So, I’m wondering … does anyone like this bill?
But …But… Where do you think the poors are going to go for their routine healthcare.
How about…Your emergency room
That’s always been the plan, let the county hospitals foot the bill
The people I’m waiting to hear from on this are the health insurance companies. I don’t see anything in this bill for them, and I suspect that they liked the individual mandate a lot.
Keep it coming, people.
Let’s hope the provider and health plan associations all spank this thing really hard.
Yup! Just as I called it!
Only a matter of time before the AMA or some other large doctor backed group weighs in. Seems the providers of care in the industry take umbrage with being the target of “fraud, waste, abuse” claims and a call to reduce reimbursements without guarantee of payment for the patients they do see.
Next up, the healthcare plans will pop up to dispute the idea that any plan can come and play in their geographic space, especially if they no longer need to be licensed by that state’s dept of insurance… This will be especially true with the Blues.
Who knew healthcare was so complicated?
National Council for Behavioral Health is also opposed. They savaged the plan in a statement this afternoon
Yesterday evening, the U.S. House released legislation to repeal and replace the Affordable Care Act (ACA). The bill contains provisions that, if enacted, could devastate Americans’ mental health and addiction coverage and care. NOTE that this bill pays for reforms in the commercial health care market by dramatically cutting funding from Medicaid, the single most important funder of mental health and addiction services in this country. The bill is scheduled for a hearing in the House Energy and Commerce and Ways and Means Committees this Wednesday. See below for a summary of the bill and information on how you can join The National Council in fighting these potentially dangerous measures.
American Health Care Act Summary
Refinances Medicaid Into Per-Capita Caps – Fundamentally changes Medicaid financing from an open-ended federal and state matching formula into per capita allotments. Under this new system, the federal government would provide a set dollar amount to states based on its number of Medicaid enrollees. Per capita caps would start in FY 2020 and use each state’s spending in FY 2016 as the base year to set targeted spending for each enrollee category (elderly, blind and disabled, children, non-expansion adults, and expansion adults). The federal caps would only increase each year by the percentage increase in the medical care component of the consumer price index. This proposed growth rate is even lower than what was included in previous version of the bill, putting even more fiscal pressure on states. The goal of this proposal is to massively cut federal spending for Medicaid, potentially leaving millions without needed care.
Restricts Medicaid Expansion – After Jan. 1, 2020, the bill will allow states to continue to receive the enhanced FMAP rate for unique expansion individuals as long as they do not have a break in eligibility for more than one month. The enhanced federal matching rate would only apply to expansion-eligible individuals already enrolled in Medicaid as of Dec. 31, 2019. After Jan. 1, 2020, states could only enroll newly eligible individuals at the state’s traditional FMAP for that individual. Non-expansion states would be provided $10 billion over five years as safety-net funding to adjust Medicaid provider payments; Repeals state option to expand by Dec. 31, 2019. This provision ends the growth of Medicaid expansion and slowly reduces the current Medicaid expansion population, who frequently break in and out of Medicaid eligibility.
Repeals EHB Requirement for Medicaid – Repeals the requirement that essential health benefits (EHB) must be provided in certain Medicaid plans on Dec. 31, 2019. Essential health benefits specifically require health plans to cover mental health and addiction treatment. By removing the EHB for Medicaid, this provision puts Medicaid enrollees at risk of losing mental health and addiction treatment coverage.
Repeals ACA Subsidies, Creates Refundable Tax Credits - Repeals the ACA’s cost-sharing subsidies in 2020 and creates an advanceable, refundable tax credit for the purchase of state-approved, major medical health insurance. Credits are not universal and are based on age and income-eligibility. Credits – ranging from $2,000 to $4,000 per individual - are available in full to those making $75,000 per year ($150,000 for joint filers). They phase down by $100 for every $1,000 in income higher than those thresholds. The repeal of the ACA’s subsidies limit affordable health coverage options for individuals with mental illness and/or addictions that do not have access to employer-based coverage.
