The Rodney Report is NJ 11th for Change's Weekly Analysis of Rep. Rodney Frelinghuysen's Words and Deeds.

• Pre-existing Conditions and High Risk Pools
• Medicaid Cuts in New Jersey, Ending Special Assistance in Schools
• Employer-based Plans: Lifetime Caps & Inequity
• Kick the Can
• Rodney & The Omnibus Bill
• The Week According to Rodney

Rep. Frelinghuysen voted “yes” on the GOP’s American Health Care Act (AHCA) last week, a drastic about-face from his public statements on an earlier version of the bill — and a violation of the promise he made to NJ 11th members during an in-person meeting in his DC office, which was captured on video. In a statement released after the vote, Frelinghuysen assured the public that his previous concerns about the bill were assuaged by two amendments that, in fact, do nothing to reduce the proposed $880 billion Medicaid cuts and little to protect those with pre-existing conditions.

Pre-existing Conditions and High Risk Pools

In a misleading statement on his website, Frelinghuysen claims that under the new bill, insurance companies cannot deny anyone coverage based on pre-existing conditions or use health status to set premiums, “Unless your state asks for and receives a waiver—a condition of which is the state having other protections in place for those with pre-existing conditions..As long as you've been continuously covered, you can't be charged more money,'' Frelinghuysen explained.

This is not exactly the case. The AHCA, as amended, enables states that obtain a waiver to construct a second pool of enrollees who had a gap in coverage, separating the healthy from the sick, and creating high-risk pools. While the amendment offers these states an additional $8 billion in federal funds through 2022, raising the total amount available for high risk pools to $138 billion, the Center for American Progress estimates that these pools are woefully underfunded. They would actually need another $200 billion to properly fund coverage for high-risk patients.

More than half of all Americans of all ages and three quarters over the age of 45 have pre-existing conditions. While there is not a specific AHCA list of pre-existing conditions, insurers would have leeway to raise premiums for a multitude of illnesses, which was banned under Obamacare (the American Healthcare Act). Before the ACA, insurance companies could deny coverage or charge higher rates for anything listed as a pre-existing condition. The lists were voluminous, including relatively minor ailments like acne, acid reflux and eczema, along with many traumas, terminal diseases and mental disorders.

Medicaid Cuts Worst in New Jersey, End of Special Ed Assistance in Schools

In addition to the 55,000 people in the 11th district who would lose coverage due to AHCA Medicaid cuts, New Jersey will face the largest cuts in the nation, an estimated 20 percent, according to New Jersey Policy Perspective. The elderly and people with disabilities disproportionately benefit from Medicaid and will be disproportionately affected.

Over 1.8 million people in New Jersey will be at risk. The end of coverage for so many in our area could result in the loss of $65 million annually for the Atlantic Health System in Morristown, and terrible health outcomes for patients, who will once again use hospital emergency rooms for their primary care, according to Brian Gragnolati, executive officer of Atlantic Health, who was quoted in the New York Times.

In a move of nearly breathtaking cruelty, the bill ends three decades of Medicaid funding for schools all over the country to provide Special Education services, equipment and preventative care, like hearing and vision tests. In New Jersey, approximately 87 percent of children with disabilities are enrolled in public school.

Employer-Based Plans: Life Time Caps & Inequality

The AHCA also allows insurance companies to reintroduce lifetime caps on employee policies as well — a provision that could impact nearly 900,000 people in the state of New Jersey. They will also, once again, be allowed to charge women more than men since they won’t be required to cover prenatal care, C-sections, assault recovery and breast cancer. Many Americans were hardly reassured this week to learn that the 13-member Senate Health Care panel, which is drafting the Senate version of the bill, consists entirely of white men.

That’s only a fraction of the damage the AHCA could inflict on New Jersey residents, and it is in direct conflict with Frelinghuysen’s inexplicable defense of his support for this dangerous bill.

Kick the Can

Frelinghuysen echoed many of his GOP colleagues at the end of his AHCA statement by suggesting that whatever may be wrong with the bill, it’s best to get it passed and let the Senate sort it out.“The citizens of this nation deserve better than a Congress that appears to be incapable of resolving controversial issues like health care reform,” he pontificated. “In this regard, I feel that we must move a bill to the Senate where significant changes to improve this imperfect product will certainly occur.”

Rodney & The Omnibus Bill

Much of Trump’s proposed funding cuts for the rest of the year did not come to pass last week when the omnibus spending bill, aka House Resolution 244 (HR 244), was approved, keeping the federal government running until the fall of 2017. Both the NIH and the EPA received increases instead of steep cuts. The NEA was not abolished but received a slight increase. Border wall funding was not approved.

