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— Sen. Cory Gardner (R-Colo.), in an interview with Colorado Public Radio, July 1, 2020
Sound familiar? Just like President Trump, these Republican senators say they support coverage guarantees for patients with preexisting health conditions. And just like Trump, their records show the opposite.
The president’s doublespeak — voicing support for these protections while asking the Supreme Court to strike them down — is spreading into some battleground Senate races this year.
It’s a classic case of buyer beware: Look under the hood of what Daines, Gardner and McSally are selling, and you’ll find a car without an engine.
Republicans for a decade have tried to repeal the Affordable Care Act, President Barack Obama’s signature health-care legislation. The Supreme Court has upheld the law twice in the face of challenges from conservative groups. As coronavirus cases reached a new high in the United States, the Trump administration filed a legal brief on June 25 asking the Supreme Court to strike down the entire law, joining with a group of GOP state attorneys general who argue that the ACA is unconstitutional.
Before the ACA, insurance companies could factor in a person’s health status while setting premiums, a practice that sometimes made coverage unaffordable or unavailable for those in need of expensive treatment or facing a serious illness such as cancer.
The ACA PROHIBITED THIS PRACTICE through two provisions: “guaranteed issue,” which means insurance companies must sell insurance to anyone who wants it, and “community rating,” which means people in the same age group and geographic area who buy similar insurance pay similar prices. The changes made insurance affordable for people with serious diseases or even those with minor health problems, who also could have been denied coverage before the law’s passage.
Now, about 20 million people covered through the ACA could lose their health insurance if the Supreme Court strikes down the law, among many other consequences bearing directly on the U.S. response to the coronavirus pandemic.
In addition to the coverage guarantee, the ACA established online health insurance marketplaces and subsidies for participating buyers. The law also directs billions of dollars a year in federal funding to states that have chosen to expand their Medicaid programs under the Obamacare law. Millions of Americans have gained coverage through those provisions.
We asked the Daines, Gardner and McSally campaigns whether the senators support or oppose the GOP lawsuit at the Supreme Court and how they would address affordability issues for patients with preexisting conditions if the ACA falls. None of their campaigns responded to our questions.
“Steve Daines will protect Montanans with preexisting conditions.”
Regarding the GOP lawsuit, a Daines spokesperson was quoted in the Billings Gazette saying the senator “supports whatever mechanism will protect Montanans from this failed law, lower health care costs, protect those with preexisting conditions and expand access to health care for Montanans.”
“What I look forward to working on is a plan that protects people with preexisting conditions.” (Gardner)
Gardner has been voting to repeal, defund or replace the ACA since 2011, the year after its passage. This year, his campaign website says nothing about the law, but his official Senate website says, “Fixing our healthcare system will require repealing the Affordable Care Act and replacing it with patient-centered solutions, which empower Americans and their doctors.”
“Of course I will always protect those with preexisting conditions. Always.” (McSally)
In 2015, McSally voted to repeal the ACA when she served in the House. In 2017, she voted to replace the ACA with the American Health Care Act, which would have allowed insurers to charge higher premiums to patients with complicated medical histories.
McSally, now in the Senate, has declined to comment on the GOP lawsuit pending before the Supreme Court. When asked by PolitiFact, “the campaign didn’t specifically answer, but pointed to her general disapproval of the ACA.”
WHAT HAPPENS IF THE GOP LAWSUIT SUCCEEDS?
Trump told The Washington Post days before his inauguration in 2017 that he was nearly done with his plan to replace the ACA. Three and a half years later, no replacement plan has emerged from the administration and Republicans in Congress hardly agree on what it would look like — or how to preserve the protections for preexisting health conditions.
Sen. Thom Tillis (R-N.C.), who is also running for reelection this year, has introduced a 24-page bill called the Protect Act that includes language guaranteeing coverage for preexisting conditions. Daines signed on as a co-sponsor on June 24, the day before the Justice Department filed its brief in the Supreme Court. McSally signed on in April 2019. Gardner is not listed as a co-sponsor.
Experts say the Tillis proposal does not offer the same level of protection for preexisting conditions as the ACA, and they warn that millions of Americans could lose their health coverage if the ACA falls and the Protect Act is the only replacement.
“Insurers before the Affordable Care Act had multiple and redundant ways that they could avoid people who had preexisting conditions,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation. The Protect Act prevents some of those practices, but it “leaves enough other loopholes that it would make it very possible and likely for insurers to be able to avoid paying benefits for the conditions they most worry about,” she said.
Before the ACA, an insurance company could reject an application outright, say, after reviewing a patient’s medical history. The Protect Act has language barring that practice.
“The second thing they could do is, they could sell you coverage, but they could exclude your preexisting condition. ‘Oh, you have diabetes? I’m not going to pay for any of those benefits,’” Pollitz said. “The Tillis bill says you can’t do that, so that’s good.”
