From its title, “Sasquatch” sounds like the story of Bigfoot — and at the start, it looks that way too. The three-part documentary series begins with journalist David Holthouse recounting the time he visited a cannabis farm and overheard the tale of three workers who had been devoured by the legendary beast. “Sasquatch” shares with […]
[Editor’s note: This story originally was published by The Daily Signal.]
By Tim Murtaught
The Daily Signal
We’ve always known that President Joe Biden has a way of misremembering his own record that is – shall we say – often unrelated to the truth.
But Biden and his team have now developed a strategy that purposely redefines words and describes things as they demonstrably are not. And in many cases, the media help them along.
The most obvious example is the invention of a new meaning for the word “bipartisan.”
In Washington, D.C., and everywhere else, when a president speaks of “bipartisan” legislation, he means something that’s supported by members of both parties in Congress.
In Biden’s White House, however, that definition is so … yesterday.
“If you looked up ‘bipartisan’ in the dictionary, I think it would say support from Republicans and Democrats,” said Anita Dunn, one of Biden’s top advisers. “It doesn’t say the Republicans have to be in Congress.”
And with that, the D.C. dictionary was distorted.
That allows Biden to ram his priorities through Congress with zero Republican votes, using the vague and arcane process called reconciliation, while still claiming bipartisan support.
Using Dunn’s definition of “bipartisan,” Team Biden can point to public opinion polls that show that at least some Republican voters support whatever it is Biden is trying to achieve.
Helpful to the cause, a Morning Consult/Politico poll found that 60% of Americans view Biden’s performance favorably, including a chunk of Republicans. Inside the poll, you see that the respondents voted for Biden over Donald Trump by a margin of 53% to 35%, or an 18-point spread. In fact, Biden won nationally by just 4 points.
This media-sponsored poll artificially makes it easier for Biden to use his new definition of “bipartisan.”
Another word Biden has bent to serve his purpose is “infrastructure,” which has up to now been understood to mean projects like roads, bridges, railways, airports, and seaports.
Funding for home care workers is included, as is $50 billion for the National Science Foundation to create something called a “technology directorate.” There are also subsidies for electric vehicles and for charging stations.
Those are issues Congress can certainly debate and approve on any given day, but they are not infrastructure.
Another way Biden plays with language and facts is in setting milestones for himself that are already inevitable or easily achievable.
He called his goal to administer 100 million coronavirus vaccine doses in 100 days “ambitious,” and imagined widespread press skepticism where there was virtually none. The truth is, the U.S. was already on pace to meet the mark when Biden took office.
The crisis at our southern border is a frequent victim of Biden’s reshaping facts to suit him.
He claimed that the dramatic increase in migrants attempting to enter the country happens “every single, solitary year.” But the surge in the number of unaccompanied minor children arriving at our border is far higher now than it was in years past.
Biden also claimed in March that he was sending back the “vast majority” of families attempting to cross the border. That was also untrue, as in February less than half of families were turned away.
In this instance, Biden would rather eliminate a word from the dictionary than change its meaning. “Crisis” is not a way the border situation is ever described in Biden World, except once accidentally by White House press secretary Jen Psaki, who was clearly unhappy to have slipped.
When asked if her use of the newly declared non-word “crisis” reflected a change in the administration’s view of the border, she said simply, “Nope.”
Riding to Team Biden’s rescue, The Associated Press dutifully issued an internal memo instructing staff to avoid using the word “crisis” to describe the scene at the southern border, unless it’s inside a quote from a person in a story.
Finally, we’ve seen Biden attempt to undo very recent history when things get controversial.
Amid conjured uproar over Georgia’s new election integrity law, Biden took to ESPN to tell a national television audience that he would “strongly support” moving Major League Baseball’s All-Star Game away from Atlanta. After that push from the most powerful human being on the planet, the sport subsequently did exactly that, relocating the game to Denver.
Stepping up to the plate as cleanup hitter a week later was Psaki, who pretended that Biden did not say what he said. In her telling of it, Biden merely acknowledged that Major League Baseball had the right to do what it did.
“Well, he supports them being able to make the decision and respond to what their players’ asks are, given many of them are impacted, of course, by these laws,” Psaki said.
Either words have meaning, or they don’t. And either events happened, or they didn’t. Just because Biden and his handlers try to maneuver around those truths doesn’t mean that the rest of us don’t notice. But George Orwell would be proud of their efforts.
[Editor’s note: This story originally was published by The Daily Signal.]
The post Redefining words to serve the Biden administration’s purpose appeared first on WND.
