#MAGA TrumpCare: What You Don’t Know About The #AHCA Will Kill You | Blog#42
According to a newly released poll, only a minority of Americans know what’s in the new healthcare bill the Senate is about to vote on:
Just 38 percent of people polled knew the Republican health care bill makes major cuts to Medicaid.
The Senate version of Trumpcare goes even further, according to the draft released by Sen. Majority Leader Mitch McConnell (R-KY) on Thursday, effectively phasing out Medicaid entirely.
But according to a new poll released by the Kaiser Family Foundation on Friday, only 38 percent of Americans are aware of the significant cuts to Medicaid that would be delivered by the House-passed bill (the poll was conducted before the details of the Senate bill were made public). Seventy-four percent of those polled, meanwhile, said they have a favorable opinion of Medicaid.
I normally provide analysis here – not news. Just this once, and just for you, I have collated news about TrumpCare, AKA the American Health Care Act (AHCA). Just for you, I have also included, at the very end of this post, a handy list of news sites for you to vary your daily news diet and stay well-informed.
First things first, here is the actual bill released by Senate Republicans on Thursday, June 23rd. I include it so you can go see that what is in the news stories is the actual truth.The Senate Discussion AHCA Bill
Side by Side Comparison of Obamacare and TrumpCare
The Los Angeles Times did a very thorough comparison between Obamacare and TrumpCare. Click here to see the full article
Cuts to Medicaid spending in the House version totaled $834 billion; the Senate version would likely cut the funding more dramatically, which will affect low- and moderate-income Americans. Expanded Medicaid coverage would cease and the funding structure would change.
Under the Affordable Care Act
- The federal government and states share the cost of insuring the poor. The amount of money that Washington gives each state varies depending on how much medical care that state’s Medicaid patients receive
- The federal government is picking up almost the entire cost of expanding Medicaid coverage to low-income adults without children in the 30 states (and the District of Columbia) that have chosen to expand their programs
Under the GOP proposal
- Will replace current Medicaid with a fixed per capita cap or a block grant. Each state would have a fixed amount of money every year. That amount would increase annually by a percentage linked to the inflation rate, though the rate would be lower than in the House bill, meaning deeper cuts.
- The expansion of Medicaid benefits currently offered under Obamacare would be phased out beginning in 2020 and shut down completely by 2024
- A fixed per capita cap or a block grant would replace the decades-old current system. Each state would have a fixed amount of money every year. That amount would increase annually by a percentage linked to the inflation rate
- The additional federal funding that covered expanding Medicaid would be eliminated by 2020
The Kaiser Family Foundation is a well-known, reputable source of healthcare analysis and news. Click here to see their analysis and a an interactive map of premiums and tax credits comparison between Obamacare and TrumpCare. It is there that using data that applies to you, that you can compare what you are getting now under Obamacare and what will happen under TrumpCare.
“Under the ACA, people with incomes from 100% to 400% of the poverty level are eligible for tax credits. Premium caps in 2020 will vary from 2.4% of income for a household at the poverty level to 10.2% at 400% of poverty ($50,000), according to Kaiser projections. The caps do not vary by age. The benchmark plan under the ACA is a silver plan with an actuarial value of 70%, meaning enrollees pay for an average of 30% of their health care expenses through cost-sharing.
Under the BCRA, people with incomes up to 350% of the poverty level are eligible for tax credits (including people with incomes below poverty). Under the BCRA, premium caps vary by age and will range in 2020 from 2.4% of income for a household below the poverty level (<$12,500 in 2020), to 17.4% of income for a 60 year old at 350% of poverty ($43,750). The benchmark plan under the Senate bill is a plan with an actuarial value of 58%, meaning enrollees pay for an average of 42% of their health care expenses through cost-sharing.”
(Washington Post, 6/26)
That’s the CBO’s estimate of how much insurance premiums would rise for elderly and low-income people over the next decade under House Republicans’ version. In a report filled with brutal numbers for Republicans, this may be the most brutal.
