North Dakota would spend 400% more on Medicaid Expansion under GOP Plan According to Republican U.S. Senator

U.S. Senator Bill Cassidy (R-Louisiana)

Last week I asked if North Dakota was in a position to pay more for Medicaid Expansion. Under the Republican repeal and replacement of Obamacare – which was enthusiastically supported by Rep. Kevin Cramer – that is exactly what would be expected of our state. A new projection by Republican U.S. Senator Bill Cassidy states North Dakota could expect to pay 400% more for the Medicaid Expansion population.

The state’s dismal budget situation makes that transition more difficult. The question is, will the Republican Legislature be willing to pick up a 400% increase in state spending for the Medicaid Expansion population, or would they simply drop that coverage and potentially leave those covered in limbo. In addition, it is not just the coverage of individual’s health care, Medicaid Expansion has been a life line for rural hospitals. It wasn’t just consumer advocates pressing the Legislature to expand Medicaid under Obamacare; it was the hospitals and the Greater North Dakota Chamber of Commerce. The expansion has been good for North Dakota business. With all that said, I’m still not optimistic because of the unsustainable budget the Republicans have left after this session.

Data: Government Accountability Office data analyzed by Sen. Bill Cassidy’s office; Table: Andrew Witherspoon / Axios

Some people are holding onto hope because the Senate needs to work on the rushed House version Kevin Cramer helped narrowly pass. Don’t get too optimistic when it comes salvaging Medicaid Expansion. Yesterday it was reported the Senate Republicans are focused on killing Medicaid Expansion. The effort is spearheaded by South Dakota U.S. Senator John Thune who said, “At some point you’re gonna get back to the original [reimbursement rate], it’s just a question of how quickly that happens.” What Thune is saying is instead of North Dakota receiving 90% of Medicaid Expansion’s expense coming from the Federal government, the reimbursement would go to the same as traditional Medicaid. Currently, that reimbursement is 50-50. The Republican debate in Congress right now isn’t whether to keep Medicaid Expansion; it is when will it be phased out.

North Dakota is not in a budget situation to pick up the costs unless a dramatic uptick in our economy occurs. Even then, it would take a little more to cover this expense to help our neighbors and rural hospitals. Political courage being one. If this burden shifts to the state, I’m curious if the North Dakota Chamber of Commerce, the Hospital Association, AARP, and the other various interests groups will rally behind the cause again.

Congressman Cramer Demonstrates the need for an Independent Investigation Removed from Partisan Politics

It is past time to remove partisan politics from investigations involving Russia and last year’s election. We’ve called on that for months on our Facebook page. The questionable timing of FBI Director James Comey’s firing now demands it. The unexpected removal has seen push back of all kinds. Some demanding truth. Others more partisan in nature. To me, the most troubling push back has been partisan.

Republicans have been delighted to point out Democrats have flipped their thoughts when it comes to Comey. Some of that criticism is justified, but shouldn’t be painted with as broad a brush. Often that criticism has simply dismissed the current role the FBI had in an ongoing investigation. Here is the thing, it isn’t just Democrats who have flipped on Comey. Republicans have changed their stance also. Case in point, here is how Congressman Kevin Cramer characterized the FBI Director last November. In an interview, Cramer told Chris Berg on 630 POV:

…Mr. Comey, as we’ve heard all along is a man of great integrity. – Congressman Kevin Cramer (Nov. 1st, 2016)

Now, the “man of great integrity” was fired and Congressman Cramer has cheered the move by President Trump. Cramer went on to say in that interview, “…the FBI needs to continue its investigation. The House committee oversight needs to launch an investigation and start hearings. I would suspect the judiciary committee. But if the oversight committee would take it on and I expect they would, that could go on with an FBI investigation and Justice Department investigation as well. The biggest thing we’ve to do is exercise our oversight of the committee and other agencies, including DOJ, because they’ve proven to be a very partisan agency.

The difference is it was Hillary Clinton, not Donald Trump; Loretta Lynch, not Jeff Sessions; an email server, not election interference he was talking about. Now, because the subject of the investigation is Donald Trump and what role, if any, Russia may have played in last year’s election, Cramer finds calls for continued investigation removed from a “partisan agency” as “laughable in a pathetic way.”

