How the Dems Used Fake Money from Cutting Trump Drug Rebate Bill To Claim Offset to New Spending


( The article below written in 2021 explains how the Democrats tried to use the cancelling of Trump’s change to the Medicare Rebate Rule meant to reduce drug prices as a way to offset their massive infrastructure plan  It is a ridiculous rigging of numbers that is not in any way a savings as they have claimed. When the Build Back Better didn’t pass they used the same  ploy again recently to cover a large portion of their new “Inflation Reduction” Act.  This is complex,  but it is an example of how Democrats deceive the public.T. Murtha)  


2+2=? Senate Uses Murky Math as It Shelves Drug Pricing Rule to Fund Infrastructure

The Senate’s release of its bipartisan infrastructure plan signals that lawmakers are poised to throw former President Donald Trump’s belated bid to lower Medicare drug prices under the bus — not to mention trains, bridges, tunnels and broadband connections.

That’s because the massive spending bill is the first of two likely to at least delay the so-called Medicare rebate rule released at the end of the Trump administration, which has yet to take effect. Congress would use the projected costs of that rule to help pay for more than half a trillion dollars in new spending on infrastructure.

What has infrastructure spending got to do with Medicare drug rebates?

Bear with us as we explain the mad logic of how Congress intends to pay for a spending program with money that doesn’t really exist. Tossing Trump’s reform under the steamroller to offset other costs offers a window into the convoluted process of congressional budgeting: Senators say the plan will provide billions of dollars of savings, even though the federal government has never spent a dime on the rebate rule. And it focuses attention on the intractable problem of bringing down drug prices: The rule would take money from drug industry brokers and provide refunds to consumers, which would suggest it was saving them and Medicare money. Yet budget analysts said the process would cost the government billions of dollars.

Let’s start with the Medicare drug rebates.

The way things work now, pharmacy benefit managers, which are often owned by insurance companies, negotiate with drugmakers to get significant reductions on a drug’s list price. They pass the bulk of that savings along to Medicare and the insurers, who can pocket some of it and use it to lower overall premiums for customers who buy drug plans in Medicare Part D.

While customers benefit from a lower premium, it doesn’t mean they actually get a better price for their drugs, said Gerard Anderson, a professor of health policy at Johns Hopkins Bloomberg School of Public Health.

That’s because a patient’s price is not based on the rebate but on a share of the original list price of the drug. If a drug costs $100, and a patient’s share is 25%, they pay $25, regardless of how big a rebate the PBM got for the insurer.

It thus serves the interest of the PBM for the drugmaker to raise prices. “When the list price goes up, your patient responsibility goes up, so the patient ends up paying more,” Anderson said. “The PBM makes money because, when the list price goes up, the rebate is larger. But the patient loses, because their cost sharing is based often on the list price.”

Since the PBM controls the formulary that says which drugs are covered in a given plan, Anderson and others point out, it is also in the interest of a drug company to raise list prices if it wants the PBM to give its drugs preferential treatment.

“If you’ve got two drugs that are available to take care of some heart disease, the PBM wants the drug that’s going to pay them the most money, and the money is the difference between the list price and the actual transaction price,” Anderson said. “So the higher the list price, the higher the profit margin for the PBM. So the drug company who wants their drug on the formulary has to raise their price in order to give the PBM a greater profit.”

A wrinkle in federal law allows that to happen. Typically in federal contracting, if someone sets a high price to give the buyer a cut, it’s considered a bribe or a kickback, and it’s illegal. But the law that created the Part D drug program carved out what’s known as a safe harbor to allow such deals in the hope that negotiations would lower overall costs.

The Trump administration’s rule attempts to end the perverse incentive by taking the safe harbor away from the PBMs and giving the rebate to customers at the pharmacy counter. Then-Health and Human Services Secretary Alex Azar said costs would fall by about 30%.

But the effort had two major problems. First, the rule was challenged in court by the PBMs on procedural grounds. Second, the Congressional Budget Office predicted that, rather than save money, it would end up costing the federal government $177 billion over 10 years because drugmakers would be less likely to provide as many discounts, causing a spike in Medicare drug coverage premiums.

