Trump Administration Continues Work to Undermine Americans’ Health Care

  

While Congress has thus far in 2018 declined to take up legislation that would dismantle affordable access to health care that was a hallmark of their 2017 agenda, the Trump administration continues to move forward with a number of regulatory initiatives that will continue to advance this misguided approach and cost more Americans the coverage they need.

One plan the administration is currently discussing would allow for wider availability of short-term, limited-duration insurance plans that cover patients for less than a year; another would permit the self-employed and small business employees to make use of association health plans. In both cases, coverage offered would not be required to meet the list of essential health benefits that the Affordable Care Act (ACA) currently requires.

As a result, a vast majority (more than 95%) of healthcare groups that submitted comments on President Trump’s recent plan to scale back these protections said that such an approach was a mistake.

Meanwhile, many of those same groups have come out in opposition of a proposal that would weaken Medicaid by creating work requirements for certain adult recipients who have benefited from Medicaid expansion. While specific efforts to implement such requirements are being led by state governments, it was the administration’s decision to allow such proposals in the first place that has enabled them to do so.

The administration’s argument, however, is disingenuous at best, as that Medicaid expansion provides healthcare coverage to working, low-income Americans. According to a December 2017 Kaiser Family Foundation issue brief, roughly 6 in 10 of the 22 million non-disabled adults receiving Medicaid benefits are employed either full- or part-time, while 8 in 10 live in a working family. Most of these individuals work either for small firms or in low-paying industries which do not offer healthcare coverage, and thus rely on Medicaid for health care.

Further, among those adults who are not working, most report a major barrier to employment such as illness, disability, or care-giving duties. According to the same Kaiser issue brief, Medicaid expansion has not negatively impacted labor market participation; in fact, some research demonstrates that Medicaid coverage supports work.

Finally, last year’s tax bill, which included a repeal of the ACA’s individual mandate, continues to wreak havoc on insurance premiums. The Congressional Budget Office (CBO) recently revised its estimates and determined that this repeal will lead to a premium increase of at least 10% in 2019. Premium increases are expected to be finalized state-by-state in early October, roughly a month prior to November’s general elections.

Omnibus Spending Bill Is Two Steps Forward, One Step Back for Public Health Issues

  

President Trump today signed into law a major $1.3 trillion omnibus spending bill which funds the federal government through the end of the fiscal year on September 30, 2018. This bill significantly increases both defense and domestic discretionary spending, and includes several important healthcare provisions critical to nurses.

ANA is pleased to note that this spending measure fully funds Title VIII Nurse Workforce Development Programs and includes a $20 million funding increase for such programs. We applaud Congress for recognizing the importance of a nursing workforce that is ready to meet the challenges of our current healthcare environment. ANA also applauds Congress for providing an additional $3 billion to fight the opioid crisis. As providers on the frontlines of this epidemic, nurses witness firsthand the devastation of addiction and overdose. We hope that this combination of workforce and opioid funding will enable the health care system – and nurses in particular – to put an end to this devastating scourge.

Congress also started to show signs of progress on gun violence prevention, as thousands of engaged Americans across the country prepare for this weekend’s March for Our Lives. Congress clarified that the Centers for Disease Control and Prevention (CDC) is permitted to engage in some gun violence prevention research, and laid the groundwork for an improved background check system. That said, much work remains to keep our children and nation safe from these senseless tragedies.  Acknowledging the CDC’s authority to study the problem without actually allocating resources carries the same chilling effect on conducting research as an outright ban.

ANA is also very disappointed by Congress’s failure to ensure affordable and accessible healthcare coverage for all Americans. The omnibus spending measure notably did not include a measure or any funding intended to stabilize the individual health insurance markets. Without such market stabilization efforts, individual premiums will continue to skyrocket and many Americans will choose to forgo health insurance coverage altogether, exposing them to physical and financial risks. ANA continues to urge Congress to act toward implementing market stabilization measures.

ANA again applauds Congress for ending (for now) the familiar cycle of lurching from budget crisis to budget crisis with no long-term, bipartisan solutions to outstanding policy issues. While the provisions noted above – nursing workforce, opioids, gun violence prevention – are a start to solving some of these issues, they do not go far enough. We urge Congress to continue to work toward solving these critical policy issues, and to realize that continuing to play politics with the stability of the individual health insurance market hurts vulnerable Americans who rely on affordable and accessible health coverage.

Time is Up on Nurse Abuse

  

This guest post is by ‘Nurse Alice’ Benjamin, MSN, RN, ACNS-BC.

As a nurse for nearly 20 years, I have witnessed and experienced physical, verbal and emotional abuse while caring for patients. I once cared for a patient who threw objects at me, yelled obscenities and racial slurs, spat on me and made unreasonable demands even though I was providing the best care possible.

Last month in Arkansas, a nurse was bitten and punched in her head repeatedly. In another incident, a nurse was choked and sexually assaulted. A majority of the time, nurses who have either been a victim or witnesses to physical and verbal abuse don’t receive news coverage. Thanks to technology and media, we have been able to highlight the magnitude and urgency of the matter, but still not intensely enough to end abuse altogether. As a nurse and media health expert, I make sure to discuss this issue on national television. I truly believe that these senseless acts of violence and abuse demand immediate attention and swift action.

Sadly, all nurses face similar, unsafe situations every day. And at times, unwarranted acts of violence are committed against us. That’s why I am proud to support the #EndNurseAbuse initiative – a national call-to-action led by the American Nurses Association urging nurses, healthcare professionals, patients and all concerned individuals to get involved. Sign a pledge to support zero tolerance when it comes to violence against nurses; report abuse whenever possible; and share the pledge with others asking them to sign too.

The clock has run out on harassment, sexual assault, and inequality in the workplace.

Across all industries and professions, women and men are speaking up to make it clear that time is up.

As we launch ANA’s Year of Advocacy, please join me by taking the pledge to #EndNurseAbuse today.