The GOP is swinging wrecking ball at affordable health care insurance and coverage of pre-existing conditions

A version of this was published in the Sky Hi Daily News October 15-16, 2018
https://www.skyhinews.com/news/opinion/opinion-muftic-the-gop-is-out-to-cost-you-money-for-health-care/

 If Donald Trump has failed to make good on at least one of his campaign promises, "cheaper and better health insurance for all" is the one.  In fact, his party and his administration are hell-bent to make health insurance cost more and even become out of reach for families on a budget.  Worse, some of their actions, if successful, would end all affordable coverage including treatment of pre-existing conditions.  The GOP has tried before to either subvert the Affordable Care Act (ACA) or completely destroy it. Now they have some new stealth tactics and they just might succeed.

 The part of their scheme already implemented is to let the healthy go scot-free without insurance and soak those who need it.  The Trump administration did this to placate the better-heeled who made too much money to qualify for subsidies and did not want all of the bells and whistles and those who felt confident they would never get sick and were never hurt in an accident.  With an executive order, the  Trump administration removed the requirement that all must have health care coverage whether they were healthy or not or pay a penalty. Trump reduced the penalty to $0. Most insurance plans covering casualties mix those they think will not ever use their coverage with those who think or know they will. This varied pool spreads the risk around and keeps premiums to all lowered. This order makes the pool left with more of the sick in it who file expensive claims, raising premium costs or deductibles for everyone.

Another GOP backed action would kick budget-conscious families where it really hurts. It would jeopardize affordable coverage of pre-existing conditions as it takes down the entire the ACA (Obamacare) with it,  premium subsidies, Medicaid expansion and all,  leaving 17 million unable to afford health insurance.  They are doing this through a lawsuit in the courts to try to declare the entire ACA unconstitutional.  The Trump administration has announced it will not defend the ACA   against a GOP initiated Texas court case that seeks to declare the entire  ACA unconstitutional.  Twenty GOP state attorney generals have joined in the suit. That case could make it to the Supreme Court, now firmly dominated by  GOP conservatives.

The Colorado Attorney General race on the ballot Nov. 6 has no incumbent, but the Democrat, Phil Weiser, is committed to defending the ACA. His GOP opponent, George Brauchler, is vague, leaving the ACA up to Congress.

Particularly angering voters is the GOP engineering the loss of pre-existing conditions coverage. 27% of Americans between 18 and 64 have pre-existing conditions.  Under the ACA provisions, those with pre-existing conditions do not pay more than those who do not have them. Pre-existing conditions range from cancer and heart problems to high blood pressure to pregnancy.

Both GOP legislators and Donald Trump pay lip service to retain coverage of pre-existing coverage. The Trump administration argues that only the portion of health care pertaining to pre-existing conditions would be removed by the Texas court case.  Some  GOP members of Congress propose to  "save" coverage of the pre-existing conditions part of the ACA if it is destroyed and the rest of the ACA is left standing by the Courts. That bill is a deceptive and useless ploy.  Not only does their bill not tell at what price you will be charged for coverage, but it also does not require insurers to cover treatment.  it would still permit higher premium costs for factors such as age, sex and where you live.
______________________________________________________________________________

What if the Supreme Court agrees in total with the unconstitutionality of the entire ACA? Seventeen million consumers will return to the olden days before the Affordable Care Act with nothing to replace it.I had been an executive with a consumer credit counseling agency then helping people get out of debt. The most frequent cause of bankruptcy and dire financial problems were medical bills.  Family finances were being destroyed by the high cost of health insurance. Their choice was to go without insurance or risk no one in their family would get sick,  relying on emergency room and charity and nothing left for cancer screenings or annual checkups or prescriptions. Many gambled and lost, destroying their family finances. I recall constant fundraising in Grand County to cover medical bills of such and such a person who desperately needed help to fend off life-threatening illnesses.   That is not a time you would ever want to revisit.





https://www.thebalance.com/how-could-trump-change-health-care-in-america-4111422

https://www.cbpp.org/health/commentary-texas-suit-is-one-among-many-attempts-to-undo-pre-existing-condition-protections

https://www.mprnews.org/story/2018/10/11/fact-check-whos-right-about-protections-for-pre-existing-conditions

https://www.cnn.com/2018/09/05/politics/texas-affordable-care-act-obamacare-lawsuit/index.html

https://www.yahoo.com/news/mcconnell-defends-trump-backed-suit-080000483.html?soc_src=hl-viewer&soc_trk=fb

https://finance.yahoo.com/news/trumpcare-will-hurt-people-next-year-201655059.html

https://www.kiplinger.com/article/insurance/T027-C001-S003-cost-of-employer-health-coverage-to-rise-in-2019.html

http://nymag.com/intelligencer/2018/09/gop-preexisting-conditions-bill-may-have-usd1-million-premium.html

https://www.cnn.com/2018/09/05/politics/texas-affordable-care-act-obamacare-lawsuit/index.html

https://www.usatoday.com/story/news/2018/09/25/obamacare-affordable-care-act-repeal-preexisting-conditions-attorney-general-elections/1419481002/

https://www.denverpost.com/2018/10/13/colorado-attorney-general-race/

https://www.reuters.com/article/us-usa-senate-mcconnell-policy/mcconnell-says-senate-republicans-might-revisit-obamacare-repeal-idUSKCN1MR2QE

GOP tax plan puts money in one pocket, takes some out of another

Roll out of the bill is now rescheduled until Nov. 2
Update: Nov. 28, update CBO Score: The new score includes the impact of removing the individual mandate from Obamacare. It verifies that premiums would rise so much, 4 million could not afford health insurance by 2019 and 13 million by end of bill. Also, the middle class cuts go away and hurts them.

https://secondnexus.com/news/report-new-cbo-score-senate-tax-reform-plan/

The CBO report, released Sunday, estimates that lower-income groups would foot a bigger bill from tax cuts than previously expected. In 2019, all income groups under $30,000 would have a bigger burden under the bill, the CBO projected.

