Episode 3 – Translating Confusing Language on My Own

In Episode 2 of my series in which I attempt to interpret and analyze the American Health Care Act, I ran into a sentence very early on in the process that left me somewhat baffled.

This is it (Section 102):

“Effective as if included in the enactment of the Medicare Access and CHIP Reauthorization Act of 2015 (Public Law …), paragraph (1) of section 221 (a) of such Act is amended by inserting ‘and an additional $422,000,000 for fiscal year 2017′” after ‘2017.’”

My Efforts to Get Information From a Congressman’s Office

So I sent an email to someone at the Washington D.C. office of Rep. Chris Stewart, R-Utah, because he is my congressmen. I wasn’t sure who I should contact there, but since I can count myself as a member of the media because I am a blogger, I went for someone who appeared to be a media relations person. However, I never received an answer to my request for an explanation.

I try to be a patient person, so I waited several days, and still received no response. By yesterday, however, I was tired of waiting so I called Rep. Stewart’s Salt Lake City office. A very nice young woman answered my question, more or less, by saying that she interpreted that sentence the way I told her I interpreted it.

Then I asked a follow-up question that she was not sure of, so she referred me to a health policy expert in the office and gave me that person’s email address. I dutifully emailed her yesterday with my question, and have not yet received a response. I am anxious to move onward with this analysis and commentary, so I am writing my own interpretation of this sentence and what follows it.  Hopefully, I am right about that. Something I heard on the news seems to indicate that I may have it right.

So Here’s My Take

Apparently this passage means that the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is to be amended so that an additional $422 million would be appropriated for the Community Health Center Program (I assume in addition to any other amount that program is already budgeted). After all, the wording does say, “and an additional $422,000,000 for 2017.” Note this is only 1 year (this year even). Once again, it appears that another law has been blended into the new bill, or that’s what it looks like from where I’m sitting.

We can ask, “Why is an additional $422 million being allocated to the Community Health Center Program?” I believe the answer is found in the following passage of the repeal and replacement bill (Section 103).

This section reads as follows (I have to warn you this is a bit long):

“Not withstanding … (this is a whole list of sections from other laws you can look up in the bill yourself if you’re so inclined) … or the terms of any Medicaid waiver in effect on the date of the enactment of this Act that is approved under section 1115 or 1915 of the Social Security Act (42 U.S.C. 1315, 1396n) for the one-year period beginning on the date of enactment of this Act, no Federal funds provided from a program referred to in this subsection that is considered direct spending for any year may be made available to a State for payments to a prohibited entity whether made directly to the prohibited entity or through a managed care organization under contract with the State.”

Here is the definition of a “prohibited entity.”

“The term ‘prohibited entity’ means an entity, including its affiliates, subsidiaries, successors and clinics –

(A) that, as of the date of enactment of this Act –

(i) is an organization described in section 501 (c)(3) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code;

(ii) is an essential community provider described in section 156.235 of title 45 Code of Federal Regulations (as in effect on the date of enactment of this Act) that is primarily engaged in family planning services, reproductive health, and related medical care, and

(iii) provides for abortions, other than an abortion –

(I) if the pregnancy is the result of an act of rape or incest, or

(II) in the case where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself;”

Clearly the definition of a “prohibited entity” perfectly describes Planned Parenthood, that national organization known for its dedication to abortion as well as a callous attitude towards it.

My Conclusion

So to summarize, Sections 102 and 103, of the American Health Care Act states that the additionally appropriated $422 million being directed to the federal Community Health Center Program is money that COULD NOT be used to provide funds in any way to Planned Parenthood, or any similar organization. Although no organization is specifically mentioned in this definition of “prohibited entity,” the main target is Planned Parenthood.

This is an action President Donald Trump and most of the Republicans promised to take during the 2016 election season, and I am sure it was appropriate to place in the bill repealing and replacing the Unaffordable Care Act. After all, that act had attempted to force all employers providing medical insurance to their employees to pay for birth control, include abortifacients. Only a couple of groups were able to get themselves excused from the birth control mandate, and that was after long court battles.

I am personally glad that this was included in the Obamacare repeal and replacement bill because, as someone who objects strenuously to abortion, I do NOT want the tax dollars I pay to any government entity to fund that horrible procedure. If Planned Parenthood is so dedicated to the killing of unborn babies (since it is unfortunately legal in this country), that tax-exempt organization can raise money to support its heinous activities from those who do want the killing to continue. They can put their money where their mouths are.


I just heard news that Paul Ryan, Speaker of the House of Representatives, just informed the President that the House did not have the votes for the bill to repeal and replace Obamacare. So I guess my little project has become a moot point. Well, it was educational while it lasted, and how ironic that as I set out to help explain the bill to the average person, it failed.

So where does the country go from here? The word from President Trump was that if the House Republicans could not get the American Health Care Act passed and sent to the Senate, the country would be stuck with Obamacare until it collapsed of its own weight. This year ought to get interesting as far as health care is concerned. As far as I am concerned, I think there was an artificial timeline, and given time,  something could get put together that would have passed.

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