The GOP covertly dropped the Trumpcare bill yesterday night. Besides devoting 7 pages to denying Medicare coverage to lottery winners it also dumps the individual and employer mandates, repeals the Medicaid expansion and also achieves the GOP’s dream of block granting Medicaid to the states.
Obamacare rested on three legs: insurers are prevented from denying coverage or raising premiums based on preexisting conditions, individuals are required to buy insurance, and government subsidies make that insurance affordable. Knocking out two of those legs without a viable replacement spells disaster.
Imagine what Donald Trump would personally give you if you asked him for help with your medical bills. This is what you are going to get from Trumpcare. Having ‘care’ in the name is going to make this one an oxymoron.
I forgot to mention the age related credit. In an earlier form of the Trumpcare bill the CBO pointed out that age-related credits that double for those over 60 would incentivize employers to drop coverage entirely and force their employees into the Trumpcare market. Combined with the inadequate subsidy this could result in 10-20 million Americans currently insured by their employers losing healthcare coverage.
I haven’t seen it spelled out anywhere but I assume that first leg is still present? Insurance companies can’t deny coverage for preexisting conditions?
Doesn’t that just mean that nobody will buy insurance unless they absolutely need it and happily pay the 30% premium when they get sick?
ISTM that one of the problems with Obamacare is that the mandate wasn’t a strong enough incentive to force young people to buy in, and that’s why premiums kept creeping up. This seems like it amplifies that problem significantly. I can’t imagine any insurance companies being a fan of this.
The most important discussions currently underway are the ones where the congressional Republicans are trying to figure out how to blame Obama for the upcoming shit-show in healthcare, and subsequent deaths.
It will be hard to get past the senate. None of the Democrats are gong to vote for it and there are Republicans on both sides who oppose it for different reasons. Some from the from the more conservative than thou “let them die and decrease the surplus population” side who object to any government money being spent on the needy, and others from the “killing off my constituents is bad for my 2018 election chances” side who don’t like the idea of pulling healthcare away from likely voters. So its going to be hard to get a bill that balances both sides.
My concern it that they will do like the did with the sequester and say “If we repeal Obamacare now with a 12 month window to come up with something else. Then the thought of kicking millions off heathcare will be so horrific that it will spur us into developing a compromise bill.” With the end result that the worst happens.
In typical Republican compassion, Chaffetz says the poor have to choose between their iphones and healthcare. Can’t afford thousands of dollars in premiums? Cutting that cell phone bill should cover it. As if.
I was afraid they’d pass something saying “we’re killing it as of Dec 2018, after that you’re on your own.” Then they wouldn’t be punished until the 2020 elections.
An internal Republican memo leaked last week revealed the main points of the new WealthCare plan, broken down as to how it will affect the Rich, the Middle Class, the Poor – and Everyone.
For the Rich:
[ul]
[li]They willl receive a 346 billion dollar tax cut.[/li]
[li]They will receive an HSA increase that they will be able to fully fund and will need the least.[/li]
[li]They will receive the benefit of new age-related subsidies which they do not need, depriving the neediest from the benefit of them.[/li]
[li]50% of all benefits from WealthCare will go to people who earn more than a million dollars per year.[/li]
[li]There is an included 10 billion dollar cut to pay for pharmaceuticals, health care devices, etc., which wealthy people can afford to pay for out of pocket but needier people cannot.[/li][/ul]
The Middle Class:
[ul]
[li]Their individual subsidies will decline about an average of 57%.[/li]
[li]Subsidies are no longer tied to income, geography, etc., meaning wealthy people who don’t need subsidies will receive them, leaving less for the more needy.[/li]
[li]Major premium increases will occur to people 55-64 years old.[/li]
[li]There will be a tax increase on employee benefits – benefits will be reduced or eliminated by employers as a result – and millions will lose coverage.[/ul][/li]
For the Poor:
[ul]
[li]Medicaid expansion will be reduced by 277 billion. Most states will drop Medicaid expansion as a result.[/li]
[li]There will be a 370 billion cut to Medicaid over 10 years, expected to pay for the tax cut for billionaires.[/li]
[li]Medicaid will be block granted and capped forever to individual states.[/li][/ul]
For everyone:
[ul]
[li]Sicker people can be charged more if they have a gap in coverage of more than 63 days.[/li]
[li]10 essential benefit protections will disappear, including mental health.[/li]
[li]Prevention and Public Health Fund, 10% of the CDC budget, will be eliminated.[/li][/ul]
Yep. Sure looks like a fine replacement – for the wealthy.
I’m not clear on what happens to the health care exchanges under this proposal. It looks like they are not touched. But if the individual mandate is eliminated, along with a good portion of the subsidies, won’t they collapse just like Trump has been predicting? I’m not clear on that.
Why do I care? Because members of Congress seem to still be required to purchase insurance through the exchanges. I’m wondering how much of an outcry there will be if THEIR healthcare gets screwed up because of this repeal and replace disaster.
Hey, I know! The Dems offer up a “choose health insurance or your iPhone” plan, where the annual cost to you of your health insurance is the purchase price of an iPhone. Gold plans cost the same as a new iPhone, silver plans cost the same as the model that was new two years earlier, and bronze plans cost the same as the model from four years ago that you can pick up on Craigslist for dirt cheap.