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30 Oct, 14 tweets, 8 min read
Of 133 million w/ preexisting conditions, 54 million will be permanently uninsurable if Trump wins his Supreme Court case & the #ACA is overturned. For others, any gap in coverage, no matter how short, could forever bar them from insurance. <NYT: thread> nytimes.com/article/suprem…
If Trump wins in Court, 165 million Americans will again face annual & lifetime caps for costs, including both those who get their insurance thru work & those who buy it on the exchanges.

Employers will negotiate which conditions, therapies, drugs they'll cover in their plans.
If Trump wins his case, being female will again be considered a preexisting condition; insurers will be free to increase premiums for women.

60 million #Medicare beneficiaries will face changes to medical care and possibly higher premiums.
"About 21 mill are at serious risk of becoming uninsured if #Obamacare is struck down. That includes more than 9 mill who receive federal subsidies."

#Biden's plan increases middle-class subsidies & establishes a new public option for individuals & employers.
More than 12 million Americans will lose #Medicaid if Trump wins his #SCOTUS case & the #ACA is overturned.

#Biden's plan automatically covers everyone who's Medicaid-eligible, even if their GOP Governors have refused federal funds to expand the program.
800,000 people with #opioid addiction who get treatment thru #Medicaid will lose care if Trump wins his case at the #SupremeCourt.

#Medicare beneficiaries will pay more for preventive care & screenings, which are now free.
If Trump wins at the Supreme Court, #Medicare beneficiaries will pay more for prescription drugs. About 5 million faced the so-called Medicare doughnut hole, or coverage gap, in 2016, which the A.C.A. sought to eliminate. If the law were overturned, that coverage gap would widen.
"Repealing the #ACA would also eliminate a 0.9% increase in the payroll tax for high earners, which would mean less money coming into the #Medicare trust fund."

2 million young adults will lose insurance, as they'll no longer be able to stay on their parents' plans.
"Without the #ACA, the cost of care for people who cannot pay for it could increase as much as $50.2 billion." These costs are passed on to other patients.
Trump's "preexisting conditions" executive order “has no technical content": there's no plan & no "guidance or the vaguest outline of what that plan should be.” The #ACA's "sweeping protections are only possible by congressional action." khn.org/news/trumps-ex…
No #Republican bill matches the pre-existing protections in the #ACA. The Protect Act, for example, has loopholes that would allow insurance companies to drop coverage of certain expensive diseases from all their policies. politifact.com/article/2018/o…
On August 3, Trump announced he had a "great plan" that would be ready for his signature in 2 weeks.

Anyone know today's date? washingtonpost.com/opinions/2020/…
On Sept 22, Trump promised he'd roll out his #ACA replacement plan in (yup) 2 weeks. cnn.com/2020/09/22/pol…
On Oct 20: Great plan, better than #Obamacare, & coming soon! How soon?

Trump's #healthcare plan is always 2 weeks away. news.yahoo.com/trumps-health-…

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More from @JillPiggott

Jill Piggott Profile picture
31 Oct
2 dozen senior Trump admin officials fear he'll use gov't power to refuse to leave office or "create favorable terms for negotiating his exit." They worry too about foreign adversaries using the internet to undermine the election. thread> nytimes.com/2020/10/30/opi…
NYT sources: most senior officials w/ Senate-confirmed jobs, regular access to Trump & highest-level briefings; some still serving. Several are currently in Intel, law enforcement, nat'l security & are focused on violent, far-right white supremacy groups encouraged by Trump.
Officials: "in 1st debate, when the president offered one of the most astonishing performances of any leader in modern American history--bullying, ridiculing, manic, boasting, fabricating, relentlessly interrupting & talking over his opponent: that’s really him.... That’s Trump.”
Read 51 tweets
Jill Piggott Profile picture
26 Oct
#Kushner wasn't "successful" til he got a WH job. He & #Ivanka owed $1.4 BILLION on their #mortgage til foreign investors prepaid nearly a century in rent. They got a self-serving taxcut into law & raked in $90 mil from undisclosed overseas sources, most Saudi Arabian. >thread
By the time #Jared & #Ivanka became White House Senior Advisers, they were a little late on their #mortgage. The Washington Post reported that by March 1, 2018, they owed $1.4 billion on 666 5th Avenue.

