Senate Republicans set to release health-care bill, but divisions remain

Washington Post, Power Post

Senate Republicans set to release health-care bill, but divisions remain

By Paige Winfield Cunningham, Juliet Eilperin and Sean Sullivan, June 21, 2017

Senate Republicans on Thursday plan to release a health-care bill that would curtail federal Medicaid funding, repeal taxes on the wealthy and eliminate funding for Planned Parenthood as part of an effort to fulfill a years-long promise to undo Barack Obama’s signature health-care law.

The bill is an attempt to strike a compromise between existing law and a bill passed by the House in May as Republicans struggle to advance their vision for the country’s health-care system even though they now control both chambers of Congress and the White House.

The Senate proposal largely mirrors the House measure with significant differences, according to a discussion draft circulating Wednesday among aides and lobbyists. While the House legislation would peg federal insurance subsidies to age, the Senate bill would link them to income, as the Affordable Care Act does. The Senate proposal would cut off expanded Medicaid funding for states more gradually than the House bill but would enact deeper long-term cuts to the health-care program for low-income Americans. It also would eliminate House language aimed at prohibiting federally subsidized health plans from covering abortions, a provision that may run afoul of complex Senate budget rules.

But on the eve of the bill’s release, Senate Majority Leader Mitch McConnell (R-Ky.) faced the prospect of an open revolt from key conservative and moderate GOP senators, whose concerns he has struggled to balance in recent weeks. Republicans familiar with the effort said Senate leaders have more work to do to secure the 50 votes needed to pass the measure, with Vice President Pence set to cast the tie-breaking vote, from the pool of 52 GOP senators. No Democrats are expected to support the bill.

Republican aides stressed that the plan is likely to undergo more changes to secure the votes needed for passage, but there were major concerns Wednesday from senators on opposite ends of the GOP spectrum.

“My main concern is I promised voters that I would repeal — vote to repeal Obamacare. And everything I hear sounds like Obamacare-lite,” said Sen. Rand Paul (R-Ky.).

Sen. Shelley Moore Capito (R-W.Va.), whose state expanded Medicaid and has been pushing for a more gradual unwinding of that initiative than many conservatives prefer, said she is waiting to scrutinize what is released but has not seen anything yet that would make her drop her concerns with the proposal.

“Up to this point, I don’t have any new news — tomorrow we will see it definitively — that would cause me to change that sentiment,” she said.

Like the House bill, the Senate measure is expected to make big changes to Medicaid, the program that insures about 74 million elderly and lower-income Americans and was expanded in most states under the ACA. In effect, the revisions would reduce federal spending on the program.

The Senate measure would transform Medicaid from an open-ended entitlement to one in which federal funding would be distributed to states on a per-capita basis. The Senate measure would also seek to phase out the program’s expansion — although at a more gradual rate than the House version.

Yet the Senate bill is expected go further than the House version in its approach to cutting Medicaid funding in the future. In 2025, the measure would tie federal spending on the program to an even slower growth index than the one used in the House bill. That move could prompt states to reduce the size of their Medicaid programs.

That provision, a nod to conservative lawmakers led by Sen. Patrick J. Toomey (R-Pa.), risks alienating moderates, including Capito and Sen. Rob Portman (R-Ohio), who also represents a state that expanded Medicaid under the ACA. Some Republicans worry that such a move would force states to cut services or coverage, potentially leaving millions of low-income people without sufficient health care.

The growth rate that is applied to Medicaid spending going forward has major implications, said Sen. Susan Collins (R-Maine). “That inflater is critical, because it translates into billions of dollars over time,” she said.

Portman and Capito have also been pushing for the inclusion of a $45 billion fund to treat and prevent opioid addiction. As of early Wednesday afternoon, the opioid money was not included in McConnell’s proposal, according to a top GOP senator and Senate aide familiar with the discussions.

“I don’t think there is right now,” Senate Finance Committee Chairman Orrin G. Hatch (R-Utah) said when asked whether the legislation includes a distinct opioid fund. “It might have to be considered separately.”

But Portman and Capito, like all senators, will have a chance to introduce amendments to the bill when it heads to the Senate floor, which McConnell said is likely to happen next week. This process will allow senators to draw attention to the causes they have championed and potentially change the final bill.

Moderates who are on the fence about whether to support the Obamacare overhaul are likely to be pleased at the bill’s approach to insurance subsidies because they would be based on financial need, potentially preserving coverage for more people who got insurance under the ACA.

Subsidies are currently available to Americans earning between 100 percent and 400 percent of the federal poverty level. Starting in 2020, that threshold would be lowered to 350 percent under the Senate bill — but anyone below that line could get the subsidies if they’re not eligible for Medicaid.

That provision, said Larry Levitt, senior vice president for special initiatives at the Henry J. Kaiser Family Foundation, would be “a real benefit to poor people in states that don’t expand Medicaid.”

In a move that will please the health-care industry, the draft also proposes repealing all of the ACA taxes except for its “Cadillac tax” on high-cost health plans in language similar to the House version. Senators had previously toyed with the idea of keeping some of the ACA’s taxes.

It would also eliminate Medicaid reimbursements for Planned Parenthood for one year. Federal law already prevents taxpayer funding to pay for abortions except to save the life of the woman or in the case of rape or incest. But some Republicans want to ban all federal funding for Planned Parenthood, which also provides health services such as birth control, because their clinics provide abortion services.

Like the House measure, the Senate bill would eliminate two central requirements of the current health-care law: that individuals provide proof of insurance when filing their annual tax returns and that companies with 50 or more employees provide health coverage for their workers.

In a move that is critical to insurers, the Senate measure would continue to fund for two years cost-sharing subsidies that help 7 million Americans with ACA plans. House Republicans have challenged the legality of the $7 billion in subsidies — which help cover consumers’ deductibles and co-pays — in court, and insurers have warned that they will have to increase premiums dramatically next year unless the federal government commits to continuing the payments.

McConnell has told Republican senators that he wants to maintain protections for people with preexisting conditions under the law. But it was not clear to some lawmakers Wednesday what that would entail.

“I haven’t seen the draft yet. I like the idea of preexisting conditions being more firmly clarified,” Portman said.

Paul criticized GOP leaders for potentially keeping some of the ACA’s “most expensive regulations,” which he says are the primary drivers of higher premiums.

“It may well be that prices don’t come down at all,” he said.