In the days before the ACA, insurers were allowed to charge higher premiums based on a patient’s health status. To prevent this, the Protect Act takes language from the Health Insurance Portability and Accountability Act (HIPAA), rather than the newer ACA.
“The Protect Act inserts old HIPAA nondiscrimination language that prevents employers from varying worker premium contributions based on health status,” Pollitz said. “But the Protect Act also includes the old rule of construction that says nothing limits what the insurance company can charge the employer or individual.”
Pollitz said the “community rating” language in the ACA provides clearer protections in this area. The Protect Act says “nothing … shall be construed to restrict the amount that an employer or individual may be charged for coverage under a group health plan.”
“The bill would reinstate three protections at risk in the Texas case — prohibiting insurers from denying applicants based on pre-existing conditions, charging higher premiums due to a person’s health status, and excluding pre-existing conditions from coverage,” Sarah Lueck, a senior policy analyst at the left-leaning Center on Budget and Policy Priorities, wrote in an analysis.
“But it would leave many others on the cutting room floor,” she wrote, because insurers would be able to exclude coverage of benefits such as maternity care, mental health and substance-use treatment; set annual and lifetime limits on insurance payouts; and charge older patients more than younger patients at greater levels than the ACA allows, among other changes.
It’s important to keep in mind that the Protect Act would not replace other parts of Obamacare, such as the online marketplaces and subsidies. Neither would it continue the ACA’s Medicaid expansion, which 37 states and D.C. have now adopted. That includes Arizona, Colorado and Montana.
Voters deserve straight answers when their health care is on the line, especially in the middle of a deadly pandemic.
Daines, Gardner and McSally have voted to end the Affordable Care Act. People with preexisting conditions would have been left exposed because of those votes; insurers could have denied coverage or jacked up prices for sick patients.
The three senators’ comments about the GOP lawsuit are woefully vague, but they can all be interpreted as tacit support. Asked about the case, a Daines spokesperson said “whatever mechanism” to get rid of the ACA would do. McSally’s campaign “didn’t specifically answer, but pointed to her general disapproval of the ACA.” Gardner avoided the question six times in one interview, but in another, he said: “That’s the court’s decision. If the Democrats want to stand for an unconstitutional law, I guess that’s their choice.”
Four Pinocchios all around.
Hospitals will begin sending coronavirus-related information directly to the Department of Health and Human Services (HHS), not the Centers for Disease Control and Prevention (CDC), under new instructions from the Trump administration.
The move will take effect on Wednesday, according to a new guidance and FAQ document for hospitals and clinical labs quietly posted on the HHS website.
Previously, hospitals reported to the CDC’s National Healthcare Safety Network, which the agency describes as the nation’s most widely used health care-associated infection tracking system.
The CDC tracked information including how many beds are available, the number of ventilators available and how many COVID-19 patients the hospitals have.
Beginning Wednesday, hospitals will report the same data but will bypass the CDC and send it to HHS directly.
According to HHS, the goal is to streamline data collection, which will be used to inform decisions at the federal level such as allocation of supplies, treatments and other resources.
But the move comes amid concerns that the White House has been sidelining the CDC and after Trump administration officials attacked Anthony Fauci, the nation’s top infectious disease expert and a member of the White House coronavirus task force.
The United States is being ravaged by a deadly pandemic that is growing exponentially, overwhelming health care systems and costing thousands of lives, to say nothing of an economic recession that threatens to plague the nation for years to come.
But the American public seems to be over the pandemic, eager to get kids back in schools, ready to hit the bar scene and hungry for Major League Baseball to play its abbreviated season.
The startling divergence between the brutal reality of the SARS-CoV-2 virus and the fantasy land of a forthcoming return to normalcy has public health experts depressed and anxious about what is to come. The worst is not behind us, they say, by any stretch of the imagination.
“It’s an absolute disconnect between our perceived reality and our actual reality,” said Craig Spencer, a New York City emergency room doctor who directs global health in emergency medicine at New York Presbyterian/Columbia University Medical Center. “To look at the COVID case count and the surge in cases and to think that we can have these discussions as we have uncontrolled spread, to think we can have some national strategy for reopening schools when we don’t even have one for reopening the country, it’s just crazy.”
The number of dead from the virus in the United States alone, almost 136,000, is roughly equal to the populations of Charleston, S.C., or Gainesville, Fla. If everyone in America who had been infected lived in the same city, that city would be the third-largest in the country, behind only New York and Los Angeles. More people in the United States have tested positive for the coronavirus than live in the state of Utah. By the weekend, there are likely to be more confirmed coronavirus cases than there are residents of Connecticut.
