President Donald Trump’s “One Big Beautiful Bill” : A Comprehensive Overview and Analysis

 

If there is anything we can all agree on about Donald Trump, it’s his propensity for hyperbole. Going all the way back to when he first appeared on Robin Leach’s “Lifestyles of the Rich and Famous”, Trump  has always described anything he’s involved with as “the biggest”, “the most”, “the best”, “the greatest ever”, and so forth. Everything he does is over the top. 

Trump, the son of a real estate entrepreneur, learned as a child that it’s not what you actually say or do, it’s all about the perception. So, now, here we are with President Trump’s 870 page “One Big Beautiful Bill” which (allegedly) contains the greatest sweeping changes in our country’s history. The bill, we're told, will become legendary. Aren’t we blessed to be here and now to witness its unveiling? But just what is in this bill and is it as wonderful as it’s being portrayed by the Republicans? Is there anything in it we're not being told? 

The bill was officially known as H.R. 1 “One Big Beautiful Bill” (aka “OBBBA”) and was sponsored by Rep. Jodey Arrington (R-TX) and originated in the House Budget Committee May 20, 2025 (I’m sure he’ll find an extra special “something” in his Christmas stocking).

The bill passed in the House with a 218 to 214 vote after barely sliding by a vote in the Senate, 51 to 50, marking a significant victory for Senate Majority Leader John Thune (R-SD) despite three Republican senators voting against the bill--- Rand Paul (R-KY), Thom Tillis (R-NC), and Sen. Susan Collins (R-ME).

The bill, which focused on tax cuts, was considered by many to be an extension of President Trump’s earlier bill, the 2017 Tax Cuts and Jobs Act (“TCJA”). The bill represents a saving of about $3.7 billion tax dollars to taxpayers (or if you look at it another way, $3.7 billion in taxes that the federal government won’t collect for various programs).

The bill makes Trump’s previous tax cuts permanent, while increasing spending for border security,  military expenditures, and energy production (with little funding for alternative energy projects). Two compromise points was postponing the sale of public land for the time being and temporarily prohibiting state regulations over artificial intelligence (AI).

Funding for the increases came, in part, from reductions in the budgets for programs like Medicaid, and the Supplemental Nutritional Aid Program, better known as “SNAP,” as well as other healthcare and nutritional support programs. Some opponents claim that the reductions will potentially leave some without healthcare and leave the underserved even worse off. Congressional Republicans deny this will happen.

For some reason, I’m reminded of when President Ronald Reagan made a similar cut in the National School Lunch Program. At one point, after being criticized over the cuts in fresh fruits and vegetables being available to school age children living poverty, he said the ketchup, which was readily available in school lunchrooms, should be counted as vegetable (also mentioned was pickle relish). It’s just not the same Gipper.  The cut of 1.5 million dollars was intended to give schools more “flexibility” to the lunch programs, however, it backfired. As I’ve said on many occasions, perception in politics is everything.

With respect to Medicaid, which was created in 1965, approximately 71.4 million people are currently using Medicaid which is intended for low income individuals and families as well as those disabled and unable to work. A further 7.3 million are enrolled in the Children’s health Insurance Program (“CHIP”), which brings the total to 78.7 million people who benefit from Medicaid, or roughly 24% of the U.S. population.  

As an aside, both Medicaid and Medicare were expanded under President Obama’s healthcare legislation, known as the “Affordable Care Act” in an effort to  provide coverage for those without any healthcare and to provide a bridge for those who fell through the cracks. So, I guess “Obamacare” has effectively been replaced by “OBBBAcare”!

Some of the changes made under Trump’s bill includes changing annual application enrollments to every six months and additional residency verification requirements in order to eliminate non-citizens from applying. Medicaid has always been for low income or handicapped individuals and their families. Under the “One Big Beautiful Bill”, there will be tighter restrictions on incomes.

Federal provider coverage will dropped from 6% to 3.5% over the next seven years.  That’s expected to have an adverse effect on small community clinics and rural hospitals (especially in low income areas like the Ozarks and Appalachia). The bill mandates that “able bodied” adults to work or volunteer up to 15 hours per week. This also applies to those receiving SNAP benefits to work or volunteer a minimum of 15 hours weekly.

According to the Congressional Budget Office, an estimated 12 million Medicaid recipients could lose coverage over the next decade. Proponents claims that only those able to work and obtain coverage on the open market and those who’ve obtained coverage fraudulently (such as illegal immigrants) will be affected.

Social Security will also be affected. Once considered to be “untouchable”, Congress regularly raids Social Security with the assurance that these “loans” with be repaid but has resulted in concerns that the national retirement safety net  will go broke over the next few decades. 

