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EXCLUSIVE

Seema Verma, a member of the coronavirus task force, spent more than $3.5 million taxpayer dollars on GOP-aligned consultants, a congressional report found.

By DAN DIAMOND and ADAM CANCRYN

09/10/2020 05:00 AM EDT

Updated: 09/10/2020 04:28 PM EDT

When Seema Verma, the Trump administration’s top Medicaid official, went to a reporter’s home in November 2018 for a “Girl’s Night” thrown in her honor, taxpayers footed the bill to organize the event: $2,933.

When Verma wrote an op-ed on Fox News’ website that fall, touting President Donald Trump’s changes to Obamacare, taxpayers got charged for one consultant’s price to place it: $977.

And when consultants spent months promoting Verma to win awards like Washingtonian magazine’s “Most Powerful Women in Washington” and appear onhigh-profile panels, taxpayers got billed for that too: more than $13,000.

The efforts were steered by Pam Stevens, a Republican communications consultant and former Trump administration official working to raise the brand of Verma, who leads the Centers for Medicare and Medicaid Services. The prices were the amount a consulting company billed the government for her services, based on her invoices, which were obtained by congressional Democrats.

They are among the revelations included in a sweeping congressional investigation chronicling how Verma spent more than $3.5 million on a range of GOP-connected consultants, who polished her public profile, wrote her speeches and Twitter posts, brokered meetings with high-profile individuals — and even billed taxpayers for connectingVerma with fellow Republicans in Congress.

The 49-year-old Verma, who advised then-Gov. Mike Pence in Indiana on health policy before joining the Trump administration, has strongly rejected any suggestion of wrongdoing in her consulting practices. In October 2019, she told a House committee that “all the contracts we have at CMS are based on promoting the work of CMS” and the spending was “consistent with how the agency has used resources in the past.”

But the probe — conducted by Democrats across four congressional committees — found that Verma surrounded herself with a rotating cast of at least 15 highly paid communications consultants during her first two years in office, even as she publicly called for fiscal restraint and championed policies like work requirements for Americans on Medicaid, the health insurance program for low-income people.

“Verma and her top aides abused the federal contracting process to Administrator Verma’s benefit and wasted millions of taxpayer dollars,” the Democrats concludedin a 53-page summary of the investigation, which was shared with POLITICO and was released on Thursday.

Verma declined to comment through the health department’s top spokesperson, Michael Caputo, who described the report as “another reckless drive-by election year hit job.”

“The CMS Administrator will continue her unprecedented efforts to transform the American healthcare system to ensure health policy innovation drives public discussion — not purposefully timed political attacks,” Caputo said in a statement.

Stevens declined to address the specific line items in her invoices, but said in a statement thata top consultingfirm, Porter Novelli, “asked me to put together a plan to educate media about CMS’s work through meetings with the CMS Administrator. I was then asked to facilitate meetings with some of the organizations in the plan as well as with thought leaders. That was the extent of my work.”

A spokesperson for Porter Novelli declined comment until the organization could review the Democrats’ report.

The congressional committees’ investigation, which spanned 18 months, found that the consultants worked directly for Verma and her top officials — an unusual arrangement that gave some of them broad power over CMS’ daily activities and policy planning and access at times to sensitive nonpublic information. Other contractors, meanwhile, racked up hefty expenses as Verma’s personal drivers and press aides; during a two-day trip to New York City in September 2018, contractors filed for almost $8,900 in reimbursements, including stays in a hotel that cost more than $500 per room per night, the report found.

The consultants separately spent eight months refining and implementing a plan intended to “highlight and promote Seema Verma leadership and accomplishment,” according to one draft of the plan, which formed the backbone of a concerted effort to secure major interviews, speaking opportunities and awards, at a cost billed to taxpayers that stretched into the tens of thousands of dollars.

While CMS has previously downplayed the “executive visibility” proposal as conceived by contractors and filled with recommendations that were mostly ignored, the congressionalcommittees found thatVerma’s aides at the health department were regularly briefed on the plan. Meanwhile, consultants pursued its objectives, such as having Verma contend for Glamour Magazine’s “Woman of the Year” award and network with brand-building organizations like Girlboss.

Consultants also charged the health department hundreds of dollars to set up each of Verma’s off-record conversations with reporters, pundits and influencers, such as billing taxpayers $837 to arrange Verma’s lunch with Marc Siegel, a Fox News contributor, and $209 for a conversation with then-Rep. Barbara Comstock (R-Va.). The consultantsalso billed taxpayers at least $1,117 for arranging Verma’s profile in AARP’s magazine and at least $3,400 to coordinate Verma’s appearance on POLITICO’s “Women Rule” podcast.

Meanwhile, Verma and her aides frequently shared market-sensitive proposals with her hand-picked team of GOP contractors before announcing the information publicly — in one case, about three months before the agency’s proposed rules were publicly issued, investigators found. That information, containing key details about Verma’s plan to overhaul the $15 billion electronic health record market, was shared with contractors in mid-November 2018 in hopes of pitching CNN’s Sanjay Gupta to do a story. Federal officials raised concerns that the information should not be shared, with Verma’s top aide warning in an email that she was “fairly concerned about giving this much info prior to a rollout.” The rules weren’t issued until Feb. 11, 2019.