But the Senate proposal may change rules for waivers that states can file with the Centers for Medicare and Medicaid Services that could allow them to potentially scale back some of these federal mandates.

While the details of McConnell’s proposal are expected to be made public Thursday, much of focus in recent weeks has been on the process used to draft the bill.

Democrats and even some Republicans have been critical of Senate GOP leaders for crafting the proposal behind closed doors without hearings and consideration of the legislation by the relevant committees.

Several GOP senators have expressed concern about moving quickly to a vote before they fully understand how it would impact health insurance markets and their constituents.

Sen. Ron Johnson (R-Wis.) said that in addition to reading the bill, “I’ll also want to get full input from constituencies in Wisconsin.”

Given that there may be just a week between the bill being posted and a final vote, he added, “I find it hard to believe we’ll have enough time.”

Amy Goldstein and Kelsey Snell contributed to this report.

Paige Winfield Cunningham covers health policy and authors PowerPost’s daily tipsheet The Health 202. A St. Louis native, she graduated from Wheaton College in Illinois and started her journalism career as a county board reporter at the Naperville Sun.

Juliet Eilperin is The Washington Post’s senior national affairs correspondent, covering how the new administration is transforming a range of U.S. policies and the federal government itself. She is the author of two books—one on sharks, and another on Congress, not to be confused with each other—and has worked for the Post since 1998.

Sean Sullivan has covered national politics for The Washington Post since 2012.

12 Ways Trump Has Declared War on Food Safety

EcoWatch

12 Ways Trump Has Declared War on Food Safety

By Scott Faber    June 15, 2017

President Trump is waging a full-scale campaign to roll back decades of progress toward making America’s food safer, healthier and more clearly labeled. If successful, the Trump administration would do more to increase hunger, obesity and food-borne illness than any other administration in American history.

Since taking office Trump has:

  1. Proposed to cut food safety funding for the U.S. Food and Drug Administration by $117 million.
  2. Proposed to cut funding for the Supplemental Nutrition Assistance Program or SNAP, by $193 billion—a 25 percent cut—and cut international food aid by $2 billion.
  3. Delayed new labeling rules for menus and packaged foods that would give consumers more information about calories and added sugars, and so far failed to issue a draft rule to implement a new law on disclosing genetically modified ingredients in food.
  4. Weakened new rules designed to drive junk food out of U.S. schools.
  5. Proposed to eliminate several U.S. Department of Agriculture programs that helped farmers sell directly to local consumers.
  6. Proposed to eliminate funding for an entire division of the Centers for Disease Control and Prevention that works to reduce obesity.
  7. Withdrawn new rules to protect drinking water supplies from polluters and proposed cutting the U.S. Environmental Protection Agency’s (EPA) budget by 31 percent.
  8. Proposed to suspended two of the largest farmland stewardship programs and mothball others.
  9. Postponed new rules designed to strengthen animal welfare standards on organic farms and proposed to eliminate funding for programs that help farmers switch to organic farming.
  10. Reversed a ban on a pesticide linked to brain damage in kids and proposed cutting EPA funding for pesticide review programs by 20 percent.
  11. Punted on new rules to protect farm-workers from pesticides, and proposed to eliminate a program to train migrant and seasonal farm-workers.
  12. Mothballed new voluntary sodium guidelines that would drive reformulation of foods.

In addition, Trump has called for so-called regulatory “reforms” that would block agencies like the U.S. Food and Drug Administration and U.S. Department of Agriculture from adopting new rules designed to keep food safe, update food labels or provide students healthier meal options in schools.

Thanks to Trump, it may soon be harder for Americans to feed their families, build healthy diets, and eat food free of dangerous pathogens and pesticides.

Pelosi ‘very worried’ about Trump’s fitness for office

The Hill

Pelosi ‘very worried’ about Trump’s fitness for office

By Mike Lillis    June 9, 2017

Rep. Nancy Pelosi (D-Calif.) is questioning President Trump’s fitness to hold his office.

The House minority leader said Friday that Trump may simply lack the curiosity, discipline and stamina to be a competent commander in chief. Trump’s Friday Twitter attack on former FBI Director James Comey, Pelosi said, is just the latest evidence.

“The president’s fitness for office is something that has been called into question,” Pelosi said during a press briefing in the Capitol. “It takes a certain curiosity to learn the facts, to base your comments on evidence and data and truth. It takes a certain discipline to be able to prioritize what is important as we try to bring the country together. And it takes some kind of stamina to keep your thoughts together.

“And I’m very worried about his fitness.”

Pelosi said White House officials should rein in Trump’s impulsive Twitter finger but expressed doubt that anyone on Trump’s team has the “courage” to do so.

“His statements need some discipline, and I don’t know if anyone in the White House has the courage to discipline the president,” she said. “It’s too bad because he needs work. And he needs sleep.”

Comey’s testimony before the Senate Intelligence Committee captivated Washington on Thursday by providing his take on one-on-one conversations with the president.

The former FBI director said he took the president at his word that he had been fired for his handling of the investigation into Russia’s meddling in the election, including possible links to Trump’s campaign. He also said he believed Trump had directed him to end an investigation into former national security adviser Michael Flynn.

Comey stopped short of accusing Trump of obstructing justice, saying that determination is the purview of the current investigative team, being led by special counsel Robert Mueller, Comey’s predecessor atop the FBI.

“That’s a conclusion I’m sure the special counsel will work towards,” he said.

Trump remained silent throughout Thursday’s hearing, but returned to Twitter Friday morning with accusations that Comey had lied under oath.

“Despite so many false statements and lies, total and complete vindication…and WOW, Comey is a leaker!” Trump tweeted.

Comey also acknowledged in his testimony that he leaked through an intermediary his memo on a meeting with Trump that included the discussion about Flynn. That became an explosive story in The New York Times a week after his firing.

Pelosi rejected any suggestion that Comey’s testimony vindicated the president. But Trump’s approach to Comey, she quickly added, is consistent with his strategy as a longtime businessman.

“He operates this way: First he tries to charm you. … If that doesn’t work, he tries to bully you. If that doesn’t work, he walks away from the deal. And if that doesn’t work, he sues you,” she said.

According to CNN, Trump’s outside attorney is poised to file a complaint with the Justice Department against Comey over the leak.

“He’s true to form, true to his nature,” Pelosi said.

Pelosi said Trump had acted deliberately to clear the room after a meeting before talking with Comey.