In 2027, that would extend to all income groups under $75,000, as individual tax reductions expire.

The change largely stems from the bill effectively getting rid of the Obamacare provision requiring most Americans to have health insurance or p...

See More


Update: Nov. 15, Sabotage of Obamacare, elimination of individual mandate, attached to Senate bill

Nov.15, 2017 Repeal of individual mandate in Obamacare attached  is to tax reform bill in Senate. How did this end up as a tax issue? Calling the penalty on those who do not have health insurance a tax. A rose is a rose but this one stinks. The budget and deficit implications also fit into the tax reform bill because it would reduce government expenses by $338 billion. Leading advocate and voice  Sen. James
Lankford  (R-OK)on MSNBC today called this penalty  a tax on the poor who could not afford to pay the premiums.  Oklahoma already has one of the  worst uninsured rate in the US.second only to Texas. https://www.census.gov/content/dam/Census/library/visualizations/2017/comm/hi-uninsured-map-4.jpg
Oklahoma refused to expand Medicaid. If they had, 84,000 would would have access to health insurance. 

https://www.kff.org/uninsured/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/
https://www.healthreformvotes.org/congress/412464

CBO score on eliminating the individual mandate would leave 4 million uninsured by 2019, 13 million by 2027 nationwide. and increase individual market premiums by 10% in most every year for the next ten years.  https://www.cbo.gov/publication/53300

Re: GOP tax reform: Schumer's claim that the GOP is 'kicking 13 million people off health insurance' is a semantics problem. Per a fact checking source I respect, .It will cause non-subsidized Obamacare premiums to rise 10% for everyone.. It mostly benefits the rich and will cause a tax increase for the middle class because of the way the inflation rate is calculated and its temporary nature. The question is by removing the penalty/mandate for all in the tax bill, to require the young the healthy to have health insurance, will it kick 13 million off of Obamacare? No, it will just make it unaffordable for thirteen million who do not qualify for the subsidy and who voluntarily choose to go without insurance  https://www.washingtonpost.com/amphtml/news/fact-checker/wp/2017/11/16/schumers-claim-that-the-gop-is-kicking-13-million-people-off-of-health-insurance/

Update Nov. 13, 2017:Per the link to Pew Charitable Trust...http://www.pewtrusts.org/…/federal-tax-deductions-and-credi… About 32.6% of Colorado tax filers itemize deductions; about 29% claim real estate deductions...which the GOP Congressional tax plans are attempting to eliminate.

The Facts on the SALT Deduction - FactCheck.org

Republican plans to eliminate or modify federal tax deductions for state and local taxes have sparked criticism from lawmakers from states that would be largely affected. Who uses the deduction and how…

FACTCHECK.ORG

Also visit: https://finance.yahoo.com/news/everything-know-senate-gop-tax-200055321.html

A version of this was published in the Sky Hi News Nov. 1: http://www.skyhinews.com/news/muftic-gop-tax-plan-middle-class-draws-short-straw/
Gideon John Tucker in 1866, as Surrogate of New York, wrote in a decision : "No man's life, liberty or property are safe while the Legislature is in session."
Tax reform is currently being considered in Congress with the GOP leaders' goal of passing tax reform before Thanksgiving. The GOP proposed a plan that would likely put some money in  middle class pockets and but then they take some out of another pocket by closing  middle class tax loopholes, credits, and deductions. Recent legislative action set deficit and tax cut totals, but the operative details are what we get Nov. 1.  

These GOP bills containing specifics have been kept secret until now but will possibly be buried in the news of the more explosive coverage of Special Prosecutor Mueller's indictments regarding the Russian connection. Nonetheless, tax reform will affect your family's pocket book for years, so listen up to see which GOP proposals could or will be included. The Tax Policy Center estimates individual taxes would increase by $470 billion over the next decade and taxes on business will be reduced by $1.6 trillion and taxes on estate and gift taxes will be reduced by $200 billion.

True, individuals will get to claim double their current standard individual deductions , and get some relief for LLC pass through. However, be prepared to withhold more from your paychecks.   The GOP wants to tax employer provided  health insurance as personal income . Your ability to invest in your 401K and defer taxation until retirement would be reduced from $18000 per year to $2400. For those who have used itemized deductions to lower their tax bills, the GOP proposed to close popular loopholes, deductions and credits benefiting the middle class. If you do not file the standard deduction, but itemize, you would no longer be able to deduct state and local taxes  anymore, but compromise on this issue may happen. The poorer have benefited by earned income tax credits and others with child related tax credits, but those may left in the dust, too. Mercifully your mortgage and charity giving will not be affected.