Taken together, the investigation offers the most detailed window yet into Verma’s extensive reliance on outside consultants during her time atop CMS — a practice first reported by POLITICO and which the health department’s inspector general found in July broke federal contracting rules.

The report draws on roughly 10,000 pages of documents obtained by congressional staff from the Trump administration’s health department, including some of Verma’s emails. The Democrats on the House Energy and Commerce, House Oversight, Senate Finance and Senate HELP committees also reviewed extensive billing records and other documents provided by consultants to CMS.

Those documents, Democrats said, demonstrate the degree to which Verma has leaned on expensive outside contractors from her first days as CMS chief — a group that included Marcus Barlow, who previously served as a spokesperson for Verma’s health consulting firm, as well as longtime GOP consultant Brett O’Donnell and a public relations firm co-led by Trump’s former transition team director, Ken Nahigian.

That firm, Nahigian Strategies, billed for nearly $3 million in taxpayer funds from CMS for aiding Verma, the Democrats found. The contracts were halted in April 2019, after POLITICO’s investigation.

“Congress did not intend for taxpayer dollars to be spent on handpicked communications consultants used to promote Administrator Verma’s public profile and personal brand,” Reps. Frank Pallone (D-N.J.) and Carolyn Maloney (D-N.Y.) and Sens. Ron Wyden (D-Ore.) and Patty Murray (D-Wash.) said in a joint statement. “Administrator Verma has shown reckless disregard for the public’s trust. We believe she should personally reimburse the taxpayers for these inappropriate expenditures.”

The four committee leaders on Thursday asked the Government Accountability Office to review the payments CMS made to its communications contractors, citing prohibitions on the unauthorized use of appropriated funds for “publicity or propaganda purposes.”

One of the consultants featured in the report pushed back on its findings. Barlow questioned the Democrats’ intentions in conducting the investigation, telling POLITICO that the committees never sought to interview him.

“They didn’t talk to me because they weren’t interested in the truth,” he said. “They were interested in making a political show.”

After this article’s publication, a Nahigian Strategies spokesperson also criticized the investigation, calling it a “narrative in search of a story.”

“It is unfortunate that a small business with a track record of delivering exceptional work to Democratic and Republican administrations in agencies across the federal government over the past 20 years has been treated in such a partisan manner with such disregard for the facts,” the spokesperson said.

O’Donnell declined to comment.

Announcing Medicaid work requirements

The Democrats’ investigation reveals how an effort to plug holes early in the Trump administration swelled into an operation that ran for more than two years, as Verma’s aides repeatedly sought out communications experts and then looked for ways to cover their costs.

The Medicaid chief initially turned to consultants like O’Donnell and Barlow as she was settling into her role in early 2017, seeking communications advice and having been blocked by the White House from hiring Barlow as an agency staffer. Over time, those consultants and others became crucial parts of agency operations by helping shape major Trump administration health priorities, with Verma leaning on them to manage policy announcements and craft her messaging, such as her talking points on repealing and replacing Obamacare in 2017.

Barlow, O’Donnell and Nahigian also advised CMS as the agency readied its rollout of new work requirements for Medicaid in early 2018 — a key plank of Trump’s health agenda. In one initiative, the three men helped write an op-ed touting Medicaid work requirements that would ultimately be published in The Washington Post under Verma’s name. Among their duties: incorporating feedback from the White House on a draft of the article and pitching headline ideas, according to emails obtained in the investigation. Nahigian “carried most of the water on this,” Barlow wrote in one Sunday night email, as the men and CMS officials deliberated about edits.

Meanwhile,Barlow and Nahigian weighed in on the wording of the CMS press release officially announcing the Medicaid work requirements. And on the day before the agency went public with the policy, a senior CMS official identified O’Donnell to a reporter as “our point person for media” on the topic.

As Verma’s reliance on outside communications experts grew, CMS officials searched for contracting vehicles to pay for consultants who had become trusted advisers to Verma. Emails obtained by the committees show top CMS officials repeatedly seeking ways to cover the cost of O’Donnell, such as moving him between contracts with different firms and exploring ways to keep his services after exhausting the funds available under an existing contract.

But Verma’s reliance on consultants created confusion inside her agency, with the Democrats identifying emails where staff raised questions or concerns about the strategy. Officials in the Health and Human Services department — which technically oversaw Verma and CMS — also appeared to be caught unawares by Verma’s media approach, shaped by her consultants.

The then-HHS chief of staff emailed Verma in August 2017, referencing a New York Times article about an anonymous Trump official who had briefed 20 reporters about the administration’s strategy on the Affordable Care Act, with the official referencing her perspective as a “mom” with “two kids.” The description fit Verma, and four people with knowledge of the episode told POLITICO that Verma and her communications advisers had organized the media briefing.

“The article below is causing an uproar internally,” HHS chief Lance Leggitt wrote to Verma. “Any clue who this [is]?” Verma forwarded the email to O’Donnell with no comment.