The Biden administration delayed the rule, and could scrap it, making that $177 billion cost more theoretical than real. But that’s where congressional budgeting comes in.

A chief selling point of the infrastructure proposal is that it is “paid for,” meaning it taps new revenue streams or ends other things that cost money so that the $550 billion in new spending in the plan doesn’t add to the federal deficit.

Even though Trump’s rebate rule has already been delayed and is likely to be killed, it is, at this moment, on the books. Since the infrastructure bill would delay the rule and its costs until 2026, the savings get counted as offsetting the new spending. Confused yet?

Delaying the rule, instead of killing it outright, means there’s still another $130 billion on the books that can be used to offset other spending — almost certainly likely to help fund the even bigger budget reconciliation measure that Senate Democrats intend to pursue as soon as the Senate passes the bipartisan infrastructure bill.

Sen. Bill Cassidy (R-La.), who liked Trump’s rule and also supports the bipartisan infrastructure bill, explained the reasoning to reporters shortly before the infrastructure legislation was released.

“The Medicare rebate rule — you know, I actually agree with the policy, but it was a $182 billion cost to the Treasury,” Cassidy said, citing a slightly different figure for the savings. “And so, it’s been signaled that it was going to be used for something. … Just speaking practically, if something’s going to score that high, and here with a party, Democrats, that don’t like it, it’s going to go away, right? So that was just a good take.”

The move is essentially painless in congressional budget terms, and PBMs are thrilled. They argue they do not actually profit from the rebates they negotiate in Part D and pass all the rebate cash along to Medicare and plan sponsors already.

They say their ability to negotiate those rebates is part of what makes them valuable, and the rule interferes. “That’s sort of the bread and butter of the work that our companies do, and undermining the ability to provide that value is obviously a real challenge,” Pharmaceutical Care Management Association CEO JC Scott said in a call with KHN and PCMA spokesperson Charles Coté.

They favor not just delaying it but spiking it completely. “From our perspective, that is the action that’s needed,” said Coté. “To create certainty for Part D and for beneficiaries, it should just be fully repealed.”

Repealing Trump’s rebate rule is not painless for people who have high drug costs, though, because, as Johns Hopkins professor Anderson explained, the 10% or so of people who would get significant rebates at the pharmacy counter would be better off.

“It helps the people that have the large bills; it harms the most the people that don’t have the large bills,” Anderson said.

Benefiting from Trump’s rule would be drugmakers, according to the CBO data and other sources. In a statement from the Pharmaceutical Research and Manufacturers of America, the industry’s lobby group, spokesperson Debra DeShong cast ending the rule as a windfall for PBMs and a cynical raid on cash meant for sick, older Americans.

“Lawmakers are threatening to gut a rule that would provide patients meaningful relief,” DeShong said. “This would be an unconscionable move that robs patients of the prescription drug savings they deserve to help fill potholes and fund other infrastructure projects.”

Senate lawmakers were hoping to pass the infrastructure bill by Thursday, then move quickly on the reconciliation bill, both paid for in part with the ill-fated rebate rule. The legislation would then go to the House when it returns from its August recess.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

Subscribe to KHN's free Morning Briefing.

 

Liz Cheney Defeat - a Win Against Self-Serving Hypocrite

 



Liz Cheney went down last week as well she should have.  In the shadow of her power-hungry father, who made sad, ridiculous commercials viciously attacking Trump that were supposed to support his daughter during her ultimate march to the losing of her congressional seat, Liz’s hateful attacks on Trump stem from her own narcissistic drive for power.  She is so driven that she even threw her own gay sister under the bus to win her congressional seat initially.  Her spiteful, vengeful campaign was not about the people of the state she represented it was about her and Wyoming  told her in their primary they had enough of her. 

Let’s take a look at the Cheney legacy that Democrats are so quick to forget.   

Dick Cheney was  so reviled that his approval rating stood at a staggeringly low 13 percent  when he left office.  Do the Dems forget that during  the several months preceding the March 2003 invasion of Iraq, and thereafter, the then vice president Cheney became aware that no certain evidence existed of weapons of mass destruction in Iraq.  Despite questions and uncertainties, Cheney  nevertheless proceeded to misrepresent the facts in his public statements, claiming that there was no doubt about the existence of chemical and biological weapons in Iraq and that a full-scale nuclear program was known to exist.