Therein lies why we need an independent investigation removed from partisan politics. Congress is full of people like Kevin Cramer whose position tumbles in the winds of political change. There are people in both political parties that participate in this despicable shift in position for partisan purposes. The American people deserve better than that. They deserve to find the truth.

This investigation is about finding exactly how a foreign power may have interjected itself in our democratic process. It is about finding out who, if anyone, played a role. It is about preserving the integrity of our domestic systems and democracy. It is bigger than Republicans and Democrats. Why be afraid of an independent commission? Why dismiss it as “laughable” or a conspiracy as Cramer has done? If there is nothing, then let the evidence presented in a credible, independent, investigation removed from politics, prove it.

Congressman Kevin Cramer Voted to make Insurance more Expensive for 8 Million Veterans

With his vote for Trumpcare, hereon known as CramerCare, Congressman Kevin Cramer voted to make healthcare more expensive for millions of veterans in America. One of the provisions in CramerCare was to prohibit veterans who are eligible for Veterans Affairs (VA) health care from receiving tax credits to help them afford insurance in the private market. The tax credits were established under Obamacare. Since this provision to eliminate the tax credit was included in the original version of CramerCare, the CBO score in March estimated it would impact approximately eight million American veterans.

READ: Congressman Cramer Votes for Rushed, Unknown, GOP Healthcare Plan

Not all veterans who are eligible for VA care enroll for its services. One of the many reasons a veteran may not choose to enroll in VA services is because they live in a rural state (think North Dakota) and would need to travel a long distance to receive care. In addition, others simply want to rely on the service from their local doctor. Removal of the tax credit will make healthcare more expensive for veterans and potentially force them into VA services. Unfortunately, VA case loads have been greatly lagging as President Trump’s hiring freeze through Executive Order prohibited them from hiring new employees.

North Dakota is home to over 56,000 veterans according to the North Dakota Department of Veterans AffairsCramer has previously used their imagery for campaign purposes. You may recall in 2014 when Cramer unethically used the Veterans Cemetery in North Dakota for a campaign ad in his race against George Sinner. The ad used veterans’ headstones as if they were props and threatened funding for the cemetery. Cramer later took down the ad from TV after increased pressure but would not apologize for his distasteful act. Yet, the internet never forgets. Here is the 2014 Cramer ad.

Cramer used veterans for political campaign purposes similar to the way he has used political talking points against Obamacare to win elections. Unfortunately after winning, he has decided his campaign against Obamacare was more important than his campaign for veterans. In his rush to repeal and replace Obamacare, he knowingly made it more difficult for millions of American veterans to afford access to healthcare outside of the VA he claims to despise. After his vote, Cramer grabbed a sixer, jumped on a bus, and headed over to the White House to celebrate this move in the Rose Garden. Our veterans aren’t to be used as props in a campaign ad and they sure as hell should be treated better than what CramerCare would do to their healthcare.

READ: The Hunt for Obamacare’s “Secret” Replacement and Congressman Kevin Cramer’s Role

Congressman Cramer Votes for Rushed, Unknown, GOP Healthcare Plan

North Dakota’s lone Congressman Kevin Cramer voted for the rushed, unknown, non-analyzed Republican plan to replace Obamacare today. The bill had zero committee hearings and no scoring from the non-partisan Congressional Budget Office (CBO). The public couldn’t even see the text of the bill the day before 217 Congressional Republicans cheered its narrow passage.

I’m not surprised by Congressman Cramer’s vote. After all, Cramer had to vote for something, or else it would have been proven that his campaign talk on replacing Obamacare was a complete and utter fraud. He simply needed to live up to his political rhetoric for the last six years following his symbolic votes to repeal the plan. Therein lies the problem in our politics today. It is full of people like Kevin Cramer who rush to uphold their political party’s image no matter the cost to the American people. Those costs on this particular item could be life or death for some.