O’Donnell himself would be gone from CMS by February 2018, shortly after an episode where he clashed with a reporter for health care publicationModern Healthcare who Verma believed had misrepresented the departure of one of her aides.

In an email to O’Donnell and her aides on Jan. 23, Verma instructed them to “take the strongest action possible with [the reporter’s] editors.” The following day, O’Donnell warned the reporter’s editor that “short of fully correcting the piece we will not be able to include your outlet in further press calls with CMS,” and the reporter later said he was removed from a Feb. 1 press call.

While the agency at the time denied that the reporter was banned, O’Donnell and CMS officials did strategize to remove him, the Democrats concluded, pointing to emails obtained in their investigation. “Modern Healthcare needs to come off the call list for today,” Brady Brookes, Verma’s deputy chief of staff at the time, wrote in an email on Feb. 1.

O’Donnell departed the agency just days afterward amid growing scrutiny ofhis role as an adviser to Verma, with a CMS spokesperson saying that they had decided not to renew his contract.

‘A shadow operation’

By mid-2018, Verma’s team was againhunting for a specialist to boost her communications strategy — specifically, an expertwho could get “more media” for Verma, according to one official’s email obtained by the Democrats. Verma’s own aides intentionally sought out Stevens, a well-regarded communications expert who specialized in promoting Republican women, and helped initiate the plan to hire her.

“Just remember that people like this are expensive per hour,” a senior CMS communications official warned Brookes in a July 24 email, as officials strategized over how to bring on Stevens. The agency would ultimately spend about $115,000 on Stevens’ services, as she tried to broker conversations between Verma and well-known Washington reporters, booked media appearances for Verma with conservative outletsand even tried toset up a meeting between Verma and then-White House communications director Bill Shine.

Stevens also adopted novel strategies to boost Verma’s profile. Between October and November 2018, she arranged a “Girl’s Night” to honor Verma, according to Stevens’ billing records obtained by the committee. The off-the-record event was intended for media personalities and prominent women and was hosted at the home of USA Today reporter Susan Page. In documents obtained by the committee, Stevens described the event as a networking opportunity for Verma, although the evening carried a pricey tab: Taxpayers were ultimately charged nearly $3,000 to cover Stevens’ costs in arranging the event.

A USA Today spokesperson said that Page was not personally reimbursed for the event or aware that CMS had been billed, and that she paid over $4,000 from her own pocket to cover catering and other costs of the reception. The evening was intended “to honor women on both sides of the aisle doing notable things,” said spokesperson Chrissy Terrell, adding that it fell “well within the ethical standards that our journalists are expected to uphold.”

But as Stevens created new opportunities for Verma, her tactics confused other consultants and some of the bookings unsettled the administrator herself, according to emails uncovered in Democrats’ investigation. After Stevens booked Verma on several political radio shows in early December 2018, leading to uncomfortable questions about partisan politics, one consultant recommended to Brookes in an email that Stevens could be used just for “profile pieces and softballs” in the future.

“I think moving forward, we would rather have a small market or station that may be less risky as to not upset the Administrator if things go off topic,” a Porter Novelli consultant wrote.

Meanwhile, Verma’s other consultants continued to craft pricey media opportunities for Verma, billing the agency for a $13,856 video shoot for a two-minute “eMedicare” video that was published in October 2018 and included a $450 charge for Verma’s makeup artist.

Consultants accompanied Verma even when traveling to events where they told Democratic investigators that no media were present, like Verma’s October 2018 trip to York, Pa., that featured a driver from Nahigian Strategies and two other consultants, according to an itinerary obtained by Democrats.

“The size of Administrator Verma’s travel entourage appears to be a particularly questionable use of taxpayer dollars given the high rates charged by Nahigian Strategies for logistical tasks such as driving and event labor on these trips,” the Democrats’ report notes.

By early 2019, Verma’s handpicked team of communications consultants had swelled to include multiple consultants who were booking media appearances and strategizing on her remarks, and even three speechwriters — an arrangement that Democrats characterized as “a shadow operation that sidelined CMS’s Office of Communications in favor of the handpicked consultants.”

Inside Verma’ agency, career officials were finding reasons to complain, too.

“This has been chaos for a number of reasons,” Johnathan Monroe, a career civil servant who helped lead the agency’s media relations team, wrote to CMS colleagues in January 2019, according to an email obtained by Democrats.

In his message, Monroe detailed how Stevens’ independent work had led to duplicated efforts and confusion inside the agency. “The fact that we have managed this much is a testament to how hard [the communications office] has been working to help correct and cope with the chaos,” the CMS official lamented.

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Ramsey Touchberry  3 hrs ago


As the White House repeatedly downplayed the state of the pandemic throughout the summer, its own coronavirus task force was quietly sending reports to states that directly contradicted the public remarks offered by President Donald Trump and Vice President Mike Pence, showed documents that were unveiled Monday by a congressional panel.Donald Trump et al. standing next to a person in a suit and tie: President Donald Trump, with Response coordinator for White House Coronavirus Task Force Deborah Birx (L) and Director of the National Institute of Allergy and Infectious Diseases Anthony Fauci (R), speaks on vaccine development on May 15 in the Rose Garden of the White House in Washington, DC.© Photo by MANDEL NGAN/AFP/Getty President Donald Trump, with Response coordinator for White House Coronavirus Task Force Deborah Birx (L) and Director of the National Institute of Allergy and Infectious Diseases Anthony Fauci (R), speaks on vaccine development on May 15 in the Rose Garden of the White House in Washington, DC.

