Court ruling on ACA muddies the future of the health care law

The U.S. Court of Appeals for the Fifth Circuit in a 2-1 decision ruled the individual mandate of the Affordable Care Act (ACA) unconstitutional and instructed the lower court, which had previously held the ACA unconstitutional, to determine whether the remaining portions of the ACA can stand.

“APIAHF is extremely disappointed in the court’s decision that puts the health of millions of Americans at risk, said Juliet K. Choi, senior vice president for government & external relations of APIAHF. 

The Fifth Circuit Court of Appeals in New Orleans ruled that the ACA's individual mandate is unconstitutional, but stopped short of saying that the entire Obama-era law is invalid.

“The Fifth Circuit’s decision against the ACA could potentially disrupt our entire American health care system by leaving the decision to a sole judge who had already ruled against the ACA.," Choi said.

The Democratic attorneys general, led by California, who have intervened in the case shave already indicated that they will appeal the decision to the Supreme Court.

If the Supreme Court chooses to hear the case, Texas v. United States, right away, the ACA's fate could become the centerpiece of the 2020 presidential election. 

If the SCOTUS justices wait until the lower court rules, the future of Obamacare would remain in limbo for years.

The opinion from the U.S. Court of Appeals for the Fifth Circuit is an embarrassment, both to the Republican-appointed judges who put their names to it and to the federal judiciary as a whole, reports The Atlantic. (The third judge on the panel, appointed by Jimmy Carter, dissented vehemently.)

Since the implementation of the ACA, sometimes referred to as Obamacare, the coverage disparity between whites and Asian Americans and Pacific Islanders had virtually disappeared.

Anticipating the matter will head to the U.S. Supreme Court, Choi said, "It is unlikely the Court would hear the appeal before the 2020 Elections, which underscores the need to elect leaders that will ensure our health care is protected.”

APIA Health Forum: Trump tax bil will have a negative impact on health care.

SCREEN CAPTURE / NBC

Around 2:30 a.m., Dec. 2, the U.S. Senate approved the controversial tax reform bill.

The U.S. Senate passed a horrendous tax reform bill that will change America for decades if signed by Donald Trump. It was written up in secret, amended at the last minute and voted upon in the early morning hours of Saturday, Dec. 2.

Although called a tax bill, its impact on health care will impact Americans for decades by eliminated the individual mandate of the Affordable Care Act, sometmes referred to as Obamacare. 

RELATED: Asian American senators decry the tax vote

On Saturday afternoon, the Asian & Pacific Islander American Health Forum issued the following press release:

"Today, the Asian & Pacific Islander American Health Forum (APIAHF) released a statement following the Senate's passage of tax legislation, including an amendment to repeal the individual mandate of the Affordable Care Act (ACA). Due to the repeal, an estimated 13 million people will lose their health insurance.

"'It is shameful that in the midst of open enrollment as millions of Americans head to the Affordable Care Act's marketplace to get coverage they can rely on, the Senate has voted to partially dismantle that same coverage in order to pass tax cuts that benefit the wealthiest in our nation, while adding an estimated 1 trillion dollars to our deficit,' said Kathy Ko Chin, APIAHF president and CEO. 

"This is dangerous for communities, such as Asian Americans, Native Hawaiians, and Pacific Islanders, who disproportionately face disparities and barriers in accessing health insurance and utilizing health care. 
"The increase to the deficit will also lead to automatic future spending cuts to certain programs like Medicare and the Prevention and Public Health Fund. Health care must be affordable and available for all. We will work alongside other health advocates in calling on Congress to listen to their constituents and heed the call to protect our care.

"Since the ACA became law, the individual mandate has helped to reduce the uninsured rates for Asian Americans, Native Hawaiians and Pacific Islanders (AA and NHPI) by half. The Congressional Budget Office estimated repealing the mandate will lead to 13 million people losing their health insurance and premiums will increase by 10 percent. 

"Many AAs and NHPIs disproportionately experience a range of chronic conditions that, prior to the ACA, were considered pre-existing conditions that required routine access to preventive care and treatment. Before the ACA, many groups, such as Korean, Indonesian and Micronesian Americans had uninsured rates above 20 percent.

"The House plans to vote on the tax bill (this week) and must work with the Senate to reconcile differences. If passed, the bill will then move to President Trump for signature, setting the stage for further attacks on health care programs in 2018.

"APIAHF urges the House to reject the Senate Bill and to stand up for the constituencies they represent."

