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  1. #1
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    Trump About Is Fair Play: GOP Reality vs Promise

    Just like I had to endure Obama's campaign promises used to depict a harsh evaluation over his 8 years, it's time to set up a thread that places focus on our new President and the total control the GOP now has. The same rules of TLR handful absolute perfection hold.

    It's off to an interesting start...

    GOP and Trump put deficit on back burner
    A serious case of fiscal amnesia may soon be sweeping the GOP.

    For eight years, Republicans hammered President Barack Obama for exploding the national debt. But now a GOP-led spending spree is coming, with Donald Trump riding to the White House on trillion-dollar promises and a Republican Congress that looks likely to do his bidding. It’s a potential echo of the last time Republicans ran Washington, when then-Vice President •••• Cheney memorably remarked, “Deficits don’t matter.”

    Trump campaigned heartily on a spending splurge and nothing he’s said since his shocking election suggests he will reverse course. Republican leaders on Capitol Hill, meanwhile, are papering over divisions with the man who frequently tossed party orthodoxy aside on the trail.

    “There is now a real risk that we will see an onslaught of deficit-financed goodies — tax cuts, infrastructure spending, more on defense — all in the name of stimulus, but which in reality will massively balloon the debt,” said Maya MacGuineas, president of the Committee for a Responsible Federal Budget.

    The non-partisan group estimated Trump’s campaign proposals would increase the national debt by a whopping $5.3 trillion over the next decade. That would make the debt as a share of the economy rise from nearly 77 percent to 105 percent, a potentially dangerous level for the government.

    Not all of the promises Trump made on the trail will be enacted, of course, but even just a few would mean a flood of red ink. A top Trump priority — major infrastructure spending — is one of them.

    “We are going to fix our inner cities and rebuild our highways, bridges, tunnels, airports, schools, hospitals,” Trump said in his victory speech last week. “We’re going to rebuild our infrastructure, which will become, by the way, second to none.”

    Obama has long sought infrastructure investments, but he was consistently rebuffed by GOP lawmakers. Now that they’ve got one of their own in the White House, Republicans in Congress are likely to play ball. House Majority Leader Kevin McCarthy said Monday that an infrastructure bill that could win bipartisan backing was indeed possible. Trump’s plans call for $1 trillion to be spent over a decade, in part through public-private partnerships and private investments.

    Trump has also vowed to “rebuild” the U.S. military and eliminate the stiff caps on Pentagon spending that Congress enacted in the 2011 Budget Control Act. That law was the result of tough negotiations between GOP lawmakers and Obama to raise the debt limit and curb rising federal deficits. Democrats have long sought to permanently break through the caps, while Republicans have resisted in the name of fiscal responsibility; but perhaps with a Republican president they would relent.

    Trump and congressional Republicans are also planning enormous tax cuts for businesses and individuals — with high-income households getting the biggest benefits. The non-partisan Tax Policy Center estimated Trump’s tax plan would increase the federal debt by $7.2 trillion over a decade. In comparison, the huge George W. Bush-era tax cuts cost less than $2 trillion. House GOP leadership is already on board the Trump tax train.

    “Donald Trump put out a tax plan in the campaign that is almost the same as the tax plan [of] House Republicans,” Speaker Paul Ryan told Fox News’ Bret Baier last week. “We are absolutely on the same page on reforming the tax code.”

    Ryan is also downplaying any differences between GOP lawmakers and the president-elect on the question of curbing entitlement spending. Trump made an ostentatious show of his support for Social Security during the presidential campaign, suggesting he was a different type of Republican, opposed to attempts to reform the popular retirement program.

    Ryan, meanwhile, made his name in Washington as a fiscal hawk and has consistently warned of Social Security’s future insolvency. But when asked about it by Baier, Ryan demurred. “Frankly, the fiscal pressures are mounting faster on health care than they are on Social Security,” Ryan said.

    AshLee Strong, a Ryan spokesperson, said House Republicans are only just beginning to talk with Trump and Vice President-elect Mike Pence about next year’s agenda.

    Trump: 'Sometimes you need a certain rhetoric to get people motivated'

    Trump’s bombastic campaign promises also included a vow to reduce budget deficits, in part through robust economic growth. But few budget analysts take that claim seriously.

    “Simply put, there's no way to make these numbers add up without some extreme growth assumptions,” said Phil LaRue, an advisor to the deficit-minded Concord Coalition.

    Democrats are not terribly surprised that Republicans are shifting their focus away from the debt as the GOP prepares to assume complete control of Washington.

