Daily on Healthcare: GOP paid leave backers gain momentum

By | February 14, 2019

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GOP paid leave backers gain momentum. Sen. Joni Ernst, R-Iowa, says she is ready to speak out more on issues of particular relevance to women, starting with the lack of paid parental leave in the U.S. Ernst, who is now the fourth-highest ranking Republican in the Senate, is working alongside a group of male GOP counterparts to write conservative legislation that would let new parents take paid time off from work after the birth or an adoption of a child. “We have shared the same concerns about issues for years and years and years, we just maybe aren’t as vocal about those issues,” Ernst said of Republicans, speaking in the first interview in her new office. “Most of the conservative women I work with, they’re very modest. They don’t want to be out at the forefront. Some of those issues are very hard to talk about. I think now is the time. If we need to speak up, we need to speak up. We’ll find our way forward with our new voice.” Democrats long have claimed paid family leave as their cause, but that has been changing — with the blessing of the Trump White House. Part of the reason for the shift is that Republicans believe they’ve found a conservative approach to paid family leave by letting new parents draw from Social Security early in exchange for delaying retirement.

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GOP support of paid leave is still a new development. Ernst described the paid effort as being in its “infancy stages” and said she didn’t yet have specific commitments from Senate Majority Leader Mitch McConnell, R-Ky. She stressed, however, that Republicans were gaining traction with the idea by presenting it as a boon to small businesses and to families who need time to bond with their infants. “I don’t want to give any false hopes, because this will be a heavy lift,” she said. “But I think it’s one that we all think is very important. We have to find the right path going forward.”

At least three GOP bills on paid family leave will be out by March. Last year, Sen. Marco Rubio, R-Fla., proposed a bill to tap into Social Security, known as the Economic Security for New Parents Act. Sen. Bill Cassidy, R-La., led the first hearing in almost four years on paid family leave. Republicans are expected to have at least three bills on the table by March: Ernst is teaming up with Sen. Mike Lee, R-Utah, to craft a bill, and Cassidy will introduce one of his own. On Wednesday, the senators gathered to discuss their next steps in a meeting that also included Sen. Todd Young, R-Ind., and Ivanka Trump, first daughter and senior White House adviser, who has advocated for paid leave regularly with lawmakers on both sides. “I don’t think that different people working on different bills means you’re not united in purpose,” Cassidy said of the different proposals underway, all of which will use Social Security. “You bring different perspectives, and ultimately, you come to a common bill that has broader support.”

Building consensus won’t be easy. Some outside conservative groups have expressed caution about expanding the role of the federal government. Democrats, meanwhile, want a totally different version of the policy. A majority of Democrats in the Senate and House have backed the Family and Medical Leave Act, which funds up to 12 weeks of paid family leave through a payroll tax. That proposal is a nonstarter for Republicans, who say they favor a program that will be both voluntary and budget-neutral. The Democratic plan also has a major provision Republicans aren’t considering: It allows for paid leave not just when families have a new child, but also when family members have to take time off to undergo a medical treatment or to care for a sick family member. “We think paid leave should cover all workers for all life events,” Sen. Kirsten Gillibrand, D-N.Y., who is running for the 2020 Democratic nomination, said at a press event Tuesday as she re-introduced the Family Act. Democrats contend families should not have to choose between their retirement and paid family leave. “Welcome to the debate,” said Rep. Rosa DeLauro, D-Conn., on Tuesday as she re-introduced the paid family leave bill with Gillibrand. “This issue now is [at] the center of public discourse in this country.”

Georgia considers jumping aboard the partial Medicaid expansion train. Republican Gov. Brian Kemp railed against Obamacare’s Medicaid expansion when he was running for office in Georgia against Democratic challenger Stacey Abrams, who dedicated much of her platform to the cause. Now, he’s open to embracing the expansion, at least in part. Kemp’s office has announced the Patients First Act, which would give the governor authority to not only consider pilot programs to reduce premiums for Obamacare customers, but would open the door for a partial Medicaid expansion that Utah, Arkansas, and Massachusetts also have sought. Such a plan, a combination of both 1332 and 1115 waivers, would need to be approved by the Trump administration, which hasn’t yet greenlighted any proposals for partial expansion. In a statement, Kemp said the proposal would help the state move “toward lowering insurance premiums, enhancing access to quality care, and improving health outcomes in every part of our state.” The Medicaid plans are what conservatives have feared: They don’t oppose states rolling back the Medicaid expansion, but they do oppose non-expansion states moving toward partial expansion. Pro-Obamacare advocates, meanwhile, are rattled by the states who are moving to roll back Medicaid in places that accepted the full expansion.

Democrats roll out ‘Medicare at 50.’ Democrats on Wednesday unveiled a bill that would let people buy into Medicare beginning at age 50, casting the provision as an expansion of Obamacare. “This is the first major improvement to the Affordable Care Act,” said Rep. Brian Higgins, D-N.Y., using the formal name for Obamacare. “The one fundamental flaw that there was, not because of fact but because of politics, was the lack of a public option.” The Obamacare legislation initially did have such a “public option,” meaning a government-run health insurance plan, but it was stripped out in committee. The provision has long been opposed by the healthcare industry, which is concerned about the lower rates it will receive for medical services compared with private health insurance. “There is no question that Medicare works for seniors and others who depend on it. But expanding the program with hospitals facing the lowest Medicare margins in history will make it more difficult to provide the critical care that all Americans expect and deserve,” Chip Kahn, president and CEO of the Federation of American Hospitals, said in a statement.

The plan is intended to move toward ‘Medicare for all.’ Democratic leaders have signaled they favor more gradual changes to the healthcare system rather than the “Medicare for all” approach backed by several Senate Democrats vying for their party’s nomination for president, which has broad Democratic support in the House. Under Sen. Bernie Sanders’, I-Vt., Medicare for All Act, everyone would receive government-financed coverage and private health insurance would disappear. “I have always supported universal healthcare, but we are not there yet,” said Baldwin, who is also a co-sponsor of the Medicare for All Act. The bill, the “Medicare at 50 Act,” would let people buy Medicare as an alternative to Obamacare plans if they are uninsured or if they want it instead of the coverage they’re getting through work. It also contains a provision that would let the health secretary negotiate drug prices.

House Republicans plan to pressure Democrats on third trimester abortions. Rep. Jackie Walorski, R-Ind., will be starting special order speeches on the House floor to support the Born-Alive Abortion Survivors Protection Act, which would mandate medical care for babies that survive abortions. The bill was introduced by Rep. Ann Wagner, R-Mo., and failed to advance by unanimous consent on the Senate side after Democrats blocked it.

Opinion: California is where liberal dreams go to die. From single-payer healthcare to high-speed rail, this large and wealth state dominated by Democrats has struggled to get major liberal initiatives off the ground.

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THURSDAY | Feb. 14

Feb. 11-14. Orlando. Healthcare Information and Management Systems Society annual meeting. Agenda.

FRIDAY | Feb. 15

1 p.m. 1789 Massachusetts Ave NW. American Enterprise Institute event on “Sense and severability: If one part of the Affordable Care Act is ruled unconstitutional, what is the proper remedy or resolution?” Details.

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