That's a B. >2 washingtonpost.com/politics/jared…
2 months after WashPost reported #Kushner owed $1.4 billion, a company "swooped in & agreed to take a 99-year lease on the building, paying a near-century’s worth of rent upfront." The #Qatar Investment Authority was a leading investor in the company. >3 nytimes.com/2018/05/17/nyr…
Read 12 tweets
Jill Piggott Profile picture
26 Oct
.@headsUPmigraine spoke w/ a rural #PCP hounded out of the profession by relentless pressure to stop rxing #opioids. She was the only PCP in +100 miles willing to accept patients on opioid therapy. Most were over 70. 2018 #AMA statement shows many share her frustration. >thread
In 2018, #AMA passed a resolution against “misapplication” of the CDC Guideline by “pharmacists, health insurers, pharmacy benefit managers, legislatures, & governmental & private regulatory bodies in ways that prevent or limit patients’ medical access to #opioid analgesia.” 2/
#AMA: "physicians should not be subject to professional discipline, loss of board certification, loss of clinical privileges, criminal prosecution, civil liability, or other penalties or practice limitations solely for prescribing #opioids" above CDC's recommended dose. 3/
Read 13 tweets
Jill Piggott Profile picture
24 Oct
.@mareasachs The good news is that you're at the peak of #migraine prevalence! Preventive treatment is always important, but especially so in people with childhood onset & women within a decade +/- of peak. n.neurology.org/content/68/5/3… Image
@mareasachs Thanks for your message! I'm rushing off now, but will check back in soon. If you're just starting to learn about #migraine, try @amfmigraine and .... americanmigrainefoundation.org
And check out this great interview by Angie Glaser (@winedarkme), who, like us, also started #migraine very young. She talks with another talented member of the #migraine sisterhood, @AbiStevens_Art. migraineagain.com/migraine-battl…
Read 4 tweets
Jill Piggott Profile picture
21 Oct
@louisanamom In 2016, CDC said there wasn't good evidence showing reductions in rx #opioids would reduce ODs. Of their study of 221 #vets (who, sadly, have higher rates of OD/suicide), they said, "caution should be taken in drawing causal inferences from this observational study.” 1/
@louisanamom I don't know why CDC's 2016 paper is titled "a detailed exploration into the association of prescribed #opioid dosage & OD deaths" when it admits there were 2 low-quality studies + their "don't assume anything about cause & effect" study! ncbi.nlm.nih.gov/pmc/articles/P…
@louisanamom In 2016, @CDCgov had NO SOLID EVIDENCE about whether rx #opioid reductions & discontinuation would help or hurt. Here's their review of evidence (table 1). Read the column "Limitations."

By 2017, they knew it didn't reduce ODs. 1/ cdc.gov/mmwr/volumes/6…
Read 8 tweets
Jill Piggott Profile picture
1 Oct
@DrTomFrieden With all due respect, Dr. Frieden, why didn't you follow science when you directed @CDCgov & you learned in 2018 that fatal overdoses went up, not down, following implementation of the 2016 #Opioid Guideline you promoted? ncbi.nlm.nih.gov/pmc/articles/P…
@DrTomFrieden @CDCgov #CDC-funded research in 2018: “declines in these opioid prescribing metrics ... have not been followed by decreases in opioid overdoses. Instead, overdoses due to illegal opioids ... have increased.” Why didn't CDC retract the Guideline when it saw deaths were going UP?
@DrTomFrieden @CDCgov In 2016, #CDC Director Frieden told the press that the risks of rx #opioids would outweigh benefits for "vast majority of patients.” But the Guideline itself said an average 96% of patients had no addiction or non-addictive abuse, misuse, or long use.
cdc.gov/media/releases…
Read 15 tweets

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