WASHINGTON: The Senate's surprise vote was only the latest narrow escape for "Obamacare," the social program with nine lives that has survived dozens of congressional attempts to kill it, and two Supreme Court challenges.
Not to mention the massive computer crash when HealthCare.gov was launched.
The saga of the Affordable Care Act illustrates how difficult it is to do away with a government program once millions are benefiting. In the latest episode, three Republican lawmakers broke with their president and leadership to join Democrats and deliver a dramatic defeat to repeal efforts.
Sens. John McCain of Arizona, Susan Collins of Maine and Lisa Murkowski of Alaska were backed by GOP governors worried about constituents losing coverage, hospitals that didn't want to go back to being stuck with bills for the uninsured, doctors trying to keep patients healthier, and people with pre-existing conditions fearful they might be exposed to coverage denials because they let their policy lapse for a few months.
"It came down to people who didn't like 'Obamacare' realizing this was going to take away their chances for coverage," said former Rep. Henry Waxman, a Los Angeles Democrat who helped write much of the 2010 overhaul under former President Barack Obama.
Despite its problems — rising premiums, shaky insurance markets — the ACA extended coverage to about 20 million people, reducing the nation's uninsured rate to a historic low near 9 percent. It delivered by combining two approaches: subsidized private insurance, and a Medicaid expansion for low-income people that 31 states have accepted. The GOP bills would have dramatically reduced spending on both, leaving anywhere from 16 million to more than 30 million uninsured. The legislation also threatened to undermine protections for people with medical problems.
Never hugely popular, "Obamacare" actually saw an increase in support as the "repeal and replace" debate intensified.
An Associated Press-NORC Center for Public Affairs Research poll picked up what could potentially be a bigger shift in public attitudes. The July poll showed that 62 percent of Americans think it's a federal government responsibility to make sure all Americans have health insurance, a 10 point increase from 52 percent who said that in March. Among independents, there was a 13-point increase.
H.W. Brands, a professor of U.S. history at the University of Texas at Austin, said people have little investment in a program's success before they experience its benefits.
"Whichever fan of the welfare state first applied the term 'entitlements' to these benefits was brilliant," said Brands. "People come to think they are entitled to them, and heaven help the politician who tries to take them away."
Said Robert Blendon of the Harvard T.H. Chan School of Public Health: "Getting rid of the law became getting rid of coverage for 30 million people. When faced with taking insurance cards away from 20 million to 30 million people, dislike of the law in no way justified taking those cards away."
Obama's office issued a statement Friday calling attention to the broader benefits of the ACA, including free preventive care and a greater focus on improving the quality of hospitals.
Those get less notice than the coverage expansion, but affect more people. For example, contraceptives are now provided free of charge to most women, a policy the Trump administration is seeking to narrow. And when people with employer coverage get routine colonoscopies, they no longer face a copayment for the test.
"It's about the dreams protected, and the untold misery and ruin prevented," said the statement from Obama's office.
President Donald Trump, however, does not seem ready to acknowledge anything good in his predecessor's signature domestic program.
Trump talks about "Obamacare" as if it's on the verge of collapse, which does not reflect reality everywhere. The Medicaid expansion, which has added about 11 million to the insurance rolls, operates more or less on automatic pilot even if costs are a concern. Private insurance markets are in trouble in some states, but not in others. People eligible for ACA subsidies are shielded from premium increases, but not those who buy coverage outside the health law's markets, many of whom face another year of double-digit premium hikes.
Trump tweeted what appeared to be a veiled threat after the Senate vote: "Let ObamaCare implode, then deal. Watch!"
Andy Slavitt, a tech-savvy executive who helped revamp HealthCare.gov for Obama, said both political parties should essentially enter into peace negotiations in the seven-year health care wars.
"It is time for it to stop being Obamacare or Trumpcare," said Slavitt. "We need to make it something that everybody owns."
Much of the public and the private sector already seem headed in that direction, said Slavitt. The question is whether the politicians will join them. Democrats shouldn't be crowing, he said.
"Republicans are the majority party," said Slavitt. "Unless (Democrats) take in ideas from the Republican party and are open to them, we are not going to get to a bipartisan agreement."
Only a cat seems to have more lives than ‘Obamacare’
Only a cat seems to have more lives than ‘Obamacare’
China-led lunar base to include nuclear power plant on moon’s surface, space official
Russia destroys energy facility in Ukraine’s Kherson, governor says
- The drone attacks are continuing and there could be emergency power cuts
Oleksandr Prokudin said the facility, which provided the city of Kherson with electricity, had come under Russian artillery and drone attacks for more than 24 hours.