A key word  search of corporate  business loopholes proposed to pay for tax cuts to the rich and reductions in corporate taxes, brought up little results yet they are getting the bulk of the tax cuts.  Would tax cuts to the wealthy and corporations organically trickle down to you in the form of more jobs and higher wages instead of going to shareholders? Nothing proposed by the GOP requires that to happen. Whether you believe it will is a matter of faith since it has rarely happened in the past and when it has, the circumstances are not the same as now. Thanks to loopholes, corporations do not pay full taxes now anyway, so that lowering their rate from 35% to 20% per the GOP proposes lowers it close to the effective rate they are paying now.The projected deficit allowed in the resolutions will be an additional $1.5 trillion to be covered by a projected growth rate stimulated by the tax cuts, but considered unrealistic by many.

Some of the financial harm to the middle class is outside of the tax bill or related to the recently passed resolution . For example, your health premiums will rise by 20%  due to Trump’s recent executive order on Obamacare that has affected the health insurance market this year and next . The CHIP children health care program serving 9 million low and middle income kids was not renewed. 32 states will run out of money within the next six months, including Colorado. The budget resolution recently passed by the House and Senate permits $1.5 trillion cuts in Medicaid and Medicare over the next ten years.

http://www.latimes.com/politics/la-na-pol-gop-budget-taxcuts-20171026-story.html

https://www.forbes.com/sites/janetnovack/2017/09/29/trump-plan-delivers-massive-tax-cuts-to-the-1-and-sharp-kick-to-upper-middle-class

https://www.youtube.com/watch?v=AfMkt7LqZKE       Joe Scarborough calls trickle down bullshit

https://www.nytimes.com/2017/10/28/business/401k-limit-tax-cuts.html?emc=edit_th_20171029&nl=todaysheadlines&nlid=33304952&_r=0

https://www.yahoo.com/finance/news/whats-middle-class-gop-dems-141515462.html

https://www.washingtonpost.com/graphics/2017/politics/tax-breaks/?tid=a_inl   chart per adjusted gross income

http://econofact.org/government-budget-deficits-and-economic-growth

https://www.vox.com/policy-and-politics/2017/10/2/16405112/voxcare-chip-funding-expired

https://www.fatherly.com/love-money/child-care-tax-credit-everyone-agreed-disappears-gop-proposal/


http://www.nytimes.com/2012/11/23/business/a-starting-point-for-tax-reform-what-reagan-did.html


http://thehill.com/opinion/finance/355147-middle-class-families-are-the-real-winners-in-the-gop-tax-plan

https://www.cbo.gov/system/files/115th-congress-2017-2018/reports/53009-costsharingreductions.pdf


http://theweek.com/speedreads/733158/cbo-estimates-bipartisan-alexandermurray-healthcare-bill-cut-deficit-by-38-billion

https://www.cbpp.org/research/state-budget-and-tax/eliminating-state-and-local-tax-deduction-to-pay-for-tax-cuts-for

reduce deductions for 401k from annual of 18K to 2,400K  any more than 2.400 taxed
https://www.google.com/search?source=hp&ei=_u_xWcnzNOmf0gKzqY_oDQ&q=401+k+tax+benefits&oq=401+K+tax&gs_l=psy-ab.1.0.0i20i263k1j0i20i263i264

http://money.cnn.com/2017/10/25/news/economy/401k-tax-break-changes/index.html
     tax in income health insurance


medicare/medicaid
   http://www.healthcarefinancenews.com/news/billions-proposed-budget-cuts-medicare-medicaid-threaten-provider-compensation

tax on health insurance as income from employers
http://www.newsweek.com/taxing-employer-funded-health-insurance-would-be-disaster-649830

http://money.cnn.com/2017/10/25/news/economy/401k-tax-break-changes/index.html
     tax in income health insurance

http://www.latimes.com/politics/la-na-pol-senate-budget-taxcuts-20171019-story.html

http://www.healthcarefinancenews.com/news/billions-proposed-budget-cuts-medicare-medicaid-threaten-provider-compensation

http://money.cnn.com/2017/10/25/news/economy/401k-tax-break-changes/index.html
     tax in income health insurance

https://www.brookings.edu/research/taking-stock-of-insurer-financial-performance-in-the-individual-health-insurance-market-through-2017/

Tucker quote from Wikipedia
   


 

Introducing America's new health care system: Trumpcare

Updated 10/15/17 A version of this was published in the Sky Hi News, Oct 18, 2017 http://www.skyhinews.com/news/muftic-welcome-your-new-health-system-trumpcare/
Introducing America’s new healthcare system: Trumpcare.  Donald Trump just  broke the old one; he owns the new one.   He can no longer blame Congress that  also tried to break it and failed.  He is the one who broke it all  by himself with his own executive orders. It gives some the choice of cheaper policies, but their new choice is between bad, worse and useless. All premiums in and out of exchanges will rise. The financial impact will be felt immediately in everyone’s pockets. Trump has opposed any  suggested fixes that would make his orders unnecessary.

However, facing 2018  Congressional elections, he claims he is ready to make a deal with Democrats , it appears . No wonder. The political repercussions will be felt in time for the 2018 midterms when the  millions of lower income and middle class voters will feel the pain in their pockebooks and realize  in real time  they  just  been taken to the cleaners by Trumpcare. Given insurance policies fine print, most will only learn the consequences when they get sticker shock, paying full price for needed services not covered by terms, deductibles, and lifetime and annual caps. The most affected are red states that use more of the subsidies he just halted and who voted for Trump Alternatives such as single payer and Medicare for All will begin to look better and better to more. If Trump blames greedy insurance companies, then single payer solves that problem: it cuts out private health insurance participation.  Congressional  Democrats in the short term are united in support of fixing Obamacare in contrast to Trumpcare. Deal with Trump? Chuck and Nancy have already been bitten with DACA's deal with him over that. They were double crossed later . Don't blame them if they do not take him up with his offer.

