I realize this is a lot to read, but for those in the US, you should be aware of what is taking place.
So as some of you have been following, the GOP controlled Congress has released their repeal and replacement of the Affordable Care Act (Obamacare).
The Congressional Budget Office was the much awaited report on how this would impact the US both fiscally and its effects on the current healthcare system.
In fact, the person chosen to head up the office was a pick of Paul Ryan and Tom Price the Secretary of Health and Human Services.
Unfortunately for the GOP this plan is absolutely a pile of garbage.
It raises prices on the most vulnerable in our society, the elderly, the disabled, the poor, many of whom are children.
Yet somehow, we can find the money to build a southern border wall and give a 10% increase to our military which already spends more than the next 12 countries combined.
The plan also defunds Planned Parenthood, which gets an annual reimbursement of around $400 million worth of women’s healthcare and contraception - no monies of which are used for abortions.
The plan axes mental health, which also axes drug and alcohol treatment - both of which are huge problems and already underfunded in our society.
32 of 33 “developed nations” provide some form of Universal healthcare, the United States being the lone holdout.
Maternity leave? Ha!!
Nope...nada....some countries even have paid maternity leave...here the woman likely just gets fired for being pregnant and taking time off to give birth.
The CBO predicts that in 2026, 7 million fewer people would receive employer-based insurance, either because their employers would choose to stop offering insurance or because the employees would opt out because the new law, unlike the ACA, doesn’t require everyone to be insured or pay a penalty.
Many of these people, including the young and healthy, would buy insurance on the individual market, in part using age-based tax credits provided by the proposed law, called the American Health Care Act (the AHCA).
All those people dropping off the employer insurance rolls actually makes the individual market–part of what the Obamacare tried to fix–look better in 2026.
The CBO indicates that’s a mirage.
The CBO says 2 million fewer people would be buying individual insurance compared to current law in 2026.
That’s in part because the 7 million people not getting insurance through their employers are buying individual insurance.
If they weren’t switching from employer insurance to individual insurance, the individual market would be down 9 million people.
Instead, those 7 million young, healthy people who would have been covered by their employers are using a federal tax break to help buy insurance.
“It’s probably not a good use of public dollars,” says Matthew Fiedler, a fellow at the Brookings Institution.
Meanwhile, the CBO forecasts that even more people would be booted from Medicaid, the federal program for giving the poor health insurance that is run largely at the state level.
CBO estimates that 14 million fewer people will receive Medicaid in 2026 under the AHCA, compared the ACA.
Five million of those people will be because states that have not opted for Obamacare’s Medicaid expansion now never will.
Nine million people in states that have expanded Medicaid coverage will lose it.
In total, the CBO estimates that 24 million fewer Americans will be covered in 2026 under the AHCA (Trumpcare?) than would have been covered under the ACA (Obamacare).
The losses start sooner than that.
The CBO says that in 2018, 14 million more people would be uninsured under the AHCA, compared to the ACA.
The CBO also says that for older people, premiums could go up a lot–and that they’ll drop for younger people because of regulatory changes the AHCA aims to make.
Under the ACA (Obamacare), a 64-year-old with $26,500 in annual income would have paid $1,700 in 2026–a $15,300 premium offset by a $13,600 subsidy.
Under AHCA, that 64-year-old would pay $14,600, or 55% of their income.
Their premium, CBO forecasts, would be $19,500, and they would only receive a $4,900 tax credit.
Certainly sounds worse.
For a 21-year-old making $26,500, the cost under the ACA of a plan would be $1,700.
(That’s a $5,100 premium minus a $3,400 subsidy.)
Under AHCA, that 21-year-old pays $1,450–a $3,900 plan with a $2,450 tax credit.
That’s a pretty good deal.
So for all those who really need the healthcare - they will not have this supposed “choice” we keep hearing Republicans spouting, because you have to be able to afford it first.
If you can’t afford to buy something, i.e. healthcare, then you have no “choice” but to sit there and die.
So now we will be back to the same issues we had before with overcrowded waiting rooms full of uninsured and underinsured people.
There’s a good argument for making insurance for younger people cheaper than it is.
Insurers like Aetna and UnitedHealthcare have been exiting the ACA insurance exchanges because they are getting too many older, sicker customers and not enough young, healthy ones.
Insurance works by transferring risk (and costs) from people who don’t need healthcare to those who do.
But a 64-year-old who has to pay half their income to buy health insurance is simply going to not buy health insurance.
Paul Ryan’s only saving grace -
The AHCA does save money, the CBO says.
It will reduce the amount the government spends by $1.2 trillion over 10 years, the CBO says.
Most of this ($900 billion over 10 years) is eaten by the repeal of taxes that were included in the ACA.
The bill would save $337 billion between 2017 and 2026, or about .8% of federal expenditures over that time.
Republicans are arguing that the CBO’s projections are wrong.
Fair enough.
The agency is not omniscient, and has gotten things wrong before.
But they’d have to be wrong by an awful lot to fulfill anyone’s campaign promises.
Tom Price, the new Secretary for Health and Human Services, said: "I firmly believe that nobody will be worse off financially in the process that we're going through,”
D. Trump has promised throughout his campaign that we would see a plan that was much more affordable (this plan is not), that patient protections would not be removed (this removes them), that he would not cut Medicaid, Medicare, or Social Security. This plan does exactly two of those things.
Here is what Donald Trump has promised with his plan -
1. At an American Airlines Center in Dallas last year, Mr. Trump said, "Obamacare. We're going to repeal it, we're going to replace it, get something great. Repeal it, replace it, get something great!"