“Our military fought all night to repel the enemy attacks. However, in the morning, the Russians succeeded in destroying the energy facility,” Prokudin said on Telegram.
The drone attacks are continuing and there could be emergency power cuts as energy workers are working to stabilize the situation, he added.
China’s Xi says tariffs ‘hurt’ multilateral trade
- China responded with a 125 percent duty on goods from the United States.
Beijing: Chinese President Xi Jinping said Wednesday tariffs “hurt” the multilateral trading system as he hosted his Azerbaijani counterpart for talks in Beijing, state media said.
Tariff and trade wars “undermine the legitimate rights and interests of all countries, hurt the multilateral trading system, and impact the world economic order,” he told Azerbaijani President Ilham Aliyev, state news agency Xinhua reported.
Beijing and Washington have been embroiled in a blistering trade war since US President Donald Trump this month slapped a 145 percent blanket tax on Chinese imports.
China responded with a 125 percent duty on goods from the United States.
Beijing’s commerce ministry this week warned other nations to be wary in seeking a deal with Washington.
“China firmly opposes any party reaching a deal at the expense of China’s interests,” a ministry spokesperson said Monday in a statement.
“Appeasement will not bring peace, and compromise will not be respected,” the statement said.
On Wednesday, Xi said that “despite a constantly changing international situation,” China and Azerbaijan had maintained close ties.
A day earlier, in phone calls with his British and Austrian counterparts, Chinese foreign minister Wang Yi urged Britain and the European Union to help in defending multilateral trade.
Pope Francis’ body to lie in state in St. Peter’s Basilica as the faithful mourn
- Heads of state are expected for Pope Francis’ funeral Saturday in St. Peter’s Square
- The three days of public viewing are largely for ordinary Catholics to grieve the pontiff
VATICAN CITY: The body of Pope Francis will be moved to St. Peter’s Basilica early Wednesday to lie in state for the Catholic faithful to pay their respects to the Argentine pontiff remembered for his humble style, concern for the poor and insistent prayers for peace.
Heads of state are expected for the funeral Saturday in St. Peter’s Square, but the three days of public viewing are largely for ordinary Catholics to grieve the 88-year-old pope, who died Monday after suffering a stroke.
Francis first lay in state in the Santa Marta Domus in a private viewing for Vatican residents and the papal household. Images released by the Vatican on Tuesday showed Francis lying in an open casket, wearing the traditional pointed headdress of bishops and red robes, his hands folded over a rosary. The Vatican’s No. 2, Cardinal Pietro Parolin, was pictured praying by Francis.
His body will be transferred Wednesday morning to St. Peter’s Basilica, which will be kept open until midnight on Wednesday and Thursday to allow the faithful to mourn. The public mourning period will end on Friday at 7 p.m.
Once inside the basilica, his casket won’t be put on an elevated bier – as was the case with past popes – but will just be placed on the main altar of the 16th-century basilica, simply facing the pews.
Italian police have tightened security for the viewing and the funeral, carrying out foot and horse patrols around the Vatican, where pilgrims continued to arrive for the Holy Year celebrations that Francis opened in December. The faithful who walk through St. Peter’s Holy Door are granted indulgences, a way to help atone for sins.
“For me, Pope Francis represents a great pastor, as well as a great friend to all of us,’’ said Micale Sales, visiting St. Peter’s Basilica from Brazil.
“I think he spread a positive message around the world, saying there shouldn’t be any violence, there should be peace around the world,’’ said Amit Kukreja, from Australia.
The funeral has been set for Saturday at 10 a.m. in St. Peter’s Square, and will be attended by leaders including US President Donald Trump and Ukrainian President Volodmyr Zelensky.
Cardinals are continuing their meetings this week to plan the conclave to elect Francis’ successor, make other decisions about running the Catholic Church as world leaders and the ordinary faithful grieve the pontiff’s death.
History’s first Latin American pontiff charmed the world with his humble style and concern for the poor but alienated many conservatives with critiques of capitalism and climate change. He last appeared in public on Sunday with an Easter blessing and popemobile tour through a cheering crowd in St. Peter’s Square.
He had some reservations about looping through the square packed with 50,000 faithful, Vatican News reported on Tuesday, but overcame them – and was thankful that he had greeted the crowd. He died the next morning.