A good piece of news is that individuals dependent on tips or overtime to make ends meet with no longer be required to pay taxes on their income up to $25,000. Many individuals, especially in the service industry, aren’t paid a standard wage. Instead, they depend on tips while others, especially in manufacturing, count on overtime to make ends meet.

Previously, workers were required to pay taxes on this extra but essential income, under Trump’s bill, they will be tax deductible on the first $12,500 of overtime earned. The child tax credit will be increased by $200, making it now  $2,200 and then adjusted for inflation thereafter.

Taxpayers will be able to write off a portion of their state and local taxes (SALT) on their federal taxes up to $40,000 on incomes up to $500,000 until 2029 when it will drop back to the current rate of $10,000. The deduction benefits those who pay high property taxes, which tend to be the wealthy. Private jets will now be tax deductible. In another prop for the well-to-do, individuals can now pass up $15 million to their heirs tax free (if any of you are rich, I’m available for adoption).  

Private school vouchers were also added to the bill. Families who earn less than three times the local income average may now receive up to $5000 in tax credits to be used for homeschooling and private schools (including religious based schools). Private colleges with a student population of 3000 or more, will pay up to 8% in taxes on their endowments. Students will now be capped on the amount of federal loans they can borrow for college. 

Car buyers will be able to write off up to $10,000 in interest annually on car loans IF the car is assembled in the United States. A boon for American auto workers. Additionally, those 65 and over will be able to deduct up to $6000 in taxable income off the top through 2028.

According to a Penn Wharton Budget Model Forecast, the beneficiaries of this portion of the bill will be those in the upper income brackets, especially the top 1% (as if they need another tax break). Low income families currently receiving Medicaid and/or SNAP benefits could lose around $28,000 over a lifetime while those earning $58,000 or more could see savings as much as $65,000 over the same period.    

When it came to the energy and the environment, it was a victory for oil and gas companies. Trump’s “One Big Beautiful Bill” cut President Biden’s clean energy tax breaks for alternative energy sources (such as wind and solar power), especially those with “foreign ownership or other connections” (ie: China). Companies currently involved with alternative energy will continue to be eligible for the full tax credits. However, starting in 2026, new construction projects will be eligible for just 60% of those credits, dropping to 20% in 2027, and disappearing altogether by 2028.

It bears mentioning that the bill includes language encouraging continue and accelerate oil and gas leasing as well as permits oil and gas companies to us deductions built into the bill to avoid paying so-called "must pay" minimum corporate taxes of 15% imposed by the 2022 Inflation Reduction Act. 

The U.S. military is the largest in the world, exceeding the next ten nations combined (including China, Russia, India, France, and the UK), but under Trump’s bill, they’ll received an increase over their current budget by $150 billion dollars, with an emphasis on rebuilding a badly depleted military in addition to creating a missile defense “Golden Dome” along the lines of Israel’s “Iron Dome” (look for China to build a “Jade Dome”) next.

In 2024, the Heritage Foundation published a summary of U.S. military readiness and key foreign threats. According to the report, the U.S. military was not adequately prepared for a two front war or a prolonged war across a broad single front. The U.S. Army’s capacity was listed as “weak” while its capability was “marginal”. The Navy’s capacity was categorized as “very weak” while its capability was “marginal” and its readiness was “weak”.

The Air Force was “very weak” when it came to readiness. Its capability and capacity were both determined as being “weak”. The Marines, as expected, were listed as “strong” when it came to readiness and capability, yet “weak” in regard to capability. The Space Force was “marginal” across the board (making us vulnerable to Martians I suppose). Overall, the report indicated that the current state of our military was on the low side of “marginal”.

The Golden Dome will be specifically designed to stop incoming intercontinental ballistic missiles (“ICBMs”) as well as the latest in high tech destruction, hypersonic missiles which travel at five times the speed of sound and “fractional orbital bombardment systems” or  as they’re better known, “FOBS”.  FOBS are a type of multiheaded nuclear ballistic missiles which, after launch, remain in low earth orbit, until being directed toward their intended target much like a maneuverable  glider.

 As an aside, in the event the crisis is alleviated (such as capitulation or diplomacy), they can redirected into space and detonated.  Critics say the “Golden Dome” only heightens global tensions while proponents believed it will serve  to deescalated the threat of a global war.

Trump has promised (and largely delivered) to enforce existing immigration laws and improve border security. Accordingly, thousands of migrants have been rounded up and deported. In an effort to continue and step up efforts, the Office of Immigration and Customs Enforcement (“ICE”)  was being given an additional $150 billion to their budget, which had been reduced to just $8 billion dollars by previous administrations. The increase now makes ICE the top funded federal law enforcement agency in the country.  