READ: The Hunt for Obamacare’s “Secret” Replacement and Congressman Kevin Cramer’s Role

We don’t know everything about this bill. For example, we don’t know exactly how many Americans Cramer voted to leave uninsured because of last minute deal making. That will be revealed over the next few days and weeks when the CBO scores the bill already passed. Preliminary reviews show what is for certain is if you have something now considered as a preexisting condition your costs will be allowed to go up. Or, if you are a senior citizen, your costs will be allowed to go up. Or, if you’re a woman, your costs will be allowed to go up.

Cramer’s vote shows his ego as an elected official is matched only by his callousness toward women, older Americans, poor North Dakotans, and children with disabilities. It is not that he didn’t want to wait to vote on the bill until after he saw the detailed impacts his vote would have. It is that he simply didn’t care.

READ: Healthcare Costs Versus Access is Front and Center Again with GOP Plan

Federal Deal May Have Funds to Reimburse North Dakota for DAPL Costs

On Sunday night, Congress reached a bipartisan deal to fund the federal government through the end of its fiscal year which ends September 30th. Included in the compromise is approximately $15 million for the U.S. Department of Justice’s Emergency Federal Law Enforcement Assistance Program. This program could provide federal funds to reimburse state and local law enforcement for the costs associated with the Dakota Access Pipeline protests.

This program has been short of funding for the past few years which has limited its reach. The compromise included this funding thanks in part to the push from U.S. Senator Heidi Heitkamp. Heitkamp has been pressing both this Congress and the last Congress to give the program a boost emphasizing the need for federal aid to cover the millions of dollars spent by state and local law enforcement during the DAPL protest.

During the protest and immediately following, we heard locally elected officials insisting the federal government should help cover the costs. In September of 2016, former Governor Dalrymple issued formal requests seeking federal aid. Those elected officials, including Governor Dalrymple, were right to make these requests. Seven months later, the federal money may finally be available.

I emphasize “may provide” because the work is not done. Senator Heitkamp has successfully convinced her colleagues of the funding’s importance to our state. Now, it is up to the State of North Dakota under Governor Burgum to submit an application for the funds. There is no guarantee we’ll receive a portion of the $15 million which is where Heitkamp’s continued efforts will be needed once the state applies. Truthfully, it is tough for anyone to argue the merits of our case. I anticipate we will get a share of the money.

This is a good development to start the week. Persistence seems to have paid off to this point. Obviously, there is more to be done if we wish to be fully reimbursed, but this potential is welcomed.

U.S. Senator Heitkamp Earns 60% Approval of North Dakotans According to Poll

A recent poll released from Morning Consult indicated U.S. Senator Heidi Heitkamp has earned approval from 60% of North Dakota voters. The results place Heitkamp in the top seventeen regarding favorability of the nation’s Senators according to their constituents. North Dakota’s U.S. Senator John Hoeven earned 65% from North Dakota voters, placing him at number ten.

I can’t say I’m surprised by the results. Though I’ve grown more frustrated with Hoeven as of late, I’ve voted for him in the past, and still like him even when I wish he’d show more independence in DC. I’ve also made it abundantly clear my support for Heitkamp over the years. The results solidify the concept that North Dakotans approve of elected officials who are willing to work together, as these two often do, to get things done. That doesn’t necessarily mean voters need to agree with the outcome all of the time, but I believe we have an inherent respect for those willing to roll up their sleeves, get to work, and not just practice simple political posturing.

As you know, Heitkamp is up for reelection in 2018 which is why we’ll focus on her. Though a formal announcement of her intent has not been delivered, all signs point to her running again. Earlier this month, Politico broke that Heitkamp had raised $1.6 million in the first quarter. She’s also been traveling the state visiting about legislative priorities which means there is no sign of slowing down.

Heitkamp has mastered the moderate, independent, thinking I believe a majority of North Dakotans do adhere and admire. At least 60% of them according to this poll. She has shown the ability to earn support and awards from the U.S. Chamber of Commerce while also maintaining around a 90% satisfaction from the nation’s labor organizations. Heitkamp has also proven she is willing to break with the rank and file of her national party when their platform and motives don’t line up with North Dakota values. I’ve written about this rural Democrat dilemma with the DNC before.