“The death of a pope is not a small thing, because we’ve lost our leader,’’ said Julio Henrique from Brazil. “But still, in a few days, we will have a new leader. So … the thing of hope remains. Who will assume Peter’s throne?”
Vietnam village starts over with climate defenses after landslide
- Last year, Typhoon Yagi’s rains unleashed a landslide that engulfed much of Lang Nu village in mountainous Lao Cai province
LAO CAI, Vietnam: Nguyen Thi Kim’s small verdant community in northern Vietnam no longer exists, wiped away in a landslide triggered by Typhoon Yagi’s devastating heavy rains last year.
She and dozens of survivors have been relocated to a site that authorities hope will withstand future climate change-linked disasters, with stronger homes, drainage canals and a gentler topography that lessens landslide risks.
It is an example of the challenges communities around the world face in adapting to climate change, including more intense rains and flash floods like those Typhoon Yagi brought last September.
Kim lost 14 relatives and her traditional timber stilt home when Yagi’s rains unleashed a landslide that engulfed much of Lang Nu village in mountainous Lao Cai province.
The storm was the strongest to hit Vietnam in decades, killing at least 320 people in the country and causing an estimated $1.6 billion in economic losses.
It is unlikely to be an outlier though, with research last year showing climate change is causing typhoons in the region to intensify faster and last longer over land.
Climate change, caused largely by burning fossil fuels, impacts typhoons in multiple ways: a warmer atmosphere holds more water, making for heavier rains, and warmer oceans also help fuel tropical storms.
Kim remains traumatized by the landslide.
She says everything is painful, especially the memory of the moment a torrent of mud swept away her and her two-year-old daughter.
“This disaster was too big for us all,” she said recalling the moment the pair were pulled from the mud hours later.
“I still cannot talk about it without crying. I can’t forget,” the 28-year-old said.
Yagi hit Vietnam with winds in excess of 149 kilometers (92 miles) per hour and brought a deluge of rain that caused destructive flooding in parts of Laos, Thailand and Myanmar.
In Lang Nu, 67 residents were killed, and authorities vowed to rebuild the homes of survivors in a safe spot.
By December, 40 new houses were ready at a site around two kilometers away.
It was chosen for its elevation, which should be less impacted by adjacent streams, and its relatively gentle slope gradient.
“Predicting absolute safety in geology is actually very difficult,” said Tran Thanh Hai, rector of Hanoi University of Geology and Mining, who was involved in choosing a new site.
But the site is secure, “to the best of our knowledge and understanding.”
Lao Cai is one of Vietnam’s poorest areas, with little money for expensive warning systems.
However, a simple drainage system runs through the new community, diverting water away from the slope.
This should reduce soil saturation and the chances of another landslide, scientists who worked on the site said.
The village’s new homes are all built of sturdier concrete, rather than traditional wood.
“We want to follow our traditions, but if it’s not safe any longer, we need to change,” Kim said, staring out at the expanse of mud and rock where her old village once stood.
Months later it remains frozen in time, strewn with children’s toys, kitchen pans and motorcycle helmets caught up in the landslide.
Like Kim, 41-year-old Hoang Thi Bay now lives in the new village in a modern stilt house with steel structural beams.
Her roof, once made of palm leaves, is now corrugated iron and her doors are aluminum glass.
She survived the landslide by clinging desperately to the single concrete pillar in her old home as a wall of mud and rocks swept her neighborhood away.
“I still wake up in the night obsessing over what happened,” she said.
“Our old house was bigger and nicer, with gardens and fields. But I sleep here in the new house and I feel much safer,” she said.
Even at the new site, home to around 70 people, there are risks, warned Hai.
Development that changes the slope’s gradient, or construction of dams or reservoirs in the area could make the region more landslide-prone, he said.
Building more houses or new roads in the immediate area, or losing protective forest cover that holds earth in place, could also make the site unsafe, added Do Minh Duc, a professor at the Institute of Geotechnics and Environment at the Vietnam National University in Hanoi.
Yagi wiped out large areas of mature natural forest in Lao Cai and while private companies have donated trees for planting, it is unclear whether they can provide much protection.
“In terms of landslide prevention, the only forest that can have good (protective) effects is rainforest with a very high density of trees, so-called primary forest,” explained Duc, an expert on disaster risk maps who also helped choose the new site.
Leaving the old community was hard for Kim, whose family had lived and farmed there for nearly half a century.
But she is grateful that she and other survivors have a second chance.
“I believe this is the safest ground for us.”
