Vowed changes to health in­sur­ance raise un­cer­tainty for thou­sands

Mea­sures could weaken but likely not stop bay cleanup ef­forts DOJ could see its role di­min­ished in over­sight of po­lice mis­con­duct

Baltimore Sun - - ELECTION 2016 - By Scott Dance sdance@balt­sun.com twit­ter.com/ss­dance By Andrea K. McDaniels and Mered­ith Cohn Bal­ti­more Sun re­porter John Fritze con­trib­uted to this ar­ti­cle. am­c­daniels@balt­sun.com twit­ter.com/ankwalker By Kevin Rec­tor krec­tor@balt­sun.com twit­ter.com/rec

When the Obama ad­min­is­tra­tion laid out a 15-year plan to clean up the Ch­e­sa­peake Bay, fed­eral and state of­fi­cials called it “one of the most com­pre­hen­sive restora­tions in decades.”

Pres­i­dent-elect Don­ald Trump can­not uni­lat­er­ally dis­man­tle the far-reach­ing pro­gram. It is re­in­forced by fed­eral law and has al­ready sur­vived a le­gal chal­lenge.

But the real es­tate mogul cam­paigned on plans to dras­ti­cally re­duce fed­eral reg­u­la­tions, and leave be­hind noth­ing but “tid­bits” of the En­vi­ron­men­tal Pro­tec­tion Agency.

The tran­si­tion could be shock­ing for con­ser­va­tion­ists but wel­come for farm­ers and de­vel­op­ers who com­plain of an ex­ces­sive and ex­pen­sive reg­u­la­tory bur­den.

“Any­thing that’s de­pen­dent on the EPA or fed­eral fund­ing I think we need to con­sider at least in jeop­ardy,” said Josh Tulkin, di­rec­tor of the Sierra Club’s Mary­land chap­ter.

The so-called pol­lu­tion diet the Obama ad­min­is­tra­tion laid out for the bay in 2010 es­tab­lished broad reg­u­la­tions on how much fer­til­izer can be spread on crops and lawns, how thor­oughly waste­water-treat­ment plants must process sewage and what lo­cal gov­ern­ments must do to re­duce runoff.

Such plans are laid out in the fed­eral Clean Wa­ter Act, so as long as the Ch­e­sa­peake is clas­si­fied as “im­paired,” it would take an act of Congress to halt the cleanup ef­fort.

“I don’t think there’s a lot of wig­gle room that one per­son could come in and do away with it,” said Valerie Con­nelly, ex­ec­u­tive di­rec­tor of the Mary­land Farm Bureau.

The plan has drawn sup­port from both Democrats and Repub­li­cans, so it’s un­clear that the Trump ad­min­is­tra­tion would tar­get it, said Ann Swan­son, ex­ec­u­tive di­rec­tor of the Ch­e­sa­peake Bay Com­mis­sion, a col­lab­o­ra­tion be­tween Mary­land, Penn­syl­va­nia and Vir­ginia.

Still, Swan­son said, she hopes Trump’s rhetoric around a new ap­proach to en­vi­ron­men­tal pol­icy was over­stated “cam­paign talk.”

Even if the cleanup plan re­mains, its en­force­ment de­pends on the strength of the EPA.

“It’s al­ways the prod­uct of a lot of lead­er­ship in how you im­ple­ment a [cleanup plan] suc­cess­fully, so the lead­er­ship at the U.S. EPA will deeply mat­ter,” Swan­son said.

Others are look­ing for­ward to re­laxed reg­u­la­tion un­der Trump. The farm bureau is ea­ger to fight a new EPA rule ex­pand­ing the types of wa­ter­ways over which it has author­ity, for ex­am­ple, while also look­ing for­ward to Trump’s promised rene­go­ti­a­tion of trade agree­ments.

“I think farm­ers at least feel like they’re go­ing to have a seat at the ta­ble,” Con­nelly said.

The election of Don­ald Trump raises new un­cer­tainty not only for the nearly 421,000 Mary­lan­ders who have in­sur­ance un­der the Af­ford­able Care Act, but also the state’s unique cost-con­trol agree­ment with Medi­care.

Un­der the lu­cra­tive agree­ment with the fed­eral gov­ern­ment, the state sets uni­form prices for hospi­tal care, which means Medi­care pays more in Mary­land than else­where. In ex­change, the state’s hos­pi­tals must keep health costs down. But they could lose mil­lions of dol­lars if the agree­ment, which is be­ing rene­go­ti­ated and ex­pires in two years, went away.

The sta­tus of both fed­eral health care pro­grams is in doubt un­der a Trump ad­min­is­tra­tion. The Repub­li­can has promised to re­peal the Af­ford­able Care Act, also known as Oba­macare.

Pres­i­dent Barack Obama has blocked past con­gres­sional at­tempts to re­peal the law. On Wed­nes­day, House Speaker Paul Ryan and Se­nate Ma­jor­ity Leader Mitch McCon­nell said they would help Trump keep his word.

Re­peal has been a pri­or­ity of Repub­li­cans since a Demo­cratic Congress ap­proved the law in 2010.

“Re­strict­ing the num­ber of op­tions in the mar­ket, which is what the Af­ford­able Care Act end­ing up do­ing, is not the way to bring rates down,” said Rep. Andy Har­ris, a Bal­ti­more County Repub­li­can.

Rep. Eli­jah E. Cum­mings, a Bal­ti­more Demo­crat, warned that re­peal “would have dev­as­tat­ing ef­fects, es­pe­cially on vot­ers in states that went most heav­ily for Don­ald Trump.”

