"Under the American Healthcare Act. you can keep your doctor."

This, as you all recognize, is the famous (infamous) "lie" told by Obama that the right wing has trumpeted for nearly a decade now to prove that Obama was the most dishonest, most criminal President in all United Staes history.  Forget that it was a phrase uttered before the factual impacts of Obamacare were known.  Forget that this was a true statement for well over 70% of the U.S. population.  (Obamacare covers only 2.9% of Americans get their health insurance through Obamacare.)  We are, of course, now living in Trumpland where truth become lies and lies become truths since there is an alternate set of facts reality (little did we know of such a world pre-Trump) that the Trump Administration has established and promotes.  But it makes sense doesn't it?  After all, if we have such wide ranging choices in the cars we can choose from or a plethora of washing machine and hair dryer brands at our beck and call, why not a choice of realities we can have the opportunity to choose from?   (Another Reagan era aphorism - "choice" - that lives on in 2107.)

So Obama "lied" about keeping your doctor.  While this is indeed a most serious breach of trust with the American people, the Trump Administration seems bent on improving on the number and depth of lying far and above that achieved by the Obama Administration.

The Washington Post

“The Congressional Budget Office’s math doesn’t add up. Faulty Numbers = Faulty Results.”
— Tweet by the White House Twitter account, July 12, 2017
The venerable Congressional Budget Office is under attack. Established in 1975 by Congress to provide independent analyses of legislation, the nonpartisan agency is under fire for its estimates of the effect of Republican proposals to repeal and replace the Affordable Care Act.
This is not a new position for the agency. The CBO’s refusal to credit much budget savings to Hillary Clinton’s 1993 health-care plan is one of the factors that killed her effort during the Bill Clinton administration. But the rhetoric attacking it this time around certainly seems sharper. All eight previous CBO directors issued a joint letter last week to congressional leadership “to express our strong objection to recent attacks on the integrity and professionalism of the agency and on the agency’s role in the legislative process.”

A recent video posted by the White House is a case in point. Titled “Reality Check,” it claims the “Congressional Budget Office’s math does not add up.” In particular, it makes two key claims — that the CBO “inaccurately measures health coverage” and that it uses “faulty assumptions and bad numbers.”
How valid is the White House case?
The Facts
“Inaccurately estimates health coverage”
This claim is based on the fact that the CBO, in its initial estimate of the ACA, projected that in 2017, 25 million people would be enrolled in the Obamacare exchanges; today, 10.3 million are. It sounds like a big miss, but the White House is playing a shell game here, highlighting a subset of the data.
The key focus of the CBO’s estimates in 2010 (which had to be revised in 2012 after the Supreme Court ruled that states could not be forced to expand Medicaid) was to estimate how many people would gain insurance under the law. On that score, CBO basically aced it, doing much better than other forecasters at the time, according to a 2015 analysis of various projections by the Commonwealth Fund.

The CBO estimated that the number of nonelderly people without insurance would drop to 30 million in 2016. The actual figure in 2016, according to the Centers for Disease Control and Prevention: 28.6 million. That represented a drop of 20 million from 2010, when the ACA became law.

This top-line estimate is what is important, because it helps determines how various health-care policies affect the federal budget. More people in employer-provided plans will drain tax revenue because of tax breaks given for employer-provided insurance, while more people on Medicaid or receiving tax subsidies for policies bought on the exchanges will boost federal spending.
CBO got the mix of types of insurance incorrect, underestimating the number of people joining Medicaid and overestimating how many employers would require employees to join the exchanges. The agency also did not predict (understandably) the website problems and slow rollout that affected enrollment from the start (and probably made employers reluctant to stop providing their own insurance).
Here’s an analogy: A farmer tries to predict how many animals would be in his barnyard 10 years from now. He gets the overall number right, but the ratio of chickens, goats and pigs is different than he expected.
The projections for the subcategories are always going to be prone to more error than overall estimates. The margin of error in polls, for instance, increases as you dig deeper into certain voting groups. But what matters most is if the poll predicts the actual margin of victory.
So, although the video claims that the CBO inaccurately measures health coverage, the CBO just about nailed the most important figure from a budget perspective. That’s relevant because, in the video, the White House is trying to undermine an equivalent figure in the CBO’s estimate of Senate GOP plans — that 22 million fewer people than under the current law would have health insurance a decade from now.
“Faulty assumptions and bad numbers”
In the second section of the video, the White House mentions that 22 million figure and says it’s wrong because the CBO “falsely assumes” that 18 million people would be on the Obamacare exchanges in 2018. The video says that this is because of “faulty baseline estimates” since only about 10 million are in the exchanges as of 2017. The video suggests that, thus, the effect of the GOP proposals is overstated.
It’s correct that the CBO baseline indicates 18 million people would be on the exchanges in 2018 — but that’s because Republican leaders in Congress told the CBO to use this particular baseline. It’s a baseline from March 2016, not the more recent January 2017 baseline, which scaled back the figure and estimates that 11 million people would participate in the exchanges in 2018. So the White House is trying to fault the CBO for a decision made by its congressional allies.

