Thursday, May 4, 2017

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.

















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