I heard him say this on the radio a little while ago.
First of all, practically speaking (not that I think it’s ever going to happen) how would it even work to “repeal” the ACA? Millions of people have health insurance that they bought through the ACA. Would they just poof lose it? It strikes me as just about as logistically possible as deporting eleventy-million immigrants. But Trump and the Republicans seem to think it’s the way, the truth, and the light. How would that work in real world terms? (Apologies for mentioning “real world” and Trump in the same paragraph.)
Secondly, “tax free health savings accounts”? WTF? My late husband was on dialysis, then had a kidney transplant, two angioplasties, a leg amputation, and a hip replacement, all after age 50 (and died at age 60). How in the hell do you save up for a series of medical catastrophes? (Of course, he couldn’t get insurance, but when your kidneys fail, you go on Medicare regardless of age. Thank you, Congress.) If people are out of work, how are they supposed to put money in a health savings account, and how can you ever save enough to cover a real medical emergency? Who cares if it’s tax-free? Can someone explain to me how this would work, even in someone’s wildest dreams?
Would there still be deductibles for office visits? Would we have to pay full price for prescriptions? According to this, the average healthcare costs for a family of four is currently $25, 826. I’m not saying it would be impossible…but there are only so many cardboard refrigerator boxes out there to live in.
I love my flex spending account. My plan year runs from September 1 to August 31. I save at $1500 per year. So, on September 1, I have $1500 I can spend on medical needs, even though I haven’t actually earned all that money yet. Then, when a medical need comes along, I just pay it with the debit card and all is swell. It doesn’t impact my monthly budget.
I can see that as a sort of health insurance, in that I have $1500 to spend before I actually save up that much. But I wouldn’t drop my health coverage for it.
Just like insurance reform, tax reform would only address a few years worth of medical inflation. We’ve just about hit that limit with the reform we’ve seen already (as far as costs go.) Giving additional tax breaks such as those proposed would only stave off (greater!) inflation for a couple years as well, that is if you don’t count the steps backward we’d be taking by repealing the ACA.
Malpractice reform would also only stave off greater inflation for a few years. In my opinion we need greater training opportunities to provide a greater supply of highly trained physicians (and perhaps to a lesser degree other professionals).
You would rightly call me a liar if I told you I had predicted Trump would get anywhere close to this point, but the one thing I hoped he would do was throw the republicans into disarray. And given his past life as a moderate I thought he might be able to make room for more sensible ideas within the party on a large platform, particularly given his exchange with Ted Cruz in which he said “I’m not gonna let people die on the streets in this country.”
Unfortunately, he really and truly is a republican tabula rasa, on which the social Darwinists will be able to write whatever prescriptions for the economy that they wish. For reasons I still don’t quite understand, the United States seems to be a developed country that is determined to un-develop.
I heard part of Trump’s speech in Pennsylvania regarding his repeal and replace “plan”. He mentioned that no one has ever read the two thousand seven hundred pages of the bill.
I’ve actually got a pdf of the bill. It’s 900ish pages.
Now, the number of pages containing the bill is not really that important, but if someone can’t get this very basic fact right, why in the hell should I believe anything he/she says?
Apples and oranges, mate. A tax-free method to pay for OOP costs is not a “replacement” for health coverage. Don T, the crappo di tutti crappo, is suggesting exactly that. Hope your ruptured ulcer doesn’t break that $1500 bank…
Trump doesn’t have a plan, he just wants to win so he can say that he win and then he’ll use whatever power he has to go after people who’ve slighted him. He’ll leave the job of running the government to whoever runs the House – and that’s not necessarily going to be Paul Ryan.
I’m not so sure that I would call it a “plan”, but the repeal bills which have been pushed by Republicans in Congress so far have simply stated that the Patient Protection and Affordable Care Act and Health Care and Education Reconciliation Act are repealed and that all provisions of law amended or repealed by the passage of those Acts are restored as if Obamacare had never been. I think that the most recent version gave a 180 day grace period.
So I guess that would mean that the exchanges really would just “poof”, since there’d be no more subsidies for them, so a bunch of people would just be SOL, and I guess it would also nuke Medicaid expansion, so sucks to be someone who is getting their coverage that way. Now, that’s what they’ve passed when they’ve known that Obama is sitting in the Oval Office with a veto pen, and maybe if it would actually pass they might want to consider some nuance before doing this to millions of their constituents. Then again, maybe not.
Exactly. It isn’t insurance and Trump is an idiot for suggesting it would be. Oh, and I get that $1500 in September, but I pay every dime of it by August 31. It’s just a short-term loan.
One thing the ACA did was to ban discrimination based on pre-existing conditions, so that people like ThelmaLou’s husband could get coverage. If the ACA is repealed, everyone with a pre-existing condition will be SOL.
And that, of course, was the basic problem pre-ACA: millions of people either had to pay impossibly high rates for insurance, or couldn’t get it at all, because of pre-existing conditions.
So the first thing the ACA did was fix that by outlawing price discrimination based on pre-existing conditions.
And because otherwise, everyone would wait until they were sick to buy insurance, the second feature of the ACA had to be an individual mandate, requiring everyone, healthy and sick alike, to purchase health insurance.
And because a lot of people wouldn’t have been able to afford to comply with the individual mandate otherwise, the third thing the ACA did was to provide subsidies for persons of relatively modest incomes.
That’s the triad, the essential structure of the ACA. Take any of those away, and you’ve got nothing. And that’s as far as you can go towards a market-based system and get practically everyone covered.
The rest - the Medicaid expansion, the Exchanges, the stuff we think of as the essentials of Obamacare - is really just a structure within which the triad can work.
But once you kick out any leg of the triad, you’re not going to have a (Republican) Obamacare replacement that’s actually going to do any good.
Anyhow, it’s been pointed out that, when push comes to shove, Trump’s basically fine with going along with GOP policy, with a few limited exceptions like trade and immigration. This is just one more for-instance.
Bolding mine. Good that it doesn’t affect your monthly budget.
Umm. If it’s like my flex spending account, you don’t save $1500 a year. you save the tax on $1500 dollars. A drop in an ocean if you have a real medical problem. I’ve use flex when I KNEW I was coming up on a VOUNTARY PROCEEDURE. Mine was LASIK for my eyes. I may have save a few hundred in tax… maybe. I knew I was going to have it done. BUT on our plan, if you don’t use it, you lose it. Not the tax benefit, but all that you put away for the year. Takes some careful planning. And hope you can predict your cancer or whatever. And then, you are only looking at pre-tax money that you have saved.
A co-worker is faced with this this year, and so is going to schedule an appointment with a dermatologist to use it. Nothing is wrong with her skin, but dermatology is not covered under our regular insurance. So, she will use her FLEX for that so not to lose it.