ACA Replacement plan

[CommuterBob]

http://www.politico.com/story/2017/02/house-republicans-obamacare-repeal-package-235343

"The legislation would take down the foundation of Obamacare, including the unpopular individual mandate, subsidies based on people’s income, and all of the law’s taxes. It would significantly roll back Medicaid spending and give states money to create high-risk pools for some people with pre-existing conditions. Some elements would be effective right away; others not until 2020.

The replacement would be paid for by limiting tax breaks on generous health plans people get at work — an idea that is similar to the Obamacare “Cadillac tax” that Republicans have fought to repeal."

"In place of the Obamacare subsidies, the House bill starting in 2020 would give tax credits — based on age instead of income. For a person under age 30, the credit would be $2,000. That amount would double for beneficiaries older than 60, according to the proposal."

"According to the document, there’s only one single revenue generator to pay for the new tax credits and grants. Republicans are proposing to cap the tax exemption for employer sponsored insurance at the 90th percentile of current premiums. That means benefits beyond that level would be taxed."

"...the legislation would allow insurers to charge older customers up to five times as much as their younger counterparts. Currently, they can charge them only three times as much in premiums."

"The proposal also includes penalties for individuals who fail to maintain continuous coverage. If they have a lapse and decide to re-enroll, they would have to pay a 30 percent boost in premiums for a year."

The TLR of the cliffs: individual mandate gone, surtax penalty for not having coverage gone, insurers can hike up premiums, tax credits given to people based on age, the top 10% of employer-sponsored plans will be taxed as income, penalty for gap in coverage.

 

[UCFKnight85]

Young people should be given access to low premium/high deductible plans and allowed to invest in HSAs. Period. The government should not be gouging them for asinine plans that they'll never, ever use.

 

[goodknightfl]

Gov't needs to get out of it.

 

[KNIGHTTIME^]

Young people should be given access to low premium/high deductible plans and allowed to invest in HSAs. Period. The government should not be gouging them for asinine plans that they'll never, ever use.

That is the real problem with Obummercare. Younger people need cheap options and high deductibles are fine for them. They need to at least take the sickest 10% and get them on a separate program instead of forcing the healthy to pay for them. Then a credit for being under 40.

 

[Knight_Light]

They need to at least take the sickest 10% and get them on a separate program instead of forcing the healthy to pay for them. Then a credit for being under 40.

That's not how insurance actuary tables work. What insurance company would ever have a policy plan for only the sickest of the sick?

 

[KNIGHTTIME^]

That's not how insurance actuary tables work. What insurance company would ever have a policy plan for only the sickest of the sick?

That would be a separate program (and I hate another government program). This way they can negotiate lower rates for the most expensive people from drug companies and hospitals. The US gives gov't grants to drug companies so they can make it at least what other countries pay for the same drugs for those 10%.

Other 90% would be in the general insurance pool which would lower rates. 10% sickest would be outside the general ACA. The sickest are going to cost more than the 90%. Keep them separate and just work to reduce costs for them.

 

[Poolside Knight]

I think most Americans like the general idea of ACA and don't want a full repeal. They just don't want working middle/upper middle class to be punished with ridiculous premium hikes and mandates. Most would be ok with tweaks that fix those issues if it is possible under the current framework.

 

[UCF11and1]

That would be a separate program (and I hate another government program). This way they can negotiate lower rates for the most expensive people from drug companies and hospitals. The US gives gov't grants to drug companies so they can make it at least what other countries pay for the same drugs for those 10%.

Other 90% would be in the general insurance pool which would lower rates. 10% sickest would be outside the general ACA. The sickest are going to cost more than the 90%. Keep them separate and just work to reduce costs for them.

Love how every republican plan starts with "give tax money to companies"

 

[reddog4720]

 

[CommuterBob]

It's out. and it's pretty much what was leaked earlier.

No method to pay for it, individual mandate repealed retroactive to 12/31/2015, cadillac plan taxes don't start until 2025, new mandate (30% penalty for not having insurance for at least 63 days within the past 12 months) doesn't start until 2019, and it is far from a full repeal.

But at least it removes the tax on tanning

 

[reddog4720]

So the $700 no insurance penalty will now cost you $900 on a low priced $250/mo premium plan, if you are subject to the surcharge.

Millions of poverty level people will likely lose their Medicaid.

And there is little detail how this will lower premium costs.....

Just not seeing how this is any better. It's different....but not sure it is better. The real winner is the small business that avoids the crazy penalties for screwing out workers from health care....but not seeing a huge change for individuals.

 

[goodknightfl]

Just kill the damn thing. No replace.

 

[Bob the Citronaut]

No go. The mandate has to go.

 

[UCFWayne]

I fail to see how this plan is any better than the current one.

