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Why Trump’s threat to sabotage Obamacare would backfire

President Donald Trump has made it explicit: He is taking Obamacare hostage to try to force Democrats to work with him on health care reform.

The president has a real basis for the threat. A lawsuit working its way through the courts right now threatens crucial subsidies that help lower costs for millions of people who bought their insurance through Obamacare. Those subsidies are known as cost-sharing reductions. The Obama administration had been defending the subsidies, but Trump could choose to end them. This could throw the insurance market into chaos. Health insurers are already nervous about that possibility.

Trump just threw more gas on that fire, in an interview with the Wall Street Journalpublished Wednesday.

“Obamacare is dead next month if it doesn’t get that money,” he mused. “I haven’t made my viewpoint clear yet.”


But, politically speaking, there is a critical flaw in Trump’s plan. Polling pretty definitively shows that Americans will hold the new White House and Congress responsible for what happens to Obamacare. If that’s true, following through on his threat would likely hurt Trump more than his opponents. He doesn’t seem to have any real leverage, and Democrats are already brushing off his threats.


This is likely to be the big health care fight. Now that the GOP’s own bill to overhaul Obamacare has stalled, the next battleground is for Trump to attack the law. But hanging in the balance are these subsidies that help make health coverage affordable for millions of Americans.

The lawsuit that could tank Obamacare

The lawsuit at play is over one Obamacare’s foundations: helping people afford private health insurance. The law offered tax credits to help lower the premiums people pay for their insurance every month. It also created these cost-sharing subsidies — the ones at stake in the Trump gambit — to help lower costs further for people who make less money.


The federal government pays these subsidies to health insurers directly. Insurers use that money to reduce out-of-pocket costs, such as copayments and deductibles, for people with lower incomes who buy health insurance on Obamacare’s marketplaces.

Those subsidies totaled $7 billion in 2016, lowering costs for an estimated 7 million people. This means that, on average, they reduced costs for each person by a little more than $1,000. You qualify for cost-sharing subsidies if your income is 250 percent of the federal poverty line, about $30,000 or less for an individual.

If that money were lost, it would cripple the insurance market. Insurers would still be required to keep costs lower for these people, but plans wouldn’t receive the federal payments to help them do that. That upends Obamacare’s whole financial model for reducing cost-sharing and could drive insurers out of the market.

“While insurers could theoretically raise premiums to offset the loss of the subsidy payments, the administration would be sending a clear signal that it’s not a reliable business partner and is not looking to run the marketplaces effectively,” said Larry Levitt at the Kaiser Family Foundation. “If I were an insurer, I’d just take my marbles with me and focus on other more profitable lines of business.”

But here’s the legal problem: The Affordable Care Act was a little vague on who would pay for the subsidies. So in 2014, the Republican-controlled House sued the Obama administration, arguing that it didn’t have the legal authority to pay these subsidies. They say the Affordable Care Act required Congress to approve that spending, and they hadn’t. That made the payments illegal, according to House Republicans.

A lower court sided with the House last year, ruling that the subsidy payments were unconstitutional without congressional approval. It put that decision on hold to allow the Obama administration to appeal, which it did. That appeal is still pending, but now the Trump administration is in charge of defending the payments.

Health plans are waiting anxiously to find out what’s going to happen. As Vox’s Sarah Kliff reported, insurers are already on edge as they make decisions about whether to participate in Obamacare next year, because they don’t know what will happen with the subsidies.

What Trump is threatening to do

Trump knows all this, and, in an interview with the Wall Street Journal, he threatened to cut the subsidies off unless Democrats worked with him:

“Obamacare is dead next month if it doesn’t get that money,” Mr. Trump said. “I haven’t made my viewpoint clear yet. I don’t want people to get hurt. … What I think should happen and will happen is the Democrats will start calling me and negotiating.”

“It wasn’t authorized by Congress,” Trump added. “I’m going to have to make a decision.”

The president has even worked behind the scenes to send this message. A recent statement from the US Department of Health and Human Services led many people to believe that the Trump administration would keep paying the subsidies. But then HHS put out another statement Tuesday afternoon disputing those reports and again putting the onus on Democrats to do something.

“The administration is currently deciding its position on this matter. We have not been contacted by Democrats to help save Obamacare, perhaps because they consider Obamacare to be a losing cause,” the new statement said. “Democrats need to help solve this failed Obamacare plan.”

