Tag Archives: paul ryan

On Medicaid money, GOP has win-or-lose proposition for states

New England’s bucolic countryside looks much the same on either side of the Connecticut River separating Vermont from New Hampshire. But Medicaid beneficiaries are far better off in Vermont.

Vermont generously funds its Medicaid program. It provides better benefits, such as dental care, and pays doctors more than New Hampshire’s program does. That brings more doctors into the program, giving enrollees more access to care.

New Hampshire has twice Vermont’s population, but Vermont spends almost as much on Medicaid and covers more enrollees. Under the complicated formulas that set federal funding, Vermont’s substantial investment helps it capture nearly as much aid from the government as New Hampshire gets.

States’ policies differ about who or what to cover in Medicaid, and those decisions have led to historical variances in how much federal money they receive. House Republicans’ effort to shrink federal Medicaid spending would lock in the differences in a way that favors those already spending high amounts per enrollee.

“Republicans are finding out why changing Medicaid is so hard and why the easiest thing to do is to do nothing given the substantial variation in federal spending across states,” said John Holahan, a health policy expert with the nonpartisan Urban Institute.

Here’s why.

Medicaid, the national health program for low-income people that covers about 1 in 5 Americans, is 60 percent funded by the federal government and 40 percent by states. Total spending in 2015 was about $532 billion, according to the latest official data.

Federal funding is open-ended, which means the government guarantees states it will pay a fixed rate of their Medicaid expenses as spending rises.

Those matching rates are tied to average personal incomes and favor the lowest-income states. Mississippi has the highest Federal Matching Assistance Percentage — 76 — while 14 wealthy states, including New York and California, get the minimum 50 percent from the federal government.

But state Medicaid spending varies significantly, too, and that influences how much federal money each receives to fund its program. State policies about how generous benefits should be and how much to pay doctors and hospitals account for those differences.

GOP leaders want to give states a set amount of money each year based on the number of Medicaid enrollees they had in 2016, a formula known as per-capita caps.

A per-capita system would benefit high-spending states already receiving relatively rich allotments from the government, the Urban Institute said in a paper last September.

According to its estimates, if the system were in effect this year, Vermont would receive $6,067 per enrollee — one of the highest allotments in the country — while New Hampshire would get the least, just $3,084 per enrollee.

Per-capita caps would limit the government’s Medicaid spending because it would no longer be on the hook to help cover states’ rising costs. But caps also would shift costs and financial risks to the states and could force them to cut benefits or eligibility to manage their budgets.

“It would present a huge problem,” said Adam Fox, a spokesman for the Colorado Consumer Health Initiative, an advocacy group.

Under the GOP bill, federal Medicaid funding to states would be adjusted annually based on a state’s enrollment and medical inflation. But that would not be enough to keep up with rising Medicaid spending per enrollee, which would force states to put up more of their money or scale back the program, the nonpartisan Congressional Budget Office said March 13.

Other analyses of the GOP plan have reached the same conclusion.

Since 1999, however, the average annual growth rate in Medicaid spending per enrollee has risen more slowly than medical inflation, according to MACPAC, the Medicaid and CHIP Payment and Access Commission, which advises Congress.

Republicans argue that overhauling federal Medicaid spending as they propose would hold down federal costs while giving states more leeway to run their programs as they see fit. “This incentive would help encourage efficiencies and accountability with taxpayer funds,” House Speaker Paul Ryan wrote last June in his white paper, A Better Way.”

Rep. Greg Walden (R-Ore.), chairman of the powerful House Energy and Commerce Committee, which has oversight of health care matters, sounded a similar note at a press conference in Washington, D.C., when the GOP plan was announced. “I think it’s really important to empower states and to put Medicaid on a budget,” he said.

But Fox argued the opposite would happen under a per-capita system — instead of gaining more control over their Medicaid programs, states would not be able to meet their needs because they’d have fewer dollars to decide how to spend, he said.

Bill Hammond, director of health policy for the nonpartisan Empire Center for Public Policy in New York, said House leaders’ decision to tie future Medicaid funding to medical inflation could help mute concerns that funding wouldn’t keep up with rising costs, but would not address the fairness issue of giving some states higher per-capita amounts than others.