    “It’s always been the case that Republicans put tax breaks for the wealthy before addressing the deficit,” said Rep. Chris Van Hollen, the top Democrat on the House Budget Committee.

    “We still haven’t seen the interplay between the congressional Republican agenda and the Trump agenda,” added Van Hollen, who was elected to represent Maryland in the Senate last week. “But clearly Republicans seem to be getting collective amnesia when it comes to long-term deficit and debt issues.”
    So, check. Deficit spending is not bad anymore. Social Security is OK now. Time to spend more on the military, I guess more than all the nations in the world combined. Tax breaks for the rich. Rebuild the infrastructure- finally, because Obama isn't asking and deficits don't matter.
    Thomas Jefferson to John Page Fairfeilds Dec: 25. 1762.
    ... But the old-fellows say we must read to gain knowledge; and gain knowledge to make us happy and be admired. Mere jargon! Is there any such thing as happiness in this world? No: And as for admiration I am sure the man who powders most, parfumes most, embroiders most, and talks most nonsense, is most admired.


  2. #2
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    Re: Trump About Is Fair Play: How bout that Great Wall

    Trump admits that his ‘big, beautiful’ wall might actually just be a fence
    As Donald Trump begins his transition to the Presidency, it’s becoming increasingly clear that his ambitions are not meshing perfectly with reality. Now it seems that “great, great wall” that became an iconic part of Donald Trump’s improbable path to the White House might actually not be a wall at all.

    In his first televised interview since being declared the winner of the election, Trump appeared on 60 Minutes and repeated his vow to build something between the United States and Mexico, while at the same time rolling back on his pledge that it’ll actually be a solid wall.

    When pressed by CBS’s Lesley Stahl about the possibility that his promised wall might actually just be a fence, as has been discussed among Republicans in Congress, Trump admitted that it might very well be.

    “Certain areas, a wall is more appropriate,” Trump added. “I’m very good at this, it’s called construction.”

    During Trump’s campaign, he made several claims regarding the promised wall, including that it would be constructed out of precast concrete, and that it could reach as high as 50 feet. Construction experts have repeatedly shot down Trump’s promise that the wall would cost as little as $8 billion to build, with estimates from people who weren’t running for President as high as $26 billion.

    The US-Mexico border is just shy of 2,000 miles long, of which about 650 miles is currently already fenced in one form or another. Those fences, as has been well documented, are easily scalable in most, if not all stretches, which is likely why Trump’s promise of a more solid replacement resonated so well with his supporters.

    In the wake of an election, reality often sets in, and in this case it appears increasingly likely that “the wall” will be nothing more than another unfulfilled campaign promise.
    Looking forward to seeing Mexico pay for a 50 foot high line drawn in the sand.
    Thomas Jefferson to John Page Fairfeilds Dec: 25. 1762.
    ... But the old-fellows say we must read to gain knowledge; and gain knowledge to make us happy and be admired. Mere jargon! Is there any such thing as happiness in this world? No: And as for admiration I am sure the man who powders most, parfumes most, embroiders most, and talks most nonsense, is most admired.


  3. #3
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    Re: Trump About Is Fair Play: Drain the Swamp

    Conway: Trump will drain swamp — but retain D.C. insiders
    Donald Trump’s campaign manager, Kellyanne Conway, said Sunday morning that “the gravy train is about to have its wheels blown off” when the Manhattan billionaire assumes the presidency in January, and that shakeup will happen regardless of who fills some of the key roles in his administration.

    The president-elect built his campaign around his outsider status, pledging to “drain the swamp” in Washington of the politicians and lobbyists who he railed against throughout the race. But his transition team includes familiar political faces like former New York Mayor Rudy Giuliani and Sen. Jeff Sessions (R-Ala.), along with a collection of lobbyists. Republican National Committee Chairman Reince Priebus, hardly a Washington outsider, is reported to be at or near the top of the list of candidates to be Trump’s chief of staff.


    Conway said Trump will stay true to his swamp-draining campaign promises, even if his transition has thus far taken a more traditional Washington form.

    “Look, these are people who are talented and have done this before. You can't just appoint novices, you have to have people who know what they're doing. But at the same time, moving forward, this is an administration that's going to run very differently than typical Washington,” Conway told host Chris Wallace during an interview on “Fox News Sunday.” “Finally, the voters got what they wanted, what they've been begging for for 30 years, which is give us the opportunity, give us a person who actually represents the outsider, non-Washington, business-experienced type of profile, somebody who goes to Washington owing nobody anything.”

