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Posts Tagged 'affordable care act'

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Summertime No Time to Stop Protecting Seniors' Healthcare

Washington, D.C. is noticeably mellower with Congress beginning its August recess.  Our “worst-in-the-U.S.” traffic is noticeably lighter.  The sidewalks are emptier.  The news from Capitol Hill has slowed to a trickle.  But the summer doldrums are no time for advocates here in D.C. or the 50 states to let our guard down.  (We just discussed this on "Behind the Headlines" from Capitol Hill on Facebook Live.) 

Last week, we narrowly escaped the passage of healthcare legislation that would have been devastating for poorer, older, and sicker Americans. The heroism of three GOP Senators and a united Democratic party pulled us back from the brink by voting against the latest Obamacare repeal bill.  

Make no mistake, intense grassroots activism in Congressional districts across the country played no small part in the defeat of repeal legislation in both houses of Congress.  From New Hampshire to Nevada, everyday Americans challenged their elected representatives to protect their healthcare – and won in a heart-pounding showdown.  

In the end, only Senators Collins, Murkowski, and McCain had the courage to defy party leadership and do the right thing.  That’s a thin reed on which to hang future hopes.  If a single one of those votes had gone the other way, at least 22 million Americans would have been well on their way to losing healthcare coverage – and the Medicaid program would have been decimated.  In fact, it’s disappointing that some of the Republican moderates who seemed to oppose the various repeal bills voted yes in the end.  Perhaps it’s because Senator McCain’s no vote gave them cover.  But where is the courage in that?

While Senate Majority Leader Mitch McConnell says it’s time to “move on,” Speaker Paul Ryan signaled that the House isn’t done trying to repeal the Affordable Care Act.   Meanwhile, President Trump continues to threaten to cut off crucial cost-sharing payments, spooking insurers and threatening to drive up premiums.  As Phil Moeller pointed out in his column for PBS NewsHour, there’s a real danger that the majority party will re-attack Obamacare after August recess ends.  

With Capitol Hill’s largely silent and long-postponed summer vacations underway, there is little appetite for re-engaging in nasty policy fights. But when the leaders and their troops are rested, there is little doubt that [they] will be back at it again. – Phil Moeller, PBS NewsHour

This means that we in the advocacy community cannot simply relax this month – tempting as that may be.  Advocates and everyday activists must continue to deliver the message to our elected representatives that it’s time to stop trying to destroy the Affordable Care Act and work across the aisle to improve it, as National Committee President Max Richtman argued in The Hill newspaper this week.  We must maintain the drumbeat whenever and wherever we encounter members of Congress this summer:  at their district offices, by phone, by email, or around town.

Make no mistake:  the activism we saw last winter and spring made a difference.  Members of Congress heard their constituents loud and clear at contentious town halls.  Phone lines, fax lines, and email accounts were jammed. Congress heard us when we said “Hands Off Our Healthcare!”

But even after all that full-throated activism, several GOP moderates in the House and Senate still caved when it was time to cast crucial votes. We came dangerously close to losing the Affordable Care Act. If anything, we must step up our activism.  We must make the case for protecting the healthcare of seniors – and all Americans – even more vociferously, letting our leaders know in personal terms the true impact of changes to our healthcare coverage. But we must also demand that our elected representatives talk to us. Hold town halls, don’t cancel them.  Keep phone lines open instead of shutting them down.  Hear us instead of hiding. And if there are future votes to undermine our healthcare, we must insist that more GOP moderates stick to their stated principles instead of running with the herd.


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Mr. President, Stop Saying Obamacare Is Imploding (Because It's Not)

updated 7/10/17

During a CNN focus group of Trump voters last week, one educated, white collar professional said that the Republican congress had to repeal and replace Obamacare because it is “imploding.”  That Trump supporter directly mimicked Trump’s own comments about Obamacare – comments which are patently misleading.  This proves once again the effectiveness of demagogic language (“Obamacare is a disaster!”) shamelessly applied to important policy questions that impact almost every American.

