Author Archives: henrykotula

Employers Require COVID Liability Waivers as Conflict Mounts Over Workplace Safety

Posted on by • Posted in 2020 Election Issues, Coronavirus, Coronavirus Liability, Employee Protections, Infection Control, Infection Control Plan, Infectious Virus, Liability, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, School Reopening, Uncategorized, Worker Protection, Worker Rights • Leave a comment

https://khn.org/news/employers-require-covid-liability-waivers-as-conflict-mounts-over-workplace-safety/

After spending a May day preparing her classroom to reopen for preschoolers, Ana Aguilar was informed that the tots would not have to wear face masks when they came back. What’s more, she had to sign a form agreeing not to sue the school if she caught COVID-19 or suffered any injury from it while working there.

Other teachers signed the form distributed by the Montessori Schools of Irvine, but Aguilar said she felt uncomfortable, although it stipulated that staff members would be masked. At 23, she has a compromised immune system and was also worried that she could pass the coronavirus on to her fiancé and other family members.

Aguilar refused to sign, and a week later she was fired. “They said it was my choice to sign the paper, but it wasn’t really my choice,” said Aguilar, who’s currently jobless and receiving $276 a week in unemployment benefits. “I felt so bullied.”

As employers in California and across the country ask employees to return to the workplace, many have considered and some are requiring employees to sign similar waivers, employment lawyers say. And many employees, mostly lower-wage and minority workers in essential jobs, are calling lawyers to complain about the waivers.

“These are illegal agreements that are totally unfair to workers,” said Christian Schreiber, a San Francisco lawyer who represents Aguilar and other employees.

The California State Legislature last year passed a law, AB-51, prohibiting employers from requiring employees or job applicants to sign away their right to pursue legal claims or benefits under state law. The law, which also prohibits firing any employee for refusing to sign, is being challenged in court by business groups.

Only a few employers have forced employees to sign liability waivers, at least partly because these waivers likely would be held unenforceable by courts, lawyers who represent employers say.

“Courts don’t recognize them because of the unequal bargaining power between employers and employees,” said Isaac Mamaysky, a partner at the Potomac Law Group in New York City. “With so many unemployed, people would sign just about anything to get a job.”

Another reason they are considered unenforceable: Workers who get sick or injured on the job generally are compensated through state workers’ compensation systems rather than through the courts, and state laws don’t allow employers to force employees to sign away their right to pursue workers’ comp claims, Mamaysky said.

Companies may have the right to require nonemployees working on their premises to sign COVID waivers. When the New York Stock Exchange reopened in late May, it made floor traders sign a form clearing the exchange of liability if they contracted COVID-19. That was legally permissible because the traders were not exchange employees, an NYSE spokesman said. He declined to say whether any traders have become infected with the virus.

The Las Vegas-based restaurant chain Nacho Daddy, which did require employees to surrender their right to sue over COVID-19, reportedly fired some who refused. Following negative media coverage, Nacho Daddy removed the language that waived legal rights and instead had employees agree to follow safety rules such as masking and social distancing. The company did not respond to a request for comment.

Having employees agree to comply with safety rules is a more common and legally acceptable approach than waivers.

“I suggest my clients go to this reasonable middle ground: Here’s what we promise to you, here’s what we want you to promise to us,” said David Barron, an employment lawyer with Cozen O’Connor in Houston.

Business groups hope Senate Majority Leader Mitch McConnell will make liability waivers unnecessary. He has proposed a Senate bill with broad liability protection for employers for five years against a range of coronavirus-related claims, and says he won’t back any COVID relief bill that doesn’t include such protections. President Donald Trump has said he supports the liability protection.

At least 10 states already have enacted laws providing some form of immunity for businesses from lawsuits brought by employees and others who contract COVID-19. Similar bills are pending in about 10 more states, according to the National Employment Law Project. The California Assembly is considering a liability protection bill for public K-12 schools.

Federal legislation to provide COVID liability relief for employers should protect only those that follow applicable health and safety guidelines, said John Abegg, executive vice president of the U.S. Chamber Institute for Legal Reform, which supports McConnell’s proposal.

But even if McConnell is able to overcome Democratic opposition and pass liability protection as part of a new pandemic economic relief bill, that still wouldn’t shield employers from lawsuits claiming gross negligence or reckless or intentional conduct in failing to implement COVID-19 safety precautions.

Across the country, hospitals and nursing homes, as well as companies like McDonald’s, Walmart and Safeway, have been hit with wrongful death lawsuits filed by families of employees who died from the virus. They typically cite egregious conduct that goes beyond ordinary negligence, potentially erasing any statutory liability relief.

Nearly 50 COVID-related lawsuits have been filed relating to conditions of employment, including exposure to the coronavirus or the lack of protective equipment, according to data collected by the law firm Hunton Andrews Kurth.

In many states, alleging intentional misconduct also may allow workers harmed by COVID-19, and their families, to file lawsuits rather than go through the workers’ compensation system, and thus seek bigger damage awards.

For instance, a suit filed in Alameda County Superior Court in June by the widow of a longtime employee of Safeway’s distribution center in Tracy, California, alleged that the company had concealed a COVID-19 outbreak from workers and informed them that personal protective equipment was not recommended, contrary to guidelines from federal and state authorities.

“I don’t know of any jurisdiction that would allow a waiver against intentional misconduct,” said Louis DiLorenzo, head of the labor and employment practice for Bond Schoeneck & King in New York, who represents employers. “That would encourage misconduct.”

Worker advocates argue that lawsuits like the one against Safeway should be encouraged — rather than blocked by waivers or immunity laws — to bring to light serious public safety problems. Cases against McDonald’s in Oakland and Chicago — in which workers claimed the restaurants had created a “public nuisance” by not taking steps to adequately protect workers and customers from COVID-19 — resulted in court orders in late June for those McDonald’s restaurants to implement safety measures such as masks, social distancing and temperature checks.

“A very tiny number of cases are being filed by workers, and those cases are valuable,” said Hugh Baran, a staff lawyer at the National Employment Law Project. “These are the kinds of claims we should want workers to bring.”