The House Select Subcommittee on the Coronavirus Crisis released eight reports, ranging from June 23 to August 9, from the White House Coronavirus Task Force that were provided to states.

The reports, which were not previously available to the public, show that while Trump and Pence publicly tried to quell fears by saying the resurgence of the virus was “overblown” and that it is “going to disappear,” top health officials within the administration warned “red zone” states about increased spread and advised specific mitigation efforts that often went ignored.

Further, the Democratic-led committee concluded, “many states are still failing to comply with key Task Force recommendations, including some recommendations first made nearly two months ago.”

The panel specifically references four states—Florida, Georgia, Tennessee and Oklahoma—that it said “acknowledged” receiving the private reports and recommendations, yet largely ignored them by not “implementing additional public health measures recommended by the Task Force to stop the spread of the virus.”

The earliest report to states on June 23 stated that seven states were in a “red zone” and that new cases were up by 70 percent in Arizona, 72 percent in Texas, 87 percent in Florida, 93 percent in Oklahoma and 134 percent in Idaho. One week earlier, on June 16, Pence penned an op-ed that “panic is overblown” about a second wave.

A July 5 report stated 15 states were now in the “red zone” and that Florida “has seen a significant increase in new cases and a significant increase in testing positivity over the past week continuing from the previous 4 weeks.” Two days later, on July 7, Trump rebuked a grim assessment by Dr. Anthony Fauci, a task force member and the country’s top infectious disease expert, saying that “we’ve done a good job” and “I think we are going to be in two, three, four weeks, by the time we next speak, I think we’re going to be in very good shape.”

A July 14 report said 19 states were in the “red zone” and that “more testing is needed.” That same day, Trump inaccurately claimed that “no other country tests like us. In fact, I could say it’s working too much. It’s working too well.”

An August 2 report said 23 states were in the “red zone” and warned about the spread in Louisiana, South Carolina and Oklahoma. The week prior, on July 28, Trump told Axios that “it’s under control as much as you can control it.”

“They are dying, that’s true. And you have—it is what it is,” the president continued. “But that doesn’t mean we aren’t doing everything we can.”

On August 3, Trump tweeted that “cases up because of BIG Testing! Much of our Country is doing very well. Open the Schools!”

An August 9 report showed that 48 states and the District of Columbia were in red or yellow zones.

The congressional panel concluded that many states refused to implement recommendations from the White House Coronavirus Task Force meant to curb the spread.

In a letter to the coronavirus subcommittee, Georgia Governor Brian Kemp (R), who recently dropped a lawsuit against the Atlanta mayor Kesha Lance Bottoms over a mask mandate, wrote that Americans in both Georgia and the U.S. “grew complacent.”

“Summer holidays coupled with televised protests caused many to let their guard down and abandon guidance provided by public health officials,” Kemp wrote.

In other examples, the committee noted that Florida has declined to initiate a mask mandate, despite the task force’s June 29 advice to do so; Tennessee refused a mask mandate and to close bars and limit restaurant activity in red and yellow zones; and Oklahoma rebuffed the task force’s mask mandate recommendation.

In total, the committee concluded after reviewing the task force reports, “14 states that have been in the ‘red zone’ since June 23 have refused to impose statewide mask mandates per Task Force’s recommendations—including states with severe case spikes like Arizona, Florida, Georgia, Oklahoma, South Carolina, and Tennessee.”

This is a developing story and will be updated with additional information as it becomes available.

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If you are paying attention , really paying attention you may have noticed that each event with TOTUS is a rally with attendees flouting the guidelines for COVID (masks, distancing and possibly hand hygiene). After these rally’s there is an upsurge of Covid cases. TOTUS never mentions these upsurges, is it possible that he place no importance on the health of his “base” or he doesn’t care? After months of an unresolved or properly addressed pandemic and the subsequent economic downturn, the administration has done nothing more than tout “pie in the sky” cures much like the “snake oil salesman” of the early days of our country. It is incredible to me that so many seemingly intelligent people follow this uninformed leader. As an assortment of reports come in from numerous locations across the country especially areas that have suffered unrest, I am at once surprised and appalled at lack of knowledge potential voters have on the issues. I should say these voters seem to have one (1) issue rather than a wide view of all of the issues and how they affect them now and in the future. It seems that many people cannot see the long range effects of poor legislation since they think it can’t hurt them. A little gruesome thought: The followers of Jim Jones possibly thought the same thing when they drank the “koolaid”!

This Presidency has been and is one of the biggest cons to be perpetrated on the voters of this country. This is all being viewed by our allies with incredulity and our enemies with delight yet the voters (TOTUS supporters) can’t see the forest for the trees (which under this administration are in danger). The cure for bad government is an informed electorate and you do not have to be a legal scholar to know what the Constitution provides us as citizens but you do have a mind to recognize truth from fiction or at the least be willing to search for truth.