It was also at Dick Cheney’s urging, that the federal government spied on millions of non-terrorist Americans without a warrant, and it was Cheney who wanted the program to continue even after it was declared illegal.After his first round in the public sphere, Cheney, working at Halliburton, enriched himself to the tune of $44 million by exploiting contacts with various corrupt Arab autocrats that he made while drawing a public salary.  He returned again to public life as vice president with Halliburton donating  to his campaign, and then getting numerous lucrative contracts during the Bush administration.

Thank you Wyoming for putting an end to the Cheney public dynasty.   

Letter to the Editor on Gun Legislation


Too often we don’t hit back and support our Republican leadership when they are falsely attacked for standing up for our values. Here is a recent letter we wrote supporting Senator Rubio:

    It’s tiring to hear from Democrat party members railing against Senator Rubio about the gun issue when their party leadership has done next to nothing to  decrease the violence and killings across the country.  Instead, their policies have encouraged  defunding of police and supported  rogue prosecutors who fail to prosecute crime and  push for the elimination of cash bail. This has led to  offenders— including violent  criminals —being released back to the streets where police officers are discouraged from making arrests. 


This same party has supported extreme abortion policies that would  permit taking a sustainable life from  a woman’s womb, instead of advocating to help women who might make a different choice.   How is it possible to maintain a culture of nonviolence and safety when  this party continues to applaud and promote the killing of defenseless babies in the womb.  Nor has Biden’s Attorney General done a thing to address the left-wing group Jane’s Revenge and their call for “open season” against pro-life pregnancy centers, despite Senator Rubio’s repeated calls to investigate them.  


No reasonable person will argue against keeping dangerous weapons from the hands of criminals and deranged individuals.  Senator Rubio has been pushing for Red-flag legislation similar to that of Florida that would do just that and has the best chance of bipartisan support.  Conversely,  the hypocritical finger-pointing of Democrats on this issue is not going to get us anywhere.  It only serves as a different type of red flag to law-abiding citizens concerned that the left is after their second amendment rights.  

We encourage all Republicans to write letters to the local paper.  Don’t hand this local forum over to the Democrats no matter what you think of it.  Raise your voice.  

T. Murtha 


Sure Joe Your Efforts Have Helped the Economy - NOT


Biden taking credit for economic growth is like Lyndon Johnson claiming he helped end poverty.    In a Wall Street Journal op-ed, he recently attributed a claim of economic rebound that has been anything but robust to the reopening of an economy that was shuttered by the governing elite during Covid. Biden, of course, was not only the apostle for those closings, he chastised Republican governors like Ron DeSantis who opened their states. He also did all he could to thwart  Governor DeSantis' efforts to keep Florida economically strong. 

Moreover, he falsely stated “In January 2021, when I took office, the recovery had stalled…” when in fact the economy was bouncing back strongly then.  The truth is his actions thwarted that recovery.  Instead of preparing our economy for the economic jolts that were sure to arrive after a pandemic, the new President Biden signed off on a plethora of executive orders pausing government leases on public lands, shutting down the Keystone XL pipeline, and creating more hurdles to drilling in the Gulf of Mexico. All of this with disregard for the uncertainties that would follow in  a  post-pandemic economy

As prices spiked, the Biden crew began to use rising prices as a justification for more spending. Even left-leaning  Jeff Bezos disagreed when the “administration tried hard to inject even more stimulus into an already over-heated, inflationary economy."  Of course, morning pundits like flipper "Morning Joe," and others like him are trying desperately to rescue the midterm from a disastrous spanking by the public.  The left simply doesn't get it when the average worker has to pay almost $5 a gallon to fill his tank, they don't want to hear about their progressive agendas.  

Biden is a long-time political hack who only knows how to falsely take credit and blame others.  He should have never been President.  



Our Strongest Tool is Voting - Message from Charlotte County Republican Party Chair




The most effective tool we have to keep our state RED is voting. As we move closer to the elections of 2022, I encourage you to make sure you are registered to vote - Republican - and that your voting information is up-to-date. Go to https://www.soecharlottecountyfl.gov/. to review and make sure your name, address and party registration is up-to-date. Remember unless a primary race is opened, you will only be able to vote in Republican primaries if you are registered as a Republican.

