Old Diary

Ignore the circus. Look at what Trump is doing to the environment, immigrants and health care.

This is a reprint from The Washington Post, an article by James Hohmann / September 18, 2019.

It’s so easy to get distracted by political theatrics, but it’s so important not to lose sight of the forest for the trees. Tectonic changes in public policy under the Trump administration will have a vastly greater impact on the lives of everyday Americans than anything he tweets or any stunt his former campaign manager pulls on Capitol Hill. A flurry of mostly under-the-radar stories over the past 24 hours put in stark relief why it’s more important to pay attention to what the president and his appointees dothan what they say. Let’s look at three specific topic areas:

— On the environment: The Trump administration plans to formally revoke California’s long-standing right to set stricter air pollution standards for cars and light trucks. This is the latest step in a broad campaign to undermine Obama-era policies aimed at cutting greenhouse gas emissions to combat climate change.

“The move threatens to set in motion a massive legal battle between California and the federal government, plunge automakers into a prolonged period of uncertainty and create turmoil in the nation’s auto market,”

Juliet Eilperin and Brady Dennis report. “Already, 13 states and the District of Columbia have vowed to adopt California’s standards if they diverge from the federal government’s, as have several major automakers. California leaders on Tuesday said they will fight any challenge to their autonomy.”

So much for federalism.

The official announcement was scheduled for today, during Trump’s swing through California, but the administration has decided to postpone the policy rollout by at least a day. Juliet and Brady explain why that might be: “Trump’s move is likely to be unpopular nationwide and in California, with Americans widely supportive of stricter fuel efficiency standards. A Washington Post-Kaiser Family Foundation poll released Friday found 66 percent of Americans oppose Trump’s plan to freeze fuel efficiency standards rather than enforce the Obama administration’s targets for 2025. A nearly identical 67 percent majority says they support state governments setting stricter fuel efficiency targets than the federal government.”

— Meanwhile, an internal National Park Service report obtained by The Washington Post reveals that the bulldozers and excavators rushing to install Trump’s border barrier could damage or destroy up to 22 archaeological sites within Arizona’s Organ Pipe Cactus National Monument in the coming months.

“The administration’s plan to convert an existing five-foot-high vehicle barrier into a 30-foot steel edifice could pose irreparable harm to unexcavated remnants of ancient Sonoran Desert peoples,”

border patrol

Juliet and Nick Miroff scoop. “Experts identified these risks as U.S. Customs and Border Protection seeks to fast-track the construction to meet Trump’s campaign pledge of completing 500 miles of barrier by next year’s election. …With the president demanding weekly updates on construction progress and tweeting out drone footage of new fencing through the desert, administration officials have said they are under extraordinary pressure to meet Trump’s construction goals. … The Department of Homeland Security has taken advantage of a 2005 law to waive several federal requirements — including the Archaeological Resources Protection Act, the National Historic Preservation Act and the Endangered Species Act — that could have slowed and possibly stopped the barrier’s advance in the stretch in Arizona.”

— You can read the 123-page report for yourself here.

— Speaking of the immigration wars, the Trump administration continues to take dramatic steps to make the United States a less hospitable destination for those who hope to seek refuge here.

Along the Texas border, for instance, the Trump administration has set up tent courts for virtual asylum hearings. The administration has budgeted up to $155 million to operate five temporary courts along the length of the border under the Migrant Protection Protocols initiative. The goal is to replace the asylum processing model that Trump has disparaged as “catch and release.”virtual court cases

“By routing migrants directly from official border crossings into the adjacent court complex, U.S. authorities can fulfill the obligation to give asylum seekers access to the U.S. court system without giving them physical access to the United States,”

Nick reports from Laredo, Tex.

“So far this year, at least 42,000 migrants have been sent back to Mexico under the MPP program, and a growing number have opted to return to Central America instead of waiting. The acting Homeland Security officials who visited the Laredo courts Tuesday defended them as a lawful and appropriate response to a border crisis that has pushed illegal crossings this year to their highest levels in more than a decade.”

— The Trump administration also wants to increase fees nine-fold for immigrants appealing their deportations, making the process unaffordable for many. In a draft Department of Justice regulation obtained by BuzzFeed News, officials propose that immigrants pay $975 to request an appeal of an immigration judge’s ruling and $895 to request a case be reopened or reconsidered with the Board of Immigration Appeals. “Currently, the fee to apply for each of these requests is $110,” BuzzFeed notes. “Experts believe, if enacted, the increases will impact certain immigrants’ very ability to obtain legal status and protections.” The proposed regulations will require a 60-day comment period before they can go into effect.

— The White House yesterday quietly fired John Mitnick, the general counsel for the Department of Homeland Security. Personnel drive policy. The general counsel is a key job at DHS because so many lawsuits against Trump’s immigration policies are pending.

“The White House this year has turned [DHS]— which oversees securing the country’s borders, disaster relief efforts and addressing domestic terrorism and cybersecurity threats — into a revolving door of officials, creating a void of permanent leadership,” the New York Times reports. “Mr. Mitnick’s ouster was prompted by the White House general counsel’s office as opposed to Stephen Miller, who has been a main force behind previous homeland security firings, an administration official said. But two other people briefed on the events disputed this account, saying that the counsel’s office had tried to keep Mr. Mitnick where he was.”

