GOP should try to make health insurance cheaper for consumers, not more expensive

Assuming the GOP drops the  “repeal Obamacare”  slogan and instead tries  to repair  the Affordable Care  Act , what could they offer?  They should  make all health insurance  cheaper for consumers instead of taking away its benefits, quit proposing implementation delays, and stopping a campaign to scare would be participants away. .  

 Every time  those with squeaky wheels   get  greased by an exemption or delay,  insurance companies warn that reducing the pool of healthy participants  would shift more costs to everyone else who gets insurance. They understand  why any more opt out provisions  and fewer  people covered  only ring up the costs.

Obamacarescaring has been part and parcel of GOP strategy to whack health care reform at the knees, and  their newest attack is to claim the federal site is not secure. Their proposed legislation to notify you of security breaches  is a proposal the administration claims fixes something that” ain’t broke” and is already handled  by other laws. The GOP disagrees. Needed or not, such legislation does not alter Obamacare and would not be the first redundant legislation cluttering law books.

 

What the GOP is  doing is  playing  on  recent news about  security failures in Target and Nieman Marcus’ credit cards and information to scare you from going on line to sign up for health insurance.

 

The GOP has attempted mightily to make Obamacare look like a failure before it even got implemented.  Scaring away potential customers  is not the only tactic the GOP has used  to self fulfill their prophesies. The GOP  has tried to  cripple  access to the system by blocking local navigators signing up people, refusing to expand Medicaid, claiming it  will be too expensive, will not give you a choice of doctors, or is  too complicated to access or is not secure. They cherry pick stories that dramatize  the few who find such is true, and ignore the ever increasing and overwhelming numbers who find it is good enough for them, their friends, co-workers, and relatives.

We can expect the GOP to come up with more ideas to replace and repair Obamacare, but beware their  bearing gifts inside  Trojan horses. Any “repairs” should  not yank the popularly supported requirements of covering pre-existing conditions or young adults on their parents’ insurance, or reinstating lifetime caps on the amount of coverage, or removing the gender and  mental health parity standards. Removjng co-pay free  cancer screenings, or annual checkups, or certain reduced drug benefits from the health care act provisions would not make health care more  affordable to anyone or make  any of us  likely to care for their own health.

GOP “ repairs” should keep the ACA’s  costs reducing provisions. Cost savings measures required of providers  and “pay-fors” built  into the Affordable Care Act, per the Congressional Budget Office, echoed by Simpson-Bowles proposals,    will save  the deficit by  $ 109 billion   over the next ten years  and added twelve years   to the Medicare fund.  

GOP’s replacement proposals  to date  sound nice, but do little.    Health savings accounts only benefit those with jobs and  who do not live pay check to pay check.  Cross state insurance sales and mal practice reform are ideas evaluated four years ago  by the Congressional Budget Office as having minimal effect on consumers’ insurance  rates or do not  result in covering most of the previously uninsured.

Footnotes: updated information:

Rand researchers found that allowing anyone to buy a noncompliant plan would have a far more detrimental effect, raising  exchange premiums as much as 10 percent and decreasing enrollment by 3.2 million, or 26 percent.  By allowing those who got notices that their policies were being cancelled as non-compliant and to keep them for a year would have an effect of  increasing policies offered on the exchanges by less than 1%, “minimal effect”.

http://www.washingtonpost.com/national/health-science/study-allowing-people-to-stay-in-existing-health-plans-unlikely-to-disrupt-exchanges/2014/01/20/e537f6d4-81fb-11e3-bbe5-6a2a3141e3a9_story.html

Re: security of ACA federal exchange websites.  "

By Devin Dwyer
@devindwyer
Follow on Twitter

Jan 16, 2014 11:58am

Nearly three months after its launch, HealthCare.gov underwent end-to-end security testing and passed with flying colors, the top cybersecurity official overseeing the website told Congress today.

Teresa Fryer, the chief information security officer for the Centers for Medicare and Medicaid Services, told the House Oversight Committee that results from the tests have alleviated her earlier concerns about risks of cyberattacks and theft of consumers’ personal information.

“This security control assessment met all industry standards, was an end-to-end test and was conducted in a stable environment that allowed for testing to be completed in the allotted time,” Fryer told the panel. The assessment was completed Dec. 18, she said.

Fryer had expressed opposition to launching the site on Oct. 1 without proper security testing, but the administration proceeded with the launch against her advice.  She also revealed in testimony last month that several “high-findings” of security risk had been flagged and resolved during intermediate testing in November and December.