Here’s what happened: The GOP-led Congress in January was in such a rush to repeal Obamacare that it moved forward before the CBO could complete an updated baseline, as it does regularly during the year. So budget instructions for the year were based on the March 2016 baseline, and the CBO was ordered to do its analysis of health-care proposals based on the old baseline.
Since then, the CBO has released an updated baseline in January and another in June. Even so, the CBO is still being told by GOP congressional leaders to calculate off the old March 2016 dateline. Close readers of the CBO estimates would note that the agency is upfront about this problem, highlighting in its estimates that it is using the March 2016 baseline.

The problem for Republicans in Congress is that switching to a more recent baseline might actually not change the bottom-line effect on the number of uninsured — while it could reduce the projected budget savings that lawmakers are counting on to use a parliamentary procedure that thwarts a Senate filibuster requiring 60 votes. (Fewer people in the exchanges could mean the savings from repealing much of the law are lower.) The whole reason for using this procedure, known as reconciliation, is to avoid having to negotiate with Democrats on the legislation. So switching to a more accurate baseline might make passage in the Senate even more difficult.
In other words, it’s rather hypocritical for the White House to blame the CBO for using a baseline mandated by Republicans as part of an effort to cut Democrats out of the process. If given a choice, the CBO presumably would prefer to offer calculations based on the most recent baseline, as then estimates of the potential effect on the budget would be more accurate.
We sought a comment from the White House but did not receive a response.

The Pinocchio Test

This is yet another misleading bit of health-care spin issued by the White House. The CBO obviously is not perfect, but it is nonpartisan and tries to do the best analytical work possible.
The CBO got the overall impact of the ACA on the number of uninsured largely correct, giving credibility to its estimates on the effects of the GOP proposals. Moreover, even the CBO concedes that the baseline it is using is not ideal, but it has to use this baseline because of orders by Republicans in Congress. So if the White House has a complaint, it should contact its allies in Congress, not blame the CBO.
This video earns three Pinocchios. 


Team Trump Used Obamacare Money to Run PR Effort Against It

The administration is tasked with overseeing the health care law. Instead, it has made a major social media push to undermine it.

The Trump administration has spent taxpayer money meant to encourage enrollment in the Affordable Care Act on a public relations campaign aimed at methodically strangling it.
The effort, which involves a multi-pronged social media push as well as video testimonials designed at damaging public opinion of President Obama’s health care law, is far more robust and sustained than has been publicly revealed or realized.
The strategy has caught the eye of legal experts and Democrats in Congress, who have asked government agencies to investigate whether the administration has misused funds and engaged in covert propaganda in its efforts to damage and overturn the seven-year-old health care law. It’s also roiled Obama administration veterans, who argue that the current White House is not only abdicating its responsibilities to administer the law but sabotaging it in an effort to facilitate its undoing by Congress.
“I’m on a daily basis horrified by leaders at the Department of Health and Human Services who seem intent on taking healthcare away from the constituents they are supposed to serve,” former HHS Secretary Kathleen Sebelius said in an interview with The Daily Beast. “We always believed that delivering health and human services was the mission of the department. That seems to not be the mission of the current leadership.”
The Department of Health and Human Services (HHS) declined repeated attempts to discuss its PR efforts. But more than half-a-dozen sources at various agencies and on the Hill outlined the scope of the anti-Obamacare push in conversations with The Daily Beast.
Under Secretary Tom Price’s stewardship, HHS has filmed and produced a series of testimonial videos featuring individuals claiming to have been harmed by Obamacare. Those “viral” videos have had decidedly limited reach, often gathering somewhere between 100 and 200 views each. But the Department has made a heavy investment in them nonetheless. To date, it has released 23 videos. A source familiar with the video production says that there have been nearly 30 interviews conducted in total, from which more than 130 videos have been produced.

