How Many Republicans See Their Own “New Plan”
(Oops)
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)
(My Choice: The GOP-careless).
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
Five-Thirty-Eight
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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