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Five Key Facts About the Obamacare Replacement Bill

Calminian

Well-Known Member
Site Supporter
If you want to argue the bill is not perfect, I'll agree, but there is a lot to celebrate here. Some good stuff from Rep. Ron DeSantis.


AHCA-Obamacare-Replacement-640x480-Getty-640x480.jpg

Chip Somodevilla/Getty Images

by JOHN HAYWARD4 May 20171,139


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Rep. Ron DeSantis (R-FL) joined SiriusXM host Alex Marlow to highlight five key facts about the GOP’s Obamacare replacement bill on Thursday’s Breitbart News Daily.

The new plan is closer to full repeal than the old GOP bill was.
“The original Ryan bill left the architecture of Obamacare in place, which is responsible for driving up premiums and deductibles for millions and millions of Americans,” DeSantis recalled.

“Conservatives looked at that and said that’s the main reason people hate Obamacare, we’ve got to deal with that. The problem, though, that we had is that we have a critical mass of members who, even though they campaigned on repealing Obamacare, did not want to roll back the architecture of Obamacare, so we were kind of at a standstill,” he explained. “And then, with the work of people like Mark Meadows and Tom McArthur from New Jersey, what we were able to do is say, ‘Let’s at least give the states the ability to opt out of the Obamacare regulatory structure and set up functioning markets, which will obviously allow people to have cheaper policies and will lower premiums for people.’”

“That’s not ideal,” DeSantis conceded. “We should just repeal it all. That would be the easiest thing.”

It shows Republicans can work together to craft a replacement bill. “I think the big upshot from this debate, what its revealed, is that people had always said ‘oh, these Republicans, they had seven years to come up with a replacement and they can’t do it.’ That’s not really the issue. I mean, there’s issues with the replacement that I would change if I could, but it is what it is. I think most members are fine with it,” said DeSantis.

He pointed out the political reality that Republicans “don’t have the 216 votes to repeal” Obamacare outright.

“Even though we voted to do it time after time, now we’re here, the iron’s hot, and we have some members that don’t want to do that. That’s why we ended up in this compromise situation. But I believe, and other conservatives believe, that this is as good as we can do right now, given where our votes are,” he said.

It will lower insurance premiums. DeSantis said the new bill “provides a path to lower premiums in a way that the original bill I think did not.”

“Actually there was a good argument that that original bill, by retaining the Obamacare regulations and insurance mandates, but defunding the individual mandate for healthy people to purchase insurance, actually may have created more adverse selection in the insurance markets, which would have of course raised premiums,” he noted. “I think this bill corrects for that and gives governors the ability to really put some market forces back into their insurance markets. That’s what we’re looking to do.”

It takes care of people with pre-existing conditions. “I think it’s important to point out, people act like before Obamacare there was no coverage for pre-existing conditions. The fact is, if you either got your insurance through employer, Medicare. V.A. – pretty much everything but the individual market – pre-existing conditions were covered. It wasn’t an issue,” DeSantis contended.

“Now in the individual insurance market there were roughly, between 2010 – 2014, Obamacare had a pre-existing insurance program before the exchanges stood up,” he recalled. “There were about 130,000 people that signed up for that who were either denied coverage, or denied coverage that was even remotely affordable for them.”

“That’s a legitimate issue, but it’s a very discrete issue,” he said. “It’s frustrating when the media will act like without Obamacare, you wouldn’t have any protection for pre-existing conditions for 300 million-plus Americans. That’s just not true. Second of all, if you really said pre-existing was the reason you needed Obamacare, you didn’t need to do a 2,000-page bill. You could have done a five-page bill. You could have appropriated money for those folks. This way, you would have saved all the crippling premium increases and deductible increases, and the plan cancellations, and all the stuff that’s happened with Obamacare.

It cleans up the expensive morass of Obamacare regulations. “Our plan has always been as Republicans – whether it’s Tom Price’s plan, whether it’s Paul Ryan’s Better Way, anything that had been proposed – was you have to fully repeal Obamacare,” DeSantis said.

“The regulatory structure is dysfunctional. It leads to insolvent markets,” he explained. “And then when you replace it, you do provide continuous coverage protection so that the insurance companies can’t kick you off if you get sick, or jack up your rates, as long as you’re paying your premiums.”

