Muftic: The Republican’s health-scare bill (column)
March 21, 2017
Sen. Angus King (I-ME) recently called the GOP/Trumpcare replacement plan for the ACA/Obamacare,"Shift and shaft; repeal and wreck." The legislation is now going through the Republican dominated House of Representatives. King is not the only one opposing it: So have American Medical Association and the American Hospital Association, the insurance company trade association, and the American Association of Retired Persons (AARP.) Some conservatives also oppose it because they want to do away with any insurance premium subsidies as being "socialism."
The GOP purrs no one will lose health insurance who has it today under Obamacare/ACA. That's today, but by 2018, and many millions of individuals will realize they have been shafted.The Brookings Institute estimates fifteen million more than today will be uninsured and the Congressional Budget Office estimates fourteen million by 2018. Premiums on individual markets will rise first but ten years later they will decrease only by 10 percent over now but 58 million will be uninsured by then, close to pre-Obamacare figures. It saves $ 300 billion reducing deficit in ten years by dropping Medicaid expansion and reducing subsidies (tax credits) to one half of Obamacare subsidies. Medicaid expansion being phased out affects 11 million now in that program as are 7 million seniors in nursing homes. Yes,the GOP reassures us, it will be patient-centered because patients can make more choices. Some choice when 24 million more than now cannot even afford premiums much less make choices of insurance plan benefits.
What is wrecked is the mechanism used to finance premium subsidies and the coverage of pre-existing conditions. Obamacare/ACA depended on taxes on the top 1 percent and others. The ACA put those who have high demand on health care, such as seniors and those who were sick, into large pools that included those with less frequent use of services paying in, too, to spread the cost of premiums around. $600 billion of taxes are being eliminated, mostly benefiting the rich, and the pools are being broken up into segregated ones for high users and/ or charging some more for fewer benefits.
.The shaft to consumers who still can afford premiums is that their benefits they get now will become optional and their premiums, especially paid by Americans over 50 years old, will pay 25 to 35 percent more per AARP. No longer required to be included in all insurance plans would be such benefits as prescription drug coverage, annual physicals, no-copay cancer screenings, prenatal/maternal care, and mental health and drug rehab coverage. These will become optional benefits for which you must pay extra or pay for them out of your own pocket or will not be included in your "affordable" policies which shrink to the catastrophic coverage category.
The shift is obvious. "The bill would cut more than 20 taxes enacted under President Barack Obama's heath law, saving taxpayers nearly $600 billion over the next decade. The bulk of the money would go to the wealthiest Americans" per an Associated Press analysis. The burden would be shifted to the the poor and older Americans . While The Trump/GOP plan calls for reduction and elimation of Medicaid expansion, older Americans will also shoulder the burden. Obamacare subsidies were based on income but Trumpcare would base tax credits on age, providing only $4 thousand tax credits to older people, yet permitting insurance companies to charge five times the premium costs of younger customers .
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