In summary, President Trump’s “One Big Beautiful Bill” will extend tax cuts over the next decade, resulting a savings of approximately $4.5 trillion dollars to taxpayers and corporations. Border security and immigration enforcement will see an increase in their Christmas stockings of $129 billion dollars, and the military will get an increase over their current budget of $150 billion dollars. That should buy a lot of new toys for them to blow up.

On the down side, the Congressional Budget Office said that Trump’s “One Big Beautiful Bill” will likely add $3.4 billion to the federal deficit over the next decade. The debt ceiling will be raised to $5 trillion dollars, ostensibly to help pay for current and future federal programs.

Medicaid will see a drop of $930 billion dollars over the next decade (some see it as a savings since it will reduce from the roll those not legally entitled to the various programs covered under Medicaid). Because of reductions in Medicaid, nursing homes receiving Medicare or Medicaid funding will face a hiring moratorium.  

The bill also provides Big Pharma with a major break. It limits Medicare's ability to negotiate lower drug prices with pharmaceutical companies. Other public assistance programs, such as SNAP, will see a reduction of $287 billion over the next ten years (the same reason as above). Meanwhile, the so-called “green industry” will lose some $488 billion dollars in federal support.

In conclusion, President Trump’s “One Big Beautiful Bill” is largely positive overall for most Americans, and certainly for big business as well as the very well-to-do. However, as usual, lower income brackets (and by extension, minorities) and some seniors didn’t fare well with reductions in the social safety net programs. However, many of the tax breaks and other cuts are temporary which may be the best a deeply divided Congress can do.

The military, as is usually the case, made out like a pirate (or should I say “privateer”?). For those who are curious, the budget for intelligence agencies are separate and are generally kept secret from the public as well as the majority of Congress.  Thus, their budgets are apparently none of our business even though we fund them through our tax dollars. Tax breaks on income, especially tips and overtime, were long overdue, but come on, private jets? Really? 

 Crackdowns on illegal immigration and dramatic improvements in border security are seen as a good thing for national security, though it may be closer to the proverbial closing of the chicken coop after the foxes are in. Educational funding had a number of pros and cons but ultimately benefited the kids, which is what matters the most (now they need to figure out how to improve the quality of their education).  

Finally, all things considered, after having spent a lot of time researching the bill, I’m not sure I would have called it “One Big Beautiful Bill”, but I guess “One Big Not Ugly Bill” doesn’t sound as marketable.

 

Thank you for reading "Another Opinion", the Op/Ed blog page for the "militant middle".  Here at "A/O" we truly value our readers. At A/O we seek the facts as they exist, not partisan talking points.  We hope you find our articles informative and engaging. Comments are welcome, provided they are not vulgar, insulting or demeaning.  Another Opinion is offered without charge and is directed toward all independent and free-thinking individuals. We ask, however, that you "like" us on whatever platform you found us on in order to keep our articles available for free to others. Lastly, in order to keep costs down, we depend on passive marketing, and therefore, depend on our readers to please forward our posts along. Below you will find links to the sources we used in writing this article. Thank you. 

 

H.R. 1 One Big Beautiful Bill text

Big Beautiful Bill 101: What you need to know about the newlaw

Affordable Care Act

Senate passes Trump’s “big, beautiful bill” in 51 to 50 voteafter marathon session

Ketchup as a vegetable

Can Donald Trump build the ‘Golden Dome’ over the US?

What are the key items in Trump’s sprawling budget bill?

Is the Pentagon headed for a military readiness crisis?

Military Readiness: Implementing the GOA’s recommendations…

Executive Summary of the 2024 Index of U.S. Military Strength

7 Overlooked Provisions In Trump and The GOP’s Ugly Tax Bill

 

Big Pharma: A Monopoly in Need of a Cure

 In last week's article we discussed some of the monopolies which dominate the American economy, and by extension, Congress, the Judiciary, and the Presidency.  While powerful, especially the financial sector, perhaps none are currently more powerful than Big Pharma. Just how big and powerful?

While we get to that in just a moment, but consider this. 70% of all Americans are dependant in some way, be it medicine or medical equipment, on what Big Pharma says we need. For the majority of that 70%, what they receive is critical to their overall health and even their very survival.

So, just who is "Big Pharma" anyway? Names such as Bayer, Pfizer, Moderna, or Johnson and Johnson are household names we're familiar with, particularly thanks to the Covid pandemic. However, many others are simply unknown except through their products which are extensively marketed.

 Starting in reverse order with the tenth largest and most influential global pharmaceutical company (all revenue is from 2020) is Sonfi, the French manufacturer of Zantac, Plavix, and Ambien, reported just over $41 billion dollars in revenue. Next is Pfizer, whose revenue was about $42 billion. Bristol Myers Squibb racked up $42.5 billion dollars. GlaxoSmithKline was seventh with $43.5 billion dollars.