    Asked when the public could expect an announcement on who will be Trump’s chief of staff, Conway reiterated that a decision is “imminent” but would not commit to a specific timetable. Stephen Bannon, the combative Breitbart chairman and Trump campaign CEO, is the other name rumored to be under consideration for the chief of staff job, and who the president-elect ultimately selects would send a clear signal about the type of administration he intends to run.


    Conway said both Priebus and Bannon were essential to Trump’s win and that “it tells you a great deal about President Trump that both of those men are thought to have very important roles in his administration, very senior roles, and that regardless of title that is absolutely what's going to happen.”

    “The gravy train is about to have its wheels blown off and its engine completely ripped from its bearings because there is just no reason to keep this consultant-lobbyist axis at such — a-x-i-s — at such a level where people feel like their interests are not being served,” she said, pausing to clarify that she had said axis, not access. “Part of the rigged, corrupt system that he was giving voice to so often was the one we heard from voters. They don't appreciate all the organs and adjuncts of Washington, D.C., working against them. This is an administration for the forgotten man and the forgotten woman.

    "Nobody thinks of lobbyists and consultants as the forgotten man or forgotten woman.”
    I love Conway. She's the perfect spinmeister.

    Washington insiders aren't bad now. We need them over novices. It looks like the swamp remains.
    Thomas Jefferson to John Page Fairfeilds Dec: 25. 1762.
    ... But the old-fellows say we must read to gain knowledge; and gain knowledge to make us happy and be admired. Mere jargon! Is there any such thing as happiness in this world? No: And as for admiration I am sure the man who powders most, parfumes most, embroiders most, and talks most nonsense, is most admired.


  4. #4
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    Re: Trump About Is Fair Play: Trash Obamacare

    Did Trump Just Endorse Obamacare's "Most Harmful" Provision?
    To a roaring crowd at the Fox News Republican presidential debate last January, Texas Senator Ted Cruz vowed to "repeal every word" of Obamacare.

    Though Cruz ultimately lost the presidential nomination to Donald Trump, the man then considered the underdog, the significance of Cruz’s sentiment was not lost on the American people.

    Forty-seven percent of voting Americans, and 83% of those who voted for Trump, think the 2010 federal health care law “went too far,” according to Fox News exit polls on Election Day.

    Former NYC Mayor Rudy Giuliani, who is reportedly being considered for a top position in a Trump administration as either Attorney General or Secretary of State, went so far as to say Obamacare is what ultimately gave the businessman the edge over Hillary Clinton on November 8.

    “Being part of the campaign, we put [Obamacare] up front in all of Donald Trump’s speeches for the last two or three weeks...That seems to me to be the thing that moved the votes,” he said Sunday in an interview on "This Week with George Stephanopoulos."

    Trump has repeatedly made the promise to “repeal and replace” the health care law, and now that he has won the citizens’ mandate, his supporters are expecting him to fulfill that promise—and fast.

    Late Friday, Trump announced during an interview with the Wall Street Journal he will make health care a priority, though he is not opposed to keeping parts of the Affordable Care Act intact, including coverage for pre-existing conditions and allowing children to remain under the parents’ plans until the age of 26. This is a far cry from Cruz’s battle call to repeal every word of the law.

    Should Trump supporters be worried about the President-elect softening his stance?

    The answer is yes, according to Michael Cannon, the Cato Institute’s director of health policy studies.

    "Trump basically endorsed keeping Obamacare's central and most harmful provision," he told FOXBusiness.com. "If he sticks to that position, it means he has abandoned repeal. His base will interpret that as complete acquiescence and conclude Trump is no better than the rest in Washington."

    On the other hand, unraveling President Obama’s signature domestic policy achievement may not be as easy as the businessman’s supporters believe, even with single party control over the legislative and executive branches.

    “The Republican base that got Donald Trump into the White House may be in for a rude awakening. Screaming ‘repeal it’ at a rally is easy. Actually crafting hundreds of pages of legislation that clears four to five Congressional committees, the best-funded lobbying groups in Washington, and manages to secure 218 votes in a very fractured House majority is much, much tougher,” Adam Beck, Assistant Professor of Health Insurance at The American College of Financial Services, told FOXBusiness.com.

    There are two ways President-elect Trump can go about repealing the Affordable Care Act, though neither of them will be quick nor easy.

