May 5, 2017

A Story That Touched my Heart

Yesterday as the House was debating and eventually passing the repeal and replacement of the Affordable Care Act (ACA) a constituent reached out to me with an emotional story and asked me to share it because in her words: “It needs to be heard”.

She recently lost one of her twins during pregnancy. Last Friday, utero surgery was necessary to try and save both babies. Tragically, one of the babies did not survive. As my constituent writes: “Could you imagine if the tests, in utero surgery and pre-natal care was not covered under our insurance? If we were saddled with tens of thousands of dollars? And then our surviving baby was slapped with “Pre-existing condition” upon their birth?” We would be financially ruined on top of the already crippling grief. This is the reason why I write to you today and I hope that you can use my story to illustrate just how important protecting pre-existing conditions is. Not just for Massachusetts, but for everyone in the United States.”

Sometimes Washington gets so caught up in amendments and floor debates and vote counts that the voices of the people who will be most impacted recede. We cannot let that happen, not with health care or any other policy that will affect the day-to-day lives of the people we represent. This is not about winning a debate and it’s not an academic exercise. It’s not about notching a “win” for President Trump. It’s about people like my constituent, who have the courage and resolve to speak out and tell their stories so we all have a better understanding of what the legislative language means to our friends and neighbors.

Trumpdon’tcare and it Looks Like House Republicans Don’t Either

Yesterday the House considered H.R. 1628, the American Health Care Act of 2017 or as we’re calling it, Trumpdon’tcare. Late in March, House Republicans abruptly cancelled a vote on this legislation because they knew it wouldn’t pass. The nonpartisan Congressional Budget Office (CBO) analyzed this legislation at the time and determined that 24 million Americans would lose health coverage, including 14 million by 2018. House Republicans rushed H.R. 1628 to the floor yesterday before the CBO could complete additional analysis, necessary because the bill has been amended.

Before getting into how devastating H.R. 1628 is, I want you to know that this legislation gives people earning more than $1 million a year a tax CUT of approximately $50,000! That’s gotten a little lost in everything else bad about this bill, but it needs to be noted.

Q: What’s Changed Since the Last Time?
A: Two Amendments re: Pre-Existing Conditions

Two amendments were added to the original Republican proposal to help buy passage of H.R. 1628. They both address concerns relating to pre-existing conditions.

In order to understand these amendments, a little background may be helpful (simplified, but hopefully understandable). The ACA specifically prohibits denying coverage to someone due to pre-existing conditions. It also prohibits insurance companies from charging different rates in the same coverage area based on the individual medical circumstances of each person – otherwise they would be in compliance with the requirement to “offer” coverage to someone with a pre-existing condition, but could charge unaffordable rates to anyone who has one, which is de facto denial of coverage. This second aspect is called “community rating”. Someone with cancer has a pre-existing condition. So does a person who has had a C-section. If you have allergies, asthma, high blood pressure, diabetes or suffer from migraines, you have a pre-existing condition. You can be denied coverage or charged so much more than your neighbor that health insurance is effectively unaffordable.

First, Rep. Tom MacArthur (R-NJ) offered a devastating amendment that lets states seek waivers from the requirement of “community rating”. As you can see from the explanation above — such a waiver could result in anyone with a pre-existing condition being subject to insurance costs that are unaffordable. A person may be entitled to insurance, but could not afford it.

MacArthur’s amendment also lets states seek waivers from the “essential health benefits” requirements of the ACA, which mandates that insurance companies cover essential services such as pregnancy, emergency room visits, mental health care, pediatric services, rehabilitation and much more. This is how he would reduce the cost of health insurance – by basically covering almost nothing.

The other amendment came from Rep. Fred Upton (R-MI). It adds $8 billion over 5 years (that is about $1.6 billion per year — but only for five years) to help pay those increased insurance costs for people with pre-existing conditions. This sounds nice until we dig deeper. To quote the AARP: “The Upton Amendment to the health care bill, American Health Care Act (AHCA), is not sufficient to protect people with pre-existing health conditions. According to one estimate, it would take $178 billion per year to adequately fund state high-risk pools, where people with preexisting health conditions would go to access health insurance coverage.”

