority within the Virginia House. According to the newest vote counts, there are 51 Republican seats and 49 Democratic seats in that physique; that might shift towards Democrats as a number of shut races are recounted over the subsequent few days.
Paul Goldman, a longtime Virginia Democratic strategist, instructed me he thinks Medicaid enlargement is a “done deal” in Virginia, even when Republicans retain their slim majority.
“All you need is a couple of Republicans, and the question is who is going to stand up and block it,” Goldman mentioned. “It’s inconceivable to me that Medicaid expansion won’t happen.”
Regardless, the Maine and Virginia outcomes sign a trajectory towards a good broader embracing of the ACA by states, at the same time as congressional Republicans cling to dimming hopes they may someday have the ability to dismantle President Barack Obama’s 2010 health-care legislation.
House Budget Democrats did some gloating:
It’s clear that the American individuals badist #Medicaid, regardless of Republicans’ continued makes an attempt to intestine it https://t.co/05aeg8sNAd
— House Budget Dems (@HouseBudgetDems) November eight, 2017
Center on Budget and Policy Priorities’ Jacob Leibenluft previewed the takeaways in a tweet final month:
If the initiative pbades, it sends highly effective message about how voters need GOP to cease blocking advantages of ACA, in states and nationally 2/
— Jacob Leibenluft (@jleibenluft) October 24, 2017
The Post’s Greg Sargent:
After final evening, the Medicaid enlargement is extra prone to acquire floor in additional states. @paulwaldman1 video games it out: https://t.co/1L1la0R4HM
— Greg Sargent (@ThePlumLineGS) November eight, 2017
Rep. Gene Green (D-Tex.):
Last evening Maine voters expanded #Medicaid, which can enable not less than 80,000 residents to change into eligible. In Texas, rejecting Medicaid enlargement is estimated to price $100B in federal and almost 1 million eligible Texans. I hope the #txlege will increase Medicaid in 2019.
— Rep. Gene Green (@RepGeneGreen) November eight, 2017
Rep. Jim Cooper (D-Tenn.):
Tennessee needs to be subsequent! If our state legislators received’t increase Medicaid, they need to put it on the poll & let the individuals resolve. 63% of Tennesseans badist Insure Tennessee. https://t.co/LsfHW5d7LP
— Jim Cooper (@repjimcooper) November eight, 2017
With the addition of Maine and Virginia, the variety of states providing their low-income residents expanded Medicaid would attain 34. Activists who organized the Maine vote are attempting to tug collectively comparable efforts in Utah and Idaho.
“I would think the Republicans would take a sober second look after these election results,” mentioned Tim Jost, a well being legislation professor at Washington and Lee University and a member of the Virginia Organizing Project’s health-care committee.
Here’s one thing else that ought to give Republicans pause. Health care was the highest concern by far for Virginia voters although it did not get loads of airtime through the marketing campaign. Thirty-nine p.c mentioned a candidate’s place on well being coverage was the highest think about deciding how they’d vote, in accordance with exit polls. Gun coverage was the next-biggest challenge, however solely 17 p.c of voters picked that as their greatest concern.
Connecticut Sen. Chris Murphy (D), a fierce gun-control advocate from the state the place the Newtown faculty capturing occurred:
Exit polls present high 2 points for #Northam voters tonight had been well being care and weapons. Say it once more. Health care and GUNS.
— Chris Murphy (@ChrisMurphyCT) November eight, 2017
And don’t neglect that market premiums are by way of the roof in Virginia. Even with that scenario, a majority of voters sided with Northam, who embraced the ACA, over his opponent Ed Gillespie, who had talked about attempting to scale back premiums and out-of-pocket bills.
These are “health-care voters,” writes actor Blake Cooper Griffin, who urged Americans in a HuffPost op-ed to make well being care their No. 1 challenge in subsequent yr’s midterm elections.
“After everything Trump and congressional Republicans have thrown at us, and as we saw in last night’s election results, we have taken on a new role — health-care voters,” Griffin wrote.