Republicans said their bill will make health insurance cheaper. Except, under Obamacare, 64-year-olds making $26,500 a year are on track to pay $1,700 in annual premiums in 2026. And under the House GOP bill, they would pay anywhere from $13,600 to $16,100.
Watch for: Premiums were predicted to be so sky-high for older, sicker Americans because House Republicans’ bill would allow states to roll back Obamacare’s protections for people with preexisting conditions. (Insurers could charge whatever they want for sick people, pricing them out of the market, said Gary Claxton, a health-care policy expert with the nonpartisan Kaiser Family Foundation.)”
BY MALLORY SHELBOURNE (The Hill)
The nonpartisan budget analyst attributed the drop to the GOP’s plan to repeal ObamaCare’s two central mandates: the requirement to have health insurance and the requirement that most large employes provide it.
“Under current law, the prospect of paying the employer mandate penalty tips the scale for some businesses and causes them to decide to offer health insurance to their employees. Thus, eliminating that penalty would cause some employers to not offer health insurance,” the CBO wrote.
“Similarly, the demand for insurance among employees is greater under current law because some employees want employment-based coverage so that they can avoid paying the individual mandate penalty. Eliminating that penalty would reduce such demand and would cause some employers to not offer coverage or some employees to not enroll in coverage they were offered.”
After Decline Of Steel And Coal, Ohio Fears Health Care Jobs Are Next
“”Ten years ago, we had steel. Ten years ago, we had coal. Ten years ago, we had plentiful jobs,” says Mike McGlumphy, who runs the job center in Steubenville, Ohio, the Jefferson County seat.
Today, the city on the Ohio River is a shell of its former self. And health care has overtaken manufacturing as the county’s main economic driver.
1 in 4 private sector jobs in the county are now in health care. The region’s biggest employer by far is the local hospital. Trinity Health System provides about 1,500 full-time jobs and close to 500 part-time jobs, more than Jefferson County’s top 10 manufacturing companies combined.”
“Texas-based donor Doug Deason has already refused to host a fundraiser for two members of Congress and informed House Majority Leader Kevin McCarthy, R-Calif., his checkbook is closed as well.
“Get Obamacare repealed and replaced, get tax reform passed,” Deason said in a pointed message to GOP leaders. “You control the Senate. You control the House. You have the presidency. There’s no reason you can’t get this done. Get it done and we’ll open it back up.”
Indeed, there was a sense of frustration and urgency inside the private receptions and closed-door briefings at the Koch brothers’ donor retreat this weekend in Colorado Springs, where the billionaire conservatives and their chief lieutenants warned of a rapidly shrinking window to push their agenda through Congress and get legislation to President Donald Trump to sign into law.”
June 26, Politico
“The White House and Senate GOP leaders have nearly $200 billion in savings to divvy up among senators’ priorities to secure votes for the imperiled bill.
A Congressional Budget office score that projected 22 million fewer Americans would have insurance under the plan sent some members fleeing Monday and left the bill in jeopardy of failing to have enough votes to even be called to the Senate floor this week.
But Republicans in the White House and in Congress were pleasantly surprised that the bill included more savings than they expected — and are trying to figure out if they can dole it out for votes.
The Senate has about $188 billion to play with.
Among the possible changes: More spending for health savings accounts to appease conservatives such as Sen. Ted Cruz and Sen. Mike Lee, according to three people familiar with the matter, and some additional Medicaid and opioid spending for moderates.”
“But over the past quarter-century, a very different pattern has emerged. President Bill Clinton’s tax and budget proposals passed by a single vote in the Senate—Vice President Al Gore broke a 50-50 tie—and with a 219-213 vote in the House. George W. Bush’s prescription drug plan passed 220-215 in the House, but only after GOP leaders held the vote open for hours. Barack Obama’s stimulus proposal won exactly 60 votes in the Senate—the bare minimum to avoid a filibuster—and his Affordable Health Care Act won the same 60-vote minimum. And the House’s bid to “repeal and replace Obamacare” passed earlier this year with 217 votes—one more than the bare minimum, due to vacancies. That bill was nearly defeated because of the polarization of the parties, and in particular the threat of primaries within the Republican Party by foes of anything that smacks of government regulation or taxes. Now, competing cross-pressures on Republican conservatives and moderates all but assure that McConnell will have almost no margin for error.
