BREAKING: I have had some conversations about the ACA repeal vote and the Arizona Senate seat which I will attach as a thread here shortly.

Follow if interested. On ACA repeal, everyone from Trump to Senate leaders have made it clear that as soon as they have the votes to repeal the ACA, they will do it.

As of a year ago, they had 49 votes for a repeal vote— one short with Pence as the tiebreaker. 2/

Trump wants health insurers not to have to cover pre-existing conditions. It’s cheaper.

Explaining this to people who don’t remember insurance before ACA is difficult. A young man last night asked me why he would buy a bus ticket if the bus company didn’t have to have busses. 1/ My explanation: insurance before the ACA was designed for the needs of insurance companies. The principal design was how to protect their profits.

The principal change of the ACA was to reverse it— to protect consumers w standard benefits, no lifetime caps & pre-ex. 2/

September 6, 2018 is setting up to be D-Day in Trump’s war to take health care protections from millions of Americans.

Amidst the distractions, no major news outlet is focusing on it.

1/ Two major things happen September 6 both highly connected.

-President Trump has instructed his Justice Department to not contest a case that would make the ACA illegal. (See next tweet...)
-The Supreme Court Justice who could likely decide this case begins his hearings.

2/

NEW HEALTH CARE NEWS: Today we unite with 280 hospitals to transform care delivery for underserved Americans— focusing on bringing the country’s best resources to meet their health & social needs.

forbes.com/sites/michelat… These hospitals represent 5% of our care delivery and will expand to more and have a focus on treating vulnerable populations.

Work is getting started in key areas: improving care to women & infants, mental health, substance abuse, and creating care sources outside the ER.

It has been 6 months since we launched @USofCare. Today we celebrate by visiting our 4th state: UT, NC, NM. Now MN.

We begin the same in every state— meeting families and health care advocates this AM.

Thank you for all the support & encouragement to get everyone health care. @USofCare We met with the @ThisIsMedicaid to kick off our 2 days in Minnesota where we will meet with over 200 people across the state.

@usofcare always starts with patients and families.

https://twitter.com/thisismedicaid/status/1026891811820920832

BREAKING: If you missed it, Trumpcare plans were announced today.👇 They are a flashback set to bring us back to pre-ACA days and damage the ACA in the process.

Been collecting inout all day so now will cover this. Follow if interested. 1/

https://twitter.com/aslavitt/status/1024624905969721344

THE MOST UNDER-REPORTED SIGNIFICANT FACT:

-ACA requires 80% of your premiums to cover your medical expenses.

-Trumpcare has NO requirement. Expect about half of your premium to cover health care. The difference— marketing and profits.

This is a boon to insurance companies.2/

Medicare is proposing a significant & controversial change to how it pays doctors.

Since I oversaw Medicare during the end of the Obama Administration, I have been asked to comment.

Warning- Payment policy is wonky but important. Follow if interested.1/ nytimes.com/2018/07/22/us/… Today Medicare pays based on the severity of the clinical visit with up to 5 levels. So a doc who sees someone with cancer gets paid more than a more “routine” visit.

Instead Medicare is proposing paying the same for all visits (except more for a new patient). 2/

I’m going to share a story about my dog who died last week. I know that’s not why you follow me so feel absolutely free to skip or unfollow me if this bothers you. I understand.

(Dogs get to enjoy the eclipse too.) Rascal spent 17 years with the same mailman. His nemesis. He barked like no tomorrow when the mail box opened every day, especially if I was on a call. A sweet dog barking behind a closed door trying to sound vicious.

(Dog Twitter obit below)

https://twitter.com/aslavitt/status/1017849383759429633

BREAKING: Trump Administration officially suspends ACA risk adjustment payments.

More details in next post. Follow if interested.

cms.gov/Newsroom/Media… This was the thread I sent last night.

https://twitter.com/aslavitt/status/1015427031293710338

BREAKING: Trump aims severe blow at ACA, says payments for insuring sicker individuals (called risk adjustment) will not be paid for prior years.

This is aggressive and needless sabotage of the ACA. Impact likely chaos.

I have more details. Follow here if interested. 1/ The aim of this, reported in the Journal 👇 but not expected until next week, is to cut back about 10% of the payments insurers are owed— those for covering the sicker.

