Whacky Trio, Three-ring
Circus, U.S. Troika, Awful Threesome in Office
Not the faces of pride, joy,
happiness, or satisfaction
(Red State Senators and Red-faced
Embarrassments)
Key parts to
the Senate bill – much more to follow. This analysis is from Vox:
•
The bill asks low- and middle-income Americans to spend significantly more for
less coverage.
•
The bill would roll back the Affordable Care Act’s expansion of the Medicaid
program, which currently covers millions of low-income Americans, and include
additional cuts to Medicaid.
•
It would rework the individual market so that enrollees get less financial help
to purchase less generous health insurance with higher deductibles.
Here is how the
Senate bill works (must be agreed
upon in the House) (my
emphasis added):
- The Senate
bill begins to phase out the Medicaid expansion in 2021 — and cuts the
rest of the program’s budget too. The Senate bill would end the
Affordable Care Act’s expansion of Medicaid to millions of low-income
Americans. This program has provided coverage
to more Americans than the private marketplaces.
- It would
also cut the rest of the public insurance program. Better
Care would also limit government spending on
the rest of the Medicaid program, giving states a set amount to spend per
person rather than the insurance program’s currently open-ended funding
commitment.
- The Senate
bill provides smaller subsidies for less generous health insurance plans
with higher deductibles. The Affordable Care Act provides
government help to anyone who earns less than 400 percent of the federal
poverty line ($47,550 for an individual or $97,200 for a family of four). The people who earn the least get the most help.
The Senate bill would make those subsidies much smaller for many people,
and only provide the money to those earning less than 350 percent of the
poverty line ($41,580 for individuals and $85,050 for a family of four).
The Senate bill will tether the size of its tax credits to what it takes
to purchase a skimpier health insurance plan than the type of plans
Affordable Care Act subsidies were meant to buy. Essentially,
these tax credits buy less health insurance.
- The Senate
bill seems to allow states to opt out of Obamacare’s marketplaces and
essential health benefits requirement. A new waiver process would allow states to overhaul their insurance markets,
including ending the essential health benefit requirement and specific
subsidies that benefit low income Americans, so long as those changes do
not increase the deficit. (I
note: For the GOP it’s always the deficit, except for excessive
spending on their “selective” programs, um).
- The Senate
bill repeals the individual mandate — and replaces it with nothing. The bill
gets rid of the Affordable Care Act’s unpopular requirement that nearly
all Americans carry health coverage or pay a fine. This could cause significant disruption in the individual market
because it takes away a key incentive healthy people have to buy coverage,
meaning only sick people may sign up.
- The bill
would cut taxes for the wealthy. Obamacare included tax increases
that hit wealthy Americans hardest in order to pay for its coverage
expansion. The AHCA would get rid of those
taxes. Obamacare was one of the biggest redistributions of
wealth from the rich to the poor; the AHCA
would reverse that.
- The Senate
bill defunds Planned Parenthood for one year. This would
mean Medicaid patients could no longer seek treatment at Planned
Parenthood clinics. Experts expect this would
result in low-income Americans getting less medical care and having more unintended pregnancies, as access to contraceptives
would decline.
- All in
all, the replacement plan benefits people who are healthy and high-income,
and disadvantages those who are sicker and lower-income. The
replacement plan would make several changes to what health insurers can
charge enrollees who purchase insurance on the individual market, as well
as changing what benefits their plans must cover.
In aggregate, these changes could be
advantageous to younger and healthier enrollees who want skimpier (and cheaper)
benefit packages. But they could be costly for older and sicker Obamacare
enrollees who rely on the law’s current requirements, and would be asked to pay
more for less generous coverage.
The
Senate bill will end Medicaid expansion in 2021 — and cut the rest of the
program too:
One
of the main ways Obamacare increased insurance coverage was by expanding the
Medicaid program to cover millions more low-income Americans. Prior to the
health law, the entitlement was restricted to specific groups of low-income Americans
(pregnant women, for example, and the blind and disabled).
Obamacare
opened up the program to anyone below 138 percent of the poverty line (about
$15,000 for an individual) in the 31 states (plus DC) that opted to participate.
How
to best summarize this GOP plan: The “AHCA: Awful, Harsh, Cruel,
Affront.”
At least from my reading … hopefully it will fail... but then watch
Trump and company pull out all the stops. Ready, Fire, Aim is more apropos.
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