Connie, Crack-o-lanterns and General Robert E. Lee
From Los Angeles Times
After delivering yet another malicious blow to the Affordable Care Act, President Donald Trump took to Twitter (of course) on Friday to tell Democrats that they “should call me to fix” the law he’s sabotaging.
It sounded like the sort of thing you’d hear in a mobster movie: “Nice insurance business you’ve got here. I’d sure hate to see anything bad happen to it.”
The fact is, a handful of Republicans and Democrats have been trying to work out a compromise on how to address the most problematic aspect of the ACA: the state exchanges where private insurers sell policies to people not covered by group health plans. Competition has been dwindling and premiums rising fast in a number of states, particularly in less populous counties.
But even if Trump actually agrees to negotiate, there seems little chance of a deal. He and many other Republicans envision a health care system that’s fundamentally different from the one enshrined by Democrats in the ACA. Instead of having Americans share health risks and costs broadly, with the healthy picking up some of the insurance tab for the ill and injured, the president and congressional Republicans want to let people avoid the costs imposed by others with risks or maladies they don’t share.
We tried the latter approach before, and it left tens of millions of people uninsured while saddling sicker Americans with double-digit premium increases and steadily growing deductibles throughout the early 2000s. The ACA moved the country away from that unworkable system — until Thursday, when Trump took two steps to push the country back in that old, failed direction.
The first was an executive order calling on federal agencies to help the roughly 20 million people not covered by large group plans shop outside the state exchanges for policies that aren’t governed by the ACA’s insurance requirements. The new rules and guidelines, which will take months to develop, aim to promote thinner policies that cover fewer risks but carry lower premiums. That trade-off would be especially appealing to younger, healthier consumers who don’t see the need for comprehensive insurance.
Encouraging people to leave the exchanges, though, defeats the main purpose of these marketplaces: to create big regional risk pools to hold down premiums by spreading health care costs broadly. And the likely consequence is that the state exchanges will be left serving only those people who do need comprehensive coverage — those in dangerous lines of work or with preexisting conditions that might be excluded from thinner plans. And the insurers that serve them will wind up charging even higher premiums to cover the higher cost per enrollee. In short, pulling healthier people out of the state exchanges will only exacerbate the problem of rising premiums that Republicans claim to want to fix.
Granted, many Republicans chafe at the idea of requiring people to buy comprehensive policies. Why should those who don’t use drugs have to carry coverage for substance abuse treatment, for instance? Why should men have to pay for maternity coverage? Or to put it more bluntly, why shouldn’t individuals be responsible for their own problems?
That’s like car insurance: Good drivers pay lower premiums. But public opinion polls show that Americans strongly favor a different model for health insurance, one that doesn’t penalize people for having gotten sick or injured.
The way to improve the state exchanges is to bring more people into them, not fewer, so that costs and risks can be spread across a bigger base. That’s the lesson from California, where aggressive marketing has helped boost enrollment of younger, healthier consumers and hold down premium increases.
Which brings us to the other, even more dramatic step Trump took Thursday: the White House’s late-night announcement that it would no longer reimburse insurers for the cost of reducing the deductibles, co-pays and other out-of-pocket expenses incurred by their lowest-income customers.
The ACA not only compels insurers to make these “cost-sharing reductions,” it requires the federal government to reimburse them. Yet Congress has declined to do so. So the Obama and Trump administrations have paid the reimbursements out of the funds the ACA provided for premium subsidies, prompting a legal battle with the House GOP leadership. The administration said Thursday that the House was right, and ended the payments effective immediately. The move will cost insurers about $7 billion a year, but that cost will still largely be passed on to federal taxpayers. To make up for the lost reimbursements, most states plan to let insurers charge higher premiums in the exchanges next year, assuming the insurers continue to do business there — which may not be a safe assumption. Because the vast majority of those buying policies in the exchange have their premiums subsidized by the federal government, the higher premiums will result in higher subsidy payments. So the pain of Trump’s decision will be felt by the U.S. Treasury.
Still, the higher premiums in the exchanges will likely drive off some younger, healthier customers, who’ll choose to go uninsured in 2018 instead. The shrinking pool will then raise premiums even more, leading to yet higher subsidies, further raising the bill for taxpayers — who at some point will recognize just whose fortunes the president is sabotaging.
When it comes to President Donald Trump fulfilling his role as leader of the federal government, nothing he has said has been as awful as his Thursday remarks on Twitter that the United States might soon stop helping Puerto Rico — a part of our nation since 1898 — recover from Hurricane Maria.
