How this choice could affect your medical care: some key careers to see
How this choice could affect your medical care: some key careers to see
This is a story from Kaiser Health News.
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This year's voters have told pollsters in no uncertain terms that health care is important to them. In particular, maintaining the protection of insurance for pre-existing conditions is the main problem for many.
But the results of the midterm elections are likely to have a great impact on a wide range of other health problems that affect all Americans. And the way in which those problems are addressed will depend to a large extent on which party controls the House of Representatives and the United States Senate, the mansions of governors and state legislatures throughout the country.
All politics is local, and it is not likely that a single race will determine national or even state action. But some key contests can provide something of a barometer of what is likely to happen, or not, in the next two years.
For example, keep an eye on Kansas. the career for governor it could determine if the state expands Medicaid to all people with low incomes, as allowed by the Affordable Care Act. The legislature in that deep red state approved a bill to accept the expansion in 2017, but could not override the then governor's veto. Sam Brownback Of the candidates running for governor in 2018, the Democrat Laura Kelly supports the expansion, while the Republican Kris Kobach does not.
Here are three major health problems that could be dramatically affected by the vote on Tuesday.
1. The Affordable Care Act
Protections for pre-existing conditions are only a small part of the HERE. The law also made major changes in Medicare and Medicaid, health plans provided by the employer and the generic drug approval process, among other things.
The Republicans kept their promises to get rid of the law in all elections since they were approved in 2010. But when the Republican Party finally gained control of the House, the Senate and the White House in 2017, Republicans discovered they could not reach an agreement on how to "repeal and replace" the law.
This year has Democrats in the attack On the votes, the Republicans took several proposals to redo the health law. Probably the most threatened Democrat in the Senate, Heidi Heitkamp of North Dakota, has hammered his Republican opponent, the representative of the United States. US, Kevin Cramer, on his votes in the House of Representatives for the unsuccessful repeal and replacement laws. Cramer said that despite his votes, he supports protections for pre-existing conditions, but he has not said what he would do or fall behind, that could have that effect.
Polls suggest that Cramer has a healthy lead in that race, but if Heitkamp achieves a surprise victory, medical care could get some credit.
And in New Jersey, Rep. Tom MacArthur, the moderate Republican who wrote the language that passed the Republican Health bill passed in the House in 2017, is in a hot race with Democrat Andy Kim, who has never held elective office. The main issue in that career, too, is health care.
It is not only the action of Congress that has the Republicans playing defense in the ACA. In February, 18 attorneys general of the Republican Party and two governors of the Republican Party. filed a lawsuit seeking a trial that the law is now unconstitutional because Congress in the 2017 tax bill revoked the fine for not having insurance. Two of those attorneys general, Josh Hawley of Missouri and Patrick Morrisey of West Virginia, are running for the Senate. Both states overwhelmingly supported President Donald Trump in 2016.
The attorneys general are running against Democratic incumbents: Claire McCaskill of Missouri and Joe Manchin of West Virginia. And both Republicans are being very criticized by his opponents for his Participation in the demand..
While Manchin seems to have taken an advantage, Hawley-McCaskill's career is qualified as a release by political analysts.
But in the end, the fate of the ACA depends less on an individual career than the one the party ends up controlling in Congress.
"If the Democrats take the House of Representatives ... then any attempt at repeal and replacement will be limited," said John McDonough, a former Democratic Senate aide who helped write the ACA and now teaches at the Harvard School of Public Health. .
Chris Jacobs, a conservative health care strategist who worked for Republicans on Capitol Hill, said a new derogation and replacement effort might not happen even if Republicans succeed on Tuesday.
"The Republicans, if they maintain a majority in the House, will have a margin of half a dozen seats, if they are lucky," he said. That probably would not allow the party to push another controversial effort to change the law. Currently there are 42 more Republicans than Democrats in the House. Even so, the GOP He barely got his health law passed. Outside the house in 2017.
And political strategists say that when the dust clears after voting, the figures in the Senate may not be very different, so the change could also be difficult. The Republicans, even with a small majority last year, could not pass a derogation law there.
2. Expansion of Medicaid
The Supreme Court in 2012 made the expansion of Medicaid from the ACA optional to cover all low-income Americans up to 138 percent of the poverty line ($ 16,753 for one person in 2018). Most states have now expanded, particularly since the federal government is paying most of the cost: 94 percent in 2018, gradually decreasing to 90 percent by 2020.
However, 17 stateAll governors of the Republican Party or state legislatures (or both) have not yet expanded Medicaid.
McDonough is confident that that will change. "I wonder if we are on the cusp of a wave of Medicaid," he said.
Four states - Nebraska, Idaho, Utah and Montana - have Medicaid expansion questions on your ballots. Everyone but Montana has yet to expand the program. Montana's question would eliminate the expiration date of 2019 included in its expansion in 2016. But it will be interesting to observe the results because the measure has met with great opposition: the tobacco industry. The initiative would increase. Taxes on cigarettes and other tobacco products. to fund the increase in state Medicaid costs.
In Idaho, the measure on the ballot is being adopted by several Republican leaders. GOP Gov. Butch Otter, who retires after three terms, approved it on Tuesday.
But the problem is at stake in other states, too. Several states that are not expanding have careers close to or closer than expected for the governor, where the Democrat has made Medicaid expansion a priority.
In Florida, one of the largest states that did not expand expanded Medicaid, the Republican candidate for governor, the former US representative. UU Ron DeSantis, Opposes the expansion. His Democratic opponent, the mayor of Tallahassee, Andrew Gillum, It supports.
In Georgia, the candidates for governor, Democrat Stacey Abrams and Republican Brian Kemp, are also in opposite sides of the Medicaid expansion debate.
However, the legislatures of both states have opposed the expansion, and it is not clear if they would be influenced by the arguments of a new governor.
3. Medicare
Until recently, Republicans have remained relatively quiet about efforts to change the popular Medicare program for seniors and people with disabilities.
His new point of conversation is that the proposals to expand the program, such as those that are often promoted "Medicare for everyone", That a growing number of Democrats are embracing - could threaten the existing program.
"Medicare has a significant risk of being cut if the Democrats take over the House of Representatives," Rep. Greg Gianforte (R-Mont.) he told the Lee Montana newspapers. "Medicare for all is Medicare for none. It will defeat Medicare, end the VA as we know it, and force Montana seniors to go to the end of the line. "
The Democratic opponent of Gianforte, Kathleen Williams, is proposing another popular idea among the Democrats: allowing people over 55 to "adhere" to Medicare coverage. That race, too, is very tight.
Meanwhile, in Washington, Republicans in Congress are more concerned about the way Medicare and other large government social programs threaten the budget.
"Sooner or later we're going to run out of other people's money," said Chris Jacobs.
Senate Majority Leader Mitch McConnell suggested in a October 16 interview with Bloomberg News that entitlement programs like Medicare are "the real driver of debt by any objective standard," but bipartisan cooperation will be needed to address that problem
Republican Jacobs and Democrat McDonough think that is unlikely in the short term.
"Why do Democrats renounce that as a theme by 2020?" McDonough asked, especially since Republicans in recent years have been proposing deep cuts to the Medicare program.
According to Jacobs, "Trump may not want that to be the center of a reelection campaign."
Kaiser Health News is a non-profit news service that covers health problems. It is an independent editorial program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.
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