Joe Biden’s 2024 Menu: The Rich.

President Joe Biden on Thursday rolled out his proposed budget for fiscal 2024, an ambitious plan that would raise taxes on the rich and on corporations while expanding the social safety net. It would cut nearly $3 trillion from the federal deficit over the next decade by imposing a 25 percent minimum tax on the richest Americans. If you want to read the entire 185-page document, have at it!

Of course, it also won’t do a single bit of that, because Republicans won’t pass any of the major parts of the plan, particularly not the tax increases, but also not the social safety net parts like paid family leave, childcare, or Biden’s plan to rescue the Medicare trust fund for at least 25 years.

Not a bit of it will become law except the most routine keep-things-as-they-are parts, which will no doubt end up in yet another omnibus spending bill passed barely in time to avoid a government shutdown. If then. Oh, also, the part that increases defense spending by about 3.2 percent, to over $835 billion, will probably do just fine. But whatever defense budget eventually passes in the fall won’t be accompanied by the tax increases that would make the expenditures slightly less odious.


So why even offer a budget that’s not going to get passed by Congress? For starters, presidents have to submit a budget request in early February (traditionally by the first Monday, but everything moves slow these days) to get the process rolling, and the budget reflects the administration’s priorities, even if the opposition is able to block them. Also, let’s remember that Donald Trump’s budgets, which zeroed out entire federal agencies, were entirely exercises in rightwing fantasy. And yet somehow we still have the National Endowment for the Arts.

So sure, a federal budget is mostly aspirational, and this year, Biden’s budget serves two practical purposes: It sets out markers for where he wants his government to go in a second term (you know, if he runs), and it’s also an opening bid in the negotiations over raising the debt ceiling. Republicans say they want to cut federal spending because the deficits are too high, and Biden’s budget is over here saying “Yeah? You show me how you’d reduce the deficit by $3 trillion in 10 years, ya mooks.”

Former Obama administration official Kenneth Baer, who served in the Office of Management and Budget, explained to the Washington Post,

“As one of the people who has spent many a long night writing and editing a budget, I take umbrage at the people who say it’s a meaningless document. It’s not a meaningless document. […] It sets the terms of the debate. It shows what’s important to you, your commitments and what you really want.”

So let’s take a look at what’s in this thing and what that says about what Joe Biden wants.

The Rich Still Need To Be Eaten

Speaking at a union hall in Philadelphia yesterday, Biden emphasized that his third budget proposal is aimed at “investing in America and all of America,” because “Too many people have been left behind and treated like they’re invisible. Not anymore. I promise I see you.”

To that end, the $6.8 trillion budget plan (over 10 years) includes about $5 trillion in tax increases on the wealthiest individuals and corporations, most of which will go to cover new programs that Biden has previously put forward but that haven’t yet been enacted.

Some specific tax increase proposals may sound familiar because some of them were in the original version of Build Back Better, but were removed after Sen. Kyrsten Sinema said Donald Trump’s 2017 Big Fat Tax Cuts for Rich Fuckwads couldn’t be reversed, not even a little.

  • Raise the corporate income tax rate from 21 percent to 28 percent, which would still be lower than the 35 percent rate prior to Trump’s 2017 cuts. It would also raise the tax rate on foreign earnings from 10.5 percent to 21 percent, to reduce the incentive for companies to move operations out of the USA.
  • Repeal Trump’s tax cuts for the wealthiest Americans by returning the top marginal tax rate to 39.7 percent from the current 37 percent. This would affect taxpayers making $400,000 a year for individuals, or $450,000 married filing jointly.
  • Tax capital gains the same as income for people making over $1 million, and close the carried interest loopholefor chrissakes finally.
  • Increase the surtax on corporate stock buybacks from one percent to four percent
  • A new minimum tax on billionaires, assessing a 25 percent minimum tax on all income of the wealthiest tenth of one percent of Americans. That’s a follow-up to the minimum corporate tax that was included in last year’s Inflation Reduction Act.
  • Raise Medicare taxes on those making more than $400,000 a year, and make more types of income eligible for Medicare taxation. We detailed that plan right here. Medicare would also be able to negotiate prices on more prescription drugs sooner, creating additional savings that would go to the Medicare trust fund.