In sixth place was Janssen, which is part of Johnson and Johnson. Their revenue in 2020 was $45.5 billion dollars. AbbVie, the maker of Humira, made $45.8 billion dollars. Merck earned a under $48 billion. Novartis, a Swiss producer of drugs such as Ritalin, earned its shareholders $48.6 billion dollars. Second place belongs to Roche Pharmaceuticals (a division of the Roche Group), manufacturer of Valium, and also a Swiss company. It's revenue for 2020 was a staggering $49.5 billion dollars.

Finally, the top earner in 2020 was a state owned Chinese company named Sinopharm, whose revenue was $50.4 billion dollars. Sinopharm is headquartered in Beijing China. It's official name is the China National Pharmaceutical Group Corporation, a holding company for China National Pharmaceutical Corporation, China National Pharmaceutical Industry Corporation, the China National Pharmaceutical  Foreign Trade Corporation, and the China National Medical Device Corporation.

 In 2009, Sinopharm merged with China National Biotec Group. You may be more familiar with their subsidiary---the Wuhan Institute of Biological Products. Sinopharm is known for R&D and the production vaccines, included the widely distributed BIBP vaccine which is being used in the treatment of Covid-19. Other leading companies which didn't make it into the top ten included AstraZeneca (12th), Eli Lilly (14th), Bayer (16th), or Novo Nordisk (17th).

As an aside, Moderna is a pharmaceutical and biotechnology company focusing on RNA therapeutics and vaccines dealing with the immune system. It's only commercial product to date is the Moderna Covid 19 vaccine.

In the U.S., the deepest pockets belong to six companies, Eli Lilly with a market value of $98 billion, GlaxoSmithKline with $103 billion, Merck has a market value of $164 billion, Pfizer $212 billion dollars, Novartis at $273 billion, and Johnson and Johnson with a market value of $274 billion. 

It's worth noting the Big Pharma doesn't spend the majority of its substantial profits on developing on medication or devices. In fact, marketing receives 19 times more funding than development, all to provide you, the customer, with that nice warm and fuzzy feeling you get watching one of those homey  "one of us" commercials on TV, radio, in print, or social media because they care.

Going further, the top 14 U.S. pharmaceutical companies spent a combine $31 million dollars just on lobbying Congress in the first quarter of 2021. Pfizer alone spent $3.7 million.  The trade association, Pharmaceutical Research and Manufacturing spent 8.6 million on Congress for that same quarter.

That doesn't include the millions they spend on wooing doctors, pharmacists, dentists, optometrists, hospitals, nursing homes or rehab centers, nor does it include money spent on medical associations, professional medical unions, colleges, seminars, or trade shows hawking their latest wonder drug or medical devise. After all, where did you think all those "samples" or other medical items (include anatomical displays and posters) you see at the doctor's office come from? 

Lastly, they spend millions yearly cultivating what they call "thought leaders" in the medical and pharmaceutical field. Thought leaders are individuals who widely respected locally, regionally and nationally that are used to promote various drugs or devises to other professionals in the medical industry. This is often the reason physicians recommend one pill or product over another. These "thought leaders" are usually very well compensated for their endorsement with trips to fancy getaways for "seminars" (all expenses paid), honorariums, and other very nice perks.

In 2020, 2/3 of Congress cashed a check from Big Pharma. The majority of money, 7.1 million, went to Republicans while Democrats received 6.6 million, but that's still just part of the story. Big Pharma spent $263 million dollars in 2021 lobbying Congress. Every member of Congress had a minimum of three lobbyists from Big Pharma knocking on their door. What were they trying to buy?

Big Pharma abhors the idea of the Federal Government passing legislation capping prescription prices (and who can blame them with a captive market of 70%?). They equally hate the notion of allowing individuals to shop around for their prescriptions in places like Canada or Mexico (where they often cite a lack of quality or oversight) and elsewhere.

The truth of the matter is that the quality of these drugs, if bought from reputable companies, are the same or better than here in the U.S.. The main difference is that the price of drugs are four times more expensive in the U.S. as they are elsewhere, and that's just the way Big Pharma likes it.

Lobbyists for Big Pharma don't always focus on every legislator. Often, they'll concentrate on key committee members who have the clout to either push through a piece of legislation (which they wrote), or just as importantly, has the ability to keep other pieces of legislation they oppose tied up in committee. This is thanks to Congress's rigid hierarchy, but also to the extensive and always up-to-date research they compile of not just every legislator, but also their key staffers.  They often know beforehand who they can count on and who they can't.