Did Frelinghuysen, as head of the House Appropriations Committee, have much to do with this? Well, that’s complicated. For one thing, omnibus bills are not budgets, pers se, but  catch-all pieces of legislation that package together a number of distinct bills or resolutions to be debated and passed or failed all at once.

As chair, Frelinghuysen is more of “floor manager,’’ leading debates and guiding chamber consideration of jurisdictional legislation. While Frelinghuysen, as full committee chair, did sponsor House Joint Resolution 99, which extended the deadline for passing the omnibus spending bill from April 28 to May 5, 2017, the responsibility for this latest bill, which prolongs funding, lies mostly with Republican and Democrat party leadership. (Note: Budget legislation is different than Appropriations; the former is passed first and sets out how much funding is available for different policy areas for the year, and the latter divides up this funding by jurisdiction. In other words, the Budget lays out funding levels for defense, education, commerce, etc., and Appropriations determines how that funding is allocated)

In last week’s newsletter, Frelinghuysen attributed the success of the bill to bi-partisan work, including several initiatives that would help New Jerseyans, such as $75 million allocated for Amtrak’s Northeast Corridor, a project that totals $328 million. He claimed credit for allocating $40 million above President Obama’s last budget request for vouchers that would help 37,000 homeless veterans find housing. He also touted the procurement of $120 million in housing vouchers for people with disabilities. For several years, these have been dubbed "Frelinghuysen vouchers'' in recognition of his advocacy work.

But Congressional Democrats have claimed victory for H.R. 244’s passage, and they may deserve it. They successfully eliminated more than 160 “poison pill” Republican policy riders. A rider is an additional provision added to an appropriations bill, often as a stealthy, procedural shortcut. A “poison pill” is when an added provision could cause the bill in question to fail when it would have passed otherwise. As a result, Dems can legitimately take credit for preventing many of Trump’s cuts, including the defunding of Planned Parenthood, along with the proposed massive increase in military spending. In the final legislation, about half of what was requested for defense spending, was granted. Instead of border wall funding, $1.5 billion was added for border security with the provision that none of it may be used for the wall.

While this bill is seen as a significant achievement for a minority party that controls neither Congress or the presidency, it is still indicative of a broken budgeting process. H.R. 244 is for the current fiscal year, which began on October 1, 2016. Because of increasingly intractable partisanship, the bill was not passed until six months after such measures were supposed to have taken effect, which puts intense stress on the government agencies and programs it funds.

The Week According to Rodney
A Look at Frelinghuysen’s Weekly Newsletter

Last week’s edition of Frelinghuysen’s E-News was more defensive than most, featuring a lengthy justification of his AHCA vote. Frelinghuysen once again bashed Obama’s foreign policy as weak — this time, the culprit was North Korea — and praised Trump’s sanctions against the nation, including restrictions against North Korea’s online gambling industry. And there was a Jerseycentric breakdown of how the omnibus bill could benefit state residents (see above).

The newsletter also included something we haven’t seen since we began covering the E-News in March: a “recommended reading” list. One must-read, according to Frelinghuysen, was a much-slagged Washington Post op-ed by Rep. Cathy McMorris Rodgers (R-Washington) titled, “My Son has a Pre-existing Condition: He’s one of the Reasons I Voted for the AHCA." A counterpoint to Jimmy Kimmel’s heart-wrenching viral monologue about his newborn son's congenital heart condition, Rodgers’ piece declares that helping patients like her son, who has Down Syndrome, was just one “inspiration” for the bill. In a vague, unemotional and unconvincing defense of the AHCA, she offers more false reassurances that it gives those with pre-existing conditions nothing to fear.

Veterans Suffer

Most editions of the E-News spotlight Frelinghuysen’s efforts on behalf of veterans. Last week he described how he “pressed” Veterans Affairs Secretary, Dr. David Shulkin, to help address the VA’s appeals and benefit claim backlog during a subcommittee hearing on the 2018 VA budget. He also mentioned his in boosting funding for homeless vets.

But Frelinghuysen neglected to mention that veterans don’t fare so well under the AHCA. Post-traumatic stress disorder could be considered by insurers as a pre-existing condition. Seven million veterans could also lose tax credits, once used to purchase private insurance, because they are eligible for medical care offered by the Department of Veterans Affairs.

 — By Lynn Halsey, Jane J. Hunsecker, Liz Jarit, Elizabeth Juviler, Karen Rose and Adam Tucker