There are signs that the outbreak is getting worse, not better. The 10 days with the highest number of new coronavirus infections in the United States have come in the past 11 days.
Case counts, hospitalizations and even deaths are on the rise across the nation, not only in Southern states that were slow to embrace lockdowns in March and April.
California, the first state to completely lock down, has reported more than 54,000 new cases over both of the last two weeks. Nevada, about one-thirteenth the size of California, reported 5,200 new cases last week. States where early lockdowns helped limit the initial peak like Pennsylvania, Illinois and Ohio are all seeing case counts grow and hospital beds fill up.
Only two states — Maine and New Jersey — have seen their case counts decline for two consecutive weeks.
“We are nearing the point where pretty much most of the gains we had achieved have been lost,” said Christine Petersen, an epidemiologist at the University of Iowa. “All of us are hoping we magically get our acts together and we can look like Europe in two months. But all the data shows we are not doing that right now.”
It is in that dismal context that schools are preparing some sort of return to learning, whether in person or remote. President Trump and Education Secretary Betsy DeVos have threatened schools that do not fully reopen.
But even though the coronavirus appears to have less severe consequences among children, sending them back to schools en masse does not carry zero risk. Children have died from the virus, and the more who are exposed mean more opportunities for the virus to kill again, even before considering the millions of teachers who may be vulnerable or the parents and grandparents asymptomatic children might be exposed to.
Already, school districts in Los Angeles and San Diego have delayed reopening plans as case counts rise.
“We do know that kids can get sick and they can even die. It’s definitely a much lower number,” Petersen said. “Even if they aren’t as infectious, if there are millions of them gathering in schools not having great hygiene, it’s a multiplier effect.”
The painful lockdowns that were supposed to reduce viral transmissions bought time to bolster testing and hospital capacity, to speed production of the equipment needed to test patients and protect front-line health care workers.
But that hasn’t happened; laboratories in the United States have tested as many as 823,000 people in a day, a record number but far shy of the millions a day necessary to wrestle the virus under control. Arizona and Los Angeles have canceled testing appointments for lack of supplies. Hospitals are reporting new shortages of protective gear and N95 masks.
The Trump administration used the Defense Production Act to order meat processing plants to stay open; it has only awarded contracts sufficient to produce 300 million N95 masks by the end of the year, far short of what health experts believe will be necessary to protect health care workers.
“A failure of national leadership has led us to a place where we are back where we were before, no national testing strategy, no national strategy for supply,” said Kelli Drenner, who teaches public health at the University of Houston. “States are still on their own to scramble for reagents and swabs and PPE and all of that, still competing against each other and against nations for those resources.”
There are troubling signs that the promise of a vaccine may not be the cure-all for which many had hoped. Early studies suggest that the immune system only retains coronavirus antibodies for a few months, or perhaps a year, raising the prospect that people could become reinfected even after they recover. A growing, if still fringe, movement of anti-vaccination activists may refuse a vaccine altogether, putting others at risk.
“A vaccine is not going to solve this. People die of vaccine-preventable diseases every day. All the failures with testing and diagnostics and all the inequities and access to care with those are going to be the same things that are going to be magnified with a vaccine,” said Nita Bharti, a biologist at Penn State’s Center for Infectious Disease Dynamics.
More than a dozen states hit hardest by the latest wave of disease have paused or reversed their reopening processes. But only 24 states and the District of Columbia have ordered residents to wear masks in public, and compliance varies widely by both geography and political affiliation.
“This is the critical time. If we are going to try to reverse this, we have to get back to the mental space and the resolute action we had in March. I’m not sure we have the energy and the wherewithal to do it,” Petersen said.
Without a dramatic recommitment to conquering the virus, health officials warn, the new normal in which the country exists will be one of serious and widespread illness, and a steady drumbeat of death.
“None of this was inevitable. None of this should be acceptable. There are ways we can do better,” Spencer said. “This will continue to be our reality for as long as we don’t take it seriously.”
But after months of repeating the same warnings — wear a mask, stay socially distant, stay home if possible, avoid places where people congregate in tight quarters — some health experts worry their message has been lost amid a sea of doubt, skepticism and mixed signals.
“It’s like a learned helplessness when we’re not helpless,” Drenner said. “There are some pretty effective strategies, but we don’t seem to have the political will to do it.”
UnitedHealth Group reported $6.6 billion in profit for the second quarter, beating Wall Street projections.
That’s also a significant increase in profit compared to the second quarter of 2019, where the healthcare giant brought in $3.3 billion, according to its earnings report (PDF) issued Wednesday.
UnitedHealth’s mid-year profits sit at $10 billion, compared to $6.8 billion in the first half of 2019.
The insurer also reported $62.1 billion in revenue for the quarter, an increase year-over-year but a number that fell short of analysts’ expectations. UnitedHealth brought in $60.6 billion in revenue in the second quarter of 2019.