[Editor’s note: This story originally was published by Real Clear Politics.]
By Susan Crabtree
Real Clear Politics
Samantha Power, President Biden’s choice to head the U.S. Agency for International Development, literally wrote the book on America’s poor record of fighting genocides around the world even as the nation’s leaders have promised “never again” after the Holocaust.
Power’s “A Problem from Hell: America and the Age of Genocide” earned her a nonfiction book Pulitzer Prize in 2003 and helped launch her out of academia to eventually become President Obama’s U.S. ambassador to the United Nations. Despite Power’s history of fighting human-rights violations around the world, some foreign policy experts and former Trump administration officials worry that the Biden administration is beginning to dismantle their work aimed at helping genocide victims even before Power arrives at USAID.
Over the last few weeks, they have started voicing deep concerns that the new administration’s shift to a broader human rights focus and away from prioritizing religious freedom in U.S. foreign policy will hurt progress made over the last four years in helping populations persecuted for their religious beliefs.
In late March, Secretary of State Antony Blinken announced that shift, which includes a focus on the rights of immigrants and refugees, victims of human trafficking, LGBTQ individuals and women’s access to abortion, birth control and other reproductive options. Blinken faulted the Trump administration for what he characterized as an “unbalanced” emphasis on religious liberty over other concerns.
“Human rights are also co-equal. There is no hierarchy that makes some rights more important than others,” Blinken said during remarks at a State Department’s release of its 45th annual report on the status of human rights around the world. “At my confirmation hearing, I promised that the Biden-Harris administration would repudiate those unbalanced views. We do so decisively today,” he said.
Although those words sound boilerplate, they put some religious freedom activists on edge. For starters, the activists point out that the horrific genocides of the last century all had religious persecution at their core. They find it ominous that some religious freedom programs have already been canceled or put on hold in the first few months of the Biden administration.
“This is a major shift away from international religious freedom – moving away from even calling it religious freedom,” said Nina Shea, who serves as the director of the Center for Religious Freedom at the Hudson Institute, a conservative foreign-policy think tank. “It’s more of a watered down freedom of belief or religion, and equating religion with belief, which is very dangerous because that would mean you have a right to believe what you want to believe but you may not be allowed to practice it in a public square.”
Downplaying religious freedom, Shea added, negates 22 years of U.S. public policy forged since President Bill Clinton signed into law the International Religious Freedom Act of 1998, which cemented a U.S. commitment to promoting religious freedom as a foreign policy priority. That law also created the bipartisan U.S. Commission on International Religious Freedom, or USCIRF, as a way to promote independent policy recommendations.
Any effort to diminish the role of religious freedom in U.S. foreign policy is particularly “misguided,” Shea argues, just weeks after the U.S. joined the European Union in sanctioning Chinese officials over the forced labor and imprisonment of an estimated 1 million Uighur Muslims. Pope Francis’s trip to Iraq in early March also highlighted the struggle Christians and Yezidis have faced rebuilding their communities after the ISIS genocide.
Sen. Ted Cruz, an outspoken advocate for religious liberty at home and abroad, is so concerned about USAID’s hold on key projects that he submitted written questions on the topic to Power after her first confirmation hearing.
Others have pointed to a recent tweet by the USAID Middle East bureau highlighting women’s history month and a video of an interview with Rita Stephen; the tweet says Stephen serves as a regional coordinator and liaison for the office of “Equity and Diverse Communities in the Middle East and North Africa,” an apparent purging of the word “religious” from the title. During the Trump administration, the office was known as the “Religious and Ethnic Communities Office.”
Other religious freedom advocates caution that it’s too early in the Biden administration to draw conclusions. They are urging patience and expressing some faith in Blinken, who while speaking up for persecuted minorities has recalled how he was shaped by his father-in-law’s survival during the Holocaust. Last Friday, during Holocaust Remembrance Day, Blinken used the occasion to take the State Department to task for not allowing Jews to seek refuge in the United States during the Nazi era; he also called for actions against those suffering persecution today. “We remember not only what happened, but also how it was allowed to happen,” he said.
During his Senate confirmation hearing, Blinken also voiced unqualified support for the Trump administration’s 11th-hour determination that China’s treatment of the Uighur populace amounted to genocide. Biden also has yet to name an ambassador-at-large for religious freedom, these advocates note, and the choice will signal how seriously he plans to take the issue.