Doing this now likely aims to get insurers to abandon the ACA at just the end.

@StephArmour1 @annawmathews 2/

BIG NEWS: Court rejects Medicaid work requirements in Kentucky. Protects 100,000 people from "arbitrary and capricious" punishment.

I'm guessing you've see a lot of bad news this week. This is very good news.

But its not over. More soon. Follow if interested. Just finished reading opinion and talking to the former KY governor and several lawyers. Astounding. Will tweet soon. 2/

Stay tuned on this news. In DC and hearing some reactions/ scenarios. Small thread shortly.

Follow if interested.

https://twitter.com/aslavitt/status/1012035863214280714

McConnell has said that he will get Kennedy’s replacement voted on by the Senate in the “Fall,” with the implication that it occurs before the midterm elections.

But not everyone is so sure. 2/

NEW: Details of the Rs ACA repeal proposal released today coming shortly in a thread after I get off one more expert phone call.

You may not feel like reading the details, but alas, you should. Follow if interested. 1/ POINT 1: End to Medicaid expansion. 12 million people in 31 states plus DC. Many would lose coverage, almost all of the rest would pay more if they could afford it. Most likely could not. 2/

BREAKING: Republicans likely to delay release of Santorum ACA repeal plan due tomorrow.

More soon here. 1/ Quick background is Heritage and Santorum have been working on a repeal plan to be ready. Rs in Senate know they don’t have the votes now but imagine it could be possible during lame duck. 2/

BREAKING: 17 million people to lose coverage next year from Trump’s effort to end pre-existing conditions.

Other key findings from just filed Amicus briefs. Follow if interested. 1/ Before I go through the takeaways, here is the background on Trump’s attack from last week.2/

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NEW: I’m just leaving Hill meetings. Conversations about what’s going on with ACA and pre-ex conditions news last 4 hours.

Have 4-5 news-y things to tweet but can’t get hit by a car or worse. Follow if interested. Here is background.👇 if you’re already aware that Trump signed on to a lawsuit banning pre-ex protections in theme ACA, skip to next tweet.
..where the story coming out more and more.2/

usatoday.com/story/opinion/…

BREAKING: The biggest health care news of the year.

The Trump DOJ tonight just told the courts to dismantle pre-existing conditions protections and other consumer protections.

This may seem predictable, but these actions are unprecedented.

More coming. Follow if interested. Before I get into it, I have to stop and just repeat this another way:

The DOJ, responsible for upholding the rule of law, is not defending the people in a frivolous lawsuit to say that wi5out the mandate, the rest of the ACA can’t be enforced. 2/

In case you missed it: Yesterday the Medicare Trustees announced that Medicare is due to run out of funds 3 years earlier.

As someone who sat on the Trust Fund, here are the implications in a few tweets.

If interested in Medicare, feel free to follow.1/

usatoday.com/story/news/pol… The trust fund are funds set aside when we pay payroll taxes to cover hospital care for seniors & ppl w disabilities.

When Obama became President, it was due to be depleted in 2018.

The ACA added 10 years to the life of the fund. Yesterday’s news is it lost 3 of those years.2/

I want to relay a conversation with a Democratic Congressman today, confirmed by a conversation I had with a prominent R who recently retired. 1/ The Democratic Congressman told me today that any R that expressed even private frustration with Trump’s behavior has retired. That in some of the remaining districts Trump has over 90% favorability ratings. 2/

BREAKING: @TopherSpiro just out out this paper that has been running around conservative circles and floating around DC to REPEAL the ACA.

This is the basis of what Trump plans to announce next month as a “great” health plan.

Actual impact far from great. Follow if interested.

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First point, @TopherSpiro does a good job in his thread of laying out the actual impacts of this bill.
-cuts to Medicaid
-harmful to low income
-permanently revokes pre-existing conditions protections

Read the thread for more. 2/

BREAKING: This weekend word broke of secret efforts to repeal the ACA in 2018.👇

Been making calls RT trying to answer the question of how real is this threat.

Tweeting shortly. Follow if interested.

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This is all secondhand.

A group led by Rick Santorum has been steadily working on a proposal to revise repeal. It is conservative DC think tanks with tacit WH blessing but apart from Senate leadership. 2/