“If people are not paying premiums and are effectively uninsurable, you still provide a backstop for them, but it’s a general public fund, rather than imposing those costs on the premium holders and jacking up their rates,” he added. “So it’s a way to deal with folks who are not insurable under the traditional definition of insurance that also spares policyholders and the individual market.”

“I mean right now, eHealth.com just came out with how much it costs right now, and then they sell individual market plans unsubsidized, for a family of four the average per-year and premium costs right now: $14,300,” DeSantis noted. “That’s more than some people’s mortgage payments, depending on what part of the country you live in, so that’s not a sustainable system. That is being driven because of the dysfunctional Obamacare regulatory structure.”

“This bill, it not only deals with pre-existing conditions, it deals with it three different ways. There’s a massive $100 billion fund. Then there was a Palmer-Schweikert $15 billion fund that is modeled after the main invisible risk-sharing program. And then there is another $8 billion just with this Fred Upton stuff,” he said, the latter a reference to Rep. Fred Upton’s (R-MI) decision to support the bill after an $8 billion amendment to protect people with pre-existing conditions was added.

“So you’re talking about probably 100,000 to 130,000 people, but maybe even less because anyone that has a policy now, it doesn’t matter if you have pre-existing conditions, you can renew it and they’re not going to jack up your rates. So it’s taken care of in multiple ways, but basically the media sets a narrative, and I think some Republicans unfortunately accept this, that Obamacare is the only way to deal with pre-existing conditions. We’ve never accepted that previous to this debate. We shouldn’t accept it,” DeSantis urged.

“Actually, Obamacare is not good for pre-existing conditions because if you’re in Iowa and you have a pre-existing condition, and the insurers are totally fleeing the market now, guess what? Nobody gets issued a policy at all,” he added. “So yes, under the law you can’t be discriminated against because of that, but if no one’s issuing a policy to anybody, a lot of good that does you. The first thing you have to have if you want to protect both healthy and sick people is a functioning, solvent market, and Obamacare clearly doesn’t deliver that.”
 
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StefanM

Well-Known Member
Site Supporter
He's wrong about preexisting conditions not being an issue with employer plans. Sure, typically they were covered, but I remember quite well having to go without treatment for a year to get past the waiting period for preexisting conditions to be covered.
 

Baptist Believer

Well-Known Member
Site Supporter
He's wrong about preexisting conditions not being an issue with employer plans. Sure, typically they were covered, but I remember quite well having to go without treatment for a year to get past the waiting period for preexisting conditions to be covered.
Shh! Be quiet!

Don't ruin their little victory with reality.

This mess still has to pass the Senate and its not going to go over so easily there. Even if they manage to pass it, they still have to come up with a workable solution that meets Candidate Trump's promises of having better coverage and healthcare outcomes for everyone, and being significantly cheaper than before.

Of course Candidate Trump turned into President Trump on the basis of promises like that and now has discovered that "no one knew" how complicated healthcare is.
 

StefanM

Well-Known Member
Site Supporter
Shh! Be quiet!

Don't ruin their little victory with reality.

This mess still has to pass the Senate and its not going to go over so easily there. Even if they manage to pass it, they still have to come up with a workable solution that meets Candidate Trump's promises of having better coverage and healthcare outcomes for everyone, and being significantly cheaper than before.

Of course Candidate Trump turned into President Trump on the basis of promises like that and now has discovered that "no one knew" how complicated healthcare is.

Trump would sign anything just to claim a victory.
 

InTheLight

Well-Known Member
Site Supporter
Trump would sign anything just to claim a victory.
Yeah, can't wait to see what he gives Democrats next September to claim he got funding for the Wall. He gave them everything they wanted this week so he could get $21B in defense funding and $1.5B in border security improvements.

Sent from my Motorola Droid Turbo.
 

InTheLight

Well-Known Member
Site Supporter
"Australia has better health care than we do, but we're going to have great health care very soon."-- Donald Trump, on same day the House passed the AHCA.


Just inching toward single payer...
 

blessedwife318

Well-Known Member
Site Supporter
"Australia has better health care than we do, but we're going to have great health care very soon."-- Donald Trump, on same day the House passed the AHCA.


