Repealing the ACA under Trump

[Danny Bateman]

I read the CBO score.

The deficit reduction is very nearly 1/3 of the original bill. So it's not as good at saving money.

 

23M are still predicted to lose care, compared to 24M last time, so...

 

Lastly, they predicted the same effects on premiums. In states that don't opt for the waivers on ACA regulations, they're predicted to drop by 4% over the next decade. In states that make "moderate" changes w/ waivers, they're predicted to drop by 20%. In the states that opt for repealing the whole enchilada, the effects were too complex for the CBO to score...

 

However, a few interesting caveats. The same age effects occur across all groups. Namely, things are going to be more affordable for younger, healthier people and get worse for older, less healthy people. Particularly, the poor elderly are supposed to get just hammered under this plan.

 

And, interestingly enough, premiums are supposed to RISE by ~20% over the next four years until they begin dropping in 2020.

 

The health insurance markets are supposed to be mostly stable under this plan, much as they are under the ACA, despite the GOP digging in and refusing to improve it. However, they spend a good paragraph detailing how roughly 1/6 of the population live in areas where the nongroup market would eventually become unstable, effectively pricing those with higher healthcare costs (those with preexisting conditions), which is exactly what critics said this plan would do.

 

They also spent a good paragraph toward the end about how people in states that choose to opt in to the waives (getting rid of EHBs or community-rating) can expect to see substantial out-of-pocket costs rise under this plan. By not offering plans featuring coverage those people needed (say, maternity coverage, mental health coverage or substance abuse coverage), those people will either have to pay for an expensive plan that covers those things or not get them. Annual/lifetime limit caps only apply to EHBs, too, so if those things get removed from a state's EHB list, those limits go away too. This is sad irony since the GOP crusade featured a major talking point about having insurance but not being able to afford using it.

 

Also, if they go ahead with their plan to sell "across state lines", that affects employer insurance as well. So, if an employer is in multiple states, there's nothing stopping them from choosing the state with the skimpiest EHB as the basis for what they HAVE to cover in their plans. This will save them money, but result in worse coverage for employees.

 

In other words, the bill still sucks.

[deedsker]

 

Also, if they go ahead with their plan to sell "across state lines", that affects employer insurance as well. So, if an employer is in multiple states, there's nothing stopping them from choosing the state with the skimpiest EHB as the basis for what they HAVE to cover in their plans. This will save them money, but result in worse coverage for employees.

 

In other words, the bill still sucks.

Further more the bill still removed employer mandate to provide insurance. You could still get screwed even if your employed! Yay!

[QMany]

[Thanks_Tom RR]

Sounds good, right!?

 

 

 

 

 

 

 

 

[zoogs]

Wow. That's a trash headline from the USA Today.

 

On second thought, cancel the 'wow' on this one.

[zoogs]

https://www.vox.com/health-care/2017/5/25/15688408/government-insurance-is-cheaper

Fiscal conservatism: choosing the more expensive option.

The regulatory changes made at the behest of the far-right Freedom Caucus do succeed in yanking insurance coverage from 1 million fewer people than would have lost coverage under the original version of the American Health Care Act.

In exchange, government spending increases by $218 billion over a 10-year period — $218,000 per additional insured person. That’s a lot of money.

In contrast:

 

 

Almost across the board, government solutions are cheaper:

• Medicaid and Medicare both cost less on a per patient basis than similar private insurance.
• In most counties, traditional government-run Medicare is cheaper than private plans purchased through Medicare Advantage.
• Adding a public option to the Affordable Care Act would reduce premiums and federal spending.
• Internationally, more statist national health care systems like Canada’s are cheaper than more market-oriented ones like Switzerland. The extremely statist UK system is cheapest of all.
• Even a system like Singapore’s that conservatives are sometimes inclined to praise actually entails massive government intervention, with over 80 percent of the hospital beds in government-run hospitals.

Health care is complicated, but the source of the big government price advantage is not. When the government acts as a giant health care buyer, it either formally through regulation or informally through purchasing power imposes price controls on the sellers of health care services.

[BigRedBuster]

That is my frustration in all of this.

 

ACA needs fixed or replaced.

 

However, everybody is looking at this through their party lenses. Nobody is actually coming up with a plan that ACTUALLY COSTS LESS!!!!

 

When are people going to actually look at reducing the COST of healthcare?

[zoogs]

I don't see it as a "party loyalty" problem so much as a uniquely American one. It bears out empirically, too. Other countries have parties, yet it is America alone that lags the rest of the developed world in this area.

 

It boils down to one reason: our very American aversion to "big government" like it's a curse word. The stock standard approach to curtailing costs is politically toxic in the U.S. It's ridiculous. For all the signs that we have at last been slowly and tardily moving in the correct direction, here comes the 2016 election and a sharp lurch back. It's such a laff, except it isn't.

[QMany]

[Danny Bateman]

Darrell Issa hangs out on a roof:

 

[zoogs]

https://www.usnews.com/opinion/policy-dose/articles/2017-05-30/republicans-raised-your-health-care-premiums-not-obamacare

 

In fact, most of the instability driving up premiums in the marketplace can be directly traced to Republicans' efforts to undermine the health care law for their own political purposes.

 

Florida Republican Sen. Marco Rubio, for example, was among the first to land a blow. In 2014, he proudly led a successful effort to cut funding for the "risk corridors" program. Rubio called the payments made from these funds a "bailout" for insurers, but in fact the program was an integral backstop to help control premiums as insurance companies in the marketplaces adjusted to the new population they were covering. The consequence of that ploy to score political points was that some insurers left the marketplace, and many Americans' premiums went up.

Brave, moderate Marco Rubio -- one of the "good Republicans", remember him?

 

For the most part, "moderate" Republicans are not that. They are more or less all complicit in the ongoing efforts to dismantle the ACA.

 

Why? Why do this?

[TGHusker]

http://www.newsmax.com/Politics/lindsey-graham-doubt-senate-healthcare/2017/06/05/id/794311/

 

Graham says it won't get done this year. House version is DOA to the Senate. He thinks ACA should just implode and then work wt the Dems to fix it. Yes that is government leadership at its best!! Thanks for leading on Graham.

[zoogs]

Of course. Such people are complicit or at least aligned with the Trump administration's efforts to sabotage the current system until their awful plan becomes palatable enough to pass. It's somehow already somewhat close. A little more "terrible ACA" messaging, we'll get there...

[Danny Bateman]

GOP busy trying to find new ways to lie to Americans about what their bill actually does. Make no mistake, they're crafting it in secret, behind closed doors, and trying to sneak it by us for a reason. Generally,when you write a GOOD bill, you don't try your hardest to obfuscate and muddy the waters about what it actually accomplishes. Instead, they're spending their time trying to figure out how to sneak a shell bill by the Senate that would allow them to have a joint session to try to address the real issues in the bill. They're simply putting lipstick on a pig.

 

[Danny Bateman]

Sen Claire McCaskill lays into Orrin Hatch pretty good over how the AHCA is being written. She mistakenly refers to the ACA as the AHCA twice, but accurate rant nonetheless, and blithering nothingness from Hatch in response: