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Congressional cuts harmful to healthcare
By Herbert C. Smitherman, Jr.
As physicians, we take an oath to do no harm. Police officers promise to protect and serve. Legislators are selected by the people to defend our rights, oversee our policies and work in our best interest. However, it seems those we have trusted to govern our nation have forgotten about the people who depend on them the most. Recently, the American Health Care Act (AHCA) was presented beDr. Herbert C. fore Congress and Smitherman, Jr. voted on in the blink of an eye. A bill that represents one fifth of our economy, impacts everyone in our country rich or poor, insured or not, was put into an 1800 page document and voted on 24 hours after being filed. The vote was held with no debate, no hearings, no Congressional Budget Office analysis, and with many congressional members admitting not to have read the bill at all. This bill, both in substance and process, was a disturbing approach to governance and a willful neglect and disservice to the American people. Let’s take a look at the facts of the AHCA Bill voted out of the House: • Under the American Health Care Act (AHCA) health insurance would be cut to as many as 24 million people, and large companies will no longer have to provide health Insurance coverage to their employees, undermining where most families in the U.S. receive their health Insurance coverage. • This new bill cuts Medicaid in a big way. Medicaid insures 70 million people in the US with 66% of its spending going toward care for poor seniors and the disabled. Under this new bill, Medicaid gets cut by $880 billion, cutting care and hurting many of the most vulnerable Americans in the country. • Hospitals got more insured patients with the ACA so the government reduced what hospitals got paid from Medicare. The new bill cuts 24 million people who received new health insurance but keeps the cuts in Medicare. Even with millions of people cut from insurance this new bill keeps the Medicare cuts to hospitals in place which would disproportionately hurt rural and urban hospitals, causing cuts to hospital services that could lead to hospital closures across the country. • While this bill robs the deserving, it is working overtime to help big business. The AHCA gives states access to waivers that can enable insurers to charge
more for people with pre-existing illnesses and can charge seniors up to five times as much as younger people for the same amount of health insurance coverage. So even though President Trump’s key campaign promise was, “No one would lose coverage for pre-existing conditions,”, this is one of the main features ripped from the bill. • The bill’s waivers serve as a free pass allowing health insurance companies to opt out of covering any basic services they so choose, such as hospitalization, pregnancy, emergency room care, gynecological services, cancer care, behavioral health and drug treatment coverage, which includes mental health and addiction treatment; a mandatory provision that was built into the Affordable Care Act. • This AHCA eliminates funding for the Prevention and Public Health Fund after 2018, which provides for investment in prevention, wellness and public health programs to improve health and restrain the rate of growth in health care costs. After this provision phases out, there will be no programming to help keep individuals well. • The $808 billion in Exchange subsidies currently provided to middle class families to subsidize the purchase of their health insurance on an ACA Exchange are radically cut in this bill and these monies are shifted to the wealthiest 1% and corporations in the form of an $800 billion tax cut. This bill decreases health insurance coverage to millions of Americans, raises premiums, eliminates protections for pre-existing illnesses, and raises deductibles. This is not a healthcare bill it is a “wealthcare bill”. The real purpose of this bill is to take money out of healthcare to pay for a GOP tax cut bill. That’s why the healthcare bill had to come first in order to find the revenue to pay for the GOP tax cuts. This bill is the largest redistribution from the poor to the rich in a single bill in U.S. history, and hurts the elderly, the sick, the poor and the middle class. So the poor and middle class pay twice. First in the loss of healthcare coverage for their families and second, no benefit from the tax breaks generated by the revenue theft from healthcare. Any bill that does this much damage to the well-being of the American people is unbecoming of the U.S. Congressional members who voted for it, and unworthy of our great nation’s history in protecting the most vulnerable among us. Herbert C. Smitherman Jr, MD, MPH, FACP is vice dean, Diversity and Community Affairs, associate professor, Department of Medicine and Karmanos Cancer Institute, Wayne State University School of Medicine/Detroit Medical Center.