The previous yr has been a trial. But I am extra dedicated than ever to the combat for progress, together with healthcare for all. I hope you may learn my Op-Ed that explains why I am a @HealthCareVoter & be part of me on this combat. https://t.co/QAjFdKvrpE
— Blake Cooper Griffin (@thegriffster) November eight, 2017
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The Healthcare.gov web site. (AP Photo/Alex Brandon)
–We’re into Week 2 of the ACA’s open enrollment interval. In this part, we’re that includes letters from readers who’ve been enrolling in market protection. Here’s at this time’s:
“I was born with Cerebral Palsy, but was able to work for over 26 years…Since my state didn’t expand Medicaid, I applied on the Healthcare.gov exchange and have been using the ACA for insurance ever since. Since I am low income, I receive a subsidy. I became depressed and suicidal when Donald Trump won the election, because I knew eliminating the ACA was at the top of his agenda. After many months of anxiety, and after my 2017 health insurance company left the market this year, I have another plan for 2018 and pay only $50.34 a month on premiums and have a $100 deductible. My heart goes out to those who do not get the subsidy. I know the uncertainty and the elimination of the [cost sharing reduction payments] have made premiums and deductibles much higher. My premium went from $612 last year to $1,243 this year. The subsidies need to be expanded to everyone until the cost of healthcare and insurance goes down. I will be eligible for Medicare in October of 2018 but the ACA has been a life saver.” –Patricia Cox, Nebraska
AHH, OOF and OUCH
(John Moore/Getty Images)
AHH: The drug naltrexone may be extremely efficient at serving to individuals break their heroin addictions — much more so than the mainstay medication buprenorphine and methadone used to deal with dependancy by substituting for heroin within the mind. Use of naltrexone — which as a substitute halts opioids from binding the opioid receptor, thus making drug use much less rewarding — gave considerably higher outcomes for opioid-addicted sufferers in a examine on the Norwegian Center for Addiction Research, The Post’s Keith Humphreys reviews.
Researchers noticed sufferers affected by opioid dependancy who had been both handled with a each day dose of buprenorphine or month-to-month injections of the extended-release naltrexone. After three months, most sufferers receiving both kind of therapy had stopped utilizing opioids, however the price of abstinence was statistically larger for sufferers on extended-release naltrexone, Keith reviews.
The findings are depicted within the chart beneath:
Additionally, sufferers utilizing naltrexone had been additionally extra glad with their care and extra prone to suggest therapy because the drug “made them really feel protected in opposition to relapse and overdose,” Keith writes.
Signage is displayed exterior the Humana Inc. workplace constructing in Louisville, Ky. (Luke Sharrett/Bloomberg)
OOF: Humana plans to slash about 2,700 jobs in a cost-cutting measure that comes as many insurers proceed to grapple with uncertainty over the way forward for the health-care trade. The Louisville-based firm’s CFO Brian Kane mentioned yesterday on a third-quarter earnings name that the transfer would save “tons of of hundreds of thousands of ,” The Courier Journal reported.
Humana is engaged on a turnaround after steep losses from promoting particular person insurance policies beneath Obamacare and a scrapped plan to merge with trade rival Aetna, though CEO Bruce Broussard mentioned the cuts had been half predated the failed merger.
(Photo by Joe Raedle/Getty Images)
OUCH: Repealing Obamacare’s particular person mandate to purchase protection would save much less cash than beforehand estimated by the Congressional Budget Office — now simply $338 billion over a decade as a substitute of the company’s earlier estimate of $416 billion. That’s as a result of the CBO now considers the mandate much less efficient at convincing individuals to purchase protection than it had beforehand estimated.
The company says 13 million fewer individuals can be uninsured with out the mandate, down from 15 million individuals beneath earlier projections. Fewer individuals getting protection means fewer individuals accessing authorities subsidies to badist cowl the prices. And that interprets to much less authorities spending.
This creates an uncomfortable scenario for Republicans, who had beforehand blasted CBO for overestimating the mandate’s results. But now, simply after they’re contemplating utilizing repeal to badist fund a tax overhaul, the CBO is responding to their issues and thus scoring rolling again the measure accordingly. If you need to learn extra about how all this works, try Tuesday’s The Health 202, the place I previewed the CBO’s shift.
HEALTH ON THE HILL
Sen. Rand Paul (R-Ky.) mentioned he has six damaged rids after he was attacked over the weekend. (Photo by Chip Somodevilla/Getty Images)
— The story across the badault on Sen. Rand Paul over the weekend will get curiouser and curiouser (as Winnie the Pooh would say, per my toddler). The Kentucky Republican tweeted yesterday that he is recovering from six damaged ribs (not 5, as initially reported) and fluid has constructed up round his lungs:
I recognize all the badist from everybody. A medical replace: ultimate report signifies six damaged ribs & new X-ray reveals a pleural effusion
— Senator Rand Paul (@RandPaul) November eight, 2017
Initially, the New York Times and others pointed to landscaping as the foundation reason behind the altercation between Paul and his next-door-neighbor, Rene Boucher. Boucher tackled Paul at his residence final Friday, leaving him along with his accidents. The Times cited three Kentucky Republicans who mentioned the badault was the results of a landscaping dispute, though a buddy who visited Paul on Saturday additionally instructed the Times that Paul was “nonetheless not sure why he was attacked.”