Seriously, there needs to be a bill that forces hospitals and practices to list a price for a service like a menu. That would have a more positive impact on pricing than this BS they are trotting out.

 

[CommuterBob]

Apparently, this is only phase 1

 

[CommuterBob]

CATO rips this replacement apart

https://www.cato.org/blog/house-gop-leaderships-health-care-bill-obamacare-lite-or-worse

The House leadership bill isn’t even a repeal bill. Not by a long shot. It would repeal far less of ObamaCare than the bill Republicans sent to President Obama one year ago. The ObamaCare regulations it retains are already causing insurance markets to collapse. It would allow that collapse to continue, and even accelerate the collapse. Republicans would then own whatever damage ObamaCare causes, such as when the law leaves seriously ill patients with no coverage at all. Congress would have to revisit ObamaCare again and again to address problems they failed to fix the first time around. ObamaCare would consume the rest of Congress’ and President Trump’s agenda. Delaying or dooming other priorities like tax reform, infrastructure spending, and Gorsuch. The fallout could dog Republicans all the way into 2018 and 2020, when it could lead to a Democratic wave election like the one we saw in 2008. Only then, Democrats won’t have ObamaCare on their mind but single-payer.

The House leadership bill retains the very ObamaCare regulations that are threatening to destroy health insurance markets and leave millions with no coverage at all. ObamaCare’s community-rating price controls literally penalize insurers who offer quality coverage to patients with expensive conditions, creating a race to the bottom in insurance quality. Even worse, they have sparked a death spiral that has caused insurers to flee ObamaCare’s Exchanges nationwide

"The House Republican leadership bill does not replace ObamaCare. It merely applies a new coat of paint to a building that Republicans themselves have already condemned."

 

[bqknight]

Apparently, this is only phase 1

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Of course it is.

 

[UCF11and1]

Why don't they use the same system Romney used in Massachusetts?

 

[Bob the Citronaut]

Of course it is.

We should keep Obamacare. It works great. It makes plenty of sense for me to pay $11,000 out of pocket before I can even touch my insurance.

 

[Poolside Knight]

I thought the GOP was the party of fear mongering. 'People will be dying in the streets' line being constantly used is as sensationalist as it gets

 

[bqknight]

We should keep Obamacare. It works great. It makes plenty of sense for me to pay $11,000 out of pocket before I can even touch my insurance.

I'm all for new healthcare ideas, I have said it before. I'm just pointing out Mr. Trump's BS Tweets.

You literally see my name and something clicks for you, doesn't it. Maybe I should be flattered.

 

[CommuterBob]

We should keep Obamacare. It works great. It makes plenty of sense for me to pay $11,000 out of pocket before I can even touch my insurance.

I honestly doubt anything in this plan changes that, given that it really doesn't do much to address cost of care or all that much as far as premiums. In fact, your premiums could even increase further under this plan. Have you looked into non-employer-sponsored plans?

 

[The Branch]

This law is ridiculous and unsustainable. The Republicans should have let it collapse under its own weight before they did anything.

 

[UCF11and1]

This law is ridiculous and unsustainable. The Republicans should have let it collapse under its own weight before they did anything.

No, they have been bitching about it for 6 years and they still don't have any idea how to fix it or have a replacement ready to go. If they cared about America, the Republicans should have been ready with a new plan

 

[Bob the Citronaut]

I honestly doubt anything in this plan changes that, given that it really doesn't do much to address cost of care or all that much as far as premiums. In fact, your premiums could even increase further under this plan. Have you looked into non-employer-sponsored plans?

And that's why I said it's a no go. Higher premium with the same deductible on the open market right now for me.

The mandate has to go. Pre existing conditions has to go. You should pay more for healthcare if you use it more or are sickly. They need to bring back catastrophic plans. I don't need to pay mammograms or birth control or mental health.

 

[Bob the Citronaut]

I'm all for new healthcare ideas, I have said it before. I'm just pointing out Mr. Trump's BS Tweets.

You literally see my name and something clicks for you, doesn't it. Maybe I should be flattered.

Yeah, your comments on healthcare click for me. You said you want to pay a little more to cover healthcare for others. I was just sharing the little more I pay.

 

[UCFhonors]

Young people should be given access to low premium/high deductible plans and allowed to invest in HSAs. Period. The government should not be gouging them for asinine plans that they'll never, ever use.

Wow you really believe Government provides insurance and saving accounts? Interesting...

It's false. But amazing that you believe that.

 

[UCFhonors]

I fail to see how this plan is any better than the current one.

Seriously, there needs to be a bill that forces hospitals and practices to list a price for a service like a menu. That would have a more positive impact on pricing than this BS they are trotting out.

I'm UCFhonors and I support this message.