Schreiber said he contacted the Montessori school about Aguilar’s firing, and it offered to reinstate her without having her sign the waiver. But Aguilar declined, saying the school was putting teachers at risk by not requiring pupils to wear masks. The school then offered her six weeks of severance pay, which she is considering.

By refusing to sign the waiver or accept her job back, she said, she was standing up for all the teachers at the school, many of whom have children and can’t afford to lose their job.

“I liked my job and I needed the paycheck,” Aguilar said. “But making you sign these papers is telling you that whatever happens, they really don’t care.”

 

 

 

The COVID-19 Downturn Triggers Jump in Medicaid Enrollment

Posted on by • Posted in 2020 Election Issues, ACA, Center for Medicare and Medicaid Services (CMS), Employer-Based Health Insurance, Health Insurance Coverage Adequacy, Job, Job Loss, Job Market, Medicaid, Medicaid Expansion, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

https://khn.org/news/the-covid-19-downturn-triggers-jump-in-medicaid-enrollment/

Reversing a three-year decline, the number of people covered by Medicaid nationwide rose markedly this spring as the impact of the recession caused by the outbreak of COVID-19 began to take hold.

Yet, the growth in participation in the state-federal health insurance program for low-income people was less than many analysts predicted. One possible factor tempering enrollment: People with concerns about catching the coronavirus avoided seeking care and figured they didn’t need the coverage.

Program sign-ups are widely expected to accelerate through the summer, reflecting the higher number of unemployed. As people lose their jobs, many often are left without workplace coverage or the money to buy insurance on their own.

Medicaid enrollment was 72.3 million in April, up from 71.5 million in March and 71 million in February, according to the latest enrollment figures released last week by the Centers for Medicare & Medicaid Services. The increase in March was the first enrollment uptick since March 2017.

About half of the people enrolled in Medicaid are children.

The increases varied widely around the country. Kentucky had the largest jump at nearly 7% from March to April. In addition, enrollment rose to 1.4 million in April from 1.2 million in February, according to the CMS data. That has continued, and today it’s up to 1.5 million, state officials said in an interview.

Kentucky has an aggressive outreach strategy using email or phone calls to contact thousands of residents who applied for state unemployment insurance, designed to make sure they know about Medicaid. “It’s been very effective, and in the past few weeks we’ve been enrolling 8,000 to 10,000 people a week,” said Eric Friedlander, secretary of the Kentucky Cabinet for Health and Family Services, which oversees Medicaid.

The Bluegrass State has also made enrollment easier by developing a one-page online form instead of having people fill out a 20-page application, he added.

“This is the right thing to do to help people get signed up for health care coverage and it supports the health industry in our state,” Friedlander said. “The health industry would collapse without Medicaid.”

Joan Alker, executive director of the Center for Children and Families at Georgetown University in Washington, D.C., said she expects Medicaid enrollment to keep rising this summer. “Given that there are no signs that the virus is coming under control anytime soon, job losses will become more permanent, and more folks will become eligible for Medicaid over time,” she said.

One reason Medicaid numbers have not grown faster, she suggested, is because people have more immediate needs than securing health coverage, especially if they are feeling well.

Many people are worried about getting unemployment insurance or getting evicted from their home, she noted. “That’s combined with the fact that many people are reluctant to go to their doctor because of safety concerns,” she said. “And, as a consequence, applying for Medicaid may not be at the top of their list.”

Chris Pope, a senior fellow at the Manhattan Institute for Policy Research, a conservative think tank, said the slower-than-expected growth in Medicaid could signal that people who were laid off had coverage through a spouse or a parent.

In addition, he said, “many jobs that went away did not offer health insurance,” citing millions of service-sector positions in industries such as hotels and restaurants that have been lost.

Beyond the surge in unemployment, Medicaid rolls have risen because states cannot discontinue coverage to people enrolled as of March 18, 2020, as a condition of receiving higher federal Medicaid funding included in a coronavirus relief package passed by Congress.

Medicaid is a countercyclical program, meaning enrollment typically rises during an economic downturn. But that forces states to face the fiscal challenge of paying for their share of the program even as tax revenue dries up.

An exception to this rule was the jump in enrollment starting in 2014 when the Affordable Care Act allowed states to expand Medicaid to cover everyone with incomes below 138% of the federal poverty level, or about $17,609 for an individual this year.

Enrollment soared by about 15 million people from 2014 to 2017, peaking at about 75 million as nearly three dozen states expanded the program. Since then, a strong economy and steadily declining unemployment levels led to a drop in Medicaid rolls until April.

Enrollment changes in April varied across the country.

California, which has the highest Medicaid enrollment in the country, saw its level hold relatively steady at 11.6 million people in April.

Nevada and Oklahoma posted nearly 4% enrollment growth rates between March and April’s data.

Florida’s Medicaid numbers jumped to 3.7 million in April from 3.6 million in March, nearly a 2.5% increase, the CMS data showed. Since then, Florida data shows enrollment has topped 4.1 million.

The Trump administration has been criticized by consumer advocates for not establishing a national campaign to promote Medicaid during the economic downturn and health crisis.

One indicator that Medicaid enrollment is still going up is the growing number of recipients in managed care plans in 16 states that reported data from March to May. Those plans have increased by a total of nearly 4%, according to a KFF report. (KHN is an editorially independent program of KFF.) Most states have shifted many of their Medicaid enrollees into these private health plans.

KFF estimated that nearly 13 million people who became uninsured after losing their jobs in March are eligible for Medicaid.

Robin Rudowitz, a KFF vice president, said there is typically a lag time of weeks or months before people who have lost their jobs and health coverage seek to enroll in Medicaid. The impact on Medicaid enrollment also lasts well after the immediate effect of a downturn, she said.

“There is a long tail,” she said.

 

 

 

 

 

KHN’s ‘What The Health?’: Trump Twists on Virus Response

Posted on by • Posted in 2020 Election Issues, ACA, Centers for Disease Control & Prevention (CDC), Coronavirus, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Economic Stimulus, Employer-Based Health Insurance, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, Food and Drug Administration (FDA), Health Insurance Coverage Adequacy, Infection Control, Infection Control Plan, Infectious Virus, Job, Job Loss, Job Market, Job Search, Job Security, Medicaid, Medicaid Expansion, Mixed Message, Mortality, National Strategy, Opioid Epidemic, Pandemic, Partisanship, Public Health, Public Safety, Quarantine, Scientists, Short Term Health Insurance, Skinny Health Plans, Social Distancing, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

https://khn.org/news/khn-podcast-what-the-health-trump-twists-on-virus-response/

KHN's 'What The Health?': Trump Twists on Virus Response | Kaiser ...