Each testimonial has the same look, feel, and setting, with the subjects sitting before a gray backdrop and speaking directly to camera about how Obamacare has harmed their lives. They were all shot at the Department’s internal studio, according to numerous sources who worked for or continue to work at HHS. Under the Obama administration, it was customary that such videos were recorded and edited by an outside contractor who then billed the department for its work. One former official said that the contractor would charge roughly $550 an hour.
Funding for those videos would come from the Department’s “consumer information and outreach” budget, which was previously used for the purposes of advertising the ACA and encouraging enrollment. The Trump administration has requested $574 million for this specific budget item, though HHS declined to detail how much it has devoted to specific line items. Two sources familiar with the videos say that HHS continues to draw money from the outreach fund, even though its objective has switched from promoting the ACA to highlighting the law’s critics and its shortcomings.
Getting the subjects to HHS’ studio also cost taxpayer money. In this case, the White House itself found individuals, often through local news stories and Republican Party connections, and flew them to Washington, D.C., to participate in roundtables to discuss Obamacare. From there, they were whisked across town to HHS headquarters.
“We had no clue [this was happening],” Tracie Sanchez of Lima, Ohio, told The Daily Beast. “That just popped up when we got there.”
A small business owner who kept her company at 49 employees for many years to avoid Obamacare’s mandate that larger employers cover workers’ health care, Sanchez said it was an “honor” to have been invited to the White House and to have appeared in an HHS video. But others who were filmed felt more ambivalent about their experience.
Dr. Ryan Stanton of Kentucky is critical of Obamacare but also acknowledges that the legislation has been beneficial in certain respects. He’s also uncertain about Republican-authored replacements. When he sat down for a recording at the HHS studio he said it “felt like they were pushing for a harder line against Obamacare” than he was delivering.
“I don’t think mine was the exact message they were looking for of, ‘Oh, let’s march against Obamacare,’” he recalled. “It was clearly an effort to push the repeal and replace.”
Following the failure of Senate Republicans to pass an Obamacare repeal and replace package this week, President Trump said that he would allow the law to fall apart as a means of compelling congressional Democrats to the negotiating table.

As I have always said, let ObamaCare fail and then come together and do a great healthcare plan. Stay tuned!
It’s a strategy designed to test the opposition’s capacity to absorb human and political suffering. It’s also one Trump has the power to pursue.
Under the Affordable Care Act, both HHS and the Centers for Medicare and Medicaid Services (CMS) have broad authorities to administer the law—from implementing and relaxing penalties, to working with commissioners to shore up markets.
The Obama White House often used these administrative powers to circumvent efforts by congressional Republicans to undermine the ACA. Trump and company have gone in a diametrically different direction.
CMS has put out debatable numbers that make it appear that state health insurance exchanges are on less stable footing. The White House has wavered routinely on whether to pay cost-sharing reductions that insurers—and virtually every health economist—say are necessary to keep markets stable. And during the tail end of the 2017 enrollment period, HHS pulled television advertising and temporarily suspended social media efforts alerting consumers to the final sign up date.
Then there is Twitter. The official HHS account has become a clearinghouse for anti-Obamacare messaging. Since the Trump administration came into office, @HHSGov has mentioned “Obamacare” 13 specific times, 10 of which could be described as openly hostile of the law. Twice the account has re-tweeted Secretary Price’s own account when it has explicitly encouraged legislative efforts to undo Obamacare. The first was on May 4, when Price applauded the house for passing its bill, the American Health Care Act. The second came on June 5, when Price used the hashtag #RepealAndReplace.

Perhaps the most glaring efforts to publicly undermine the ACA, has come on the Department of Health and Human Service’s own website. In the Obama administration, this piece of online real estate featured direct links for consumers to apply for coverage and infographic breakdowns of the ACA’s benefits and critical dates. Since Trump was inaugurated, it has been retrofitted into an bulletin board for information critical of the law.

Currently, for example, the banner image on the site leads to a page explaining the ways in which the ACA “has done damage to this market and created great burdens for many Americans.” The “Health Care Home” section no longer contains a page on “Delivery System Reform” and “Facts & Figures.” And instead of a readily available link for visitors to access the main sign-up portal for obtaining health care coverage, the site has a post criticizing the now infamous and encouraging people to use private sector web brokers.

Subtle changes have been made to the “About the ACA” section of the website as well that reflect the current administration’s hostility toward to the law.
  • * The “Plain Language Benefits” section has been scrapped as has the section on “ER Access & Doctor Choice.”
  • * Under the “pre-existing conditions” section, the Trump version has removed any mention of women no longer being able to be charged more than men for coverage.
  • * Under the “Young Adult Coverage” section, the Trump HHS site no longer notes that before the ACA insurance companies could have removed enrolled children at the age of 19.
  • * Mentions of the “Affordable Care Act” have been replaced with “current law.”
  • * And while the Obama HHS site had a section noting that the ACA forced insurance companies to provide “easy-to-understand” summaries of benefit and coverage packages, the Trump site has no such page.

