The stupidity of Trumpcare: Government will spend $33 billion more to cover 8.9 million fewer Americans, as premiums soar

By Michael Hiltzik

Feb 26, 2018 | 2:55 PM

The Republiclans taking away your health insurance: Vice President Mike Pence was flanked by Republican congressional leaders last year to talk up the GOP’s Obamacare repeal bill. The bill failed, but the Republicans found other ways to kill the ACA insurance market. (Shawn Thew / European Pressphoto Agency)

Those fiscal geniuses in the White House and Republican-controlled Congress have managed to do the impossible: Their sabotage of the Affordable Care Act will lead to 6.4 million fewer Americans with health insurance, while the federal bill for coverage rises by some $33 billion per year.
Also, by the way, premiums in the individual market will rise by an average of more than 18%.
Heck of a job.
These figures come from the Urban Institute, which on Monday released the first estimate of the impact of two GOP initiatives. The first is the elimination of the individual mandate, which is an offshoot of the GOP tax-cut measure signed by President Trump in December. The measure reduced the penalty for not carrying insurance to zero as of next Jan. 1.


Those affected by these large premium increases would be disproportionately middle-income people with health problems.
The second is Trump’s plan to expand short-term insurance plans, which don’t comply with many of the ACA’s essential benefits requirements and allow insurers to reject or surcharge people with preexisting medical conditions or histories.
The Urban Institute broke down the impact of Trump and Republican policies thusly:
— Eliminating the individual mandate, combined with such lesser acts of vandalism as eliminating cost-sharing reduction payments to insurers last year and eviscerating the outreach and advertising budget for the 2017 ACA open enrollment period: 6.4 million more people uninsured than under previous law, as the uninsurance rate climbs to 12.5% of the nonelderly population from 10.2%.
Health Insurance
Obamacare repeal bills could put coverage out of reach for millions of sick Americans  — Expansion of short-term non-compliant policies: 2.5 million more Americans without minimum essential coverage. Short-term policies, which were limited under the Obama administration to three months maximum and no renewals, would be expanded under Trump to last up to a year. Under the law, short-term policies don’t count as real Obamacare insurance.
— Premiums in the individual market: Higher by 18.2% in 2019 in “full-impact states” (41, plus the District of Columbia, which allow short-term policies under some circumstances.) Eight other states prohibit or limit the expansion of short-term policies, so their premium increases will be lower on average. Nationwide, premiums will rise by 16.4%. In Texas, North Dakota, Alabama, Nebraska and Arizona, the increases will exceed 20%.
— Because government premium subsidies rise in tandem with premium increases, the cost of subsidies borne by the government will rise by $33.3 billion next year, or 9.3% — to $391.4 billion from $358.1 billion under existing law.
The mechanism by which the GOP policies will crater the individual insurance market isn’t hard to understand. Both major initiatives — eliminating the individual mandate and offering bare-bones policies — siphon younger, healthier consumers out of the individual market.

Nov 15, 2017 | 9:45 AM  David Anderson, a health insurance expert at Duke University, understands why short-term policies will look like a good deal to young consumers feeling hale and hearty. Others, such as with preexisting conditions, won’t even be eligible to buy those plans, guaranteeing that higher-risk patients stay in the ACA pool. Anderson posits a 23-year-old earning $35,000. That consumer would think a full-scale Obamacare plan is a good deal only if he or she has “a significant medical history or reasonable probability of pregnancy.”
The economically rational response for the healthy in that segment would be to pay $100 or less a month in premiums and barely use any services over the course of the year. The danger, of course, is that anyone can get hit by a bus or find themselves holding an unexpected cancer diagnoses. Then they’re screwed.
“Those affected by these large premium increases would be disproportionately middle-income people with health problems,” the Urban Institute researchers said. That’s because “they prefer health insurance that covers essential health benefits, are unlikely to have access to medically underwritten short-term limited-duration policies, and are not financially protected by the ACA’s premium tax credits.”
Millions of others, including the U.S. taxpayer and families who need treatment and have incomes too high to be subsidized, also are screwed. That includes families with household incomes approaching or exceeding 400% of the federal poverty line: $48,560 for an individual and $100,400 for a family of four.
The damage estimate can’t be restricted to the immediate impact on individuals and families, the researchers observed. “As healthier enrollees exit for short-term plans, insurers will by necessity reexamine the profitability of remaining in the compliant markets. This may well lead to more insurer exits from the compliant markets in the next years, reducing choice for the people remaining and ultimately making the markets difficult to maintain.”
In other words, the Republican sabotage will continue to undermine health coverage in the U.S. The only alternative, it becomes clearer with every day, is some form of single-payer, Medicare-for-all coverage. That’s increasingly becoming part of Democratic Party orthodoxy, and it’s about time.


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Opinion: Healthcare Bill Is About The GOP Saving Itself, Not American Citizens

By Demetrius Harris on Sat, Sep 23rd, 2017 at 2:24 pm

The latest attempt by the GOP to replace Obamacare has nothing to do with providing coverage for American citizens. Members of the Republican Party are simply trying to save their political careers as opposed to saving the lives of the constituents that they serve.