Farahnaz Ispahani, a global fellow at the Woodrow Wilson Center and a senior fellow at the Religious Freedom Institute, remains hopeful that the new administration will maintain, and perhaps even strengthen, the U.S. religious freedom agenda. As an immigrant and a Muslim woman of color, Ispahani has praised Biden for overturning Trump’s ban on travel from several African and majority-Muslim countries.
In a recent op-ed for The Hill newspaper, Ispahani urged Biden to include religious freedom in the upcoming global summit for democracy planned for later this year. “Adding protection of religious freedom to the list of priorities would attract support from American conservatives, help strengthen the democracy and human rights agenda in foreign policy and contribute to Biden’s goal of diminishing polarization at home,” she wrote.
Despite these calls for patience, there’s a reason many activists and former Trump administration officials are bracing for an unraveling of their religious freedom work. Promoting religious liberty is embedded in U.S. law, but State Department and USAID funding decisions over the last decade often haven’t made it a priority.
Even after the Obama administration finally declared ISIS’ atrocities in Northern Iraq genocide, there was internal State Department resistance to providing assistance to the decimated communities to help them rebuild. Some in the foreign-policy community argued that all refugees should be given equal treatment whether they were victims of genocide or not. While the debate played out in Washington, members of the Yezidi and Christian communities who weren’t killed by ISIS fled with the refugees, only returning in large numbers over the last few years when the Trump administration directed U.S. tax dollars to rebuild their homes and infrastructure. The communities still remain under constant threat from Iranian militias.
From the early days of the Trump presidency, Mike Pence and top administration political appointees, including Mike Pompeo and USAID administrator Mark Green, fought against United Nations red tape that made it difficult to direct U.S. money to victims of genocide and religious atrocities, including ISIS victims in Iraq and the Rohingya communities in Burma.
With the help of Pompeo and Sam Brownback, Trump’s ambassador-at-large for religious freedom, the administration also elevated the issue of religious freedom by hosting annual international summits highlighting the plight of persecuted religious minorities around the world. The summits, held in 2018 and 2019, led to greater news coverage and awareness about numerous abuses worldwide. Last summer, the Associated Press and the Wall Street Journal uncovered new horrifying aspects of China’s persecution of Uighurs, including forced abortions and sterilizations to curb its Muslim population.
“Advancing religious freedom became a foreign policy priority for us when we talked to the world,” Samah Norquist, who served as the chief adviser for international religious freedom to the USAID administrator at the end of the Trump administration, told RealClearPolitics. “It wasn’t just rhetoric – not like ‘Yes, we are from America and we care about freedom.’ USAID responded to genocide, built its partnership and engagement with local voices and leaders and worked with other country donors to respond to those faith communities who face atrocities and discrimination around the world.”
There was a lot of internal pushback, as there was with a lot of Trump initiatives, Norquist recalls, but she credits Green’s leadership and the bipartisan respect and goodwill he cultivated in helping push some of policy changes through, especially when it came to expanding partnerships with faith-based groups operating among the local communities impacted by the persecution.
Brownback’s annual Ministerial to Advance Religious Freedom has now been handed off to other countries to host, as he and others planned, a sort of Olympics-style model of hosting aimed at engaging countries around the world. Brazil is planning to hold the international summit in Rio de Janeiro in November after Poland hosted a virtual version last fall because of the COVID pandemic.
Now a private citizen, Brownback and Gayle Manchin, who chairs the U.S. Commission on Religious Freedom, will host a separate religious freedom summit this July in Washington, D.C. That event will feature 40 civil society and religious groups representing nearly all the world’s religions. But such gatherings are limited in terms of their impact without the ability to direct U.S. funds to key projects around the world.
The groups are particularly worried that USAID projects that partner with faith-based groups are in jeopardy. The Trump administration fought internal agency resistance to providing funding to faith-based groups, building on a precedent from another Republican administration. President George W. Bush led a successful $15 billion effort to combat AIDS in Africa by working with governments, foundations, non-governmental organizations as well as churches and other religious entities throughout the continent.
Yet, at the start of the Trump administration, there was so much bureaucratic resistance within the State Department to partner with faith-based organizations that in 2018 Congress passed the Iraq and Syria Genocide Relief and Accountability Act, requiring direct U.S. assistance to these persecuted communities, including through faith-based programs. The measure was so uncontroversial and had so much bipartisan backing that it passed in the House on a voice vote and in the Senate by unanimous consent.