The House in a 222-192 vote on Monday (Dec. 3) voted to approve a motion to go to conference with the Senate on tax legislation.

The people responsible for Americans' health issued a joint statement this month, the American Psychiatric Association, American College of Physicians, American Congress of Obstetricians and Gynecologists, and American Academy of Pediatrics, among others, voiced strong opposition to the GOP's tax proposal.

The American Hospital Association approved of some portions of the bill that included the tax-exemption for nonprofit hospitals, but was also dismayed at the elimination of the individual mandate.

"We are also disappointed that the tax legislation passed with a provision that would eliminate the individual mandate, which would result in the loss of health insurance coverage for millions of Americans," said an AHA statement. "The goal of the ACA was to extend coverage and, as a result, millions have benefitted from access to needed care. We must protect that access to care for those who need it and ensure the most vulnerable patients are not left behind."

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Heroic senators save healthcare for millions: Mazie Hirono, Lisa Murkowski, Susan Collins & John McCain

This week, the U.S. Senate's Republicans made several attempts to do away or weaken the Affordable Care Act.

UPDATED: July 29, added video of Sen. Mazie Hirono's speech.)

THERE WERE many heroes in the U.S. Senate's dramatic vote on health care that took place in the wee hours of Friday (July 28).

The 48 Democrats needed three GOP defections to keep the Republicans from repealing or weakening President Obama's Affordable Care Act.

The amendment fell, 51-49, to the consternation of the GOP majority and Trump administration. If it had passed up to 22 million people would lose their health insurance.

Sen. Lisa Murkowski stood firm against the public threats from the Trump administration that would withhold funds from Alaska initiatives. Interior Secretary Ryan Zinke made it clear that her vote might affect the state's energy and mining industries

Sen. Susan Collins remained consistent in her opposition to Trumpcare (which basically is no-care) because of the negative impact it would have on hundreds of thousands of her Maine constituents and the defunding of Planned Parenthood.

In the most dramatic moment, Sen. John McCain, with a scar above his left eye from an operation just a few days ago, strode down the aisle and gave a thumbs down to the so-called "skinny repeal" of Obamacare, which would have kept The Affordable Care Act but do away with some objectionable portions of it. 

McCain cast the pivotal vote because up to the time he voted, it was not clear which way he would go. Tuesday he gave a strong emotional appeal for the Senate to return to "regular order" and let the senators come up a health plan through committees, public hearings and compromise. However his vote Wednesday to open debate on the Republican proposal puzzled pundits and Congress watchers, who began thinking his vote was up for grabs.  

RELATED: Profiles in Disappointment - Sen. John McCain

Hawaii's Sen. Mazie Hirono, like McCain, also left her sickbed in Honolulu to recover from cancer surgery in order to participate in this vote. Hirono said that both she and McCain are acutely aware of the advantages they have for the outstanding medical care that they received because they could afford it.

Standing before the Senate, minutes before the critical vote on the "skinny repeal," Hirono gave an emotional appeal shaming her Republican colleagues.

“Where is your compassion? Where is the care that you showed me when I was diagnosed with my illness?” she asked. “I find it hard to believe that we can sit here and vote on a bill that is going to hurt millions and millions of people in our country. We are better than that.”

She fought back tears as she recalled her family's immigrant journey from Japan to Hawaii. “And now, here I am a United States senator,” Hirono said. “I am fighting kidney cancer, and I’m just so grateful that I had health insurance so that I could concentrate on the care that I needed rather than how the heck I was going to afford the care that would probably save my life.”

It should also be mentioned the American people who for six months kept the pressure on the politicians by writing letters, calling their offices, attending their town halls to urge them to fix Obamacare or how the ACA helped them or their family. Democracy came alive.

After seven years, the Repubicans have failed to come up with a responsible option to Obamacare. The GOP might actually have to talk to Democrats in order to improve the ACA flaws that even President Obama says is needed.

Senators wrestle with health insurance bills.

Senators Dean Heller and Susan Collins confer on the health insurancee vote.

SENATE LEADER Mitch McConnell is throwing stuff at the wall to see what sticks. The latest attempt to undo the Affordable Care Act went down in flames Wednesday (July 26).

The three AAPI women senators voted against the Republican proposals.

For the second time in less than 24 hours, the U.S. Senate took another vote on providing healthcare for Americans. This time, it was an outright repeal of the ACA by taking away the funding. And what would replace it? Nothing. That would leave ACA participants - over 22 million - without health insurance.