President Donald Trump — who has spent the past six months trying to play down the coronavirus pandemic — seems to have pivoted. In back-to-back briefings on July 21 and 22, Trump cautioned that the U.S. is in a dangerous place vis-a-vis the pandemic. He urged the public to wear masks — although he has rarely worn one in public.

Meanwhile, Republicans in the Senate are scrambling to put together a package for the next COVID-19 relief bill, facing a July 31 deadline, when some of the benefits passed in the spring expire. House Democrats passed their bill in May.

This week’s panelists are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Margot Sanger-Katz of The New York Times and Tami Luhby of CNN.

Among the takeaways from this week’s podcast:

  • Although Trump’s renewed emphasis on COVID-19 has surprised some of his critics, it may persuade his supporters to take actions promoted by public health officials. Trump’s emphasis on the importance of face coverings, perhaps coupled with the rising number of cases in parts of the country, could convince people who were otherwise dismissive of masks. People who do not necessarily trust public health officials may listen to Trump.
  • Republicans on Capitol Hill are in disarray on how to approach the next coronavirus relief bill. They are not in lockstep with the White House and are not supporting Trump’s call for a payroll tax cut.
  • One reason members of Congress are not eager to cut the payroll taxes is that the economic downturn has spurred concerns the Medicare and Social Security trust funds are being depleted faster than expected. However, analysts point out that when employment rises again, some of those concerns could dissipate.
  • A key sticking point in the economic relief package is whether to extend the bump in unemployment benefits that Congress approved in the spring. Lawmakers are facing a hard deadline on the issue because that money runs out next week, and the prohibition on evictions that was also part of an earlier COVID-19 relief bill ends even sooner. With rent, mortgages and other bills coming due Aug. 1, unemployed consumers could face a tough beginning of the month.
  • The Food and Drug Administration has approved limited use of pool testing for COVID-19. That allows approved labs to put together a small number of tests to run at once, thus conserving some of the materials needed for the process. If the pool tests positive, then those people whose results were pooled have to be tested again individually. The efforts have limited usefulness when rates of transmission are high in a community, but they may be helpful in specific settings, such as schools or workplaces.
  • New data shows that opioid addiction ticked back up in 2019, after a slight decline. Part of the problem is the growing use of the powerful — and dangerous — drug fentanyl. Economic woes also play a role. Addiction is often referred to as an epidemic of despair.
  • Although it’s unlikely the judicial system will overrule the administration’s efforts to bolster short-term insurance plans — which are generally less expensive but don’t offer as much protection for consumers as policies sold on the Affordable Care Act’s marketplaces — they could be circumvented if Democrats take over the White House. Even still, Democrats would likely have to find a way to make ACA plans more affordable.

 

 

 

 

 

Dental and Doctors’ Offices Still Struggling with COVID Job Loss

Posted on by • Posted in 2020 Election Issues, Coronavirus, Crisis, Crisis Management, Deferred Healthcare, Dentist, Economic Crisis, Economic Recovery, Job, Job Loss, Job Market, Job Search, Job Security, Office Visit, Outpatient Care, Physician, Physician Practice Management, Primary Care, Uncertainty, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

https://khn.org/news/dental-and-doctors-offices-still-struggling-with-covid-job-loss/

Dental and Doctors' Offices Still Struggling with COVID Job Loss ...

California’s outpatient health care practices largely shrugged off two recessions, adding more than 400,000 jobs during a two-decade climb from the start of 2000 to early 2020. It was an enviable growth rate of 85% and a trend largely mirrored on the national level.

Then came COVID-19.

Anecdotal stories abound about the crushing impact the pandemic has had on a range of outpatient medical services, from pediatric and family medical practices to dental offices, medical labs and home health care. In California, as in many other states, thousands of doctors, dentists and other health care providers temporarily closed offices this spring as state health officials directed them to suspend non-urgent visits. Many others sat open but largely idle because patients were too scared to visit the doctor given the risk of running into someone with COVID-19 in the waiting room.

As the economy has reopened, so have many medical offices. But the latest state and federal employment data underscores the lingering toll the pandemic has taken on the health care sector.

Doctors’ Offices Shed Jobs Amid COVID

In California, and across the nation, the number of workers in doctors’ offices grew by more than 50% in the past 20 years, before seeing rapid declines amid COVID-19. This chart shows proportional growth in employment over time, with percentages relative to January 2000.

In California, employment in medical offices providing an array of outpatient care fell by 159,300 jobs, or 18%, from February to April, according to California’s Employment Development Department. The sector has recovered some, but job totals in June remained 7% below pre-crisis levels, the latest figures show. Data is not yet available for July, when COVID-19 cases in California again began to rise sharply and communities across much of the state reverted to partial shutdowns.

Nationwide, employment in outpatient care fell by about 1.3 million jobs, or 17%, from February to April, and in June also remained 7% below pre-crisis levels.

Doctors’ offices typically rely on patient volume for revenue. Without it, they can’t make payroll. Many small medical clinics weren’t flush with cash before the crisis, making COVID-19 an existential threat.

“Never in our history have we had more than a month’s cash on hand,” said Dr. Sumana Reddy, owner of the Acacia Family Medical Group in Monterey County. “Think of it that way.”

Reddy operates two clinics, one in Salinas and the other in the town of Prunedale. Many of her clients come from rural areas where poverty is common. When COVID-19 hit and stay-at-home orders took effect, the number of patients coming to the practice fell by about 50%, Reddy said. To keep her patients safe and her business afloat, Reddy largely shifted to telehealth so she could provide care online.

She also turned to federal aid. “I took the stimulus money,” she said. “I asked for advances from anywhere I could get that. So, now I’m tapped out. I’ve done every single thing that I can think of to do. And there’s nothing more to do.”

By late June, patient volume at Reddy’s practice stood at roughly 70% of the level seen before the crisis.