Until Congress changes the law, the agencies must continue to direct funds to faith-based groups operating in Iraq, but in mid-March, a top USAID official in the Bureau for Development, Democracy and Innovation asked acting USAID Administrator Gloria Steele to pause all strategic religious engagement and international religious freedom sector meetings, as well as the larger international religious freedom implementation plan, until receiving guidance from the Biden administration. In recommending the pause, the official said it would provide the opportunity to ensure that USAID’s engagement with faith-based partners fits the president’s definition of human rights.
Pooja Jhunjhunwala, USAID’s acting spokesperson, said the pause for a review is normal practice at the onset of a new administration and would not necessarily result in canceled or defunded religious-freedom programs. She also noted that the name of the Religious and Ethnic Communities Office has not changed and that the tweet referring to the office as the “Equity and Diverse Communities in the Middle East and North Africa” was simply wrong, although she provided no explanation for the error.
“[USAID’s] Partnership Center is doing a comprehensive review of the agency’s work on religious engagement and religious freedom, looking to build on past administration efforts and meeting the needs and opportunities in this new season,” she said in a statement to RCP.
Jhunjhunwala also pointed to Biden’s executive order from mid-February creating an interagency Center for Faith-based and Neighborhood Partnerships as a demonstration of the administration’s commitment to prioritizing faith-based engagement. In early March, Biden appointed Adam Nicholas Phillips, a pastor of a self-described “open, active and inclusive Christ-centered” church in Portland, Ore., as the director of the center. Jhunjhunwala described him as the agency’s “lead on engaging faith-based civil society groups for diplomatic, international development and humanitarian work around the world.”
Despite this stated commitment, some religious freedom projects in the works at the end of the Trump administration were canceled at the beginning of the Biden administration – including one aimed at solving a problem Samantha Power highlighted during her Senate confirmation hearing in late March. Power testified that the biggest challenge international human rights and genocide investigations face is securing unfettered access to the communities impacted without local militia impeding the probes.
She was responding to a question by Democratic Sen. Chris Coons about how best to document the recent atrocities in Ethiopia’s northern Tigray region. But weeks earlier, two days into the Biden administration, USAID rejected a project planned in Nigeria dedicated to providing a detailed accounting of Christian and Muslim persecution by jihadist terrorists Boko Haram and militant Fulani herdsmen and others. Hundreds of Christians and Muslims opposed to Islamic extremism have been killed in central Nigeria over the last year.
Local Christian bishops had appealed to USAID to support the project, which was to be funded through USAID’s local solutions support program, created through legislation and authored by Democratic Sen. Pat Leahy .
“We heard that it was well along the way and was approved at the highest levels,” said Shea, who was involved in organizing the project. “We got a letter two days after the inauguration that it was suddenly rejected.”
Jhunjhunwala declined to directly comment on the decision to reject the Nigeria documentation program. A knowledgeable source said it was twice determined that the proposal did not meet technical requirements “necessary to pursue the concept further.” No one at USAID provided an explanation for what this means.
Instead, Jhunjhunwala emphasized that “religious freedom remains a priority in our engagement and programming” in Nigeria. Between 2020 and January 2021, she said, USAID’s mission in Nigeria awarded five grants totaling $500,000 to faith-oriented organizations, four of which are Nigerian and all of which were signed under the Trump administration. And, she said, the agency is planning more religious-freedom focused community-based programming over the next year. She also noted an additional five grants that were provided directly to “faith-based or faith-oriented” organizations in Nigeria, although she didn’t provide the dollar amount of the grants.
In recent weeks, USAID also is holding up a Uighur cultural preservation project in Central Asia and has frozen millions of dollars of aid aimed at addressing inter-religious tensions in Indonesia, Sri Lanka, Bangladesh and Nagorno-Karabakh, knowledgeable sources report.
While current law prevents changes from being made to religious freedom programs In Iraq without notifying Congress about a shift in funds, critics say the contracts are being slow-walked. In early January, Trump administration officials agreed to provide additional funds to an existing contract to help refurbish and build housing units for displaced Yezidis in Kocho, Iraq. After an external lobbying effort on behalf of the contract, USAID announced the assistance award last week but didn’t say whether the entire $5 million originally slated for the project will still be allocated. The agency also didn’t disclose whether it still plans to move forward with a separate $800,000 project to transform a current school building — where ISIS terrorists rounded up Yezidis and executed them — into a formal museum.
Susan Crabtree is RealClearPolitics’ White House/national political correspondent.
[Editor’s note: This story originally was published by Real Clear Politics.]
The post Biden’s administration now putting religious freedom on hold appeared first on WND.
