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CALL YOUR REPS people, tell them NO NO NO on #AHCA/DonTCare - House vote THURSDAY
CALL YOUR REPS people, tell them NO NO NO on #AHCA/DonTCare - do it NOW - Thurs is the vote: http://www.house.gov/representatives/
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believe it or not I WAS CORDIAL.. I didn't scream, curse, throw my cell at the computer screen.
"Hello. My name is __________ from _________, NY. Please pass along to Mr. Collins that I request he vote against this ridiculous health care bill as it will kill tens of millions of people."
"OK may I get your contact info?"
"Of course. My name is _______ from ____ NY."
"OK. I'd be happy to pass this along to representative Collins."
"Thank you." ( And fuck you too.... no I didn't say that...until I hung up.)
(Yeah right, I'm sure you will.)
The young guy sounded like a 'college republican' in khaki pants, penny loafers, white shirt and solid green tie... short haircut.
Now can I get pissed off??
Thanks for listening.
Now I feel better.
Why deductibles would rise under the GOP health care plan
Drew Altman, Kaiser Family Foundation
https://www.axios.com/why-deductibles-would-rise-under-gop-plan-2322246232.html
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The CEO Pay Tax Break in the Republican Health Care Proposal
http://www.ips-dc.org/report-the-ceo-pay-tax-break-in-the-republican-health-care-proposal/
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The way the GOP health care plan works: the MORE help you NEED, the LESS you GET
The perverse reality of the Republican health care bill
http://www.vox.com/policy-and-politics/2017/3/13/14914802/republican-health-care-bill-perverse-cbo-ahca
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The GOP health plan is an act of class warfare by the rich against the poor
http://www.vox.com/2017/3/13/14914062/republican-health-care-plan-cbo-redistribution-poor-medicaid
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5 Key Questions: Medicaid Block Grants & Per Capita Caps
http://kff.org/medicaid/issue-brief/5-key-questions-medicaid-block-grants-per-capita-caps/
Drew Altman, Kaiser Family Foundation
Health care is complicated, as the president has discovered. But here is one thing that is not so complicated: if people have modest means and limited tax credits, and coverage is expensive, they will mostly buy health plans with lower premiums — and high deductibles.
This is what is likely to happen under the GOP health care bill, the American Health Care Act. Only people who need more health care will stretch for more generous coverage. If that happens, those health plans will draw too many sick people, causing insurance companies to stop offering them for fear of losing money. That would leave mostly the low-premium, high-deductible plans.
As the chart shows, the average deductible for a typical plan in the non-group market under the GOP plan would be about $1,550 higher in 2017 than it would have been under the Affordable Care Act, based on our analysis for this column. Most of the debate has been about what would happen to premiums — but for consumers, it's total out-of-pocket costs that matter.
Under the Affordable Care Act, the low-premium, high-deductible health plans are called "bronze" plans — so think of this as the "bronzification" of the non-group market. The result: premiums may be lower in some cases, but deductibles will go up.
This is what is likely to happen under the GOP health care bill, the American Health Care Act. Only people who need more health care will stretch for more generous coverage. If that happens, those health plans will draw too many sick people, causing insurance companies to stop offering them for fear of losing money. That would leave mostly the low-premium, high-deductible plans.
As the chart shows, the average deductible for a typical plan in the non-group market under the GOP plan would be about $1,550 higher in 2017 than it would have been under the Affordable Care Act, based on our analysis for this column. Most of the debate has been about what would happen to premiums — but for consumers, it's total out-of-pocket costs that matter.
Under the Affordable Care Act, the low-premium, high-deductible health plans are called "bronze" plans — so think of this as the "bronzification" of the non-group market. The result: premiums may be lower in some cases, but deductibles will go up.
https://www.axios.com/why-deductibles-would-rise-under-gop-plan-2322246232.html
_ _ _ _
The CEO Pay Tax Break in the Republican Health Care Proposal
The House Republican plan to replace the Affordable Care Act would give health insurance companies a huge tax break on their executive compensation, encouraging them to dole out even larger pay packages to their already overpaid top managers.
The plan would re-introduce a tax loophole that allows corporations unlimited deductions for executive pay — as long as the pay is in the form of stock options or other so-called “performance” compensation. Obamacare eliminated this loophole for health insurance companies, imposing a strict $500,000 limit on deductions for the expense of each executive’s compensation. This set an important precedent for reducing taxpayer subsidies for CEO pay.
To better understand the taxpayer savings from the Obamacare CEO pay reform, the Institute for Policy Studies has analyzed executive pay at the five largest U.S. publicly held health insurance companies in 2015, the most recent year for which data are available for all five firms, in the report The CEO Pay Tax Break in the Republican Health Care Proposal.
• The ACA deductibility limits generated an estimated $92 million in additional public revenue in 2015 from just these companies (Aetna, Anthem, Cigna, Humana, and UnitedHealth). On average, these corporations owed an extra $3.5 million in taxes per executive.
• This $92 million in savings from limiting pay-related deductions for just 26 executives is the equivalent of the average annual ACA premium subsidies for 28,500 Americans. . . .
