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From the category archives: affordable care act

affordable care act

Senate GOP's "Mean" Healthcare Bill Must be Defeated

Getting a look at the Senate Republican healthcare bill after weeks of secrecy is like peeking under a rock.  There’s a lot under there that you don’t really want to see – and would like to believe doesn’t really exist.  Unfortunately, the Senate version of the American Health Care Act is very real – and dangerously close to becoming law.

Prognosticators who said the House-passed bill would be “dead on arrival” in the Senate, or who predicted that the Senate would be a moderating influence on the legislation, were dead wrong.  Instead, Senate Republicans have clearly chosen to put political expediency above the health of our most vulnerable citizens.

In some ways, the Senate bill is slightly less onerous than the House version; in other ways it’s worse – especially for the old, the sick, and the poor.  In a press statement today, National Committee President Max Richtman calls the bill “unconscionably cruel.”

This is a lose-lose for seniors and the American people.  The biggest loss is that the AHCA ends the Medicaid program as we know it.  Astoundingly, the Senate bill makes even deeper cuts to Medicaid than the House did.  This is devastating news for today’s and tomorrow’s seniors suffering from Alzheimer’s, cancer, the after-effects of stroke and other serious conditions who depend on Medicaid to pay for long-term care.  Millions will lose Medicaid coverage over the next ten years.” - Max Richtman, President and CEO of NCPSSM

 

The Washington Post clearly explains why the Senate bill hurts Medicaid beneficiaries even more than the House version:

Medicaid would be funded by giving states a per capita amount or block grant, beginning in 2021. The amount would grow more slowly than in the House bill, meaning bigger spending cuts overall. - Washington Post, 6/22/17  

This is why the Senate healthcare bill is so hazardous for older Americans in several other ways:

*It still permits insurance companies to charge older Americans five times more than young adults. 

*The tax credits that replace Obamacare subsidies are still too meager to make up for net increases in older Americans’ premiums. 

*Though it forbids insurers from denying coverage for pre-existing conditions, the waivers of essential benefits mean older patients with chronic diseases like diabetes, cancer, or heart disease could see their premiums skyrocket. 

 *Like the House bill, the Senate legislation weakens Medicare by reducing the solvency of the Part A Trust Fund.

Only the young, healthy and wealthy will truly benefit from this bill, whose true purpose is not to facilitate health coverage, but to give a multi-billion dollar tax break to the rich and the pharmaceutical companies. Our family members and friends who cannot afford exorbitant premiums and out-of-pocket costs will suffer.  Some will doubtless go without healthcare altogether.  Their health will deteriorate, and when they arrive at the doorstep of Medicare, they may be in worse condition – which can increase the financial burden on Medicare, too. 

Make no mistake, if the bill passes the Senate and the House, President Trump will sign it into law. The National Committee has identified 11 GOP Senators who could be persuaded to stop the AHCA with sufficient public pressure.  As few as three Republican dissenters could kill this bill. Americans of conscience must demand that their Senators put people before party and defeat this heartless legislation before it’s too late.

 

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For the latest on Trumpcare and its devastating implications for seniors, watch “Behind the Headlines” on Facebook Live from Capitol Hill.

 

Mitch McConnell's "Secret" Healthcare Plan... and the SeniorHeroes who could stop him

When the House passed its American Health Care Act (AHCA) last month, conventional wisdom said it was doomed in the Senate.  Moderate Republican Senators would never go along with the more harmful provisions of the House bill – or so the narrative went.  It appears those predictions were off base.  If the latest reporting from Capitol Hill is accurate, Majority Leader Mitch McConnell has put the Republican healthcare plan on a fast-track for passage in late June or early July.  A 13-member working group has been meeting in secret to craft the Senate version of the AHCA – without committee hearings.  Zero open debate.  Zero public input.  Or as the Washington Post described the process:  “sabotage, speed and secrecy.”  In order to keep pushback to a minimum, McConnell may not release the details of the bill until about 48 hours before the Senate votes on it.  That is insufficient time for Senators – and the public at large – to evaluate legislation that could dramatically affect the lives of tens of millions of Americans.

