 Medicaid Directors Of All 50 States Issue Joint Statement Slamming GOP Health BillOn Thursday, the National Association of Medicaid Directors sent Congress a devastating letter about their planned overhaul of American healthcare. The NAMD is an organization comprised of quite literally every single Medicaid chief in the country, and any statement issued by the entirety of its body is a rare thing. Ironically, the Trump era seems to have ushered in more than one situation in which there is unanimity in opposition to his policies and positions.Medicaid directors are appointed by state governors, which means that the office is filled by partisan picks. Fully 34 of the 50 states, in fact, have Republican governors, so the joint statement isn t just bipartisan   it s almost hyper-partisan.That makes this sharp criticism of the Graham-Cassidy bill even more poignant:BREAKING: The bipartisan Medicaid Directors from all 50 states just issued this negative statement about Graham-Cassidy.Big. Very unusual. pic.twitter.com/ZtqaAI8hg1  Andy Slavitt (@ASlavitt) September 22, 2017That tweet is clickable, and each image in the tweet is clickable, but here are the important parts, in case you don t feel like popping over to Twitter. The bill makes some major changes to Medicaid funding, including a massive transfer of funds from  blue  states to  red  states, and a transition to  block grants  that do not account for increased membership in Medicaid programs. That is to say, states would get the same fixed amount of money no matter how many people signed up, making states with high membership among those with the lowest per-patient allowance. Taken together, the per-capita caps and the envisioned block grant would constitute the largest intergovernmental transfer of financial risk from the federal government to the states in our country s history. The scope of this work, and the resources required to support state planning and implementation activities, cannot be overstated. States will need to develop overall strategies, invest in infrastructure development, systems changes, provider and managed care plan contracting, and perform a host of other activities. The vast majority of states will not be able to do so within the two-year timeframe envisioned here, especially considering the apparent lack of federal funding in the bill to support these critical activities. With only a few legislative days left for the entire process to conclude, there clearly is not sufficient time for policymakers, Governors, Medicaid Directors, or other critical stakeholders to engage in the thoughtful deliberation necessary to ensure successful long-term reforms. The mostly-Republican board of Medicaid Directors also took the GOP to task for trying to pass this bill before getting a score from the non-partisan Congressional Budget Office. Usually, that s the minimum a bill must have to even be considered for a vote. But Republicans are attempting to pass this bill before the end of the month, since that s the cutoff for them to do so with a simple majority. The Senate parliamentarian ruled that budget reconciliation, the process by which bills can be passed with a simple majority, expires at the end of Fiscal Year 2017. After September, votes will once again be subject to filibusters, meaning Republicans will need to muster 60 votes for anything they want to pass, unless they take Donald Trump s advice and invoke the  nuclear option  in the Senate.That s unlikely to happen, and Republicans are more desperate than ever for a win in Congress. That makes Graham-Cassidy a real danger to the future of American healthcare, despite this damning letter from the NAMD, and despite the massive opposition to the bill by every medical association, most states, nearly all consumers, and even some Republicans.Buckle up, my friends. This could get ugly.Featured image via Alex Wong/Getty ImagesNews
medical directors of all states issue joint statement spamming gop health billion thursday national association medical directors sent congress devastating letter planned overhaul american healthcare the name organization comprised quite literally every single medical chief country statement issued entirety body rare thing ironically trump era seems ushered one situation unanimity opposition policies directors appointed state governors means office filled partisan picks fully states fact republican governors joint statement bipartisan almost makes sharp criticism bill even poignant breaking the bipartisan medical directors states issued negative statement very unusual andy slavitt aslavitt september tweet clickable image tweet clickable important parts case feel like popping twitter the bill makes major changes medical funding including massive transfer funds blue states red states transition block grants account increased membership medical programs that say states would get fixed amount money matter many people signed making states high membership among lowest allowance taken together caps envisioned block grant would constitute largest intergovernmental transfer financial risk federal government states country history the scope work resources required support state planning implementation activities overstated states need develop overall strategies invest infrastructure development systems changes provider managed care plan contracting perform host activities the vast majority states able within timeframe envisioned especially considering apparent lack federal funding bill support critical activities with legislative days left entire process conclude clearly sufficient time policymakers governors medical directors critical stakeholders engage thoughtful deliberation necessary ensure successful reforms the board medical directors also took gop task trying pass bill getting score congressional budget office usually minimum bill must even considered vote but republicans attempting pass bill end month since cutoff simple majority the senate parliamentarian ruled budget reconciliation process bills passed simple majority expires end fiscal year after september votes subject filibuster meaning republicans need muster votes anything want pass unless take donald trump advice invoke nuclear option unlikely happen republicans desperate ever win congress that makes real danger future american healthcare despite damning letter name despite massive opposition bill every medical association states nearly consumers even friends this could get image via alex imagenes