And there is this from the Association of American Medical Colleges: “A modest amount of new funding may incrementally reduce premiums for those with preexisting conditions, but only for five years. Patients will still be at risk, leaving those with cancer, congenital heart conditions, mental illness, or other needs with access to coverage they cannot afford.”

No wonder Republicans would not wait to get the impact report from the non-partisan Congressional Budget Office. Several Republicans have also admitted they didn’t even read the whole bill before they voted for it yesterday.

So What’s the Same as the Last Time?

With all the rightful concern over how this bill has been amended, it’s important not to forget its core elements. Here are just a few:

• It eliminates the employer mandate. Currently 177 million Americans get their health coverage through their employer who would now be under no obligation to offer it;
• Americans between 50-64 can be charged up to 5 times more for the same coverage as younger persons;
• The Medicare Trust Fund is raided to the tune of $175 billion;
• The legislation eliminates all funding under the ACA for prevention and public health after 2018;
• The legislation eliminates the requirement that basic mental health and addiction treatment be covered by Medicaid. This will effectively take treatment off the table for people who can’t afford it on their own.

I voted NO. H.R. 1628 passed and the entire vote is recorded below:

Taking Money Out of Your Paycheck but Giving You the Day Off Instead (Maybe)

On Tuesday the House considered H.R. 1180, the Working Families Flexibility Act of 2017. This legislation amends the Fair Labor Standards Act (FLSA) to give employers the authority to opt out of paying employees overtime. Instead employers could offer compensatory time in place of overtime. So instead of earning additional money for time worked beyond 40 hours, employees would be granted additional time off.

There are several problems with this approach. H.R. 1180 does not require employers to give their employees a choice on whether or not they receive time off or payment for overtime. That decision is solely left up to the employer. While certainly some employees would welcome additional time off, plenty of workers would prefer more money in their paychecks. There is also no guarantee that an employee will be granted the time off when requested. While H.R. 1180 requires employers to pay employees for any unused comp time, the funds do not have to be distributed until the end of a calendar year. Employers don’t have to add interest to this money no matter how long they are holding onto it, even though it technically belongs to the employee. I voted NO. H.R. 1180 passed and the entire vote is recorded below:

Funding the Government

On Wednesday the House considered H.R. 244, On Motion to Concur in Senate Amendments Nos. 2 and 3, and in No. 1 with Amendment. Translation: this is the legislation to fund the federal government through the end of the 2017 fiscal year. Let’s start with what’s NOT in this legislation. There is no money to build the wall along the Mexican border that President Trump promised. There is no money for a deportation force and no cuts to funding for “sanctuary cities.” There are no cuts to Planned Parenthood and no weakening of the Wall Street Reform and Consumer Protection Act.

H.R. 244 does provide an additional $2 billion in funds for the National Institutes of Health (NIH). There is a $650 million increase to help address the opioid crisis in our country. Funding is increased for the Pell Grant and the legislation includes language allowing students to use that money year round. Under current rules, that grant money can’t be used for summer classes. There is more money in this bill for the State Department and for the Department of the Interior. The Environmental Protection Agency’s Clean Water State Revolving Fund even gets an increase. Here is what Republican Senator Lindsey Graham had to say about the spending bill: “From my point of view, we pretty well got our clock cleaned.”

Perhaps that’s why President Trump tweeted Tuesday that “Our country needs a good shutdown in September to fix mess!” The President of the United States called for a government shutdown at the end of September because he was upset about this bill. Sad! I voted YES. H.R. 244 passed and the entire vote is recorded below:

The Wrong CHOICE Act

This week the House Financial Services Committee scheduled a markup of the CHOICE Act, a 600-page attempt to repeal the most important provisions of the Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010. This legislation became law after the 2008 financial crisis to ensure we won’t experience another worldwide financial collapse that facilitated the worst recession since the Great Depression. While Republicans claim the bill will help small community banks and credit unions, the Wrong CHOICE Act deregulates the largest financial institutions in the world, hamstrings both state and federal regulators from pursuing bad actors, and returns us to the Wild West that Wall Street enjoyed prior to the financial crisis. Democrats are concerned about the bill's language gutting the Consumer Financial Protection Bureau (CFPB) which has recovered billions of dollars for consumers harmed by fraudulent mortgage servicing, student loans, payday lending, discriminatory auto lending, and abusive debt collection practices.