Trump’s  threats to stop payments to insurance companies who help low income pay insurance premiums (not to prop up their stock prices as Trump claims)  have already caused exchange premium prices  to rise 20-25% in some states since  insurers anticipated his move. October 12 he made good on that threat with his order.  Per a recent Congressional Budget Office score , the impact on all  premiums  of the payment stop will  be an average increase of  20-25%..  An estimated seven million who buy insurance through the insurance exchanges  will find premiums hiked, but so will the subsidies increased to help them pay.  This order   will raise the deficit by $194 billion over ten years since the government will make up the difference in subsidies and insurance companies will pas on costs to everyone else in higher premiums, or the insurance companies will just drop out of the program.

Trump’s order includes a creation of a parallel system of  cheap association plans. There  will be no  requirements for  them  to cover anything so essential to many: prescription drugs, hospitalization, low co pays or affordable deductions, maternity care, cancer screenings including prostate and mammograms,  annual physicals,  pre-existing conditions, mental health care and drug rehab. Consumers buying into association plans  wanting  to make up the the unanticipated loss of uncovered benefits  would pay extra  from their pockets at  full  market price or go without. That is Trump's definition of "great care".

Currently fourteen million buy their insurance through the exchanges. The only ones who benefit from Trumpcare will be the two million  buying  insurance through the exchanges who make too much money now  to get subsidies. Even then, Trumpcare  will  bait and switch them  to accept his "great care"  association plans that resemble  a hamburger with   two buns but with  little meat and condiments .

The eventual   financial failure  of Obamacare is not the death spiral caused by Obamacare,  but it a death spiral engineered by the Trump administration on purpose as part of their plan to de facto repeal  it.  In time, the entire  Obamacare private insurance  based exchange system will collapse as the  parallel  association system will destroy the ACA’s “pool” comprised of  both those  with the healthy  who lightly place claims and  those with pre-existing conditions or with health problems.The  healthy will be  lured into cheaper stripped down plans. The result will be virtual high risk pools left to the sicker who   will see their premiums soar to become unaffordable.

This executive order  is such a fundamental change to the intent and financing of Obamacare, that it is the mother of all executive overreach.  resulting in court challenges which will further drag out uncertainties and  will cause continued premium increases  for everyone as the market is destabilized.

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Footnotes: A bipartisan "fix" to the subsidies has emerged from a Senate committee, but its fate is unknown.  GOP Senate leadership may refuse to bring it to the floor. Then it must pass the Senate and go to the House and require the President's signature.  Trump has issued various conflicting views on his support. http://www.cnn.com/2017/10/17/politics/health-care-csr-payments-deal-reached/index.html

Trump  may want to pay attention to the following impact on his core base of supporters and red states:

Criteria: access, quality, numbers applied for financial aid to afford health care in a recent study revealing 15 worst states to get health care. https://www.cheatsheet.com/culture/worst-states-live-want-decent-health-care.html/

All but one (Nevada) voted for Trump in 2016. The 5 worst: in order of the worst first
Arkansas, Mississippi, Oklahoma, Alabama. W. Virginia.

According to the Associated Press. Nearly 70 percent of those benefiting from the so-called cost-sharing subsidies to insurance companies live in states Trump won last November. https://twitter.com/AP/statuses/919246698081288192

https://www.forbes.com/sites/brucejapsen/2017/10/08/how-narrow-networks-doom-trumps-insurance-sales-across-state-lines/#7e4ea38a35f9.

http://www.npr.org/sections/health-shots/2017/08/15/543714171/cbo-predicts-rise-in-deficit-if-trump-cuts-payments-to-insurance-companies

"Blog posting: 9/271/17 Heads up: GOP's Repeal/replace Obamacare is a cat with 9 lives
ies https://www.pbs.org/newshour/amp/bb/trump-ending-obamacare-subsidies-health-insurers-heres-ends-paying

http://www.chicagotribune.com/news/nationworld/politics/ct-trump-health-care-executive-order-20171012-story.html

https://www.yahoo.com/news/pro-trump-states-most-affected-health-care-decision-134810734.html

https://www.usatoday.com/story/news/politics/2017/10/12/trumps-health-insurance-order-pushes-association-plans-drive-down-costs-some/752816001/

https://www.washingtonpost.com/powerpost/key-senators-reach-bipartisan-health-care-subsidy-deal-and-trump-expresses-support/2017/10/17

Graham/Cassidy health care: block grants for blockheads

Their bill does everything that the worst ones defeated earlier did, except puts funding into "block grants" to states, which is more like grants for "blockheads" who believe this will lower premiums or provide any meaningful or affordable  coverage for those who had insurance under Obamacare. .It removes subsidies of premiums in the exchanges killing the exchanges which was the mechanism form lowering the costs of premiums to middle America. It reduces both expansion and traditional Medicaid funding  and those premium support funds by a third before it goes away entirely in 2026., It removes any standards or even requirements for employers to provide insurance. It removes requirements that anyone have insurance,   and  permits irresponsible and freeloaders to count  on charity care  should any unforeseen illness or accident occur.  This leaves the responsible and  the sick  in the pool to pay super high premiums .   It allows   states to charge more to seniors and for everyone who has a  pre-existing condition.  It removes any requirements  to offer any essential benefits, including annual physicals and cancer screenings.
. If consumers swallow their soothing reassurances, they are in for a shock as 30 million lose their insurance, not because they were forced to buy it, but because they cannot afford the premiums without the subsidies or were covered by Medicaid. To say otherwise is sheer BS and those who swallow the GOP line will be much wiser in a year or two...and angry as well that they were bamboozled.   

