FIRST, A NOTE FOR INTERNATIONAL TGB READERS: The outpouring of protest at the Saturday Women's March in cities across the U.S. turned out to be much larger than anyone anticipated – certainly me.
And what surprised me most - in the best possible way - is that more millions of people in cities around the world joined the protests.
(Both images from The New York Times.)
Something big is happening, it is worldwide and we all need to nourish it, encourage it and keep it moving forward for all the reasons the marchers took to the streets on Saturday.
I mentioned this not long ago but it bears repeating: when necessary and reasonable, Time Goes By will be part of that resistance because our democracy, my democracy (I had no idea I was so patriotic until now) may depend upon it.
First and foremost, this blog has always been about “what it's really like to get old” as it says up there on the banner, and that will never change.
Time Goes By benefits greatly from readers and commenters who live in other countries and I have always been careful to write about ageing in a general sense, for all of us wherever we live.
But by necessity now, sometimes TGB will need to be America-centric to address both threats to all Americans, and to American elders specifically (as today) which other media too often overlook. I apologize to international readers but I don't see any other way for the foreseeable future.
There will still be plenty of good conversation about growing old – just please bear with me while I try to work out a balance.
On his first day in office, President Donald Trump signed an executive order (which has the force of law without Congressional approval) that will scale back parts of the Affordable Care Act.
Here is the new press secretary, Sean Spicer, making the announcement to reporters in the White House briefing room:
Well, that certainly was vague while being ominous too. Did you hear the reporters in the room asking, “What does that mean?” as Spicer left the room? Me too.
Before I get to that, let me remind you that there are a few important elements of the Affordable Care Act – Obamacare – that benefit elders specifically.
There is a full list of ACA Medicare benefits here.
In addition, Obamacare opened Medicaid to low-income adults with incomes up to 138 percent of the poverty line in states that opted to expand their Medicaid programs – so far, about 15 million people in 31 states and the District of Columbia have benefited.
What we do not know now is how this first presidential executive order (full text), signed on Friday, will affect Obamacare provisions for Medicare.
Politico calls the order “sweeping” and wrote that it
”...encourages federal agencies to dismantle large parts of Obamacare, possibly including the hugely unpopular mandate requiring most Americans to purchase insurance.
“While only Congress can repeal the law, the nine-paragraph order effectively tells the federal government to take as much leeway as possible to 'ease the burdens' on individuals, states and the health industry.”
The Washington Post offered some additional ideas of what the order may mean:
“'Potentially the biggest effect of this order could be widespread waivers from the individual mandate, which would likely create chaos in the individual insurance market,' said Larry Levitt, senior vice president at the Kaiser Family Foundation.
“In addition, he said, the order suggests that insurers may have new flexibility on the benefits they must provide.
“'This doesn’t grant any new powers to federal agencies, but it sends a clear signal that they should use whatever authority they have to scale back regulations and penalties. The Trump administration is looking to unwind the ACA, not necessarily waiting for Congress,' Levitt said.”
In a bit more detail, The New York Times suggests that the executive order should be seen more as a “mission statement” more than an “edict that can instantly change the law.”
”Mr. Trump has sent a strong signal that he intends to fight the health law...And the order, crucially, notes that agencies can act only 'to the maximum extent permitted by law.' (How the Trump administration interprets those permissions, of course, is yet untested.)
“The order spells out the various ways that a Trump administration might fight the parts of the health law until new legislation comes...Regulations can be changed, but, as the order notes, only through a legal process of 'notice and comment' that can take months or years.
“How much of the order is bluster and how much it signals a set of significant policy changes in the pipeline is unclear. The order was not specific and did not direct any particular actions.”
In other words, the order urges agencies of the federal government to try to destroy Obamacare by chipping away at provisions without actually have to use the word “repeal,” while giving them plenty of time to come up with a replacement.
There is no reason to believe that provisions for Medicare recipients won't be among the ones changed or removed. And there is nothing we can do about it. According to Wikipedia,
”...executive orders are subject to judicial review, and may be struck down if deemed by the courts to be unsupported by statute or the Constitution.”
Unlikely. We will need to use our resistance tools elsewhere.