 Another false prediction from a few weeks ago said that the Senate would scrap the House bill and start from scratch. But this week Senator John Cornyn (R-TX) revealed that the Senate bill retains about 80% of what the House passed.  Since the House bill was so unequivocally bad for older Americans, hearing that the Senate version is at least 80% as bad is cold comfort. The Senate leadership will try to appease GOP moderates with the same kind of token gestures that saved the AHCA from defeat in the House.  It is vitally important that those moderates not cave like their House colleagues did.  Too much is at stake for our nation’s seniors and Americans as a whole.

 The National Committee has identified 11 moderate GOP Senators who may be persuaded to vote against the Republican health care plan – if they are willing to put their constituents’ well-being above party and political expediency.  They are:

 Sens. Lisa Murkowski and Dan Sullivan (R-AK)

Sens. John McCain and Jeff Flake (R-AZ)

Sen. Cory Gardner (R-CO)

Sen. Charles Grassley (R-IA)

Sen. Susan Collins (R-ME) 

Sen. Dean Heller (R-NV)

Sen. Rob Portman (R-OH)

Sen. Lamar Alexander (R-TN)

Sen. Shelley Moore Capito (R-WV)

 In fact, we call on these Senators to become what we call “SeniorHeroes” – real-life superheroes standing up for older Americans while the rest of their party pursues a dubious scheme.  From what we know of the Senate bill, there isn’t much in the evolving Senate bill for moderates to applaud.  Sen. Lisa Murkowski expressed those doubts publicly on Thursday.  Here are some of the key areas where the Senate version will likely fail older Americans:

 MEDICAID EXPANSION.  Senate Republicans are considering “compromises” that would phase out funding more slowly – but do not appear to be considering any approach that would maintain Medicaid expansion over the long run.  (Many of the more moderate Senators represent states which chose to expand Medicaid – and have a lot to lose.)

 PER CAPITA CAPS.  The Senate reportedly will retain the House-passed bill’s Medicaid per capita caps, which would strain state budgets and possibly force rollbacks in benefits or outright termination of coverage for millions of seniors who depend on Medicaid to pay for long-term care.  Although it’s unclear whether the Senate will keep the House bill’s $834 billion in Medicaid cuts, Medicaid still likely will be slashed by hundreds of billions of dollars. 

PRE-EXISTING CONDITIONS AND ESSENTIAL HEALTH BENEFITS.  The Senate may reject provisions in the House bill that would have allowed insurers to charge higher premiums for individuals with pre-existing conditions, but will likely allow states to waive essential benefits coverage.  This would dearly cost older Americans seeking essential benefits, such as hospitalization, ambulance services, and rehabilitation services. 

TAX CREDITS.  The House bill would drive up seniors’ out-of-pocket costs by replacing Obamacare’s income-based subsidies with tax credits based solely on age.  Older Americans could pay up to 800 percent more in net premiums under this plan.  The Senate has toyed with making these tax credits more “robust,” but the more it increases these credits, the deeper it must cut Medicaid to match the savings in the House bill. 

We do not know whether the Senate will allow insurers to charge older enrollees five times more than younger ones, as the House legislation does.  Also uncertain is whether the Senate will repeal the Medicare payroll tax on high income wage earners (as the House did), which would reduce the solvency of Medicare by three years.

It’s a safe bet that, like the House version, the Senate GOP healthcare plan will cost older Americans more, make essential health benefits harder to obtain, and cause millions who desperately need healthcare to lose coverage.  GOP moderates will be under intense political pressure to toe the line and support the party’s plan, even though the Republican bill has scant public support in even the reddest of states.  In asking GOP moderates to don their capes and become SeniorHeroes, we hope they remember who they were elected to serve.  It certainly wasn’t Mitch McConnell. 

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For more about the GOP's secret Senate healthcare plan, watch this week's "Behind the Headlines" on Facebook Live from Capitol Hill. 