The measure, known as as the Obamacare Repeal Reconciliation Act, failed 45-55, with seven Republican senators voting against it, along with all Democrats and independents in the upper chamber. 

It should be noted that Sen. John McCain, who has received criticism for voting along party lines, opposed the proposal. He was joined by GOP Sens. Lamar Alexander (Tenn.), Susan Collins (Maine), Dean Heller (Nev.), Shelley Moore Capito (W. Va.), Lisa Murkowski (Alaska) and Rob Portman (Ohio) opposed the legislation.

Heller, who drew intense criticism from his constituents when he voted to open debate on the issue, proposed an amendment to request protection of the Affordable Care Act's Medicaid expansion was defeated Wednesday evening by a 90-10 vote. Over 138,000 Nevadans would lose their health insurance if ACA is somehow watered down or eliminated.

The language in Heller's amendment asked the conference committee not to consider cutting Medicaid or shifting costs to states, but would not have imposed any binding requirements on the committee.

On Tuesday evening, the Senate voted against the Better Care Reconciliation Act, 43-57, McConnel's replacement for the ACA with nine Republicans joining the Democrats.

On Thursday, McConnel will try again to give tax breaks to millionaires and billionaires by offering up the so-called "skinny repeal," which would do away with some aspects of the ACA such as the individual mandate and the rule that requires companies with more than 50 employees to provide health insurance. 

There are some in the Senate who believe this more modest reduction would have a better chance for passage. However, if Heller remains steadfast in his opposition against any Medicaid reduction, and he votes with moderates Murkowski and Collins, the three no votes would be enough to stop any efforts to weaken or do away with the ACA.  

“We are better than this as a country, and the American people deserve more from us as their representatives," said California's Sen. Kamala Harris. "This vote to consider a bill that kicks more than 20 million people off of their health care is utterly shameful, but we cannot throw up our hands when it is time to roll up our sleeves." 

Sen. Tammy Duckworth of Chicago urged people to continue calling their senators. "Now more than ever, the American people must keep speaking out and making their voices heard," she said. "And Senate Republicans must listen – to their constituents and to the most vulnerable among us like the members of the disability community who have been here day after day literally fighting for their lives. Then, I hope we can leave this partisan process behind and pursue the honest-to-goodness fixes to the Affordable Care Act that both parties can support to improve our nation’s healthcare system.”

"Any proposal Senate Republicans come up with will kick millions off of their health care and hurt the sickest, oldest and poorest in our communities," said Sen. Mazie Hirono, D- Hawaii.  She returned to the Senate floor to vote against the Republican proposals after she underwent surgery to remove a cancerous tumor last week.

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ATTN NEVADA RESIDENTS: Keep calling or emailing Sen. Heller to register your opposition against the Republican plans to eliminate or weaken the Affordable Care Act.
Email him at: https://www.heller.senate.gov/public/index.cfm/contact-form
Call him at his district offices: 702-388-6605 in Las Vegas; or 775-686-5770 in Reno; or Washington DC, 202-224-6244.

Profiles in Disapppointment - Sen. John McCain

The John McCain memorial in Hanoi

IN A RECENT TOUR of Hanoi, our tour bus cruised past a memorial commemorating McCain's imprisonment. The bus didn't stop, didn't even pause for photographs. By the time the guide announced it, we were way pass the monument to see the details. 

Sitting in the back seat of the bus, I was able to get a better look than others on the bus and managed to click a few shots of the memorial. 

I couldn't believe what I saw. The memorial was of a man being hung by his arms, head bowed. That was John McCain and the reason the senator can't raise his arms above his shoulders to this day. The torture he endured in his six years as a POW during the Vietnam War is unimaginable.

McCain's heroism and patriotism cannot be questioned. But Donald Trump ridiculed the hero during the 2016 presidential campaign. "I like people who were not captured," he said.

Sen. John McCain giving his speech Tuesday.

I have had so much respect for the man since he first ran for office. That's why I'm disappointed in the John McCain of 2017.

Senator McCain gave one of his best speeches today (July25) when he spoke in front of the Senate after the vote to open debate on the House's Trumpcare bill that would have 22 millioin people lose their health insurance.

Just days after an operation, Arizona's senator gave an emotional speech seemingly rebuking the GOP's procedure that created a health plan behind closed doors. “I. Will. Not. Vote. For. This. Bill. As it is today," he pronounced emphatically. "It's a shell of a bill right now. We all know that.”

