Timothy Jost, Emeritus Professor at the Washington and Lee University School of Law and one of the nation’s foremost experts on government health care policy, replies to Congressman Goodlatte’s statement of support for President Trump’s recent actions threatening health insurance coverage for millions of Americans through the Affordable Care Act.

Goodlatte’s statement: On Thursday, President Trump signed an Executive Order with the goal of maximizing competition in the health care marketplace and potentially providing Americans more affordable health insurance choices. This action directs Administration officials to take a look at the options available through the regulatory process and consider expanding access to things like Association Health Plans, which allow small employers to band together to offer affordable insurance, selling insurance across state lines, and using health reimbursement arrangements to give employees greater choice over how to finance their health care. These are reforms that I have also supported in Congress.

The facts: Association health plans in the past have defrauded small businesses and left them with millions in unpaid claims.  Short term health plans offer inadequate coverage and undermine the market for major medical coverage.  These are bad ideas that have already been tried and failed. Congressman Goodlatte should try to make health reform work for his constituents rather than undermining it.

Goodlatte’s statement: Additionally, last year the federal courts concluded that the Obama Administration unconstitutionally usurped congressional authority by sending federal funding to private insurance providers without the approval of Congress. Last week, President Trump announced that the federal government will not continue an appeal of this ruling. Therefore, these unauthorized payments cannot continue. This is yet another example of how President Obama’s executive overreach, which ignored the other two branches of government in a naked attempt to try and achieve his policy agenda, backfired and worsened the already imploding Obamacare system. This is exactly why the Senate needs to take action to repeal and replace Obamacare, as the House has already done with my support, and help all Americans access the affordable coverage they desire.

The facts: It is incorrect to say that “the federal courts” concluded anything. A single district court has ruled that the cost-sharing reduction payments had not been appropriated. That decision was appealed by the Obama administration. President Trump has not dismissed that appeal, and could not do so in any event because the appellate court has allowed 19 states, including Virginia, to intervene in the appeal. Given the inability of Congress to get anything done, President Obama exercised executive authority to implement the ACA. Given the continuing inability of Congress to get anything done, President Trump is now doing the same thing. He has issued more executive orders so far than any president since Roosevelt.  And the House of Representatives did not repeal and replace the Affordable Care Act. It merely amended parts of the statute. Congressman Goodlatte no doubt did not read the legislation.

Although President Trump may be backing off, Congressman Goodlatte issued the following statement essentially supporting the president’s latest actions to undercut the Affordable Care Act:

Timothy Jost, Emeritus Professor at the Washington and Lee University School of Law and one of the nation’s foremost experts on government health care policy, wrote at the Health Affairs website:

These two steps obviously furthered the administration’s two-part strategy to undermine the ACA. President Trump is reportedly furious that Congress failed to repeal the ACA and has set out to single-handedly dismantle it himself. The cost-sharing reduction (CSR) payment cut-off will, in tandem with other steps taken by the administration to discourage enrollment in the individual market, drive up the cost of coverage. The executive order will open escape routes so that healthy people will leave the ACA-compliant individual market for cheaper, non-compliant forms of coverage.
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Several conservative commentators have characterized the administration’s decision as a victory of the Constitution over lawlessness. They claim that the Obama administration made payments that had not been appropriated by Congress, in violation of the Constitution, and the Trump administration is finally complying with the Constitution. Why is anyone surprised, much less outraged?

This opinion was supported by the decision of a district court judge below in House v. Price. But it is important to note that the Obama administration never argued that it could make the payments without an appropriation—it argued that there was an appropriation. The Trump administration has now concluded, after making the payments for months, that the “best interpretation of the law” is that there is no appropriation. But the case is still on appeal to the D.C. Circuit, which could still conclude that the Obama administration was correct. A judge in the Northern District of California could also reach that conclusion. This is not a question of constitutionality versus lawlessness, but rather a dispute as to what the law is.

And health care correspondent Sarah Kliff wrote as Vox:

There is no question that this new policy is lose-lose-lose for key stakeholders with no upside:

— It will raise Obamacare premiums by an estimated 20 percent in 2018, as health plans have to charge more to make up the lost funds. By 2020, premiums would increase 25 percent due to this change.

— Pulling the plug actually increases the national deficit. As those insurance plans make double-digit rate increases, the government will have to spend billions more on the other subsidies that 10 million Americans receive to purchase that coverage.

— The Congressional Budget Office estimates that this move will ultimately cost the government $194 billion over the next decade.

— The number of uninsured Americans would rise by one million people in 2018, in the CBO’s estimate.

— Insurance companies lose out, too, particularly those that assumed Trump would pay these subsidies and set their premiums accordingly. They now stand to face significant financial loses on the Obamacare marketplaces.

To recap: Trump is enacting a policy where the government spends billions more to insure fewer people.

You’d think that would be a concern to a self-styled deficit hawk like Goodlatte. Apparently not.

Congressman Goodlatte added more than $80,000 to his campaign coffers between July 1 and September 30 of this year, according to a report filed with the Federal Election Commission.

