Posted on 03/28/2017 8:46:45 AM PDT by Kaslin
The failed House Republican American Health Care Act (AHCA) was always a work in progress. The three-phased approach to reform health care called for passage of the AHCA to repeal the Affordable Care Act (ACA) taxes and mandates; and slow the growth in Medicaid as (i.e. phase one). Phase two was the selective removal of Obamacare regulations by the Secretary of Health and Human Services. Phase three was to be a forthcoming health care bill to revamp onerous insurance regulations.
Passage of the AHCA (the Obamacare repeal bill) would have resulted in numerous benefits – getting rid of the individual and employer mandates, stopping the open-ended exchange subsidies and the huge expansion of Medicaid that will bankrupt America over time, are but a few.
However, it had its shortfalls. One misguided provision was the Managers Amendment, which would not allow Americans to use any part of their tax credits to fund Health Savings Accounts (HSAs). Instead of being able to use a portion of their tax credit to pay for doctor visits, prescriptions, and OTC drugs, Americans would only be allowed to use their credits towards insurance. This was a big mistake for a variety of reasons. Purportedly the amendment disallowing tax credit to fund HSAs was designed to appease those who do not want anyone using their tax credit for an abortion. Of course, this same rule would have also prevented Christian health sharing ministry members from using the credit towards their and fellow members’ medical care.
Tax credits were a sticking point for some conservative Members of Congress. A tax credit for those who lack employer coverage is the right thing to do politically, however. Higher-income workers get huge subsidies through the tax code for employer coverage, so it’s hard-hearted to tell moderate-income people who lack employer coverage they get nothing. A tax credit is also an opportunity to give millions more Americans an HSA. If the credits were automatically deposited into individuals’ HSAs, they could be used for health insurance premiums, copays, cost-sharing and to pay directly for care.
If allowed to do so, Americans may even decide to forgo health insurance coverage and use the entire credit/HSA to pay directly for medical care. That provision allowing this should be included in any future bill. For well over half the population, an HSA with $2,000 to $4,000 would be sufficient to fund their entire annual health care needs in cash.
Consider this: the goal of Obamacare was to get as many healthy people into the insurance market as possible to subsidize the money-losing enrollees with pre-existing health conditions. That’s why I say Obamacare is a bad deal for most Americans by design. As a result of the high Obamacare premiums, millions of Americans now have health insurance coverage with deductibles so high that their health plan pays little if any of their routine medical bills. Yet all plans are required have no annual limits or lifetime limits on benefits. Stated another way, people are required to buy expensive health coverage that is not expected to pay for their own care; rather it’s designed to pay for someone else’s catastrophic medical needs. There is nothing wrong with pooling risk, but Obamacare goes far beyond pooling risk and instead coercively redistributes wealth from young to old; healthy to sick.
The key to reining in runaway health costs is not to boost coverage to more and more people as Obamacare tried to do. The key to slowing the growth in health care spending is to make more and more people care more about their medical spending. To this end, it would actually be better for the health care system if millions of Americans decided to forgo insurance, dropped coverage and used their tax credit/HSAs on direct primary care. That is something that most policy analysts fail to understand. Increasing comprehensive health insurance coverage does not reduce health care expenditures (it increases spending). Rather, starving the beast does reduce expenditures. To that end, another good idea is to revamp the essential health benefits required in all plans. It cannot be done through budget reconciliation along, but some experts believe that Secretary Price has the authority to tweak these provisions. Secretary Price already has the power to drop the appeal of House vs. Price (formerly House vs. Burwell) that found the ACA’s cost-sharing subsidies are illegal because they have not been appropriated by Congress. Dropping the appeal would stop the government from paying Obamacare’s illegal cost-sharing subsidies, which would likely cause insurers to pull out of the market unless changes were made. That too would put pressure on Congress to find a solution to the stalemate that exists on reforming insurance regulations. These are the regulations that make Obamacare premiums so expensive.
The Republicans in the House need to use their brains and grow a spine. Obamacare is collapsing. All that will prevent the collapse is either: 1) Huge budget-busting taxpayer subsidies until the end of time; or 2) reforming the insurance markets, which Democrats are loath to do. Congress needs to get back to work on a new health reform proposal. While that is in progress Secretary Price should continue with Phase Two (tweaking regulations), which might lead to a sound health reform.
Well I hope Trump knows Ryan is his enemy...because he is.
I fear they’ll come out with Obamacare 2.1 and try to impose that on us...
Trump is pretty smart + Ryan is the speaker that the rest of “his side” provided him with.
I’m just not getting a good feeling about how this is playing out. But I’ll give it some time. It may not yet be obvious what Trump’s long game is.
I think he wants health care that looks a lot like food stamps
That would explain pretty much everything...sadly.
Not a great look when Trump insists that most Republicans don’t want everyone to have access to needed healthcare—unless by that he means that the government should give it to everyone. Which is where either Obamacare 1.0 or 2.0 will land us.
40 million uninsured = 13.5 million households approximately.
Give each household 4000 HSA = 55 billion a year?
Everyone would be buying off the marketplace as with food stamp users going to Krogers and not to the gov’t grocery store.
That’s Trump’s ideal in my mind.
He does intend to give it to the poor. He is not conservative on this issue.
We’ll just have to wait and see.
But no Republicans are advocating taking healthcare (Medicaid) away from the poor—and he is implying that that’s what they want to do.
Those added during ObamaCare expansion into medicaid
But folks making 4x the poverty line aren’t poor and rolling back Obamacare would put insurance and healthcare within reasonable financial range for them again.
But in Obamacare 2.0 those folks would get the new healthcare entitlement (refundable tax credit) anyway.
Senators Portman, Capito, and Collins didn’t see it that way. 3 senators is enough to sink anything.
They’re the ones who need straightening out—not the Freedom Caucus.
Senators will trade.
Which, as I'm sure you know, are two of the three things that command huge majorities in Congress and among the voters.
The only bill that has any chance of passing Congress is one that gives universal basic healthcare to everyone, free of charge. This is what the voters demand, it’s what they want, and the reason they don’t have it yet is because some Members of Congress are too sensible and the rest are too reliant on bribes from the insurance and drug industries.
The fight over a “free market” in basic health services has been over for fifty years.
What we need to fight over (but won’t, because nobody gets how socialized the system was BEFORE anybody ever heard of Obama), are two things: First, what “basic” healthcare excludes, and two, what a liberated insurance industry will be allowed to write policies for.
That there will be a “public option” is a certainty. Either the GOP House delivers it, or their majority will be gone and will never return.What’s controversial on the other side is whether there will be a “private option”, and what the “private option” will be allowed to cover.
Hillarycare (the final bill) specified 5 years in prison and a $50 000 fine for any doctor who took a payment to deliver a service outside of her system. That’s where the Democrats want to go.
A private option to allow you to choose (and to pay for) what you want, and also to allow you to self-insure against the cost can be preserved for the future, but only if the Republicans wake the f*** up and act quickly.
The uninsured population (for the most part) get free care in every ER in the country, right now, and they have done for 31 years.
The notion that, if they were given money, they would be writing checks to hospitals is ludicrous. They don’t pay for medical services, they never have, and they never will.
YOU pay for their services, through an incredibly complicated and stupid system of payment from your employer if you have one, insurance that isn’t really insurance, and wealth transfers through taxation and much higher costs for any bills you can be screwed into paying.
All “full repeal” will do is increase the magnitude of your responsibility to pay for all those uninsured through the mechanisms described above.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.