As you’ve likely heard her independent mindset has caused some frustration to those in the Democratic Party both nationally and on the left here locally. It is important for them to remember, once the election is over you represent a constituency, not just a party. To me, that is refreshing to see during this time. Strong fundraising and high approval ratings in our state are a good start for Heitkamp in a race that will be high profile. The gears are greased, now she just needs to put it in drive.

President Trump’s Budget is Further Proof Democrats Need to Refocus on Rural America

The Executive Budget proposal released from President Trump demonstrates why Democrats need to refocus on the working class and rural America. Multiple analyses have shown the negative impacts of Trump’s proposal would disproportionately harm rural Americans, low-income workers, and senior citizens. Some of them are the very same individuals who overwhelmingly voted for Trump and have shifted more Republican in recent years.

Following the 2016 election and my reelection defeat, I wrote an open letter to the Democratic National Committee from a rural Democrat. To boil it down, I said national Democrats needed to begin talking with us in rural America and not just about us. That would help change the perception of the party being that of coastal elites. We gained some traction and attention from Democrats across the country mostly those in rural, red states. Sally Boynton Brown was a candidate to chair the DNC and joined us for a discussion about prioritizing rural areas. Then it ended.

Unfortunately, I’ve seen the focus of the party immediately shift to simply resisting Trump. Don’t get me wrong; I believe we need to resist his harmful proposals Congressional Republicans are all too eager to push through. But resistance can’t be all; we need to promote our policy alternatives. What is our solution for workers who have felt forgotten over the years? How do we prove that our party has answers that support rural economic development? Demonstrate to farmers you won’t push erroneous rules that create barriers to their operations. Remind senior citizens you’ve stood by them and their healthcare since the creation of Social Security and Medicare and you’re now determined to alleviate the cost.

Until recent years, agriculture was the powerhouse in the North Dakota economy. Under the Trump budget, The USDA receives a 21% cut which is the third largest reduction to a department in his proposal. This large cut is coupled with harming trade deals to our agricultural industry. As our economy started to shift toward energy, our airports picked up as workers from all over the country came here to work. Rural airports saw gains but needed help. Under Trump’s budget, the Essential Air Service is eliminated. How will that impact Devils Lake or Jamestown? What about the senior citizens who rely on rural transportation to go to their rural hospital that is able to stay open because of Medicaid? Both of which take a hit under the President and Congressional Republican’s initiatives. Public schools, which are sometimes the largest employer in our small towns are diminished in Trump’s proposal to promote private schools usually located in the more populated cities.

This budget houses the depletion of rural America. Democrats must counter it.

It is not just President Trump who believes tax cuts for millionaires, billionaires, and corporations should be subsidized by ripping the food out of low-income Americans’ mouths. North Dakota’s Congressman Kevin Cramer said, “If you are not willing to work, let him not eat.” to justify his vote to cut temporary food assistance for low-income families in 2013. Most of these individuals have worked or are transitioning to new employment. In the North Dakota legislature, Republicans have refused to transfer dollars toward Medicaid to help our seniors, people with disabilities, and nursing homes after it was cut by the Governor. This demonstrates it is not one person in the executive branch in Washington D.C.; it is a part of their platform. The Democrats need a clear plan to show their counterparts are wrong for the people who keep voting for them.

The status quo is not enough either. You cannot just be the party of “no” and replicate what the Republicans did under President Obama for eight years. As my Republican friends like to remind me, Democrats, in general, are not exactly popular right now. Defaulting to simply being anti-Trump won’t be enough. It will take work to regain the trust. Defending programs while finding efficiency is a start.

While they want to gut and dismantle, demonstrate you’re looking to innovate and protect that which is necessary for people to thrive and find the American Dream in all parts of the country.

So, where is the Democrats’ rural plan? How are you going to tell North Dakotans and people in other rural states your ideas are better suited for them? How will you convince them they’re wrong when they think Democrats just want to take money out of their paycheck to pay for something else? How will you prove you are the party of the working man and woman? I’ve said time, and again you cannot wait until 2018, this vision needs to form now. The path to regaining the trust and confidence in rural America is long overdue. The opportunity has presented itself if you’re up to the challenge.