“Electric and all infrastructure (in Puerto Rico) was disaster before hurricanes,” he tweeted. “We cannot keep FEMA, the Military & the First Responders, who have been amazing (under the most difficult circumstances) in P.R. forever!”
The comments came as authorities announced that just 9 percent of the U.S. territory’s 3.4 million people had electricity, down from 17 percent, after problems at a San Juan power plant. More than three weeks after the hurricane hit, one-third of residents still don’t have access to safe water. Some are so desperate they’re drinking water from toxic Superfund sites. Complicating matters, the recovery effort became more costly when the federal government didn’t renew a Jones Act waiver for Puerto Rico, which means no foreign-flagged vessels can bring goods to the island from U.S. ports, only U.S. vessels with mostly American crews, thanks to an antiquated 1920 law that Congress should consider scrapping.
While the end to the waiver may be dubious, there is no indication that the federal government will abandon Puerto Rico at its moment of need. Trump’s follow-up comments Friday about helping Puerto Rico struck a note of straightforward solidarity, so Thursday’s tweets are likely inconsequential. But they remain appalling. Puerto Ricans deserve better. So do their fellow Americans.
Connie’s guilting me into painting my buttocks so she can see the Eagles in concert. Here’s the back story. The other day our good friend Connie (the one who lives on Canard Road and who’s trying unsuccessfully to quit estate sale-ing) was at a wedding shower for her daughter and I was there as well. Near the end of the event, I walk into the main area where some folks had gathered and I heard Connie say that there was a radio contest where you could win two tickets to see the Eagles at Philips Arena on Oct. 21.
You could win those tickets by painting your... buttocks...to look like a jack-o-lantern. The radio station was calling it a “crack-o-lantern” contest.
So as her friends laughed and her son in law looked on in horror, Connie proceeds to tell everyone that she would like to paint her rear end and enter the contest because she’d love to see the Eagles live in concert.
Hearing this conversation and wanting to egg Connie on, I jokingly said “I’ll do it with you, Connie.”
Well she immediately jumped on that and suddenly we were going to take on this new venture to have our butts painted and win tickets to see the Eagles. We started discussing ideas about what we’d paint on our buttocks and how we’d have such a great time at the concert and who, in fact, we could get to actually paint on our .... posterior canvasses — you know, typical wedding shower conversation.
Since I was only joking I just forgot about the whole thing until a few days ago when I get an urgent text from Connie. Here’s what it said:
“Did you send in your crack-o-lantern pic? We are running out of time. I figured yours will be epic and enough for us to win so I’m going to put all my confidence in your buttocks for the win! Remember I am old and this may be my last chance to see the Eagles. Rock stars are dropping like flies.”
I replied with: “You can’t put all that pressure on my buttocks.”
Connie: “My LAST chance.” (and she added a pumpkin emoji).
She kept emphasizing “last chance” like either she or all the Eagles would die before she SEVERO AVILA Jim Powell of Young Harris Pat Bagley, Salt Lake Tribune could see them in concert again so I felt a definite sense of pressure to come through for her.
And notice how with one text message she has now removed herself from the contest and it’s only me who should submit a photo. Yet if I win, she gets a ticket. The woman is a master manipulator...and somehow I respect that.
But I should add here that you can’t not love Connie. She’s good as gold and will give you the shirt off her back if you ask her. And she is certainly good for a laugh.
We were sitting at the Rome City Brewing Company (formerly The Brewhouse) the other day having dinner and Connie is going on about how General Robert E. Lee is looking down on us.
I look over to where she’s pointing — above the bar — and there stands two statues of a man in a long jacket, hat, bow tie and a big mustache. But it ain’t General Lee. Up until this point, Connie has believed that Confederate General Robert E. Lee has kept a silent vigil over the patrons of the Brewhouse when in fact it’s actually famous whiskey company founder JACK DANIEL.
Oh, before I forget I should add here that at that dinner I tried the cajun pasta at RCBC and it was phenomenal. I highly recommend it. I got the half order and it was enough for me. So tasty.
But I digress. What I’m saying is I love Connie. She’s a hoot. And she takes good care of me.
I think I’ve missed the deadline for submitting my “crack-o-lantern” photo to the radio station (I’m heartbroken as you can imagine) and now I feel bad because Connie probably won’t get to see The Eagles on Oct. 21.
I saw them a couple years ago at Verizon Amphitheater and it was incredible. They did all the old hits and it sounded immaculate. If you closed your eyes, you’d think it was 1977 all over again. They are amazing live. And I just wanted Connie to experience that “one last time” as she so dramatically put it.
Maybe if Connie and I both went to the bar and prayed at the feet of Jack Daniel he might bless us with a couple tickets.