Dental Offices Hit Hard by COVID

The coronavirus pandemic prompted steep declines in dental office employment, undoing 20 years of steady growth. This chart shows proportional growth in dental employment over time, with percentages relative to January 2000.

Many dental offices have been hit even harder. From February to April, the number of dental office employees in California fell by 85,000, or 60%, a rate of decline that outpaced even job losses in the state’s restaurant industry. Nationwide, dental employment fell by about 546,000 from February to April, a 56% decline.

“March, April, mid-May — we were pretty much closed except for emergency care,” said Dr. Natasha Lee, who owns Better Living Through Dentistry, a practice in San Francisco’s Inner Sunset neighborhood. “While dental offices were considered essential, most were closed due to guidance from health departments and the CDC to postpone routine and preventative medical and dental care and just to limit things to emergency.”

Lee has reopened her clinic but is doing less business. She and her staff need extra time to clean tools and change their personal protective equipment.

“With the social distancing, the limiting [of] patients in the office at a time and the slowdown we’ve had, we’re probably seeing about, I’d say, two-thirds of our normal capacity in our practice,” she said in late June.

As for employment, California hospitals have fared better than outpatient medical offices. Hospitals shed about 2% of jobs from February to June.

“They have more capacity in a large organization to withstand the same shock,” said John Romley, a professor and economist at the University of Southern California’s Leonard D. Schaeffer Center for Health Policy and Economics.

Romley said he is optimistic the health care sector overall will recover faster than some other sectors of the economy, since health care remains a necessity.

Still, red flags abound. The recent spike in COVID-19 cases and deaths in many parts of the nation raises the specter of future shutdowns and, with them, additional health care layoffs. In California, Gov. Gavin Newsom recently ordered a second shutdown for dine-in restaurants, movie theaters and bars statewide, as well as churches, gyms and barbershops in much of the state. For now, dental and doctors’ offices can continue operating.

Older Californians Are Postponing Care

A recent census survey found that 42% of California respondents had put off medical care because of the pandemic.

But it’s uncertain when patients will feel comfortable returning to the doctor for routine and preventive care. A series of Census Bureau surveys conducted between June 11 and July 7 found that 42% of Californians who responded had put off medical care in the previous four weeks because of the pandemic. About 33% said they needed medical care for something unrelated to COVID-19 but did not get it.

“I’ve been telling my staff and patients that we should prepare for things to stay not too different for six months to a year,” Reddy said, “which is pretty depressing for most people to think about.”

 

 

 

 

 

 

 

US coronavirus data will now go straight to the White House. Here’s what this means for the world

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Data, Data Analytics, Data Control, Data Gathering, Data Governance, Data Integrity, Data Interpretation, Data Ownership, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Expert, Expert Opinion, False Hope, False Narrative, Honesty, Infection Control, Infection Control Plan, Infectious Virus, Integrity, Misinformation, Misinterpret, Mislead, Misleading, Mistrust, Mixed Message, Pandemic, Public Good, Public Health, Public Safety, Quarantine, Scientists, Silence, Silencing, Silencing Speech, Social Distancing, Transparency, Trust, Truth • Leave a comment

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US coronavirus data will now go straight to the White House ...

Led by physicians, scientists and epidemiologists, the US Centers for Disease Control and Prevention (CDC) is one of the most reliable sources of knowledge during disease outbreaks. But now, with the world in desperate need of authoritative information, one of the foremost agencies for fighting infectious disease has gone conspicuously silent.

For the first time since 1946, when the CDC came to life in a cramped Atlanta office to fight malaria, the agency is not at the front line of a public health emergency.

On April 22, CDC director Robert Redfield stood at the White House briefing room lectern and conceded that the coronavirus pandemic had “overwhelmed” the United States. Following Redfield at the podium, President Donald Trump said the CDC director had been “totally misquoted” in his warning that COVID-19 would continue to pose serious difficulties as the US moved into its winter ‘flu season in late 2020.

Invited to clarify, Redfield confirmed he had been quoted correctly in giving his opinion that there were potentially “difficult and complicated” times ahead.

Trump tried a different tack. “You may not even have corona coming back,” the president said, once again contradicting the career virologist. “Just so you understand.”

The exchange was interpreted by some pundits as confirmation that the CDC’s venerated expertise had been sidelined as the coronavirus continued to ravage the US.

In the latest development, the New York Times reported this week the CDC has even been bypassed in its data collection, with the Trump administration ordering hospitals to send COVID-19 data directly to the White House.

Diminished role

When facing previous public health emergencies the CDC was a hive of activity, holding regular press briefings and developing guidance that was followed by governments around the world. But during the greatest public health emergency in a century, it appears the CDC has been almost entirely erased by the White House as the public face of the COVID-19 pandemic response.

This diminished role is obvious to former leaders of the CDC, who say their scientific advice has never before been politicised to this extent.

As the COVID-19 crisis was unfolding, several CDC officials issued warnings, only to promptly disappear from public view. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, predicted on February 25 that the virus was not contained and would grow into a pandemic.

The stock market plunged and Messonnier was removed from future White House press briefings. Between March 9 and June 12 there was no CDC presence at White House press briefings on COVID-19.

The CDC has erred during the pandemic, most significantly in its initial efforts to develop a test for COVID-19. The testing kits proved to be faulty – a problem compounded by sluggish efforts to rectify the situation – and then by severe delays in distributing enough tests to the public.

But many public health specialists are nevertheless baffled by the CDC’s low profile as the pandemic continues to sweep the globe.

“They have been sidelined,” said Howard Koh, former US assistant secretary for health. “We need their scientific leadership right now.”

What does it mean for the world?

The CDC being bypassed in the collection of COVID-19 data is another body blow to the agency’s standing.

Hospitals have instead been ordered to send all COVID-19 patient information to a central database in Washington DC.

This will have a range of likely knock-on effects. For starters, the new database will not be available to the public, prompting inevitable questions over the accuracy and transparency of data which will now be interpreted and shared by the White House.

The Department of Health and Human Services, which issued the new order, says the change will help the White House’s coronavirus task force allocate resources. But epidemiologists and public health experts around the world fear the new system will make it harder for people outside the White House to track the pandemic or access information.