The top influence buyers are Starkey Hearing Technologies, which gave around $564,000 to members of Congress; the majority of which went to Republicans. However, Masimo Corporation (maker of medical devises) gave all of its $533,714 to Democrats. Pfizer split its $487,000 equally between the two parties. RAAS Nutritionals gave all its $400,000 to Democrats.

Other donors included Abbotts Labs which donated slightly more of its $284,000 to the GOP. Johnson and Johnson did just the opposite with its $275,000. Eli Lilly gave most of its $214,000 to Democrats too, as did the remaining top 20 donors.

The top Big Pharma lobbyist for 2021 was the trade association, Pharmaceutical Research and Manufacturers, Inc which gave $22,903.000 (mainly to Democrats), dwarfing the other four leading lobbying organizations, whose donations hovered between $7 and 9 million each.

Big Pharma has fought to keep the conversion of name brand drugs (like Bystolic, which is used for controlling difficult to maintain blood pressure) from becoming generic because that would substantially lower prices and effectively remove that drug from their inventory, which affects their bottom line.

Therefore, pharmaceutical companies make minor changes in their drug patients (in what's called "evergreening") to extend their control over various drugs and keep prices artificially high. "Evergreening" is something some member of Congress would like to see, but not so Big Pharma.

Speaking of generics, it's worth noting the very little new drugs are actually developed in-house by some of the major drug makers. Using a 2017 annual report, STAT, which analyses the biomedical, pharmaceutical, and medical industry, looked at 62 new products belonging to Pfizer and Johnson and Johnson (44 for Pfizer and 18 for J&J).  Out of the 44 new products, only 10 were developed by Pfizer and two of Johnson and Johnson's 18. 

In looking at the drug market in general, 81% of all new developments came from outside sources. Typically one of the big pharmaceutical companies will acquire the rights to the new drug and sit on it without ever developing it for the market or, alternatively, will "lease" out the patent for research purposes.

At this point you are probably wondering who is suppose to keep Big Pharma in check. Well, the answer is (at least theoretically) the Food and Drug Administration (FDA). But all is not as it seems. The role of the FDA is to monitor the pharmaceutical and medical industry while verifying its claims, help regulate prices, and approving any new drugs brought to the public market. Additionally, the FDA is partially funded by this same industry through user and other fees.

However, with decades of cutbacks in funding, the FDA has now come to rely on those it regulates for its operational budget. Big Pharma provides 75% of the FDA's funding of its drug review budget. In effect, since the drug and other companies control the purse strings, the FDA has become all but impotent.

Should the FDA attempt to push back or exert to much control, all the drug companies has to do is reduce, delay, or stop introducing anything which generates a fee in order to have an impact.  As a result, in December of 2021, the House Committee on Oversight and Reform released a very revealing report about the clout of Big Pharma and its influence over the FDA.

For instance, the prices of the top leading 12 drugs used by Medicare recipients increased 250% simply by using various market strategies to avoid conversions to generics to minimize competition as well as "hiding" real profits and extending their monopoly over these drugs by decades. Furthermore, these same 12 drugs are now priced at over 500 times what they were when they were first introduced to the market.   

The same report also discovered that the top 14 drug companies spent $577 billion dollars on stock buybacks and dividends over the last previous five years, which was $56 billion more than was spent on research and development. These same 14 companies also received millions in taxpayer based grants and subsidies designed for the development of new drugs, not to mention huge tax breaks.  

So, what does this mean for you and me? It means simply that the medical industry, like any other industry, is largely confined to a few very wealthy and influential corporations whose first loyalty is its officers and shareholders. It also means that the care of the patient is often secondary to the profit made from some pill or device. A cured patient is a lost customer. Lower prices are lost profits.

Big Pharma will continue to peddle its influence in the halls of Washington, and closer to home in state legislatures while it has a pill for every ill to sell to us, real or imagined. Professional medical associations are often motivated by the bottom line to move patients through like an assembly line.

The more patients seen the greater the billable hours and drugs or whatever else sold. Meanwhile insurance companies second guess doctors in order to minimize costs, overriding recommendations even to the point of harm to the patient.

Western medicine, unlike in the East, is focused mainly on the treatment of symptoms and outcomes, whereas in Eastern medicine the focus is on prevention first. Medical professionals in the West tend to ignore natural or homeopathic cures, which may take a little longer, has fewer (if any) side effects, preferring what some call "controlled poisons" whose potential side effects can be worse than the illness.  Sadly, we can say the same about Big Pharma, whose profit over patient side effects are killing America.  The ancients saw healing as a gift from the gods. Today it's big business and profit.

If you want to know more, please take a look at the links below. If you enjoyed the article, please consider passing along to others and don't forget to subscribe. It's free! Lastly please be sure to "like" us on Facebook or whatever platform you use to read A/O. It helps with the algorithms and keeps our articles in circulation.