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Ab Goodnough, The New York Times August 30, 2020 0:36 0:45   

WASHINGTON — Marilyn Cortez, a retired cafeteria worker in Houston with no health insurance, spent much of July in the hospital with COVID-19. When she finally returned home, she received a $36,000 bill that compounded the stress of her illness.

Then someone from the hospital, Houston Methodist, called and told her not to worry — President Donald Trump had paid it.

But then another bill arrived, for twice as much.

Cortez’s care is supposed to be covered under a program Trump announced this spring as the coronavirus pandemic was taking hold — a time when millions of people were losing their health insurance and the administration was doubling down on trying to dismantle the Affordable Care Act, the law that had expanded coverage to more than 20 million people.

“This should alleviate any concern uninsured Americans may have about seeking the coronavirus treatment,” Trump said in April about the program, which is supposed to cover testing and treatment for uninsured people with COVID-19, using money from the federal coronavirus relief package passed by Congress.

Luis Fernandez, who was sick and hospitalized with COVID-19 last month, near his home in Houston, on Aug. 22, 2020. (Michael Starghill Jr./The New York Times)
Luis Fernandez, who was sick and hospitalized with COVID-19 last month, near his home in Houston, on Aug. 22, 2020. (Michael Starghill Jr./The New York Times)

The program has drawn little attention since, but a review by The New York Times of payments made through it, as well as interviews with hospital executives, patients and health policy researchers who have examined the payments, suggest the quickly concocted plan has not lived up to its promise. It has caused confusion at participating hospitals, which in some cases have mistakenly billed patients like Cortez, who should be covered by it. Few patients seem to know the program exists, so they don’t question the charges. And some hospitals and other medical providers have chosen not to participate in the program, which bars them from seeking any payment from patients whose bills they submit to it.

Large numbers of patients have also been disqualified because COVID-19 has to be the primary diagnosis for a case to be covered (unless the patient is pregnant). Since hospitalized COVID patients often have other serious medical conditions, many have other primary diagnoses. At Jackson Health in Miami, for example, only 60% of uninsured COVID-19 patients had decisively met the requirements to have their charges covered under the program as of late July, a spokeswoman said.

Critics say the stopgap program is among the strongest evidence that Trump and his party have no vision for improving health coverage, and instead promote piecemeal solutions, even in a national health crisis. Trump had promised a plan to replace the Affordable Care Act by the beginning of August, but none has been announced and he and other Republicans barely mentioned health policy in their national convention last week.

For now, as tens of thousands of new coronavirus cases are reported each day in the United States — and as Democrats eagerly frame the election as a referendum on Trump’s handling of the pandemic and his efforts to wipe out the health law in the Supreme Court — the COVID-19 Uninsured Program is his best offer.

“This is not the way you deal with uninsured people during a public health emergency,” said Sara Rosenbaum, a professor of health law and policy at George Washington University.

The program has clearly paid what, in many cases, would be staggering and unaffordable bills for thousands of COVID-19 patients. In addition to hospital care, it covers outpatient visits, ambulance rides, medical equipment, skilled nursing home care and even future COVID vaccines for the uninsured, “subject to available funding.” It does not cover prescriptions once patients leave the hospital, or treatment of underlying chronic conditions that make many more vulnerable to the virus.

Health care providers in all 50 states had been reimbursed a total of $851 million from the fund as of last week — $267 million for testing and $584 million for treatment— with hospitals in Texas and New Jersey receiving the most.

But the Kaiser Family Foundation, a nonpartisan research organization, has estimated that hospital costs alone for uninsured coronavirus patients could reach between $13.9 billion and $41.8 billion, far more than what the program has paid out so far.

“The claims have just been so much smaller than anyone would have expected,” said Molly Smith, vice president for coverage and state issues forum at the American Hospital Association. “One thing we’ve heard a fair amount of is just serious backlogs and delays. But probably a lot of claims aren’t getting into the system at all because our members have determined they don’t qualify.”

The hospital association says that some hospitals have reported not submitting a substantial number of claims for their uninsured, with estimates ranging from 40% to 70%, because COVID-19 was not ruled their primary diagnosis.

“Either hospitals code inconsistent with ICD-10 rules,” said Tom Nickels, an executive vice president of the hospital association, referring to the diagnostic codes that hospitals use for billing, “or they don’t get paid even though the patient is clearly getting treated for COVID.”

Harris Health, a two-hospital public system in Houston, did not bill the federal fund for 80% of the roughly 1,300 uninsured COVID-19 patients it had treated through mid-July because many of them also had other medical problems — most often, sepsis, an overwhelming reaction to infection that causes blood-pressure loss and organ failure. In other cases, “an underlying health condition was the primary reason for hospitalization, but was exacerbated by the COVID-19 disease,” Bryan McLeod, a spokesman, said.

Nationally, the total average charge for uninsured COVID patients requiring a hospital stay is $73,300, according to FAIR Health, a health care cost database, although they may be able to negotiate a lower amount.