    The Republicans do not have a filibuster-proof majority in the Senate, meaning they would need to swing eight to nine votes from the Democratic side in order to pass legislation. That is unless, as the Democrats infamously did in 2010, the Trump administration rams a bill through Congress with no approval from the other side of the aisle.

    “It is conceivable they could do this on a straight party-line vote, hold the House [caucus] together. You have to nuke the filibuster in the Senate, and just go straight party-line all the way,” Paul Howard, senior fellow and director of health policy at the Manhattan Institute, told FOXBusiness.com.

    Though as President Obama found out that can be an unpopular option. Merely six years after his groundbreaking legislation was enacted, it became the rallying cry for the opposition party, possibly even catapulting a political newcomer into the Oval Office.

    The other option is reconciliation. Reconciliation is a legislative process allowing certain matters to be expedited by forbidding a filibuster, which means the Senate would only need 51 votes for approval.

    However the scope of this process is limited to assessing certain tax, spending and budget measures.

    As it pertains to the healthcare law, this means “anything tax-related” could be addressed, according to Beck.

    “This could be a January 21 or January 22 initiative…they will be able to repeal anything that they can put through reconciliation,” Beck said. “The individual mandate, which is essentially a tax provision. That’s going to be gone. The employer mandate, gone. The tax subsidies that fund the exchange are going to be gone.”

    Because of the promises Donald Trump has made to his supporters, Beck believes he will be under “a ton of political pressure to get the repeal part of the Affordable Care Act through right away,” which could give way to “a lot of chaos.”

    While Trump’s administration may be able to begin the repeal process immediately, the replace part will be a little more difficult especially since they have yet to unite behind a coherent replacement plan. Trump has outlined some traditional Republican bullet points such as HSA’s, purchasing insurance across state lines and reestablishing high-risk pools; far from a comprehensive alternate policy proposal.
    So far the President elect is testing the waters with another flipflop. Major parts of Obamacare are no longer bad. An interesting dilemma considering the mandate was needed to pay for pre-existing conditions. Another interesting idea is to replace Obamacare with Obamacare. Guess we'll have to call it TrumpCare.
    Thomas Jefferson to John Page Fairfeilds Dec: 25. 1762.
    ... But the old-fellows say we must read to gain knowledge; and gain knowledge to make us happy and be admired. Mere jargon! Is there any such thing as happiness in this world? No: And as for admiration I am sure the man who powders most, parfumes most, embroiders most, and talks most nonsense, is most admired.


  5. #5
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    Re: Trump About Is Fair Play: GOP Reality vs Promise

    I didn't make it past this:
    The non-partisan group estimated Trump’s campaign proposals would increase the national debt by a whopping $5.3 trillion over the next decade. That would make the debt as a share of the economy rise from nearly 77 percent to 105 percent, a potentially dangerous level for the government.
    $5.3 trillion over a decade? Really? I'm not for deficit spending, but $5.3 trillion over a decade represents a fraction of the debt rise that occurred under 8 years of Obama, and that doesn't even take inflation into account. If that's "whopping", then how would one describe the debt trend under Obama?

    As for Trump, I'll start off the same way I did with regards to Obama. I didn't support Obama, and choose to take a wait-and-see approach. I waited, and I saw fiscal irresponsibility. I waited and I saw government picking winners and losers, with too many of the chosen "winners" being really big losers. Solyndra comes to mind. I waited and I saw a guy who drove our citizens in opposite directions, all by mandating we pick sides. I waited and I saw a guy who refused to place any responsibility on his own people for elevating their status, preferring to lay all blame at the feet of white oppression. I waited and I saw a guy who refused to call Islamic terrorism what it is. I waited and I saw workforce participation march downwards in a stunningly linear fashion almost his entire term. I waited and I saw record levels of people dropping into poverty, taking government benefits, etc. I waited and am still waiting for him to call out cowards who randomly assault our police or riot when they don't get their way. I waited and I saw a guy who groveled at the feet of other nations, always apologizing and never leading. I saw a guy who simply seemed out of his league.

    Trump? My gut looks to his past, and sees a guy who was always interested in whatever benefited himself. My hope now is that at his age he no longer has interest in feathering his own nest, and he really is interested in the betterment of the bulk of our nation. I definitely don't take for granted it will happen that way, but it is the hope.

    Living in Wisconsin, I've had enough of the divisive strategy of Obama and our own clown of a governor. I've also had quite enough of the "tolerance" of the liberals, who pout and riot at the very suggestion of things not going their way. Grow some balls and get on with life. Sheesh.