 

CBO Confirms: GOP Healthcare Bill is a Huge Setback for Older Americans

Twenty-three million people will lose health insurance in the next decade under the GOP's American Health Care Act (AHCA) according to the latest Congressional Budget Office (CBO) report.  The CBO analysis concludes that the House Republican plan benefits the young and healthy at the expense of older and sicker Americans. The report indicates that “near seniors” (aged 50-64) will be hit particularly hard by the GOP healthcare bill, as we discussed this morning on our Facebook Live broadcast from Capitol Hill.  

 

“The CBO report was no surprise to those of us who are looking out for the best interests of older Americans. The GOP leadership was so focused on passing repeal and replace legislation that they failed their due diligence by ignoring an ominous flaw; their bill will drive up seniors’ out-of-pocket costs by repealing subsidies that help defray the cost of premiums,” says Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare.  

 

According to the CBO, near seniors could see their net premiums rise by as much as 700-800 percent if the AHCA becomes law.  A 64 year-old with an income of $26,500 per year who paid $1,700 annually for an Obamacare policy would now pay a whopping $13,600 under the Republican plan.

 

The report also confirms that the House bill will only compound the problems faced by near seniors with pre-existing conditions. While an amendment by Rep. Fred Upton (R-MI) adds $8 billion over five years to fund high-risk pools for patients with pre-existing conditions, that will not be nearly enough to offset the extra costs to seniors. 

 

“People who are less healthy (including those with pre-existing or newly acquired medical conditions) would ultimately be unable to purchase comprehensive non-group health insurance at premiums comparable to those under current law, if they could purchase it at all,” the CBO says

 

Seniors who rely on Medicaid will suffer under the American Health Care Act.  The CBO report calculates that the AHCA slashes Medicaid spending by $834 billion. Medicaid currently helps pay for long term care for millions of seniors nationwide. The CBO estimates that some 14 million Medicaid recipients would lose coverage under the AHCA – or not be able to attain it in the first place – within the next 10 years.  In fact, more than half of the increase in uninsured Americans under the AHCA would come from this vulnerable population.

 

The GOP healthcare bill also weakens Medicare by repealing a tax on high wage earners, which would decrease the solvency of the Medicare Part A Trust Fund by three years.  The CBO had earlier estimated that the Part A Trust fund would forgo $177.3 billion over ten years if the ACA Medicare payroll tax is repealed, opening the door for those who want to privatize (or "voucherize") Medicare. 

 

The amended American Health Care Act is an assault on the health care of all seniors,” says Richtman.  “We can only hope that the Senate will take the CBO’s new figures into consideration – and reverse the provisions that are so demonstrably harmful to our nation’s seniors.” 


 

 

Paul Ryan's Medicare Privatization Scheme Edging Closer to Reality

Paul Ryan’s dystopian dream of privatizing Medicare may soon come true.  At least he seems to think so.  In an interview with right-wing Wisconsin radio host Vicki McKenna, the House Speaker said that Medicare “reform” is coming to the Capitol this Spring.  “I’m pretty sure the budget committee in the House will pass that on in the House Republican budget,” Ryan said.  In fact, House Budget Committee Chair Diane Black (R-TN) has already promised to include Medicare privatization in the budget resolution next month.  This is scary news for millions of current and future retirees.

To justify his Scrooge-like assault on Medicare, Ryan continues to perpetuate the myth that Medicare is an “entitlement.”  In fact, it is a remarkably efficient social insurance program.  Having paid into it their entire working lives, Americans are counting on having affordable health care coverage to protect them upon retirement.  Why does Paul Ryan want to take that away, effectively reneging on the nation's commitment to current and future retirees? 

In the past, President Obama stood as an impenetrable barrier between Ryan and his privatization scheme.  Though candidate Trump promised “not to touch” Medicare, the President has already broken that pledge by supporting the GOP healthcare plan, which shortens the solvency of the program.   Despite Trump’s campaign promises, his budget director refused to publicly discourage Congress from privatizing Medicare.  In fact, Speaker Ryan said in his radio interview that he and the Trump administration are having “an ongoing conversation” about it. Current and future retirees clearly cannot trust this White House to protect their Medicare benefits, which they have paid for during their entire working lives.