The latest attempt by the GOP to replace Obamacare has nothing to do with providing coverage for American citizens. Members of the Republican Party are simply trying to save their political careers as opposed to saving the lives of the constituents that they serve.

After years of promising to repeal and replace the ACA package, the GOP is backed into a corner, and their response is to institute an insidious bill, that denies coverage to those who need it most. Pushing the bill out for vote without the benefit of proper examination and debate is a sign of underhandedness and trickery.

Republicans have placed their personal career goals above and beyond the specter of a comprehensive, inclusive healthcare package that would benefit the entire country. It should be mentioned that the effort to repeal and replace the ACA, was from the very beginning, a political maneuver designed to eradicate legislation by Barack Obama without merit.

Led by the father of all fools, Donald Trump, the GOP have attached their success as a party to hollow promises made without vision or expertise. The result is a bill that has GOP members like Iowa Senator Chuck Grassley, to openly admit that he intends to vote in favor of the bill, simply because Republicans have to deliver on their campaign promises. He says this while also conceding that the bill provides at least ten reasons to be voted down. In the eyes of the GOP, doing the despicable is better than breaking a campaign promise.

(Continued Below)

When you consider the potential for 32 million people losing coverage, UNLIMITED rising premiums and noncoverage of pre-existing conditions how can any GOP member vote yes for this package in good conscious?

Republicans who are seeing their political careers flash before their eyes in regards to 2018 midterm elections are operating without conscious, care or duty to country. The GOP have put votes and policy above the well-being of taxpayers. They have put the survival of party over the survival of your family.

Republicans have proved without a shadow of a doubt, that they are a collection of self-serving, conniving liars. Now that it’s clear that the drowning GOP has decided to use this reprehensible healthcare package as a life preserver for their party let’s make sure that they are the ones dead in the water in 2018. RESIST…


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‘Sacrificing Democracy’: Senate GOP Plans to Hide TrumpCare From US Public

“Republicans know their healthcare bill is super unpopular and so are trying to shield it from public scrutiny,” wrote Nate Silver
Jake Johnson, staff writer

“We have no idea what’s being proposed,” said Sen. Claire McCaskill (D-Mo.). ((Photo: Moriah Ratner via The Hill)
In an act of secrecy denounced by one commentator as “an insult to Americans and our democratic process,” two GOP aides told Axios on Monday that although the Senate will soon complete its version of the widely panned American Health Care Act—also known as TrumpCare—the bill will be withheld from the public indefinitely.

“We have no idea what’s being proposed. There’s a group of guys in a back room somewhere that are making decisions.”
—Sen. Claire McCaskill

Explaining the reasoning behind the Senate’s lack of transparency, one of the aides remarked, “We aren’t stupid.”

Once the bill is complete, Axios’s Caitlin Owens reported, it will be sent to the Congressional Budget Office (CBO) to be scored.

“It’ll take CBO about two weeks to evaluate and score a draft bill,” Owen added. “Senate Republicans then want to vote on the bill before the July 4th recess.”

On social media, commentators were swift in denouncing the move as hypocritical and undemocratic. Nate Silver of FiveThirtyEight observed, “Republicans know their health care bill is super unpopular and so are trying to shield it from public scrutiny.

Before Axios’s reporting made clear the Republicans’ intentions to keep their deliberations secret, Sen. Claire McCaskill (D-Mo.) castigated her colleagues during a recent Senate Finance Committee meeting for keeping the Congress and the public out of the health care loop.

“We have no idea what’s being proposed,” McCaskill said. “There’s a group of guys in a back room somewhere that are making decisions.”

She continued:

We’re not even going to have a hearing on a bill that impacts one-sixth of our economy. We’re not even going to have an opportunity to offer a single amendment.
Andy Slavitt, who served as acting administrator of the Centers for Medicare and Medicaid Services from 2015 to 2017, also took aim at the GOP’s tactics in a Washington Post op-ed published over the weekend, accusing Senate Republicans of using “three tools” to ram through their wildly unpopular health care plan: “sabotage, speed, and secrecy.”

Slavitt noted that the architects of the health care plan face a vexing dilemma: “What to do with a bill that is clogging your agenda but only 8 percent of Americans want you to pass and members of your own caucus swore was dead on arrival?”

Instead of rewriting the bill from scratch and attempting to adopt measures that would make it less harmful—previous CBO estimates indicated that if the House version of TrumpCare were implemented, 23 million people would lose insurance—the Senate has instead decided to recede into the darkness, shielding their deliberations from criticism and keeping crucial information hidden from the public.

News that the Senate is planning to send their version of TrumpCare to the CBO without making it public comes as reports have indicated that “moderates” within the GOP who previously insisted that Obamacare’s Medicaid expansion be maintained are caving quickly under pressure from their fellow Republicans.

And as the Huffington Post recently reported, Senate Majority Leader Mitch McConnell (R-Ky.) is attempting to capitalize on the attention being paid to other matters—namely former FBI James Comey’s recent testimony—to quietly pass deeply significant legislation.

“How bad is the Senate health care bill likely to be?” the official Twitter account of House Ways and Means Committee Democrats wondered. “So bad that they can’t share it with the public, apparently.”

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