A few hours later, he inexplicitly voted for the Republican-sponsored Better Care Reconciliation Act—the Trumpcare bill McCain said he would could not support. Fortunately, the Republicans lost that vote, 43-57, far short of the to votes needed to pass. (It would be 50-50 and then Veep Pence would break the tie as he did in the vote to open debate.)

McCain has not hesitated to criticize Trump, especially in regards to the Russia connection. He has questioned Trump's knowledge on national security issues and foreign relations. McCain has even been the target of Trump's slings when Trump rediculed the former prisoner of war's service record.

But when it comes to a vote, as in the Obamacare repeal vote, McCain has consistently followed the party line, choosing party over country.

McCain's own state is one of 31 states that expanded Medicaid under the ACA, and Republican Gov. Doug Ducey is worried about tens of thousands losing their health insurance. His constituents would applaud him if McCain voted against any version of Trumpcare and instead helped the Democrats fix the flaws in the ACA.His vote Monday to repeal the current health care law even though there is no plan to replace it, was in stark contrast to the inspirational words that he uttered earlier in the day.

McCain blasted the way Republican leaders conjured up the healthcare proposal, “coming up with a proposal behind closed doors in consultation with the administration, then springing it on skeptical members, trying to convince them that it was better than nothing.

“I don’t think that’s going to work in the end, and it probably shouldn’t,” he said.

“I. Will. Not. Vote. For. This. Bill." proclaimed McCain. 

The senator will have a chance to redeem himself in the coming days when Trump and the GOP try to repeal Obamacare or make it so watered down it will be doomed to fail. Words - no matter how noble or eloquent -- ring hollow and mean absolutely nothing if they are not turned into action.

UPDATED: This date was updated to clarify the Senate vote that took place Tuesday night.

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Sen. Mazie Hirono speaks out against healthcare bill then undergoes surgery; vote delayed

SCREEN CAPTURE

In a meeting at the White House, it was probably no coincidence that Senators Susan Collins and Lisa Murkowski, both of whom expressed reservations about Trumpcare, were seated on either side of Donald Trump.

SEN. MAZIE HIRONO, D-Hawaii, had successful surgery on Tuesday to remove a rib lesion, the latest operation in her ongoing battle with stage-four kidney cancer.
The day before she underwent surgery, she spoke in the Senate chamber against the Trumpcare proposal being pitched by Senate leader Mitch McConnell as a replacement for Obamacare.

Anyone who has looked at the Republican Senate Healthcare plan knows that this is not a healthcare bill - it is a tax cut bill for the wealthiest Americans, said Hirono. “Trumpcare would be a disaster for the American people … healthcare is a right for everyone … we must fight against this mean, ugly bill.”

RELATED: Asian American senators blast GOP health plan

The bill would leave 22 million more Americans uninsured in 2026 than under President Barack Obama’s Affordable Care Act, said the nonpartisan Congressional Budget Office estimated Monday. In addition, it would take a large portion of the Medicaid funding and give it to wealthy individuals and corporations.

As Hirono stated, the wealthy will benefit the most from the Better Care Reconciliation Act. The top one percent of households (who will be making $875,000 or more) are in line for an average tax cut of more than $45,000, raising their after-tax incomes by 2 percent. And those in the top 0.1 percent (who will be making $5 million or more) would receive an average tax cut of nearly $250,000, boosting their after-tax incomes by 2.5 percent.

Hirono's surgery went well, according to her staff. The Hawaii senator said that if need be, she would leave her sick bed and return to the Senate to vote against the bill.

Fortunately, she won't have to rush back because today (June 27). Senate leaders postponed the vote targeted before the July 4th break which starts Friday for a week. More senators expressed concern after the CBO report was released. The GOP would need 50 votes for a tie and supposedly Vice President Pence would vote to break the tie. 

Trumpcare losing support among Republicans

Three GOP votes would have to switch in order to defeat the bill. At last count, there are up to 12 Republican senators who said they could not support the bill as it is currently written.

At least four radical right senators said they would not vote for bill because it didn't go far enough to dismantle the ACA. Those four would join the so-called moderate Republicans who don't support the bill because of its proposed cuts to Medicaid and Planned Parenthood. 

Sen. Dean Heller, R-Nev., the first moderate senator to oppose the legislation, has vowed to withhold support for the bill because of its cuts to Medicaid. “It’s going to be very difficult to get me to a yes,” Heller said Friday. “They have a lot of work to do.”

Sen. Susan Collins, R-Maine, announced Monday she will vote no on a procedural motion to advance the bill in its current form. She strongly objects to the defunding of Planne Parenthood and said the Medicaid cuts would harm her state, 1 of 5 Maine residents depend on Medicaid.

