Tuesday, March 7, 2017

Trumpcare/GOP plan is shift and shaft, replace and wreck

My initial reaction:


The GOP/Trumpcare is shift and shaft. replace and wreck
(Credit  independent Sen.  Angus King for those words)


Updated and retitled " Trumpcare is Shift and Shaft, repeal and wreck.   3/10.17
In Sky Hi Daily News print and e editions, 3/15/17 : Republican's Health Scare Bill

Sen. Angus King  (I-ME)recently called the GOP/Trumpcare replacement plan for the ACA/Obamacare,"Shift and shaft; repeal and wreck". The legislation is now going through the Republican dominated House of Representatives. King  is not the only one opposing it: So have American Medical Association and the American Hospital Association, the insurance company trade association, and the American Association of Retired Persons (AARP.)  Some conservatives also oppose it because they want to do away with any insurance premium subsidies as being "socialism"..

The GOP purrs no one will lose health insurance who has it today under Obamacare/ACA,. That's today, but by 2018, and many millions of individuals  will realize they have been shafted.The Brookings Institute estimates fifteen million more than today will be uninsured and the Congressional Budget Office estimates fourteen million by 2018.  Premiums  on individual markets will rise first  but ten years later they will decrease only by   10% over now  but  58 million will be uninsured  by then, close to pre Obamacare figures.  It saves $ 300 billion reducing deficit in ten years  by dropping Medicaid expansion and reducing  subsidies (tax credits)  to  one half of Obamacare subsidies. Medicaid expansion being phased out affects  eleven million now in that program  as are 7 million seniors in nursing homes. Yes,the GOP reassures us, it will be patient centered because patients can make more choices. Some choice when 24 million more than now cannot even afford premiums much less make  choices  of insurance plan benefits.

What is wrecked is the mechanism used to finance premium subsidies and the coverage of pre-existing conditions.  Obamacare/ACA depended on taxes on the top 1% and others. The ACA put those who have high demand on health care, such as seniors and those who were sick, into large pools that included  those with less frequent use of services paying in, too, to spread the cost of premiums around.  $600 billion of  taxes are being eliminated, mostly benefiting  the rich,  and the pools are being broken up  into segregated  ones for  high users  and/ or charging  some  more for fewer benefits.

.The  shaft to consumers who still can afford premiums is that their benefits they get now will become optional and their premiums, especially paid by over 50 years old Americans, will pay 25 to 35% more per  AARP. No longer required to be included in all insurance plans would be such benefits as prescription drug coverage, annual physicals, no-copay cancer screenings, prenatal/maternal care, and mental health and drug rehab coverage.  These will become optional benefits for which you must pay extra or pay for them out of your own pocket or  will not be included in your "affordable" policies  which shrink to the catastrophic coverage category.

The shift is obvious. "The bill would cut more than 20 taxes enacted under President Barack Obama's heath law, saving taxpayers nearly $600 billion over the next decade. The bulk of the money would go to the wealthiest Americans" per an Associated Press analysis. The burden would  be shifted to  the   the poor and older Americans . While The Trump/GOP plan calls for reduction and  elimination of Medicaid expansion,  older Americans  will also shoulder the burden.  Obamacare subsidies were based on income but Trumpcare would base tax credits on  age, providing only $4 thousand tax credits to older people, yet permitting insurance companies to charge five times the premium costs of younger ones. .

__________________________________________________________________________________ 
 Here is where your Colorado Congresspoeple stand now on the GOP/Trumpcare bill  per an a NPR report.  Opposed,are all Democratic House members and  Democrat Sen. Michael Bennet, . In favor of Trumpcare/GOP legislation,  Mike Coffman (6th district) . "Equivocal" Republicans are Scott Tipton, Ken Buck ,and Doug Lambourn,.and  Republican Sen. Cory Gardner. However. other sources list Gardner  as one of the four Republican senators who will vote against the  GOP proposal because of the cuts to Medicaid, he says,





The  GOP sales pitch supporting Trumpcare is based on false pretenses and untruths.  They claim Obamacare is failing so take their plan or leave it ..    They claim premiums have soared. They point out horror stories in seven states,, yet the total number of those seeing premium rises are only 3% of Americans. In fact, health care costs under Obamacare  have risen less than they were projected to rise without  Obamacare. They claim a third of the counties(mostly rural ) have only one plan to choose from, yet they propose a plan that would cause rural health providers and hospitals to close their doors as they lose paying customers.