“He knew that what he was doing was incriminating, and he didn’t want any witnesses,” she said.

But like Comey, Pelosi stopped short of charging Trump with obstructing justice. Trump has “abused power,” she said, but the deeper legal implications are still unclear.

“There’s no question he abused power,” she said. “Whether he obstructed justice remains for the facts to come forward, and that’s what we want are the facts.”

Pelosi amplified Democrats’ long-held request that GOP leaders create an outside, independent panel — akin to the 9/11 commission — to step in with its own investigation of Russia’s election meddling.

“We are limited,” she said, “by what the Republicans are willing to do.”

Business Insider

Pelosi: My first meeting with Trump as president was unlike anything I’ve experienced with other presidents

Veronika Bondarenko,   Business Insider     June 10, 2017

The first thing President Donald Trump said upon meeting congressional leaders was that he won the popular vote, House Minority Leader Nancy Pelosi said on Friday.

During an appearance on MSNBC’s “Morning Joe” talk show, Pelosi recalled her first meeting with Trump at the White House after he was elected.

“First thing he says to open the meeting: ‘You know, I won the popular vote,'” she said, later adding that she had to tell Trump there were no facts to support his assertion.

Trump won the 2016 election by a wide margin in the Electoral College but lost the popular vote to Hillary Clinton by about 3 million.

Trump’s disputing of these numbers and allegations of voter fraud created controversy for him in the wake of the election.

Pelosi said that even though she and President George W. Bush had disagreed on many things, they were at least operating from a shared understanding of facts.

“I wish he were president now,” Pelosi said of Bush, adding that he once told her she would end up missing him. “I wish Mitt Romney were president. I wish John McCain were president.

“We all have to start at a place when we’re dealing with facts, evidence, data, and then you can compromise,” Pelosi said.

As Climate Change Threatens Food Supplies, Seed Saving is an Ancient Act of Resilience

Resilience

As Climate Change Threatens Food Supplies, Seed Saving is an Ancient Act of Resilience

By Sarah van Gelder, originally published by YES! magazine    June 9, 2017

On Feb. 26, 2008, a $9-million underground seed vault began operating deep in the permafrost on the Norwegian island of Spitsbergen, just 810 miles from the North Pole. This high-tech Noah’s Ark for the world’s food varieties was intended to assure that, even in a worst-case scenario, our irreplaceable heritage of food seeds would remain safely frozen.

Less than 10 years after it opened, the facility flooded. The seeds are safe; the water only entered a passageway. Still, as vast areas of permafrost melt, the breach raises serious questions about the security of the seeds, and whether a centralized seed bank is really the best way to safeguard the world’s food supply.

Meanwhile, a much older approach to saving the world’s heritage of food varieties is making a comeback.

On a recent Saturday afternoon, a group of volunteers in the northern Montana city of Great Falls met in the local library to package seeds for their newly formed seed exchange, and to share their passion for gardening and food security.

“We don’t know what’s going to happen to our climate in the future,” said Alice Kestler, a library specialist. “Hopefully, as the years go by, we can develop local cultivars that are really suited to the local climate here.”

For millennia, people the world over have selected the best edible plants, saved the seeds, and planted and shared them in sophisticated, locally adapted breeding projects that created the vast array of foods we rely on today. This dance of human intelligence, plant life, pollinators, and animals is key to how human communities became prosperous and took root across the planet.

The Great Falls Library Seed Exchange is continuing that tradition even while a modern agribusiness model works to reduce the genetic diversity of our food stocks and consolidate control over the world’s seeds. Six seed companies now control three quarters of the seed market. In the years between 1903 and 1983, the world lost 93 percent of its food seed varieties, according to a study by the Rural Advancement Foundation International.

Perhaps we shouldn’t be surprised that giant agribusiness companies have no interest in the vast varieties and diverse ways people breed plants. It is hard to get rich off of an approach based on the distributed genius of people everywhere. Such a model doesn’t scale or centralize well. It is intensely democratic. Many people contribute to a common pool of knowledge and genetic diversity. Many people share the benefits.

Making big profits requires scarcity, exclusive knowledge, and the power to deny others the benefits. In this case, that means the appropriation of the knowledge built up over generations, coupled with the legal framework to patent seed varieties and punish those who fail to comply.

Especially in a time of climate change, though, genetic diversity is what we need to assure food security and resilience.

The Great Falls Library Seed Exchange is on the second floor of the library, which sits less than a mile from the Missouri River. Climb the brick building’s big, central staircase, and you can’t miss the brightly painted seed catalog. Borrowers are encouraged, but not required, to save some of the seeds and return them to the library for others to plant.

The exchange began just over a year ago, and is one of 500-some seed libraries worldwide. It sources its seeds from local organic farms and distant companies that specialize in plants that can grow in the rugged terrain of the northern plains, as well as heirloom varieties that have proven their worth over generations of seed saving. Locals also bring in their favorite varieties to share.

Each grower chooses which of each variety to save for seed, and those choices shape future availability.

“Since we have such a short growing climate here, getting seeds from plants that fruit early is really advantageous,” Kestler said. Some growers, though, select for the biggest fruit; others for the best-tasting. This built-in diversity helps to secure a resilient food supply.

“The seed in its essence is all of the past evolution of the Earth, the evolution of human history, and the potential for future evolution,” author and seed saver Vandana Shiva told me when I interviewed her in 2013. “The seed is the embodiment of culture because culture shaped the seed with careful selection. That is a convergence of human intelligence and nature’s intelligence.”

The Norwegian doomsday vault makes an important statement about the irreplaceable value of the genetic diversity of our planet, and it may prove to be an important failsafe in the event of disaster. But the time-honored process of saving and sharing seeds is dynamic. It naturally adapts to changing conditions, like climate change, and keeps the power with people everywhere to make choices that assure local resilience.

“Seed saving is such an important political act in this time,” Shiva said. “Save the seeds, have a community garden, create an exchange, do everything that it takes to protect and rejuvenate the seed.”

Single-payer healthcare plan advances in California Senate — without a way to pay its $400-billion tab

Los Angeles Times Essential Politics

This is Essential Politics, our daily look at California political and government news. Ballot measures California Legislature. Reporting from Sacramento.