“If a low-spending state decides it wants to spend more money on paying hospitals and doctors or adding more benefits, they would have a harder time doing that without breaking the federal cap,” he said.

Medicaid advocates in New Hampshire are worried because their state has few alternatives to make up for a loss in federal funding. New Hampshire lacks an income or sales tax.

“There is a tremendous amount of fear among families here as Republicans try to dismantle the ACA,” said Martha-Jean Madison, co-director of New Hampshire Family Voices.

Published under a Creative Commons license. Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.

Ryan fundraised for health insurer hours before intro of ACA overhaul

Just hours before House Speaker Paul Ryan held a press conference to sell his health care overhaul legislation — using a PowerPoint presentation mocked for misrepresenting basic facts — he was doing something he’s much better at: fundraising.

The two things were related. The Thursday morning breakfast fundraiser he attended was hosted by a lobbying firm working to unwind the Affordable Care Act on behalf of health insurance company Blue Cross Blue Shield, one of the big winners of Ryan’s proposed legislation.

The breakfast, according to an invitation, was sponsored by McGuireWoods PAC, the political action committee for the lobbying firm McGuireWoods. Blue Cross Blue Shield, an Anthem company, pays McGuireWoods $120,000 a year to lobby on changes to health reform, records show. Attendees of the event paid were asked to pitch in as much as $10,000.

Ryan’s American Health Care Act (AHCA), which rolls back most of the revenue-generating provisions of the ACA, reduces premium subsidies, and imposes deep cuts to Medicaid, has largely been panned by medical professionals, health policy experts, and political advocacy groups from across the ideological spectrum.

But the bill enjoys enthusiastic support from some corners of the health care industry — primarily health insurance firms and medical device companies that directly benefit from the legislation.

America’s Health Insurance Plans, the trade group that lobbies on behalf of health insurance companies, wrote a letter to Congress on Wednesday praising much of the AHCA.

“The proposed legislation includes a number of positive steps to help stabilize the market,” wrote AHIP president Marilyn Tavenner, citing the bill’s provisions on “continuous coverage” and added flexibility for “health plans to offer consumers more choices.”

Alissa Fox, the senior vice president for the Blue Cross Blue Shield Association, another health insurance lobby group, also provided a statement praising the bill.

The ACHA includes a special 30 percent premium surcharge insurers can charge anyone who has gone without health coverage for at least two months. The bill also reduces the types of medical coverage Medicaid policies are required to cover — the type of flexibility insurers have sought in order to cover less health care costs.

As we reported earlier this week, insurance lobbyists are particularly fond of a tax change made by the Republican health bill that removes limitations on deductions for executive compensation. That reversal will reduce the tax bill for health insurance companies while incentivizing higher pay for insurance employees.

The ACHA would also permanently repeal the 2.3 percent excise tax on medical device tax, which was imposed by Obama’s health reform law. AdvaMed, the lobby group representing the largest medical device firms, released a statement commending the Republican-led House Ways and Means Committee for the repeal of the tax.

While some media outlets praised Ryan’s “wonky” style and use of bar graphs to make his case for the bill on Thursday, many reporters noted that the speaker stumbled when asked basic questions about the legislation.

Ryan notably called the ACA system of younger, healthier people helping to subsidize the insurance of elderly, sick patients a “fatal conceit.” But that general principle — of high- and low-risk consumers alike pooling their resources — is a fundamental element of all health insurance programs. Ryan also “made a series of misleading statements,” noted Politico’s Danny Vinik, who pointed out that the speaker cherry-picked data to exaggerate ACA premium increases.

Despite the perception of Ryan as a policy expert — a brand carefully manufactured by friendly D.C. reporters — the speaker has devoted himself to relentless fundraising. Records show Ryan spent much of the year flying to resorts and huddling with lobbyists to raise huge amounts of cash to maintain his party’s control of the House of Representatives. The Team Ryan joint fundraising committee, hosted by McGuireWoods on Thursday morning, is allowed to raise as much as $244,200 per person.

This article by the Center for Media and Democracy first appeared at The Intercept.

