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Jul 31 2017

Trumpcare: Beating a Dead Horse

On Sunday’s “State of the Union,” host Jake Tapper was told by White House budget director Mike Mulvaney that Trump wants the Senate to hold another vote to repeal Obamacare before moving on to any other legislative business. The Donald’s delicate ego can’t take the fact that this dead horse can’t even get a majority of votes in the Senate. He has no understanding of the mood of the majority of Americans which is fix what’s wrong with the Affordable Care Act. Trump, in his determination to kill the ACA and hurt as many Americans as possible, threatened to withhold the subsidies for insurance companies and end employer contributions for members of congress. That refers to the $8 billion in cost sharing that help the poor who don’t qualify for Medicaid pay for insurance. Of course, he did this in a tweet. His tweet ranting continued through the day, saying Republican Senators “looked like fools” and an end to the filibuster, like that would help this rotting legislation get 51 votes. He doesn’t pay any attention to what happened last week.

Apparently, neither did a group of Republican Senators who are trying to write legislation that will get 50 votes:

The proposal from Sen. Lindsey Graham (R-S.C.) would block grant federal health care funding to the states and keep much of Obamacare’s tax regime. White House officials also met with House Freedom Caucus chairman Mark Meadows (R-N.C.) to brainstorm how to make the idea palatable to conservatives, according to two sources familiar with the meeting.

Meanwhile, on Sunday’s “Meet the Press” Health and Human Services Secretary told Chuck Todd, that while the ACA was the law of the land, it is unworkable:

“Our job is to follow the law of the land, and we take that mission very, very seriously,” Price said. “The role of the Health and Human Services Department is to improve the health, the safety and the well-being of the American people. And what we understand, what the American people understand, is that their health and well-being is being harmed right now by the current law.”

“Our goal is to put in place, as well as the president’s goal, is to put in place a law, a system, that actually works for patients. You can’t do that under the current structure,” Price continued. [..]

“Talk to the families that are making $50,000 a year and have an insurance card through Obamacare but they don’t have any care because they can’t afford the deductible,” he said. “This is a system that is, that is imploding and has failed the American people. That’s where the president’s passion comes from.”

Well, Mr. Secretary, why aren’t you working to lower the deductibles? None of the bills that the Republicans have put forth did that. Or much else, except give tax cuts to the wealthy. The only reason that there is a problem with Obamacare in states that have not gotten into the plans is the uncertainty that Trump and the Republicans have created in the insurance markets in those states. Participating states, like California and New York, have greater choices and

In a lack of understanding how insurance works, Price also suggested that he was willing to waive the individual mandate falsely claiming that it was a contributing cause to higher healthcare costs. The fact is, as any actuary will tell you, the more healthy people in the insurance pool, the lower the premiums and deductibles for everyone. Eliminating the mandate will certainly cause insurance companies to raise rates as they loose healthy enrollees. There is also evidence that the ACA penalty could be too low

A new analysis highlights that it is often cheaper for people to pay ObamaCare’s penalty for not having health insurance than to buy coverage, meaning the penalty might be too low to spur middle-income people to get covered.

The analysis from the consulting firm Avalere Health finds that for people making less than 200 percent of the poverty line, or about $23,000, purchasing insurance is usually cheaper because of income-based subsidies under the law.

The penalty for not having health insurance in 2015 is $325 or 2 percent of income, whichever is greater.

But for healthy middle-income people, for whom the subsidies are lower, paying the penalty and forgoing insurance is often cheaper, it finds.

So, the analysis notes, the penalty could fail to push people to buy insurance. It found the special ObamaCare sign-up period for people who discovered the mandate penalty while filing their taxes has so far signed up a “lackluster” 68,000 people. Up to 6 million people are estimated to owe the penalty.

In the same vein, previous data from Avalere showed much higher sign-up rates for lower-income people. HealthCare.gov signed up 76 percent of people with incomes from 100 percent to 150 percent of the poverty line. But for people with incomes from 300 percent to 400 percent, only 16 percent signed up, even though they are still eligible for a subsidy.

One of the solutions then is too increase the penalty for not being insured. This will increase the number of healthy insured and lower the rates for everyone. Did I mention negotiating lower drug prices which would save billions, help lower health care costs AND lower insurance premiums, co-pays and deductibles?

Don’t tell Price any of this because, like The Donald, he has beans in his ears and won’t listen to reasonable or, for that matter rational, solutions. They want their Obamacare repealed and dead regardless of how many lives it destroys or costs. The 99% are expendable.

Meanwhile, the spineless Republicans in the Senate will be chasing Unicorns and Leprechauns doing Trump’s bidding.

Whatever happened to “let Obamacare implode?”