Wednesday, March 08, 2017

GOP Offers A Terrible "Repeal & Replace" Insurance Plan

(The graphic above, from the New York Times, shows the high points of the plan being pushed by Republican congressional leaders.)

(This chart, from the Kaiser Family Foundation, shows the change in tax credits [called subsidies when paid in advance] between the ACA and the new Republican plan.)

Donald Trump is bragging about the new Republican plan to replace Obamacare. That just means he has broken another promise he made (lied to Americans). He had promised that the new plan would provide insurance for all Americans, but this plan doesn't even come close to that. In fact, fewer Americans will have health insurance if it passes.

Some observations about the plan:

* The plan will cause between 10 million and 20 million Americans to lose their current health insurance. We're not sure of which figure is closer because the Republicans have not submitted their plan to the nonpartisan Congressional Budget Office for scoring -- and they're trying to rush the plan through Congress before the CBO delivers the bad news. I suspect the total of those who lose their insurance will be closer to the 20 million figure.

* About half of the American population has an income that's within 150% of the poverty level. With lower (or no) subsidies, they will not be able to pay higher prices for insurance.

* Millions will lose their insurance because their subsidies will be cut or eliminated, but they won't be the only ones. Large businesses will no longer be required to provide insurance for their employees -- and it's a safe bet that many of them will decide to drop that insurance benefit.

* While those in the working class will see their tax credit (i.e., subsidy) cut, those making $75,000 or more will now get that credit (which they did not receive under the ACA). It's another example of the Republicans taking from the poor to give to the rich.

* With millions more Americans without insurance, hospital emergency rooms will once again be packed by those without insurance (and many of them without the ability to pay). The law says they have to treat those people, but someone must pay or the hospitals will cease to exist. That means they will have to charge more for their services to everyone else. In other words, medical costs will rise higher and faster.

* Insurance premiums will also rise higher and faster than they currently do. The insurance companies will have a significantly smaller base of people (and that base will be sicker since many young healthy people will opt out of buying insurance). Added to that will be the higher costs of medical care. If this plan is passed, many will soon pine for the "low" cost of insurance under Obamacare.

* Many of the poor will continue to go without any kind of insurance (to help them afford life-saving measures like preventative care). The plan not only caps Medicaid funds at current level (meaning no new states can expand Medicaid), but also makes the Medicaid program simply a block grant to the states. That means states can make their own rules, and you can be sure that many GOP-controlled states (like Texas) will be very stingy, excluding most of the poor from health insurance.

This is a terrible plan, and it casts a dark cloud over health care in the United States. The U.S. was already the only developed nation that did not provide health insurance for all its citizens, and now many millions more will have to try to survive without health insurance. It shows that the Republicans simply don't care about the welfare of most Americans. They care only about how they can funnel more money into the bank accounts of the rich and the corporations.

There may be a couple of glimmers of light shining through that dark GOP cloud:

First, the bill may not be able to get through Congress. The Democrats will oppose it, and they might be joined by enough Republicans to kill it. The House Freedom Caucus (teabagger Republicans) don't like the plan. They want a repeal without a replacement plan (or at least a plan with any kind of subsidies). If enough Republicans oppose the plan, it will die (and in the Senate, it wouldn't take many).

Second, if the plan does somehow make it through Congress, the effect will be so bad on health care in this country that many more Americans will see a single-payer, government-run insurance program (like Medicare for all) as a viable option to fix the mess -- and that is really what is needed.

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