Politico reported late Wednesday that Trump himself called HHS and ordered them to rebut the earlier reports that the payments would be made, worried that they would hurt his negotiating position.

Trump’s problem, in one chart

Trump seems to think that taking such a hard line will bring Democrats to the table. Ultimatums were a tactic he also deployed when negotiating with conservatives during the health care debate.

But they didn’t work then. Here is the problem this time, from a recent survey by the Kaiser Family Foundation:

Americans aren’t going to blame Democrats if Obamacare implodes. They’re going to blame Trump and his fellow Republicans. Trump’s now-transparent threat to sabotage the law makes it all the more likely that the fallout will land on him.

Further complicating things: Congressional Republicans might not be willing to let Obamacare fail on their watch. Some of them have suggested that lawmakers should go ahead and approve the subsidy payments for now. A group of leading health care organizations — including the American Medical Association and the US Chamber of Commerce — have urged the government to continue paying the subsidies.

Top Democrats, perhaps aware of all this, quickly dismissed Trump’s threat on Wednesday.

"This cynical strategy will fail,” Senate Minority Leader Chuck Schumer of New York said in a statement. “Our position remains unchanged: drop repeal, stop undermining our health care system, and we will certainly sit down and talk about ways to improve the Affordable Care Act.”

And Trump himself seems to know he’s playing a dangerous game.

“The longer I’m behind this desk and you have Obamacare,” he told the Journal, “the more I would own it.”





The Human Cost Of Trump’s Rollback On Regulations

 If Tom Ward had to die from his work, he’d rather fall off a scaffold than endure the slow death his father did from the debilitating lung disease silicosis. “I would choose to go much quicker,” he said, “rather than to have my family watch me suffer.” Ward fears that other workers will face the same suffocating illness as his father, thanks to the regulatory rollback underway by the Trump administration.

Ward’s father spent several years working as a sandblaster in Michigan. It was most likely on that job that he breathed a lethal amount of crystalline silica, a carcinogenic dust that comes from sand and granite. Excessive silica has been ruining workers’ lungs for as long as rock and concrete have been cut. Frances Perkins, U.S. labor secretary under Franklin D. Roosevelt, spoke publicly of the dangers of silica back in the late 1930s.

After numerous efforts under other presidents failed, the Obama administration finally tightened the regulations covering silica last year, further restricting the amount of dust that employers can legally expose workers to. The tougher standards were 45 years in the making, the subject of in-depth scientific research and intense lobbying by business groups and safety experts. When the rules were finalized in March 2016, occupational health experts hailed them as a life-saving milestone.

But now the enforcement of the rules has been delayed ― and the rules themselves could be in jeopardy.

Last week, the Trump administration announced that it was pushing back the implementation of the new silica regulations. For now, the delay is just three months ― from late June to late September, since “additional guidance is necessary due to the unique nature of the requirements,” as the Labor Department put it. A spokeswoman said the agency wouldn’t comment beyond that.

But to occupational health experts who’ve waited years for the tighter rules, the new delay casts a cloud of uncertainty over their future. The leading home-building trade group and other business lobbying groups have sued to halt the regulations, saying they are too costly for employers. Defending the silica rule would now be the responsibility of the Trump administration, which has eagerly dismantled one Obama-era regulation after another at the urging of corporations. (The rule could also be subject to an appropriations rider by the GOP-controlled Congress.)

While the administration has not signaled that it intends to reverse the silica rule, it has issued an executive order directing all agencies to review the regulations currently on their books, presumably for potential watering down or scrapping. Trump’s own labor nominee, Alexander Acosta, cited that order during his confirmation hearing as one reason he would not yet commit to enforcing the silica rule if he becomes labor secretary.

Sen. Elizabeth Warren (D-Mass.) noted the huge public health implications at stake. “You can’t tell me whether or not, high on your list of priorities, would be to protect a rule that keeps people from being poisoned,” she told Acosta.

I never dreamed I would have to spend my retirement years in this debilitating manner.Leonard Serafin, silicosis victim

The delay of the new silica regulations was not a surprise to Ward, given the Trump administration’s promises to deregulate businesses in order to boost hiring. But it was nevertheless painful to see. Ward now leads training at the Michigan Bricklayers and Allied Craftworkers Union, a personal mission given that his father died at age 39 after “an awful few years” of suffering from silicosis.