Healthcare Cost Versus Access is Front and Center Again with GOP Plan

Following the awaited nonpartisan Congressional Budget Office (CBO) assessment of the Republican healthcare plan, Speaker Paul Ryan was eager to show his excitement. Not long after, Rep. Kevin Cramer shared Ryan’s enthusiasm though he has yet to make a statement of his own. Apparently, it was easy for them to get passed the sticker shock of 14 million more Americans losing their insurance next year and 24 million more Americans losing their coverage within the next ten years because some premiums will dip down. Not all of them.

According to the same CBO report they hold up with pride, the reason some premiums will drop in 2020 is because older Americans on low incomes won’t be able to afford their health insurance anymore. Thus the older, often more ill, Americans that tend to drive up the cost of care will no longer be a burden on the market. That’s right, the very population who utilizes healthcare more because they need it won’t be able to afford to participate.

Estimates say senior citizens who make under $30,000 a year will spend almost half of their income on health insurance under the GOP plan. It isn’t tough to imagine the negative impact this will have on their checkbook. This is where Medicaid would normally come in handy as a safety net for low-income families who have depleted their assets. Unfortunately, under this same GOP plan, Medicaid would be devastated. To put it another way, these older Americans with little income will not be able to afford their own insurance, and depending on how their state handles Medicaid with the dramatic reduction of federal funds there won’t be a safety net for them either. This example is why when people say these healthcare policy debates are a matter of life and death it isn’t just hyperbole.

Of course, Cramer was going to cling on to the spin of the report anyway he could. He already voted in favor of the bill to rush it out of his committee before even understanding the real impacts on his constituents. Hell, he and his colleague Rep. Burgess were the “architects” of the bill. Rest easy, the committee spent a grueling 27 hours on the bill. That is almost an hour per million people kicked off of health insurance in ten years under their plan according to White House estimates.

Don’t get me wrong, we need to find a way to contain healthcare costs. But it should be cost savings everyone enjoys. We cannot pursue that goal at the expense of kicking the old, sick, and poor out of access. This is exactly what the current GOP plan proposes to do. I’ve said previously, I don’t believe these politicians understand the plight of the working poor and in this case, low-income older Americans.  But after all, if they don’t force through some healthcare plan it would be a political “blood bath” in 2018 according to Ryan. Those 14 million Americans who will lose their coverage that same year are a mere inconvenience for their political hopes I suppose.

It has become clear yet again where the divide rests in the healthcare debate. The question appears to be, do you believe everyone should have access to life-saving care regardless of income or do you believe access should come as a luxury attained through earnings? The fact this is the premise of which our healthcare policy debate circles is incomprehensible to me, but it is the reality of our healthcare debate in America.

“If you ask someone to give up something, there will be resentment”

The current healthcare replacement plan Congressional Republicans are ramming through will hurt working and older Americans on low incomes. Though we don’t have solid numbers from the nonpartisan Congressional Budget Office because of the speed at which they’re moving the bill, other assessments show millions of Americans could lose their insurance. Here is the catch, those same Congressional Republicans are beginning to publicly show they don’t necessarily care.

Congressman Michael Burgess

In Saturday’s New York Times there was a telling moment of candor from Rep. Michael C. Burgess. When it comes to the political difficulty of pushing through a healthcare policy without fully understanding the impacts on the economy and people’s insurance coverage, Rep. Burgess had this to say:

If you ask someone to give up something, there will be resentment. If that claims my congressional career, so be it. It will have been worth it to effect this change. – Rep. Michael C. Burgess, R-Texas

The “something” Burgess is asking people to give up? Their health insurance. You know, the thing that is supposed to help people afford procedures and check-ups to stay healthy and alive. But here is the thing, under the current healthcare replacement plan, only the working poor and middle class appear to be the ones asked to give up something. Meanwhile, insurance CEOs and upper-income earners will receive large tax cuts. This isn’t just my opinion; it is from analysis by the nonpartisan Joint Committee on Taxation. In other words, some are being asked to give up nothing while others are being asked to potentially give up everything.

