Very sick, not fully covered: Attended by Dr. Evil
(Is he dead yet)
Extremely critical issue for the 2018
midterms and beyond:
Perhaps the #1 issue on the table — since it affects us all.
Update
on GOP Drive to Repeal and Replace the ACA a quick analysis and although a long post, it has things that need to be said for clarity — enjoy.
Republicans
last year succeeded in repealing the Obamacare requirement that people buy
health insurance or pay a tax penalty – the
so-called ACA mandate.
Trump said that
repeal would end Obamacare – it has not and in fact has caused more bad than
good contradicting Trump’s: “I’ll
give you the best program ever – believe me.” Um, well Mr. Trump: We
have proof otherwise – see below:
Purpose of the original
ACA mandate: Get
everyone insured to get lower prices for everyone with the basic same basic and
necessary care. That did not work as hoped or planned and many reasons linger
more so today
under Trump – the so-called Fixer – more below shows he is not fixing
anything.
However, now without the mandate more
troubles have evolved:
1. To make
up for the losses, insurance companies have had to (and many have already) charged
more to the sick or medically vulnerable patients left behind and already with
fixed premiums.
2. Premiums
set by Trump have risen 232% and with less coverage.
Trump/GOP
created the so-called “skinny” plans (official name: “Association Health Plans-AHP”) back
in June 2017 some results:
1. They allow insurance companies to offer cheaper
yet less-comprehensive policies.
2. These “skinny plans” only last up to one year,
then customers start hunting all over again.
3. Since these plans are short-term only up to
one year (I note: That sounds like a new cell phone or cable deal wherein they
get you hooked on a bargain change deal. But, READ THE FINE PRINT, which only
lawyers do. They say small print: “New customers only - only for one year” –
then what: We are supposed to just hide, go away, get sicker, or die?)
4. Companies after one year can charge higher
premiums or deny coverage based on medical history and pre-existing conditions,
which BTW: Obamacare made illegal for long-term plans and people love that part.
5. These new
skimpy or skinny plan initially appeal to young, healthy Americans (that is until
they get in a health emergency and then back to someone else paying as they hit
the ER’s – something also Obamacare said was not totally necessary except in
real emergencies – not routine care that yes, even young people seek and need
too despite their views on that).
6. Some AHP’s may not/do not for example cover basics like Rx
drugs or maternity care.
Other
Trump plans harm:
Initially, under
the ACA users had 90 days to sign up for insurance on the federal marketplace –
Trump cut it down to 45 days, and then customers saw the on-line websites closed
every Sunday for 12 hours – citing maintenance.
One cause for the “maintenance” shutdowns: The Obama “Navigator
program” funding which trained people and companies to help people sign up for
insurance dropped from $62.5m to a mere
$10m under Trump. (More saving they can brag about, I guess).
BTW: Trump also cut
Obamacare advertising to $10m – a 90% reduction.
Ending
cost-sharing reduction payments:
Cost-sharing
reduction (CSR) payments from the government to companies reimbursed them for
covering lower-income Obamacare patients.
Trump cancelled
that system and payments in October 2017 and immediately insurance companies increased
their 2018 premiums to offset that programs and thus compensate themselves for
any losses.
One bright
spot is that ending those CSR payments had little effect on lower-income
Americans – they still receive other healthcare subsidies to help them maintain
a good plan, but that in turn led to higher costs for patients who pay
full-price for their medical coverage.
It is obvious
that “Trump-care” is not thinking about the little people.
What is
the overall impact?
1. Obama's signature accomplishment – the ACA – basically
is still in good standing.
2. The 2018
government report (CMS: The Centers for Medicare & Medicaid
Services) shows 11.8 million Americans re-enrolled in Obamacare plans, and 27%
were new users.
3. That is around 400,000 fewer people than 2017,
and a smaller figure than expected given Trump’s efforts to wipe out Obama
entirely.
Key Study Points:
Gallup found
55% of Americans worry about having access to and affording good medical care –
the 5th year healthcare has topped issues.
Gallup also
reported the uninsured rate had dropped to a record low 10.9% in 2016, but has risen to 12.3% under Trump (that he said would
not happen).
Reminder: What does the existing law do?
The Patient Protection and Affordable Care Act, known
as Obamacare or the ACA, was the largest overhaul of our healthcare system
since the 1960s.
1. It aimed to eventually slow the growth of healthcare
spending, which was still is the highest in the world.
2. It intended to extend
health insurance coverage to the estimated 15% of Americans who lacked it and
were not covered by other health programs for the poor and elderly.
3. It created by law, state-run marketplaces - with websites akin to online shopping sites -
where individuals can compare prices as they shop for coverage.
Some of the
more popular provisions included:
1. Children can
stay on their parent's health care plan until age 26.
2. No one can be
denied insurance for a pre-existing medical condition.
3. Companies
can no longer charge women more than men.
4. Businesses
with more than 50 full-time employees must offer health insurance.
So, why
do conservatives still oppose the ACA (Obamacare)?
They say –
as they say about most things not their idea – it imposes too many costs on
business, with many describing it as a “job killer.”
However, under
Obamacare, healthcare sector jobs rose by 9%. A 2017
study found that around 2.6 million jobs could be lost by 2019 if
it is repealed under Trump.
They decry
Obamacare as an unwarranted intrusion into the affairs of private businesses
and individuals.
Noteworthy:
1. During the Obama presidency, the
GOP-run House voted over 50 times to repeal the ACA and twice forces a partial
government shutdown.
2. After
repeated legal challenges, in 2012 the Supreme Court declared Obamacare
constitutional.
3. Despite
having a majority on Capitol Hill under President Trump, a Republican repeal
bid again failed
and in dramatic fashion this year.
3. Democrats many
times have acknowledged ACA is not perfect and they have offered numerous times
to work with the GOP to fix any flaws. The GOP refuses out of stubborn
arrogance.
Related must-read sites:
Also related – short article from a Kaiser
Family Foundation analysis they found that individual market
performance insurers have become profitable again in 2017, and the first half
of 2018.
• Insurers'
gross margins are getting better. The margins — which measure how much their
income from premiums exceeds their costs — are far higher than at any time in
the history of the ACA.
• Their
second-quarter loss ratios for 2018 averaged 69%, lower than at any point since
the earliest years of the ACA.
• Between
the lines: Premiums went up a lot between 2017 and 2018 (an average of 23% per
member for the second quarter of each year).
B/L and what to watch: There are signs that the ACA population may be both older and sicker, having spent more days in the hospitals in the past 3 years. If so, that could be a sign that healthier customers are dropping out.
My 2 cents: Obama
made promises, even with minor fixes (which were needed and the GOP hated in
total resisted) was and based on the above working.
Any blame for
rising costs, lack of good affordable, full-coverage plans, may I suggest the
GOP collectively seek the nearest mirror – they will see a reflection the cause
and ineffectiveness of their “resistance” – which they keep blaming on a
program that has, is, and continue – but they will not – they are too stubborn
and arrogant. Case closed.
But, the good
news is outlined above with the more-recent awful Trump steps.
So, I say: Thanks Mr. Obama — sorry, Mr. Trump
Empire, Inc., not even close.
Thanks for
stopping by.
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