“Knowing it was 100 percent preventable is the part that really hurts,” he said. 

Silica has been called the “silent killer.” It’s not visible to the naked eye ― particles can be one hundred times smaller than a grain of sand ― and the effects on the lungs are cumulative. But there are clear ways to curb exposure to silica, like wetting down rock that’s being cut, installing ventilation or dust-collecting equipment on the worksite, and wearing respiratory equipment designed to filter out the dust.    

When the proper precautions aren’t taken, the results can be debilitating. Railroad worker Leonard Serafin shared the story of his own battle with silicosis in a letter his family provided to The Huffington Post in 2012.

At the time, the Obama White House was sitting on the silica rule, and advocates worried that the reforms might not be finished before Obama left office. Serafin had worked as a trackman on a railroad for 32 years, laying out the crushed rock and gravel in which the tracks were laid. He said the work led to chronic obstructive pulmonary disease and a litany of other lung maladies.

“I never dreamed I would have to spend my retirement years in this debilitating manner,” Serafin wrote. “I find it difficult to attend social events such as concerts and plays with my family because of my chronic cough. Even coughing while standing at a cash register line at a retail store causes people to distance themselves from me. ... When I exert myself, my daily coughing becomes a spastic type of cough, which leaves me exhausted, breathless with chest pain.”

Although U.S. regulators had been aware of silica’s dangers for decades, it wasn’t until 1971 that the federal government imposed legal limits on workers’ exposure to it: 100 micrograms per cubic meter for laborers in most industries, and 250 micrograms for those working in construction and shipyards. Many experts believed those limits were too meager, however. The caps weren’t lowered to the 50 micrograms recommended by the Centers for Disease Control and Prevention until Obama’s presidency.

The Occupational Safety and Health Administration has estimated that the new rules would cut down silica exposure for roughly 2.3 million workers, preventing an estimated 600 deaths annually. Extrapolating on that data, the AFL-CIO labor federation says even the three-month delay in enforcement “will lead to an additional 160 worker deaths.”

David Michaels, the head of OSHA under Obama, called the reform “the most important health standard OSHA has issued in decades.”

But in the eyes of the construction industry, it’s one of the most expensive. OSHA says that instituting the new controls would cost businesses an estimated $511 million annually. Meanwhile, industry lobbies say the real cost to them would be in the billions each year ― most of it due to additional equipment and labor.

While praising the Trump administration’s decision, a consortium of construction industry trade groups urged Trump to extend the delay well beyond the original three months, saying it “remains concerned about the overall feasibility of the standard in construction and has requested that the agency delay enforcement for a year.”

Supporters of the rule note that those upfront costs don’t take into account the long-term financial benefits to workers and society. Preventing disability and death saves money, after all.

OSHA estimated that the reforms would have a net benefit of $7.7 billion each year, largely due to savings on health care and lost productivity. The Economic Policy Institute, a left-leaning think tank, calls the silica rule a “case study” in how seemingly expensive safety regulations can have economic benefits over the long term.

Ward thought the debate over the rule’s financial costs had finally been put to rest. For years, he heard dollars and cents being weighed against lives lost or saved. Now that he’s hearing it again, he’s worried about the bricklayers who will come up after him.

“The rule really was to prevent future illnesses,” said Ward. “It may be too late for me and my generation. This is about the future generation of craft workers.”




Trump supporter's undocumented husband deported back to Mexico

The husband of an Indiana woman who voted for Donald Trump and supported his hardline immigration policies has been deported back to Mexico, according to CNN.

Roberto Beristain, now 43, entered the U.S. in 1998 to visit his aunt, but ended up staying after he met his U.S.-born wife, Helen Beristain.

The couple married and lived happily in the U.S. together until a trip to Niagara Falls in 2000, when Beristain and his wife were both detained by border officials for accidentally crossing into Canadian territory.

Beristain was given a voluntary deportation order back to Mexico, but decided to stay in America with his wife since she was pregnant at the time, according to the South Bend Tribune.

Beristain has been able to secure a work permit, a driver's license and a Social Security card in the 17 years following the incident.

He was also able to purchase the popular restaurant where he had worked for years, Eddie's Steak Shed in Granger, Indiana.