Single-payer healthcare plan advances in California Senate — without a way to pay its $400-billion tab

Patrick McGreevy June 1, 2017

A proposal to adopt a single-payer healthcare system for California took an initial step forward Thursday when the state Senate approved a bare-bones bill that lacks a method for paying the $400-billion cost of the plan.

The proposal was made by legislators led by Sen. Ricardo Lara (D-Bell Gardens) at the same time President Trump and Republican members of Congress are working to repeal and replace the federal Affordable Care Act.

“Despite the incredible progress California has made, millions still do not have access to health insurance and millions more cannot afford the high deductibles and co-pays, and they often forgo care,” Lara said during a floor debate on the bill.

The bill, which now goes to the state Assembly for consideration, will have to be further developed, Lara conceded, adding he hopes to reach a consensus on a way to pay for it.

Republican senators opposed the bill as a threat to the state’s finances.

“We don’t have the money to pay for it,” Sen. Tom Berryhill (R-Modesto) said. “If we cut every single program and expense from the state budget and redirected that money to this bill, SB 562, we wouldn’t even cover half of the $400-billion price tag.”

Berryhill also said the private sector is better suited to provide healthcare.

“I absolutely don’t trust the government to run our health system,” he said. “What has the government ever done right?”

Lara’s bill would provide a Medicare-for-all-type system that he believed would guarantee health coverage for all Californians without the out-of-pocket costs. Under a single-payer plan, the government replaces private insurance companies, paying doctors and hospitals for healthcare.

The California Nurses Assn., which sponsored the bill, released a fiscal analysis this week that proposed raising the state sales and business receipts taxes by 2.3% to raise $106 billion of the annual cost, with the rest proposed to come from state and federal funding already going to Medicare and Medicaid services.

Sen. Ted Gaines (R-El Dorado Hills) called the plan “reckless” and said the taxes would hurt businesses and families while financially crippling the state government.

“It’s offensive to the people who have to pay for it,” he said.

Some Democrats felt the bill was rushed and undeveloped. Sen. Ben Hueso (D-San Diego) withheld his vote on the bill on grounds it does not provide enough detail of what a single-payer system would look like.

“This is the Senate kicking the can down the road to the Assembly and asking the Assembly to fill in all of the blanks,” Hueso said. “That’s not going to happen this year.”

Lara said action is required because of what is happening in Washington.

“With President Trump’s promise to abandon the Affordable Care Act as we know it — for one that leaves millions without access to care — California is once again tasked to lead,” he told his colleagues.

He said his father recently had heart bypass surgery but went through the emergency room for help after his insurance company initially turned him down.

Even if the bill is approved, it has to go to Gov. Jerry Brown, who has been skeptical, and then voters would have to exempt it from spending limits and budget formulas in the state Constitution. In addition, the state would have to get federal approval to repurpose existing funds for Medicare and Medicaid

How Fox News dealt with CBO saying 23 million would lose coverage under the AHCA

Vox

How Fox News dealt with CBO saying 23 million would lose coverage under the AHCA

We watched every instance in which Fox News had to confront the number.

Updated by Alvin Chang    May 31, 2017

The morning after a nonpartisan analysts reported that the Republican replacement for Obamacare would cause 23 million people to lose their health insurance — many of them in the reddest states — Fox & Friends invited President Trump’s budget director, Mick Mulvaney, onto the show.

The exchange went like this:

BRIAN KILMEADE (host): 23 million will lose insurance. True or false?

MULVANEY: False. If you look at the methodology, they assume that folks who were on Medicaid, which is free, will choose to get off Medicaid when the mandate goes away. Now you tell me if this sounds like the real world.

STEVE DOOCY (host): Sure. And I know the [Congressional Budget Office] looked at it. Millions of Americans are not going to buy insurance if they don’t have to because they don’t want to.

It was one of the rare instances Fox & Friends mentioned the “23 million” number, but a quintessential example of how the Fox News Channel has often covered the devastating CBO analysis — by obscuring details and blaming the source, which is similar to how right-wing news sites cover this administration.

Mulvaney does both, saying CBO erred in saying people would voluntarily leave Medicaid. He (and the hosts) fails to mention that the bill kicks low-income adults without children off Medicaid and makes it easier for states to kick people off the program.

It’s part of a pattern on Fox News, which often framed the CBO score in two ways. The first was that the CBO analysis is wrong, or that CBO has been unreliable in the past. The second is that Obamacare is failing and this bill gives people the freedom to escape that failure.

Not thinking too hard about the human cost

As my colleague Jeff Stein writes, this bill is a bigger liability for Republicans than Trump’s scandals. It’s what Democrats are campaigning on and what seems to have the most resonance, perhaps because people don’t want to be in the traumatic situation of having to choose between financial ruin and medical treatment.

Many of those who stand to lose insurance live in states that voted heavily for Trump. The bill hurts a host of demographic groups that support Trump — including older Americans, those who live in more rural areas, and areas suffering most from the opioid crisis.

The CBO scores get at the heart of these fears.

So the injection of these numbers into the AHCA debate caused a dissonance on several Fox News shows. When Fox & Friends had to confront these numbers, the reaction was to minimize the CBO analysis. For example, in March, after the first CBO report, Kilmeade acknowledged that Trump voters would be hurt but assured them this was part of a larger plan:

They say the people that are going to be hurt most under the current plan, the way the calculus is done by the CBO, are Americans between the age of 50 and 64. Right before Medicare, the older part and last leg of their career. That translates into mostly Trump voters.

But then you factor in the fact that this is a three-phase plan. The second phase is when [Health and Human Services Secretary] Tom Price is supposed to theoretically sit there and put in regulations that’ll make this more of a conservative project.

Host Ainsley Earhardt questioned the CBO, saying:

Here’s the thing. Donald Trump says the Democrats are the ones that put us in this mess. They are complaining about this.

Can you really trust the CBO? Can you trust the report?

Jonathan Gruber, the architect of Obamacare, he said blatantly — we played the sound bites for you yesterday — he said we can trick the CBO, call them mandates and not taxes, and they will pass this thing through.

Then on May 4, the House prepared to vote on the second version of the AHCA without a CBO score showing the policy’s impact. That morning, Doocy confronted the “24 million” number by saying it’s better because it “reduces taxes and stuff like that”:

When you saw that figure a month or two ago, where something like 24 million would wind up losing their health care: That is a great political ad for the Democrats, whoever is going to run against any of the Republicans coming up in 2018.

But here’s the thing: What if it’s — the hope for everybody is this is actually better. Reduces taxes and stuff like that.