As we discussed on our "Behind the Headlines" Facebook Live broadcast Thursday, here is what Ryan’s insidious “reform” would do:  Instead of receiving guaranteed benefits, all Medicare participants would be given vouchers to help pay premiums for traditional Medicare or private health insurance.   In either case, the vouchers would not be able to keep up with rising health care costs, leaving seniors to cover the difference out of their own pockets.  That’s why we call the voucher program “coupon care.” 

Ryan's plan would likely drive healthier, younger and wealthier seniors toward private insurance. Poorer and sicker seniors would remain in traditional Medicare, driving up costs until the program collapsed under its own weight.  But that’s not all.  Ryan also wants to hike the Medicare eligibility age from 65 to 67.  This in itself is a massive benefit cut, as 65 and 66 year olds would have to buy private insurance on their own dime. Those who couldn’t afford it might go without health insurance entirely. In a recent National Committee poll, 65% of likely voters opposed raising the eligibility age.  Among younger voters, the opposition was even stronger.

As Ryan predicts, Medicare privatization will likely pass the House as part of the Republican budget resolution.  Its future in the Senate is less certain, but too close for comfort.  Senate Republican leaders need only 50 votes to wreck Medicare.  The National Committee is building a “firewall” of moderate GOP Senators who we believe can be convinced to protect Medicare.  With an unpredictable President in the White House, that is the best way – along with vocal grassroots activism – to defend current and future retirees against the destruction of a program that has worked effectively for more than 50 years, and enjoys enduring public support.

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House GOP Votes to Gut Medicaid, Weaken Medicare & Put Seniors' healthcare at Risk

The National Committee strongly condemns the American Health Care Act (AHCA) just passed by the House, which needlessly puts the healthcare of millions of older Americans in jeopardy. “Despite the bill’s name, risking the health of our nation’s most vulnerable citizens to give the wealthy an $880 billion tax cut is tremendously uncaring --- and does not reflect real American values,” says Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare. “In modifying the original AHCA bill to give reluctant Republicans political cover, the House leadership made a bad piece of legislation even worse.”

“Recent amendments to this cruel, ill-advised bill could put coverage for older Americans with pre-existing conditions like cancer and diabetes out of reach. The $8 billion (over 5 years) added to the legislation at the last minute to defray the cost of higher premiums is woefully inadequate.  It’s a thin veil that covers a head of snakes.”

Paul Waldman of the Washington Post wrote a scathing, but accurate article about the human costs of the GOP healthcare bill - especially to patients with pre-existing conditions: 

"Make no mistake, if you’re one of them and this bill passes, your life will become hugely  more complicated, potentially more costly and possibly in danger if you’re unlucky." - Paul Waldman, Washington Post 5/3/17

The bill contains several other poison pills for older Americans. It replaces Obamacare subsidies with meager tax credits which discriminate against older Americans.  A $4,000 annual tax credit doesn’t come to close to covering premiums for seniors ages 60-64, meaning millions of older Americans will lose coverage altogether.

The bill cuts nearly $1 trillion from Medicaid by converting it into a block grant program or imposing per capita caps, which will make it harder for impoverished seniors to access long term skilled nursing care and community or home care.  Overall, the Congressional Budget Office estimates that 14 million people will be kicked off the Medicaid rolls in the next 10 years if this bill becomes law.

The AHCA reduces Medicare’s solvency by repealing Obamacare’s 0.9% payroll tax on wages above $200,000. This could lead to cuts in Medicare, including privatizing the program --- harming current and future beneficiaries.  

Under the GOP bill, insurers can charge older enrollees five times more than younger ones.  The Congressional Budget Office predicts that by 2026 this provision will substantially raise premiums for older people by as much as 25%.

“We can only hope that the Senate majority will kill this reckless legislation before it punishes seniors - and millions of other Americans – for the crime of needing and wanting affordable health care,” Richtman says. 

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If you missed our "Behind the Headlines" analysis of the GOP healthcare bill on Facebook Live, you can watch it here

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