Posted on 05/03/2017 7:38:47 PM PDT by 2ndDivisionVet
House Republicans look to have the votes they need to pass their embattled health care bill. All it took, apparently, was adding a few billion dollars to the bill, to provide cover to moderate lawmakers who had been reluctant to support it.
This latest change, added to the American Health Care Act on Wednesday night with a vote expected less than 24 hours later, steers an additional $8 billion to reduce insurance costs for people with pre-existing medical conditions. Experts say the funding is still short of what is actually necessary to keep many of those patients from experiencing insurance price spikes if the bill becomes law.
The provision appears to do enough to satisfy the concerns of a handful of moderates who helped doom the bill in late March, when House leaders had to scrap a planned vote at the last minute. Those moderates, combined with conservatives won over by a separate amendment last week, appear to have given leadership just enough votes to advance the bill out of the House after a months-long slog.
The amendment appears to have won over crucial moderate lawmakers
The latest amendment, pushed by Rep. Fred Upton (R-MI), is intended to fend off accusations that the bill guts Obamacare’s protections for people with pre-existing conditions.
It is co-sponsored by three congressmen — Jeff Denham of California, David Valadao of California and David Young of Iowa — that the best whip counts had as ‘Lean No’ votes. By, presumably, flipping those three votes to ‘Yes’, the amendment appears likely to be sufficient to pass the bill in the House, even though it could still lose upwards of 20 Republicans.
Upton’s role here is crucial. He is the former chairman of the House Energy and Commerce Committee and an experienced health care legislator. His defection to ‘No’ on Tuesday suggested that even the revised version of AHCA could be in real trouble.
But after a dramatic trip to the White House on Wednesday, Upton reversed himself and said he would support the bill with his amendment. He later told reporters at the Capitol that he had actually started working on the amendment on Monday night, the day before he publicly announced his opposition.
Upton’s conversion — along with that of Missouri Republican Billy Long, another surprising defection earlier this week — seems to have persuaded enough wavering Republicans to come onboard.
The amendment provides more money to lower costs for sick people
The Upton amendment follows from the earlier MacArthur amendment, which wooed conservatives but spooked moderates. That earlier amendment allows states to opt out of the Obamacare rule that prohibited health plans from charging people more for their insurance because of their existing health conditions.
In order to allow insurers to opt out of those rules, states have to meet certain conditions, such as setting up a “high-risk pool” for people with high medical costs, and people could not be charged more as long as they maintained coverage.
But many experts believed that the funding available under AHCA would not be sufficient to pay for those high-risk pools and prevent major price hikes for the patients with pre-existing conditions.
So the Upton amendment pushes even more funding — $8 billion over five years — toward those costs. It is an addition to the $100 billion-plus fund originally included in the bill for states to create programs that reduce insurance costs.
The new money is designated specifically for states that seek a waiver under AHCA and for people in those states who would see higher insurance premiums or out-of-pocket costs because of that waiver.
States could use the money to pay insurers directly to keep costs down, to help people buy insurance in the high-risk pool, or to provide direct subsidies for people to buy their own insurance, Larry Levitt at the Kaiser Family Foundation told me.
But, Levitt said, “There is still nothing in the bill that guarantees people with pre-existing conditions will have access to affordable coverage if states waive community rating.”
The problem is that the bill neither specifies how the money should be spent nor provides enough of that money, Levitt said. People in states with the AHCA waivers could see “massive premium increases,” he told me: “There's no way a reinsurance program or direct subsidies could ever fully offset that for everyone, and states aren't required to do so.”
As for high-risk pools, which Vox’s Sarah Kliff explained here, Levitt said the funding is “inadequate” and “there are no requirements for what the eligibility, premiums, or benefits in high-risk pools would have to be.”
There could still be another fight over funding
Republicans are rushing the bill through the House before the Congressional Budget Office can tell them how much it would cost and how many people it would cover. So moderate Republicans who reluctantly got onboard with AHCA could end up coming back later to ask for more money, Upton said Wednesday.
“Is it enough money? I don’t know. That’s the question that I asked,” Upton told reporters. “I was led to believe that $5 billion would be enough, which is why it’s $8 billion, to make sure that in fact it’s more than enough.”
“If it’s not,” he said, and CBO comes back with a report that shows that, “then a number of us, including me, will seek more money.”
Which, presumably, would require a whole new — and difficult — vote.
But this version still has the strong mandate even Obama couldn’t get? This is ACA Plus.
David Young is my congressman. He parades as a conservative, and is a heck of a nice guy, but wishy-washy as all get out. I voted against him in the primary and probably will this time too.
Myth. There was no mandate in the first one. Only a tax incentive. There is a big difference. We have solar panel incentives here in AZ, but no mandate to own solar panels.
I don’t understand how this fixes current healthcare problems. Am I still going to pay thousands of dollars a year for health coverage with a $6000 deductible?
For the individual?
I'm already looking at Costa Rica or Hungary to get dental work done. Hungary has one of the best dentistry clinics in the world and it's far cheaper than the U.S. Implants are just $500-$1,000 per tooth, and that includes the crown, implant, and the bone graft.
Yet another form of subsidy. Expect more of same as Obamacare 2.0 gets implemented, this time 100% “owned” by republicans with no one to blame.
Am I missing something — it hasn’t even made it to the senate, yet?
If this doesn’t pass, the Dems will go into an unprecedented gloat.
No, I am talking about the “Republican” version. They are going to levy a huge fine against anyone who goes without insurance for more than 63 days. Anyone who goes beyond 63 days without insurance, may never be able to get back in the market again. That’s a mandate with far more teeth than the empty threats of the Democrat ACA.
Bump for morning
People with pre-existing conditions do not need insurance. They need charity.
The sooner our society understands that, the sooner we can provide them with better care.
My understanding is that they are going to allow insurance companies to charge a fee for those with a lapse in coverage. That’s the only way to keep people from waiting until they get sick to buy insurance.
This plan isn’t the greatest, but it is a step in the right direction given that there will never be enough conservative republicans in office to undo everything Obamacare did.
I love how they will say of illegal immigrants, "no one should be illegal." But when it comes to hard-working, law-abiding U.S. citizens, the YOU/Obama/Trump/Ryan are eager to call them illegal. We are just the property of the government. To me, anyone who voted for/supports this bill is nothing other than a socialist. It allows the government to force people to do something that isn't in their interest and pay a large portion of their income for "insurance-in-name-only."
Yet, people consider this version better because it has better bribes for the states. No one actually cares about it's victims.
The Obama mandate had teeth in the fact that the IRS collected the penalty (2.5% of income or $700, whichever was higher). Trump is not going to enforce it, but Obama was.
There are also getting rid of the Obamacare taxes ( 0.9 percent additional Medicare tax and the 3.8 percent net investment tax), which is good.
A pre-existing condition is a planned claim. That is not “insurance” any more than if you could buy fire “insurance” to pay a “claim” after your house has burned down.
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