​Reimbursements have varied widely with few obvious explanations; New Jersey providers, for example, have received $72 million in COVID treatment claims while those in neighboring New York have received half as much. Providers in hard-hit Texas and Florida, states that have not expanded Medicaid to cover more poor adults, have received $144 million and $53 million for treatment, respectively.

“It’s just not clear to me what’s going on,” said Jennifer Tolbert, director of state health reform at the Kaiser Family Foundation, who has looked closely at the program and its claims database.

Despite its limitations, some hospital executives said they liked the program because it paid Medicare rates, which are considerably higher than those for Medicaid, the government health insurance program for the poor, or any normal funding they would receive for charity care.

“This was a really progressive policy we were really surprised by, frankly,” said Dr. Shereef Elnahal, the chief executive of University Hospital in Newark, New Jersey, which has received $8.2 million for treating 787 uninsured patients with COVID, about a third of its coronavirus patients.

Unlike previous administrations during public health emergencies, Trump’s has not encouraged even temporary expansions of Medicaid — except for limited COVID testing — in states where the program covers few poor adults. It also declined to broadly reopen enrollment for Affordable Care Act plans once the pandemic began, although people who lose job-based coverage can enroll.

“You’re seeing a clash between enhancing Medicaid to allow it to cover the uninsured, versus providing a fixed amount of bailout money for providers who can figure out how to get to it,” Rosenbaum said.

The Trump administration has not said how much money it will ultimately allot for the COVID-19 program. It is a small part of the Provider Relief Fund, which totaled $175 billion to start but has been spent down to $60 billion. Most of that money has helped health care providers cover financial losses during the pandemic.

A spokeswoman for the Department of Health and Human Services said in an email that it had not set a limit on how much of the fund would be spent on covering uninsured costs. She said the agency had no plans to change the program to cover patients for whom COVID is a secondary diagnosis.

For now, the confusion continues. Luis Fernandez, an oil industry worker in Houston who was laid off in January, had been uninsured for years when he got sick with COVID last month. He spent 16 days at Memorial Hermann Southwest Hospital and received bills totaling $85,000.

“I called the financial aid lady, told her I was on unemployment and she said, ‘What are you going to do?’” Fernandez, 33, said. “She wanted me to go back to work, like, tomorrow, so I can start paying them.”

A spokeswoman for Memorial Hermann said he had received the bill due to “a process error.”

“We do expect it to be paid since the primary diagnosis is COVID-19,” said the spokeswoman, Alex Loessin.

Cortez’s latest bill was for $76,363.

“This one scares me,” said Billy Cortez, her adult son, who shared a copy of the bill with The Times.

Stefanie Asin, a spokeswoman for Houston Methodist, said in response to questions from The Times that the program would cover all of Marilyn Cortez’s costs but that the hospital system submitted bills to the program only once a month, creating delays. She described the process as lengthy, with “multiple steps and handoffs,” she said.

“We are looking to improve and accelerate this process for the benefit of our patients,” Asin said, “so they will not inadvertently get an unnecessary bill.”

Cortez still needs an oxygen tank, blood thinners and other medications that cost more than $500 a month. She also needs to start seeing a cardiologist because of all the blood clots she developed during her illness. Oxygen and outpatient visits related to COVID are supposed to be covered by the federal program, but nobody has told her that.

If Cortez lived in a different state, all her expenses would likely have been covered by Medicaid. But, like several million poor Americans, she is in the so-called coverage gap: ineligible for Medicaid because Texas is among a handful of states that have resisted expanding the program under the Affordable Care Act. And because of a glitch with the law, she and others are also ineligible for the subsidies that the law provides to help pay for private insurance.

For now, her son Billy is paying for her medications and praying she gets past the fatigue and coughing that still dog her. He said he was extremely grateful that his mother’s hospital bills would be paid, but worried about what the next two years, before she turns 65 and qualifies for Medicare, might bring.

“I feel like this isn’t going to be over any time soon,” he said.

This article originally appeared in The New York Times.

© 2020 The New York Times Company

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In the recent RNC convention, I have noticed that in the remarks, many members of the White House staff and some party members have stated that they get tested daily. If this is indeed the case, then why is it that we do not have national testing yet? These statements are either lies or political rhetoric. Why would “our leaders” withhold testing from the citizenry? This question should puzzle all of us. Why is Dr. Fauci left out of conversations while the CDC issues false information and then is forced to retract it? We already know that the administration has no ability to tell the truth, yet why would testing be withheld from the public as this would be boost for them in this election season? This could be a conundrum if they were honest people however their track record for the truth is full of ruts and potholes. These questions and statements could apply to any political party but it applies to the one currently in control of the White House. It is a long standing sense from many voters that politicians are not trustworthy but we pay attention to what they say and do. If you remove party from politics, you have individuals with their personal faults which influence their actions on their behalf not ours (the people who elected them). It is odd that we (voters) to our detriment have become inured to the ramblings of our elected officials, shouldn’t we take the rose colored glasses off and take a serious look at who we are voting for?