And ultimately, when it comes to politics, this is going to redeem Speaker Paul Ryan. Plus, it’s going to give President Trump his first big — and it is big — legislative win.

I’m largely focusing on Fox & Friends because it has one very important viewer — President Trump — who has praised the show multiple times, and even thanked them for helping him win the presidency. It is the inner monologue of a president who has aggressively criticized most other media outlets for their reporting of his presidency.

Some shows on the network were slightly more nuanced, saying that people will choose to be uninsured because Obamacare will no longer mandate people to have insurance.

The bottom third also suggests the new version of the bill protects people with preexisting conditions. It does not.

There was little talk of why the mandate existed in the first place, and the mechanism the AHCA uses in its place: a penalty for people who want to buy insurance on the marketplace after a lapse in coverage.

Painting the CBO — and subsequently the media — as biased

Occasionally a guest would be on a Fox News show to represent the opposing viewpoint, and they would defend the 24 million number, though almost immediately a conservative guest or the host would reframe the discussion around CBO’s credibility or Obamacare’s failure. But it was this inherent conflict — between left and right, between “them” and “us” — that framed the coverage around the CBO report.

After watching the nearly 100 times people on Fox News confronted these numbers, the CBO report stopped feeling like a number describing humans. Rather, it felt like a political concoction — a number whipped up to make Obamacare repeal harder.

In fact, media outlets and experts who cited the CBO score were also treated with contempt. Below is a screenshot of a segment on how unfairly the mainstream media is treating the AHCA after the CBO score:

It’s cruel to disorient people like this

American health care is complicated. This AHCA debate is complicated. Yet it’s these complicated details that determine the cost and quality of care for our bodies.

So when nonpartisan analysts say that a bill will cause 23 million to lose insurance in 10 years and make costs skyrocket for older and poorer Americans, it should clarify our political opinions.

But Fox News has taken advantage of television as a medium to try to convince its viewers that “23 million” is a partisan tool, not an evidence-based projection. It’s basing its rhetoric on personality, on partisanship, on tribalism, and insisting that people trust them, not the mainstream media or the nonpartisan analysts who are desperate to take down Donald Trump.

Let’s put it this way: When our satellites tell us a powerful hurricane is headed toward us, it’s irresponsible not to tell everyone to get out of the way. But convincing the people that the tools are malfunctioning, that the hurricane isn’t coming their way, that the rest of the news reports are wrong? That’s cruel.

Two Scientists, Two Different Approaches To Saving Bees From Poison Dust

NPR

Two Scientists, Two Different Approaches To Saving Bees From Poison Dust

Dan Charles May 27, 2017

A tractor pulls a planter while distributing corn seed on a field in Malden, Ill. Two scientists agree that pesticide-laden dust from planting equipment kills bees. But they’re proposing different solutions, because they disagree about whether the pesticides are useful to farmers.

Bloomberg/Bloomberg via Getty Images

It’s planting time in America. Farmers are spending long days on their tractors, pulling massive planters across millions of acres of farmland, dropping corn and soybean seeds into the ground.

Most of those seeds have been coated with pesticides known as neonicotinoids, or neonics for short. And despite attempts by pesticide makers to reduce this, some of that coating is getting rubbed off the seeds and blown into the air. That dust is settling on the ground, on ponds, and on vegetation nearby.

Honeybees and wild bees, looking for food, will encounter traces of the pesticides, and some will be harmed. They may become disoriented and bring less food back to their colony. Many may die.

Several years ago, Christian Krupke, an insect specialist at Purdue University in Indiana, became one of the first researchers to discover that rogue dust was wiping out bee colonies. At first, Art Schaafsma, an entomologist at the University of Guelph, in Canada, didn’t believe it was true.

“Unfortunately — myself included — in the early days there was a lot of skepticism,” Schaafsma says. He regrets that reaction now. “We do have a problem, and we’ve got to fix it,” he tells me.

There are a lot of things that Krupke and Schaafsma disagree about when it comes to neonicotinoids. Krupke believes — while Schaafsma does not — that bees may also be harmed by exposure to smaller quantities of neonicotinoids that show up in the leaves and pollen of plants grown from coated seeds, or even in wildflowers that grow in or near fields where the crops are planted.

They do agree that the dust is a problem. They just have different ideas about how to fix it.

Schaafsma’s solution is sitting in a garage on the Ridgetown Campus of the University of Guelph. It’s a shiny new piece of farm equipment, a seed planter that Schaafsma has taken apart and re-engineered.

Like most modern planters, it uses air pressure to move the seeds from a storage bin through tubes and into the soil. Schaafsma points to the end of one pipe. “This is the air intake, OK? See the problem already?

That pipe is close to the ground. When a tractor pulls this planter across a field, dust will get sucked into this opening, along with air. Inside the planting mechanism, “the air is rushing past that seed, it’s laden with dirt, and it’s acting like a sandblaster,” Schaafsma says. That dirt grinds a little bit of the neonicotinoid coating from the seed, and then carries the pesticide dust with it as it exhausts from the planter, straight up into the air.

That’s normally how the planter works. But Schaafsma has made some changes on this one, outfitting it with special dust traps, similar to high-quality vacuum cleaner filters. “We’re probably filtering 99 percent of what comes out of the exhaust,” he says.

Schaafsma thinks that this equipment, if installed on all seed planters, would eliminate most of the risk to bees from neonicotinoid-treated seeds.

Schaafsma has been testing his theory by setting up honeybee hives near corn fields that were planted using his filter-outfitted equipment, monitoring these hives and measuring their honey production. “We just want to demonstrate that it can be done — that bees and corn can co-exist,” he says.

Schaafsma wants co-existence because he wants farmers to be able to use neonicotinoid-treated seed. “I see them as valuable tools, which should be handled with care,” he says.

This, however, is where Schaafsma and Christian Krupke part ways. Krupke is not convinced that farmers are getting much benefit — if any — from the seed coatings. In most cases, Krupke says, the pesticides don’t appear to be worth the money that farmers are spending.

So his solution is even simpler: Stop using them so much. At the very least, he says, seed companies should give farmers the option of planting seeds without neonicotinoids on them. Right now, it’s often difficult to find such untreated seeds.