2. There’s Enormous Incentive Not to Let the President Lose a Key Vote
In every one of those key votes, the president prevailed. Why? Because, when the vote is that close, no member of Congress wants to be seen as the person who inflicted a poetical defeat on a president of his or her own party. Back in 1993, then-Senator Bob Kerrey—no fan of Clinton’s character or policies—decided at the last minute to support Clinton’s budget proposal, telling him: “I could not and should not cast a vote that brings down your presidency.” Further, these reluctant party members have often been rewarded with significant concessions. Clinton abandoned any effort at an energy tax to win over suburban Democrats; Obama’s health care plan bent heavily toward insurance companies to help win the support of Senator Joe Lieberman, whose state of Connecticut was home to many insurance companies. At Lieberman’s insistence, the bill also dropped the whole idea of a “public option,” a step toward a single-payer system dear to the hearts of more progressive Democrats.)
And in this case, concessions are even more likely because …
3. “Winning” Matters Way More Than What’s Actually in the Bill”
What Members of Congress Said:
“The new health care bill will cut $8 billion dollars from Medicaid, and begins the rollback on Medicaid expansion the Affordable Care Act championed.” PBS News
“For example, I’m for 100 percent repeal, that’s what I want, but if you offer me a 90 percent repeal, I’d probably vote for it. I might vote for 80 percent repeal.”
Senator Dean Heller, R-Nevada
Senator Ron Johnson, R-Wisconsin
(The Hill, June 25)
Sen. Ron Johnson (R-Wis.) said Sunday the Senate should not be voting this coming week on its healthcare bill.
“We don’t have enough information. I don’t have the feedback from constituencies who will not have had enough time to review the Senate bill,” he said on NBC’s “Meet The Press.”
“We should not be voting on this next week,” he said.
“Unlike the average college student, who spends their university years studying to pass the next midterm or, more realistically, planning their next alcohol-drenched bacchanalia, Paul Ryan stayed focused on loftier goals: denying health-care coverage for millions of low-income and elderly Americans. Or so he implied while defending his current effort to roll back Medicaid, via his unpopular plan to repeal and replace Obamacare, while speaking with National Review editor Rich Lowry at an event Friday hosted by the conservative magazine. “Sending it back to the states, capping its growth rate,” Ryan said wistfully. “We have been dreaming of this since I have been around, since you and I were drinking at a keg.””
Toomey defended the cuts, saying they were “necessary to make [Medicaid] a sustainable program.”
As the chairman of the Subcommittee on Health Care, Toomey helped spearhead the bill’s drafting process and the push for deep Medicaid cuts, which Democrats and some Republicans fear will force states to either eliminate coverage for many needy patients or assume a much more sizable chunk of the cost.
Toomey defended the bill in an interview with Bloomberg today, calling the Medicaid cuts “necessary to make [Medicaid] a sustainable program.” He said the bill had “gotten lots of outside input” during the draft process—but it was drafted without a single public hearing.
Here’s how the bill would work: Under current law, Medicaid is an open-ended entitlement program, meaning the government is required to match state expenditures for the costs of covered services to those deemed eligible (primarily low-income and disabled people). The Senate legislation would replace that program with a system of capped federal payments that would drastically reduce federal spending over time.
That means states would be forced to decide whether to scale back on coverage or raise a significant amount of funding, likely through taxes or budget cuts, to make up the difference.
In addition, the bill would eliminate the ACA’s mandates to buy coverage and repeal tax increases designed to pay for the ACA, effectively resulting in tax breaks for the wealthy.
