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Coffee CAHC policy round-up: December 8, 2017

Coffee CAHC is a twice-weekly newsletter where we round up and comment on the latest health coverage policy developments both nationally and here in Maine. We hope you find these updates helpful!

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Coffee CAHC

115th Congress, 1st session

128th Maine Legislature, adjourned


Friday, December 8, 2017


It’s another short, afternoon version of Coffee CAHC for you today, readers.

For the 3 of you who miss my long-winded-ness, don’t worry – I’ll undoubtedly be back to full force in the new year! But I’m taking some days off between now and the end of 2017, which means that Coffee CAHC is going to be a little bit more succinct than my norm.

Today, for instance, is technically a day off for me. I’m with my family celebrating my dad’s birthday (happy birthday, Steve the First!), and also the day that we celebrated his impending retirement after slightly more than 42 years working for the Maine State Employee Association. I’m absolutely abusing my Coffee CAHC editorial powers today to wish him both a happy birthday and a relaxing retirement!


National level

The good news: the government is not going to shut down tonight.

The bad news: they have only kicked the can down the road for a few weeks to buy themselves more time to dig themselves out of the hole they’ve created for themselves.

Remember, the year-end “continuing resolution”, or CR, is a big, omnibus spending bill that touches on pretty much every aspect of the federal government. It is also the legislative vehicle that we expect to finally see action from Congress on reauthorizing funding for both CHIP (insurance for kids) and federally qualified health centers (vital primary care and other medical services in rural and underserved areas).

It is, to be blunt, jaw-droppingly shameful that Congress hasn’t already taken action to fund these two essential programs that have always enjoyed ironclad bipartisan support. If they can’t figure out how to keep kids insured and preserve their constituents’ access to primary care, then I genuinely don’t know what they’re doing down there.

The tax reform/health care repeal bill continues to be worked in conference between the House and the Senate. The only real “update” since Wednesday is that, unfortunately, it looks like the work Senator Collins put in to try and mitigate the damage done by the proposed repeal of the individual mandate will be summarily rejected by the House.

I imagine this must be very frustrating to her – to have worked in good faith on trying to get her changes into the package, only to see a hyper-partisan, hyper-conservative bloc in the House unravel it all. I wish I could say that I was surprised, but, as I said the other day, I have little to no faith in Congress to function with anything even approximating “good faith” at the moment. This was also my biggest concern with Senator McConnell’s “promise” not to let Medicare or Medicaid take a hit as a result of the tax bill starting a colossal, deficit-busting fire in the federal budget: I just don’t believe it. Not worth the paper it’s printed on.

And now, Speaker Ryan has made clear that destroying Medicaid and Medicare is up next, and has been exactly his plan all along. I think it’s really important that we remain very clear-eyed about this. The Republican tax bill adds over a trillion dollars to the deficit, which they cavalierly ignore when it means they can shove some cash at some billionaire donors; Speaker Ryan’s stated reason for cutting Medicare and Social Security is his “concern” over the deficit. It’s very hard for me to reconcile these two things without concluding that the Speaker, and those who votes with him, are lying about their concern over the deficit and that what they actually care about is making the rich richer and making the poor and working Americans pay for it.

I’m shocked, shocked, to find that gambling is going on in here…


State level

The Appropriations Committee will be meeting this coming Wednesday, December 13th, from 1pm on. Have I already mentioned this? I feel like maybe I have. Well, bears repeating!


Would you like to know more?

The good news: enrollment in the ACA is way up over the same point in last year’s period. The less good news: because of the shortened enrollment period, we may not hit last year’s numbers. It’s crucial to push hard in the week remaining to get those numbers up as high as they can go.

Remember, while it’s true that robust enrollment numbers are important as a signal of ongoing support for the ACA, each one of those millions who signs-up is also a real person who is going to have health coverage when they need it: every one of the millions who doesn’t, may very well be missing their chance to keep themselves covered because of the sabotage that the Trump administration has bent over backwards to conduct.


Until next time, friends, I remain,


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