Fryer told lawmakers today there have been no successful attacks on the website since Oct. 1, and that mitigation strategies to limit risks to cybersecurity have been effective.

“The protections that we have put in place have successfully prevented attacks,” she said. “There have been no successful security attacks on the FFM [federal marketplace], and no person or group has maliciously accessed personally identifiable information.

http://abcnews.go.com/blogs/politics/2014/01/healthcare-gov-passes-critical-security-tests/

 

Gov. Scott Walker and the Heritage Foundation propose Obamacare replacement that is hardly patient centered

Excuse me, Governor Scott Walker, (R of Wisconsin) . I heard you    on Cindy  Crowley’s show on  CNN today.  You say you want  to repeal Obamacare and replace it  with something that is more” patient centered.” You did not go into detail, so I tried to fill in the blanks.

If I read your other  recent public statements correctly, what I suspect you mean is that anything Federal is less “patient centered”  than anything state funded and run.  A comprehensive reform mandated from Washington is ideologically repulsive to you and any solution short of that  is better any time  than some big federal program, even if it costs more.  

Surely, if you had a chance,  you would not  remove the  Affordable Care Act benefits  of patients who already have finally acquire  insurance to cover  pre-existing conditions or allow  young adults to say  on their parents’ insurance, or would you favor  reinstating lifetime caps on the amount of coverage, or removing the gender and  mental health parity standards, among others. Removing co-pay free  cancer screenings, or annual checkups would not make health care more  affordable to anyone or make  any of us  likely to care for their own health. How much more “patient centered”  do you want to get?

However, in reading between your lines, I saw no indication you would continue with those benefits and protections  if you had the ability to  repeal and replace Obamacare, except you would replace it with  proven unworkable approaches to help those with pre-existing conditions and let consumers choose the details of their coverage from the free market.

At least I give you credit for trying to come up with a way to cover the uninsured but it still relies on some government entity subsidizing premiums or care.   It is just what you are doing in Wisconsin that   seems contradictory, inadequate, and needlessly expensive.

That you believe in state run health insurance over some big government federal plan, is obvious.  However, you already  gave up some state control, anyway.    Even when your state was given the power and funding  by Obamacare to set up your state run exchanges  , you sent your citizens  to Uncle Sam’s   exchanges.  You refused federal money to expand Medicaid to the near poor, used your own state money to expand similar Medicaid programs a little, and are proposing  to spend more  state funds to send more of the near poor into the federal exchanges upon which you have frowned.

 You say you  are embracing the Heritage Foundation’s newest plan.  The Heritage Foundation was the one promoting the Massachusetts plan once upon a time as an alternative to a single payer system that would have cut out private insurers and smacked of Canada. On second thought, horrified their proposal became a model for Romneycare and Obamacare,  they now propose plan B:  just subsidizing the poor’s health insurance premiums and funding high risk pools for those with pre-existing conditions, excluding requiring any  consumer benefits and protections  or any cost savings measures imposed  on hospitals and physicians now  included in the ACA. 

Yours and the Heritage Foundation’s new alternative would let consumers pick and choose their benefits on a free market.  What free market?  The free market in health insurance does not exist; it is exempt from anti trust laws, free to collude with fellow providers, and incentivized by profit motives  to limit in small print  and prejudice  their  coverage in a way  that  results in the fewest losses. Been there,  done most of that, already, and the ACA was constructed  to deal with their excesses in the first place. The Heritage Foundation approach, if anything,  is insurance company centered, not patient centered.     

 States have had high  risk pools for some time too, but the costs of premiums were so high that they only reduced the insurance premiums to the levels of those who could afford non high risk catastrophic insurance premiums…never made affordable to those who  never could  afford even those premiums,   anyway. It was just too darn expensive to do otherwise and it never worked well anywhere. It was only marginally “patient oriented” since coverage was so limited with such high deductibles, contained no consumer protections or preventative care,  and was  unaffordable for  so many.   Let us see  a list of benefits and a  price tag attached to that one, Governor, before we   swallow that idea as a viable alternative.

Likewise, your  proposal of  subsidizing the near poor  to buy insurance on the federal exchange and expanding Badger Care a little has come under intense fire by Democrats for being  more expensive than accepting 100% of  federal dollars for Medicaid expansion, even if the state had to pick up 10% of the costs after 3 years. .

 Ideology has  trumped your fiscal conservatism and you simply have come up with a way to use tax payer money to keep on underwriting the ever soaring health care costs in the country and allowing substandard coverage to continue unabated for everyone else. Yours is an expensive band  aid still partially dependent on federal exchanges  that covers only a small part of the patient centered wound .