Sen. Lisa Murkowski, R-Alaska, said Monday she doesn’t “have enough information” to vote in favor of the legislation, but has not yet firmly said she opposes it. “This is big stuff, and so making sure that we get it right is something that I have said is an imperative,” she said. She also objected to the Planned Parenthood cuts. 

The delay in the vote can give McConnell time to pressure those senators to change their vote. Some right-wing PACs said they would target those Republican senators opposed to the bill. McConnell reportedly also has $200M slush fund to dispense to change some mnds.

It will also give the Democrats, who are strongly against the GOP's Better Reconciliation Act and criticized the secret meetings that excluded their input and crafted the bill, time to reassure those Republicans on the fence or who have already cited their objections to the bill to stay strong and vote their conscience. GOP senators will be under tremendous pressure to go vote along party lines instead of voting what's good for the country.

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Guide to protesting Trumpcare

Sen. Kamala Harris, D-Calif., in an opinion piece for the Lenny Letter blog outlined a guide to opposing the Senate BCRA and urged people to make their voices heard, "because this is not a drill," she said.

It was ordinary people writing and calling their representatives that prevented the House version from coming to a vote and they can do it again, said the Indian/American senator.

"This week, we have a chance to defeat it again. And every one of us needs to speak up and speak out.

"If your senator opposes the bill, thank them and ask them to continue doing everything possible to stop it. Reach out to friends in states with senators who are still on the fence. Maybe even have some tough conversations with friends or family members who oppose the bill about the actions they should take to make sure it gets defeated

"If your senator supports the bill or is undecided, explain how this bill will impact you or your loved ones. Tell your story. Tell them that if they vote for people to lose their health care, they should — and will — lose their jobs.

"Be persistent, be passionate, and be persuasive."

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House passes Trumpcare, a health care plan that nobody likes (except Republicans)

2 million Asian/Americans andPacific Islanders affected

Donald Trump invited the GOP congress members to the White House to celebrate after the health care vote.
Notice anything? There are no people of color.

THE U.S. House of Representatives today voted 217-213 to pass the American Health Care Act (AHCA), the Republican plan to repeal and replace the Affordable Care Act. After the vote, the GOP congress members had a beer party.

The reactions from AAPI political leaders came fast and were unanimous in their condemnation in the manner the vote was taken and the impact the AHCA would have have on their constitutents.

Initial estimates from the Congressional Budget Office (CBO) found that the proposed legislation will take away coverage from 24 million Americans over the next decade, including up to 2 million Asian Americans and Pacific Islanders (AAPIs). 

“I am incredibly saddened and outraged that Republicans ignored the expressed opposition from doctors, hospitals, patient advocates, health experts and even members of their own party to pass this heartless bill," said Rep. Judy Chu, D-Calif., who voted against the bill.  Chu is chair of the Congressional Asian Pacific American Caucus (CAPAC), made up of all the AAPI members of the House and Senate.

"It is unconscionable to me that they would charge ahead with – and then celebrate – a vote that they know will force millions off their insurance and raise prices for people with preexisting conditions." 

GOP leaders rushed the vote through the House without waiting for the Congressional Budget Office report on its potential cost, impact and efficacy.

"The haste to act and then immediately hop on a bus to the White House shows that they were more concerned with helping Trump keep a campaign promise than with actually improving healthcare," said Chu.

If the House version of Trumpcare is accepted by the Senate (which is unlikely), here are some of impacts:

• Kicks 7 million veterans off their insurance, 
• Shortens the life of Medicare, 
• Creates an "age tax" for people aged 50-64  by charging them 5 times more than young people,
• Eliminates coverage for 24 million Americans, including nearly 2 million Asian Americans and Pacific Islanders across the country. 
• Defunds Planned Parenthood for one year, and would once again allow being a raped or domestic violence victim to be a pre-existing condition,
• Creates a “women’s tax” that would permit insurance companies to charge women more than men for essential coverage like pregnancy. 
• Cuts $838 billion from Medicaid, endangering care for individuals with disabilities, low-income children, and seniors in nursing homes and long-term care facilities.  
• Rips away mental health and addiction services from those who need it most. 

Trumpcare does all this while giving the 400 richest families in America an annual tax break of $2.8 million.

The American Hospital Association, the American Medical Association representing physicians, and AARP, have all opposed the Republican replacement to Obamacare. Then, who's supporting it? The extreme right Congress members in the so-called Freedom Caucus, Wall Street and - of course - Big Insurance.

