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Sometimes policymakers, including presidents, speak in code – they say one thing, but mean something else.

Here are some suggestions for how to listen to, and translate, key statements related to health care that may be in the State of the Union Address. 

For example, if you hear the following phrases, consider the following translations:

1. Add more choice in Medicare

Translation: Add more private plan options, and/or increase favoritism of private Medicare Advantage plans over traditional Medicare.

2. Modernize Medicare

Translation: Privatize Medicare, such as steering more people into private Medicare Advantage plans, or going as far as Speaker Ryan’s VoucherCare proposals – which would change Medicare from a defined benefit program into a set contribution toward the cost of private insurance.

3. Allow more flexibility for states

Translation: Cap spending for and/or block-grant Medicaid. Reduce the Affordable Care Act (ACA) Medicaid expansion and allow states to offer plans that don’t meet ACA coverage standards.  Allow requirements for “community engagement” for Medicaid recipients – meaning add work requirements designed to reduce the number of people who qualify for Medicaid.

4. Most anything about the Affordable Care Act

Translation: Work to sabotage the ACA in any way possible. (Note: The Affordable Care Act isn’t “imploding.” Although the president and Congress did all they could to wreck the program, record numbers signed up in the shortened enrollment period.)

5. Reduce costs, fraud, waste and abuse

Translation: Cut essential programs for people at risk. (Note: The recently passed Tax Bill added $1.5 billion to the federal deficit, setting up policy-makers to insist “we can’t afford” Medicare, Medicaid, Social Security, food stamps, and other key programs that families rely on.)

6. Protect religious freedom and people of conscience

Translation: Let providers refuse to provide care (overall health care, abortions), or insist on providing care (end-of-life), and/or refuse care to groups of people they find offensive. This could lead to a form of legalized discrimination and could harm older and disabled people

7. Reduce paper work and burdens on providers

Translation: Roll back patient protections and rescind regulatory and other oversight of patient care and rights.

Let’s hope we don’t hear any of these phrases tonight. But if we do, you’ll know what they really mean.  

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