The current election season has shown to be a battle of lies against truth. The truth being somewhere left, right and center of what is evident. The unfortunate part of this is that so many voters are uninformed about the issues. The issues are all clouded by the constant playing on the fears of voters. These fears are what creates and perpetuates the divisions between the various voting blocs. The reality is : “what affects one of us affects all of us in some degree”. While one person who has financial issues due to Government policies another doesn’t, when one person has issues with current health care, another does not. The idea of government policies is to provide equally for all voters. Currently those policies are in limbo at best and nonexistent at worse. The GOP stance generally is smaller government which in theory is ok but in reality is a fairy tale and a good talking point as most people don’t know what that means. The DEM’s stance is government coverage for the most important issues (health care for one). The oddest part of all of this mismatching of ideologies s that IF these two sides would spend less time bashing one another and trying to please big donors we could possible have a United Government that works for ALL of us. It is unfortunate that we have been entertained into believing the ravings of a narcissist and his minions (some of whom have their own unrelated agendas), when what we need are serious minded folks who actually want to serve. There will always be differences of opinions among voters over various issues but these differences do not need more unfounded and just wrong information poured on as fuel on a fire. The real governance has to start at voter level with the removal by vote of ineffective legislators as the current crop has for years stayed in office much too long to be effective for us-the voters.

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There are millions of opinions in this country yet we have failed to learn from the past and we are suffering for it now. If the time were taken to look back on the past 50 years of government we could see the evolution of special interest groups, the conservatives and the “moral’ right. These are groups who have “their” interests which are not necessarily the interests of the country as a whole but they have influenced our elections and policies  which has affected us all up to this day. The ways these efforts have affected us: Botch McConnell- blocking legislation put forth by the Obama administration and taking a neutral stance on legislation by TOTUS. Underneath the public information are the backroom deals and many of those deals are not ultimately good for us and we have no input on their implementation. With all of this, these elected officials come to us each election season as people of good will and ask for another term. Our failure as voters is that we are wont to read the dull and long history of what each of these folks have done to us over time. Perhaps we should look at the ways these people who  we elected to serve ALL of us are serving just some of us on the backs of MOST of us.

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After several days of watching and listening to reports on the Post Master and related, I have wondered if anyone really understands the implications of the current administration’s campaign against mail in votes. First  we should understand that we have essentially a lame duck administration abetted by a neer do well Congress. The original sin of Congress in forcing the Post Office to prepay their pension obligations was the beginning of the money issues within the Department. The post office has not been able to break even since that fateful directive in 2006.- HR 6407. This makes the Postal service pay into the retirement and health care fund the amount shown below:

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`(3)(A) The United States Postal Service shall pay into such Fund–
`(i) $5,400,000,000, not later than September 30, 2007;
`(ii) $5,600,000,000, not later than September 30, 2008;
`(iii) $5,400,000,000, not later than September 30, 2009;
`(iv) $5,500,000,000, not later than September 30, 2010;
`(v) $5,500,000,000, not later than September 30, 2011;
`(vi) $5,600,000,000, not later than September 30, 2012;
`(vii) $5,600,000,000, not later than September 30, 2013;
`(viii) $5,700,000,000, not later than September 30, 2014;
`(ix) $5,700,000,000, not later than September 30, 2015; and
`(x) $5,800,000,000, not later than September 30, 2016.
`(B) Not later than September 30, 2017, and by September 30 of each succeeding year,

This is only part of the entire law, to read it in it’s entirety search: HR6407. The Trump administration and it’s abettors are asserting that the President is correct in his assessment in spite of the fact that many of them benefit from mail in  and absentee votes. This blind following is why we have a raging pandemic and deteriorating economy. It is unfortunate that too many voters latch on to one issue and ignore the wider range of ills brought about by this administration.

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POLITICS 

08/03/2020 09:28 pm ET

After Undermining Postal Service, Trump Claims It’s Not Ready For Mail-In Voting

The president made more unfounded claims criticizing mail-in voting, which more Americans are expected to use amid the coronavirus pandemic.

By Sarah Ruiz-Grossman

 

President Donald Trump again went after the United States Postal Service, this time claiming it is not “prepared” for a rise in mail-in ballots in the upcoming general election.

Voters are expected to vote by mail in record numbers in November as gatherings in public, including at polling places, threaten people’s health amid the coronavirus pandemic.

“There’s never been a push like this for mail-in ballots,” Trump said at Monday’s White House coronavirus briefing. The president went on to criticize primary elections in states like New York and New Jersey, which used expanded mail-in voting this year, and railed against Nevada’s Democratic Gov. Steve Sisolak, who’s expected to sign a bill to mail ballots to all eligible voters.

Trump then went in on the postal service, which has been a target of his attacks for years.

“By the way, I have to say, the post office for many years has been run in a fashion that hasn’t been great. … And I don’t think the post office is prepared for a thing like this,” Trump said of mail-in ballot use in the general election. “How can the post office be expected to handle?”

The president went on to list how USPS receives not only “regular mailing,” but also “a massive number of purchases” from “the internet” and Amazon, calling this “a tremendous strain.” (Some states provide secure drop boxes for voters so they can opt not to send their ballots through the mail, however.)

HuffPost did not immediately get a response from USPS for comment.