Obamacare is most definitely not imploding, but Trump and the GOP in Congress have convinced an awful lot of people that it is – simply by repeating the same falsehoods on a regular basis. Why does this matter?  It matters because the Senate may vote on its Obamacare repeal and replacement plan within the next couple of weeks.

The GOP’s Better Care Reconciliation Act would deprive 22 million Americans of health coverage over the next ten years and gut Medicaid, hitting the old and the sick unusually hard. As long as Republicans continue to justify repeal with false claims that Obamacare is in a “death spiral,” advocates for the most vulnerable members of our society must continue to call them out.

Both the New York Times and the Washington Post this week found it necessary to debunk misleading Republican claims about Obamacare and the Senate bill to replace it.  The Times entitled its piece, “Five Misleading Republican Claims About Health Care,” while the Post went with “Decoding the White House spin on Obamacare ‘failures.’”  The papers’ fact-checkers had plenty of material to work with. 

These and other analyses are crucial to understanding what’s really happening with Obamacare and the GOP repeal and replace legislation:

1) Obamacare is not “imploding” or in a “death spiral.”  Despite recent instability mostly induced by the Trump administration and Congress itself, Obamacare is hardly imploding.  A new study by the Kaiser Family Foundation suggests that Obamacare markets are, in fact, "stabilizing" and "regaining profitability."  The CBO forecasts that the Obamacare system will remain stable for the foreseeable future - if it is not further undermined. 

2) Premiums for Obamacare policies are not generally rising 200-300%.  Though a few states have unfortunately seen triple digit premium hikes, the National Conference of State Legislatures found that average premium increases nationwide were 25% this year.  Because some 84% of enrollees’ premiums are covered by Obamacare subsidies, few feel the effects of the increases.  Their net costs may even decrease.  

As the Post’s fact-checkers point out, “Average insurance premiums in the Obamacare marketplace now are about at the level predicted by the Congressional Budget Office for 2017 when it first evaluated the law in 2009.”  In other words, some premium hikes were predictable as the new marketplaces found their footing – and not likely to be repeated every year.

3) Insurers are not abandoning state insurance exchanges in droves.  The Post reports that an average of five insurers participated in each state’s marketplace in 2014, ranging from one to 16 companies per state. According to the Kaiser Family Foundation, the average number of insurers in 2017 is 4.3, ranging from one to 15 companies per state.  Not a huge decline.  Still, “slightly more than 2 million people, mostly in rural areas, don’t have competitive plans to choose from and are seeing premium increases,” writes the Post’s Dana Milbank.  But again, many of those premium hikes are offset by Obamacare subsidies.

4) The Trump administration and Congress could have done a lot more to stabilize Obamacare; instead they undermined it.  Here’s how:  

*The administration balked at paying cost-sharing subsidies that would have relieved financial pressure on reluctant insurers.

*President Trump signed an executive order soon after taking office instructing federal agencies not to enforce the Obamacare mandate that all Americans have health insurance, discouraging participation in the exchanges.

*The administration ended public outreach efforts to encourage Americans to sign up for health care.

*In fact, President Obama and the Democrats in Congress asked Republicans to work with them to strengthen Obamacare during the    first six years after the law was passed, only to have the GOP Congress vote to repeal it some 60 times.   

5) The President and his allies in Congress have spooked the insurance markets.  They have sown tremendous uncertainty about Obamacare’s future with their attempts to repeal the law and harsh rhetoric, spooking insurance companies and potential customers.  The former chief marketing officer for HealthCare.gov estimated that Trump’s rhetoric alone has deterred nearly 500,000 people from signing up this year.

Furthermore, the Post reports that figures the White House uses to smear Obamacare are often based on comparisons of the insurance markets from before the law took effect and today.  Such apples-to-oranges comparisons are misleading and not useful.