In addition to the election of two county commissioners and two airport commissioners, school board races are on the primary ballot, as are Punta Gorda city council members. So you want to make sure you vote in this primary.

Early Voting: August 8
Primary Election Date: August 23

Currently filed local candidates can be found at the Supervisor of Elections Announced Candidate Pages

I also encourage you to sign up to get a vote-by-mail ballot just in case anything prevents you from voting in person. You can still vote in person if you can. Your vote is critical in both the upcoming primary and general election when our Governor will need your support to keep Florida free.

Gene Murtha, Chair, Republican Party of Charlotte County


Stop False Leftist Branding

 


Most of us know by now that we can’t trust most of our press.   The so-called “Associated Press” should be called  “Pravda West”.  There is no more reporting of facts.  Most if not all so-called  “news” is reported through a leftist filter.  The political left has cleverly branded a law that prohibits teachers from having conversations about sexual orientation and gender identity in grades K to 3 the “ Don’t Say Gay” bill.  


What does this bill actually say. One section says schools generally “may not discourage or prohibit parental notification of and involvement in critical decisions affecting a student’s mental, emotional, or physical health or well-being.” Parents also can’t be blocked from “education and health records created, maintained, or used by the school.”

Another section says: “Classroom instruction by school personnel or third parties on sexual orientation or gender identity may not occur in kindergarten through grade 3 or in a manner that is not age-appropriate.”


So why isn’t this bill being called “the stand-up for parent rights” or “don’t harm our kids”   “we are the parents” bill or something that correctly labels it for what it is.  Instead we Republicans repeat the false branding that the left has given it.  (Fox News constantly does it too. ) Just like when the left started calling the protest and break-in by some over zealous and fringe members of the protest an “insurrection.” Lookup the word insurrection - seriously were these people led by the guy in the Chewbacca with horns  outfit capable of overthrowing our government?  


We have to stop perpetuating  the left’s political branding and quickly condemn  it and change it when it arises. We have to strongly use our own labels.  “Let ‘s go Brandon” was very effective.  We need more of this. 

Words Matter - The Left’s Use of False Narratives

 Left wing progressives continue to use inflated, false branding  in their goal to move the country further and further towards a socialist regime. Using the term “racist” for anyone who disagrees with their extremist views is one example.  Another is calling the January 6 protestors “insurgents.” Yes, they were disruptive, yes, lawbreaking was involved.  But Words have to have meaning, and the continuous mislabeling of the U.S. Capitol breach as an “insurrection” is an example of how a false narrative can gain currency and cause dangerous injustice. 


The latest attempt at a false narrative Is the calling HB1557 the “don’t say gay” law.   The bill supports the right of parents to be involved in decisions regarding their children's well-being and to limit discussion of gender and sexuality issues in classrooms.  No matter how many times they call Florida’s HB1557  "don't say gay" it does not change the fact that there is a huge difference between acceptance of adult gay couples and the attempt to normalize the idea of young children changing their gender. 


Words matter. I hear Republicans and even so-called conservative news broadcasters use these terms created by the left.   Republicans need to stop mimicking this language — as long as we do, they win.  It’s the “Parents Rights” law, nothing else.  

How to get Rid of RINOs


How can you get rid of RINOS? Support strong candidates running them in upcoming primaries. Here is one that needs your help.  


Constitutional attorney Harriet Hageman is the candidate running to unseat Liz Cheyney of her congressional seat representing Wyoming. Hageman has deep roots in the state and grew up on a ranch in Wyoming where she and her siblings had to move cows and fix fences, while Cheyney has spent most of her life in Virginia and bought a home in Wyoming in 2012, so she could run for the Senate  (dropped out of this race) and in 2016 run for the US Congress. She is a hawkish Bush-era Republican who  later supported the 2nd impeachment of Donald Trump and has been one of the RINO members of the Democrat’s January 6th Commission. 