Colorado Gov. John Hickenlooper, other governors oppose Graham-Cassidy health care plan

Colorado Gov. John Hickenlooper and Ohio Gov. John Kasich asked the Senate to not consider an amendment put forward by Sens. Lindsey Graham of South…

DENVERPOST.COM

Would you buy a used car from Donald Trump? Repeal without replacement, a terrible deal.for the GOP

Trump's  newest deal he does not want you to refuse is to have Congress vote for repeal of Obamacare with a promise to give Congress a year to come to a solution.   This idea is a trust buster. He reversed himself from a prior promise to do both simultaneously. The plan he endorsed resulted in 22 million uninsured, hardly his pledge to replace Obamacare with something better. The GOP has not come up with a replacement in 7 years and 6 months  of trying and this  repeal without replace is  a gift to Democrats.  First, a year for now is the mid terms and it would be the best ammo Democrats could have to defeat vulnerable GOP House candidates. (All House members are up for re-election in 2018).

Delaying the replacement for a year would destroy Obamacare at once  since this guarantees no insurer would participate in the exchanges because insurers have to set prices based upon risk a year in advance and it is even  a program may not even exist after 2018. Either they would pull out or they would raise premium  rates so high, it would make Obamacare financially unsustainable or affordable.   Not coming up with a replacement  during this coming 12 months in a year would mean an end of  insurance   for 32 million who have benefited by the affordability of health insurance Obamacare provided, not just the 22 million who their proposed legislation would leave without insurance in the next ten years.

What the GOP is weighing is that by a repeal without replacement vote now  is  it would protect their core who swore to vote for repeal and protect them from attacks  in their primaries from their right who would consider anything resembling Obamacare too far to the left because it continued the outline of a federal program. Only 30% of the GOP wants repeal without replacement, per a USA today poll.

What it would  also do is give opposition to GOP plans to cut Medicaid and exchange subsidies to grow even more to the current type of House and Senate versions that are polling between support of 10 to 30% and even are upside down among  their own GOP affiliated  voters. Do they really think opposition will cool in the middle of an election year? If the GOP thinks that the sabotage of  Obamacare will be blamed on the Democrats because they think it would  be  a  successful strategy be  to force Democrats to the table out of desperation, the fact is the public is not so stupid. They know that the GOP can fix it if they want and have the power to do so since they control both houses of Congress and the White House. Moderate Democrats have always expressed desire to work with the GOP on a repair fix without a need to sabotage Obamacare as a motivation to get them to the table.  The China Shop rule: The GOP broke it; they own it.

https://www.vox.com/policy-and-politics/2017/6/30/15900564/health-bill-politics-midterms

http://www.foxnews.com/politics/2017/06/28/fox-news-poll-27-percent-favor-senate-gop-health-care-plan-as-vote-gets-delayed.html

https://www.usatoday.com/story/news/politics/2017/06/28/suffolk-poll-obamacare-trump-senate-health-care-plan/103249346/

The CBO score on Trumpcare:

http://money.cnn.com/2017/03/09/news/economy/cbo-obamacare/index.html
I am getting sick and tired of the GOP's BS preemptive strike in anticipation of the CBO "score" on the cost and impact of their House Trumpcare bill. Their claim: the CBO is never right, so forget it. Unfortunately for them, the CBO score on Obamacare was actually quite close, though the bottom line on the numbers covered by Obamacare while close did not happen exactly in a way as predicted, partially due to a Supreme Court decision.. Of course, the GOP has no other official "score" and that is the one the public accepted. They should be called out for their deception and challenged to present equally non-partisan, official figures.

https://www.cbo.gov/publication/52752    CBO score on House final version; 23 million uninsured, and 

Trumpcare shifts to the Senate and Colorado senator Cory Gardner is in the hotseat

A version of this appeared in all editions of the Sky Hi News 5/10/17

With a narrow vote, the GOP dominated House of Representatives threw  their version of repealing Obamacare and replacing it with Trumpcare to the Senate.  Colorado’s GOP Senator Cory Gardner will be facing voters  again in 2020.  He is one of a GOP committee of thirteen men crafting the Senate version. Women were the largest group  harmed by the House version.

If Gardner can take comfort that voters may forget how he voted in on Trumpcare with any Senate alterations in 2017 or 2018,  he should dream on because   the  full impact will  be seen clearly for what it does  since it will be fully implemented and  painfully and personally felt around  2020.  It is not only a pocket book issue, it is a matter of life and death for those  harmed by the House Trumpcare version,  including  women, the over 50 crowd, lower middle class, the poor, the near poor, those with pre-existing conditions. All  with employer provided insurance are at risk, as well.. Over  400,000 in Colorado alone would lose their health insurance in ten years.  Rural hospitals and urban charity hospitals would lose  many paying customers, causing some to close.