This affects all nations, because one of the CDC’s roles is to provide sound, independent public health guidance on issues such as infectious diseases, healthy living, travel health, emergency and disaster preparedness, and drug efficacy. Other jurisdictions can then adapt this information to their local context — expertise that has become even more essential during a pandemic, when uncertainty is the norm.

It is difficult to recall a previous public health emergency when political pressure led to a change in the interpretation of scientific evidence.

What happens next?

Despite the inevitable challenges that come with tackling a pandemic in real time, the CDC remains the best-positioned agency – not just in the US but the entire world – to help us manage this crisis as safely as possible.

In the absence of US leadership, nations should start thinking about developing their own national centres for disease control. In Australia’s case, these discussions have been ongoing since the 1990s, stymied by cost and lack of political will.

COVID-19, and the current sidelining of the CDC, may be the impetus needed to finally dust off those plans and make them a reality.

 

 

 

Maps Of The USA That Made Us Say “Whoa”: States Resized According To Population Density

Posted on by • Posted in Clinical Testing, Contact Tracing, Coronavirus, Economic Crisis, Economic Recovery, Economy Reopening, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Infection Control, Infection Control Plan, Infectious Virus, Mortality, National Strategy, Pandemic, Population Distribution, Population Health, Public Health, Public Safety, School Reopening, Social Determinants of Health, Social Distancing • Leave a comment

https://www.ranker.com/list/maps-mash-v1/mel-judson?format=slideshow&slide=25

States Resized According To Population Density

When a winner becomes a loser: Winston Churchill was kicked out of office in the British election of 1945

Posted on by • Posted in 2020 Election Issues, Election, Leadership, Leadership Cares, Leadership Integrity, Leadership Messaging, Leadership Trust, Trust, Truth, Voting, Voting by Mail • Leave a comment

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When a winner becomes a loser: Winston Churchill was kicked out of ...

The end of World War II in Europe and the defeat of Hitler and Nazi Germany in early May 1945 turned British Prime Minister Winston Churchill into the world’s most eminent statesman. He was feted and celebrated everywhere he went and had an approval rating of 83%.

Yet he suffered a humiliating election defeat in 1945.

Churchill’s electoral fate shows, I believe, that democratic elections are not won due to past achievements, personal glory and celebrity status, but because of a persuasive and realizable program for the next four or five years. Winning parties or candidates need a vision that addresses the genuine concerns and deep anxieties of the voters.

In 1945, it seemed a foregone conclusion that Churchill and his Conservative Party would win the next general election. No election had taken place during the war. The members of the British Parliament, the House of Commons, had been elected as far back as 1935.

While Churchill wanted to delay a general election until the end of the war in Asia, the Labour Party decided to leave Britain’s national unity government soon after victory in Europe was achieved, which sparked an election that took place on July 5, 1945.

Ballots weren’t counted until July 26, to allow votes from soldiers and residents of Britain’s far-flung overseas empire to arrive by mail.

Labour won a landslide victory. As soon as the election result was announced, Churchill went to Buckingham Palace to submit his resignation to King George VI. Labour leader Clement Attlee arrived at the palace within minutes of Churchill’s departure and was appointed new prime minister.

But at first he was greeted by an uncomfortable silence. Attlee finally told the king, “I’ve won the election.” The king, greatly displeased by the socialist Labour Party’s victory, said, “I know. I heard it on the six o’clock news.”

Watershed election

The magnitude of the loss was historic.

The Labour Party received 47.7% of the vote, compared to the Conservatives’ 36.2% and the Liberal party’s 9%.

This was a crushing blow for the Tories. Due to Churchill’s immense personal popularity, he was easily reelected in his Woodford constituency in Essex, but his party was decimated. Labour had a massive majority of 146 seats in the new Parliament.

The Labour government of 1945 would radically change British society by embarking on decolonization, which quickly led to the dissolution of the British Empire, and the creation of a new, progressive social and economic consensus that would last until Margaret Thatcher’s election victory in 1979.

Churchill took the defeat very badly.

He was just short of his 71st birthday, exhausted, in ill health and demoralized. He fell into a deep depression (his “black dog,” as he called it) and spent much time in the south of France to pursue his hobbies of painting and bricklaying.

When the king later offered him the country’s highest honor, The Order of the Garter, Churchill declined, saying that he couldn’t possibly accept such an honor, as the British voters had given him the “order of the boot.”

Churchill now was the official leader of the opposition, but it took him more than a year to overcome his apathy and reengage with politics. It was only U.S. President Harry S. Truman’s invitation to give a speech at Westminster College in Fulton, Missouri, in March 1946 – this was the “Iron Curtain speech” – that revived his political instincts and made him become politically active again.

How to lose an election

Until the last few days before the vote was held, Churchill and much of the country had been firmly convinced that he and his party would be returned to power with a large majority.

On occasion, however, Churchill realized that he had little to contribute to the raging debate about the future of British society.

“I have no message for them,” he said.

As a scholar who has written a book on Churchill’s politics, “Churchill’s Cold War: The Politics of Personal Diplomacy,” I see several reasons for the loss he and his party experienced.

The six-week election campaign in June and July 1945 sought to sway voters exhausted by six devastating years of war. They wanted a view of a bright future.

Soldiers in the field, too, were fed up with fighting and looked forward to a new age of prosperity and peace. Labour proposed a progressive social reform program that would transform the future of British society. The Conservative program was much more vague and focused on Churchill’s leadership.

Churchill and his party also conducted a poor election campaign. Symbolic of this was Churchill’s first campaign broadcast on June 4, 1945, in which he accused Attlee of harboring socialist dictatorial ambitions and even compared him to the Nazis. Outrageously, Churchill declared that Labour “would have to fall back on some sort of a Gestapo” to push through its reforms.

Attlee pointed out that the speech showed Churchill to be ill-suited to being a leader in peaceful times.

Labour had more attractive and persuasive ideas, such as government-supported full employment, the introduction of a free national health service and the nationalization of many key industries such as steel, coal and railways.

And Labour seemed to know how to implement these policies: Churchill had put senior Labour leaders in charge of running the country’s economic ministries during the war.