Then, yesterday, Paul’s chief strategist, Doug Stafford, appeared to name the landscaping idea into query, tweeting a hyperlink to a Breitbart story that casts doubt on it:
— Doug Stafford (@dougstafford) November eight, 2017
Boucher’s motive continues to be unclear, although he has mainly admitted to the badault, my colleague Aaron Blake writes. Aaron lays out quite a lot of puzzling questions that neither Paul nor Boucher nor their attorneys have answered. Like what the dispute Boucher’s lawyer described as “trivial” was actually about — and why they could not clarify whether or not it truly is trivial. Stafford positive did not appear to explain it as trivial. “It is a pending, serious criminal matter involving state and federal authorities,” Stafford mentioned. “We won’t have any further comments at this time.”
“The wording there — ‘involving state and federal authorities’ — is also somewhat intriguing,” Aaron writes. “Why are the federal authorities going to be concerned? We solely know up to now of the arrest warrant in Kentucky. Is it simply because Paul is a U.S. senator and they’re inherently concerned? Federal legislation, for what it is value, makes attacking federal officers like members of Congress punishable by as much as 10 years in jail if ‘private damage outcomes’…There are much more questions than solutions proper now. And the entire thing appears to be getting extra opaque somewhat than much less.”
—Boucher is because of seem in court docket at this time to face prices, my colleague Ed O’Keefe reviews. He was charged with fourth-degree badault and launched final Saturday on $7,500 bond. Kentucky State Police mentioned Monday that Boucher could face extra severe prices given the extent of Paul’s accidents.
Read the Breitbart piece in addition to one in The Washington Examiner, which posits a political idea of the case.
— Do Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) really feel like damaged data but? Maybe, however they’re persevering with to petition Congress to go laws funding the additional Obamacare funds to insurers to cowl their cost-sharing reductions for the subsequent two years — funds the Trump administration has ceased making. Alexander took to the Senate ground yesterday to once more make his case, pointing to skyrocketing market premiums in his residence state of Tennessee. Congress ought to go the bipartisan measure earlier than President Trump returns from his stint in Asia, he urged.
“I hope that when the president returns from Asia, he will go to his desk and find a nice package there with a bow on it, presented by Senator Murray and me, 24 of us in the United States Senate, Republicans, Democrats, that does exactly what the American people I think want us to do — lower premiums, avoid chaos, work together, take a step in the right direction, and let’s see if we can help the American people in that way,” Alexander mentioned.
Rep. Diane Black, (R-Tenn.). (AP Photo/J. Scott Applewhite).
—Yesterday, a bunch of abortion-opposing lawmakers and activists pressured leaders in Congress to incorporate language in a year-end spending bundle permitting health-care suppliers to sue in the event that they’re pressured to carry out an abortion over their private objections. Existing legislation already prohibits discrimination in opposition to any health-care suppliers who received’t take part in abortions, however the Conscience Protection Act would allow suppliers to additionally take authorized motion in the event that they really feel coerced or face discrimination for not taking part within the process, The Hill reviews.
Rep. Diane Black (R-Tenn.), chair of the House Budget Committee, urged swift motion on her laws. “It is time for this comprehensive, reasonable and modest bill to be voted on so we can allow millions of Americans who believe as I do in the sanctity of life to abide by those beliefs without having them trampled on by their own government,” she mentioned.
March for Life President Jeanne Mancini mentioned this: “It is un-American for somebody to be pressured to go in opposition to what they know of their conscience is fallacious. I can’t consider something extra un-American than forcing an individual – particularly a well being care skilled who’s responding to a life saving mission —to participate within the destruction of life.”
Just a few extra choose reads from The Post and past:
The Washington Post hosts Secretary of Veterans Affairs David Shulkin for a dialogue that may embody his division’s efforts to curb the veterans’ suicide price, deal with post-traumatic stress dysfunction and different well being issues.
The American Enterprise Institute holds an occasion on the opioid disaster with Rep. Greg Walden (R-Ore.) on Nov. 13.
STAT holds an occasion on the FDA on Nov. 13.
What if Hillary Clinton had received? From The Post’s Depatment of Satire:
Watch Rep. Steve Scalise (R-La.) problem Rep. Sam Johnson (R-Tex.) to a scooter race:
I challenged @SamsPressShop to a scooter race.
Here’s what occurred subsequent. pic.twitter.com/qcK2fZhRuu
— Rep. Steve Scalise (@SteveScalise) November eight, 2017
Former President Bill Clinton chats with Conan O’Brien:
Watch the official trailer for Steven Spielberg’s film about The Post: