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Posts Tagged 'obamacare and medicare'

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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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Note to Paul Ryan: Let Sleeping Healthcare Bills Lie

Speaker Paul Ryan made some extraordinary statements on today's CBS This Morning – even for him.  First, he chastised President Trump for offering to work with Democrats on health care reform, saying it was “hardly a conservative thing” to do.  The reason:  “Democrats are not for repealing Obamacare. We are.”  Clinging to ideology over reality, Ryan declared, “I don’t want government running healthcare.”  Oh really?  Has he heard of a program called Medicare? Oh, that’s right - he wants to privatize it.   Ryan hasn’t gotten around to turning Medicare into a voucher program just yet, but at least seniors can rest easier knowing that the GOP health plan went down in flames.

Less than a week later, a rift seems to be opening between the President and the Speaker on this issue.  President Trump may have finally realized that the only way to get a real healthcare fix through Congress is to work with Democrats and stop coddling right-wingers in the House.  He even fired off a tweet this morning aimed squarely at the ultraconservative House Freedom Caucus, which helped defeat the Republican plan:

"The Freedom Caucus will hurt the entire Republican agenda if they don't get on the team, & fast. We must fight them... in 2018!” – Trump Tweet, 3/30/17

Of course, Democrats won’t work with Trump unless he gives up on repealing Obamacare and pivots toward fixing its flaws.  That’s something Ryan and the House Republicans have refused to do during the entire seven years that Obamacare has been “the law of the land.”  In fact, Republicans have taken measures both on the Hill (and in the new Trump White House) to actively undermine the law.  Trump’s offers to work with Democrats won’t mean much unless his HHS Secretary and his administration refrain from manipulating regulations to stifle Obamacare.

This afternoon, Congressman Luis Gutierrez (D-IL) told CNN, “[Obamacare] needs to be modified to give more people coverage. If Trump wants to do that, I’m all for working with him.”

It’s hard to believe, but in this case Trump – not Ryan – may be taking the more politically savvy approach.  Here’s why:  the American people by and large loathe the defeated GOP healthcare bill.  A new Associated Press poll indicates 62% of Americans dislike the dead GOP legislation.  Here’s an even more eye-opening number:  8 in 10 Republicans oppose the provision that would have allowed insurers to charge seniors 5 times as much as younger people.  President Trump’s spider sense has told him to move toward the middle on health care. Meanwhile, Paul Ryan threatens to bring the moribund GOP healthcare bill back to life.  He would be wise to study those poll numbers and let sleeping bills lie. 

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If you missed our Facebook Live discussion with Social Security champion, Rep. Jan Schakowsky (D-IL), you can watch it here. 

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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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Why Seniors Should Care About Obamacare Repeal

There’s a great piece in the current Money magazine by Elizabeth O’Brien about the impact of ACA repeal on seniors.  The title alone makes it worth the read:  “Think Changes to Obamacare Won’t Affect You?  Think Again.”   In this article, O’Brien lays bare the consequences of ACA repeal to seniors, who, as the title implies, may not be aware of the repercussions for Medicare.

"The Affordable Care Act contains about 165 provisions affecting Medicare, according to Medicare's trustees. These range from improving benefits for the 57 million current beneficiaries to shoring up the program’s long-term finances for future ones.

These provisions include free wellness visits and preventative screenings for cancer, diabetes, heart disease and a host of other medical conditions – with no out of pocket costs – all of which could disappear if the ACA is repealed.  Likewise with the prescription drug “donut hole,” which the ACA was closing, saving the average beneficiary $1,000 a year.  As O’Brien notes, before Obamacare came along:

"More than three million beneficiaries hit the donut hole before the law took effect, and some [seniors] were forced to skip doses, split pills, or not fill their prescriptions at all due to high costs.

Who wants to go back to seniors splitting pills or going without their medicines?  

O’Brien also points out that because of the savings the ACA provided to Medicare, repealing the healthcare law will cost Medicare $802 billion between now and 2025.  There’s also a strong refutation of the argument by House Speaker Paul Ryan and HHS Nominee Tom Price that Medicare is “going broke,” which they will use as a canard to cut benefits.

Most tellingly, the Republicans are gunning for tax provisions that help pay for the ACA which mainly affect the upper middle class and the wealthy.  O’Brien quotes Matthew Yglesias of Vox:

"Republicans’ desire to eliminate these taxes is a big driver of their push to repeal Obamacare. Subsidizing the health care costs of working-class people is expensive, and while Democrats want rich people to pay the freight for doing it, Republicans do not."

The bottom line:  seniors and millions of newly insured Americans will pay more for healthcare – or go without it entirely – so that high earners can get a tax break. 

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Powerful new Ads target Obamacare Repeal

The Alliance for Healthcare security, of which the National Committee is a member, has released the latest in a series of tv spots opposing repeal of the Affordable Care Act.  Watch the new ad here.  It's worth the 30 seconds of your time.  

This latest one is probably the most powerful of the series, which began airing in December.  The opening narration pulls no punches. "Congress has taken the first step to rip apart our healthcare with no plan to replace it," says the announcer.  The bulk of the ad features actual health care professionals in blue scrubs and white coats talking right into the camera about why repeal is such a bad idea.

"They don't have a plan to insure the 30 million people who will lose their healthcare," says Theresa, a registered nurse.  "No plan to cure existing conditions, like cancer," says Michelle, another RN, while a third nurse states simply, "It's gonna cause pain."

The tagline is:  "Tell Congress we need a plan that protects our care."

The ad is elegant, clean, and effective.  Pressure from advocacy groups and negative media coverage of the repeal efforts on Capitol Hill seem to be having an impact.  As the Associated Press reported today, some Congressional Republicans are starting to back away from repeal and talking more about what sounds like "repair," which is something even President Obama and Democrats had always said they would welcome. The Associated Press describes "a softer tone that comes as [the GOP's] march to fulfill a keystone campaign promise encounters disunity, drooping momentum and uneasy voters."

Last week, Congressional Republicans seemed like they were on a tear to repeal - ramrodding through a budget resolution that would defund Obamacare with the promise of a replacement bill soon after.  Not anymore, apparently.  

"Republicans triumphantly shoved a budget through Congress three weeks ago that gave committees until Jan. 27 to write bills dismantling the law and substituting a Republican plan. Everyone knew that deadline meant little, but now leaders are talking about moving initial legislation by early spring." - Associated Press

Seniors, especially, have a lot at stake in any repeal and replacement because of the Affordable Care Act's improvements to Medicare - including free preventative screenings and wellness exams, the closing of the Medicare Part D prescription drug "donut hole," and the extended solvency that the ACA provided to the Medicare Part A trust fund.  

Let's hope that this continued ad campaign by the Alliance for Healthcare Security, and the voices of organizations like ours along with pressure from the public will convince the GOP that outright repeal without a replacement that protects the healthcare of all Americans is a really unhealthy choice.  



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