“Elim­i­nat­ing some­one’s health in­sur­ance is not a so­lu­tion to stem in­creas­ing pre­mi­ums,” Cum­mings said in a state­ment. “Re­peal­ing Oba­macare would in­crease the na­tional deficit by hun­dreds of bil­lions of dol­lars, and it would be dev­as­tat­ing for the work­ing poor, in­di­vid­u­als with pre-ex­ist­ing con­di­tions, and mil­lions of others who only re­cently were able to ob­tain health in­sur­ance.”

Leni Pre­ston, pres­i­dent of the ad­vo­cacy group Con­sumer Health First, said any change to Oba­macare should be thought out so mil­lions of peo­ple aren’t just thrown off health in­sur­ance with­out an­other op­tion.

More un­clear is what will hap­pen to Mary­land’s hospi­tal cost-con­trol deal with Medi­care.

“I am hope­ful that I can work with Gover­nor Ho­gan and the rest of our con­gres­sional del­e­ga­tion to pre­serve Mary­land’s unique model,” Sen.-elect Chris Van Hollen said.

“The Medi­care waiver in Mary­land has re­ally de­pended on the gov­ern­ment con­trol of the pric­ing of health care,” Har­ris said. “I think in gen­eral that pol­icy is not a phi­los­o­phy that Mr. Trump has.”

Pre­ston said the ar­range­ment could go away if the fed­eral of­fice that over­sees it is elim­i­nated by the Trump ad­min­is­tra­tion or sim­ply if new staff mem­bers are un­fa­mil­iar with the pro­gram.

Af­ter serv­ing as an ag­gres­sive watch­dog for po­lice mis­con­duct dur­ing the Obama ad­min­is­tra­tion, the Depart­ment of Jus­tice could see its role di­min­ished un­der Don­ald Trump, an­a­lysts say.

Such a shift would dras­ti­cally al­ter the fed­eral response to the con­tin­u­ing de­bate around polic­ing in Amer­i­can cities at a time when many lo­cal de­part­ments are ill-equipped to tackle re­forms on their own, they said.

“This is a cat­a­clysmic change,” said Jonathan Smith, a for­mer chief of spe­cial lit­i­ga­tion in the Jus­tice Depart­ment’s civil rights di­vi­sion, where he over­saw more than 20 in­ves­ti­ga­tions into po­lice agen­cies. “The world re­ally did change un­der our feet.”

Trump, the self-styled “law and or­der” can­di­date, said dur­ing the cam­paign he would rein­tro­duce the con­tro­ver­sial stop-and-frisk poli­cies crit­i­cized by Pres­i­dent Barack Obama’s Jus­tice Depart­ment in cities across the coun­try.

Rudy Gi­u­liani, a top Trump ad­viser and cam­paign sur­ro­gate, has been a cham­pion of the tac­tic since his ten­ure as mayor of New York dur­ing the1990s. He has been men­tioned as a pos­si­ble Trump pick for at­tor­ney gen­eral.

While Obama has fo­cused on crim­i­nal jus­tice re­form, Trump cam­paigned on stronger sup­port for po­lice of­fi­cers and a tougher ap­proach against crime.

Sa­muel Walker, pro­fes­sor emer­i­tus of crim­i­nol­ogy and crim­i­nal jus­tice at the Univer­sity of Ne­braska, Omaha, said those dif­fer­ences in tone are likely to be re­flected in how Trump de­ploys his Jus­tice Depart­ment.

“This is a his­toric shift in pub­lic pol­icy, and the poli­cies in the fed­eral gov­ern­ment, and that’s based on Trump’s words, the Repub­li­can plat­form and the var­i­ous peo­ple who are his ad­vis­ers and sup­port­ers,” Walker said.

Stephen Rushin, an as­sis­tant law pro­fes­sor at the Univer­sity of Alabama, said “it’s hard to imag­ine a Rudy Gi­u­liani DOJ be­ing the same rig­or­ous en­force­ment arm as Eric Holder’s or Loretta Lynch’s DOJ” on po­lice re­form.

The shift could have a pow­er­ful im­pact in Bal­ti­more, where Obama’s Jus­tice Depart­ment is cur­rently ne­go­ti­at­ing a court-en­forced con­sent de­cree man­dat­ing po­lice re­forms with city of­fi­cials.

A re­cent Jus­tice Depart­ment in­ves­ti­ga­tion found dis­crim­i­na­tory and un­con­sti­tu­tional prac­tices at nearly all lev­els of the Bal­ti­more Po­lice Depart­ment.

Rushin said all signs point to a Trump ad­min­is­tra­tion be­ing less liti­gious on po­lice re­form. more a more le­nient deal could play into talks now, said David Har­ris, a law pro­fes­sor at the Univer­sity of Pitts­burgh who stud­ies polic­ing.

“It is go­ing to be at the back of ev­ery­body’s mind around that ta­ble,” said Har­ris. “I’m sure that the peo­ple in the Depart­ment of Jus­tice would like to get it wrapped up be­fore the next ad­min­is­tra­tion comes in, but maybe the peo­ple on the other side of the ta­ble [rep­re­sent­ing the city] will want things to move more slowly.”

Mayor-elect Cather­ine E. Pugh, who takes of­fice Dec. 6, said she is not con­cerned about reach­ing an agree­ment be­fore Trump takes over. A greater con­cern, she said, is how the city will pay for the re­forms.

Po­lice Com­mis­sioner Kevin Davis has said his depart­ment is com­mit­ted to re­form with or with­out the Jus­tice Depart­ment’s in­volve­ment.


Repub­li­can Pres­i­dent-elect Don­ald Trump de­liv­ers his ac­cep­tance speech at the New York Hil­ton Mid­town Wed­nes­day morn­ing.

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