House GOP health bill jettisons insurance mandate, much of Medicaid expansion

House Republicans unveiled their much anticipated health law replacement plan Monday, slashing the law’s Medicaid expansion and scrapping the mandate that individuals purchase coverage or pay a fine. But they opted to continue providing tax credits to encourage consumers to purchase coverage, although they would configure the program much differently than the current law.

The legislation would keep the health law’s provisions allowing adult children to stay on their parents’ health insurance plan until age 26 and prohibiting insurers from charging people with preexisting medical conditions more for coverage as long as they don’t let their insurance lapse.  If they do, insurers can charge a flat 30 percent late-enrollment surcharge on top of the base premium, under the Republican bill.

In a statement, House Speaker Paul Ryan (R-Wis.) said the proposal would “drive down costs, encourage competition, and give every American access to quality, affordable health insurance. It protects young adults, patients with preexisting conditions, and provides a stable transition so that no one has the rug pulled out from under them.”

The GOP plan, as predicted, kills most of the law’s taxes and fees and would not enforce the so-called employer mandate, which requires certain employers to provide a set level of health coverage to workers or pay a penalty.

Democrats quickly condemned the bill. “Tonight, Republicans revealed a Make America Sick Again bill that hands billionaires a massive new tax break while shifting huge costs and burdens onto working families across American,” House Minority Leader Nancy Pelosi tweeted. “Republican will force tens of millions of families to pay more for worse coverage — and push millions of Americans off of health coverage entirely.”

The legislation has been the focus of intense negotiations among different factions of the Republican Party and the Trump administration since January. The Affordable Care Act passed in 2010 without a single Republican vote, and the party has strongly denounced it ever since, with the House voting more than 60 times to repeal Obamacare. But more than 20 million people have gained coverage under the law, and President Donald Trump and some congressional Republicans have said they don’t want anyone to lose their insurance.

When Republicans took control of both Congress and the White House this year, they did not have an agreement on the path for replacement, with some lawmakers from states that have expanded Medicaid concerned about the effect of repeal and the party’s conservative wing pushing hard to jettison the entire law.

Sen. Rand Paul (R-Ky.), one of those favoring a full repeal, tweeted: “Still have not seen an official version of the House Obamacare replacement bill, but from media reports this sure looks like Obamacare Lite!”

Complicating the effort is the fact that Republicans have only 52 seats in the Senate so they cannot muster the 60 necessary to overcome a Democratic filibuster. That means they must use a complicated legislative strategy called budget reconciliation that allows them to repeal only part of the ACA that affect federal spending.

Beginning in 2020, the GOP plan would provide tax credits to help people pay for health insurance based on household income and age, with a limit of $14,000 per family. Each member of the family would accumulate credits, ranging from $2,000 for an individual under 30 to $4,000 for people ages 60 and higher. The credits would begin to diminish after individuals reached an income of $75,000 — or $150,000 for joint filers.

Consumers also would be allowed to put more money into tax-free health savings accounts and would lift the $2,500 cap on flexible savings accounts beginning in 2018.

The legislation would allow insurers to charge older consumers as much as five times more for coverage than younger people. The health law currently permits a three-to-one ratio.

Community health centers would receive $422 million in additional funding in 2017 under the legislation, which also places a one-year freeze on funding for Planned Parenthood and prohibits the use of tax credits to purchase health insurance that covers abortion.

Both the Energy and Commerce and Ways and Means Committees are scheduled to mark up the legislation Wednesday. The committees do not yet have any Congressional Budget Office analysis of how much the legislation would cost or how many people it would cover.

Party leaders have said they want to have the bill to President Trump next month.

In a statement, senior Democrats on both panels said the measure would charge consumers “more money for less care. It would dramatically drive up health care costs for seniors. And repeal would ration care for more than 70 million Americans, including seniors in nursing homes, pregnant women and children living with disabilities by arbitrarily cutting and capping Medicaid,” said Rep. Frank Pallone of New Jersey and Rep. Richard Neal of Massachusetts.

The House GOP plan makes dramatic changes to Medicaid, the state-federal health insurance program that covers 70 million low-income Americans. The program began in 1965 as an entitlement — which means federal and state funding is ensured regardless of cost and enrollment. But the Republican bill would cap federal funding for Medicaid for the first time.