  • Ultimately, the HHS website is a place to obtain information on Obamacare but not a vehicle of obtaining coverage under the law. But changes have been made to as well, and they’re directly related to consumer education. Under the “Get Answers” section of the site, there no longer is a “Cost & Savings” tab that allows visitors to find out where to find prices, if they have to pay penalties, or if they qualify for savings.

How much damage these alterations have had on Obamacare is ultimately unknowable. But those whose job it once was to encourage enrollment insist that the burying of information, the pausing of advertising, and creation of policy confusion has collectively had a profound effect.
“I think uncertainty causes people to freeze,” said Andy Slavitt, the former acting administrator at CMS. “So I think it is quite impactful. And look, you’re not hired into the administration to decide whether you agree with the law you’re asked to execute. That’s not your job... Congress appropriates funds for you to carry out laws that they passed, not to spend those funds on activities that counteract those laws.”

Brushing Up Against the Letter of the Law
On Feb. 17, 2017, Sens. Patty Murray (D-WA) and Ron Wyden (D-OR) wrote Price a letter raising their concerns with the changes HHS had made to and its decision to pull enrollment-deadline advertising (PDF). On June 6, 2017, Sens. Elizabeth Warren (D-MA) and Murray wrote the HHS’ inspector general requesting an investigation of the agency’s “actions to undermine the ongoing implementation” of the ACA (PDF). A week later, four leading congressional Democrats wrote a letter to the comptroller general of the Government Accountability Office (GAO) requesting an investigation into the various ways in which HHS used its public relations resources to help promote repeal of Obamacare (PDF).
Their offices tell The Daily Beast that they have not yet received responses from the administration. As for GAO, however, there is ample precedent to suggest that it will look into the matter. In 2010, the office examined HHS’ decision to pay contractors for help producing television advertisement concerning changes Obamacare made to the Medicare. It concluded that HHS had operated within the law because the ads did not constitute “a purely partisan activity”—which it defined as “completely devoid of any connection with official functions” and “completely political in nature.”
Years later, the GAO came down differently on another Obama agency. In December 2015, the office ruled that the Obama administration’s Environmental Protection Agency had engaged in “covert propaganda” in its use of social media to encourage public support for its clean-water regulations.
Both Murray and Wyden’s office said that they are waiting to hear back from the GAO on whether the Trump administration has engaged in similarly out-of-bounds conduct. But administrative law experts say that the department is coming close to, if not fully crossing, the line of legality. HHS is allowed to use funds for purposes of educating the public but it is prohibited under its appropriations statute from engaging in overt advocacy—such as encourage the passage or defeat of legislation.
The testimonial videos venture into the realm of political influencing, said Cary Coglianese, the Edward B. Shils professor of law and professor of political science at the University of Pennsylvania. But it was the tweets from Price and the HHS account—the ones encouraging and applauding passage of legislation—that drifted into legally troublesome areas.
“It certainly all sounds highly problematic and inappropriate,” said Coglianese. “It does seem very much akin to the kind of propaganda that the GAO faulted EPA for engaging in. The tweets by the Secretary are clearly seeking to shape public attitudes about Obamacare and whether it should be repealed and replaced. He is explicit about that. And it is highly unusual and, I think, problematic when government officials engage in that kind of public outreach.”

NOTE:  Sadly, these two examples of the Trump Administration attempting to undermine the Affordable Care Act dovetail quite nicely with Trump's and the Trump Administration's fairly tenuous relationship with facts.  Reality, let's say.   These is not examples of "government spin" or misstatement or inadvertent typos.  They are government propaganda that bear no relationship to the truth.

But let's look back at what the Obama Administration did along the same lines: outright lying, let's say.  Remember when Obama was going to confiscate all the guns from every red-blooded American?  Remember when Obama was secretly massing Blue Helmeted United Nations' troops to foment a coup?  Remember when Obama was massing Federal Troops in Texas (to, once again, foment a coup) under the guise of a FEMA Disaster exercise?  Remember when Obama was illegally issuing Executive Orders to bring Sharia Law across the land?

Remember when none of these right wing accusations turned out to be true?

But today?  Every time Trump tweets or opens his mouth to speak what we hear is as often "untrue" as true.

Have A Good Day Folks.  But Be Watchful.  Truth Can Be A Tricky Thing.


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