Through the first half of 2020, UnitedHealth has earned $126.6 billion in revenue, up from $120.9 billion in the first six months of 2019.
The insurer attributes the unexpectedly high profit to large amounts of care deferral due to the coronavirus pandemic and said it’s likely to see that offset in future quarters as elective procedures and other services resume.
In the earnings release, CEO David Wichmann touted the company’s efforts to combat the pandemic in the second quarter.
“Our 325,000 dedicated team members, including the 120,000 clinicians serving on the front lines of care, have tirelessly responded to COVID-19 with agility, innovation and compassion,” Wichmann said in a statement.
“We moved swiftly to assist the people we serve and their care providers, including the provision of $3.5 billion in proactive voluntary customer assistance and accelerated care provider funding. We remain committed to taking further actions to address any future imbalances as a result of the pandemic,” he said.
Though COVID-19’s full impact on finances remains unclear, UnitedHealth maintained its full-year earnings guidance of between $15.45 and $15.75 per share.
https://www.cnn.com/world/live-news/coronavirus-pandemic-07-15-20-intl/index.html
More than 400 million people across three Indian states will re-enter lockdown, weeks after a nationwide lockdown was lifted on May 30.
This comes after India recorded 100,000 new coronavirus cases in the past five days as the country struggles to gain control of the worsening pandemic.
On Wednesday, it saw 29,429 new cases, bringing the total to 936,181 confirmed cases and 24,309 deaths.
State and city-wide measures: As cases and deaths continue to soar in India, two of its most populous states — Bihar and Uttar Pradesh — announced various lockdown restrictions.
Bihar’s government announced a 16-day long state-wide lockdown on Tuesday, which would come into effect from July 16, while Uttar Pradesh’s government said Sunday that a lockdown will take place every weekend until the end of July.
Both states had previously lifted their lockdowns on May 30 except for districts with a high number of cases.
The city of Bengaluru, in Karnataka state, which had also initially lifted restrictions, went into a week-long lockdown on Tuesday until July 22. This comes after the state of Maharashtra reinstated a lockdown on June 29 until July 31.
India began easing lockdown restrictions on May 30, but certain states such as West Bengal and Jharkhand continued to have lockdown measures and restrictions on movement, with the exception of certain essential services.
More than 100 million people in these states have remained under lockdown restrictions since late March.
In the capital, New Delhi, where there are no overarching lockdown measures, restrictions continue in its “containment zones,” which include more than 600 localities as of Monday, according to the territory’s Revenue Department.
https://www.cnn.com/world/live-news/coronavirus-pandemic-07-15-20-intl/index.html
British Prime Minister Boris Johnson committed to an eventual independent inquiry into “what happened” in the UK during the coronavirus pandemic, but added that now is not the time for it.
“Of course we will seek to learn the lessons of this pandemic in the future,” Johnson told the House of Commons during parliament’s weekly prime minister’s questions on Wednesday.
Johnson also told lawmakers he cannot “simply with a magic wand” ensure every job is retained throughout this period.
When asked by opposition leader Keir Starmer if he would personally intervene in reports that airline British Airways are re-hiring staff on worse terms, Johnson said the government is “absolutely clear” they want companies to keep workers in employment “where they possibly can.”
“No one should underestimate the scale of the challenge this country faces,” Johnson said, assuring the government is doing a “huge amount” to help the aviation sector.
https://www.cnn.com/world/live-news/coronavirus-pandemic-07-15-20-intl/index.html
The United States saw a record number of new cases Tuesday with 67,417, according to data from Johns Hopkins University. As of Tuesday, more than 3.4 million people in the US have been infected, and 38 states are reporting an increase in the number of new cases from the week before.
With Covid-19 cases soaring in the US South and Southwest, the nation’s public health experts fear the end is not yet in sight and wonder what normal will look like as the pandemic stretches on through the rest of the year.
While New York and New Jersey were the early virus hotspots, California, Florida, Arizona and Texas now have become the states to watch, Dr. Anthony Fauci, the nation’s top infectious disease doctor, said Tuesday.
The states continue to report new records:
Meanwhile, at least 27 states have paused or rolled back plans to reopen their economies. Among them is Nevada, where 37 bars have filed a lawsuit to fight Gov. Steve Sisolak’s order to revert back to Phase 1 of the state’s reopening plan.
But Fauci cautioned that relaxed restrictions in California, Florida, Arizona and Texas are partly to blame for rising cases in those states, particularly among young people.
Addressing the climb in the number of cases overall and among young people, US Centers for Disease Control and Prevention Director Dr. Robert Redfield said Tuesday the nation is in a much better place than it was in the spring, because the mortality rate is lower, but said “we’re not out of the woods for this.”
HENRY KOTULA 