You would think this would be a eye-catching story: A Black Live Matter co-founder – supposedly a Marxist — goes on a home buying binge, spending $3.2 million to purchase four houses in places like wealthy Malibu and the Bahamas. Yet, ABC, CBS and NBC yawned at this blockbuster revelation from Sunday’s New York Post. This is despite the fact that ABC and CBS both previously hyped BLM co-founder Patrisse Khan-Cullors.
Here’s how the New York Post explained it in a front-page expose on Sunday:
As protests broke out across the country in the name of Black Lives Matter, the group’s co-founder went on a real estate buying binge, snagging four high-end homes for $3.2 million in the US alone, according to property records.
Patrisse Khan-Cullors, 37, also eyed property in the Bahamas at an ultra-exclusive resort where Justin Timberlake and Tiger Woods both have homes, The Post has learned. Luxury apartments and townhouses at the beachfront Albany resort outside Nassau are priced between $5 million and $20 million, according to a local agent.
The self-described Marxist last month purchased a $1.4 million home on a secluded road a short drive from Malibu in Los Angeles, according to a report.
Yet the networks are averting their gaze so far, pretending this story isn’t out there. Fox and Friends Sunday, by contrast, noticed the hypocrisy.
On July 20, 2020, CBS This Morning interviewed BLM co-founders Cullors and Opal Tometi. The hosts ignored the Marxism of Cullors and Tometi’s praise for thug dictator Nicolas Maduro. On January 7, 2021, ABC’s GMA3 acted as a publicist for Cullors.
Now, suddenly, CBS and ABC aren’t interested in the wealthy, free-spending Marxist co-founder?
The silence on CBS, Monday, was sponsored by Nature’s Bounty. On Good Morning America, Toyota. On NBC’s Today, Cadillac. Click on the links to let them know what you think.
[Editor’s note: This story originally was published by Real Clear Energy.
By Oliver McPherson-Smith
Real Clear Energy
At his inauguration address earlier this year, President Joe Biden called on Americans of all stripes to come together in the struggle against the pandemic, climate change, and social injustice. Little more than two months later, however, it seems that House Democrats on the Energy and Commerce Committee have all but forgotten this message of solidarity. As America continues to weather the pandemic, the recently released CLEAN Future Act will put struggling communities on the hook for the rollout of electric vehicle charging stations. This reverse Robin Hood ‘Tesla tax’ would make the poorest fund the luxuries of the wealthiest.
The Climate Leadership and Environmental Action for our Nation’s (CLEAN) Future Act sets the ambitious goals of cutting greenhouse emissions to 50% of the 2005 levels by 2030, and net zero by 2050. To meet these targets, the bill spills over almost 1,000 pages of energy, transportation, and environmental regulations, grants, and mandates.
Hidden deep in the bill are a raft of provisions to expand the roll-out of electric vehicle (EV) charging stations. Section 435, for example, will allow utilities to bill energy ratepayers to recover the costs of expanding EV charging networks. Similarly, section 205 enables the EPA administrator to make grants from a Carbon Mitigation Fund to install fast-charging electric vehicle infrastructure along urban and rural highways and public roads.
The problem is that all taxpayers and electricity consumers will fund the expansion of EV charging infrastructure, but only the wealthiest will enjoy it. EVs are not known to be cheap, with the average price of a vehicle sitting somewhere around $55,600.
The luxury status of EVs is also evident in the tax returns of those who claim the federal EV tax credit. According to the Congressional Research Service, 17% of taxpayers had an adjusted gross income of $100,000 or more in 2016. But 78% of those claiming the EV tax credit were in this higher income echelon.
Despite plundering the poor, the CLEAN Future Act tries to cover its tracks through thinly veiled lip service to social justice. Section 440B provides grants of up to 80% of the cost of an EV charging project in underserved or disadvantaged communities. While that might sound generous on paper, it is divorced from the reality of working-class America.
According to the Bureau of Labor Statistics, the annual mean wage of workers in all occupations is below the average cost of an EV. For underserved communities, both urban and rural, these green charging stations are white elephants. For wealthy road-trippers, however, they’ll offer a convenient place to charge up on their way through.
A close reading of the CLEAN Future Act should not disparage the promise and potential of EVs. Tesla is a wildly successful American company, built on the back of ingenuity and entrepreneurship. Given that climate action is increasingly a bipartisan issue, helping more consumers buy the car that they want will no doubt spur the uptake of EVs. With the right policy mix, the federal government can support consumer choice while limiting the burden on low-income consumers.