Meanwhile, the Republicans have employed similar demagoguery to promote their own repeal and replace legislation.  The Times found several GOP claims about the Senate healthcare bill to be factually dubious, including assertions that the legislation does not “pull the rug from anyone currently covered by Obamacare” – and that the bill “reduces taxes on the middle class” when, in fact, the top 1% of earners reap most of the benefits.  The cruel truth is that some 22 million Americans would lose health coverage under the GOP bill over the next ten years, including 15 million Medicaid beneficiaries – many of whom are needy seniors who rely on the program to pay for long-term care.  We must not allow the clever manipulation of language by those who would destroy Obamacare to hurt so many millions. 

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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.

 

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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.” 


 

 

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GOP Obamacare Replacement Hurts Older Americans; Gives wealthy $600 Billion tax break

MSNBC’s Ali Velshi summed up the problem with the GOP’s Obamacare replacement plan succinctly:  The winners are the young, the wealthy, and insurance companies.  The losers are the elderly, poor, and sick.  That seems like the opposite of what would be morally just – and smart policy – for the wealthiest nation on earth.  Instead, the healthiest and wealthiest benefit while the sickest and most vulnerable suffer under this new plan.  Our nation’s seniors, in particular, will fare significantly worse if the American Health Care Act (as it’s benignly named) becomes law, because it weakens Medicare and radically restructures Medicaid – two of the most important federal programs for the elderly.  Meanwhile, the bill gives the wealthy a $600 billion tax cut over ten years.

Here are some of the most harmful facets of the GOP plan affecting seniors:

*Imposes “per capita” caps on Medicaid payments to the states after 2020, amounting to a $370 billion funding cut over 10 years.  This will likely compel states to cut benefits to seniors who rely on Medicaid to pay for skilled nursing and long-term care.  Standard & Poor’s estimates that 4-6 million beneficiaries will lose Medicaid coverage altogether.

*Rolls back insurance premium support for Americans in their 50s and 60s, putting their health and wellness at risk in the crucial years before they are eligible for Medicare.

*Allows insurance companies to charge older Americans up to five times more than younger enrollees, putting health coverage out of reach for millions of middle-aged Americans and younger seniors.

*Repeals a tax on wealthy Americans that was helping to keep Medicare solvent.  Eliminating those taxes on high earners will reduce the solvency of the Medicare Trust Fund by at least 4 years.

The Republican plan replaces Obamacare’s health insurance subsidies with tax credits that will barely make a dent in older Americans’ premiums.  Individuals between the ages of 50 to 59 would receive a tax credit of $3,500 per year; Anyone over 60 would receive a meager $4,000 per year.  What’s more, the tax credits are phased out for individuals earning over $75,000 annually or $150,000 jointly.  Given that healthcare premiums for a 64 year-old are projected to climb to $13,125 per year under the GOP plan, these tax credits will fall pathetically short.

Even with the tax credits, fresh analyses indicate that Americans’ out-of-pocket healthcare costs will rise under the GOP plan.  In its blog, The Big Idea, today Vox concludes:

"Once the differences in tax credits are accounted for, the bill would increase costs significantly.  [Higher] cost-sharing would greatly increase financial risk.  If you’re now paying 50 percent of your costs, instead of 75%, a big hospital bill could be devastating.”  - Vox’s The Big Idea

For all the Republicans’ griping about Obamacare premiums being too expensive, Vox estimates the average policyholders’ out-of-pocket costs will increase by $1,542 per year even if their premiums go down.

Returning to Ali Velshi’s summary of winners and losers, one can see a resemblance between the way the GOP plan health pits the young against the old, the wealthy against the less fortunate, and the healthy against the sick… and the tactics they employ in attempting to cut Social Security and Medicare.  The trouble is that eventually everyone will grow old, and at some point in our lives we all will be sick.  Everyone – young and old – needs affordable health care.  In replacing Obamacare with this newer, more miserly plan, millions of Americans will not be able to afford the healthcare they need. 

 

 

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