  6. #6
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    Re: Trump About Is Fair Play: GOP Reality vs Promise

    Quote Originally Posted by myv65 View Post
    I didn't make it past this:

    $5.3 trillion over a decade? Really? I'm not for deficit spending, but $5.3 trillion over a decade represents a fraction of the debt rise that occurred under 8 years of Obama, and that doesn't even take inflation into account. If that's "whopping", then how would one describe the debt trend under Obama?

    As for Trump, I'll start off the same way I did with regards to Obama. I didn't support Obama, and choose to take a wait-and-see approach. I waited, and I saw fiscal irresponsibility. I waited and I saw government picking winners and losers, with too many of the chosen "winners" being really big losers. Solyndra comes to mind. I waited and I saw a guy who drove our citizens in opposite directions, all by mandating we pick sides. I waited and I saw a guy who refused to place any responsibility on his own people for elevating their status, preferring to lay all blame at the feet of white oppression. I waited and I saw a guy who refused to call Islamic terrorism what it is. I waited and I saw workforce participation march downwards in a stunningly linear fashion almost his entire term. I waited and I saw record levels of people dropping into poverty, taking government benefits, etc. I waited and am still waiting for him to call out cowards who randomly assault our police or riot when they don't get their way. I waited and I saw a guy who groveled at the feet of other nations, always apologizing and never leading. I saw a guy who simply seemed out of his league.

    Trump? My gut looks to his past, and sees a guy who was always interested in whatever benefited himself. My hope now is that at his age he no longer has interest in feathering his own nest, and he really is interested in the betterment of the bulk of our nation. I definitely don't take for granted it will happen that way, but it is the hope.

    Living in Wisconsin, I've had enough of the divisive strategy of Obama and our own clown of a governor. I've also had quite enough of the "tolerance" of the liberals, who pout and riot at the very suggestion of things not going their way. Grow some balls and get on with life. Sheesh.
    I have grown balls and have moved on with life. I'll be watching the future. If you notice, I haven't scootered this thread, but I am using his glasses.

    An added $5 Trillion Deficit is now OK? It isn't a fraction if you don't count the fiscal 2009 Bush budget. It's more of the same from my eyes.


    I'm holding off on Trump and how he sets up his businesses. That's still being tested by the spokes people. Anything less than a blind trust will prove your wondering.

    As to divisive? Come on now. Trump ran his campaign on being divisive and his choice of Bannon doesn't show change to that.

    So moving on, Obama is gone. History. Trump is in. This is about all things Trump. You seem to ignore what the GOP gave Obama and blame him for the effect and not the improvements while working with a Congress that stated they would work against him in his first year. Luckily, you guys don't have that. Total control and therefore an element of total responsibility that Obama never had.
    Thomas Jefferson to John Page Fairfeilds Dec: 25. 1762.
    ... But the old-fellows say we must read to gain knowledge; and gain knowledge to make us happy and be admired. Mere jargon! Is there any such thing as happiness in this world? No: And as for admiration I am sure the man who powders most, parfumes most, embroiders most, and talks most nonsense, is most admired.


  7. #7
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    Re: Trump About Is Fair Play: GOP Reality vs Promise

    .
    Quote Originally Posted by otoc View Post
    I have grown balls...
    Congrats.

    Your posts however, have the same tenor... or is that soprano?.

  8. #8
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    Re: Trump About Is Fair Play: GOP Reality vs Promise

    The greatest president ever!! I mourn his departure with heavy heart...

    And the departure of millions of the unborn and those murdered in late term and those murdered in partial birth abortion. What A HERO!!...

    http://www.martinoauthor.com/list-obama-failures/
    Last edited by tucker; 11-15-2016 at 10:15 AM.
    They who can give up essential liberty to obtain a little temporary safety deserve neither liberty nor safety.
    ~ Benjamin Franklin

  9. #9
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    Re: Trump About Is Fair Play: GOP Reality vs Promise

    cheaper than a life time of government handouts. free birth control? that would help but then that's not the goal.

    bb

  10. #10
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    Re: Trump About Is Fair Play: GOP Reality vs Promise

    Quote Originally Posted by baghdad bob View Post
    cheaper than a life time of government handouts. free birth control? that would help but then that's not the goal.

    bb
    Goggle free birth control its available. People have to be responsible enough to use it, many aren't. Using abortion as last chance birth control is repulsive...
    Last edited by tucker; 11-15-2016 at 11:15 AM.
    They who can give up essential liberty to obtain a little temporary safety deserve neither liberty nor safety.
    ~ Benjamin Franklin

  11. #11
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    Re: Trump About Is Fair Play: GOP Reality vs Promise

    Quote Originally Posted by otoc View Post
    . . .