Your task is to classify the provided input as real or fake news. Label 0 is meant for fake news, Label 1 is for real news. TEXT:  Medicaid Directors Of All 50 States Issue Joint Statement Slamming GOP Health BillOn Thursday, the National Association of Medicaid Directors sent Congress a devastating letter about their planned overhaul of American healthcare. The NAMD is an organization comprised of quite literally every single Medicaid chief in the country, and any statement issued by the entirety of its body is a rare thing. Ironically, the Trump era seems to have ushered in more than one situation in which there is unanimity in opposition to his policies and positions.Medicaid directors are appointed by state governors, which means that the office is filled by partisan picks. Fully 34 of the 50 states, in fact, have Republican governors, so the joint statement isn t just bipartisan   it s almost hyper-partisan.That makes this sharp criticism of the Graham-Cassidy bill even more poignant:BREAKING: The bipartisan Medicaid Directors from all 50 states just issued this negative statement about Graham-Cassidy.Big. Very unusual. pic.twitter.com/ZtqaAI8hg1  Andy Slavitt (@ASlavitt) September 22, 2017That tweet is clickable, and each image in the tweet is clickable, but here are the important parts, in case you don t feel like popping over to Twitter. The bill makes some major changes to Medicaid funding, including a massive transfer of funds from  blue  states to  red  states, and a transition to  block grants  that do not account for increased membership in Medicaid programs. That is to say, states would get the same fixed amount of money no matter how many people signed up, making states with high membership among those with the lowest per-patient allowance. Taken together, the per-capita caps and the envisioned block grant would constitute the largest intergovernmental transfer of financial risk from the federal government to the states in our country s history. The scope of this work, and the resources required to support state planning and implementation activities, cannot be overstated. States will need to develop overall strategies, invest in infrastructure development, systems changes, provider and managed care plan contracting, and perform a host of other activities. The vast majority of states will not be able to do so within the two-year timeframe envisioned here, especially considering the apparent lack of federal funding in the bill to support these critical activities. With only a few legislative days left for the entire process to conclude, there clearly is not sufficient time for policymakers, Governors, Medicaid Directors, or other critical stakeholders to engage in the thoughtful deliberation necessary to ensure successful long-term reforms. The mostly-Republican board of Medicaid Directors also took the GOP to task for trying to pass this bill before getting a score from the non-partisan Congressional Budget Office. Usually, that s the minimum a bill must have to even be considered for a vote. But Republicans are attempting to pass this bill before the end of the month, since that s the cutoff for them to do so with a simple majority. The Senate parliamentarian ruled that budget reconciliation, the process by which bills can be passed with a simple majority, expires at the end of Fiscal Year 2017. After September, votes will once again be subject to filibusters, meaning Republicans will need to muster 60 votes for anything they want to pass, unless they take Donald Trump s advice and invoke the  nuclear option  in the Senate.That s unlikely to happen, and Republicans are more desperate than ever for a win in Congress. That makes Graham-Cassidy a real danger to the future of American healthcare, despite this damning letter from the NAMD, and despite the massive opposition to the bill by every medical association, most states, nearly all consumers, and even some Republicans.Buckle up, my friends. This could get ugly.Featured image via Alex Wong/Getty ImagesNews
Your task is to classify the provided input as real or fake news. Label 0 is meant for fake news, Label 1 is for real news. TEXT: medical directors of all states issue joint statement spamming gop health billion thursday national association medical directors sent congress devastating letter planned overhaul american healthcare the name organization comprised quite literally every single medical chief country statement issued entirety body rare thing ironically trump era seems ushered one situation unanimity opposition policies directors appointed state governors means office filled partisan picks fully states fact republican governors joint statement bipartisan almost makes sharp criticism bill even poignant breaking the bipartisan medical directors states issued negative statement very unusual andy slavitt aslavitt september tweet clickable image tweet clickable important parts case feel like popping twitter the bill makes major changes medical funding including massive transfer funds blue states red states transition block grants account increased membership medical programs that say states would get fixed amount money matter many people signed making states high membership among lowest allowance taken together caps envisioned block grant would constitute largest intergovernmental transfer financial risk federal government states country history the scope work resources required support state planning implementation activities overstated states need develop overall strategies invest infrastructure development systems changes provider managed care plan contracting perform host activities the vast majority states able within timeframe envisioned especially considering apparent lack federal funding bill support critical activities with legislative days left entire process conclude clearly sufficient time policymakers governors medical directors critical stakeholders engage thoughtful deliberation necessary ensure successful reforms the board medical directors also took gop task trying pass bill getting score congressional budget office usually minimum bill must even considered vote but republicans attempting pass bill end month since cutoff simple majority the senate parliamentarian ruled budget reconciliation process bills passed simple majority expires end fiscal year after september votes subject filibuster meaning republicans need muster votes anything want pass unless take donald trump advice invoke nuclear option unlikely happen republicans desperate ever win congress that makes real danger future american healthcare despite damning letter name despite massive opposition bill every medical association states nearly consumers even friends this could get image via alex imagenes