Here We Go Again

Posted: April 8, 2014 by Marner in Uncategorized

It must be an election year. Once again, some Republicans (this time in the Senate) have put forward a “plan” to replace the Affordable Care Act. Just like every one that has come before it, it is nothing more than a collection of old Republican talking points with little substance behind them, no idea of what it will cost, and no ideas on how to pay for it.

The Republican Senators, Hatch, Coburn, and Burr, start off in the most predictable way: repealing the ACA. I really wish these guys would get some new material, because this line is getting tiresome. Anyone with a brain larger than a peanut knows that Obama will veto any attempt to repeal the ACA and the Republicans will never hold enough seats to override the veto. Anyone that argues that repeal is even remotely an option (Cruz) is blowing smoke straight up your ass. Now these guys are not only saying that the ACA must be repealed, but they are exempting from repeal all changes to Medicare. Those would remain in effect, including the hundreds of millions of dollars they claim Obama cut from Medicare. It would also keep cuts to Medicare Advantage that Republicans have been so worked up about. I guess they’ve given up on trying to get any traction with those. But let’s just overlook this repeal pandering and get to their proposal.

To their credit, these Senators do maintain the ACA provisions that poll well, sort of. They keep the ability of parents to have their children on their plans until they turn 26, but then they tell the states they can opt out of that requirement. They still eliminate benefit caps and also state that insurers can’t kick people off their plans when they cost too much. One other provision they sort of keep is the ability to change plans without regard to pre-existing conditions. The catch is that the customer can’t have a break in coverage. If you lose your job and can’t afford to pay for insurance for a few months until you find a new job, it sucks to be you.

The ACA restricts age-adjusted premiums to no more than three times the premium for a healthy young person. The Republican plan would increase this ratio to five times. If you think Boehner’s upset about how much he has to pay as a smoker in his 60’s now, just wait until he sees his bill under this plan! But it’s not enough for them to raise seniors’ rates another 60%+. No, they say that if a state wants to increase that ratio even more, or just eliminate it altogether, they only have to pass a law stating so. That’ll certainly go over well with the AARP crowd.

This plan does offer a tax credit for people earning up to 300% of Federal Poverty Level, while the ACA goes up to 400%. For someone age 35-49, the credit is $2,530 per year. That only comes out to $211 a month, but it’s a tax credit so you wouldn’t see it until you filed your taxes. Given that this plan eliminates price caps, I don’t see that credit going very far.

As expected, this Republican plan eliminates the individual mandate, but does nothing to answer the question of how to keep premiums down with a self-selected pool. They also dust off the old idea of state high-risk pools, but with no explanation of how states can afford to run them without charging premiums that are way too high for anyone to afford. One other old idea they resuscitate is allowing insurers to cross state lines. That will lead to states allowing insurers to go back to issuing the worthless policies that are now forbidden, but reciprocity would force other states to recognize those policies as valid.

These Senators haven’t given up on their desire to privatize Medicare by allowing states to use Medicare funding to enroll people in private plans. They also make the obligatory call for tort reform, even though it would result in less than 1% in savings for health care costs.

In reality, this “new” plan is no different than the old plans that have been floated previously. If enacted, it would do nothing but leave more people uninsured than before the ACA and increase the costs of those who are able keep their insurance. Medicare would eventually be privatized and patients would lose the ability to be compensated for damage done to them by doctors. I’m sure someone thought this plan was a great idea, but it was probably the same person who thought shutting down the government was a brilliant strategy. The rest of us see it for what it is: a desperate attempt to keep the base riled up.

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