Nice Things We Need

The budget also includes some domestic programs that were good ideas when they were proposed in Build Back Better, and were still good ideas when Joe Manchin demanded they be removed from Build Back Better. A few have been downsized for the budget plan, which also adds some items that weren’t in BBB.

  • Restore the enhanced child tax credit and make it permanent. Hell yes. It markedly reduced child poverty in the US, and it’s damn near criminal that it was allowed to lapse. Also way better for America’s children than allowing them to work in meatpacking plants.
  • College affordability. The budget calls for higher maximum awards for Pell grants and for a $500 million grant program to make two years of community college free — not quite the full free community college program Biden originally ran on.
  • Universal Pre-K and affordable child care. Not quite the full programs proposed in Build Back Better, but as CNN summarizes, this would fund “a new federal-state partnership program that would provide universal, free preschool. The spending plan would also increase funding for existing federal early care and education programs.”
  • Paid family and medical leave — another big priority that still needs doing. 12 weeks of paid family and medical leave; for fuckssake let’s get this done. Yeah, in 2025 after we retake the House and expand the Senate majority.
  • More free school meals. During the pandemic, we gave every kid eat. The Biden budget would provide $15 billion to enable wider free lunches, though hey, since it’s a wish list, why not just say we want universal free school lunch? Kids learn better if they’re not hungry.
  • Make the IRA’s Obamacare subsidies permanent. The enhanced premium subsidies, which started out as part of the American Rescue Plan, have helped reduce the percentage of Americans without healthcare coverage to record lows. But they’re set to expire in 2025.
  • Reduce maternal mortality. It’s still a crisis, with far greater rates of maternal mortality for Black women than for white women. The budget calls for $471 million in funding to expand maternal health care, particularly in rural areas. It would also require all states to provide Medicaid postpartum care for 12 months instead of the current 60 days.
  • $35 per month insulin for all Americans. It was included in the IRA for folks on Social Security, so let’s make that the standard for those on private insurance or who have no insurance at all. It’s literally a matter of life or death.
  • Lower prescription drug prices for seniors. The IRA put a $2000 cap annual on out-of-pocket costs for Medicare beneficiaries (going into effect in 2025). Biden wants to further limit copays for generic prescription drugs for chronic conditions to $2.

Yes, We Still Need Climate Spending

While the Inflation Reduction Act was the biggest American investment ever in fighting the climate emergency, Biden’s budget proposal also recognizes that there’s a lot more that needs doing, so it calls for still more funding to move America closer to reaching our Paris climate agreement goals. We want to wrap this sucker up, but take a look at this CNBC piece for more details on how the budget would expand our transition to clean power and cutting carbon emissions. Among the basics:

$24 billion for climate resilience and conservation

$16.5 billion for climate science and clean energy innovation

$6.5 billion for energy storage and transmission projects

$4.5 billion for jobs building clean energy infrastructure

$3 billion for advancing adaptation finance

$1.8 billion for environmental justice initiatives

$1.2 billion for the Energy Department’s industrial decarbonization activities

Want even more info? I’m leaving a tab open with the White House fact sheet on the budget’s climate priorities, because this is what the agenda for keeping the planet habitable should look like.

So those are some darn good priorities — and a blueprint for the 2024 campaign, too.

And now, back to two years of hearings on Twitter and Hunter’s laptop. Total waste of time, but they may help make a very strong case for not letting Republicans anywhere near power again.

[2024 Budget of the US Government / WaPo / CNBC / NYT / CNBC]

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Submissions to Senate concussion inquiry call for national registry, more research, consistent guidelines

Australia’s peak body for general practice has called for government investment to tackle the issue of concussion in sport, including research funding, bigger Medicare rebates for longer consults and the establishment of an Australia-wide concussion registry. 

The Royal Australian College of General Practitioners (RACGP) is one of a number of groups and individuals to put in submissions to a Senate committee inquiry into the impact of concussion and head trauma in contact sports.

The RACGP said the current lack of consistent definitions for concussion was resulting in confusion and an inconsistent approach to treatment and management of concussion, while differences in protocols between sports were adding to the problem.

RACGP national president Dr Nicole Higgins said there was insufficient evidence to fully understand and determine the long-term impacts of concussion and head trauma, and that significant research was needed. 

“We need a national approach to management of concussion, with evidence-based guidelines across all sports and codes, ” Dr Higgins said.