2. During his June 2015 presidential announcement speech, Mr. Trump said, "But Obamacare kicks in in 2016. Really big league. It is going to be amazingly destructive. Doctors are quitting. I have a friend who's a doctor, and he said to me the other day, 'Donald, I never saw anything like it. I have more accountants than I have nurses.' It's a disaster. My patients are beside themselves. They had a plan that was good. They have no plan now."
3. In September 2014, Mr. Trump tweeted, "I'm not against vaccinations for your children, I'm against them in one massive dose. Spread them out over a period of time & autism will drop!"
4. Mr. Trump told The Hill the federal government should not play a huge role in healthcare regulation. He said, "The only way the government should be involved, they have to make sure those companies are financially strong, so that if they have catastrophic events or they have a miscalculation, they have plenty of money. Other than that, it's private."
5. In a 1999 interview with Larry King Live, Mr. Trump took a different stance, saying, "If you can't take care of your sick in the country, forget it, it's all over. I mean, it's no good. So I'm very liberal when it comes to healthcare. I believe in universal healthcare. I believe in whatever it takes to make people well and better."
6. In an interview on "60 Minutes," Scott Pelley asked Mr. Trump about his plans to fix the healthcare system.
"There's many different ways, by the way. Everybody's got to be covered. This is an un-Republican thing for me to say because a lot of times they say, 'No, no, the lower 25 percent that can't afford private'… I am going to take care of everybody. I don't care if it costs me votes or not. Everybody's going to be taken care of much better than they're taken care of now."
7. When Mr. Pelley asked Mr. Trump how his health law would care for the uninsured, Mr. Trump said, "the government's gonna pay for it. But we're going to save so much money on the other side. But for the most it's going to be a private plan and people are going to be able to go out and negotiate great plans with lots of different competition with lots of competitors with great companies and they can have their doctors, they can have plans, they can have everything."
8. At a Republican rally in New Hampshire in February, Mr. Trump said negotiating with pharmaceutical companies could reap huge savings, according to Fortune.
The candidate said, "Because the drug companies have an unbelievable lobby. And these guys that run for office, that are on my left and right and plenty of others, they're all taken care of by the drug companies. And they're never going to put out competitive bidding. So I said to myself wow, let me do some numbers. If we competitively bid, drugs in the United States, we can save as much as $300 billion a year."
HHS Tom Price -
“We strongly support the plan,” Health and Human Services Secretary Tom Price said on NBC’s Meet the Press, adding it would bring coverage to more people without raising costs. “I firmly believe nobody will be worse off financially in the process that we’re going through.”
In a feisty exchange with Sen. Bernie Sanders at his confirmation hearing on Wednesday, HHS nominee Rep. Tom Price said he hadn’t had “extensive discussions” with Trump on issues like Medicaid and Medicare but he expected they’d remain in place.
Liars.
The proposed changes mean a lot for consumers - particularly low-income families and seniors.
First, we would see a rollback in coverage for low-income families.
What didn't get as much attention as the 22 percent average premium increase this Open Enrollment season was the fact that a large portion of shoppers wouldn't be hit quite that hard thanks to subsidies and expanded Medicaid coverage offered by the government in an attempt to make health insurance more affordable.
Now this plan will gut Medicaid...those most vulnerable amongst us.
And Medicare will but cut as well.
Approximately 15.7 million people have enrolled in Medicaid and CHIP since the October 2013 expansion.
Repealing Obamacare would cause an estimated 22 million people to become uninsured – including many consumers who are covered through the Medicaid expansion.
Eight million children are covered by CHIP, so if that program expires (which it is currently set to do at the end of September 2017) as part of Medicaid's rollback, that leaves even more people uninsured.
If Medicare requires premium payments and for senior consumers to buy private insurance, that, along with other potential changes like changing age banding requirements from a 3-to-1 ratio to a 5-to-1 ratio (which serves as a rate cap for what insurers can charge older consumers) means that some seniors will end up with wildly different, and potentially more expensive, healthcare options.
It's not far-fetched to predict a scenario where many seniors - facing a more expensive and confusing array of private health insurance options - just throw up their hands and forego coverage.
Changes to both programs go outside of just consumers.
Medicaid cuts would affect insurers in the Medicaid managed care market, not to mention "hospitals, drug companies, medical equipment manufacturers, doctors and other health-care providers.”
If Medicare becomes another insurance marketplace, that could be a boon for insurers offering Medicare Advantage plans who would stand to gain many more customers.
The purpose of Obamacare was to offer healthcare protection.
Though it's been mired in compromise and controversy, it's achieved this goal, or is at least well on its way.
Changes to Medicaid and Medicare, and the subsequent results those changes will have on the health insurance system, threaten to roll back those protections for the people who need them most.
Higher cost for coverage and a more convoluted system may not be what Republican lawmakers are trying to impose, but it's what their proposed changes may result in if they go forward.
They have had eight years to create a plan that is better than the ACA and THIS pile of crap is what they hand the American people after countless debates and attempts to defund the ACA.
If we are judged by how we treat our most vulnerable citizens then we are in a sad state indeed.
Not to mention the tax breaks this plan gives to the very rich...
Today, the Congressional Budget Office answered those questions, releasing its official scoring of the American Health Care Act, and the results are not pretty.
An $883 billion tax cut, $274 billion of it going to the richest 2%.
$880 billion stripped from Medicaid.
And 24 million fewer insured individuals over the next ten years.
Added to the already uninsured.
Ten years from today, if President Trump and the Republicans have their way, there would be 24 million more Americans without health insurance, a total of 58 million Americans living in this country ten years from now will not have health coverage.
This is UnAmerican and is flat out morally wrong,
especially for the 9th richest nation in the world.
Please feel free to contribute or debate, just don’t be jerks okay?especially for the 9th richest nation in the world.
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