    So moving on, Obama is gone. History. Trump is in. This is about all things Trump. You seem to ignore what the GOP gave Obama and blame him for the effect and not the improvements while working with a Congress that stated they would work against him in his first year. Luckily, you guys don't have that. Total control and therefore an element of total responsibility that Obama never had.

    Moving on... LOL! Perfect troll setup. Love the tone and obvious "lets all forget about the patriot4us/otoc shilling for 8 years of a failed presidency and move on to just criticizing T"!

    Talking about Obama is verboten!!

    Almost comical you'd come peddling this BS in TLR with your history.. which you'd also like everyone to forget... I'm sensing a theme... 10 years ago...

    I'm not sure how much you missed (we understand it's hard to see with your head so far up bamma's arse)... but the rest of us have not forgotten Mr. "I won" had complete control of gubberment for the first 2 years pf his presidency. That's how the porkulus and bammacare got rammed down our throats. GW never had that... but I don't remember you making any statements absolving him from responsibility like the blanket BS you are spreading for your black Jesus.

    I do remember a lot of BOOOOSSSHHH!

    So in short...



    "The most dangerous myth is the demagoguery that business can be made to pay a larger share, thus relieving the individual. Politicians preaching this are either deliberately dishonest, or economically illiterate, and either one should scare us...
    Only people pay taxes, and people pay as consumers every tax that is assessed against a business."


    -The Gipper


  12. #12
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    Re: Trump About Is Fair Play: GOP Reality vs Promise

    Quote Originally Posted by tucker View Post
    Goggle free birth control its available. People have to be responsible enough to use it, many aren't. Using abortion as last chance birth control is repulsive...
    all because of obamacare and who's talking repeal? keep them burdened with unwanted pregnancies and in povertry.

    bb

  13. #13
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    Re: Trump About Is Fair Play: GOP Reality vs Promise

    Quote Originally Posted by baghdad bob View Post
    all because of obamacare and who's talking repeal? keep them burdened with unwanted pregnancies and in povertry.

    bb
    When you've paid your ten thousand dollar deductible, your nine dollar per month birth control pills are FREE... and those nasty Republicans think that's not how it should be.

  14. #14
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    Re: Trump About Is Fair Play: GOP Reality vs Promise

    assuming most of the people that can't afford birth control have Medicaid here is the miracle.

    https://www.plannedparenthoodhealthi...lans/medicaid/
    They who can give up essential liberty to obtain a little temporary safety deserve neither liberty nor safety.
    ~ Benjamin Franklin

  15. #15
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    Re: Trump About Is Fair Play: GOP Reality vs Promise

    dusted off the hotair propaganda talking point?

    These FAQs provide further guidance on the scope of coverage required for contraception and
    the extent to which plans and issuers may utilize reasonable medical management. Specifically:
    1)
    Plans and issuers must cover without cost sharing at least one form of contraception in each of the methods (currently 18) that theFDA has identified for women in its current Birth Control Guide 12
    This coverage must also include the clinical services, including patient education and counseling, needed for provision of the contraceptive method.

    2)
    Within each method, plans and issuers may utilize reasonable medical management
    techniques.
    A plan or issuer generally may impose cost sharing (including full cost
    sharing) on some items and services to encourage an individual to use other specific
    items and services within the chosen contraceptive method. For example, a plan may
    discourage use of brand name pharmacy items over generic pharmacy items through the
    imposition of costsharing. Similarly, a plan may use cost sharing to encourage use of
    one of several FDA-approved intrauterine devices (IUDs) with progestin.
    3)
    If utilizing reasonable medical management techniques within aspecified method of
    contraception, plans and issuers must have an easily accessible, transparent, and
    sufficiently expedient exceptions process that is not unduly burdensome on the individual
    or a provider (or other individual acting as a patient's authorized representative).
    a.
    If an individual’s attending provider
    13
    recommends a particular service or FDA-
    approved item based on a determination of medical necessity with respect to that
    individual, the plan or issuer must cover that service or item without cost sharing.
    The plan or issuer must defer to the determination of the attending provider.
    Medical necessity may include considerations such as severity of side effects,
    differences in permanence and reversibility of contraceptives, and ability
    to adhere to the appropriate use of the item or service, as determined by the
    attending provider.
    bb

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