“It’s also important that all sports — and across all states and nationally — there’s a commitment to management and reporting to ensure we have the data available.”

The latest international Consensus Statement on Concussion in Sport is due to be handed down later this year.

Dr Higgins said she hoped the release would allow a consistent definition of concussion.

The RACGP’s submission said the development of an Australia-wide concussion registry would provide a valuable source of data to determine long-term impacts of concussion and repeated head trauma.

The submission said GPs play a vital role in monitoring and managing prolonged concussion symptoms, such as post-concussion syndrome and suspected chronic traumatic encephalopathy (CTE).

“Applying a 10 per cent increase to Medicare rebates for longer consultations and introducing a new 60-minute-plus consultation Medicare item would make a real difference for GPs and practice teams managing these complex health issues.”

Other submissions received by the committee include:

Sydney-based neurologist Dr Rowena Mobbs said in her submission that the community had “turned a blind eye to systematic concussion”.

“The absence of mandatory reporting on concussion, neurological care after concussion, and stories of returning to the field too early are harrowing,” Dr Mobbs said.

“Furthermore, the dearth of meaningful, fully independent, and appropriately funded research has represented a dark chapter in Australian sport.”

Among her recommendations were:

  • Federal government funding for longitudinal research on patients with existing symptoms of CTE
  • The federal government to mandate a code of conduct for sports organisations including a public register of suspected and confirmed player concussions, funding independent neurological player assessments after concussion, and establishing sub-specialist concussion and CTE clinics for at-risk athletes

Insurance for long-term injuries ‘inadequate and inequitable’    

Monash University law academic Dr Eric Windholz said existing insurance arrangements for long-term injuries from concussions and repeated head trauma in contact sports were inadequate, inequitable and in some cases may operate in breach of worker’s compensation laws.

Dr Windholz said injury payment schemes had maximum payment periods and ceased on the expiry of players’ contracts.

He said state and territory workers’ compensation schemes had exemptions for professional players, but that the arguments for the exemptions were “redundant in a world in which sport has been corporatised and commercialised”.

Support ‘basically non-existent’ says former Australian Rules player 

Retired Queensland Australian Rules player Lydia Pingel called for accountability for sporting clubs and organisations to ensure they took protocols and guidelines seriously.

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First on CNN: HHS secretary sends letter to state governors on what’s to come when Covid-19 public health emergency ends | CNN



CNN
 — 

Plans are moving forward at the US Department of Health and Human Services to prepare for the end of the nation’s Covid-19 public health emergency declaration in May.

On Thursday, HHS Secretary Xavier Becerra sent a letter and fact sheet to state governors detailing what exactly the end of the emergency declaration will mean for jurisdictions and their residents.

“Addressing COVID-19 remains a significant public health priority for the Administration, and over the next few months, we will transition our COVID-19 policies, as well as the current flexibilities enabled by the COVID-19 emergency declarations, into improving standards of care for patients. We will work closely with partners including state, local, Tribal, and territorial agencies, industry, and advocates, to ensure an orderly transition,” Becerra wrote in a draft of the letter obtained by CNN.

“In the coming days, the Centers for Medicare & Medicaid Services (CMS) will also provide additional information, including about the waivers many states and health systems have adopted and how they will be impacted by the end of the COVID-19 PHE,” he wrote. “I will share that resource with your team when available.”

Declaring a public health emergency in the United States means that certain actions, access to funds, grants, waivers and data – among other steps – can happen more quickly in response to the crisis for the duration of the emergency. A declaration lasts 90 days – unless HHS ends it – and may be renewed.

On January 30, the White House announced its intention to end the Covid-19 national and public health emergencies on May 11, signaling that the administration considers the nation to have moved out of the emergency response phase.

Becerra had agreed to give governors a 60-day notice to prepare for the end of the emergency. Thursday’s letter was sent 90 days ahead of the emergency’s planned end.

“We are having ongoing conversations about what else we need to do in the next 90 days to ensure a smooth transition. I can tell you that every one of our agencies has been working hard on this plan,” an HHS official told CNN. “We’re going to have a series of additional materials that will go out, as well as a series of conversations over the coming days and weeks.”