The plan would re-introduce a tax loophole that allows corporations unlimited deductions for executive pay — as long as the pay is in the form of stock options or other so-called “performance” compensation. Obamacare eliminated this loophole for health insurance companies, imposing a strict $500,000 limit on deductions for the expense of each executive’s compensation. This set an important precedent for reducing taxpayer subsidies for CEO pay.
To better understand the taxpayer savings from the Obamacare CEO pay reform, the Institute for Policy Studies has analyzed executive pay at the five largest U.S. publicly held health insurance companies in 2015, the most recent year for which data are available for all five firms, in the report The CEO Pay Tax Break in the Republican Health Care Proposal.
• The ACA deductibility limits generated an estimated $92 million in additional public revenue in 2015 from just these companies (Aetna, Anthem, Cigna, Humana, and UnitedHealth). On average, these corporations owed an extra $3.5 million in taxes per executive.
• This $92 million in savings from limiting pay-related deductions for just 26 executives is the equivalent of the average annual ACA premium subsidies for 28,500 Americans. . . .
http://www.ips-dc.org/report-the-ceo-pay-tax-break-in-the-republican-health-care-proposal/
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The way the GOP health care plan works: the MORE help you NEED, the LESS you GET
The perverse reality of the Republican health care bill
The Congressional Budget Office’s analysis of the GOP’s American Health Care Act is one of the most singularly devastating documents I’ve seen in American politics. For a thorough explanation of the findings, read Sarah Kliff’s explainer. But here is the one-sentence summary: Under the GOP’s bill, the more help you need, the less you get.
The AHCA would increase the uninsured population by about 24 million people — which is more people than live in New York state. But the raw numbers obscure the cruelty of the choices. The policy is particularly bad for the old, the sick, and the poor. It is particularly good for the rich, the young, and the healthy.
Here, in short, is what the AHCA does. The bill guts Medicaid, halves the value of Obamacare’s insurance subsidies, and allows insurers to charge older Americans 500 percent more than they charge young Americans.
Then it takes the subsidies that are left and reworks them to be worth less to the poor and the old, takes the insurers that are left and lets them change their plans to cover fewer medical expenses for the sick, and rewrites the tax code to offer hundreds of billions of dollars in tax cuts to the rich. As Dylan Matthews writes, it is an act of class warfare by the rich against the poor.
The result isn’t just 24 million fewer people with insurance: Of those who remain insured, the pool is tilted toward younger, healthier people who need help less, because many of the older, poorer people who need the most help can no longer afford insurance. As German Lopez notes, a 64-year-old making $26,500 would see his premiums rise by 750 percent. 750 percent! And with that 64-year-old gone, premiums are a little bit lower, because the pool is a little bit younger.
The AHCA would increase the uninsured population by about 24 million people — which is more people than live in New York state. But the raw numbers obscure the cruelty of the choices. The policy is particularly bad for the old, the sick, and the poor. It is particularly good for the rich, the young, and the healthy.
Here, in short, is what the AHCA does. The bill guts Medicaid, halves the value of Obamacare’s insurance subsidies, and allows insurers to charge older Americans 500 percent more than they charge young Americans.
Then it takes the subsidies that are left and reworks them to be worth less to the poor and the old, takes the insurers that are left and lets them change their plans to cover fewer medical expenses for the sick, and rewrites the tax code to offer hundreds of billions of dollars in tax cuts to the rich. As Dylan Matthews writes, it is an act of class warfare by the rich against the poor.
The result isn’t just 24 million fewer people with insurance: Of those who remain insured, the pool is tilted toward younger, healthier people who need help less, because many of the older, poorer people who need the most help can no longer afford insurance. As German Lopez notes, a 64-year-old making $26,500 would see his premiums rise by 750 percent. 750 percent! And with that 64-year-old gone, premiums are a little bit lower, because the pool is a little bit younger.
http://www.vox.com/policy-and-politics/2017/3/13/14914802/republican-health-care-bill-perverse-cbo-ahca
_ _ _ _ _
The GOP health plan is an act of class warfare by the rich against the poor
The Congressional Budget Office’s assessment of Republicans’ plan to replace Obamacare is a description of one of the largest, most significant income redistribution programs the US government has ever considered — from the poor to the wealthy rather than the other way around.
The plan, the CBO concludes, would take more than $1 trillion away from programs targeting poor and middle-class families, to fund an $883 billion tax cut targeted at the wealthy. It is upward income redistribution of a truly massive scale.
“No legislation enacted in recent decades cut low-income programs this much — or even comes close,” Robert Greenstein, the founder and president of the Center on Budget and Policy Priorities and Washington’s leading advocate for poor and low-income Americans, says.
There are massive cuts to Medicaid: The biggest damage to the poor will come from the plan’s cuts to Medicaid, which total $880 billion over 10 years, almost exactly the same amount as the plan cuts in taxes. “By 2026, Medicaid spending would be about 25 percent less than what CBO projects under current law,” the CBO finds. The program would insure 14 million fewer people — the biggest single coverage loss caused by the Republican bill.
