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GOP amendment would give $15 billion to insurers for high-cost patients
The Hill ^ | 04/06/2017 | JESSIE HELLMANN

Posted on 04/06/2017 8:32:25 AM PDT by GIdget2004

An amendment to the GOP's repeal plan would dole out $15 billion to insurers over nine years to help cover the costs of sick, expensive patients.

Lawmakers say the new funds would bring down premiums for healthy people by subsidizing medical costs for people with especially high expenses.

Under ObamaCare, insurers are required to charge everyone of the same age the same amount for premiums, regardless of their medical history or conditions.

That means costs are spread out among healthy and sick people, and insurers would essential pass those costs on to healthy people. The $15 billion would help subsidize those high costs, but the amendment doesn't lay out how the money would be distributed but leaves it up to the Health and Human Services department.

In 2020, the administration of the program will be handed over to the states.

"I believe what we've written here helps us mitigate their need to stay in the healthcare system but also mitigates the extra costs that have been transferred to other folks trying to buy healthcare coverage," said Rep. David Schweikert (R-Ariz.), one of the sponsors of the amendment.

The idea, modeled after a program in Maine, appears similar to the "reinsurance" aspect of ObamaCare for its first three years.

(Excerpt) Read more at thehill.com ...


TOPICS: Government; News/Current Events
KEYWORDS: 0carenightmare; 115th; ahca; first100days; highcostpatients; highriskpatients; highriskpool; obamacare; speakerryan; trumphealthcare
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To: WENDLE

If you are at this stage you are already on either Medicaid, DSSI or Medicare. Medicare is a pre-paid tax for healthcare, it is FIXED, RATIONED, RESTRICTIVE, DISCRIMINATORY and monthly premiums go up yearly. That $10 COLA raise SS gave you which is another tax, this year the majority went to Medicare premiums.

Every one wants to call it an entitlement, it’s not, it is PRE-PAID TAXES force ably taken from your paycheck for the # of years you worked, in our case 40 yrs.

If you happened to be Ret. Over 65 Military your Secondary is Tricare Life, the same as Medicare it is FIXED, RATIONED, RESTRICTIVE and DISCRIMINATORY. Test have been denied, put off 2-3 yrs, when they should be yearly. You are DoD MANDATED where you get your daily meds. 2 sources Fraud prone Express Scripts who just has the USPS shoves $3K retail worth of 3 months of meds in your unsecured mailbox NO ID sign for, or Military base. What is on the formulary depends on base size. Pharmacy is not equipped to handle handicapped, it is closed all Fed holidays, weekends, and no scripts turned in after 3:30pm you pick them up the next day. EScript doesn’t work half the time and you have to turn around and confirm it with them before they fill it. It is designed for Active Duty. Refills take 5 days, and where they come from depends where you live, ours is Pensacola, we live near Memphis and the Naval base in Millington, TN 20 miles away.

Express Scripts takes 2 weeks for a first fill, 2 weeks for refills. Both refill systems are automated.

There are no options, no appeals, and neither cover hearing aids which most seniors end up needing.

NOR are you allowed to purchase a third ins that would cover what they don’t cover. It voids your Secondary Tricare Life, for which you spent 20 or more yrs being underpaid and over deployed, which congress decreed is part of your benefits of being paid lower wages.

If you die before you begin to collect SS/Medicare, they keep it all.

O’care had more options to it than the RIGGED MEDICARE/TRICARE LIFE system does.


41 posted on 04/06/2017 9:53:18 AM PDT by GailA (Ret. SCPO wife: suck it up buttercups it's President Donald Trump!)
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To: GIdget2004

High-cost patients = AIDs patience.

Degenerates who engage in risky behavior deserve the consequences of their actions.


42 posted on 04/06/2017 9:57:09 AM PDT by Flavious_Maximus
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To: Garth Tater; sagar

HA! that post made me laugh. You nailed it, but I have a lot more woods than you thought. :)

And yes, I own the land almost all the way to the top of the hill. But the guy that owns the land above mine recently died and the property has now basically gone to seed...

You must be one of my neighbors. :-)

Oh, and the guitar player in my band installs home solar power systems. He’s a wealth of knowledge about that. Ever turn an old washing machine into a creek power generator?


43 posted on 04/06/2017 9:57:45 AM PDT by Mr. Douglas (Best. Election. EVER!)
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To: GailA

Expect ito get much worse.