You must have actually learned something in economics. These other yahoos are bowing down to the gospel of big government.

 

[bignow]

If it isn't revised we are/were headed for a $8-10B insurance company bailout due to false estimated enrollees team Obama proposed.

Want to really fix it, make Federal Govt employees enroll in the program including House and Senate members.

 

[KNIGHTTIME^]

Like I said....let's get the sickest 10% out of the ACA pool. Give younger healthy people a lower premium (catastrophic insurance). Work on getting the drug prices (for the same drug) in line with what other countries pay for the same drug. The US is essentially subsidizing the world with prescription prices. We pay the higher costs, but other countries negotiate lower prices for the same drug.

 

[Great2BAKnight2]

I'm UCFhonors and I support this message.

You must have actually learned something in economics. These other yahoos are bowing down to the gospel of big government.

There's actually a service called SmartShopper where you call and tell them the medical service you need, they provide a list of places in your area. If you go to one of those locations, you get paid money for doing so. The money comes from directing you to lower cost (but still fully capable) locations and it's saving the insurance company tons of money that they pass on to you and SmartShopper. They talked about it on Planet Money and it's an interesting concept. Reward people for going to a less expensive place.

 

[UCFhonors]

Like I said....let's get the sickest 10% out of the ACA pool. Give younger healthy people a lower premium (catastrophic insurance). Work on getting the drug prices (for the same drug) in line with what other countries pay for the same drug. The US is essentially subsidizing the world with prescription prices. We pay the higher costs, but other countries negotiate lower prices for the same drug.

Again. This makes no economics sense, at all. No economist on the entire spectrum would support anything like this. Unless you have some link they says this could work?

 

[UCFhonors]

There's actually a service called SmartShopper where you call and tell them the medical service you need, they provide a list of places in your area. If you go to one of those locations, you get paid money for doing so. The money comes from directing you to lower cost (but still fully capable) locations and it's saving the insurance company tons of money that they pass on to you and SmartShopper. They talked about it on Planet Money and it's an interesting concept. Reward people for going to a less expensive place.

I'll have to listen to that podcast. Transparency in all aspects of life is a virtue. Its particularly beneficial in purchasing decisions.

I believe it's still illegal in many states for medical professionals to advertise with prices. And of course it's still illegal to buy insurance across state lines and to import drugs. So transparency is an uphill battle.

 

[goodknightfl]

Replacement is not needed. Kill most of the new insurance requirements, allow for across state line purchasing, More freedom, more choice, less cost. Allow for health savings accounts, if the feds can not stand not spending money set up a fund that pays the first $250 to $500 of medical bills for each person each year, rather than subsidize a policy low income people can't afford to use. At least poor people could get 3 to 5 Dr visits in without expense. catching problems early will prevent bigger ones later.

 

[reddog4720]

I'll have to listen to that podcast. Transparency in all aspects of life is a virtue. Its particularly beneficial in purchasing decisions.

I believe it's still illegal in many states for medical professionals to advertise with prices. And of course it's still illegal to buy insurance across state lines and to import drugs. So transparency is an uphill battle.

United Healthcare has a price tool right on their website for their users. You put in exactly what procedure you need or want done and it will bring up a full list of every doctor or facility that offers it and how much it costs, then it shows how much they cover and how much you'll owe all based on your plan.

 

[UCFKnight85]

United Healthcare has a price tool right on their website for their users. You put in exactly what procedure you need or want done and it will bring up a full list of every doctor or facility that offers it and how much it costs, then it shows how much they cover and how much you'll owe all based on your plan.

This is true in most insurance plans now. Honors is just spouting nonsense like saying it's illegal to publish prices. LOL

 

[Bob the Citronaut]

United Healthcare has a price tool right on their website for their users. You put in exactly what procedure you need or want done and it will bring up a full list of every doctor or facility that offers it and how much it costs, then it shows how much they cover and how much you'll owe all based on your plan.

You shouldn't have to go to the insurance company though to get pricing or a list of doctors you can use. You should be able to shop office by office or hospital by hospital for the best price and best care. The insurance company has set prices they pay no matter the quality of care. There's no competition when the insurance company/government set the pricing. I don't need to explain the benefits of a free market.

 

[CommuterBob]

Seems like all this really is is a tax cut for the very wealthy

 

[reddog4720]

You shouldn't have to go to the insurance company though to get pricing or a list of doctors you can use. You should be able to shop office by office or hospital by hospital for the best price and best care. The insurance company has set prices they pay no matter the quality of care. There's no competition when the insurance company/government set the pricing. I don't need to explain the benefits of a free market.

The guy on craigslist selling kidneys will give you a great deal.

 

[reddog4720]

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Seems like all this really is is a tax cut for the very wealthy