Monday, January 16, 2017

Some GOP's proposals to replace Obamacare are baiting and switching consumers

Heads up.  The GOP is about to bait  you with "better health insurance" and switch you to worse coverage. .They want to lure you with  the honey of  lower premiums but  reduce your  benefits and cost you more money from your pocket. All of this is being done in the  ideological name of letting the free market compete.  

News for consumers: There is no true free market in insurance. Exempted from any  federal anti trust provisions, insurers are free to get together set prices and benefits.  The result could be  giving us little choice or a bunch of bad choices unless  minimum standards  of benefits and consumer protections are required by the new law as consumers seek cheapest premiums. You will, however,  always be given a choice between which is nicer to customers, the one with quacking ducks or swimming dogs.

Their proposals strike at the heart of two pillars of Obamacare, comprehensive, quality health insurance, whether employer or public provided.. Many eliminate subsidies that make insurance affordable to millions and offer controversial , inadequate substitutes. Mandating standards and consumer protections have not been any part of their proposals.

The Trump administration, probably reflecting Donald Trump's  nominee for cabinet head of Health, Education and Welfare, Rep. Tom Price, has yet  to propose a replacement  plan, but Price's past positions give consumers a slap in the face. His plan evaluated by the Congressional Budget Office would result in 18 million losing insurance now, 27 million in a few years. Premiums would rise 20to 25%. Price has advocated for total repeal of the ACA, eliminating subsidies and replacing  them with tax credits ($1200 per year for everyone), and increasing tax savings plans,  setting up pools for those with pre-existing conditions, and eliminating Medicaid expansion.  Left blank are any  consumer protection provisions now in Obamacare.  High risk pools have failed as uneconomical wherever they have been tried, tax credits require up front expenses paid back at filing of income tax (with no indication of how much the credit will be  or what it will based upon who will be covered or the amount of  deductibles) , and there are no standards for what should be included in benefits, leaving it up to the market to provide the worst possible benefits , reverting to installing life -time caps, kicking the sick off the plan.  Health savings account are just another way to force consumers to pay more for their own insurance out of their own pockets and  it only works for those who have a large enough paycheck to stand the deductions. It is just a substitute with another name for high deductibles.

Obamacare mandates are also being targeted by the GOP.  One complaint  is that men have to pay for services they will never use such as pre- natal care and delivery or birth control or mammograms. Before Obamacare, women were charged more for insurance than men because of the higher expenses of their services.  The answer in some GOP proposals: Remove the men paying in means women get to pay more.

Other GOP proposals would  allow consumers  to opt out of having health insurance. Removing this mandate will allow the  irresponsible healthy to  gamble they will never get sick,  resulting in much higher costs for those who want and need  quality, comprehensive health insurance. Why? Because that is who will be left to pay into the insurance pool, the sicker and responsible. Soundness  and affordability depends on the largest pool of healthy and sick possible all paying in and lifting mandates will shrink the pool.


Here is what either no affordable coverage or reduced benefits will do to you: Many once again would be in jeopardy of bankruptcy and foreclosure. According to the Federal Reserve, 47% of US families have only $400 in personal reserves to cover emergencies. A visit to the ER costs $1000 alone. Those most likely to lose insurance are the poor, the sick, and the unemployed.

Before Obamacare, medical bills caused 60% of all personal bankruptcies. Most of those taking bankruptcy then had health insurance, but the insurance was so poor with life time limits , high deductibles and lacking in comprehensive coverage. In 2016, of those with health insurance under the age 65, that number was reduced to 20%, still not good enough, and for those without health insurance it was 53%. The obvious conclusion from that is that Obamacare standards and consumer protections need to be expanded to cover even more of the uninsured, not shrink the numbers with access to affordable, quality, comprehensive health insurance. Note, Tom Price, Trump's nominee to lead Health and Human Services prievious proposal of $1500 annual tax credit would only cover one visit to the ER but it would meet the Trump standard of insurance for all in a very cynical way.

No comments:

Post a Comment