“Again, absentee is great, it works. Like in Florida, they’ll do absentee, it really works,” said Trump, who has voted by absentee ballot himself and ignores that absentee ballots are, in fact, mail-in ballots. “But universal mail-in ballots, it’s going to be a great embarrassment to our country.”

Trump has repeatedly and baselessly claimed elections using mail-in ballots are “fraudulent.” There is no evidence of this.

Meanwhile, in recent weeks, Postmaster General Louis DeJoy — a major Trump campaign donor appointed in May — has recently made changes to the postal service in the name of cutting costs, including slashing overtime for employees and telling them to leave mail behind if it will delay carriers’ routes — all of which could slow down mail delivery in the coming months.

With the November election less than 100 days away, the U.S. continues to lead the world in coronavirus cases and deaths, with more than 4.6 million confirmed cases and over 155,000 dead from the virus so far.

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Michael Hiltzik

Social Security advocates who breathed a sigh of relief when Senate Republicans rejected President Trump’s demand to place a payroll cut in the latest coronavirus relief bill exhaled too soon.

The version unveiled Monday by Senate Majority Leader Mitch McConnell (R-Ky.) incorporates a provision even more menacing for Social Security (and Medicare too).

This is the so-called TRUST Act, which was crafted by Sen. Mitt Romney (R-Utah) and has been bubbling along in Capitol Hill corridors since last year.

They are plotting to use the cover of the pandemic to slash Social Security.

Nancy Altman, Social Security Works

The TRUST Act is a device to tamper with Social Security behind closed doors and in a way that would allow senators and members of Congress to wreak havoc on the program without leaving fingerprints.

The TRUST Act is now a provision of the HEALS Act — the Senate GOP’s opening bid on coronavirus relief. So it’s timely to give it a close look.

We’ll start by pointing out that Social Security advocates are universally opposed to the measure, which they see, correctly, as an expression of longtime conservative hostility to the program.

“In the midst of a catastrophic pandemic,” says Nancy Altman, president of Social Security Works, Republicans “should be focused on protecting seniors, essential workers, and the unemployed. Instead, they are plotting to use the cover of the pandemic to slash Social Security.”

The TRUST Act — the acronym stands portentously for “Time to Rescue United States’ Trusts” — would work by ginning up a sense of near-term emergency about the finances of Social Security, Medicare and the federal highway trust fund.

The crisis is largely imaginary, for the Social Security trust fund, by far the biggest of the reserves with $2.9 trillion today, is not in danger of exhaustion for at least 15 years. Nevertheless, the TRUST Act would require the Treasury to issue a report on the status of the funds within 45 days of the measure’s passage.

Congress would then appoint bipartisan committees mandated to “draft legislation that restores solvency and otherwise improves each trust fund program,” as Romney has described the process. Whatever proposals these panels produced would be fast-tracked in Congress and not subject to amendment. (The bills would need 60 votes in the Senate.)

On the surface, this seems almost innocuous — so much so that the act has attracted co-sponsorships from a handful of inattentive and somewhat conservative Democrats, including Sen. Joe Manchin of West Virginia and Sen. Kyrsten Sinema of Arizona. They should pay better attention.

Romney has stated that his model for the TRUST Act is the Simpson-Bowles fiscal commission empaneled by Barack Obama in 2010. That should be a dead giveaway of the dangers.

That commission, which was headed by former Sen. Alan K. Simpson (R-Wyo.) and Erskine Bowles, an ex-investment banker claiming Democratic Party cred from a stint as President Clinton’s chief of staff, was a mess. Its goal was to produce some putatively bipartisan recommendations for deficit reduction, but it was unable to come up with any that could garner a majority vote, so it never actually produced any recommendations.

The proposals that did surface were generally good for the wealthy, not so good for the middle class or low-income Americans. Matters weren’t helped by Simpson’s ignorance about Social Security, which he expressed in unbelievably crass language — at one point referring to the program, which provides more than half the income for two-thirds of all American retirees, as “a milk cow with 310 million tits.”

Since the TRUST panels’ deliberations will be offered to Congress on a take-it-or-leave-it basis, the process rather serves what the GOP refers to as the need to gut Social Security “behind closed doors,” to quote an unwittingly revealing line uttered last year by Sen. Joni Ernst (R-Iowa).

It should be obvious that if fiscal changes in Social Security are favorable for the broad public — say by raising payroll taxes on wealthier Americans who currently get a break on them — they don’t have to be crafted behind closed doors or outsourced to a committee that absolves most senators and representatives of responsibility.

If they involve cutting benefits, a step that would harm the majority of retirees and rank-and-file workers, then it pays to do the work in secret.

So it shouldn’t come as any surprise that the biggest fans of the TRUST Act are water-carriers for richer Americans. They include the Committee for a Responsible Budget, which was supported for years by the late hedge fund billionaire Pete Peterson, by both Simpson and Bowles, and by the Koch-financed organization Americans for Prosperity.

One shouldn’t be fooled by these TRUST Act advocates’ assertions that Social Security needs to be “fixed.” Down deep, they mean “fixed” in the sense that one “fixes” a cat or the Mafia “fixes” a snitch. Democrats on Capitol Hill should keep their wits about them, and “fix” the TRUST Act before it goes any further.

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