Nonetheless, forcing lower income taxpayers and energy ratepayers to fund the rollout of EV charging stations constitutes a Tesla tax on the less-wealthy. When Marie Antoinette was told that the poor could not afford bread, she reportedly said to “let them eat cake.” For Americans who are struggling in the wake of the pandemic, House Energy and Commerce Committee Chairman Frank Pallone has effectively declared to let them charge their Teslas.
Oliver McPherson-Smith writes for the American Consumer Institute, a nonprofit educational and research organization. For more information about the Institute, visit www.TheAmericanConsumer.Org or follow us on Twitter @ConsumerPal
[Editor’s note: This story originally was published by Real Clear Energy.]
[Editor’s note: This story originally was published by Real Clear Health.]
By Peter Pitts & Jason Zerncik
Real Clear Health
The debate over healthcare costs is nothing new. But like many topics where every-day Americans find themselves at the intersection of policy and economic matters, the COVID-19 pandemic has only further heightened the impact of a critical drug pricing rule finalized by the Centers for Medicare and Medicaid Services (CMS) in the closing days of 2020.
Recent years have seen an increased prevalence of high deductible health plans, defined by the IRS as $1,400 or more per year for an individual and $2,800 or more for a family plan. The 2020 Kaiser Family Foundation Employee Benefits Survey shows the average deductible for individual annual coverage has increased 25% over the last five years and 79% over the last ten. 26% of covered workers had an annual deductible of $2,000 or more in 2020.
To offset commercially insured patients’ out of pocket costs, pharmaceutical manufacturers offer copay assistance coupons for many drugs. These coupons pay a portion, or in some cases, the entire amount that a patient’s health plan assesses for a drug via copays and deductibles. For costly specialty medications, especially those without generic alternatives, coupons are often critical for patients to access the care they need.
A 2020 Massachusetts Health Policy Commission study noted that coupons increase adherence to prescribed therapies, which has the potential to decrease healthcare spending on emergency department visits, hospitalizations, and other care needs brought about by not taking one’s medication. The study also concluded that eliminating coupons – without substantial protections for patient affordability – would likely create serious challenges for many patients.
Unfortunately, the recently finalized CMS rule could do exactly that. An unintended consequence? Perhaps. But hardly an unexpected one.
The complexity of the rule and its intersection with other equally complex drug pricing policies highlights a situation that is unclear at best and certainly a challenge for industry leaders and politicians, let alone physicians, pharmacists … and patients.
The CMS rule requires that pharmaceutical manufacturers ensure the benefit of their coupons goes solely to the consumer (patient). Effective in 2023, if a coupon’s full value is not realized by the patient, the pharmaceutical manufacturer will be required to count it as a discount to the drug’s Medicaid price. However, the complexity of intertwining policy matters makes this a bit murky.
Pharmaceutical manufacturers are required to give state Medicaid programs their “best price” – the lowest price they offer to any other purchaser of a drug. Pharma companies typically negotiate rebates with insurers’ pharmacy benefit managers (PBMs) in exchange for preferential tiering, or favorable coverage, especially in competitive therapeutic classes. Various price concessions are factored in when computing the “best price in market” that drug manufacturers must match for Medicaid.
While it may seem puzzling how anyone but a patient could benefit from copay assistance coupons, a recent trend among insurers reveals the back-and-forth struggle over cost shifting within the pharmaceutical industry that leaves patients stuck in the middle – and PBMs recouping the value of coupons via a tool known as “copay accumulators.”
Copay accumulators are tactics employed by health plans in which the plan does not count the value of a manufacturer coupon toward a patient’s deductible. To illustrate, if a patient has a $1,500 deductible and receives $500 of copay assistance on a prescription claim, the patient’s deductible is not decreased by $500. It remains the same. An endless, bottomless copay.
Most coupon programs have an annual benefit cap, so it is not uncommon for patients whose plans incorporate accumulators to exhaust the support funding at some point in the year and then be faced with having to pay their full deductible. This creates the type of cost hurdles that force everyday Americans to decide between paying their rent or mortgage or seeking medical care.
But it gets worse. Under the CMS rule, a coupon in an accumulator scenario is considered a price concession to an entity other than a consumer since it lowers the health plan’s cost for the drug. As a result, the CMS rule would require the full coupon value to be factored into Medicaid discounts. The result is that coupon programs could soon become financially untenable for manufacturers, causing patients to lose generous benefit amounts for specialty therapies.