The time is now for rebuilding Detroit’s election process Garlin Gilchrist II Candidate for Detroit City Clerk
Voting in the city of Detroit continues to become a more challenging process each election. Whether you vote in person or by absentee ballot, every election brings longer lines, broken voting machines and confusion over ID requirements, making it more difficult for Detroit voters to exercise their rights in the democratic process. Last fall, the city grabbed national headlines for having vote tally discrepancies, to the point where votes could not be recounted in nearly 60 percent of Detroit’s precincts. In addition, the ACLU of Michigan sent a strongly worded letter to Garlin Gilchrist II the current Detroit City Clerk, demanding she stop misinforming voters about voter identification requirements. This is unacceptable. It’s no surprise that residents do not trust the integrity of our elections and are staying home on Election Day. The result is that only about 48% of registered voters in Detroit cast ballots in the 2016 general election. New voting machines and better training for election-day volunteers is an important first step, but not enough to restore trust and increase voter turnout. Many Detroiters, like my wife and I, do not own a car. We had to travel nearly a mile and a half, then wait an hour
and a half to vote. Many voters can’t take that much time off of work or they don’t have a way of getting to the polls. That’s why every idea must be on the table for Detroit’s next city clerk to improve access to voting for Detroiters. We must increase the number of polling locations, so no voter has to travel more than a mile to vote, especially in neighborhoods we know have limited bus service. Those who want to vote by absentee ballot and miss the mailing deadline should not be forced to drive downtown to the Coleman A. Young Municipal Center or the Elections Office on West Grand Boulevard to submit their ballot. Traffic can be heavy, and parking at those locations is expensive and hard to find. If you are short on time, getting there by bus is often not an option. To accommodate voters, we should use neighborhood locations like city recreation centers, health centers and other existing city facilities as drop-off points for absentee ballots. Ideas like this have worked in other cities and improved voter turnout. For example, Philadelphia, a similar geographic size as Detroit, offers more than 1,500 polling places compared to fewer than 500 in Detroit. That means no Philadelphia voter travels more than five blocks to cast a ballot. This contributes to that city’s 64 percent voter turnout, a significantly higher rate than Detroit’s 48 percent last November. Rebuilding trust in the integrity of elections in Detroit must happen quickly or we will lose the voices of even more frustrated residents. As we witnessed last fall, we cannot allow our voices to go unheard or discounted for another election. The stakes are far too high.
End the killing of black children by police Brian L. Pauling CEO and President 100 Black Men of America, Inc.
The time is now for America’s legislative body at the state and local levels to bring a full stop to the endless harassment and killing of black children at the hands of the men and women in law enforcement sworn to protect and serve them. Of those that made the news, Jordan Edwards, a 15-year-old from a Dallas suburb was the latest victim of law enforcement. Jordan’s death follows an unrelenting pattern of black children who are subjected to undue harassment Brian L. Pauling and excessive force, or death, by police officers. Many of these reported killings have taken place in settings where children are simply doing what young people do in the course of their daily life. In school, at social events, in playgrounds and on their streets black children are harassed, tormented or killed by police officers. For victims, their families and the greater community, the trauma of these acts against children is too much to bear. These acts also shed light on our state and local legislative bodies as institutions that have not acted in the better interest of keeping our children safe. After waiting months, we have learned the U.S. Department of Justice will not file charges against the two Ba-
ton Rouge police officers, Blane Salamoni and Howie Lake, for the death of Alton Sterling last summer in a convenience store parking lot. Now, it is up to the Louisiana State Attorney General to decide whether to pursue criminal charges against these two police officers. Will the state attorney general fail citizens, too? The failure to prosecute and convict nearly every officer involved in fatal force shooting of unarmed black people, underscores the urgent matter of substantive accountability and justice. The police officer who killed Jordan Edwards was swiftly terminated, but that is not accountability in measure to the life he took. Police officers are public servants. They answer to municipal and state elected officials. When will our elected officials stand for justice and ensure that the children of our communities are protected and served rather than harassed and killed? Do we need to elect new legislators in order for them to take notice and take action regarding these egregious killings and traumatic treatment of our citizens? Police officers, by law, are granted an extraordinary range of authority to make life and death decisions. It is time for elected representatives to use their authority — entrusted by the public who vote them into office — to rein in police officers by changing the laws that shield them. The safety of our children, wherever they may be, begins and ends with elected representatives who enact laws and have the power to hold their subordinates accountable for their actions or failures. We certainly will hold them accountable on Election Day.
