Friday, June 23, 2017

Senate Healthcare Bill

CNN Comparing Senate Bill to ACA and the House Plan

I don't have much to add here and I need to go to sleep. :-)

Thoughts?

24 comments:

Anonymous said...

Donald Trump's tax cut for his family and his wealthy friends has to be paid for somehow. Snouts at the public trough need to be fed.

--Hiram

John said...

Hiram,
Please remember that technically these successful folks are not feeding at the public trough.

ACA required them to take more "feed" from their personal barns and deposit it in the public trough. From which tens of millions of our fellow citizens eat from voraciously instead of expending the effort to fill their personal barn with knowledge, skills & feed.

This new proposal would just be undoing what ACA did by letting the successful people keep more of what is theirs.

I am not saying if this is good or bad, just noting the difference.

Sean said...

This bill is going to kick ~20 million Americans off of health insurance so that wealthy people can pay 3.8% less tax on their capital gains (retroactively, no less!). And if you think it's just the unvirtuous that are going to be affected by this, you're wrong.

For instance, 75% of people who have long-term stays in nursing homes end up using Medicaid at some point and those cuts are going to be devastating (that's a lot of middle-class families who don't have to empty their savings today so Grandma or Grandpa has a place to live but will be forced to in the next decade).

This bill fundamentally is opposed to the promises the President and Congressional Republicans made during the campaign. It will raise premiums for many, and out-of-pocket costs will go up dramatically. Subsidies to help low-income people buy health insurance will be available to fewer people, and the value of those subsidies is calculated based on a plan that only covers 58% of medical expenses versus 70% under the ACA. By eliminating the individual mandate, this bill eliminates the need for young, healthy people to get in the market thereby encouraging the so-called "death spiral" they claim the ACA is in today.

This bill is bad public policy that will produce worse health outcomes for Americans. Worse than that, it is cruel -- lavishing money on the wealthy while it whacks basic health care for the poorest and sickest among us.

Anonymous said...

"From which tens of millions of our fellow citizens eat from voraciously..."

Yes. How dare people want health care.

Moose

Anonymous said...

Please remember that technically these successful folks are not feeding at the public trough.

Do they consume less at the public trough if they do it untechnically?

--Hiram

Anonymous said...

Trump needs to find a trillion dollars in savings to fund tax cuts for his kids and his wealthy friends. He is getting it by taking away health insurance from 24 million Americans. It's as simple and as contemptible as that. .

--Hiram

John said...

Again, social services should be a state responsibility and that is all this bill does. Moves the funding mechanism and details back to the states.


So lobby your local politicians and neighbors of you don't trust them to take care of our less fortunate neighbors.

I trust them and our local charities to do so.

John said...

Hiram, yes

Sean said...

The history of block granting federal programs or leaving such things up to the states hasn't been all that great IMO, as we discussed in the welfare thread not that long ago. Do you have some examples that you can point to where states have developed significantly improved ways of providing social services? Because I'd love to hear about them, if they exist.

Anonymous said...

Again, social services should be a state responsibility and that is all this bill does

No, social services should meet the needs of people who need them. States don't need them. No state has ever been treated for cancer. No state in the history of mankind has ever been vaccinated. No state in the history of the universe has ever been cared for by a home service worker. No state has ever worked in a mine in Kentucky. Not one.

--Hiram

Anonymous said...

Do you have some examples that you can point to where states have developed significantly improved ways of providing social services?

The states want the money from block grants so they can cut taxes. Residents who have a problem with that are encouraged to move elsewhere. I spend a lot of time in Florida, and I don't know how many times I have been told that they plan to move back to a real state when they feel they will need health care to be paid for, of course, by the taxpayers of that state.

--Hiram

John said...

Sean, To list which is better one has to determine criteria of what is good / bad,

I think this is best done at the state level.


People in Wyoming likely see success differently than people in MN.

John said...

Hiram, You are so funny. :-)

And if I remember correctly the mm dems raised taxes even after ACA raised taxes.

Sean said...

"People in Wyoming likely see success differently than people in MN."

Do they treat cancer differently in Wyoming than they do here?

Sean said...

The shredding of the ACA's essential health benefits is going to have huge impacts on people in the private employer health insurance market as well.

Currently under the ACA, large employer plans (which cover 86% of people who have health insurance through their employer) can't impose yearly or lifetime caps on insurance coverage and they have to have out-of-pocket spending limits. Those caps and limits only apply to items covered as essential health benefits.

But here's the catch -- large employer plans only have to comply with the EHB of one of the states they are offered in. Under the ACA, with a common set of EHB, that's not a problem. Under the BRCA/AHCA, though, that becomes problematic. If just one state lowers their EHB standard, the large employer plan could adopt that state's EHB and apply it to every other state they sell in.

Ah, but wait -- it gets worse! States who want to keep the full EHB are prohibited by federal law from forcing these large employer plans to comply with state standards if the large employer plan is self-funded. That's true for 70% of large employer plans representing over 75 million people.

So, in Appelen World, the people of Wyoming could very well in fact be deciding the sort of health insurance you have here in Minnesota.

John said...

Good thing my politics are like Wyoming voters then.

Sean said...

Once again, your positions on health care have devolved into complete incoherence.

Sean said...

It should also be pointed out that eliminating EHB substantially weakens pre-existing conditions protections. (If, for instance, mental health is no longer treated as an EHB, insurers can refuse to offer a person with a history of depression a policy that covers mental health care or they can charge them up the wazoo for it.)

John said...

And again you are thinking the absolute worst of business people and state level politicians.

John said...

Maybe my opinion devolves because I am relatively uninterested in the topic.

All these laws do is move money around. There is little in them to push people to live healthier.

John said...

Speaking of which, my blood draw is Monday. We will see if my healthier eating and losing -14 pounds improves my results.

Sean said...

"And again you are thinking the absolute worst of business people and state level politicians."

I'm reflecting reality. Why do you think that most credit cards in this country are issued out of one of three states: South Dakota, Delaware, or Nevada? And why do you think health insurance companies will operate differently than banks?

John said...

We got next years planned premiums and the folks participating in the healthy living program are seeing a significant reduction.

Whereas the others are seeing increases.

Sean said...

Disaster