It is important to note here that Cheney who has no real connection to this state is the only US House Representative for  Wyoming. While she is a so-called Conservative Republican, she has not been deeply engaged in policies that would support the State.  She has been busy politicking with Democrats like Nancy Pelosi. Meanwhile Bush-era RINOs and Democrats are funding her campaign. Money is piling up in Cheney’s re-election fund — more than $7 million last year. It’s roughly 10 times as much as her Trump-backed primary challenger Harriet Hageman drew. And it’s so much cash from so many unexpected places that seasoned campaign operatives aren’t sure she can even spend it all on a House race in Wyoming.


Hageman  has been been sounding the alarm on Biden’s "30 x 30" initiative, also known as "America the Beautiful," which aims to conserve 30 percent of the nation’s land and waters by 2030.  She argues it’s a "land grab," a threat to Wyoming and an attempt by Democrats to hasten the decline of rural America.  She says “ The federal government under Joe Biden and radical Democrats are intent on taking over and federalizing our private property rights under the auspices or claim of combating climate change.” She champions  the people of Wyoming in rejecting burdensome and onerous government overreach. 


To contribute to Hageman’s caampaign go to https://www.hagemanforwyoming.com

Biden’s War on Oil and Gas Production Fuels Putin

Vladimir Putin realizes what we all know, which is that a good chunk of allies in Europe are highly dependent on Russian oil and natural gas. 


Two years ago, the U.S. was the world’s largest oil and gas producer, making the U.S. self-sufficient in energy and a major exporter. Mr. Biden’s war on oil and gas production has helped enable Putin.  Putin realized that reliance on Russian petroleum and natural gas would make it difficult for the West to put economic pressure on him.  Moreover, the rising price of his major export was providing the capital to wage an invasion.  


Given Biden’s election promises and left flank push for eliminating use of fossil fuel, Biden is now caught between an angry electorate watching  oil and gas prices rise even higher after months of rising costs and the cry for cutting off Russian oil imports.  The dynamic gives Putin important leverage in his invasion of Ukraine.


Russia's invasion has sent oil prices soaring to their highest levels in more than a decade. They've also crushed hopes of a strong global rebound from the coronavirus crisis.

Ukraine and Biden – A Story of Failure and Corruption


In 2014 when Russia annexed  the Crimea and went on to back Russian separatists in the Ukraine’s east, then Vice President Joseph R. Biden Jr. pressed President Barack Obama to take action, and fast, to make Moscow “pay in blood and money” for its aggression.  Fortunately President Obama , a Biden aide told the New York Times, was having none of it.

Biden continued to press  to increase lethal aid, backing a push to ship FGM-148 Javelin anti-tank missiles to Kiev.  The president flatly rejected the idea and dispatched Biden to the region as an emissary, cautioning him “about not overpromising to the Ukrainian government,” Biden wrote  in a memoir.

Biden began pressing the Ukraine’s leaders to tackle the rampant corruption that made their country a risky bet for international lenders — and pushing reform of Ukraine’s cronyism-ridden energy industry. “You have to be whiter than snow, or the whole world will abandon you,” Mr. Biden told the country’s newly elected president, Petro O. Poroshenko, during an early 2014 phone call, according to a New York Times article. 

Just as these efforts were happening Biden’s son Hunter joined the board of a Ukrainian gas company that was the subject of multiple corruption investigations, a position that paid him as much as $50,000 a month which in the view of some Obama administration officials, including the ambassador to Kiev — threatened to undermine Mr. Biden’s agenda.

A look back at what the former vice president actually did in Ukraine reveals that his work in Ukraine did not accomplish much nor did it  “fundamentally change the overall institutional corruption,” said Edward C. Chow, an expert on geopolitics and energy policy at the Center for Strategic and International Studies, a nonpartisan Washington think tank. “And having his son doing what he did was a distraction that undermined his message.”

In 2015 Biden, while he was pushing for stronger anti-corruption moves in Ukraine, would not even discuss steps that could make all questions vanish: asking his son to quit the Burisma board, as editorial boards and Ukraine experts were suggesting. 

And this is the guy, the one who failed miserably in the region and still has his son’s suspicious involvement there in his shadow, who we have at the helm during a crisis that could push the country into a war with Russia over the Ukraine.