Posted on 3/21/2017 2:42 PM By NCPSSM
Let us not speak of pigs and lipstick, but simply say that the freshly tweaked GOP health care bill introduced last night still socks it to older Americans. In an attempt to throw bones to both moderate Republicans and Tea Partiers, Speaker Paul Ryan has come up with a revised bill that’s even worse than the original for seniors and “near seniors” (under 64 years of age). The Center for Budget and Policy Priorities has just released a detailed analysis forecasting higher net premiums, co-pays, and out-of-pocket costs for older Americans under the revised bill. Here is our own take on why there's nothing to like in the tweaked legislation:
Millions of seniors depend on Medicaid to cover the cost of long-term care, while low income Americans 50-64 rely on the program for basic health care. The original GOP bill cut nearly $1 trillion from Medicaid and imposed per capita caps on federal payments to the states. The revised legislation adds another insidious idea to the equation by introducing block grants, where states can decide to curtail or outright cut certain services. Per capita caps and block grants mean one thing: less funding for older patients who need medical services and long-term care - and in some cases, complete loss of coverage. For seniors, It’s two bad ideas in one bill.
The revised GOP bill does nothing to address a major problem with the original. Under the revised legislation, Insurance companies would still be able charge older Americans up to five times as much as people in their 20s (a practice referred to as “age rating”), one reason why the Congressional Budget Office estimated that 24 million people would lose coverage under the Republican plan.
Obamacare provided generous subsidies to people who couldn’t afford private insurance premiums. The GOP bill replaced those subsidies with paltry tax credits that discriminate against older patients. Paul Ryan’s tweaked version kicks the problem over to the Senate by authorizing the upper chamber to increase tax credits for older Americans… if it wants to. There’s no guarantee the Senate will actually do this, or that fatter tax credits will make it into the final bill. Once again, the revised GOP plan leaves older folks worse off.
While giving nothing to seniors, the revised bill still repeals $600 billion in tax cuts for the wealthy (and $24 billion for pharmaceutical companies) that Obamacare utilized to expand health coverage and strengthen Medicare. The tweaked bill actually sweetens the deal for the wealthy – repealing the taxes in 2017 instead of 2018.
The GOP plan still weakens Medicare through the repeal of a 0.9% tax on income over $200,000. By rescinding the tax, the GOP plan reduces the solvency of Medicare by 3 years – and the revised bill does nothing to lengthen it. Reducing Medicare’s solvency gives budget hawks an excuse to privatize and cut the program, which hurts seniors.
We don’t know whether the dressed-up GOP plan will pass the House. It’s possible that the concessions to Tea Partiers and token gestures to moderates – plus active lobbying on President Trump’s part – will allow it to squeak by. Either way, Speaker Ryan squandered an opportunity to reverse some of the damage to healthcare and long-term care for our older and most vulnerable citizens.
Posted on 3/8/2017 2:04 PM By NCPSSM
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.