The most damaging hit on Colorado  is that funding for  Medicaid expansion under Obamacare would be eliminated.  With Obamacare  Medicaid  qualifications were loosened to cover those who fell in the crack between qualifying tor  traditional Medicaid and their an  income level needed to pay for the lowest subsidized premiums.   Colorado  could  vote to restore the loss of Medicaid expansion  at the cost to taxpayers of $15 billion over ten years. That is how significant this loss to the state and our families would be.

With the House Trumpcare bill. 22% of Colorado adults  with  the most conservative definition of pre-existing conditions could be dumped into a “high risk” pool. So inadequately would those pools be  funded  under the House version that the premiums would have to be raised to the point of being unaffordable to make up the difference. In any case  women could be charged more than men again for  coverage of their special services, from pre-natal to maternity care, cancer screenings, mammograms, birth control pills,  assuming those benefits would even  be offered. All guarantees  of  such benefit inclusion were removed in  the House Trumpcare bill.

Winners could  be premium reductions for some , especially men under 50 with no pre-existing conditions . The  greatest beneficiaries are the  wealthy  who saw Obamacare taxes on them of $300 billion  eliminated and some health care providers who were relieved of another $300 billion in taxes.  No one will be required to have insurance and employers will not be required to provide it or to include essential benefits  or coverage of pre-existing conditions if they do.

In 2018, all members of the House of Representatives will be up for re-election.  In 2017 if not later, all will get another bite at their poisonous Trumpcare apple because the Senate and the House versions will go to a conference committee. The result of that melding will be voted upon by the House and Senate again . Keep your eyes on the following GOP Representatives  in Congress  who voted for the House Trumpcare bill this month: Doug Lamborn, Ken Buck, and  Scott Tipton.  GOP Rep. Mike Coffman and all Democrats voted no, including Grand County’s  Representative Jared Polis.

The sources for these figures and analyses follow..

http://kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-aca-replacement-plans-womens-health/

http://www.cnn.com/2017/05/04/politics/house-health-care-vote/index.html?sr=fbCNN050417house-health-care-vote/0745PMVODtopLink&linkId=37210223

http://www.skyhinews.com/news/colorado-health-care-series-part-4-experts-warn-to-beware-effects-of-dismantling-obamacare/

http://www.cbpp.org/sites/default/files/atoms/files/4-13-17health-factsheets-co.pdf

https://www.forbes.com/sites/beltway/2017/03/22/the-ahcas-tax-changes-and-transfers-would-benefit-the-wealthy-hurt-the-low

https://www.medicaid.gov/medicaid/by-state/stateprofile.html?state=colorado

https://www.yahoo.com/news/mike-coffman-faces-backlash-town-092650189.html

https://www.coloradostatesman.com/report-gop-health-plan-would-cost-colorado-15-billion-or-leave-hundreds-of-thousands-without-care/

http://www.denverpost.com/2017/03/13/denver-health-other-hospitals-worry-about-newly-uninsured/

http://connectforhealthco.wpengine.netdna-cdn.com/wp-content/uploads/2016/09/C4HC_OE_2016-17Report_WEB.pdf

http://www.9news.com/news/local/next/colorado-congressman-ken-buck-explains-his-healthcare-flip-flop/437288128

How many people die because lack of health insurance? Harvard study 2009: 45,000

Repeal and replacing Obamacare off to a bad start and headed for outrage by voters

A very ill informed, insensitve GOP Representative, Raul Labrador of Idaho,  dared to assert at his town hall that he knew no one who died from lack of access to  health care . Before Obamacare in 2009, a study showed that 45,000 died a year because of lack of health insurance.  His outraged audience knew better.  These are the kind of men who approved the House replacement for Obamacare.The same representative earlier said that he did not believe health care was a right.   In the Senate, their version will be shaped by a committee composed only of men, yet the victims and patients most adversely affected by the House version are  women.

http://news.harvard.edu/gazette/story/2009/09/new-study-finds-45000-deaths-annually-linked-to-lack-of-health-coverage/#_=_

http://www.cbsnews.com/news/gop-congressman-nobody-dies-because-they-dont-have-access-to-health-care/

http://www.cnn.com/2017/05/05/politics/senate-republican-health-care-men/

http://www.cnn.com/2017/05/05/politics/senate-republican-health-care-men/

The House Trumpcare bill could be laying the groundwork for their worst nightmare: a single payer system

If House’s Trumpcare is not fundamentally altered  by the Senate, the Freedom Caucus and conservatives  will be paving the way for the GOP's worst nightmare: a single payer system.  Obamacare, which still leaves the cost of the health care system the most expensive in the world by a factor of over two times and with outcomes ranking near the bottom of the industrialized world, was designed and passed by the self interested fearfully seeking a way to head off “national health” and protecting  the private insurance industry as the preferred insurance delivery mechanism.

The solutions to the health care issues on the table , especially the unaffordability of health insurance, was constructed by the conservative think tank, Heritage Foundation, as a way to keep the “free market” health insurers central to any solution to US’s health system.   The fear was that if some solution that involved the private sector was not successful, the pressure for a Canadian or European system would gain popularity and the insurance industry would go the way of the dodo. So much pain would  be felt by consumers by the House Trumpcare version,  and whether  if the Senate upholds it or changes it, we can expect consumers  to take revenge on many GOP Representatives, all of which are up for election in 2018. By 2020, there could be enough  angry voters to look for another system and that may be a single payer system.