The federal government picks up between half and 70 percent of Medicaid costs. The percentage varies based on the relative wealth of the state.

Under the GOP plan, federal funding would be based on what the government spent in the fiscal year that ended Sept. 30. Those amounts would be adjusted annually based on a state’s enrollment and medical inflation.

Currently, federal payments to states also take into account how generous the state’s benefits are and what rate it uses to pay providers. That means states like New York and Vermont get higher funding than states like Nevada and New Hampshire and those differences would be locked in for future years.

Republicans have pushed to cap federal funding to states in return for giving them more control in running the program.

The legislation also affects the health law’s expansion of Medicaid, in which the federal government provided enhanced funding to states to widen eligibility. The bill would also end that extra funding for anyone enrolling under the expansion guidelines starting in 2020. But the legislation would let states keep the extra funding Obamacare provided for individuals already in the expansion program who stay enrolled.

About 11 million Americans have gained Medicaid coverage since 2014.

Changing the expansion program is a delicate balance for the Republicans. Four GOP senators from states that took that option said Monday they would oppose any legislation that repealed the expansion.

“We are concerned that any poorly implemented or poorly timed change in the current funding structure in Medicaid could result in a reduction in access to life-saving health care services,” Sens. Rob Portman of Ohio, Shelley Moore Capito of West Virginia, Cory Gardner of Colorado and Lisa Murkowski of Alaska wrote in a letter to Majority Leader Mitch McConnell.

Provided under a creative commons license by Kaiser Health News. Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation

Hundreds greet Paul Ryan in Rhode Island with chants of ‘Coward!’

Around 200 people chanted “Coward!” and booed as Republican House Speaker Paul Ryan attended an event in Rhode Island.

A strong police presence kept the crowd across the street from a Providence office building, where Ryan met March 2 with Year Up, a nonprofit career training organization.

Ryan was not seen entering the building, but a motorcade carrying him pulled into an alley, where there’s a back entrance, away from protesters.

“We want him to hear loud and clear that his values are Wall Street values, they’re not Rhode Island values,” said Georgia Hollister Isman, the state director of Rhode Island Working Families. “We’re also here in solidarity with our friends in Wisconsin who’ve been trying for months to get a town hall meeting with him.”

Ryan spokesman Zack Roday said “it is unfortunate protesters chose to demonstrate at Year Up,” where Ryan toured the facilities and took questions from students.

The demonstrators said they were protesting the policies of Republicans including Ryan and President Donald Trump, especially their plans to repeal and replace the 2010 Affordable Care Act. People also carried signs that said, “No Ban No Wall” and “Hey! Wisconsin we found him!”

“No matter where he goes, wherever he takes his radically dangerous Ryan-Trump agenda, the resistance will be there to meet him,” said state Rep. Aaron Regunberg, a Providence Democrat, who spoke to the crowd through a megaphone.

The protesters said their ire wasn’t aimed at Year Up, which offers low-income young adults six months of intensive career training followed by a six-month internship with one of its corporate partners.

But its board president, Paul Salem, is with a private equity firm whose members have donated to the GOP. Campaign finance records collected by the Center for Responsive Politics show people with Providence Equity Partners gave more than $700,000 to groups associated with the Republican Party and candidates in the 2016 election cycle.

Roday said Ryan also met on March 2 with executives from CVS Health, based in Woonsocket.

Paul Ryan is fundraising off healthcare while working to kill it

House Speaker Paul Ryan has a reputation for policy wonkishness, which he doesn’t deserve. He also has a reputation for raising boatloads of cash, which he does deserve. Care to guess which one’s driving his healthcare priorities? For bonus points, name the two billionaire brothers who are glad to see him do it.

Ryan did a fundraising “physicians and dentist industry” breakfast on Feb. 1 of this year, (here’s the invitation obtained exclusively by the Center for Media and Democracy) and the suggested contributions were worth more than a cup of coffee and some scrambled eggs: $10,000 for a “sponsor,” $5,000 for a “host,” $2,500 for a political action committee, and $1,000 for an individual attendee.