The policy problem is the rule’s requirement that pharmaceutical manufacturers ensure that health plans give patients credit for the value of coupons. This sounds like a good idea, but health plans perform accumulator adjustments after prescription claims are processed, independent of the pharmaceutical manufacturers’ control. While drug makers would prefer, and certainly encourage, health plans to credit patients for their coupons, their ability to “ensure” this happens, as the rule prescribes, is nearly impossible. That’s got to change.
The Biden Administration needs to act. Establishing policy that helps patients gain affordable access to prescription drugs is, and should remain, a top priority. But the CMS rule goes about it the wrong way. “Robbing Peter to pay Paul” is never good policy – and certainly not in healthcare. While a reduction in Medicaid pricing is a positive outcome, many commercially insured patients could lose a vital support line to their critical medicines. It is unrealistic to believe that pharmaceutical manufacturers will be able to continue offering copay assistance as they currently do if their coupons are subject to this rule.
Further complicating matters, the recently passed American Rescue Plan (ARP), aka, the COVID relief bill, contains a repeal of the cap on Medicaid rebates beginning in 2024. Currently, rebates may not exceed 100% of a drug’s Average Manufacturer Price. Under ARP, this logical stipulation is removed, creating the potential that drug manufacturers could be forced “upside down” on products to remain covered under Medicaid plans – rather than offering “best price,” they could potentially have to pay the government to offer their medicines to patients.
Given the availability of this negotiating lever on the horizon for states, adding the additional impact of manufacturer coupons being subject to rebate inclusion is an unwise and dangerous provision that only stands to harm those whom coupons are intended to benefit – American patients.
Peter J. Pitts is a Visiting Professor at the University of Paris School of Medical School and President of the Center for Medicine in the Public Interest. He is a former Associate Commissioner of the US Food & Drug Administration and member of the United States Senior Executive Service.
Jason Zemcik is Senior Director of Product Management at TrialCard, a biopharmaceutical solutions firm and leading provider of copay assistance programs on behalf of pharmaceutical manufacturers. He was named to the Medical, Marketing, and Media (MM+M) 40 Under 40 List of healthcare marketers in 2021 and is a frequent speaker, author, and panelist on topics impacting manufacturer copay assistance programs.
[Editor’s note: This story originally was published by Real Clear Health.]
Friday’s New York Times front-page story by White House reporter Annie Karni portrayed the president bravely fighting another plague: “Biden Moves To Curb Plague Of Gun Crime – Orders Restrictions on Homemade Firearms.” The jump-page headline made President Biden a literal life-saver: “Biden Moves to Save Lives by Regulating Kits to Make Guns.” All because of a Democratic gun crackdown that hasn’t even begun yet.
President Biden, calling gun violence in the United States “an international embarrassment,” took a set of initial steps on Thursday to address the problem, starting with a crackdown on the proliferation of so-called ghost guns, or firearms assembled from kits.
Acknowledging that more aggressive actions like banning assault weapons, closing background check loopholes and stripping gun manufacturers of their immunity from liability lawsuits would have to wait for action from Congress, he said it was nonetheless vital to do what he could on his own to confront what he called an epidemic of shootings that are killing roughly 100 Americans a day.
While the moves the president announced fall far short of the broad legislative changes long sought by proponents of making it harder to buy guns, especially semiautomatic weapons often used in mass shootings, they addressed narrower issues also of intense concern to many Democrats and supporters of gun regulations.
The most substantive of the steps was directing the Justice Department to curb the spread of ghost guns. Kits for these guns can be bought without background checks and allow a gun to be assembled from pieces with no serial numbers.
Heard of ghost guns? The Times has reported on them sporadically – then came the Biden administration fear-mongering, and suddenly they are a favorite of “right-wing extremists” and on the gun-grabber’s priority list.
Ghost guns, experts said, have become particularly appealing to criminal organizations and right-wing extremists who want access to untraceable firearms that do not require any background checks. They are often linked to shootings in states like California that have instituted strict gun laws.
Even a modest step like addressing the issue of ghost guns, which have been in circulation for years, shows how paralyzed the politics surrounding gun control have become.
Despite the National Rifle Association’s financial troubles, the group’s lobbying presence remains formidable and the gun movement’s hold on the Republican Party unshaken. Action on key gun issues — universal background checks and a ban on assault weapons, for example — remains stalled because of the narrow partisan divide in the Senate and the 60-vote requirement imposed by the filibuster.
The Times never shows any distaste for how teachers unions or Planned Parenthood have a stranglehold on the Democratic Party. Partisan loyalty to special interest groups are noteworthy only when Republicans are involved.