Romney Care , on which the Heritage Foundation proposal was patterned, was showing success and it was working well enough  in Massachusetts that Obamacare became  its template.  The basic theory was to subsidize premiums  charged by private insurers so those with lower incomes could afford them. By  mandating all of the insurers offered by anyone, government or private, to provide at minimum essential benefits and to cover those with pre-existing conditions at the same premiums prices  as everyone else. private insurers could then compete against each other to provide either extra benefits or lower cost.  The exchanges established state by state would provide that competitive market place taking into consideration the specific  conditions of each state.  The exchanges (market places) provided the mechanism to screen the eligibility of participants to get a subsidy based on their income level.   It was clear there was a group of near poor who did not even have enough income to afford even a subsidized insurance premium, but had too high an income or assets that did not qualify for Medicaid, the nearly free  free safety net system for the very poor. That was to covered by expansion and changing the qualification income  allowed by traditional Medicaid.

The Supreme Court upheld mandates requiring all to have insurance or face a penalty. The insurance theory is that the more healthy who became part of the group insured (the pool) would pay for premiums for health services they would use lightly or not at all and in turn would help pay for those who needed more care.   The Supreme Court upheld the mandates, the subsidies survived, but states could opt out of accepting federal money to expand Medicaid. Penalties were not enough to force heathy into the pool into the numbers predicted. Thirty-one states, about half of those  with state houses dominated by the GOP, expanded Medicaid, leaving a gap of coverage for many in other states and lowering total participation figures projected earlier.  

There is no free lunch, and the way to  pay for the subsidies for comprehensive coverage to make them affordable and for the Medicaid expansion were taxes on the rich and certain health related industries to the tune of $600 billion over ten years.

Obamacare has worked to a great extent. The cost of health care rose, but not as much as predictions for costs to rise without Obamacare.(called, bending the cost curve) . The result was that all government provided health costs went down, adding at least twelve years to the life of Medicare.  For those who made too much to get premium subsidies, their premiums covered better insurance, but they objected to the cost or changing providers. No one liked the mandates, having to change insurance companies or beloved doctors,  or the cost and deductibles and premiums. Otherwise nine years later, around 60% of those polled wanted it to remain when they viewed the alternative proposed by the GOP House that would have left 24 million who gained insurance under Obamacare without insurance within ten years. The uninsured rate is now the lowest in history.  This is the system the House GOP upended and only 17% of those polled approved  of it.  Removing mandates on anyone and destroying the “pool” segregating those with pre-existing conditions into underfunded pools that will increase their premiums, increasing the premiums on those over 50, so that the healthy and young could pay less, removing nearly 15 million from Medicaid expansion, making all  essential benefits optional, and the $600 billion of taxes would be relieved from the rich and the health industry. The funding mechanism for Obamacare would be destroyed. The result over ten years was that those who could afford premiums only with Medicaid or slowly reduce subsidies, or whose employers ceased offering insurance plans because they were no longer required to do it, would lose coverage, returning the US to the uninsured rate before Obamacare.  

Bernie Sanders popularized the most economical , simple and fair alternative and at least 43 % of Democrats approve it now: Medicare for All. This extremely popular Medicare program is indeed a type of single payer system, as is Medicaid. It would remove the free market system from the equation  (or reduce its  role considerably) and it would be a single payer system, similar to most  European models.

So desperate could be consumers who found they had been baited  by promises of lower premiums and better coverage and switched to a system that left them paying more for less or unable to afford any insurance at all , that by 2020 Medicare for All could be much more popular. By that time, the negative  impact on each person will have been realized or felt and dulcet promises by the GOP would have been debunked.

In the meantime, for Medicare for All to ever become law, the  political balance of Congress , Senate and House, and the stranglehold of the Freedom Caucus on the House would have to be changed  The 2018 election with an angry backlash could provide that opportunity. It depends so much upon what the Senate and any conference committee with House approval does in the next few months whether Medicare for All could be headed off . They could do it with any  replacement legislation that would address consumers’ concerns and affordable access to comprehensive insurance for the same numbers or more than provided by Obamacare.

www.washingtonpost.com/amphtml/blogs/plum-line/wp/2017/07/06/the-dumbest-criticism-of-single-payer-health-care/

https://www.theatlantic.com/politics/archive/2017/02/universal-health-care-polls-obamacare-repeal/516504/

The background and provisions of Obamacare rely on the past 9 years of columns written on the subject and the footnotes with sources of data and information tapped in writing them. Search this website for terms like Obamacare, Romney Care, Medicare for All, and other terms in this posting.
Scroll though my prior website: www.mufticforum.com for more 2011 and prior postings.