The breakfast was held at a private, members-only establishment for Republicans called the Capitol Hill Club. (The house rules forbid tipping, so here’s hoping the medical providers were kind to the staff.)

It’s an odd phrase, “physicians and dentist industry,” and not just because “physicians” is plural and “dentist” is not. (That’s presumably just a clerical error.) Most Americans think of the provision of health care as a profession – a higher calling, even. They don’t think of it as an “industry.”

But it is, of course. And, like any industry, it has its own financial interests, internal conflicts, and politics. Many healthcare providers are satisfied with government programs like Medicare and the 2010 Affordable Care Act (ACA), and some want to see them expanded. But many others, especially some of those on the higher end of the income spectrum, would benefit financially if these programs were repealed.

That’s because these programs don’t just provide health insurance coverage to millions of Americans. They also attempt to keep costs under control by restricting the ability of specialists to overtreat patients and overcharge for their services. That’s one reason why incoming Health and Human Services Secretary Tom Price — a tea party Republican and an orthopedic surgeon — bitterly opposed a provision of the ACA that tests new kinds of physician payment.

The Centers for Medicare and Medicaid Services (CMS) administers Medicare. Its rules and mechanisms for paying doctors have been widely adopted by private health insurers. Ryan and the House Republicans want to phase out Medicare in its current form and replace it with a voucher program, a move that would effectively gut these payment rules and lead to higher incomes for medical specialists.

It’s not surprising that this “industry” got its own breakfast fundraiser with Ryan, since so many of these highly-paid professionals will benefit financially if the GOP repeals the ACA or privatizes Medicare.

Paul Ryan may be sincere in his extremist beliefs. But they haven’t hurt his fundraising, either. The Wall Street Journal reports that he raised nearly $90 million in 2016 alone, and that more than $52 million came through Ryan’s own political committees. And Ryan raised even more money in January 2017 than he did in January of the previous year.

Know who else wants to eliminate these programs? The Koch Brothers.

As the Center for Media and Democracy has reported, Koch family foundations and Freedom Partners, the “Koch brothers’ secret bank,” bankrolled practically every “grassroots” group opposing the ACA in order to manufacture a phony “uprising” against expanded health care coverage. Many of these groups, including Heritage Action and the 60 Plus Association, cheered Sen. Ted Cruz when he brought the U.S. government to the brink of default in October 2013 in a stunt to repeal the ACA. The Kochs’ astroturf group Americans for Prosperity also spent millions of dollars in the 2012 and 2014 elections trashing “Obamacare” and Democratic candidates who had the temerity to support extending insurance coverage to more Americans.

Why? As The New York Times explained in 2012, the Kochs and their minions “are trying to present the law as a case study in government ineptitude to change the way voters think about the role of government for years to come.”

“We have a broader cautionary tale,” Tim Phillips, the president of the Kochs’ astroturf group Americans for Prosperity told the Times. “The president’s out there touting billions of dollars on climate change. We want Americans to think about what they promised with the last social welfare boondoggle and look at what the actual result is.”

In other words, the Kochs don’t want you to believe that government can work to address problems because they really don’t want the government addressing the problem of climate change.

The ACA isn’t perfect, but it demonstrated the government’s ability to make concrete improvements in people’s lives. That is enough to make it a target for Koch attacks, along with successful government programs like Social Security and Medicare.

The Koch Brothers love Paul Ryan nearly as much as they hate government. A 2011 internal email between Wisconsin Americans for Prosperity staff and Tim Phillips, uncovered in the course of an investigation into whether or not Scott Walker was illegally coordinating with dark money groups, put it bluntly:

“. . . We have one of the brightest and strongest minds in America in Paul Ryan. A poll just released today shows him with an approval rating at 38 percent in his district. While he is doing the heavy lifting for our cause in Washington, we can’t let him slip back home. Supporting him through educational efforts across the state will help him and our two vulnerable freshmen members of Congress . . .”

An interesting memo from an organization that has declared to the IRS that it does not engage in campaigns and elections. The use of the word “educational” doesn’t change the fact that this paragraph appears to say that a tax-exempt educational organization is working to re-elect three members of Congress, including Ryan.