Just inching toward single payer...
Anyone shrewd enough to pay attention knows that Trump is for universal healthcare.

Sent from my SM-G920V using Tapatalk
 

Baptist Believer

Well-Known Member
Site Supporter
Anyone shrewd enough to pay attention knows that Trump is for universal healthcare.
Exactly right. He has been quite clear about that for a number of years. He got more careful with his words when he because a candidate since universal healthcare was "off message" for his campaign, but I doubt he has changed that view.

I'm actually for a hybrid single-payer / private insurance arrangement myself. Have the government expand medicaid to cover everything above a certain limit (let's say $100,000/yr), and have private insurance cover the gap between $0-100,000. It greatly lowers the risk for insurance companies which will allow premiums to fall and wellness benefits to increase, while the small minority of people who have major health issues can be covered without completely destroying the financial stability of those who are ill. Lower premiums will be a major financial incentive for those without $100,000 sitting in the bank to purchase insurance.

There will be downward financial pressure from both private insurance and the buying power of the federal government to help bring down costs.

Obviously, that's not going to fix everything, but it is a starting place.
 

InTheLight

Well-Known Member
Site Supporter
Another easy fix they could do would be to make people eligible for Medicare when they hit age 60, instead of age 65.
 

Rolfe

Well-Known Member
Site Supporter
"Australia has better health care than we do, but we're going to have great health care very soon."-- Donald Trump, on same day the House passed the AHCA.


Just inching toward single payer...

But...Trump is a Conservative.
 

TCassidy

Late-Administator Emeritus
Administrator
I'm actually for a hybrid single-payer / private insurance arrangement myself.
I have been advocating a single payer system for years. With the option of being able to purchase private insurance if you want to.

My insurance is single payer with, for the most part, doctors being on the government payroll (VA).

My wife's plan is single payer with doctors in private practice (Medicare). Both systems work. The latter a bit better than the former, but the latter costs her $130 per month plus small co-pays while mine costs me nothing.

It will work if we can just divorce politics from the issue. But I'm not holding my breath. :)
 

InTheLight

Well-Known Member
Site Supporter
The same way we pay for all government services. Taxes. And more taxes. And more taxes.
Ok, a payroll tax, an income tax, or what?

After filing taxes this year and seeing that almost $19,000 was taken out of my wife's checks for health insurance I'm almost ready to get on the single payer train. We are a family of four, two teenagers, all healthy.

A 5% payroll tax would be a bargain, for example.

I would not be happy with the lack of choices with single payer but insurance policies already limit some choice.

Sent from my Motorola Droid Turbo.
 

TCassidy

Late-Administator Emeritus
Administrator
almost $19,000 was taken out of my wife's checks for health insurance
Wow! While I was still working $58 per pay check was deducted for the whole family. That's $1500 per year. My employer paid an additional $455 per month. That's under $13,500 total for a "Cadillac" policy. Either your wife had a lot better policy than I did or somebody (probably a big insurance company, or maybe her employer) was making a lot of money at your expense.

When I retired I continued her insurance via COBRA at $412 per month. When we moved to Texas the same policy with the same company went up to $709 per month. In January of 2014, when Obamacare started up the policy went up to over $1000 per month, then the next month they cancelled the policy because it did not meet the new standards under Obamacare. (It lacked pre and post natal care and abortion coverage - something a woman in her 60s just didn't need).

So I signed her up for Obamacare and paid $67 per month until she turned 65 and got Medicare.

I am not wild about the new replacement presently working its way through Congress, but we have to do something to get healthcare costs under control. Even minor health issues can bankrupt a middle class family.
 

InTheLight

Well-Known Member
Site Supporter
Wow! While I was still working $58 per pay check was deducted for the whole family. That's $1500 per year. My employer paid an additional $455 per month. That's under $13,500 total for a "Cadillac" policy. Either your wife had a lot better policy than I did or somebody (probably a big insurance company, or maybe her employer) was making a lot of money at your expense.