"We cannot play politics with people’s lives, and what happened today put political goals ahead of the lives of hardworking Americans, said Rep. Ami Bera, D-Calif., of two physicians in Congress. "The fact that this bill was rushed through with no budget analysis or public debate shows just how bad it is. This is a sad day for America’s patients, and for the public’s trust in Congress.”

Before serving in Congress, Dr. Bera practiced internal medicine, served as Sacramento County’s Chief Medical Officer, and taught at the UC Davis School of Medicine.

When the Republicans got enough votes to pass the AHCA, Democrats began singing "Nah, nah, nah, hey, hey, goodbye" saying that the GOP just lost the 2018 midterm elections by voting against Obamacare, the popular health care initiative introduced during the Obama presidency. Listen, below:

Here are some more reactions:

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Trumpcare thwarted; AAPI leaders credit resistance; Obamacare remains in place

Fox News

Donald Trump and Rep. Paul Ryan appear chagrined in the failure of the American Health Care Act.

TRUMPCARE, the American Health Care Act authored by Speaker of the House Paul Ryan and strongly supported by the Trump White House, was pulled from a House vote this afternoon (12:40 p.m., PST), according to CNN.

After a hastily called meeting between Donald Trump and Ryan, during which Ryan let the Chief Executive know he didn't have enough GOP support to pass the act, it was decided to pull the bill that would have repealed and replace Obamacare.

What killed the AHCA was not the Democrats, who are in the minority in the House, but the infighting in Trump's own party. Ryan and Trump could not negotiate the balancing act of appeasing the so-called Freedom Caucus, formerly the Tea Party, wanted to take away more of what they considered "entitlements" from Obamacare (such as mental health and maternity care); and as the entitlements were taken away, moderate Republicans rebelled because they couldn't support a bill that would take away health care from their constituents.

“If this bill comes to the House floor again, we will organize and defeat it," said Rep. Pramila Jayapal, D-Wash. "We know when we organize, we win. We cannot be complacent. This is just another fight in a series of battles. But today, we can say that we protected care for tens of millions of Americans across the country.”

RELATED:

• Fate of Trumpcare in limbo
• AAPI congress members vow to fight Trumpcare

The  Affordable Care Act  known as Obamacare, one of President Obama's prime accomplishments during his eight years in office, will remain in place providing healthcare for millions of Americans. 


While the Democrats celebrated, there was concern that the hard work of fixing the Affordable Care Act will likely be opposed by the White House and the GOP majority. According to his book The Art of the Deal, Trump's philosophy when he feels attacked, is to strike back 10 times harder. 

“I’ve been saying for the last year and a half that the best thing we can do politically speaking is let Obamacare explode,” said Trump at a press conference after the AHCA was pulled. Would he  place his personal need for revenge above doing what's necessary to make Obamacare work for millions of Americans?

Even President Obama acknowledged that his signature legislation would need some tinkering. "Just because a lot of the Republican criticism has proven to be false doesn't mean that there aren't legitimate concerns," said Obama in October 2016.

Millions of people are unhappy with their coverage under Obamacare, and in some states, newly regulated insurance markets have struggled ― with premiums rising for a few and insurers, stung by financial losses, pulling up stakes. And there are still a number of states - mostly those with GOP governors - where the ACA never was allowed to take root preferring to allow their own constituents remain uninsured.

"Now is the time for Democrats and Republicans to come together, because the job isn’t over until every American has affordable and accessible healthcare," said Rep. Ami Bera, D-Calif. "Real lives are at stake here and I’m ready to get to work." Bera is one of two medical doctors in the House of Representatives.

An energized citizenry

Spurred by a bad measure that would have repealed the ACA and leave 24 million Americans uninsured, voters were inspired by the anti-Trump movement by contacting their congressional representatives.

“Today, Congressional leadership did not bring the repeal bill for a vote. This is a testament to the power of collective community action around the nation, as the very people who would be impacted by Congress’ actions have spoken up loud and clear: protect our care,” said Kathy Ko Chin, president and CEO of the Asian & Pacific Islander American Health Forum.

Fate of Trumpcare in limbo after GOP infighting postpones vote

INSTAGRAM/JCAPAC

On the 7th anniversary of Obamacare, House and Senate members gathered outside the capitol Tuesday to show their support for the Affordable Care Act.