Under Obamacare, the Medicaid program was expanded, to cover everyone up to 138 percent of the poverty line (~$36,000 for a family of four), provided that states accepted the expansion. That meant that for the first time ever, all poor Americans in 31 states plus DC had health insurance. . . .
The plan, the CBO concludes, would take more than $1 trillion away from programs targeting poor and middle-class families, to fund an $883 billion tax cut targeted at the wealthy. It is upward income redistribution of a truly massive scale.
“No legislation enacted in recent decades cut low-income programs this much — or even comes close,” Robert Greenstein, the founder and president of the Center on Budget and Policy Priorities and Washington’s leading advocate for poor and low-income Americans, says.
There are massive cuts to Medicaid: The biggest damage to the poor will come from the plan’s cuts to Medicaid, which total $880 billion over 10 years, almost exactly the same amount as the plan cuts in taxes. “By 2026, Medicaid spending would be about 25 percent less than what CBO projects under current law,” the CBO finds. The program would insure 14 million fewer people — the biggest single coverage loss caused by the Republican bill.
Under Obamacare, the Medicaid program was expanded, to cover everyone up to 138 percent of the poverty line (~$36,000 for a family of four), provided that states accepted the expansion. That meant that for the first time ever, all poor Americans in 31 states plus DC had health insurance. . . .
http://www.vox.com/2017/3/13/14914062/republican-health-care-plan-cbo-redistribution-poor-medicaid
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5 Key Questions: Medicaid Block Grants & Per Capita Caps
1. WHAT MEDICAID FINANCING CHANGES ARE CURRENTLY BEING CONSIDERED?
President Trump and other GOP leaders have called for fundamental changes in Medicaid financing that could limit federal financing for Medicaid through a block grant or a per capita cap. Unlike current law where eligible individuals have an entitlement to coverage and states are guaranteed federal matching dollars with no pre-set limit, the proposals under consideration could eliminate both the entitlement and the guaranteed match to achieve budget savings and to make federal funding more predictable. To achieve budget savings, federal funding limits would be set at levels below expected levels if current law were to stay in place. In exchange for these federal caps, proposals could allow states to eliminate the entitlement to coverage and impose enrollment caps or waiting lists or reduce eligibility levels or offer states other increased flexibility to design and administer their programs. Many proposals do not specify the rules for state matching payments or what core federal eligibility and coverage standards would be changed. (Figure 1)
Figure 1: A block grant or per capita cap would be a fundamental change to Medicaid financing.
2. HOW WOULD A BLOCK GRANT WORK?
Under a block grant, states would receive a pre-set amount of funding for Medicaid. Typically, a base year of Medicaid spending would be established and then the cap would increase by a specified amount each year, typically tied to inflation or inflation plus some percentage. To generate federal savings, the total amount of federal spending would be less than what is expected under current law. Under current law, federal Medicaid spending matches states spending for eligible beneficiaries and services without a pre-set limit. If state spending increases due to increased enrollment or program costs, then federal spending increases as well. Under a block grant, if program costs exceed the federal spending cap due to increased enrollment during a recession or rise in health costs for example, states would have to increase state spending or reduce enrollment or services. (Figure 2)
Figure 2: Under a block grant, reductions in federal spending are obtained by setting caps below expected spending.
President Trump and other GOP leaders have called for fundamental changes in Medicaid financing that could limit federal financing for Medicaid through a block grant or a per capita cap. Unlike current law where eligible individuals have an entitlement to coverage and states are guaranteed federal matching dollars with no pre-set limit, the proposals under consideration could eliminate both the entitlement and the guaranteed match to achieve budget savings and to make federal funding more predictable. To achieve budget savings, federal funding limits would be set at levels below expected levels if current law were to stay in place. In exchange for these federal caps, proposals could allow states to eliminate the entitlement to coverage and impose enrollment caps or waiting lists or reduce eligibility levels or offer states other increased flexibility to design and administer their programs. Many proposals do not specify the rules for state matching payments or what core federal eligibility and coverage standards would be changed. (Figure 1)
Figure 1: A block grant or per capita cap would be a fundamental change to Medicaid financing.
2. HOW WOULD A BLOCK GRANT WORK?
Under a block grant, states would receive a pre-set amount of funding for Medicaid. Typically, a base year of Medicaid spending would be established and then the cap would increase by a specified amount each year, typically tied to inflation or inflation plus some percentage. To generate federal savings, the total amount of federal spending would be less than what is expected under current law. Under current law, federal Medicaid spending matches states spending for eligible beneficiaries and services without a pre-set limit. If state spending increases due to increased enrollment or program costs, then federal spending increases as well. Under a block grant, if program costs exceed the federal spending cap due to increased enrollment during a recession or rise in health costs for example, states would have to increase state spending or reduce enrollment or services. (Figure 2)
Figure 2: Under a block grant, reductions in federal spending are obtained by setting caps below expected spending.
http://kff.org/medicaid/issue-brief/5-key-questions-medicaid-block-grants-per-capita-caps/