This month, Krupke and some colleagues published two scientific papers with evidence to support his case. The first study, conducted by researchers at seven Midwestern universities, concluded that neonicotinoid-treated soybean seeds performed no better than untreated seeds in fending off aphids, one of the major pests that the seed treatments are supposed to control. According to the study, farmers would be better off leaving their seeds untreated, monitoring their fields, and resorting to conventional spraying of pesticides when the aphids attacked.

In another study, Krupke found that the seed treatments weren’t of much benefit to corn yields, either. In some fields, pesticide-treated seed performed better, in other fields it did worse. Combining the results from all the sites, the average yield from the treated seed was about 2 percent higher, but Krupke says that difference is not statistically or economically significant — certainly not the kind of clear effect that would justify its use on nearly all the corn in the country.

Companies that sell seeds and neonicotinoid pesticides have attacked similar studies in the past, arguing that farmers clearly do see benefits from the seed treatments, because they’re happy to pay for them. Other researchers, including Schaafsma, have reported that treated seed has produced higher yields, with the increase ranging from 1.5 to 5 percent.

Krupke says he’d like to do more extensive studies comparing treated and untreated seed, but companies that control the seed now are refusing to provide samples for him to use.

Krupke says that there’s growing interest among farmers in plant seeds that are not treated with neonicotinoids — if only they could find such seeds.

Schaafsma, for his part, thinks it will be easier to stop dust pollution from seed planters than to convince farmers not to use pesticide-coated seeds. This is something that farmers clearly would like to do, he says, and it’s technically feasible. Bayer CropScience, the big chemical company that sells most of the neonic seed coatings, has developed its own version of a dust trap that could be installed on planters.

The problem is, none of the big farm-equipment companies are offering the dust traps for sale. These companies that make planting equipment, such as Case, Kinze, and John Deere, have installed shields that direct the neonic-laden exhaust down toward the ground, rather than into the air, but Schaafsma says that’s not good enough.

“The only people who don’t recognize [the problem] well enough yet are the equipment manufacturers,” he says.

The place in America where (almost) no one drinks their tap water

Christian Science Monitor

The place in America where (almost) no one drinks their tap water

Local officials in eastern Kentucky’s Martin County insist the water is fine, despite repeated violations of EPA limits. But residents have been relying on bottled water for years.

Story Hinckly    Staff writer

May 18, 2017 Inez and Tomahawk, Ky.—T.J. Fannin, sitting on his porch as the sun sets, speaks fondly of the 27 years he spent working in nearby coal mines. But despite the hard labor that fueled a coal boom and sent millions of dollars into Kentucky’s coffers, he says he and his neighbors lack a basic amenity: clean tap water.

“[O]n the TV you see someone go to the faucet and get a drink of water, and it just makes me mad cause, you know, we can’t do that,” says Mr. Fannin, who buys two or three 24-packs of bottled water a month for drinking and cooking. “There’s an odor to the water…. It’s just like stagnant water [that] comes out of the bottom of a pool.”

It’s no secret that the decline of coal has hit the mountain spine of Appalachia hard. But it’s less well known that an amenity of life most Americans take for granted isn’t a given, more than 50 years after Lyndon B. Johnson launched his “war on poverty” here in Martin County, Ky.

And what really gets Fannin’s goat, he says, is that residents here face far higher water bills than in nearby counties. This, despite frequent warnings that the local water has exceeded Environmental Protection Agency (EPA) limits for certain chemicals.

“We should have a top-notch water system, septic system, schools, roads,” given all the proceeds from coal mining over the years, says the former miner. “We got this 4-lane [highway] down here and that’s basically all we got.”

In a place where political distrust runs high and funds are scarce, little has been done to improve the county’s water quality or infrastructure, as reported by the Ohio Valley Resource’s Benny Becker in January.

Local officials argue that the water issue has been blown out of proportion by a handful of outspoken residents, whose activism sends the water district jumping through bureaucratic hoops instead of fixing a creaking system. For the rest of the community, relying solely on bottled water is seen as just a way of life, not a reason to protest.

Two students hanging out in the high school parking lot say their parents have always had a family rule against drinking from the tap. Becky, a grocery cashier in nearby Warfield, says she hasn’t consumed the county’s water since 1999. Neither a hardware-store owner nor a retired butcher can remember the last time they drank from the tap.

“There is a fundamental breakdown in the expectation of democracy in places like Appalachia,” says Alexander Gibson, director of Appalshop, a media organization in Whitesburg, Ky. “They have observed that a complaint to the government disappears like the morning fog.”

Exceeded EPA limits repeatedly since 2005

In the bowels of the Martin County Water District offices, Joe Hammond sits in front of an Excel sheet, a map of the county’s water lines taped on the wall above him.

Piles of paper teeter beside his elbows, while packs of bottled water are stacked next to the filing cabinets. He says the girls in the office drink that, not him. As far as he’s concerned, the local water is fine.

“I raised two fine young children with that water,” says Mr. Hammond, the supervisor of the water district.

But Lee Mueller, who was also born here, became concerned about the water when he moved back in the 1980s.

“I had written stories about it for years,” says Mr. Mueller, who served as the Lexington-Herald Leader’s eastern Kentucky bureau chief for three decades. He blames the water quality for his own cancer diagnosis. “I didn’t really get involved with water until we were getting notices of violation that were two months old from the water district that they were required by law to inform residents that they had exceeded contaminant levels for various cancer-causing agents.”

According to Kentucky Division of Water records, Martin County’s water system has exceeded EPA limits for certain chemicals in its drinking water multiple times every year since 2005. Martin County was out of compliance in eight of the last 10 tests for haloacetic acid (HAA5) limits and 6 of the last 10 tests for total trihalomethanes (TTHM) limits.

These chemicals – by-products of chlorine treatment intended to make the water palatable – aren’t considered as dangerous as the lead that laced Flint’s water in Michigan. But the notifications sent to residents by the water district warn that extended exposure increases the risk of cancer.

Gail Brion, an engineering professor at the University of Kentucky who previously worked for the EPA, says the agency sets conservative limits for HAA5s and TTHMs. But an ethical controversy arises, says Professor Brion, when the government gives you no choice but to pay for bottled water in order to avoid this health risk.

Funding and priorities

The highest elected official in Martin County, Judge Executive Kelly Callaham, can be found in his corner office in the county’s newest courthouse. When asked about his county’s water quality, Judge Callaham leans forward in his chair and waves one hand in the air.