Given the wall of Republican opposition, supporters of more restrictive gun laws and regulations applauded even the modest moves that Mr. Biden announced on Thursday, underscoring how their ambitions have been circumscribed by political realities.
The Times conjured up more lives saved by Biden, based on nothing but wishful thinking.
Outside of mass shootings, gun violence remains the leading cause of death for Black men ages 15 to 34, Mr. Biden said in his remarks, noting that additional funding he has proposed for community violence programs can save lives.
The text box used a lazy term (“epidemic”) to refer to a trend that is not contagious: “Calling for action as about 100 Americans a day are dying in an epidemic of shootings.” Over a year into an actual epidemic, one would think the paper would know better.
Karni concluded by circling back to Biden:
The House passed two gun control bills last month, but they are languishing in the Senate in the face of the chamber’s 60-vote threshold for passing most legislation, which requires the support of at least 10 Republicans.
“They have offered plenty of thoughts and prayers, members of Congress, but they have passed not a single federal law to reduce gun violence,” Mr. Biden said. “Enough prayers. Time for action.”
In Friday’s New York Times, their lead National story proved Georgia is still heavily on the paper’s mind and especially the state’s supposedly harsh, racist new restrictions on voting. Political reporters Lisa Lerer and Reid Epstein unloaded on the GOP in “Georgia Governor Sets His Sights on Overcoming Trump’s Wrath.”
Their lead sentence showed a penchant for Democratic hyperbole, as if slightly tightening some voting rules in the state that have been loosened drastically over recent years signified the return of Jim Crow: “Three years ago, Brian Kemp was elected governor when Republicans embraced his nearly decade-long quest to restrict voting access in Georgia. Now he has tied his re-election hopes to making voting in the state even harder.”
The next two graphs weren’t any better as they kept up the charade:
After infuriating former President Donald J. Trump by resisting his demands to overturn the state’s election results, Mr. Kemp became an outcast in his own party. He spent weeks fending off a daily barrage of attacks from right-wing media, fellow Republican lawmakers and party officials, and Mr. Trump vowed to retaliate by sending a hard-right loyalist to oppose him in the primary next year.
But the sweeping new voting bill Mr. Kemp signed two weeks ago has provided a lifeline to the embattled governor to rebuild his standing among the party’s base. The bill severely curtails the ability to vote in Georgia, particularly for people of color. Mr. Kemp has seized on it as a political opportunity, defending the law as one that expands voting access, condemning those who criticize it and conflating the criticism with so-called cancel culture.
Let’s pause for briefing but important fact check: The law does not “severely curtail the ability to vote in Georgia.”
Continuing to keep their guns turned on Kemp, they did what they’ve almost certainly not done with Democrats during the Trump-Russia probe, which was gripe about someone’s number of interviews and TV appearances (click “expand”):
Since signing the bill into law on March 25, Mr. Kemp has done roughly 50 interviews, 14 with Fox News, promoting the new restrictions with messaging that aligns with Mr. Trump’s baseless claims that the election was rigged against him.
A political ascent would represent an unlikely turnaround for Mr. Kemp, making him the most prominent Republican to find a way to overcome Mr. Trump’s campaign of retribution, and perhaps providing an early test of the former president’s ability to impose his will on the party’s electoral future.
Mr. Kemp’s argument is designed to pump adrenaline into the conservative vein, by focusing on two of the most animating topics of the political right: election mechanics and an ominous portrayal of the Democratic left.
The new law Mr. Kemp is championing makes it harder to acquire an absentee ballot, creates new restrictions and complications for voting and hands sweeping new power over the electoral process to Republican legislators. It has drawn harsh criticism from local companies like Coca-Cola and Delta, and prompted Major League Baseball to move its All-Star Game out of suburban Atlanta as a form of protest.
Those “restrictions and complications” exist in blue states as well, including Minnesota and Colorado (where Major League Baseball just relocated its All-Star game). The Times just won’t cover them.
Leaning hard into the racism lie, Lerer and Epstein concluded by allowing a Democrat to go unchallenged in accusing Kemp of playing racial politics:
Democrats say his ardent support of the law and attacks on [Stacey] Abrams are a cynical effort to bolster his standing among his conservative base while suppressing votes for his general election opponents.
“This is all politics,” said Representative Nikema Williams, the chairwoman of the state Democratic Party, who replaced the civil rights icon John Lewis in Congress. “Let’s also be clear that a part of that politics is keeping Black and brown people away from the polls so he can continue to win elections in Georgia.”
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