This brings the total raised so far this year for Goodlatte’s 2018 reelection campaign to more than $460,000.

As usual the vast majority of donations come from corporate and trade association political action committees. And the NRA Political Victory Fund kicked in $2,950 to bring its total contributions this year to $4,950.

(See previous posts about Goodlatte’s campaign finances here, here, here and here.)

Congressman Goodlatte Thursday was among a minority of Republicans who voted against a package of emergency relief for Puerto Rico and other parts of the US struck by natural disasters.

The Republican-controlled House voted 353-69 to approve $36.5 billion in emergency relief for Puerto Rico and other areas hit by recent disasters. Senate approval is expected in coming weeks.

[President] Trump and his aides on Thursday suggested that there would be a limit to how much help Puerto Rico could expect from Washington to solve some of its longer-term problems, although Trump is expected to sign the latest emergency package.

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Besides helping Puerto Rico recover from Hurricane Maria, the House-passed bill would also provide funds for the storm-struck areas of Florida, Texas and the U.S. Virgin Islands, and fire-ravaged California.

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Much of Puerto Rico remains without electricity or running water three weeks after Hurricane Maria made landfall.

Goodlatte’s hard-hearted attitude toward the suffering people of Puerto Rico might be seen as a sign of his professed devotion to fiscal and budgetary restraint– were it not for his votes for irresponsible spending during the George W. Bush administration and his  support for Trump’s $25 billion border wall boondoggle.

For years Congressman Goodlatte, as chair of the House Judiciary Committee, has dodged serious immigration reform by claiming we need to fix all our border security problems (real or imagined) first. It’s becoming more and more apparent that he is using this simply to evade his responsibility.

So it’s no surprise that he called President Trump’s latest statement of immigration principles a “serious proposal,” when it is nothing of the kind.

The Washington Post reports:

The Trump administration released a list of hard-line immigration principles late Sunday that threaten to derail a deal in Congress to allow hundreds of thousands of younger undocumented immigrants to remain in the country legally.

The administration’s wish list includes the funding of a wall along the U.S.-Mexico border, a crackdown on the influx of Central American minors and curbs on federal grants to “sanctuary cities,” according to a document distributed to Congress and obtained by The Washington Post.

The demands were quickly denounced by Democratic leaders in Congress who had hoped to forge a deal with President Trump to protect younger immigrants, known as “dreamers,” who were brought to the United States illegally as children. Trump announced plans last month to phase out the Deferred Action for Childhood Arrivals (DACA) program, an Obama-era program that had provided two-year work permits to the dreamers that Trump called “unconstitutional.”

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Trump had said several times over the past month that he did not expect a DACA deal to include funding for a border wall, emphasizing that the money could be included in separate legislation. But ensuring funding for the wall, which is projected to cost more than $25 billion, is the top priority on the list. White House aides declined to specify during the call how much money the president would expect from Congress.

In other words, Trump continues to hold the fate of 690,000 DACA enrollees hostage for his utterly impractical and ridiculously expensive wall fantasy.

As I’m sure even Goodlatte knows, Trump’s “serious proposal” is a complete non-starter.

Congressman Goodlatte and the vast majority of his Republican House colleagues (even Tim Murphy) on Tuesday passed the Pain-Capable Unborn Child Protection Act, which would outlaw most abortions after 20 weeks of pregnancy.

The bill, clearly designed to chip away at the right of a woman to choose to terminate a pregnancy , is based on the dubious belief that fetuses are capable of feeling pain at 20 weeks– in the middle of the second trimester, when abortion is currently legal under the Supreme Court’s Roe v. Wade decision.

According to Goodlatte:

At 20 weeks babies hear music, respond to human voices, and, most importantly, they can feel pain.

But Chris Gavaler notes with plenty of backing at the Dear Bob blog:

This is a lie. Science has proven no such thing. The majority of scientific studies supports pain-capability at 24 weeks, 27-28 weeks, or 29-30 weeks.

As is often the case, Goodlatte seems more concerned about children before they are born than after they are born.

Update: A Democratic fact sheet on this misbegotten bill.

Congressman Goodlatte offered prayers but nothing else on Monday after the deadliest mass shooting in US history killed at least 59 people in Las Vegas and wounded hundreds more.

Goodlatte, who proudly touts his support from the National Rifle Association, has consistently opposed even the most common-sense regulations on gun ownership. In fact he has done all he can to loosen the regulations that do exist.

The NRA has generously rewarded Goodlatte for his devotion to their wishes. As of last year the organization had donated $52,250 to his political campaigns.

Among other actions, Goodlatte voted to overturn a rule that would bar gun ownership by some who have been deemed mentally impaired by the Social Security Administration. He has opposed universal background checks and renewing the ban on private sale of assault weapons. He refused a request from Andy Parker, the father of TV news reporter Alison Parker, to hold hearings in the House Judiciary Committee on gun laws after Alison was killed by a gunman.

Expect inaction and obstruction from Goodlatte until the next mass shooting horror– when the congressman will again be pleased to offer more prayers.

