ACHA. Another acronym that falls short on facing the real problem with our health care system.
Republicans' latest attempt to change Obamacare is nothing more than misdirection. It replaces "subsidies" with "tax credits", continues Medicaid expansion until an election year (when nothing gets done), and keeps the most costly items such as guaranteed issue, community rating, and no pre-existing conditions in place.
It eliminates the individual mandate and creates a new continuous coverage rule allowing insurers to charge 30% higher premiums for up to 12 months to those who have a break in insurance coverage greater than 63 days. The new rule, like the mandate tax, has no teeth.
Speaking of taxes, it eliminates almost $600 million over ten years - which is a good thing. Except for the fact that over half of that amount does nothing to reduce or influence costs of health care or health insurance. More than half ($275 million) is going back to high income earners who are currently paying more in taxes for Medicare and investment income. We should also note these two taxes aren't indexed so as incomes rise more of us would pay these them over time.
For Medicaid it would roll back the enhanced matching rate for the expansion population. This has serious implications for states who fell hook, line, and sinker for the bait of government funding that they knew wasn't financially sustainable.
Think about it: traditional Medicaid funding for those the program was intended to help is paid at roughly a 63%/37% federal to state ratio. By law the range is set at 83% all the way down to 50%. Under expansion the funding started at 100% federal and will reduce to
no lower than 90%. Not only is the expansion paid at a higher level, it is also paid to fund able bodied, working adults.
With Medicaid expansion running significantly over budget already it's amazing that the GOP hasn't pushed this financial disaster to the forefront. They should be putting pressure on the other side of the aisle to address how Obamacare gives more to fund those who can work while penalizing states for trying to care for those who need help most. Instead these clowns roll out cuts to the program without explaining why they might be necessary or focusing on who the cuts are geared towards.
We should have known this was going to be a poo-poo platter. Anything short of full repeal - which takes 60 senators to accomplish - is nothing more than lip service.
Going forward my advice to Congressman Ryan, Secretary Price, and President Trump is simple: Stop pretending you can do something that we know you can't. Be truthful. Democrats own Obamacare. They used a supermajority to pass a bill on a party line vote. They then used the Nuclear Option to push it through. Retaliation isn't the answer. Instead it ensures an endless cycle of political warfare that leaves constituents in the crossfire.
You owe it to the people who elected you to stand up and say that because Democrats are being obstructionists there is nothing you can do to make our health care and health insurance systems better. While you would like to see things change for the positive it falls on Democrats to come up with solutions that can come as a compromise. The compromise can't include their go-to move of throwing more money or expanding an entitlement program that is already financially unsustainable.
It must be the opposite, which is coming up with a solution to the real problem: how do we control costs of care and what ways are best to utilize insurance to help protect us from health issues that we can't control or predict.
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