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Posts Tagged 'obamacare and medicaid'

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The GOP's "Really, Really Good" Healthcare Reset is Really, Really Worse



 "The [GOP healthcare bill] is getting better and better"

 “A lot of people like it.”

 “Things are going very well.”

These are President Trump’s most recent pronouncements about the GOP’s American Health Care Act (AHCA).  Let’s hope for the sake of our nation’s seniors (and all Americans) that the President’s statements are wildly optimistic.  The White House is pressuring Congress to vote on the AHCA this week – lest the first 100 days of Trump’s presidency expire without a single major legislative victory.  Never mind that the healthcare of 24 million Americans hangs in the balance.

The National Committee and other seniors’ advocates rightly breathed a sigh of relief when the bill was pulled from the House floor last month for lack of GOP votes.  The Republican healthcare bill would have gutted Medicaid, weakened Medicare, and allowed insurers to charge older Americans up to five times as much as young adults, among other travesties.  But just when everyone thought the AHCA was dead, some House Republicans have revived it, zombie-like, to stalk Capitol Hill again.  This week, representatives from the right-wing Freedom Caucus and the moderate Tuesday Group let it be known that they were hovering around a deal to get the AHCA passed

The supposed “deal” would amend the bill to allow states to seek waivers from requiring insurers to provide “essential benefits.”  If a state (say a Red one, for instance), didn’t want insurers to be forced to cover hospitalization in all health plans, they could ask the Department of Health & Human Services (led by Obamacare nemesis Tom Price) for permission to waive that requirement.  States could also request waivers so that insurance companies could force sicker patients into “high risk pools” where the premiums would be sky high.  Meanwhile, all of the really harmful parts of the original bill for seniors would remain intact.  President Trump says the GOP healthcare bill has “gotten really, really good.”  But in truth, the latest changes make a really bad bill even worse.

Here’s the good news, though:  all of this talk about a deal and bringing the AHCA to a vote within President Trump’s first 100 days may be magical thinking.  Just because the head of the Freedom Caucus, Rep. Mark Meadows (R-NC), and Tuesday Group co-chair, Rep. Tom MacArthur (R-NJ), seem to be close to agreement does not guarantee that their members will fall in line, especially House moderates who probably know that the new amendment endangers essential benefits coverage and that high risk pools could cost their constituents dearly (which could cost these moderates dearly in the 2018 congressional elections).  Congress-watchers have noted that there is no legislative language for the proposed amendment yet, and wonder how it could be produced so soon. Also, the plan to bring healthcare to a vote next week may be overly ambitious, considering the House must also craft an appropriations bill before April 28th to avoid a government shutdown.  This is why Democratic sources on the Hill say “no way” is healthcare going to come up for a vote next week.

Here's how National Politics Reporter M.J. Lee summed up the prospects for a quick vote on CNN this afternoon:

"If the White House wants a vote, they will have to win over many members of Congress who are skeptical about tackling this again." - M.J. Lee, CNN
 

President Trump insists (to no one’s surprise) he wants it all:  funding for his border wall AND passage of the American Health Care Act – a demand that, like his pronouncements that “a lot of people like” the GOP healthcare bill and “things are going very well,” are likely only loosely based on reality. 

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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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