WITH THE WHITE HOUSE's foot on the pedal down to the floorboard, it looks like a vote on the GOP-sponsored American Health Care Act will occur sometime later today, the 7th anniversary of the Affordable Healthcare Act (ACA), also known as Obamacare.

UPDATE March 23, 12:30 p.m. PST - House vote has been postponed. It won't happen today. GOP House members to meet tonight to try and hammer out differences. Therefore, there's more time for you to contact your representative.

Despite Donald Trump's threat to "go after" members of the GOP who are thinking of voting "no" on the measure, and a lot of arm-twisting, many Republicans are still wavering between their loyalty to their party or to their country, between a complete rejection of the Affordable Care Act or simply a fix. 

RELATED: AAPI Congressmembers vow to fight Trumpcare

"Thanks to this law, more than 20 million Americans have gained the security and peace of mind of health insurance," said President Obama in a statement released this morning. "Thanks to this law, more than 90 percent of Americans are insured — the highest rate in our history. Thanks to this law, the days when women could be charged more than men and Americans with pre-existing conditions could be denied coverage altogether are relics of the past," Obama wrote. "America is stronger because of the Affordable Care Act."

For whatever reason, there is enough uncertainty whether or not there are enough votes to pass Trumpcare that the GOP leadership has delayed the vote that was supposed to have taken place this morning (March 23). The more the White House tries to appease the conservative Republicans, who want a complete repeal of Obamacare,  moderate GOPers who think the bill is becoming too extreme and harmful to their constituents, are switching their pearlier support of the Paul Ryan's Trumpcare.

The American Medical Association, the American Hospital Association, national nurses' organizations and AARP have opposed the Paul Ryan proposal saying it would be disastrous for patients and the American public - costs would go up and more people will be left without affordable health care.

RELATED: CBO says new version of Trumpcare is even worse than before

Also included in Trumpcare, for reasons that are difficult to justify: a tax break for the wealthy. Essentially, it doesn't promise health care for all, only "access" to health care.

Please forward this letter from Republican Jeff Jeans, who is alive today because of Obamacare, to your representatives, especially if your congressmember is one of those Republicans sitting on the fence.

Every vote counts and you can still be a factor in defeating Trumpcare.

*** Obamacare saved my life  Friend -- I was a lifelong Republican and worked on Ronald Reagan and George Bush's campaigns. My grandparents were even invited to Reagan's inauguration. I vehemently opposed Obamacare when it became law, as I recently shared during my question to Paul Ryan during a televised CNN Town Hall. But then Obamacare saved my life. I took a new job and moved my family across the country -- but due to a glitch, my employer was unable to offer health care coverage. I lost my voice and ignored it for quite some time, thinking it was an allergy. My voice never returned, and I was having difficulty breathing, so my wife made an appointment with the doctor. I was diagnosed with stage III, borderline stage IV vocal cord cancer, and I had no health insurance. We offered cash upfront to pay for my treatments but were denied over and over again. We had always assumed that if you had money that you could get treatment. We were wrong -- six weeks away from being dead wrong! Although I had cancer, Obamacare gave me access to an insurance card, and I began receiving life-saving treatments the day my insurance plan took effect. I would be dead if it weren't for Obamacare, the same law I had so loathed. People across the country have received life-saving care, thanks to Obamacare. But that isn't stopping the House from moving forward with a vote to repeal the law, tomorrow. We can't allow that to happen. Join thousands of Americans who support quality, affordable coverage for every American. Add your name now and we'll follow up with ways you can take action right now. Now it is my time to give back and work on behalf of the legislation that saved my life, helping others to avoid the same pitfalls I had fallen into. Health care should not change with every new administration, and we should be able to rely on steady, affordable care with guaranteed patient protections. Access to timely treatment, affordable medication, and regular doctor visits are essential for every American. Obamacare allows people to take responsibility for themselves, purchase insurance, and pay for their own care. Repealing it with no adequate and immediate replacement will destabilize the health care market and leave millions of my fellow cancers survivors at risk in the future. Constant worry about having affordable care is an added stress that no patient needs. After my experience gaining health care through the Affordable Care Act, I began a Facebook page called "Obamacare Saved My Life." It has given me the opportunity to meet thousands of others who are reliant on Obamacare for coverage -- and they are terrified about the future. My wife and I share that same anxiety, even though I've been cured of cancer and am one of the lucky ones. It would only take one incident of cancer, one heart attack, one stroke, one bad car wreck, or a bad fall to join the ranks of those labeled as "pre-existing." It only takes one test to show that you have high cholesterol or high blood pressure to be thrown into that group with us. Americans now know what better health care is, and we should all demand it -- for the well-being of our citizens and our economy -- for America. Anything less is simply not an option. If you agree, make your voice heard now: https://my.ofa.us/Obamacare-Works Thanks, Jeff Jeans

GOP ignores CBO; votes on Trumpcare nears

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ONE OF PRESIDENT OBAMA's mistakes was that he underestimated the animus the radical right had against him. He assumed that he could negotiate with the ultra-conservative members in Congress and they would move from their extreme position and meet him somewhere in the middle. 