CFPB lawsuit seeks consumer restitution from high-cost online installment lenders By Charlene Crowell Four online lenders offering highcost, small-dollar installment loans face a federal lawsuit alleging that the lenders collected on debts that consumers did not legally owe. Filed in late April by the Consumer Financial Protection Bureau, the lawsuit charges online lenders Golden Valley Lending, Silver Cloud Financial, Mountain Summit Financial and Majestic Lake Financial as having engaged in unfair, deceptive, or abusive acts. The lawsuit also alleges the businesses did not make proper disclosures to consumers. Consumers living in 17 states are affected by the lawsuit. If successful, the lawsuit could Charlene Crowell result in restitution for affected consumers, ban future loan collections, and civil monetary penalties. According to CFPB, since at least 2012, the lenders sold installment loans valued from $300 and as large as $1,200 that carried annual percentage rates from a low of 440 percent to as high as 950 percent. These high interest rates allegedly violate state usury laws and in turn, void all of part of the loans. CFPB alleges that the four corporations unlawfully collected loans as the transactions violated state laws, as well as the federal Truth in Lending Act (TILA) and the Dodd-Frank Wall Street Reform and Consumer Protection Act. As such, the firms: • Failed to disclose the real cost of credit, including the annual percentage rates on the loads made; • Deceived consumers about loan payments that were not owed; and • Collected loan payments which consumers did not owe. “We allege that these companies made deceptive demands and illegally took money from peoples’ bank accounts. We are seeking to stop these violations and get relief for consumers,” said CFPB Director Richard Cordray. The standard loan repayment schedule was one payment every two weeks or 20 payments over a 10 month period of time. For each payment made, a “servicer fee” was charged, usually $30 for every $100 in outstanding principal, plus 5 percent of the original principal. For example, on an $800 loan, borrowers would actually repay $3,320 over the 10-month repayment schedule. To provide context for just how cost-
ly these loans were, in less than six months - from August to December of 2013 - two of the firms, Silver Cloud and Golden Valley, originated approximately $27 million in loans; but collected $44 million from consumers. In recent years, the Center for Responsible Lending (CRL) has advocated against predatory payday and car title lenders who have been pushing longer-term loans that can be as high as $10,000. “For these loans, the packaging is different but the end result is the same: a triple-digit interest rate, long-term loan that is structured to give payday lenders access to borrowers’ bank accounts and keep them stuck in a cycle of unaffordable debt,” said Diane Standaert, a CRL EVP and Director of State Policy. “This growing issue will not be resolved until a combination of legislation, regulation and enforcement are together ensuring that consumers and the financial marketplace will be protected. Complete consumer protection will occur when the financial marketplace is comprised of lenders who serve, rather than exploit, consumers,” Standaert concluded. Last year, CFPB returned $39 million to consumers wronged by unlawful debt collection practices and additionally collected $20 million in civil penalties. As of March 2017, CFPB has returned nearly $12 billion to 29 million Americans harmed by illegal and predatory actions of financial companies. However, CFPB’s ability to continue to protect consumers remains in jeopardy. Recent legislation introduced in the House of Representatives would strip the agency of its authority and independence. The Financial CHOICE Act, dubbed ‘the Wrong CHOICE Act’ by consumer advocates, would reverse consumer protection advanced by CFPB over a range of lending areas. On May 4, the measured was approved by the House Financial Services Committee on a 34-26 vote. A full floor vote on the bill is expected in mid-May. “Among other things, the ‘Wrong CHOICE Act’ would prevent the consumer agency from regulating small dollar loans and initiating enforcement actions against the unfair, deceptive and abusive practices of predatory actors,” said Melissa Stegman, a senior policy counsel with CRL. Charlene Crowell is the communications deputy director for the Center for Responsible Lending. She can be reached at charlene.crowell@responsiblelending.org.