Your average American, though, never sees himself as an oppressed proletarian, but rather as a temporarily embarrassed plutocrat.
(Stolen from John Steinbeck, or Upton Sinclair; or one of those godless commie writer-types.)
I’m sticking with the aforementioned TrumpsCare".
The CBO’s analysis on the AHCA: https://www.cbo.gov/publication/52486
“CBO and JCT estimate that enacting the American Health Care Act would reduce federal deficits by $337 billion over the coming decade and increase the number of people who are uninsured by 24 million in 2026 relative to current law.”
That’s a Republican win-win.
And the great part is that that “reduction in federal deficits by $337 billion over the coming decade”?
That means that they can use that to get more tax reductions for the wealthiest 1%! Most excellent!
The GOP is trying to discredit the CBO analysis. The problem is that their own internal analysis was even worse.
Health insurance is NOT the same as car insurance!
Unlike with car insurance, everyone of us will become expensive in our medical needs one day - being young and healthy is a temporary condition for everyone…
THe good thing about the CBO score is that it shows how Republicans can make the bill better if they were so inclined:
- Make the Medicaid block grants more generous so that more people get covered by it.
- Make the tax credits more similar to ACA subsidy levels.
- Increase the penalty for failing to maintain continuous coverage.
- Keep all of ACA’s taxes and Medicare cuts
- Eliminate all the coverage mandates having to do with “free” goods and services
Then send it back to the CBO. The end result would be more people covered(although less than ACA), more deficit reduction, and lower premium costs. It still wouldn’t be a great bill, but at least it would go from horrible to maybe we could live with it.
To address the politics of this, one interesting beneficiary of the Republican bill are middle class Americans under 50. The bill relieves them of the mandate, reduces their costs, and raises their tax credits. The Republicans are really shitty at policy, but very good at politics. That’s one reason I think calling it Wealthcare will backfire. This isn’t redistribution from the poor to the rich. It’s also redistribution from the poor to the middle class, which is a policy that tends to be very popular outside bleeding heart circles.
Vox explains:
You know, remove those tax cuts for the ultra wealthy, and you might have a genuine middle class populist bill on your hands.
BTW, speaking of lousy names, AHCA? Seriously? It’s like, “Well, we didn’t like ACA, so we added an H to it. Now it’s like totally different!”
You forgot to add “healthy” to the descriptor list. ONLY those “middle class Americans under 50” who don’t have a chronic condition or illness benefit - such a person with, say, sickle cell anemia, or a spinal cord injury, or other chronic and incurable condition is going to also be screwed under this system.
Nice try. Seriously.
Trouble is, the Republican strategy at this point seems to be covered by:
- Deny there are any problems
- Attack the CBO
Most voters aren’t sick, and this bill actually doesn’t screw sick middle class voters in any way. They will pay the same for private insurance as anyone else as long as they stay insured. So even most sick middle class people are going to see a benefit in that their tax credits will be more than they get now in ACA subsidies.
A bit of a nitpick, since many chronic conditions are not “disabilities”, but would not a person with spinal cord injury be considered “disabled” and qualify for Medicare?
Wait, people with disabilities qualify for Medicare?
Okay, I did a quick check and that quick check turned up that you have to actually be collecting disability benefits to qualify for Medicare. So many people with disabling conditions would not get Medicare.
I wasn’t aware of details before, but yeah, not all disabled people are automatically allowed to be on Medicare.
Well, apparently you have to be permanently disabled, and (usually) collecting Social Security Disability for 24 months. So about 3+ years after disability.
source: https://www.ehealthmedicare.com/about-medicare/disability/
Folks with End Stage Renal Disease or ALS (Lou Gehrig’s disease) may apply immediately. Renal Failure and ALS patients must have good lobbies. It’s true that many ALS patients may not survive 3 years after they become disabled, but same is true of lots of other conditions.
Lastly, a lot of people have apparently been moved from welfare rolls to Disability. I’m guessing this will have ramifications for Medicare that I had not considered before. Maybe not bad one, if they are generally healthier than the average Medicare recipient and their payments meet their costs.
No. Not automatically.
If that were the case my spouse would have been on the Medicare for the past few decades.
“Disabled” for purposes of getting Medicare means unable to do any gainful work at all. My spouse was repeatedly denied that status because, while he unquestionably has spinal damage and unquestionably has physical limitations and additional daily expense arising from that damage his hands and brain still work and thus he is deemed capable of actually doing some sort of work (never mind that few people are willing to employ him).
“Spinal cord injury” does not automatically mean helpless (ask Ambivalid about that if you’re unclear on the concept). It does not automatically mean you’re using a wheelchair to get around.
This is a MAJOR misunderstanding people have about disability in the US. You may have what the vast majority consider a clear disability, but you won’t be disabled enough to qualify for SS payments or Medicare.
If you can’t get Medicare (or Medicaid) and you’re disabled enough no one will employ you (even if such discrimination is questionable to actually illegal) you will lose your medical coverage… and thus, not you will NOT be able to maintain coverage and in addition you will be penalized if you do manage to acquire coverage down the line.
Likewise, there are chronic conditions like diabetes, or sickle cell, or a bunch of others where the person incurs considerable expenses every single day they’re alive, which can even exceed their income. Such a person finds a high deductible less useful, and due to on-going expenses will never be able to save money in a HSA because all their money goes to staying alive.
And so what if it’s not the majority of people in a certain age range. What makes it OK to discard a minority because they’re expensive or inconvenient? Not to mention ALL people, of whatever age, are at risk of acquiring chronic conditions or permanent impairments - that’s one of the reasons to have insurance in the first place!
That was a major problem with some of the cheap policies people used to love - sure, they were low cost but if you did come down with a serious/chronic/permanent problem you’d find they weren’t so great and would leave you hanging very quickly.
Which makes sense if the insurance you are buying is priced to reflect the risk that that will happen to you. Anytime you insure ANYTHING, you make that judgment. It is entirel rational to say, “Hmm, I can pay half my income to insure against a major sickness or injury that has about a 1% chance of happening. Or I can just not.”
Making the young subsidize the old was not the worst idea in the world from a moral standpoint, but from a practical standpoint it has been an utter failure. Young people have decided to tell the government where to stick that idea and the government’s options for dealing with that problem are limited and even if they could be more draconian, they wouldn’t have the balls. So we have to get pricing for young people down to a more realistic level.
They didn’t drop the requirements for disability for people to move from “welfare” to disability, what they did was drop the “welfare”. The truth is that when welfare was more generous than SSI disabled people who could get welfare chose it over SSI - is it that surprising that when welfare benefits were cut or even terminated a bunch of folks applied for disability?
No, young people on Medicair are NOT healthier than the average Medicare recipient because a healthy 68 year old or 80 year old can get Medicare and may cost the program nearly nothing, but a young person has to have a truly serious problem to get on Medicare… they’re costing more than the healthy old folks.