You may recall hearing of Rep. Burgess on ND xPlains before. That is because Rep. Cramer invited him to visit with healthcare stakeholders in North Dakota a couple of weeks ago. Rep, Burgess, is “one of the prime architects of the repeal and replace legislation.” Since that meeting, some of the organizations and associations in attendance have come out against the Burgess-Cramer healthcare plan. One of the reasons associations have joined opposition is because of what their plan does to Medicaid Expansion which especially helps the working poor.

Congressman Kevin Cramer

Rep. Cramer has shown his disdain for low-income people before this healthcare debate. In 2013, Cramer voted against food assistance for low-income families. When he was called out on it, he quoted a Bible verse: “For even when we are with you, we would give you this command: If you are not willing to work, let him not eat.” This was the same year Cramer insisted he was keeping his paycheck during the 2013 Government shutdown because “he earned it.”

Apparently, the Congressman buys into the notion that low-income families are lazy and do not work, or are in their situation based solely on poor decision making. It is the same mentality Rep. Jason Chaffetz of Utah used when he suggested poor people need to choose between iPhones and insurance. I don’t buy into that. Is it the reason some individuals find themselves in the lower income bracket? Yes. But, I’ve seen too many families in my time in the Senate and my work in the non-profit sector who bust their ass, some even working more than one job, and still can’t afford much. We should not pull the rug from under those individuals. Sometimes the very reason families end up with little to no money is because they became sick and medical expenses took everything they had. This was especially true before Obamacare became law. Oh, the irony.

It is also important to remember Cramer has been on government provided health insurance likely since 1993, give or take a year or two. He was appointed to State Tourism Director under Governor Ed Schafer. He was then appointed to be the Economic Development Director, and eventually appointed to the Public Service Commission. The “Good Old Boys” network will always find you a cozy job in government with the best health insurance around if you play your cards right.

For those who aren’t politicians with the inside track to government health insurance, this bill being rushed through may make insurance unaffordable if you are the working poor or lower middle class. I write this to demonstrate that some of these elected officials don’t understand the plight of the working poor. And with the candid comments by Burgess over the weekend and Cramer in 2013, it appears they don’t care either.

The Saga of Congressman Cramer’s “White Pantsuit” Debacle Continues

The saga of Congressman Kevin Cramer’s “white pantsuit” debacle just won’t go away. Friday, Cramer again doubled down on his original comments in a Politico interview. Over the weekend, his apologists and political cheerleaders insisted nobody cared about his remarks. Today, his wife Kris Cramer, who is also a paid staff member (see line 5), made even more public statements defending his criticism of Democratic women’s outfits during President Trump’s speech to a joint session of Congress. Apologists like to complain about Democrats pointing out Cramer’s demeaning comments. Has it escaped them it is their team that won’t stop talking about it?

Donald Trump & Kevin Cramer

Rep. Cramer preaches it wasn’t the women’s wardrobe he meant to reference as being ugly. Instead, he told Politico:

“What was ugly was their demonstration, their rudeness, their…all sit together and make vulgar — or make inappropriate hand gestures to the president of the United States while he’s delivering a message to the joint session of Congress.” – Rep. Kevin Cramer

I’m curious what Cramer thought about “vulgar” comments regarding “inappropriate hand gestures” made by then candidate Donald Trump when he boasted about sexually assaulting women? Why wasn’t that “rudeness” subject to talk radio comments followed by numerous media appearances to defend his position?

It is telling how nobody of important political stature has come to defend Cramer’s comments. Perhaps what he and his wife perceived as “ugly” behavior wasn’t all they’re making it out to be? Neither Senator Hoeven nor Senator Heitkamp wanted to touch this subject. The question becomes, why keep bringing it up? My guess is either to remain in President Trump’s view as an unquestioning loyalist after being passed over for a cabinet position, or to distract North Dakota voters from his secret activities when it comes to replacing Obamacare.