Friday, March 10, 2017

Trump-care or Ryan-care (AHCA vs. ACA) Two Views: (1) GOP vs. (2) Public Majority

How Many Republicans See Their Own “New Plan”

How Millions of Americans See the Two Plans
(Simple choice: “Move forward” or “Back to the Future”)

New GOP Healthcare Plan (AHCA) vs. Current ACA (Obamacare)

Added Quick Link from the KFF (Kaiser Family Foundation): An excellent source of side-by-side comparison of the ACA (2010) and the new AHCA (2017).

As we know the current health care law (ACA) has been renamed to now the AHCA (American Health Care Act) or more likely: Trump-care or Ryan-care.

(My Choice: The GOP-careless).
WHO LOSES, basically lower-income and seniors and well, read on to see more below - all could be left uninsured or they will drop out and return to ER’s for primary care (them watch the GOP cut that, too)!! 
Obamacare contains many provisions to help poor / lower-income Americans with expanded Medicaid who earn up to $16,400 a year (now some 11 million people in 31 states and DC). Those with incomes under $30,000 receive subsidies to help lower premiums, deductibles, and out-of-pocket costs.
Now, the GOP’s AHCA plan reverses much of that. It also proposes an end to Federal enhanced Medicaid funding for new enrollees starting in 2020. Those already in the program could stay as long as they remain continuously insured. But half will have a break in coverage each year so participation will fall off quickly.
THEN THIS HAMMER FALLS: The new bill then goes beyond just eliminating Medicaid expansion – it overhauls the whole Medicaid program (which now covers some 70 million people). The AHCA proposes to send states a fixed amount of money (like a block grant which the GOP loves – that’s all, what how you spend it attitude). That would be based on enrollees that the GOP calls “per-capita (per person) cap. Thus, that action alone limits Federal money by shifting any cost to states.
Paul Ryan has pushed this since day-one, so those needy better hope the money is there when they need it for care – a Rick Perry “oops” won’t suffice.
Problem is many states don't have the “extra” money to make up the difference. They would likely be forced to: (1) reduce eligibility, (2) curtail benefits, or (3) cut provider payments. That in turn hurts poor adults, low-income children, women, seniors, and the disabled. (Nice touch, Mr. and Mrs. Gee Old Poops, really nice touch).
The bill would also eliminate subsidies to help reduce deductibles and co-pays for moderate-income policyholders in individual markets. The tax credits it provides would not go as far Obamacare's subsidies do right now.
Plus these possible provisions:
1.  People making $20,000 a year take the biggest hit of any.
2. A 27-year-old would get only $2,000, instead of current $3,225 under Obamacare.
3. A 40-year-old would get $3,000 versus nearly $4,150 today.
4.  The biggest losers would be a 60-year-old, who would receive only $4,000, instead of nearly $9,900 now under Obamacare.
5.  Older Americans could have to pay more. 

Enrollees now 50’s and early 60’s benefit from Obamacare since insurers only charge three times more than younger policy holders. The GOP rule widens that band to five-to-one, which means that adults ages 60 to 64 would see annual premiums go up by some 22% ($3,200 – to nearly $18,000).
1.  Those 50 – 59 have a 13% increase (just over $1,500 – annually $12,800).
2.  GOP doesn't provide generous tax credits as Obamacare does, either.
i.e., a 60-year-old making $40,000 would get only $4,000- Obamacare is about $6,750. 
3.  The sick could get coverage (but may be limited). 
The Republican plan lifts the requirement that insurers cover a certain share of the cost of getting care. This change would allow carriers to offer a wider selection of policies, including more with higher deductibles and co-pays. That could make it more difficult to find plans with low deductibles that the sick often want. But, it does not lift the Obamacare provision that limits how much enrollees have to pay out of pocket each year (2017 max is $7,150).
GOP plan has stronger protections for those with pre-existing conditions than some earlier GOP plans proposed. It like Obamacare requires insurers to cover those patients and not charge them more because of their pre-condition health needs.

Now some winners – call them the “Lucky Dozen.”
1.  Younger Americans could get cheaper plans. Obamacare was designed so that younger policyholders would help subsidize older ones. That would change under the Republican bill because it would allow insurers to charge older folks more. Ages 20 to 29 would save about $700 to $4,000 a year.
2.  Those under age 30 would also get a refundable tax credit of up to $2,000 to offset the cost of their premiums, as long as their income doesn't exceed $215,000 for an individual. It's more likely that younger folks who are earlier in their careers would fall under this cap.
3.  The GOP tax credits would also likely be more generous than Obamacare's subsidies for these folks. (e.g., a 27-year-old making $40,000 a year would receive $2,000 – now only $103).
4.  The healthy could buy less expensive policies. Under Obamacare, only enrollees under age 30 and certain other people could buy catastrophic plans, which had lower monthly premiums but higher deductibles. In 2017, catastrophic plans came with $7,150 deductibles, but Obamacare enrollees couldn't use subsides to pay the premiums.
5.  The GOP plan opens up policies to everyone and allow enrollees to use tax credits. This change, however, may not have as big an impact since insurers already offer plans with high deductibles that are eligible for Obamacare subsidies.
6.  Higher-income Americans could pay fewer taxes, get more tax benefits since it: eliminates two taxes on the wealthy that helped pay for Obamacare.
7.  Nearly everyone in the Top 1%, who earn more than $774,000 a year, would enjoy a hefty tax cut, averaging $33,000, according to the non-partisan Tax Policy Center.
8.  Those in the Top 0.1% would get an average tax cut of about $197,000.
9.  And the bill would allow folks to contribute more to Health Savings Accounts, which are primarily used by better-off Americans who can afford to sock money away for health care expenses.
10. People higher on the income scale to claim the tax credit to help pay their premiums. Under Obamacare, an enrollee who makes more than $47,500 is no longer eligible for a subsidy.
11.  The GOP plan would let a policyholder making up to $75,000 claim the full tax credit. The benefit would phase out slowly until the enrollee hits $215,000 in income.
12. Insurance companies could get a big tax break. Obamacare allowed insurance companies to deduct only $500,000 of their executives' pay as a business expense. The GOP bill would repeal that limitation, starting in 2018. Top insurers pay their leaders millions in compensation every year so this provision could mean a nice tax savings for the companies.

Related good links:

From the New Yorker
From the LA TIMES a “Side-by-Side Comparison”
From CNBC – “It stinks”
From NBC NEWS – “What should we call it?”

The way I see the GOP and their “new” plan. As always it ends up being a gimmick that favors the rich and top crust while pandering to the rest about lower taxes, more jobs, less regulation, more for defense spending. The result:

GOP on repeal and replace — real truth.

In the end, as before, we see another slick fancy new label for an old product: “Trickle Down.”

When will they ever learn?

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