The rest is history. Obama compromised so much he moved to the right on his health care plan and eventually adopted the Republican plan that was in effect in Massachusetts.

That is why the Affordable Care Act, also referred to as Obamacare, is so flawed and needs to be fixed. Paul Ryan's health care plan, the American Health Care Act, also known as Trumpcare, is not the answer. The House is set to vote on this proposal this Thursday after rushing it through committees.

“The Republican proposal will make healthcare more expensive, ration care for seniors and working families, and penalize those most in need, including millions of Asian Americans and Pacific Islander," said Rep. Judy Chu, D-Calif. and chair of the Congressional Asian Pacific American Caucus (CAPAC). 

"This bill also makes drastic cuts to our safety net by raiding the Medicare trust fund and forcing states to ration Medicaid. It is shameful that Republicans have chosen to give millions in tax breaks to insurance companies at the expense of the American people, and I will continue to push back against these partisan efforts that will have dangerous consequences for our communities.”

After the Congressional Budget Office came out with its report last Monday, some Republicans have spoke out against the Ryan plan, giving Democrats the hope they might have enough votes to block the proposal. 

But, I wouldn't hold my breath. Giving lip is not the same as casting your vote. When it comes down to to the actual vote this Thursday, we'll see where their loyalties are -- with their party or with the American people.

Trumpcare "would penalize unemployed workers, block funding for Planned Parenthood and make big cuts to our safety net by turning Medicaid into a voucher program," said Rep. Ami Bera, D-Calif. 

The Congressional Budget Office Report highlights the real cost of Trumpcare: By 2018, 14 million Americans would lose health insurance coverage under the Republican's effort to repeal and replace the Affordable Care Act (ACA). Up to 24 million Americans would lose health insurance coverage by 2026. By 2020, 52 million people would be uninsured. Under the ACA, that number would be 28 million. Over the next two years, premiums for people who have health insurance not covered by their employer would increase by up to 20 percent. Between 2017 and 2026, CBO estimates there will be $880 billion of cuts to Medicaid, adversely impacting middle to lower income families and seniors who rely upon government funding to afford health coverage. Medicaid spending by the federal government would decrease by 25 percent by 2026. Enrollment in Medicaid will be reduced by 14 million people by 2026. Included in this plan are $592 billion of tax credits for the wealthy, as opposed to $361 billion in tax credits to help middle class and working class families afford health care. The Republican plan would cut $170 billion from the Medicare Trust Fund, shortening the life of Medicare by 3 years. The complete report issued by the CBO can be found here.  “Our families are already under threat in so many ways: the gutting of health care security, the increased profiling of and attacks on black and brown bodies, the assaults on women’s and LGBTQ rights," stated Johanna Puno Hester, Asian Pacific American Labor Alliance National President and Assistant Executive Director of the United Domestic Workers, AFSCME Local 3930. “Repealing the Affordable Care Act would mean cuts to Medicaid and higher costs and less care for millions of families including nearly 40 percent of children nationwide,” said Luisa Blue, APALA National Executive Board Member and Executive Vice President of the Service Employees International Union (SEIU) who helped found the SEIU Nurse Alliance. “As a former nurse, I have witnessed how critical it was for patients to have access to affordable care and preventative care. We cannot allow the Republican Congressional leadership to take away healthcare from millions of Americans. This directly impacts so many Asia/ American Pacific Islanders, who like the rest of us are just trying to work hard to build a better life for their families.”“I am particularly offended by the priorities expressed in this legislation. The Republican plan asks some of the most vulnerable communities to pay more while giving wealthy Americans a massive tax cut they don’t need. For example, under the GOP plan Medicaid expansion would be phased out, but the richest 400 families in the country would get a $28 billion tax cut. “Are there challenges to the current health care system that need to be addressed? Absolutely. But this Republican proposal fixes none of them and creates several more that will leave millions of Americans without the access to care they desperately need.”