 

Pharma 50: The 50 largest pharmaceutical companies in theworld

STAT: Do large pharma companies provide drug developmentinnovation? Our analysis says no

Pharma campaign Cash Delivered with Surgical Precision

The Biopharmaceutical Industry Provides 75% Of The FDA's Drug Review Budget

OpenSecrets: Pharmaceutical and Medical Products

Having the Stones to Take on Goliath

As readers of Another Opinion know, I've been engaged in a battle Kynect (Kentucky's "model" insurance exchange) and with Humana, to which I've been assigned. Just to briefly recap, my wife and I applied for insurance through the Kentucky insurance exchange known as "Kynect" (we have the distinction of being the second applicants to register when it went operational in August 2013). Somehow we managed to find every computer glitch and SNAFU in the system despite repeated assurances to the world by Governor Beshear that program was working without any hitches. By early October, our status had been elevated to the highest tier and I found myself dealing with programmers, systems analysts, and systems designers as they attempted to create "work arounds" in their programming and a host of other corrections.

Finally, by February 2014, things had settled down. Since we were enrolled in the system at the end of 2013, we were permitted to pick our start date for coverage to begin. We could chose from January, February or March. Since January had past and we had no medical bills worth any note, and as February was about over, we opted from March. However, "someone" at Kynect decided, when entering the information, that we really meant to say April instead of March, and changed our start date so we ended up absorbing medical bills for March (in all fairness, the senior manager at Kynect with whom we had been working gave us the option of correcting it back to March, however, the time required would have put us well into April anyway, so we opted just to "eat" the costs). Nevertheless, we ended up with some pretty good insurance, but no good deed goes unpunished, especially when dealing with the government.

At the end of 2014, we started getting notices from Kynect saying our coverage was changing (and apparently without our consent). I called our insurance provider several times over the next 45 or so days and was "assured" that our coverage was not changing and we should ignore the notices received from Kynect; we would keep our existing coverage we were repeatedly told. Finally, in early February 2015, I phoned Kynect to see what was going on. Well, it seems that their income calculation formula had changed and we were being removed from our insurance provider and transferred to Humana. Despite my protestations, we were moved in mid-February. At the same time, we received notices from our (now) former provider that our premiums were about to expire (Kynect paid a portion and we paid the balance). Although I repeatedly explained what had happened and offered to fax or email our notices from Kynect, I was advised that my offer (and my explanation) were appreciated but not acceptable. They needed "official" notice direct for Kynect. "Okey dokey" I said, and promptly contacted Kynect to (again) express my frustration and relay their request. I was told that an official notice will be sent, however, an "advisement" had already been issued.

Meanwhile, I discovered that despite Kynect's repeated promises (parroting Obama's) that I could keep my doctors, that in the event I

couldn't, my new carrier would pay for any prescriptions and tests. I, however, would be responsible for paying the office visit. Needless to say, I was dismayed when my primary doctor of 32 years (and who is the area's only known sub-specialist) wouldn't see me when I showed up for my scheduled appointment. I was told that I couldn't even pay cash money for the visit, and to jab the knife a little deeper, my doctor could not write me any more prescriptions while I searched for his replacement. Once my refills ran out, I was, to use the proper medical terminology, screwed. As soon as I got home, I immediately phoned Kynect. Again, they offered their heartfelt and most sincere apologies, but there was nothing that could do about changing the insurer. It was suggested to connect my new provider, Humana, to see if they could locate a doctor for me. "Fat chance" I thought as I said "thank you" as politely as I could muster and hung up the phone.

So I contacted Humana's Customer Service Department. After going through a battery of options to select from (which included what language I wanted---I will never ever press a button for English as long as I live in this country), and a ten minute wait, I finally spoke with a living breathing person. After explaining my situation (while listening to timely interjections of "we're sorry for your inconvenience), I was given a list of six doctors for me to call. I quickly learned that none of these were specialist of the type I needed, but it didn't matter. None were accepting Humana. So, for the next two months, I made my daily calls with the latest of doctors Human had given me, but I jump ahead of myself.

Somewhere along the third week, I managed to get lucky. One of the customer representatives I spoke with (and whose first language was apparently English), blurted out near the end of one of my frustrated phone calls that I could submit a "Continuing Patient Care Request" and then almost as an afterthought, asked if I would like to do so. "Hell yeah" I said. So together---her writing out the synopsis while I provided my medical history, prescriptions, and reason for my request. When we ended, she said it would take approximately 7 to 10 days to get a decision (really? That was like a sleepover by this time). So while I waited, I continued to make my calls and get my daily rejections only to call Humana and get my next list of six doctors with the names sounding less and less familiar by the day from the ever changing representatives (after, of course, having to repeat my story). Some of the rejections were due to the physician winding down their practice; moved out of state; or were simply located in the wrong part of the state; wrong specialty; or simply was not accepting Humana any longer.