Maintains Popular Provisions of ACA – Preserves requirement for insurers to accept all consumers regardless of pre-existing conditions and allows children to stay on their parents’ insurance plans until age 26.
Repeals the Individual Mandate – Repeals the ACA’s individual mandate and instead allows insurance companies to charge a 30 percent surcharge if consumers go without “continuous” insurance coverage for two months or more.
Eliminates a Number of ACA Taxes – Eliminates the medical device tax, the tanning tax, a tax on high earners and a tax on investments. Again, these provisions are financed by dramatic cuts to funding in Medicaid.
TAKE ACTION
Now is a critical time to contact your members of Congress. The National Council is calling upon its members to join fight to protect Medicaid. Find out how by going to our Unite for Behavioral Health (Unite4BH) page.
https://www.thenationalcouncil.org/policy-action/unite4bh/
If you are rich and don’t have to worry about health insurance, you like this bill because it puts more money in your pocket. If you are a right-wing congressman with health insurance in a safe district, you like this bill because it makes you look like you care about spending, and you get more campaign funds from rich people who have health insurance and more money in their pockets. If you are an old white person on Medicare, you like this bill because it keeps “those people” from getting free stuff that only you are entitled to. Not so much for the other 310 million Americans.
Any insurance - literally any type of coverage - loves to spread risk across as many policy holders as possible.
With a newly licensed 16-year-old driver, my car insurance tripled but they loved having me because I never once filed a claim. Same with my personal liability policy, which quadrupled, all because I had a new high-risk driver added on to my policies.
Paul Ryan and apparently Donald Trump.
" before the Congressional Budget Office has returned its score."
The GOP are trying to do and end run here folks.
It is hard to understand what Ryan and Co. are trying to accomplish with this bill. Does this really get them off the hook with their base?
They have to have known that the bill would be DOA with the hardcore conservatives. He’s known where those folks stood on his proposals for years.
If the tactic was to rush the thing through the process before the CBO did their markup that didn’t make a whole lot of sense, either.
Which has been the GOP meme about ACA for the last six years - “we didn’t have TIME!!!”
Reminds me of the middle of the night on the Medicare Prescription plan vote - which they held secret, suddenly had a rushed vote - which they then held-open (the window for reps to vote) extra long in order to cajole one more vote.
How quaint. Outside of rural areas, how many of those NFP remain? And therein lies one of the many problems in U.S. health care - for profit hospitals. Breaking even is about all any hospital should expect to do without being subsidized.
Hell, they couldn’t even get Breitbart:
About 90 miles to the east of Houston lies Orange County. Orange County went 80% for that man. Just announced that the only hospital in the county is closing, because they can’t make a profit. Residents outraged! Want government to “do something.”
Fuckers getting what they voted for.
But can they connect the dots?
OT, but it can’t be that much of a hardship as Texas has about 7,532 counties (proving that they were for smaller government first, just lots and lots of smaller government), so no one who lives in Orange County can be more than 15 minutes from another county hospital, right?
Add:
Just had to Google it, and I’m right. 380 square miles or smaller than Greater LA with a population of just about 83K. They can go get well in Port Arthur or Beaumont, long as theys gots insurance.
I’m baffled by this, as well. From what I’ve read, no, it really doesn’t meet the demands of their base. Commenters on redstate and freerepublic are loudly voicing their disapproval and, so far, all of the major conservative organizations have come out strongly against it.
On both the policy and the politics, this just doesn’t make a hell of a lot of sense. There is so much to attack in this bill that it’s a target-rich environment; everyone will find something they absolutely hate. Even worse, nobody will find anything they absolutely love, which means that the bill has no champions.
Edited to add that we’re not the only ones wondering. From a post over at RedState:
… The writing on the wall seemed clear: It was dead the moment the public saw it. It is of major importance that the architects of this bill come out and tell us 1) why they pushed this idea and 2) what they hoped to accomplish with no support outside of the leadership circles of the GOP Congress.
…
What was even the point of this exercise? You have unveiled a plan no one likes and one that will hurt you with the very base you promised to repeal Obamacare for in the first place. This is insane and poorly thought out.