Housing, full employment, social welfare and the health system stood at the top of the list of most voters’ needs. Foreign affairs and national security policy, which Churchill emphasized, ranked much lower.

Another problem for the Conservatives was their poor image, which Churchill was not immune from. Despite the tremendous esteem he was held in, the elderly Churchill, with his elite background and paternalistic Victorian habits, was seen by many as out of touch with the modern world.

He also had outdated views about race and empire that for many – even back in 1945 – sounded not quite right for the new postwar era. Canadian Prime Minister MacKenzie King, who knew him well, concluded that maintaining “the British Empire and Commonwealth is a religion to him.”

Running on a bad record

Except for the years 1924 and 1929-31, Britain had been led by Conservative governments for more than two decades. The Tories could hardly avoid being seen as responsible for the high unemployment and miserable social and economic conditions of these years, especially because the conditions continued well into the 1950s.

The Conservatives were also viewed as the party of the appeasers who had, in the runup to the war, downplayed the Nazi threat, with Prime Minister Neville Chamberlain even having weakly given in to Hitler’s territorial demands.

Taking all these elements into account, it was little wonder that Churchill and the Tories lost the 1945 election.

But Churchill did not give up. In 1950 Churchill also narrowly lost the next general election. Just over a year later, with the Labour government in deep internal crisis and running out of steam, yet another election was called.

This time Churchill was victorious. In October 1951, he became prime minister again and felt greatly vindicated. He used his remaining four years as peacetime prime minister to reengage with the Soviet Union and attempt to negotiate an early end to the Cold War. Churchill retired in 1955 at the age of 80.

 

 

 

 

One question still dogs Administration: Why not try harder to solve the coronavirus crisis?

Posted on by • Posted in 2020 Election Issues, Accountability, Blame, Centers for Disease Control & Prevention (CDC), Clinical Testing, Competency, Contact Tracing, Coronavirus, Crisis, Crisis Management, Data, Data Analytics, Data Integrity, Data Interpretation, Data Ownership, Economic Crisis, Economic Recovery, Employer-Based Health Insurance, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Expert, Expert Opinion, False Hope, False Narrative, Health Insurance Coverage Adequacy, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Job, Job Loss, Job Market, Job Search, Job Security, Judgement, Leadership Decentralized, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Out of Control, Out of Pocket Expenses, Pandemic, Preexisting Conditions, Public Health, Public Safety, Public Trust, Quarantine, Scapegoat, School Reopening, Scientists, Social Distancing, Trust, Truth, Underinsured, Unemployment, Unemployment Insurance, Uninsured, Wishful Thinking • Leave a comment

https://www.washingtonpost.com/politics/trump-not-solve-coronavirus-crisis/2020/07/26/7fca9a92-cdb0-11ea-91f1-28aca4d833a0_story.html?utm_source=ActiveCampaign&utm_medium=email&utm_content=Republicans+Roll+Out+%241+Trillion+Coronavirus+Relief+Plan&utm_campaign=TFT+Newsletter+07272020

Questions to ask students in class to help them deal with the ...

Both President Trump’s advisers and operatives laboring to defeat him increasingly agree on one thing: The best way for him to regain his political footing is to wrest control of the novel coronavirus.

In the six months since the deadly contagion was first reported in the United States, Trump has demanded the economy reopen and children return to school, all while scrambling to salvage his reelection campaign.

But allies and opponents agree he has failed at the one task that could help him achieve all his goals — confronting the pandemic with a clear strategy and consistent leadership.

Trump’s shortcomings have perplexed even some of his most loyal allies, who increasingly have wondered why the president has not at least pantomimed a sense of command over the crisis or conveyed compassion for the millions of Americans hurt by it.

People close to Trump, many speaking on the condition of anonymity to share candid discussions and impressions, say the president’s inability to wholly address the crisis is due to his almost pathological unwillingness to admit error; a positive feedback loop of overly rosy assessments and data from advisers and Fox News; and a penchant for magical thinking that prevented him from fully engaging with the pandemic.

In recent weeks, with more than 145,000 Americans now dead from the virus, the White House has attempted to overhaul — or at least rejigger — its approach. The administration has revived news briefings led by Trump and presented the president with projections showing how the virus is now decimating Republican states full of his voters. Officials have also set up a separate, smaller coronavirus working group led by Deborah Birx, the White House coronavirus response coordinator, along with Trump son-in-law and senior adviser Jared Kushner.

For many, however, the question is why Trump did not adjust sooner, realizing that the path to nearly all his goals — from an economic recovery to an electoral victory in November — runs directly through a healthy nation in control of the virus.

“The irony is that if he’d just performed with minimal competence and just mouthed words about national unity, he actually could be in a pretty strong position right now, where the economy is reopening, where jobs are coming back,” said Ben Rhodes, a deputy national security adviser to former president Barack Obama. “And he just could not do it.”

Many public health experts agree.

“The best thing that we can do to set our economy up for success and rebounding from the last few months is making sure our outbreak is in a good place,” said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. “People are not going to feel comfortable returning to activities in the community — even if it’s allowed from a policy perspective — if they don’t feel the outbreak is under control.”

Some aides and outside advisers have tried to stress to Trump and others in his orbit that before he could move on to reopening the economy and getting the country back to work — and life — he needed to grapple with the reality of the virus.

But until recently, the president was largely unreceptive to that message, they said, not fully grasping the magnitude of the pandemic — and overly preoccupied with his own sense of grievance, beginning many conversations casting himself as the blameless victim of the crisis.

In the past couple of weeks, senior advisers began presenting Trump with maps and data showing spikes in coronavirus cases among “our people” in Republican states, a senior administration official said. They also shared projections predicting that virus surges could soon hit politically important states in the Midwest — including Michigan, Minnesota and Wisconsin, the official said.

This new approach seemed to resonate, as he hewed closely to pre-scripted remarks in a trio of coronavirus briefings last week.

“This could have been stopped. It could have been stopped quickly and easily. But for some reason, it wasn’t, and we’ll figure out what that reason was,” Trump said Thursday, seeming to simultaneously acknowledge his predicament while trying to assign blame elsewhere.