Think Tanks and Newspaper Analyses
“Officials with the conservative U.S. political network overseen by the Koch brothers say they are unhappy with the healthcare bill that may be voted on by the Senate this week and will lobby for changes to it.
At a weekend event with conservative donors, top aides to Charles Koch, the billionaire energy magnate, said the Senate bill does not go far enough to dismantle former President Barack Obama’s signature healthcare law, also known as Obamacare.
“We have been disappointed that movement has not been more dramatic toward a full repeal,” said Tim Phillips, president of Americans for Prosperity, a grassroots advocacy group backed by Charles Koch and his brother, David.”
Michael Hiltzik, Los Angeles Times
Senate Republicans finally revealed on Thursday why they’ve been crafting their Affordable Care Act repeal in secret. As the newly released draft shows, it’s a rollback of health coverage for millions of Americans that could cost the lives of tens of thousands a year.
But make no mistake: This is not a healthcare bill. It’s a tax cut for the wealthiest Americans, paid for by a reduction in government funding for healthcare. The measure would constitute one of the largest single transfers of wealth to the rich from the middle class and poor in American history.
Senate Majority Leader Mitch McConnell, the ringmaster of this circus, says the bill will be scheduled for a vote next week.
Stakeholders and experts in healthcare have been bracing for the details of the Senate GOP draft for weeks, or ever since a small group of Republican senators began working on it behind closed doors. The Senate has scheduled no hearings on the draft. As my colleagues Noam Levey and Lisa Mascaro reported last week, they shut out not only their own Republican colleagues, but “major physician groups, hospitals, consumer advocates and organizations representing millions of patients with cancer, diabetes, heart disease and other serious illnesses.”
Under the Senate bill, low-income people would pay higher premiums for bigger deductibles.
— Larry Levitt, Kaiser Family Foundation
That didn’t keep some advocates from pounding on the door. CEOs of 10 health insurance companies, including Blue Shield of California, pleaded Tuesday in a letter to McConnell to protect Medicaid. The cuts being contemplated in that program would place an insupportable burden on the states, which share the program’s costs. States would have no options other than to blow up their budgets, throw thousands of residents off Medicaid, or drastically cut benefits.
What Cabinet-Level Officials Are Saying
Health and Human Services Secretary Tom Price
— AtlanticLIVE (@AtlanticLIVE) June 25, 2017
Tom Price questioned the ability of the agency to estimate the number of people who would lose health insurance under Congress’s Obamacare repeal-and-replace plan.
“Their ability—anybody’s ability—to predict what human behavior is going to be without looking at the entire construct, is difficult.”
What White House Staff Are Saying
— This Week (@ThisWeekABC) June 25, 2017
— ABC News Politics (@ABCPolitics) June 25, 2017
Reality check: Most of them have jobs already. (Huffington Post)
White House counselor Kellyanne Conway on Sunday came right out and said what so many Republicans are probably thinking ― that taking Medicaid away from able-bodied adults is no big deal, because they can go out and find jobs that provide health insurance.
Apparently nobody has told Conway that the majority of able-bodied adults on Medicaid already have jobs. The problem is that they work as parking lot attendants and child care workers, manicurists and dishwashers ― in other words, low-paying jobs that typically don’t offer insurance. Take away their Medicaid and they won’t be covered.
Sunday News Shows
ABC This Week with George Stephanopoulos
Meet The Press
David Brooks on CNN
Conservative New York Times columnist David Brooks told CNN on Sunday that President Trump’s political movement has not brought about the new conservatism some had hoped for. “I think he opened the door for a new kind of conservatism but has not fulfilled it,”
George F. Will interviewed by Lawrence O’Donnell on MSNBC
Columnist Charles Krauthammer On Fox News
Phil Donohue on CNN Reliable Sources
Many of you may remember Phil Donohue from his show years ago. This is an interview with him on CNN, Sunday, June 25th.
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