The Koch Brothers and their allies are determined to use their billions to permanently change the political landscape. As a Koch operative told the New York Times in 2014,

“We’re focused on optimizing our efforts … Being in the field and testing during the slower periods, and in smaller areas, allows you to refine strategy and tactics so that you can make the larger investments with confidence.”

Another Koch official added, “What we took from studying it was that we have to have a bigger, more permanent infrastructure on the ground in these states, and this takes time.”

It also takes money – lots of money. The Kochs are happy to throw their billions behind politicians like Paul Ryan. They’re even happier when they can get a tax break for it.

As for Ryan, one thing is clear: He’s determined to raise as much money as possible to fuel his own rise, and his party’s, no matter how many people’s health may suffer in the process.

CMD’s Mary Bottari contributed to this article.

 

Editorial: Paul Ryan degenerates into an unapologetic partisan hack

Not so long ago, House Speaker Paul Ryan, R-Wis., had at least some aura of integrity. He resisted Donald Trump’s candidacy nearly down to the wire, going so far as to say the GOP was not Trump’s party.

Ryan appeared to have principles. We disagreed with him on nearly all the issues, but at least we believed that he believed in the positions he took.

That was another Paul Ryan ago.

Now he’s toeing the line on the most egregious of Trump’s avalanche of executive orders — the travel ban on people from seven Muslim-majority countries.

In supporting Trump’s self-serving act of religious discrimination, Ryan sold out not only his previously stated values, but also those of the Constitution. The time to begin organizing his ouster from Congress next year is now

Hypocrisy

Here’s what Ryan had to say last summer when Trump claimed that the massacre at a gay nightclub in Orlando validated his call for a ban on Muslims: “Muslims are our partners,” he responded. “The vast, vast majority of Muslims in this country and around the world are moderate. They’re peaceful. They’re tolerant. So they’re among our best allies, among our best resources in this fight.”

He told former radio host Charlie Sykes that he hated even talking about Trump’s anti-Muslim comments for fear of giving them credence.

“This is not the U.S. Constitution,” he said. “This is not the U.S. Bill of Rights. Let’s just be really clear about this.”

So when Trump slammed the door on the hands of Muslim travelers who were opening it legally, Ryan’s professed values should have prompted him to lash out. Instead, he did a back flip and supported the move.

“What is happening is something we support,” Ryan said to reporters after hundreds of travelers were imprisoned in U.S. airports, setting off protests and demonstrations.

“We need to pause and we need to make sure that the vetting standards are up to snuff so we can guarantee the safety and security of our country,” said the new Ryan.

But as he well knows, our vetting standards for visas are already rigorous. When asked what Trump’s administration would do differently than what’s already being done, White House Chief of Staff Reince Priebus gave the vague answer that we need to ask “more questions” of travelers who lived in or traveled through the seven designated countries.

Based on the way Trump’s immigration order is written, it would kill tourism to the U.S. and make it difficult for foreign heads of state, such as German Chancellor Angela Merkel, to enter the country.

Potential corruption at the highest level

Beyond his tortuous flip-flop on the merits, Ryan should have done a double-take when the list of banned countries was revealed. What do Iran, Iraq, Libya, Somalia, Syria, Sudan, and Yemen have in common besides Muslim majorities? Donald Trump has no business interests in any of them, and no terrorist attacks have been committed on U.S. soil by citizens of those nations.

But he’s deeply involved in other countries in the region that escaped his ban.

He overlooked Turkey, even though the State Department last month issued a travel warning for that country, citing “increased threats from terrorist groups.”

Trump is licensing his name to two luxury towers in Istanbul. An FEC filing reported his income from that deal is between $1 million and $5 million.

Also not included in the ban is the United Arab Emirates, where Trump is building a golf course. And, even though Trump blamed Saudi Arabia for the 9/11 terrorist attacks, he’s still doing business there, according to FEC filings.

All of this means that in addition to supporting an executive order that belies the philosophical foundations on which our nation was founded, Ryan also is looking the other way while issues of potential corruption arise at the highest level of government.

The Trump “revolution” was supposed to be about punishing entrenched elected officials for putting their partisanship and their self-interests ahead of their duties. Now it’s up to voters in Wisconsin’s First Congressional District to get rid of the hypocritical partisan pawn who claims to serve them in the House.