Finally, the tenth day came and I was on the phone for what I hoped would be my approval. However, as if to throw salt on the previously mentioned proverbial knife wound, I was told that no decision had been reached yet, so in addition to calling for my list of six, I now had to ask for status updates (as an aside, I was also providing them with updates on the doctors whose names they had given me. Evidently their list hadn't been updated in quiet awhile). Then it came.

I had been reading when the phone rang. I started to ignore the call, figuring it was another solicitor calling, despite my being on the "No Call" list, when I noticed it was my (now) former primary doctor's office calling. So I answered, expecting to hear some other piece of bad news. I don't know if I can correctly express my emotion or thoughts as I was informed that they had just concluded a series of conference calls with my current provider and given my medical needs and length of time I've been with their office, my request was approved. She was calling as quickly as possible to let me know and schedule an appointment as soon as I wanted. I remember being instantly relieved; excited; angry at having been put through the hoops; the corporate and government bureaucracy, that I must of had her repeat herself two or three times (I don't she minded. She knew me from all these years and how much I had fought this).

So, we scheduled an appointment and she explain that my efforts also resulted in a change in policy, both for their offices as well

as for Humana's that would allow longstanding patients to remain with their primary care physician provided the physician was willing to keep the patient on. I didn't feel the need to gloat but I was quietly pleased to know that my efforts may also be helpful to others in a similar position as mine. Most people would have given up I realize, but I not one of those people. I don't believe in giving up the fight if the cause is just, be it for me or for someone else. I've been a community and political activist for well over 35 years. I've also helped countless numbers of individuals take on their own "Goliath" over the decades (while "Goliath" is a good, if not common, analogy, I'm reminded more of Odysseus and the Cyclops, Polyhemus, and in particular Odysseus's response as he sailed away; having outwitted this son of Poseidon). I did it from elementary school on; while in the military; in college; and in every job I ever had. It's simply my nature I guess.

As an comical aside, remember those notices I had been receiving from my the original insurance provider mentioned above? Well, I continue to receive them, advising me that my premium remain due while I continue to advise them that I was removed by Kynect at the end of January. Meanwhile, I've checked with Kynect and have been assured that they have been repeatedly notified of my removal from their policy (I was even provided a reference number which I had sent on). Despite their disinterest in my notices from Kynect, I faxed of copies to them all the same. Just a few days ago, I received a new set of membership cards. You just have to love corporate bureaucracy.


Greek Myths & Greek Mythology
http://www.greekmyths-greekmythology.com/odysseus-and-cyclops-myth/

The Great Obamacare Circle Jerk: The Final Round

I'm one who really hates leaving loose ends. Call it a quirk of mine. I just like finishing whatever I start, particularly if there is the potential to learn something new. So on that note, let me take you back to a previous article of mine,"The Great Obamacare Circle Jerk", which I posted on April 12. As you recall, I had been stripped of my primary healthcare provider of nearly 33 years by my state's healthcare exchange and forced in to a new healthcare program which I didn't want. My wife and I were completely happy with what we had.

I filed a "Continuity of Care" request, which was submitted to the insurance company's medical review board. I pointed out that my primary doctor and I had a strong and unique relation which stretched back close to 33 years. I stressed that he became the kind of subspecialist I needed as a result of my rather unique set of medical circumstances, and that he was perhaps the only doctor in the area with this subspecialty. He treated me as an equal partner in my care; none of this "godlike" attitude which some doctors are notorious for having. He always listen to my suggestions and read any material I came across, which we'd discuss during my next office visit (I've always taken a proactive stance to my medical care). I also pointed out that if they didn't want to cover this doctor, that I would be willing to pay for the office visit out of pocket.

Although the insurance company assured me it would be only five to ten days before received a response, it was a full two weeks after their ten day limit came and went. Meanwhile, I called every day after the tenth day passed, always getting someone new, to ask if they had made a decision; explaining each time the same events over and over to whomever was unlucky enough to get my phone call. I repeatedly stressed the importance of keeping this doctor, and pointed out that I was in need of an immediate decision since I was getting low on my prescriptions.

It was always on my own initiative in calling them. Never did they ever call me. Anyway, some two weeks after their promised response deadline lapsed, I was finally advised of their decision. According to the hapless customer service representative, my request had been denied. I was told that their decision had actually been made almost a week prior but had just recently been entered into the system. How interesting I thought since each time I'd call I was told that either an email or phone message was being left with their medical review team in change of making the decision. You would think somebody would have the professionalism or common courtesy from this committee (if indeed there really is one) to either contact their own representative for a call back to me or better yet, to call me personally since I asked that my request be treated as urgent, but no.