http://finance.yahoo.com/news/cbos-huge-report-impact-trumpcare-200918767.html

http://www.latimes.com/business/hiltzik/la-fi-hiltzik-obamacare-charts-20170104-story.html


http://www.cnsnews.com/news/article/house-gop-health-bill-adds-big-tax-cut-rich

https://www.yahoo.com/news/its-merciless-democrats-focus-on-seniors-while-attacking-gop-health-care-bill-133511919.html

http://www.npr.org/2017/03/08/519282174/aarp-policy-director-criticizes-republican-health-care-plan

http://www.npr.org/2017/03/10/519629973/new-health-care-bill-find-out-where-your-member-of-congress-stands

https://www.washingtonpost.com/powerpost/doctors-hospitals-and-insurers-oppose-republican-health-plan/2017/03/08/d9f0f5c2-0426-11e7-ad5b-d22680e18d10_story.html?utm_term=.0ad08b958d5b

http://talkingpointsmemo.com/edblog/judge-rules-aetna-lied-about-reason-for-leaving-obamacare-exchanges


http://abcnews.go.com/Health/wireStory/big-differences-gop-health-care-bill-obama-era

http://mainebeacon.com/sen-king-republican-health-care-proposal-will-shaft-mainers-who-need-coverage/

http://www.marketwatch.com/story/brookings-institution-expects-cbo-estimate-of-at-least-15-million-more-uninsured-under-republican-health-care-bill-2017-03-09

https://www.nytimes.com/interactive/2017/03/09/us/politics/who-is-really-affected-by-rising-obamacare-premiums.html?_r=0

http://www.denverpost.com/2017/01/18/obamacare-repeal-could-close-colorado-hospitals/

http://www.newsweek.com/obamacare-repeal-threatens-rural-hospitals-and-trump-voters-who-depend-them-538627

https://www.yahoo.com/finance/news/cbo-deal-death-blow-gop-133300363.html

___________________________________________________________________________________
Earlier coments.

In fact, health care costs under Obamacare  have risen less than they were projected to rise without  Obamacare. They claim a third of the counties(mostly rural ) have only one plan to choose from, yet they propose a plan that would cause rural health providers and hospitals to close their doors as they lose paying customers. They claim insurance companies are leaving the market because of Obamacare, but other factors are at work  including court rejections of mergers because the health care industry is already controlled by a nearly non-competitive monopoly of larger insurers, making a mockery of the  free market forces of competition needed to reduce costs. Nothing in the GOP/Trumpcare plan would change that. 

Its GOP honey coated: sales point: they are luring you to support the plan is that you don't have to have health care insurance if you do not want it and you can buy any insurance you
want and cherry pick benefits.How the credits work to help you pay for it is not yet clear. What happens to those who do not make enough to pay any taxes? How will they get credits to offset costs? Will consumers have to upfront costs or pay for them from health savings plans they themselves pay for?  Health savings plans are a way to make consumers pay more from their take home pay for their own insurance. This is a cost shift to consumers. What if your pay check cannot stand more contributions to health savings plans?
Other questions to be answered: how many will lose their ability to afford insurance, what will happen to those who lose their
Medicaid because of the extreme cuts and ending that program in the future as we know it? What other benefits are removed from requirements such as covering presecription drugs, annual checkups, cancer screenings and the pink and blue pills.  Choice may mean  women  will have to pay more for their insurance than men, men will get the advantage, and whether this system is cheaper for the federal government
than Obamacare. Budget hawks will be most interested in the latter.
All of this awaits Congressional Budget Office scoring and scrutiny by others however the various GOP dominated House Committees plan to go ahead without the CBO evaluation of costs and numbers of people covered.  That is an outrage and against even House rules and should not be allowed.
At this point it is probably dead on arrival because it shoves a chunk of
the costs of Medicaid to the states who had already received federal funding for it, and it ends Medicaid expansion in a few
years.. Half of those 22 million who received Obamacare were those who benefitted from Mediciad expansion. The Freedom Caucus also opposes any subsidies of insurance premiums that the GOP plan perptuates because it is "socialism".
The Medicaid issue could be the nail in the coffin hammered in by some GOP Senators who come from states that accepted Medaid expansion. The Medicaid cuts will hurt their state's budgets. That is just for starters because how credits subsidies will be applied or works is not yet clear. They may be hiding cuts that are not yet obvious because they are masked by making subsidies based on age instead of income. We now will be awaiting Congressional scoring and scruitiny by such groups as AARP and independent non profit foundations such as the Kaiser Family Foundation. Initial comments is that older Americans not yet old enough for Medicare will take the brunt of the cost shift to them.  Of course, Democrats will be united against the plan, and the GOP cannot afford to lose many GOP Senator's votes, either from the Freedom Caucus members or those from states who had accepted federal funds for Medicaid expansion., including Cory Gardner of Colorado..http://www.motherjones.com/…/republican-senators-obamacare-…


House Speaker Rep. Paul Ryan (R-WI) opens a joint session of the U.S. Congress with U.S. President Donald Trump on February 28, 2017 in the House chamber of the U.S. Capitol in Washington, DC. Trump’s first address to Congress is…
YAHOO.COM

No comments:

Post a Comment