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Coffee CAHC policy round-up: November 3, 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, November 3, 2017


I hope that, by now, many (if not most) of you have had your power restored. What a week!

Devoted readers may recall that I am a particularly big dork when it comes to all things Marvel (e.g. the comic books and movies). Last night, I saw the newest entry in the Marvel Cinematic Universe, “Thor: Ragnarok”. It’s absolutely wonderful. While it’s true that I’m something of a Marvel fanboy, I have had my fair share of critique of the movies. This one really stands up. It gets the Steve Stamp of Approval.


National level

The GOP tax overhaul package is starting to take shape, with the release of the House’s version of a bill. Advocates were pretty nervous that this could end up being a vehicle for yet another tilt at the ACA/health care windmill – especially after President Trump and some members of Congress started suggesting in the past few days that it could be used to repeal the individual mandate. But mandate repeal isn’t in there, and all in all, it’s relatively free of health care topics.

There are, of course, a few exceptions (naturally). The major one is a proposal to eliminate the ability of individuals to deduct certain high-cost medical expenses. This deduction is a classic example of something where the number of individuals impacted is relatively low, but the impact for those individuals tends to be extremely high. We’re talking about a deduction for medical expenses that exceed 10% of household income. These are major expenses, and that deduction can make a massive difference for those who take advantage of it.

I’m gonna editorialize for a second here: I don’t get it. I really don’t. How is this possibly a conservative idea? Letting people deduct large medical expenses on their taxes should be the very definition of a conservative idea, one would think. But, hey, repealing the estate tax (you know, that thing that only impacts half of the value of estates worth more than $10,000,000) is expensive and so I guess letting lower-income sick Americans take it on the chin is, in their estimation, worth the tradeoff. (end monologue)



State level

Again, cannot emphasize enough that Mainers will be voting this coming Tuesday – November 7th – on whether or not to finally get with the program and expand Medicaid. CAHC resoundingly endorses and urges a “yes” vote on question 2 on the ballot this Tuesday.

It is vitally important for our state that we finally accept this deluge of federal dollars to invest in our people and our economy. Frankly, it’s long overdue. It has only been the obstructionist, ideologically-driven obstinacy of a handful of individuals in Maine’s government over the past few years that has prevented about 70,000 Mainers from being eligible for any health care at all (apart from waiting until they are too sick to avoid an ER visit, which helps absolutely nobody: not the people getting sick, not the hospitals struggling to provide primary care through their ER, and not the rest of us who pay for that in higher charges when we go to the hospital).

We’d certainly encourage anybody who is interested in this issue, and who has time over the next few days, to visit and get in touch with the campaign to volunteer. Remember, we don’t just need to win: we need to win big, to show the Legislature and the Governor that Medicaid expansion has been given a robust mandate by the people that cannot be ignored or overturned.


Would you like to know more?

Vox has an interesting little article recapping a focus group they ran recently comprised of “die-hard Republican” Trump supporters, where one of the 16 shared some surprising views on single payer. (And if you’re interested in more on single payer, here’s a great New York Times report on Senator Bernie Sanders’ trip to Canada to learn more about their system, and a sobering piece from Axios revealing that most Americans have no idea that single payer would mean changing their current health coverage.)

Finally, it seems like day 1 of open enrollment this year was relatively chaos-free.


Until next time, friends, I remain,


Comments are closed.

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