Diabolical Moves to Pass a Flawed AHCA

 

Background

My representative in Washington in the House of Representatives is John Katko who is serving his second term in Congress. He represents a sprawling CNY district which includes an inner city (which has been identified as one of the most stubborn pockets of poverty in the US), suburban areas which are quite affluent, including the one where his family lives, and rural areas where poverty is more the rule than the exception.

He has been elected in an area which has fairly recently been turned red by empty factories and recession. Republicans promise the hardest hit folks that they know the secret to turning the economy around and bringing jobs back. Democrats did not believe that they could promise any such thing. Republicans poured money into Katko’s election. The Democrats never came forth with the level of support that was necessary to help turn the area blue again. Ever since the Citizen’s United decision Republican PACs and donors have poured money into areas where it looked like they had a shot at turning any little dot on the map into a red dot. And their attention to detail has paid off.

So now we have a representative who is basically bought and paid for, who has, so far, voted the party line. And we have the health care bill coming up for a vote, supposedly as early as Thursday, March 23, 2017. In a district with as many poor people as Katko’s,  the number of people who will lose health care if the AHCA passes will be enormous. One of the problems is, of course, that the full impact of this bill will not be felt until 2020 so that these poor unsuspecting folks can vote this guy in again before they get zapped. Isn’t our politics lovely? Anything that can be done will be done.

I sent my Representative in the House the following letter asking him to get in touch with his better self:

Rep. John Katko:

Although I am sorry to write such a long letter I hope you will indulge me and read it in its entirety.

I am thinking that you are not thrilled by everything that is happening in Washington. I know that you are an earnest man who has a serious interest in serving the people in your district, which is a mix of urban, suburban, and rural cultures with diverse needs that few other representatives have to deal with. I suspect that you are a Catholic man, or at least a man of faith. I know that your unshakeable Conservative values include a firm pro-life stance and probably an economic view that fits with the one usually held on the right, one of fewer regulations and possibly even tax breaks to help employers take greater risks.

I don’t believe that someone with your inflexible position on women’s reproductive rights should be in government at all, but there are obviously many people in this district who do not agree with me. So I will leave this issue aside except to say that if you have your way in this matter it will make women’s lives far more difficult and will reset the clock on women’s rights back to my grandmothers’ days.

However, what seems most doubtful to me is that you want to “deconstruct” the American administration as the President’s men and women seem to want to do. It seems doubtful to me that you want to invite Vladimir Putin in to influence American politics. I find it hard to believe that you would like to vote in lower taxes for the wealthy at the expense of the poor and middle class people you represent. You just don’t seem like a person who wants to see our schools with insecure funding which could have profound effects on the quality of education in America and make opportunities unequal across the states.

I also find it hard to fathom why you might want to support the American Health Care Act when so many in your district would lose health insurance and so many seniors would be negatively affected. You don’t seem that extreme to me. I would guess that you are more moderate than some of your colleagues. But I do not know how ambitious you are. I do not know what you owe to the national party and the super PACs and other Conservative organizations. I do not know how courageously you would fight the very powerful pressure brought to bear on Conservatives in Washington by the base and the upper echelons of the party and by big money people.

Well I guess we, as your constituents, will see how extreme you are or how courageous you can be. Will you fight for the needs of your constituents the way a parent fights to meet the needs of their children. Every day I awake to see what new actions of this administration have weakened the foundations of our democracy and every day I am more and more shocked and distressed about what I see. Yet every day I feel more and more helpless to have any way to stop this administration from undoing every single thing I think any modern culture should try to do for the people it governs.

Sincerely,

Mr. Katko knows that the AHCA is not a good replacement for the ACA. He knows that it will create hardships for a large number of his constituents, and that it will please some of his constituents. He is between a rock and hard place but I was hoping that he would take the moral high road instead of the economic low road. I was hoping he would be brave enough to pick people over party in this instance. I am still hoping for that.

Federal Government Sweetens the Pot

The Federal government, however, is quite diabolical when it is determined to get its way. They have added an enticement to the health care bill that is only being offered to Upstate NY because Mr. Katko (and others upstate representatives) was having problems liking this legislation. They have also included some tidbits to tempt other Republican representatives who are less than delighted with this rushed and deeply flawed piece of legislation. The New York Times included a piece about these “carrots” in this morning’s edition.

https://www.nytimes.com/2017/03/20/us/politics/house-health-care-new-york-republicans.html

In this article the authors, Thomas Kaplan and Richard Pear (with Jesse McKinley contributing reporting from Albany) tell us the following:

“House Republican leaders, trying to lock down the votes of wavering upstate New York Republicans, inserted a last-minute special provision in their health care bill that would shift Medicaid costs from New York’s counties to its state government”

(While it is true that Medicaid costs are among the mandated budget items that are an enormous burden on county budgets and while it is equally true that relief plans should be in the works, this Federal move to immediately shift the burden of these costs to the State of New York budget is a totally unplanned move that could perhaps bankrupt the state and is at the very least a political ploy strategically designed to get a very bad health care bill to pass, and at the most is something the states should raise an outcry about. Is it even legal?)

The article goes on to say:
“The move – one of a number of changes designed to gain more votes – would affect New York State only. It could save county governments outside of New York City $2.3 billion a year. But it could shift costs to state taxpayers or deny New York the same total in matching federal aid if the state continues to require those counties to contribute to the cost of Medicaid. Upstate New York Republicans, backed by local government officials, pressed for the measure over the angry opposition of New York’s Democratic governor, Andrew M. Cuomo.”

“The more we learn about the repeal and replacement for the Affordable Care Act, the sicker New York gets,” Mr. Cuomo said in a statement Monday night.”

While I can see what this measure does for county budgets I cannot, for the life of me, see what if does for poor people who need health care.

“The newly released set of changes does not directly provide more generous tax credits for older Americans as many Republicans had been requesting, but it lays the groundwork for the Senate to enhance those tax credits at a later stage in the legislative process.”

“President Trump and House conservatives already agreed to other changes involving Medicaid, including offering states the option of imposing a work requirement for certain able-bodied beneficiaries. They also agreed to let states choose a lump-sum block grant to fund their Medicaid programs instead of a per-capita allotment originally set in the House Bill.”

The Republicans representative who were wavering are now feeling that they can get back on board. But, although you can patch some tires and drive on them, some tires prove unfixable. Putting patches on this bill does not in any way make it a better health care plan. In fact New York’s governor has more to say:

“This cut is so severe that the majority of hospitals, nursing homes and assisted living facilities located in upstate New York and on Long Island would be devastated, Mr. Cuomo said.”

What do I Say to Mr. Katko Now?

I guess this puts the ball back in his court, although I still believe that he has to legislate in ways that serve the majority of his constituents but, in particular, the poorest of his constituents, since we are talking about something that means life or death in many cases. I also know that he will have a county executive to deal with and that this relief from what she calls “unfunded mandates” will put a great big old smile on her face. And who will win? Supposedly I will win because my taxes will go down or there will be more money to spend locally, but I have never minded that some of my tax dollars help people less fortunate than me. I have little extra money to contribute to the many charitable causes that break my heart, but this, since I am used to it, is a relatively painless way to give back for my many blessing.

John Katko, please stick to your guns and vote down this bill which will hurt many of your constituents and perhaps the entire state of New York, which DT would love to humble because of the Governor’s defiant statements. As I said, diabolical.

 

 

 

 

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