But things went awry during one of Beristain's routine check-ins with Immigration and Customs Enforcement (ICE) on February 6, when he was unexpectedly detained shortly after President Trump signed an executive order that broadened the priorities for whom ICE agents should pursue.

In the middle of the night on April 5, the father of two was suddenly deported.

"They suddenly told me it was time to go," Beristain explained in a statement released by his attorneys.

They told me to get my stuff, they put me in the back of a van, and sped toward the border. They took me to another facility while in transport to sign paperwork. I asked to speak with my attorney, but was told there wasn't time for that. At around 10:00 pm, I was dropped off at the Mexico-U.S. Border and walked into Mexico.

Helen Beristain says she never imagined that she and her husband would be affected by the new administration's stringent immigration policies.

"We don't want to have cartels here, you don't want to have drugs in your high schools, you don't want killers next to you. You want to feel safe when you leave your house," she told WTIU. "I truly believe that. And, this is why I voted for Mr. Trump."

"[Trump] did say the good people would not be deported, the good people would be checked," she explained.




Competition-winning 4th grade robotics team told to 'go back to Mexico'

A group of black and Latino fourth graders from Pleasant Run Elementary in Indianapolis won a regional robotics challenge — and were in turn taunted by lesser-ranked competitors and their parents with cries of "go back to Mexico!" The five-person Pleasant Run PantherBots, three of whom are Latino and two of whom were black, became the target of the racist bullying at both a school auditorium and parking lot at the Plainfield, Indiana, competition, the Indianapolis Star reported.

The team consists of Elijah Goodwin, 10; Angel Herrera-Sanchez, 9; Jose Verastegui, 10; Manuel Mendez, 9; and Devilyn Bolyard, 9.

"They were pointing at us and saying that 'oh my god, they are champions of the city all because they are Mexican. They are Mexican, and they are ruining our country,'" Diocelina Herrera, mother of Herrera-Sanchez, told the IndianapolisStar.

"It's not going to affect us at all," Goodwin, the team's leader, said. "I'm not surprised because I'm used to this kind of behavior ... When you have a really good team, people will treat you this way. And we do have a pretty good team."

n a statement, Plainfield Community Schools Superintendent Scott Olinger condemned the racist behavior and singled out parents who participated for particular dismay.

"The Plainfield Community School Corp. does not condone or tolerate language or behaviors that degrade others," Olinger wrote, according to the Star. "Had our organizing team been made aware of the alleged behaviors by unknown adults on Feb. 2, we would have taken immediate action."

The statement continued:

"We were pleased to host such an impressive array of young students, and we were equally proud of the teamwork, camaraderie, knowledge and fun that these children displayed. To learn now that adults may have acted in a way that distracted from the success of the day is disheartening. In the Plainfield schools, such behavior is unacceptable, regardless of whether it comes from adults or students."

While it's not clear what motivated this particular hateful attack, similar stories of racism in schools have been cropping up in recent months. According to a survey by the Southern Poverty Law Center, the bigoted campaign rhetoric of President Donald Trump and his hardline policies in office has negatively affected the K-12 school environment.

While it's not exactly clear what spurred this specific racist incident, similar events have been on the upswing in recent years.

Of the more than 10,000 teachers, counselors, administrators and other school employees who responded to the poll, 90 percent said the election had negatively affected the environment at their school.

Eight in 10 reported fears for marginalized students including "immigrants, Muslims, African-Americans and LGBT people," while four in 10 reported "derogatory language" directed at minority students.

"More than 2,500 described instances of bigotry and harassment directly related to election rhetoric," the SPLC added.



Even Mitch McConnell Doesn’t Think Mexico Will Pay For The Border Wall

Senate Majority Leader Mitch McConnell (R-Ky.) is skeptical that Mexico will pay for the wall President Donald Trump promised to build along the U.S. border.

When Politico Playbook asked McConnell if he thought that Mexico would pay for the wall, he replied, “Uh, no.”

Having Mexico foot the bill became a rallying cry at Trump’s campaign events last year.

“And who’s going to pay for it?” he would ask. “Mexico!” the crowd would shriek in reply.

Yet it became clear just days into Trump’s presidency how unfeasible such a plan would be. Press secretary Sean Spicer floated the idea of raising taxes on imports from Mexico by 20 percent as part of a broader package to fund the wall’s construction in January. He quickly retracted the suggestion.

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