In addition to Birx and Kushner, the new coronavirus group guiding Trump includes Kushner advisers Adam Boehler and Brad Smith, according to two administration officials. Marc Short, chief of staff to Vice President Pence, also attends, along with Alyssa Farah, the White House director of strategic communications, and Stephen Miller, Trump’s senior policy adviser.

The working group’s goal is to meet every day, for no more than 30 minutes. It views its mission as half focused on the government’s response to the pandemic and half focused on the White House’s public message, the officials said.

White House spokeswoman Sarah Matthews defended the president’s handling of the crisis, saying he acted “early and decisively.”

“The president has also led an historic, whole-of-America coronavirus response — resulting in 100,000 ventilators procured, sourcing critical PPE for our front-line heroes, and a robust testing regime resulting in more than double the number of tests than any other country in the world,” Matthews said in an email statement. “His message has been consistent and his strong leadership will continue as we safely reopen the economy, expedite vaccine and therapeutics developments, and continue to see an encouraging decline in the U.S. mortality rate.”

For some, however, the additional effort is too little and far too late.

“This is a situation where if Trump did his job and put in the work to combat the health crisis, it would solve the economic crisis, and it’s an instance where the correct governing move is also the correct political move, and Trump is doing the opposite,” said Josh Schwerin, a senior strategist for Priorities USA, a super PAC supporting former vice president Joe Biden, the presumptive Democratic nominee.

Other anti-Trump operatives agree, saying he could make up lost ground and make his race with Biden far more competitive with a simple course correction.

“He’s staring in the mirror at night: That’s who can fix his political problem,” said John Weaver, one of the Republican strategists leading the Lincoln Project, a group known for its anti-Trump ads.

One of Trump’s biggest obstacles is his refusal to take responsibility and admit error.

In mid-March, as many of the nation’s businesses were shuttering early in the pandemic, Trump proclaimed in the Rose Garden, “I don’t take responsibility at all.” Those six words have neatly summed up Trump’s approach not only to the pandemic, but also to many of the other crises he has faced during his presidency.

“His operating style is to double- and triple-down on positions and to never, ever admit he’s wrong about anything,” said Anthony Scaramucci, a longtime Trump associate who briefly served as White House communications director and is now a critic of the president. “His 50-year track record is to bulldog through whatever he’s doing, whether it’s Atlantic City, which was a failure, or the Plaza Hotel, which was a failure, or Eastern Airlines, which was a failure. He can never just say, ‘I got it wrong and let’s try over again.’ ”

Another self-imposed hurdle for Trump has been his reliance on a positive feedback loop. Rather than sit for briefings by infectious-disease director Anthony S. Fauci and other medical experts, the president consumes much of his information about the virus from Fox News and other conservative media sources, where his on-air boosters put a positive spin on developments.

Consider one example from last week. About 6:15 a.m. that Tuesday on “Fox & Friends,” co-host Steve Doocy told viewers, “There is a lot of good news out there regarding the development of vaccines and therapeutics.” The president appears to have been watching because, 16 minutes later, he tweeted from his iPhone, “Tremendous progress being made on Vaccines and Therapeutics!!!”

It is not just pro-Trump media figures feeding Trump positive information. White House staffers have long made upbeat assessments and projections in an effort to satisfy the president. This, in turn, makes Trump further distrustful of the presentations of scientists and reports in the mainstream news media, according to his advisers and other people familiar with the president’s approach.

This dynamic was on display during an in-depth interview with “Fox News Sunday” anchor Chris Wallace that aired July 19. After the president claimed the United States had one of the lowest coronavirus mortality rates in the world, Wallace interjected to fact-check him: “It’s not true, sir.”

Agitated by Wallace’s persistence, Trump turned off-camera to call for White House press secretary Kayleigh McEnany. “Can you please get me the mortality rates?” he asked. Turning to Wallace, he said, “Kayleigh’s right here. I heard we have one of the lowest, maybe the lowest mortality rate anywhere in the world.”

Trump, relying on cherry-picked White House data, insisted that the United States was “number one low mortality fatality rates.”

Fox then interrupted the taped interview to air a voice-over from Wallace explaining that the White House chart showed Italy and Spain doing worse than the United States but countries like Brazil and South Korea doing better — and other countries that are doing better, including Russia, were not included on the White House chart. By contrast, worldwide data compiled by Johns Hopkins University shows the U.S. mortality rate is far from the lowest.

Trump is also predisposed to magical thinking — an unerring belief, at an almost elemental level, that he can will his goals into existence, through sheer force of personality, according to outside advisers and former White House officials.

The trait is one he shares with his late father and family patriarch, Fred Trump. In her best-selling memoir, “Too Much and Never Enough,” the president’s niece, Mary L. Trump, writes that Fred Trump was instantly taken by the “shallow message of self-sufficiency” he encountered in Norman Vincent Peale’s 1952 bestseller, “The Power of Positive Thinking.”

Some close to the president say that when Trump claims, as he did twice last week, that the virus will simply “disappear,” there is a part of him that actually believes the assessment, making him more reluctant to take the practical steps required to combat the pandemic.

Until recently, Trump also refused to fully engage with the magnitude of the crisis. After appointing Pence head of the coronavirus task force, the president gradually stopped attending task force briefings and was lulled into a false sense of assurance that the group had the virus under control, according to one person familiar with the dynamic.

Trump also maintained such a sense of grievance — about how the virus was personally hurting him, his presidency and his reelection prospects — that aides recount spending valuable time listening to his gripes, rather than focusing on crafting a national strategy to fight the pandemic.

Nonetheless, some White House aides insist the president has always been focused on aggressively responding to the virus. And some advisers are still optimistic that if Trump — who trails Biden in national polls — can sustain at least a modicum of self-discipline and demonstrate real focus on the pandemic, he can still prevail on Election Day.

Others are less certain, including critics who say Trump squandered an obvious solution — good governance and leadership — as the simplest means of achieving his other goals.

“There is quite a high likelihood where people look back and think between February and April was when Trump burned down his own presidency, and he can’t recover from it,” Rhodes said. “The decisions he made then ensured he’d be in his endless cycle of covid spikes and economic disruption because he couldn’t exhibit any medium- or long-term thinking.”

 

 

 

‘That’s Ridiculous.’ How America’s Coronavirus Response Looks Abroad.