When I asked why, I'm given a story, which in hindsight, seems a bit farfetched. Accordingly, I was told that the medical review committee designated someone to contact the doctor's office to see if they would agree to accept their insurance. As you may recall from my previous article, my doctor had carried this particular insurance for years, but effective the first of January 2015, would no longer be accepted. I was also advised that I could not pay by credit card or even by cash! Can you imagine being turned down for cash? Well, I was, and now the insurance company is telling me that I'm not allowed to pay cash or credit card for anything medical as it would constitute a "fraud". Admittedly, my first thought was disbelief. I've never been turned down for good ole American greenbacks ever. Then I was hit with the thought, could this be what people mean by the so-called Obamacare "death panels"? You are forced to accept treatment from who they approve or do without. By the same token, they can turn you down for a particular treatment and there is nothing you could do about it or any place you can go since you are "in the system" and there's no recourse beyond the appeal. As for a new doctor, I was given a choice of three---none of which have the expertise that I require. I asked if it wouldn't be cheaper to allow me to see my existing doctor than for me to see a new doctor who was not only unfamiliar with me but unfamiliar with the type of treatment I required? The end result I pointed out could be misdiagnosis, wasted office visits and fees, not to mention useless prescriptions and possible ongoing trips to an immediate care center or even emergency room...all of which they would have to pay for.

Naturally they "sympathized" with my situation, but stated that their decision was final and there was not further appeals. Since I had previously brought the matter of prescriptions, I was told that certain medicines (including one in particular that I'm taking) could be rejected no matter what it was for or how well I responded to it. To be more specific, I was told that my doctor (whomever that turns out to be) would have to call to get permission to prescribe it each time as long as there was no generic version. Otherwise, they reserved the right to decline coverage of the prescription and/or authorizing a substitute of their own choice (thus overriding the physician). Then they had the audacity to end the call by thanking me for calling and asking if I was satisfied with their responses! I admit dear reader, I've never done well with authority figures, and I tolerate even less bureaucratic simpletons setting in a cube somewhere, who has no clue who the hell I am or cares what my unique medical needs are, making decisions about me---especially my healthcare---based on their bottom line or some profit making arrangement they've made with a drug manufacturer. That just doesn't cut it with me, but there it is.

Right now, we have several local Republicans running for governor; each of whom has promised to either reform, cut back or vanquish our Obamacare based insurance system (for that matter, so are various potential and announced GOP Presidential candidates). Listen, I am absolutely the poster boy for what's wrong with my state's insurance system. It's not the hassle free system that they try to make it out to be, but at the same time, without it, we and others like us would have no coverage at all. The problem here is that it was rolled out without being fully thought through. Two years in, and there are still plenty of bugs, glitches, and administrative "Catch 22" issues, which is where I find myself.

What is needed is something more sensible like a single payer platform wherein everyone receives a basic level of coverage and then have the option of buying an additional "add on" coverage cafeteria style that fits their unique healthcare needs. This could be done either on the open market or through their employer. That way everyone gets to see at least some measure of medical care and small companies, which couldn't afford to offer insurance to their employees, could still remain competitive and those currently offering (or struggling to offer) insurance could cut back on their benefit packages without unduly affecting their employees. Another obstacle which should be removed immediately is a simple one: allow individuals to keep their existing doctors regardless of what package they have. After all, wasn't that President Obama's primary argument in selling Obamacare to the American People---that no one would lose their doctor? Or that we wouldn't lose our prescription coverage? Well, under Obamacare and at least Kentucky's version, that is proving to be a blatant boldfaced lie. Not everyone gets to keep their doctor, even if they're a specialist and no one else is available. And no, not everyone gets to keep their medication unless there's a generic substitute, otherwise, they simply don't get the medication or they're forced into taking something which may or may not work or work as well; even to the point of potentially having a negative reaction to it.

So friends, there you have it. A firsthand account of someone who has dealt with Obamacare and Kentucky's insurance exchange. For

some, perhaps even the majority of individuals, it may work. However, it remains flawed and it has been my experience thus far, that if you happen to fall into the category where you are in some way an exception to their rule, such a requiring a specific doctor, continuing with a specific doctor, or requiring a certain medication, and I would add to that requiring certain medical procedures, you're in deep trouble. The system doesn't allow for exceptions nor do the faceless bureaucrats running system seem to particularly care about your medical needs. Their sole concern seems to be about improving their bottom line, and in that quest, just maybe, is the truth about the so-called "death panels" we've all heard about. Naturally, I'm sure it's nothing personal.