— On health care, conservatives have been talking about block-granting Medicaid since Ronald Reagan’s administration. It looks like it’s about to start happening. Tennessee became the first state to seize on Trump’s calls to fundamentally rethink the Great Society entitlement program, a move that would rupture the federal government’s half-century-old compact with states for safety-net insurance for the poor.

“Tennessee is setting up the nation’s first test case of how far the Trump administration is willing to go to allow a state the ‘flexibility’ that has become a watchword of the administration’s health-care policies,” Amy Goldstein reports. “If TennCare, as that state calls its Medicaid program, wins federal approval for its plan, it could embolden other Republican-led states to follow suit. It also almost certainly would ignite litigation over the legality of such a profound change to the country’s largest public insurance program without approval by Congress. …

“Its draft proposal would affect more than 1 million of the 1.4 million state residents on TennCare, according to the state’s Medicaid director. … National patient-advocacy organizations already have been protesting. A dozen groups wrote to the governor in late April that, for sick and vulnerable patients, changing to a block grant ‘jeopardizes their access to treatment and, in turn, their health.’ … TennCare has an important role in a state with large pockets of poor residents. Half of Tennessee children depend on the program. …

“Medicaid block grants were part of unsuccessful Republican legislation two years ago that would have dismantled major parts of the Affordable Care Act … Internal GOP disagreements over the idea were a significant reason those bills failed. Since then, President Trump has called for Medicaid block grants in his budgets, though Congress has ignored the idea. Seema Verma, administrator of the Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS), has urged states to move toward block grants, although guidance she has written for states has been under review for months at the White House’s Office of Management and Budget.”

— The Trump administration’s moves to weaken the ACA have taken hold, and companies are cashing in. BloombergBusinessweek has a deep dive on how health insurance plans that don’t cover the bills are flooding the market because of the president’s efforts to undermine Obamacare:

“David Diaz woke up his wife, Marisia, and told her he didn’t feel right. David had had a massive heart attack. … The double-bypass operation was successful, and two weeks later he was discharged. On her way out, Marisia gave the billing clerk David’s health insurance card. It looked like any other, listing a copay of $30 for doctor visits and $50 for ‘wellness.’ She’d bought the plan a year earlier from a company called Health Insurance Innovations Inc., with the understanding that it would be comprehensive. She hadn’t noticed a phrase near the top of the card, though: ‘Short-Term Medical Insurance.’ … Six months after David’s surgery, the Diaz family got a particularly big surprise bill —- an error, Marisia thought when she saw the invoice. But when she called her insurer, she was told she’d have to pay the full amount: $244,447.91. …

“The Diazes’ plan was nothing like the ones consumers have come to expect under the 2010 [law], which bars insurers from capping coverage, canceling it retroactively, or turning away people with preexisting conditions. But the law includes an exemption for short-term plans that serve as a stopgap for people between jobs. The Trump administration … has widened that loophole by stretching the definition of ‘short-term’ from three months to a year, with the option of renewing for as long as three years. Fewer than 100,000 people had such plans at the end of last year, according to state insurance regulators, but the Trump administration says that number will jump by 600,000 in 2019 as a result of the changes. Some brokers are taking advantage, selling plans so skimpy that they offer no meaningful coverage.”

— The vaping industry, which has cultivated close ties to Trump and congressional Republicans, was caught off guard by Trump’s announcement that he will ban almost all flavored vaping products. “Now some companies are going into crisis mode to try to protect against a ban that would probably put small operators out of business and result in million-dollar losses for the giants,” Laurie McGinley, Neena Satija, Josh Dawsey and Yasmeen Abutaleb report. “Some companies have harnessed staffers and lobbyists with ties to the White House and Capitol Hill to gather information about the still-unfinished policy and figure out how they might navigate a path forward … Ironically, the company accused of igniting the underage vaping epidemic a few years ago [Juul] might benefit from the ban over the long term because the prohibition will be even harder on smaller competitors, some experts say. Tobacco giant Altria owns about a 35 percent stake in Juul. Smaller players, such as the Vapor Technology Association, say many of its members could not survive such a ban and vow a fight. The group plans to send hundreds of vaping advocates to swarm Capitol Hill on Wednesday to express their ire.”

— In related new, a California man died of a suspected vaping-related illness, at least the seventh reported death associated with the use of vapes or e-cigarettes. Kayla Epstein and Lena H. Sun report: “The unnamed Tulare County man died of ‘complications related to the use of e-cigarettes,’ according to the county Health and Human Services Agency. The 40-year-old had been in the hospital for ‘several weeks’ before his death, said department spokeswoman Jan Winslow. He had a history of vaping, though Winslow said officials were still investigating what products he used. Though his death certificate would state he died due to vaping, Winslow said the man also had ‘some complicating illnesses’ that she could not disclose…”

The president’s policies are having dramatic, even irreparable, impacts on people’s lives.

— Read on www.washingtonpost.com/news/powerpost/paloma/daily-202/2019/09/18/daily-202-ignore-the-circus-look-at-what-trump-is-doing-to-the-environment-immigrants-and-health-care/5d81aa3688e0fa7bb93a8bfb/


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