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Expert, Expert Opinion, False Hope, False Narrative, Infection Control, Infection Control Plan, Infectious Virus, Job, Job Loss, Job Market, Job Search, Job Security, Leadership Decentralized, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Partisanship, Public Health, Public Safety, Quarantine, Scientists, Social Distancing, Underinsured, Undocumented Immigrants, Unemployment, Uninsured • Leave a comment

WATCH THE VIDEO

Video -'That's Ridiculous.' How America's Coronavirus Response ...

From lockdowns to testing, we showed people around the world the facts and figures on how the U.S. has handled the pandemic.

The United States leads the world in Covid-19 deaths, nearing 150,000 lost lives. The unemployment figures brought on by the pandemic are mind-boggling. The Trump administration’s slow and haphazard response has been widely criticized. But what does it look like to young people around the world, whose governments moved quickly and aggressively to contain the coronavirus?

We wanted to know, so we reached out to quite a few and showed them charts, facts, photos and videos illustrating the U.S. response. Spoiler: They were not impressed.

Many advanced economies, from Germany to Singapore, directly supplemented salaries to save jobs. Other nations with fewer resources started mass testing at the first sign of an outbreak. Many countries mandated universal lockdowns — and successfully flattened the curve. In some parts of Europe, you could be fined for straying too far from your home. And Vietnam, a nation of 95 million people, has not seen a single Covid-19 death.

This Opinion video is a follow-up to a popular video we produced last year, which asked young Europeans to respond to American policies such as health care and parental leave. Many comments suggested we produce a sequel. Well, here it is — the Covid-19 edition.

 

 

 

 

Pandemic Proves Why Leaders Must Protect Americans From Junk Insurance Plans

Posted on by • Posted in 2020 Election Issues, Chronic Care Management, Chronic Conditions, Chronic Diseases, Consumer Advocacy, Consumer Protection, Coronavirus, Dept of Health and Human Services (HHS), Employer-Based Health Insurance, Essential Health Benefits, Health Insurance Coverage Adequacy, Health Policy, Job, Job Loss, Job Market, Job Search, Job Security, Out of Pocket Expenses, Pandemic, Preexisting Conditions, Short Term Health Insurance, Skinny Health Plans, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

https://morningconsult.com/opinions/pandemic-proves-why-leaders-must-protect-americans-from-junk-insurance-plans/?utm_source=ActiveCampaign&utm_medium=email&utm_content=Republicans+Roll+Out+%241+Trillion+Coronavirus+Relief+Plan&utm_campaign=TFT+Newsletter+07272020

Cartoon – Short Term Health Insurance | HENRY KOTULA

The coronavirus pandemic hit the nation hard and fast, infecting Americans from coast to coast, overwhelming health care systems and wreaking havoc on the economy. Those with pre-existing conditions – like diabetes and cardiovascular disease – are more vulnerable to the deadly virus. Americans have higher rates of these chronic conditions than other countries, in part because so many people live without health insurance or have shoddy coverage. This has become increasingly worse over the last four years as underlying health coverage has shrunken for the virus’s hardest hit victims: Black Americans, Native Americans and people of color.

Of the hundreds of thousands of Americans now recovering from COVID-19, many will undoubtedly have new chronic conditions, like lasting lung damage. This will be on top of the pre-existing conditions many who were predisposed to coronavirus already had. Record job losses in the wake of the pandemic have resulted in the loss of employer-sponsored coverage for more than 5 million Americans who are now on the hunt for new, affordable health insurance plans.

This presents the perfect storm for junk insurance plans – short-term limited duration insurance plans – that allow discrimination based on pre-existing conditions, expose consumers to financial risk and provide inadequate coverage. STLDIs are more dangerous now than ever in our new COVID-19 reality. Let’s be clear: These junk insurance plans – touted by the Trump administration and supported through taxpayer dollars – are not the answer. It is time for our leaders to put back the limitations on how long they can be used.

As their name suggests, short-term limited duration plans are meant to be used temporarily to bridge short-term gaps in coverage that arise from a job loss or other extenuating circumstance. However, new federal rules under the Trump administration have allowed the coverage period of STLDI plans to expand from six to 12 months. The administration has also promoted these plans to states as being eligible for federal subsidies, meaning our tax dollars help pay for them. President Donald Trump himself has touted these plans for being more affordable than Obamacare, but that is because they lack the same protections and do not meet minimum essential coverage standards under the law.

That is what makes these plans so dangerous. Though they tend to be less expensive than Affordable Care Act plans, they leave consumers vulnerable to unanticipated out-of-pocket costs by offering bare-bones coverage. Unlike ACA plans, STLDI plans can exclude coverage for pre-existing conditions, do not cover the cost of prescription drugs, have annual or lifetime maximums on covered services, and are not required to cover preventive services like cancer screenings or maternity care.

The lower price tag may lure consumers suffering financially during the pandemic, but they are high risk for those who do not fully understand what they are buying. Without carefully reading the fine print, many may not know before purchasing that STLDI plans are exempt from ACA rules as well as regulations for insurers recently passed in the Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act. We have already seen the pandemic exacerbate existing health inequalities in America, and now these plans expose consumers, especially low-income individuals and those with chronic conditions, to more discrimination and financial ruin.

The Department of Health and Human Services has already acknowledged that these plans fall short. In fact, the government is having to cover the cost of COVID-19 testing for people with STLDI plans, classifying them as “uninsured.” Yet, they will not cover the cost of COVID-19 treatment, meaning those with STLDI plans could face bills in the thousands of dollars, considering the average cost to treat a hospitalized coronavirus patient is $30,000.

Consumers for Quality Care, a coalition of advocates and former policy makers which provides a voice for patients in the health care debate, recently sent a letter to HHS Secretary Alex Azar and Centers for Medicare & Medicaid Services Administrator Seema Verma asking that they protect consumers from these dangerous plans.

This pandemic has laid bare how dangerously unprepared America’s health care system is for a large-scale public health crisis. People needed high-quality insurance coverage before coronavirus hit, and they will need it long after the pandemic subsides. Let this be a lesson to the Trump administration – it is time to stop backing junk insurance plans and remove them from the open market. If our leaders fail to act, the lives and financial well-being of millions of Americans are at stake.