It is breathtaking. $788 per paycheck deducted 24 times per year. As far as a health care plan it's not anything special--$3,500 deductible per person/$7,000 per family. $45 co-payments, and $15 prescription drug benefits. I talk to friends of mine and they are in similar situations.

Taking almost $19,000 off the top of our W-2 wages seriously reduces our taxable income, that's for sure. Will the new Trump tax plan get rid of health care costs as being non-taxable? If so, we're in a world of hurt.

When I retired I continued her insurance via COBRA at $412 per month. When we moved to Texas the same policy with the same company went up to $709 per month. In January of 2014, when Obamacare started up the policy went up to over $1000 per month, then the next month they cancelled the policy because it did not meet the new standards under Obamacare. (It lacked pre and post natal care and abortion coverage - something a woman in her 60s just didn't need).

I cost the most under her policy, about $650 per month. My wife is around $525; the kids are about $200 a month each.

I am not wild about the new replacement presently working its way through Congress, but we have to do something to get healthcare costs under control. Even minor health issues can bankrupt a middle class family.

It's a step in the right direction. At least we will have some choices. But I don't see how it's going to dramatically reduce monthly premiums. I won't have to buy maternity insurance and I can opt out of drug treatment coverage. That might be $100 a month?
 

Reynolds

Well-Known Member
Site Supporter
"Australia has better health care than we do, but we're going to have great health care very soon."-- Donald Trump, on same day the House passed the AHCA.


Just inching toward single payer...
Just being honest, our system has become so messed up, I would prefer single payer. I believe that was the purpose of Obama care, mess it up so bad we would welcome single payer to get rid of it.
 

StefanM

Well-Known Member
Site Supporter
I'm 100% in favor of some form of single payer.

Our experiment in private insurance is failing, and costs are only going to get worse.
 

Brent W

Active Member
100% for Single Payer as well. This political win the Republicans are claiming for healthcare is going to ruin them 2 years from now. It is awful and solves no problems just gives Trumps ego a boost. I hope Trump is ready to not have Republicans control Congress because he sure is having a hard enough time with "his" party in control of it.
 

FollowTheWay

Well-Known Member
Site Supporter
If you want to argue the bill is not perfect, I'll agree, but there is a lot to celebrate here. Some good stuff from Rep. Ron DeSantis.

The GOP healthcare plan is a disaster. Most people including you have no idea what the draconian consequences of this bill would be.

In Rare Unity Hospitals Doctors and Insurers Criticize Health Bill
It is a rare unifying moment. Hospitals, doctors, health insurers and some consumer groups, with few exceptions, are speaking with one voice and urging significant changes to the Republican health care legislation that passed the House on Thursday.
In Rare Unity, Hospitals, Doctors and Insurers Criticize Health Bill

The bill’s impact is wide-ranging, potentially affecting not only the millions who could lose coverage through deep cuts in Medicaid or no longer be able to afford to buy coverage in the state marketplaces. With states allowed to seek waivers from providing certain benefits, employers big and small could scale back what they pay for each year or reimpose lifetime limits on coverage. In particular, small businesses, some of which were strongly opposed to the Affordable Care Act, could be free to drop coverage with no penalty.

I'm not just talking about Medicaid's support for extending ObamaCare to the poorest people in the country. This plan proposes an $880 billion cut to Medicaid in general. Are you aware that most Medicaid funds are spent to allow senior citizens to stay in nursing homes? M<y aunt taught the deaf for 30 years and has teacher's insurance and pension as well as a fair amount of savings. But she had no idea that she would live to age 102!! Who does? She had severe Alzheimer's disease the last 4 years of her life. This tremendous cut in Medicaid would have thrown her out on the street.