We are also concerned about the bill’s repeal of the Volcker rule, which is designed to stop commercial banks from gambling with federally insured deposits. The legislation repeals the Department of Labor's fiduciary duty rule, which simply requires that people who hold themselves out as financial advisors are legally obligated to act in their client's best interests and are not placing clients in retirement products just because they make more money for the advisor. The Department of Labor has found that investors lose approximately $17 billion per year from their retirement accounts because investors do not receive financial advice that is in their best interests and the costs they do incur are not transparent.

Instead of advancing a bill deregulating the largest financial institutions and undermining basic consumer protections, I urged Republicans on the committee to work with Democrats on a bill that provides reasonable regulatory relief to small community banks and credit unions, institutions that work hard in their communities to lend to everyday Americans and small businesses. This would pass in no time with healthy bipartisan support.

Instead of heeding the lessons of the 2008 financial crisis, the Wrong CHOICE Act would take us back to its darkest days. Republicans would not adopt any Democratic amendments. One of the amendments I introduced would halt the implementation of the Wrong CHOICE Act until the Office of Government Ethics certifies that it does not directly benefit President Trump nor any executive branch appointee who has influence over federal regulations. It was a straightforward amendment that would have simply ensured people in government are making decisions based on what’s best for the American people and not for themselves. That amendment didn’t pass either.

The reduced oversight of the Wrong CHOICE Act paves the way for potential conflicts of interest within the Trump Administration. The bill passed out of the committee on a party line vote. I expect the full House to consider this legislation soon.

You can view some of my statements from the markup on YouTube.

Behind the Curtain — More House and Trump Administration Actions You Don’t Want to Miss

Here are this week’s additions. If you need to catch up or share with friends, you can find the full list here.

72. On May 2, 2017 the Environmental Protection Agency (EPA) removed all scientific data on climate change from their official website, including a section explaining exactly what it is. That particular section has been in place for twenty years. This is one more glaring indication of the direction that the Trump Administration plans to take our country on the environment.
73. On May 2, 2017 we learned that Trump advisor and son-in-law Jared Kushner did not include some important information in his required ethics disclosure form. Kushner failed to disclose loans on properties worth over $1 billion, including a startup that partners with Goldman Sachs. This is one more in a rapidly growing list of ethics questions surrounding Trump advisors. Why didn’t Kushner fully disclose his business ties?
74. On May 2, 2017 the United States Department of Agriculture (USDA) rescinded nutritional guidelines for school lunches established by former First Lady Michelle Obama in her Let's Move Campaign, as well as through the Healthy, Hunger-Free Kids Act of 2010. The intent of these efforts was to provide more nutritious school lunches to students. The practical impact of this USDA directive will be offerings that are lower in nutritional value than the meals currently being offered.
75. On May 4, 2017 President Trump signed an Executive Order “Promoting Free Speech and Religious Liberty”. It directs the IRS to exercise "maximum enforcement discretion" over the Johnson amendment. This amendment prevents churches and other tax-exempt religious organizations from getting involved in political campaigns. The EO also gives "regulatory relief" to organizations that object on religious grounds to an ACA provision requiring employers to provide certain health services, including coverage for contraception. For decades the Johnson amendment has prevented houses of worship from being used in a partisan or political manner. While it would take an act of Congress to repeal the amendment, this EO damages that wall between church and state.
76. H.R. 1180 as described above
77. H.R. 1628 as described above

What’s Up Next

A District Work period is scheduled. The next House votes will take place on Tuesday May 16th.