“You could drink four gallons of our water every day for 70 years and you have a chance of getting cancer. Well, hell, if you eat hot dogs, read what’s in hot dogs. You could eat four hot dogs a day for 70 years and you probably wouldn’t last 70 years,” says Callaham. “ ‘Could cause cancer,’ and ‘will cause cancer’ is a whole different deal.”

Callaham blames the EPA-mandated notices and the local newspaper, the Mountain Citizen, for what he considers unnecessary hysteria.

Editor Gary Ball has published a steady stream of articles on the water issue, as well as Callaham’s alleged misuse of county finances, including the $10 million courthouse building. “The system has been mismanaged for years,” Mr. Ball says.

Kentucky began issuing a “severance” tax on coal companies in 1972 to assist economic development. According to state records obtained by the Monitor, out of $34.5 million in coal severance funds disbursed since 2001, Martin County spent $7.3 million – or about 21 percent – on sewer and water improvements.

Comparatively, state Senator Ray Jones – who represents five counties including Martin County – says his home of Pike County spent 70 to 75 percent of its severance tax funds on water and sewer infrastructure.

“A lot of it comes down to funding,” says Senator Jones, “but a lot of it comes down to priorities.”

Among other projects, Martin County spent about $3.3 million in coal severance funds on the new courthouse, and another $7 million to build the Inez Business Center. Local critics say these funds could have made a big dent in repairing Martin County’s water system, with estimates of total renovation running between $13 and $15 million.

Coal severance revenues have plummeted in recent years. In 2016, Martin County received only 12 percent of what it got in 2009. Today the revenues provide just enough to cover the bond payments on the new courthouse.

Callaham says he wouldn’t have built it if he knew the coal severance money was going to run out so quickly.

But Darren Sammons with the Kentucky Department of Local Government says, “[W]e have been advising local officials for years to expect lower coal severance revenues and to budget accordingly.”

A system built for 600, serving 3,500

Meanwhile, Hammond is left to address the water district’s manifold problems as best he can.

Martin County’s water system – including a treatment plant – was built in 1968 for 600 customers. It currently serves 3,500. This expansion of lines in eastern Kentucky’s rocky hills created an underground system susceptible to holes and line breaks – and therefore water loss.

The EPA estimates the average water loss in the US to be 15 percent per month, but Martin County has been under investigation by the Kentucky Public Service Commission (PSC) in recent years for water loss rates greater than 60 percent.

When there’s a problem, Martin County residents often call the local newspaper instead of the water district, circumventing Hammond.

The newspaper goes directly to the PSC, which responds to the paper’s complaints by issuing Hammond extensive paperwork, which he says diverts resources away from dealing with customers’ problems.

“I’m still working on things they have asked for” – back in June 2016, he says.

‘People are afraid to complain’

A Facebook group called Martin County Water Warriors, which has more than 1,000 members, regularly posts updates on water quality issues – everything from photos of corroded water heaters to updates about the next hearing on Martin County’s water (June 1 in Frankfort, Ky.).

Nina and Mickey McCoy, longtime environmental activists, say they have also tried to organize citizen meetings to demand action on the city’s water quality, but with little effect. Once, they ordered dozens of pizzas and not a single person showed up.

In a place where Big Coal holds so much sway, few are willing to publicly share their grievances.

“People are afraid to complain about the water,” says Mr. McCoy, because they fear losing their jobs or severance packages. “Or their third cousin might be fired. It runs deep.”

There’s also a pervasive feeling that speaking up won’t accomplish anything.

“The government just doesn’t seem to work on this level for the people,” says Dan Preece, a world history teacher at Sheldon Clark High School – who is willing to speak on the record only because he is tenured.

“When the kids see over time what does get spent here … you see a new courthouse built, but we can’t get the water fixed,” says Mr. Preece. “They don’t feel like they matter, like this is not a problem worth solving.”

But Jones, for one, is working on solving it.

“It needs to be a collaborative effort between local officials, local citizens, and state officials,” says Jones, who in February introduced legislation to give the PSC greater leverage over water districts. “It’s not going to be resolved overnight… but there needs to be a plan.”

Staff writer Christa Case Bryant contributed reporting.

CSM, In Pictures Water: a vital resource in crisis

http://www.csmonitor.com/Photo-Galleries/In-Pictures/Water-a-vital-resource-in-crisis#710033

Trump administration rejects ban on harmful insecticide, dozens of farmworkers get sick

ThinkProgress

Trump administration rejects ban on harmful insecticide, dozens of farmworkers get sick

Chlorpyrifos is linked to neurotoxic symptoms like nausea, dizziness, and confusion.

By Esther Yu Hsi Lee, Immigration Reporter at ThinkProgress.     May 15, 2017

More than 50 farmworkers in California became sick from pesticide drift, Kern Golden Empire reported, one month after a controversial pesticide was deemed safe to use by the Trump administration.

On May 5, workers harvesting cabbage on a farm near Bakersfield were exposed to a “pesticide odor” from mandarin orchards in the west sprayed with Vulcan, an organophosphate-based chemical. The active ingredient in Vulcan is chlorpyrifos, a chemical linked to human health problems manufactured by Dow AgroSciences, a division of Dow Chemical. Chlorpyrifos was slated to be banned by the U.S. Environmental Protection Agency under the Obama administration.

Approximately 12 people with symptoms of vomiting and nausea were decontaminated, but 11 of those 12 refused any further treatment, according to an incident log on the Kern County Fire Department webpage. One person was taken to the hospital while more than half of the farm-workers left before medical personnel arrived on scene. The Kern County Fire Department, Kern County Environmental Health and Hazmat responded to the area for a mass decontamination.

“I’m not pointing fingers or saying it was done incorrectly. It was just an unfortunate thing the way it was drifted,” Efron Zavalza, Supervisor and Food Safety Specialist at Dan Andrews Farms where the incident occurred, told the publication. “The wind came and pushed everything east and you know we were caught in the path.”

“Anybody that was exposed, that was here today, we encourage them to seek medical attention immediately. Don’t wait. Particularly if you’re suffering from any symptoms. Whether it’s nausea, vomiting, diarrhea, seek medical attention immediately,” Michelle Corson, Public Relations Officer, Kern County Public Health, said.