Obamacare is failing; therefore Trumpcare to the rescue...sheer BS

The case made by the GOP today that Obamacare is collapsing is sheer BS. That is the best case they seem to be making to approve Trumpcare and it is based on false premises. The poster child is that an insurer has pulled out of Iowa, but also as the Washington Post and Yahoo News report, insurers are already leaving the Obmacare exchanges because of the unstable market conditions created by the GOP's repeal/replace efforts. The GOP is self fulling their own prophecy. http://www.latimes.com/…/la-fi-hiltzik-obamacare-charts-201…

Per Yahoo News re Iowa" last insurer still planning to offer individual coverage in most of the state next year warning it may leave “without swift action” by state or federal officials act to “provide stability.”https://www.yahoo.com/n…/uh-oh-most-iowa-apos-225803321.html

https://www.washingtonpost.com/news/wonk/wp/2017/05/03/iowa-at-risk-of-having-no-obamacare-insurers-next-year-in-all-but-five-counties/?utm_term=.c1164c7566cb

The china shop rule: Trump broke health care insurance; he owns it

When Donald Trump and Mike Pence used their political capital, their arm twisting, and their sham $8 billion offer to give GOP Representatives  on the fence cover to be able to claim pre-existing conditions were covered (when they will not) , they own it. With their votes, the GOP indicated their willingness to  break the health care system that is approved by over 60% of voters to switch them to with  a plan that has 17% public approval. While Trump owns  it , those who voted for it do, too, and their votes are on the record.  From hence forth, their bill will be known as Trumpcare .The only Colorado Republican who voted no on Trumpcare: Mike Coffman. The rest of the Colorado GOP representatives voted for it. The political price they pay for it will be high. Their priorities are clear and  consumers and many of their constituents are not among them.  The price consumers would pay will be not only  in dollars out of their pockets, but in terms of life and death because of underinsurance and 24 million more would  have none at all. Even if this bill does not survive in the Senate, we now know where certain GOP House members stand and they will have to live it down through their 2018 campaigns for re-election. Democrats are already sharpening their knives.

What it means is that those who supported Trumpcare will have given their tacit approval to take away insurance from so many, most of whom are in the middle and lower middle income brackets. Fifteen million of those losing coverage  nationwide would be due to the loss of Medicaid alone. The GOP and Trump have  agreed it is OK that the 31 states who accepted Medicaid expansion to lose it,  including Colorado. 600,000 in Colorado have benefited from the Medicaid expansion since Obamacare began. If states want to cover Medicaid expansion themselves, it would cost $15 billion in Colorado  or we will watch  the near poor suffer the consequences.    

420,00 in Colorado would lose insurance , sending them once  again  to the  the ER for the sniffles or  hope for charity care, or  pay from their own pocket for  all services, including essential services once  covered  under Obamacare: . ambulatory, emergency, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative services and devices, laboratory services, preventive care and chronic disease management, and pediatric services including dental and vision.

Over 22% of adults under 65 in Colorado ( as much as 36% in Southern states)  with pre-existing conditions would face being placed in a risk pool  by their legislatures , a system that  now with Trumpcare has  no limit in raising the amount premiums charged to consumers and is $192 billion short of sufficient funding.  The AARP estimates huge increases in premiums for those with pre-existing conditions to  make up the underfunding of high risk pools.”For consumers who have buy coverage in a high-risk pool, AARP’s PPI projects that the premiums could reach $25,700 a year in 2019, when this provision would go into effect.” affecting 40% in the 50 to 65 year old group. Others predict even higher increases ranging from $5K to $143,000 premiums.   In any case,  all of those over 50 wiould be paying higher premiums since insurers are allowed to charge them more than they do under Obamacare.

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For those who feel smug with  your employer insurance, wake up. Employers wiould no longer be required to give you any health insurance.  Coverage of pre-existing conditions or essential benefits  will no longer be required  to be included and neither  will essential benefits , depending upon your state .legislature.   Due to a last minute amendment, those detested life time caps were reinstated.

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The GOP leaders rushed a vote today without hearings, reading the final bill text , or waiting for the dreaded score from the Congressional Budget Office to tell them how much it would cost the government, consumers, states, and how many would lose their health insurance. . Those who did  look at it and opposed it  still were the American Medical Association, and ten other patient stakeholders because so many would be left with no insurance,  per  the New York Times 5/4/17

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Want to do away with both Obamacare and Trumpcare and yet have lower premiums and comprehensive coverage for everyone? ? Want to have a health care  system that costs a third less than today as low as   the rest of the industrial world and have better  health outcomes and longer life? Then give single payer another look because the whole country becomes the “pool” and the cost  of treating the sick and poor is spread around so that  everyone pays a little toward that and no one  group shoulders the burden because their costs are higher. Of course, private insurance companies disappear or they become an alternative for the very rich offering cadillac supplementals.  Both Medicaid and Medicare are single payer systems so that Americans have had plenty experience with a single payer system, even though they may not have known that is what they are.

https://www.nytimes.com/2017/05/03/us/politics/gop-eyes-8-billion-addition-to-win-a-crucial-vote-to-the-latest-health-bill.html?hp&a

http://www.aarp.org/politics-society/advocacy/info-2017/healthcare-bill-will-increase-premiums.html?intcmp=AE-POL-ADV-EOA2

https://www.usatoday.com/story/news/politics/2017/05/04/fact-check-pre-existing-conditions-debate/101283530/

https://www.coloradostatesman.com/report-gop-health-plan-would-cost-colorado-15-billion-or-leave-hundreds-of-thousands-without-care/

https://www.medicaid.gov/medicaid/by-state/stateprofile.html?state=colorado

https://www.wsj.com/articles/little-noted-provision-of-gop-health-bill-could-alter-employer-plans-1493890203

http://www.aarp.org/politics-society/advocacy/info-2017/healthcare-bill-will-increase-premiums.html?intcmp=AE-POL-ADV-EOA2