GOP Health Bill Jeopardizes Out-of-Pocket Caps in Employer Plans

Last-minute amendment would allow states to obtain waivers from certain Affordable Care Act requirements

GOP Health Bill Jeopardizes Out-of-Pocket Caps in Employer Plans

ObamaCare didn't simply set up a system by which the needy could obtain insurance perhaps for the first time. It also set national standards for insurance provided by employers. For example before ObamaCare, an employer could set a lifetime limit on medical care. A previously wealthy friend of mine was employed by Disney and sang in the Metropolitan Opera and in the movie "The Wiz." Then he had an accident which left him in a coma for 6 months and partially paralyzed for the rest of his life. He has required more than $6M worth of operations. First the Disney insurance cut him off and the even Medicaid Disability cut him off. if ObamaCare hadn't passed he would have died. Another previously well-off friend who was a patent attorney has battled a rare form of cancer for 5 years trying experimental treatments at America's best cancer centers (The Mayo Clinic, The Cleveland Clinic, John's Hopkins, Sloan Kettering and the Univ. of Texas MD Anderson Cancer Center). His insurance shut him down and he has spent all of his savings trying to stay alive. Under ObamaCare these lifetime ceilings were taken away. They return under the new GOP proposal. These people were not indigents. They were both highly productive members of society

Of course the major impact would be on those who did not previously have insurance but can now afford it under ObamaCare. Earlier this year, the Congressional Budget Office estimated that the bill would cause 24 million Americans to lose their health insurance by 2026.

The bill would repeal the subsidies under the Affordable Care Act, or Obamacare. The subsidies are based on income and regional differences in health insurance costs. Roughly 83 percent of the 12.7 million people who get their healthcare insurance through the Obamacare exchanges receive subsidies that help pay for the coverage, according to the latest federal data.

This plan will most likely bring down the cost of insurance but only because the insurance would be far inferior to the insurance that meets ObamaCare standards. Most people don't understand the broad definition of pre-existing conditions is. And it varies from state to state and even for different insurance companies.


These pre-existing conditions could cost you big bucks under new health care bill
These pre-existing conditions could cost you big bucks under new health care bill
While insurance companies have varying lists of "declinable" or "uninsurable” conditions, here’s a partial list of health issues that may not be covered under the new health care bill, according to CNN:

  • Acne
  • Acromegaly
  • AIDS or ARC
  • Alzheimer's Disease
  • Amyotrophic Lateral Sclerosis
  • Anemia (Aplastic, Cooley's, Hemolytic, Mediterranean or Sickle Cell)
  • Anxiety
  • Aortic or Mitral Valve Stenosis
  • Arteriosclerosis
  • Arteritis
  • Asbestosis
  • Asthma
  • Bipolar disease
  • Cancer
  • Cardiomyopathy
  • Cerebral Palsy (infantile)
  • Chronic Obstructive Pulmonary Disease
  • Cirrhosis of the Liver
  • Coagulation Defects
  • Congestive Heart Failure
  • Cystic Fibrosis
  • Demyelinating Disease
  • Depression
  • Dermatomyositis
  • Diabetes
  • Dialysis
  • Esophageal Varicosities
  • Friedreich's Ataxia
  • Hepatitis (Type B, C or Chronic)
  • Menstrual irregularities
  • Multiple Sclerosis
  • Muscular Dystrophy
  • Myasthenia Gravis
  • Obesity
  • Organ transplants
  • Paraplegia
  • Parkinson's Disease
  • Polycythemia Vera
  • Pregnancy
  • Psoriatic Arthritis
  • Pulmonary Fibrosis
  • Renal Failure
  • Sarcoidosis
  • Scleroderma
  • Sex reassignment
  • Sjogren's Syndrome
  • Sleep apnea
  • Transsexualism
  • Tuberculosis
The list above includes health issues considered pre-existing conditions before Obamacare. It is not a comprehensive list.
I've highlighted some that I consider to be fairly common. Some of them you might not put in that category but I think most of us would include: acne, anxiety/bipolar disease/depression/, diabetes, Menstrual irregularities, obesity, pregnancy and sleep apnea as common problems.
Anxiety disorders are the most common of all mental health problems. Research into these disorders has shown that up to 1 in 4 adults will have an anxiety disorder in their lifetime, and that up to 1 in 10 people will have an anxiety disorder each year. Depression is also common. Obesity and diabetes are certainly on the rise. And what about pregnancy. Yes, insurgence companies can refuse to cover pregnancy costs for a pregnant woman applying for a polity.


Oh, but there is one tremendous benefit. Billionaire Warren Buffett said Saturday that the GOP healthcare plan constitutes a "huge" tax cut for the wealthy.
Buffett: GOP healthcare plan a ‘huge tax cut for guys like me’






 
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