Chlorpyrifos — a widely-used organophosphate insecticide in use for over 50 years — is used on a variety of crops like oranges, apples, cherries, grapes, and broccoli. It can cause neurotoxic symptoms in humans like nausea, dizziness, and confusion. When exposed to high dosages, humans can suffer from respiratory paralysis or death. A study by researchers at Columbia University found that exposure was linked to brain function and lower IQ among children. For years, environmental groups have pressured the EPA to look into the correlation between pesticide usage and problems that could affect workers on an organic and cellular level.

Also at ThinkProgress: Dow Chemical gave $1 million to Trump’s inauguration, now wants pesticide risk study buried.

During the Obama administration, EPA scientists recommended taking chlorpyrifos off the market. Despite the scientific evidence, new EPA Administrator Scott Pruitt rejected the ban on chlorpyrifos on the grounds that the agency needs to “provide regulatory certainty” for the thousands of U.S. farms that rely on chlorpyrifos. Dow Chemical donated $ 1 million to fund Presdient Donald Trump’s inauguration ceremony. In a letter to the Trump administration sent in April, Dow Chemical asked the administration to “set aside” and ignore research showing that the pesticide could be harmful to endangered species.

U.S. judge finds that Aetna deceived the public about its reasons for quitting Obamacare

LA Times

U.S. judge finds that Aetna deceived the public about its reasons for quitting Obamacare

Michael Hiltzik, Contact Reporter   May 12, 2017

Aetna claimed this summer that it was pulling out of all but four of the 15 states where it was providing Obamacare individual insurance because of a business decision — it was simply losing too much money on the Obamacare exchanges.

Now a federal judge has ruled that that was a rank falsehood. In fact, says Judge John D. Bates, Aetna made its decision at least partially in response to a federal antitrust lawsuit blocking its proposed $34-billion merger with Humana. Aetna threatened federal officials with the pullout before the lawsuit was filed, and followed through on its threat once it was filed. Bates made the observations in the course of a ruling he issued on Monday blocking the merger.

Aetna executives had moved heaven and earth to conceal their decision-making process from the court, in part by discussing the matter on the phone rather than in emails, and by shielding what did get put in writing with the cloak of attorney-client privilege, a practice Bates found came close to “malfeasance.”

Aetna tried to leverage its participation in the exchanges for favorable treatment from DOJ regarding the proposed merger. — U.S. District Judge John D. Bates

The judge’s conclusions about Aetna’s real reasons for pulling out of Obamacare — as opposed to the rationalization the company made in public — are crucial for the debate over the fate of the Affordable Care Act. That’s because the company’s withdrawal has been exploited by Republicans to justify repealing the act. Just last week, House Speaker Paul Ryan (R-Wis.) cited Aetna’s action on the “Charlie Rose” show, saying that it proved how shaky the exchanges were.

Bates found that this rationalization was largely untrue. In fact, he noted, Aetna pulled out of some states and counties that were actually profitable to make a point in its lawsuit defense — and then misled the public about its motivations. Bates’ analysis relies in part on a “smoking gun” letter to the Justice Department in which Chief Executive Mark Bertolini explicitly ties Aetna’s participation in Obamacare to the DOJ’s actions on the merger, which we reported in August. But it goes much further.

Among the locations where Aetna withdrew were 17 counties in three states where the Department of Justice asserted that the merger would produce unlawfully low levels  of competition on the individual exchanges. By pulling out, Aetna could say that it wasn’t competing in those counties’ exchanges anyway, rendering the government’s point moot: “The evidence provides persuasive support for the conclusion that Aetna withdrew from the on-exchange markets in the 17 complaint counties to improve its litigation position,” Bates wrote. “The Court does not credit the minimal efforts of Aetna executives to claim otherwise.”

Indeed, he wrote, Aetna’s decision to pull out of the exchange business in Florida was “so far outside of normal business practice” that it perplexed the company’s top executive in Florida, who was not in the decision loop.

“I just can’t make sense out of the Florida decision],” the executive, Christopher Ciano, wrote to Jonathan Mayhew, the head of Aetna’s national exchange business. “Based on the latest run rate data . . . we are making money from the on-exchange business. Was Florida’s performance ever debated?” Mayhew told him to discuss the matter by phone, not email, “to avoid leaving a paper trail,” Bates found. As it happens, Bates found reason to believe that Aetna soon will be selling exchange plans in Florida again.

As for Aetna’s claimed rationale for withdrawing from all but four states, Bates accepted that the company could credibly call it a “business decision,” since the overall exchange business was losing money; he just didn’t buy that that was its sole reason. He observed that the failings in the marketplace existed before Aetna decided to withdraw, but that as late as July 19, the company was still planning to expand its footprint to as many as 20 states. In April, top executives had told investors that Aetna had a “solid cost structure” in Florida and Georgia, two states it dropped.

While the Department of Justice was conducting its investigation of the merger plans but before the DOJ lawsuit was filed, “Aetna tried to leverage its participation in the exchanges for favorable treatment from DOJ regarding the proposed merger,” Bates observed. During a May 11 deposition of Bertolini, an Aetna lawyer said that if the company “was not ‘happy’ with the results of an upcoming meeting regarding the merger, ‘we’re just going to pull out of all the exchanges.’”

Not such a veiled threat? Aetna’s Mark Bertolini tells the DOJ what will happen if it blocks the Humana merger. After the DOJ sued to kill the deal, Aetna cut back even more.

In private talks with the DOJ, Aetna executives continually linked the two issues, even while they were telling Wall Street that the merger was “a separate conversation” from the exchange business. Bertolini seemed almost to take the DOJ’s hostility to the merger personally: “Our feeling was that we were doing good things for the administration and the administration is suing us,” he said in a deposition.

Bates found “persuasive evidence that when Aetna later withdrew from the 17 counties, it did not do so for business reasons, but instead to follow through on the threat that it made earlier.”

The threat certainly was effective in terms of its impact on the Affordable Care Act, since Aetna’s withdrawal has become part of the Republican brief against the law. That it says so much more about Aetna executives’ honesty and integrity probably won’t get cited much by GOP functionaries trying to repeal the law. Aetna is at least partially responsible for placing the health coverage of more than 20 million Americans in jeopardy; that it did so at least partially to promote a merger that would bring few benefits, if any, to its customers is an additional black mark.

If there’s a saving grace in this episode, it’s that the company’s goal to protect the merger hasn’t worked, so far. The DOJ brought suit, and Bates has now thrown a wrench into the plan. Aetna has said it’s considering an appeal, but the merger is plainly in trouble, as it should be.