Posted on 05/04/2017 7:42:58 AM PDT by SeekAndFind
The House vote on the GOP’s Obamacare repeal bill is down to the wire, with dozens of Republicans waffling as “undecideds.” What’s the holdup? Ninety-six percent of people who have to buy their own insurance stand to benefit from this bill, which will likely drive down premiums by double digits.
The remaining 4 percent — those with pre-existing conditions — will be protected by a federal fund to subsidize their insurance costs. They won’t get priced out of the market, because the fund will pay the lion’s share of their premiums.
But some Republicans are running scared. Although the bill solves two problems — lowering premiums and protecting people with pre-existing conditions — these fence sitters are worried about something else: getting re-elected.
As a member of the New York delegation put it, the issue is “optics.” They’re cowed by the media’s false reports that the GOP is abandoning people with pre-existing conditions.
In fact, no one wants to do that. There is a consensus that people with pre-existing conditions should be able to get insurance. The issue is who pays the hefty price tag. Obamacare forced healthy buyers in the individual market to foot the entire bill. That’s why their premiums have doubled since the law went into effect.
The new House bill sets up a fairer way: a $130 billion pot of money, federally funded, to pay for people with pre-existing conditions. The entire nation chips in, not just people stuck in the individual market.
Under Obamacare, the healthy and the chronically ill paid the same premiums. It’s called community pricing. Healthy people would never meet their sky-high deductibles. Instead the premiums extorted from them would be used to cover huge medical bills for the chronically ill, who consume 10 times as much medical care.
In fact, Aetna CEO Mark Bertolini reports that less than 5 percent of Obamacare enrollees consume over half of the health care.
Most healthy people saw that being charged the same as these sick people was fundamentally unfair and refused to sign up.
The GOP bill offers a solution. States can choose to get a waiver from Obamacare’s community pricing rule, so that insurers can sell to healthy people at a far lower cost. States that get the waiver should see double-digit premium decreases for the healthy almost immediately. Obamacare’s community pricing was the single biggest reason premiums have doubled since 2013, according to actuarial consultants at Milliman.
Naysayers claim the federal fund to subsidize people with pre-existing conditions won’t be adequate. Nonsense.
How many people will need help? Not as many as Democrats claim. Before Obamacare, 250,000 people a year with pre-existing conditions were denied coverage for health reasons by major insurers. In 2010, when the ACA established a temporary program for people not being served by state high-risk programs, another 115,000 got help. Adding the two figures together, count on 365,000 people to need help paying for their premiums because of their medical histories. To be safe, call it 400,000.
Based on the $32,000 per person the ACA’s temporary program spent insuring people with pre-existing conditions, the federal fund will need $128 billion a year. So the $130 billion a year the GOP bill provides is likely adequate.
New York, New Jersey and several other states ruined their individual insurance markets two decades ago by imposing community pricing, which drove out healthy buyers. Lawmakers in those states would be smart to wise up, get a waiver and offer low prices to most buyers. But don’t count on it, at least not in New York.
But several states — Alaska, Minnesota, Idaho and Oklahoma among them — have already acted, without waiting for Congress. They used state funds to help cover the sickest people, and relieve pressure on healthy premium payers. Alaska averted a 40 percent premium hike that way last year.
To summarize: The funding is adequate and the approach works. Spineless politicians whining about optics should look in the mirror. What’s they’re really missing is backbone.
-- Betsy McCaughey is chairman of the Committee to Reduce Infection Deaths.
Still afraid of the media.
Apparently they’ve learned nothing from watching Trump.
And they never will. The cowardice is in their DNA. I wish we would primary every one of them and have Trump enthusiastically support their opponent. It's a pipe dream, but I'm allowed to dream.
Betsy's going to lose all credibility with this kind of claim.
The estimates I've seen range from 25% to 50%.
If it really was 4% she would be right -it wouldn't be an issue - but it clearly is an issue and it clearly impacts more people than she admits.
The cowardice is in their DNA.
They are not cowards. Take away their obamacare exemption and watch how hard they fight. In reality they are self interested careerist pigs always taking the path of least resistance.
RE: The estimates I’ve seen range from 25% to 50%.
Can you cite for us, a reliable source?
Our leaders, in their usual timidity, have been afraid to boldly speak up and point out that, rationally, healthcare cannot be a “right”. I have noted for decades that this would ultimately lead to problems. I recently read a quote: “All great power has to do to destroy itself is to continue to attempt the impossible.” Stephen Vizinczey.
I remember decades ago as a hospital orderly watching a 16 year old girl die from renal failure and it was only a year or so later dialysis became possible. What a miracle, right? But it cost $25,000 a year in 1975 dollars to do, per person. Gummint, that great provider of all things good could not sit by and watch only the wealthy survive this “roll of the dice” catastrophe and so instead of declaring healthcare a right, outright, our courageous politicians decided to do the easy thing and just fund it. I remember thinking at the time that this would cause repercussions down the line.
Here we are, now, 4 decades later and our courageous politicians (/s) have yet to weigh in on the question with authority and so, by default, have created the expectation in the population that “healthcare is a right” which to the rational mind is equivalent to an edict prohibiting the tide. Once again our politicians have decided to kick the can down the road and hide. How long can this go on? I suspect not much longer.
As you can see from my prior post, I agree with Betsy about our politicians being cowards but for the exact opposite reason. And it really does not matter if it is 4% or 50%, once gummint starts “giving money away” literally every single one of us is going to have a “pre-existing condition”.
Here's an HHS study that puts it between 23% and 51% based on the definition used.
And here's a Kaiser study putting it at 27%.
Regardless of the exact number 4% doesn't pass the snicker test.
Sounds like those with pre-existing conditions are going to pay less than the rest of us. Guess I need to go find myself one…
It matters if you're trying to gauge the credibility of the author.
Next I want to wait and buy car and home insurance after my car or house have a pre existing condition, like an accident or fire. That would save a lot of money.
Counterproposal — complete repeal followed by all 300 million of us taking a simultaneous mass piss in the graves of those who voted for it, followed by conversion of their houses into museums about why tyranny never works. Do we have a deal?
The 4% are people with preexisting conditions who are not already covered under other plans. For example, the percentage of FReepers with a such conditions is high but many of us get Medicare. Lotta people here also have jobs with insurance.
That is what was charged not what it actually costs.
I sincerely doubt these politicians are cowed by the media.
More likely, their Wall Street sponsors want to keep Obamacare in place. Follow the money.
I think that was the cost initially which was why it was so important for the politicians to step in and cover it before the media could turn it into a freak show/circus to manipulate the electorate. Which they did pretty quickly.
Granted, back then, a politician who advocated letting the poor die from renal failure when the wealthy did not would have been suicidal. But no effort to get in front of this all has ever been made and so those politicians became hostage to the media pointing out that leukemia, breast cancer, AIDS, you name it was unfair and these victims had to be taken care of as well. Once the voters pry open the door to the Treasury there doesn’t seem to be any way to push them out again.
Health care cost bear no relationship to the people's ability to pay.
I am old enough to remember when families sobbed at the door to get an injured child into a hospital, no cash or insurance no care, it was just the way it was.
I remember giving my father shots of veterinary antibiotics for an infection that wouldn't heal. Fixed him up fine but a sad commentary on the times.
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