The end of the public health emergency will affect some Medicare and state Medicaid flexibilities provided for the duration of the emergency. This includes waivers like the requirement for a three-day hospital stay before Medicare will cover care at a skilled nursing facility.

“We’ve been working closely with the governors on the public health emergency. This is a combination of both federal flexibilities that we allow, and the states are often the ones who are using those flexibilities,” the HHS official said.

“Just about every aspect of the pandemic response, I would say, has been in partnership with our state partners. And so, I think they have been, frankly for months now, the ones that we have been going to and the ones that we publicly committed to notifying in advance of changes to the public health emergency declaration.”

But the emergency’s end will not impact the authorizations of Covid-19 devices, including tests, vaccines and treatments that have been authorized for emergency use by the US Food and Drug Administration.

During the Covid-19 pandemic, the FDA has issued about 15 times as many emergency use authorizations as it did for all other previous public health emergencies, Commissioner Dr. Robert Califf said Wednesday in a joint hearing of the House Oversight and Investigations and Health subcommittees.

“Today, we’ve issued EUAs or provided traditional marketing authorizations to over 2,800 medical devices for Covid-19, which is 15 times more EUAs than all other previous emergencies combined,” Califf said. He added that the effects of the end of the emergency declaration will be “modest” because the “EUAs are independent of the public health emergency, so we can keep them going as long as we need to.”

The emergency is slated to end May 11. “What happens on May 12? On May 12, you can still walk into a pharmacy and get your bivalent vaccine,” Dr. Ashish Jha, the White House’s coronavirus response coordinator, wrote on Twitter last week.

He said that at some point, probably in the summer or early fall, the Biden administration will transition from federal distribution of Covid-19 vaccines and treatments to purchases through the regular health care system – but that’s not happening quite yet.

Overall, there are additional Medicaid waivers and other flexibilities that states and territories have received under the public health emergency. Some of those will be terminated. But state Medicaid programs will have to continue covering Covid-19 testing, treatments, and vaccinations without cost-sharing through September 30, 2024.

The end of the public health emergency declaration means Medicare beneficiaries will face out-of-pocket costs for over-the-counter home Covid-19 tests and treatment. However, people with Medicare will continue to have no cost for medically necessary lab-conducted Covid-19 tests ordered by their health care providers.

Covid-19 vaccinations will continue to be covered at no cost for all Medicare beneficiaries.

Those with private insurance could face charges for lab tests, even if they are ordered by a provider, according to the Kaiser Family Foundation. Vaccinations will continue to be free for those with private insurance who go to in-network providers, but going to an out-of-network providers could incur charges once federal supplies run out.

And the privately insured will not be able to get free at-home tests from pharmacies and retailers anymore unless their insurers choose to cover them.

Americans with private insurance have not been charged for monoclonal antibody treatment since they were prepaid by the federal government, though patients may be charged for the office visit or administration of the treatment, according to Kaiser. But that is not tied to the public health emergency, and the free treatments will be available until the federal supply is exhausted. The government has already run out of some of the treatments so those with private insurance may already be picking up some of the cost.

The uninsured had been able to access no-cost testing, treatments and vaccines through a different pandemic relief program. However, the federal funding ran out in the spring of 2022, making it more difficult for those without coverage to obtain free services.

Also, the “ability of health care providers to safely dispense controlled substances via telemedicine without an in-person interaction is affected; however, there will be rulemaking that will propose to extend these flexibilities,” according to the letter’s fact sheet.

One of the most meaningful pandemic enhancements for states is no longer tied to the public health emergency. Congress severed the connection in December as part of its fiscal year 2023 government funding package, which state Medicaid officials had urged lawmakers to do.

States will now be able to start processing Medicaid redeterminations and disenrolling residents who no longer qualify, starting April 1. They have 14 months to review the eligibility of their beneficiaries.

As part of a Covid-19 relief package passed in March 2020, states were barred from kicking people off Medicaid during the public health emergency in exchange for additional federal matching funds. Medicaid enrollment has skyrocketed to a record 91 million people since then.

A total of roughly 15 million people could be dropped from Medicaid when the continuous enrollment requirement ends, according to an analysis the Department of Health and Human Services released in August. About 8.2 million folks would no longer qualify, but 6.8 million people would be terminated even though they are still eligible, the department estimated.

Many who are disenrolled from Medicaid, however, could qualify for other coverage.



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