The curtain has come down on Ryan’s pose of sincerity. He serves his party above all else.

Trump stands by baseless claim millions voted illegally, vows investigation

President Donald Trump stands by his belief that millions of people voted illegally in the U.S. election, the White House said, despite widespread evidence to the contrary.

“The president does believe that,” White House spokesman Sean Spicer told reporters.

On Jan. 25, his Twitter account said Trump is ordering a “major investigation” into voter fraud, specifically his belief that people voted in more than one state or “those who are illegal and … even, those registered to vote who are dead (and many for a long time).”

Officials in charge of the Nov. 8 election have said they found no evidence of widespread voter fraud and there is no history of it in U.S. elections.

Even House of Representatives Speaker Paul Ryan, the most senior Republican in Congress, said he has seen no evidence to back up Trump’s claims.

Trump won the Electoral College that decides the presidency and gives smaller states more clout in the outcome, but he lost the popular vote to Democratic rival Hillary Clinton by about 2.9 million.

Trump has repeatedly said he would have won the popular vote, too, but for voter fraud. He has never substantiated his claim.

Also, Trump’s attorneys dismissed claims of voter fraud in a legal filing responding to Green Party candidate Jill Stein’s demand for a recount in Michigan last year. “On what basis does Stein seek to disenfranchise Michigan citizens? None really, save for speculation,” the attorneys wrote. “All available evidence suggests that the 2016 general election was not tainted by fraud or mistake.”

Secretaries of state across the country also have dismissed Trump’s voter fraud claims as baseless.

Wade Henderson, president and CEO of The Leadership Conference on Civil and Human Rights, said invented claims such as Trump’s are used to undermine the advancement and enforcement of voting rights laws.

“The White House is bashing immigrants, undermining voting rights, and playing to bigotry all at once,” Henderson said. “Sen. Jeff Sessions once made up fraud charges to wrongly prosecute voting rights activists and the White House appears to be using the same anti-civil rights playbook. Peddling these lies just drives this administration farther from reality and from the people it claims to govern.”

Henderson added, “This conspiracy theory raises serious doubts about whether our new president can be trusted on anything.”

(Reporting by Jeff Mason and Timothy Ahmann; editing by Grant McCool)

Planned Parenthood: Ryan lies about access to health care in Wisconsin

During a CNN town hall meeting last week, House Speaker Paul Ryan told a patient who relies on Planned Parenthood that she would have many other places to go for her health care if he is successful in kicking Planned Parenthood out of the Medicaid program.

However, ending funding for preventive care at Planned Parenthood would devastate essential health care access among the country’s and state’s most vulnerable populations — most prominently in Paul Ryan’s own back yard.

If Paul Ryan really wanted women to get the health care they need, he would not propose ending Planned Parenthood’s ability to serve 50,000 people in Wisconsin, leaving most of them without another provider.

As a part of the pubic health network in Wisconsin, no one knows better than Planned Parenthood the lack of access people in our state already face. We have been unable to identify alternative health care providers who are able to absorb Planned Parenthood’s patients in Wisconsin — including in Paul Ryan’s own district.

In 73 percent of the counties PPWI serves, there is not a provider who could absorb Planned Parenthood’s patients. In those rare communities where there are other community health care providers, many would be unable to meet our patients’ need if Planned Parenthood could not provide care.

In fact, more than 6,000 people living in Speaker Ryan’s own district rely on Planned Parenthood for cancer screenings, STD testing and treatment and birth control. On behalf of these patients, we ask Speaker Ryan where these people go for health care? Community based health centers like Planned Parenthood are critical for especially vulnerable patients without easy access to other providers.

Even with Planned Parenthood’s continued care, there is a tremendous unmet need for health care in Wisconsin and in Speaker Paul Ryan’s own district. In Ryan’s district specifically, STD rates, teen births, poverty, infant mortality and unemployment rates are all higher than the state average. We’ve been hearing from leaders, partners and patients across Wisconsin, including those in the Speaker’s district. What they all know is ensuring continued access to a trusted and affordable community health care provider like Planned Parenthood is something we should all agree is important to help keep our communities safe, healthy and strong.