Saturday, December 31, 2016

The GOP's political cowardice and bait and switch: repeal Obamacare now with replacement details 3 years later

The GOP  members of Congress are planning to pull the wool over the eyes of voters. What they are proposing  to do is to make good on campaign promises to repeal Obamacare immediately , delay its implementation, and then in three years to tell consumers what they will do to replace it. The timing for the next election cycle could not be more obvious, since changes would not go into effect until after the next general elections for Congress, Senate and presidency. That is political cowardice at its worst and bait and switch consumer fraud as well. 

GOP politicians are aware they must come up with a replacement because of the political backfire if they do not. Repeal without replacement would give Colorado consumers hard times again. In Colorado, 67 thousand plus received on the average of over $300 in subsidies awarded based upon their low income levels. That is 60% of the total who bought insurance through the Colorado exchange. Over 39% of subscribers of exchange offered insurance did not require subsidies. To buy insurance on the open market, those 67,000 would have to make up the difference but due to low income, could not. These figures  do not take into account another nearly 60 thousand   receiving Medicaid  plus CHP (Child Health Care), with Medicaid  expanded to include them under provisions of Obamacare..In Grand County individuals earning less than  $15,856  or $30 thousand for a family of four have been covered by  expanded Medicaid.  Individuals earning between $15, 856  a year and $45,960  and families of four earning between $32,499 and $94,200  have qualified  for reduced cost premiums  per  income level.  Those subsidies would go away if some current GOP proposals were enacted.

For eight years GOP members  have tried to come up with a replacement plan that even comes close to the coverage, consumer protection standards,  and affordability of Obamacare , and have not found one. Pres.elect Trump's cabinet pick for Health and Human services, Tom Price, has a plan, but experts looking at it conclude it would leave consumers sicker and poorer.18 to 27 million would lose health insurance and premiums would increase 20 to 25%, per the Congressional Budget Office. Implementation plans also creates such uncertainty  that within that three year period, insurers will pull out of Obamacare, not because they are being mean-spirited, but because the uncertainty will lead to business decisions inherent in the insurance industry. What should be demanded, not that it will since the GOP controls both houses of Congress, is that any repeal  must be accompanied with replacement at the same time so that the public can see who  of the current near 20 million getting benefits from subsidized medical insurance or expanded Medicaid   and those receiving employer provided insurance now meeting high standards  will get screwed.

GOP members are talking about retaining popular provisions of requiring coverage of pre-existing conditions and permitting kids under 25 to be covered by their parents' insurance. How to pay for pre-existing coverage is the question not answered since under Obamacare the healthy insured expand the pool to spread the cost around. Attempts to provide subsidies to premiums restricted to those with pre-existing coverage have failed in states  including Colorado that have tried it because of the costs.

Furthermore those left without insurance would once again burden hospitals' ER rooms and require more charity care, with costs passed on to consumers who had insurance in the form of higher premiums.

There are some hidden benefits to those receiving employers insurance and Medicare that could go away if the GOP had its way. What those receiving insurance from their employers do not often realize is that Obamacare requires 80% of premiums to be used for actual coverage, and not for advertising or high exec salaries or extravagant overhead. Large employers are required to provide insurance. Lifetime caps on benefits are forbidden. Cancer screenings and annual checkups are required with no co-pays.   Furthermore, Obamacare cut health care  increasing costs to the federal government enough to extend the life of Medicare  at least 12  years to 2029 and that would have to be made up in some way. Obamacare also requires Medicare to cover cancer screenings and annual checkups without co-pays and closes the donut hole in drug coverage.

Addendum:  My comments posted on Facebook January 4, 2017.
For the  life of me wonder why it is helpful for the struggling middle class to take away their health insurance and replace it with either nothing or a worse, more expensive one devoid of protections from such as life time caps, high or no coverage of annual physicals or cancer screenings. These benefits affect all of those getting medicare, medicaid, employer provided insurance or insurance bought on the exchanges. Let us see how much the GOP intends to keep these protections and benefits. Bet they won't. Stay tuned. I noted, too, in an earlier statement by the GOP that the reason the GOP is planning to replace Obamacare gradually is their concern for the business interests of the insurers. Ha. It certainly isn't out of concern for the interests of the struggling middle class. The Democrats need to shout that one from the mountain top, too.

Addendum: Feb. 27, 2017:
Ali Velshi  on CNN interviews person from Columbia U. Half of the 20K covered by Obamacare get Medicaid Expansion (11 mil).. 31 states did Medicaid expansion; half have GOP governors.  Right now states and federal government split costs and GOP proposals floated would give the states a block grant, but no guarantee in future would be enough or would the block grants be the same.
Currently subsidies for those on Exchanges based upon sliding scale of income. GOP proposals would change that to one based on age and young people would get $2K credit (enough for catastrophic, but not much more) and older people would get $4K credit. However, cost of older people 5x younger so not enough for the older, sicker.

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