 

Details are still conveniently sketchy, but Congressman Goodlatte reacted favorably to the Trump-backed Republican “tax reform” plan announced Wednesday.

As for who stands to benefit the most from this plan: it’s clearly not the vast majority of Goodlatte’s Sixth District constituents. The New York Times reports:

The tax plan that the Trump administration outlined on Wednesday is a potentially huge windfall for the wealthiest Americans. It would not directly benefit the bottom third of the population. As for the middle class, the benefits appear to be modest.

The administration and its congressional allies are proposing to sharply reduce taxation of business income, primarily benefiting the small share of the population that owns the vast majority of corporate equity. President Trump said on Wednesday that the cuts would increase investment and spur growth, creating broader prosperity. But experts say the upside is limited, not least because the economy is already expanding.

The plan would also benefit Mr. Trump and other affluent Americans by eliminating the estate tax, which affects just a few thousand uber-wealthy families each year, and the alternative minimum tax, a safety net designed to prevent tax avoidance.

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Mr. Trump has also pledged repeatedly that the plan would reduce the taxes paid by middle-class families, but he has not provided enough details to evaluate that claim. While some households would probably get tax cuts, others could end up paying more.

While we await more details, it’s worth noting that the massive tax cuts for the wealthy and corporations would cost the federal government trillions of dollars in revenue and cause a huge increase in the federal deficit.

The GOP’s outline for tax reform could cost the country $2.2 trillion in lost revenue over a decade, according to a preliminary study by the Committee for a Responsible Federal Budget , a fiscally conservative advocacy group.

“These numbers come with a high degree of uncertainty and exclude a number of potential offsets where no details exist. But it is clear that much more work needs to be done to ensure tax reform is fiscally responsible,” the group said in its study.

Senate Republicans are allowing themselves up to $1.5 trillion in deficit-financed tax cuts to pass tax reform. If the group’s estimates are correct, they will need to find billions more in revenues to pass the bill according to standards they set for themselves.

The plan’s Republican backers assure us that the tax cuts will spur unprecedented economic growth which will produce enough new tax revenues to close the gap in a way that has never happened before– a scenario rejected by (among others) Bruce Bartlett, an adviser to President Ronald Reagan.

So why isn’t a “deficit hawk” like Goodlatte– who routinely introduces balanced budget amendments to the Constitution and warns of the dire consequences of increasing deficits– sounding alarms about this latest plan?

One of Goodlatte’s GOP colleagues– who speaks more forthrightly than Goodlatte ever does– explained:

“It’s a great talking point when you have an administration that’s Democrat-led,” said Representative Mark Walker, Republican of North Carolina and the chairman of the Republican Study Committee, a group of about 150 conservative House members. “It’s a little different now that Republicans have both houses and the administration.”

You only need look at Goodlatte’s voting record to understand the truth of that remark.

Even though nearly one-third of the children living in the Sixth District obtain health care through Medicaid and the Children’s Health Insurance Program (CHIP), Congressman Goodlatte has never been a friend of those vital laws.

In 2009, for example, he voted against a law that extended CHIP coverage to four million children without health insurance.

Now The Richmond Times-Dispatch reports:

Virginia will run out of money to provide health care to 65,000 children from low-income families by January if federal lawmakers fail to reauthorize the Children’s Health Insurance Program, which is set to expire when the federal fiscal year ends Sept. 30, said Linda Nablo, chief deputy director of the Department of Medical Assistance Services, which administers the services in question.

“It’s just insane,” Nablo said in an interview. “I cannot imagine that Congress would want to have on their plates that they just ended coverage for millions of children.”

Enacted in 1997, CHIP — which is operated in Virginia as Family Access to Medical Insurance Security, or FAMIS — has been reauthorized by Congress every few years without much fuss. But this year it has been overlooked in the tumult raised over the Republican-controlled Congress’s latest attempt to repeal the Affordable Care Act, known as the Graham-Cassidy bill.

Although Goodlatte has touched on a number of other matters on his Twitter account and Facebook page in recent weeks, he has yet to say a word publicly about the impending health crisis facing thousands of children in his district. You’d think this would be one of his highest priorities.

Let’s hope the congressman can finally overcome his hostility to helping children from low-income families obtain health care their families could otherwise not afford.

No thanks to Congressman Goodlatte, Anthem has agreed to offer health insurance through the Affordable Care Act to every part of Virginia that stood to lose it entirely in 2018.

Announcing the agreement, Gov. Terry McAuliffe pointedly said:

[T]his decision does not change the fact that President Trump and Republicans in Congress are actively working to undermine the Affordable Care Act, to the detriment of states like Virginia. It is imperative that leaders in Washington take quick action to make sure the Marketplace in Virginia and those across the country are sustainable for years to come.

Republican Goodlatte has done everything in his power to undermine the Affordable Care Act, which provides health insurance to more than 30,000 of his Sixth District constituents. He blamed the threatened cutoff in Virginia on the law itself and said it was up to McAuiliffe to find a solution.

Thanks for nothing, Congressman.