Friday, May 05, 2017

Breaking Down The GOP Health Care Bill

Yesterday, the republicans in the U.S. House of Representatives voted to replace the Affordable Care Act, otherwise known as Obamacare, with a new healthcare bill.  This new bill, a newer version of the radically unpopular bill that the House tried to pass several weeks ago, removes protections for people with pre-existing conditions (among other things).  This means, insurance companies would be able to charge those insured more money based on their health.  The Center for American Progress estimates the premiums for an otherwise healthy 40-year old with just one of the following pre-existing conditions to be rather daunting:

So if you have diabetes, for example, you can expect to see your annual insurance premiums increase by $5,600.  That's just your premium, it does not include medications.  

I've been doing A LOT of reading on this subject. I'm not going to cite any sources because all the information is out on the web if you want to find it.  It's not hard.  And I would venture to guess that I've probably spent more time researching this topic that most of the republicans who voted yesterday.

Why?  Because I am concerned for my own health, of course, but moreso for my parents.  This new bill will essentially decimate the coverage my mother receives for herself and the grants and funding she receives to help maintain my father in the nursing home.  Should this bill pass in the Senate, my parents are screwed.

So in the hope that you've read this far, allow me to break down for you the main components of the GOP's healthcare bill, fairly called so because not one Democrat or Independent voted for the bill:

1.  States can get waivers so insurance companies can charge more to people with pre-existing conditions.  The protections afforded by Obamacare will be removed.  Insurance companies will be able to charge whatever they want.  The actual list of what constitutes a pre-existing condition could be endless.  Below is a list of what some insurance companies consider to be pre-existing conditions.

If you have one of the above, expect to pay more for your insurance.  If you have more than one, expect to pay even more than that. 

2.  States can opt out of the rules that require insurance plans to cover basic stuff, like Emergency Room care, ambulance rides, hospitalization, prescription coverage, pregnancy.

3.  Expect things like mental health coverage and drug treatment coverage to whither.

4.  Under the ACA, insurance companies may charge an older person no more than three times its premium for a younger person with an identical plan. The new bill would increase the maximum allowable ratio to 5 to 1, which could significantly increase older people's premiums for comparable plans. States would be able to set different maximum ratios.

5.  Big companies no longer have to provide health insurance to their employees.

6.  There will no longer be a requirement to have healthcare.  But if you go 60 days without health coverage, you will be penalized if you rejoin a health plan.  You will see a 30% increase in your insurance premiums for the first year.

7.  While the ACA offers a scale of credits that take into account family income, cost of insurance and age, the GOP plan would offer flat tax credits per individual, focused on age. The House GOP bill would provide tax credits of $2,000 to $14,000 a year for individuals who don’t get insurance coverage from an employer or the government. The credits would be based on age instead of income and would be capped for higher earners.

People who are older, are lower-income or live in areas with high insurance premiums would likely receive smaller tax credits under the new bill than they do under the ACA. Those who are younger, have higher incomes or live in areas with lower insurance premiums would likely receive more government assistance than they currently do
Further breakdown:  a 64-year-old who makes $26,500 a year could see net out-of-pocket costs increase from $1,700 a year under the current law to $14,600 a year under the GOP plan, according to Congressional Budget Office estimates. A 40-year-old making the same amount would pay a few hundred dollars more after the tax credits, from $1,700 under Obamacare to $2,400 under the GOP bill.
8.  Medicaid.  Medicaid is getting cut by almost $900,000,000,000.  That's 900 BILLION dollars. 
First, the federal support of expanded Medicaid coverage, to those earning no more than 133 percent of the federal poverty level, would be rolled back. States that expanded Medicaid would no longer receive extra funds for new expansion beneficiaries after 2020.
People who receive Medicaid would be required to work unless they are disabled, pregnant or elderly.
Beginning in 2020, federal Medicaid financing would be changed to a per capita cap rather than a matching program, under which the federal government has supplied funds based on the number and needs of the enrollees.
Additionally, after 2020, state Medicaid plans would no longer be required to provide ACA-designated essential health benefits, including emergency services, pregnancy and newborn care, prescription drugs and pediatric services. Capping federal funds for Medicaid could have a huge impact on seniors and disabled children who depend on that coverage.
School districts rely on Medicaid to provide costly services to millions of students with disabilities across the country. For nearly 30 years, Medicaid has helped school systems cover costs for special education services and equipment, from physical therapists to feeding tubes. The money is also used to provide preventive care, such as vision and hearing screenings, for other Medicaid-eligible children.

9.  There is an upside to all this, though.  The new plan will provide a huge tax cut for the wealthiest Americans.  Those earning at least $200,000 per year will be among those who received a $300,000,000,000 (again, that's BILLION) tax cut.  So there's that.

Does all this scare you?  It should.  
To those who voted for Trump, this is what you asked for.
Thanks, from the rest of us.