44 posted on 04/06/2017 10:01:15 AM PDT by WENDLE (Obama administration Wire Tapped the Trump campaign for political purpose.)
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To: thinden

The money is too subsidize the cost of a private insurance policy not pay for the medical expenses. I actually think this is a good compromise. There may be a lot of hard core, survival of the fittest types on Freeper, but the general population is much different. They have accepted the fact that healthcare is a right. The republicans are now tasked with finding the best way to do that with the least intrusion by the government in the process. I think they need a complete repeal and replace, but repeal only is never going to happen. That bridge was crossed a long time ago and then burned.


45 posted on 04/06/2017 10:02:04 AM PDT by redangus
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To: Mr. Douglas

I’m in W.Va about 10 miles from the Kentucky line. If there’s a better place to ride out the coming storm I certainly have never seen it. People around here are used to getting by with what they have and there is a wealth of knowledge concerning the old ways that is available for the asking - to tell you the truth, it’s getting the old coots to shut up that’s the hard part - and I ought to know, ‘cuz I am one :)


46 posted on 04/06/2017 10:16:19 AM PDT by Garth Tater (What's mine is mine.)
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To: faithhopecharity

Bailouts are not necessary.

The pre-existings are approx 30% of our population; that’s a LOT. It is the 500lb gorilla in the room and will drive everyone’s premiums higher and higher.

Put all high-risk patients in Medicare Part “C”, where they are in HMOs, and some can choose to get their own supplement.


47 posted on 04/06/2017 10:19:08 AM PDT by Chauncey Gardiner
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To: Garth Tater

HA! I’ve been here six years (Lived in Seattle for 46) and I can’t believe what I’ve learned along those lines since I moved here.

BTW, I own a very interesting movie called, The Wild and Wonderful Whites of West Virginia. I bought it at the recommendation of Fred Reed.


48 posted on 04/06/2017 10:41:31 AM PDT by Mr. Douglas (Best. Election. EVER!)
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To: GIdget2004
That means costs are spread out among healthy and sick people, and insurers would essential pass those costs on to healthy people.

No, we taxpayers who don't want anything to do with obamacare will be paying the bills... again.

49 posted on 04/06/2017 11:11:32 AM PDT by bgill (From the CDC site, "We don't know how people are infected with Ebola")
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To: Mr. Douglas
I was lurking here back when you moved and I was always interested in how you were faring. It sounds like you've done well for yourself. Congratulations! It's always nice to know there are fellow Freepers in the neighborhood.

One word of advice though, throw out that Whites of W.Va. DVD - we aren't like that at all and please don't listen to all the West Virginia jokes those Kentucky boys tell - they're only half true (unlike the Kentucky jokes we tell which are ALL based in fact :)
50 posted on 04/06/2017 11:30:43 AM PDT by Garth Tater (What's mine is mine.)
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To: Garth Tater

All I know for sure is that when I hear banjo music, I need to paddle faster. :)

About the movie, sadly, I think there is actually a lot of truth in it, and I base it on what I see where I live. The drug abuse here, and people living off disability is shocking. When I lived in Seattle, I knew almost nobody, my entire 46 years there, that fit into either category.

However, with that said, I use wal-mart as a contradiction to what I just said. To wit, all classes mix where I now live. We all go to Wal-mart because it’s pretty much all there is. And it is a nice place with all sorts of people.

In Seattle, Wal mart was an absolute pit. The clothing section looked like a white trash teenaged girl’s bedroom. Pretty much literally. So we never went there.

i.e. in the big city you can basically avoid the “riff-raff”. In small town America, we all mix together, regardless of class. I am in a southern gospel band that tours a LOT of small churches in a 100 mile radius. I’ve seen all kinds, and a lot of all kinds. I even played in a band with members that could have been extracted right out of that movie.

But yeah, it is focusing on the negative. There are a lot of really good people where I live. It is one of the reasons we moved here!


51 posted on 04/06/2017 11:47:46 AM PDT by Mr. Douglas (Best. Election. EVER!)
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To: GIdget2004

Trump and the GOPe got elected by those of US wanting to repeal Ocare. What the hell are the GOPe afraid of? Oh yeah, once a WELFARE program using WORKING Folks monies is established there is no (re)turning it back(to the TAX PAYERS)!


52 posted on 04/06/2017 12:07:33 PM PDT by Harpotoo
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To: Washi

>
The government, especially federal, should NEVER have gotten involved in health care in the first place, in ANY capacity.

They’ve never had the mandate, and they’ve never had the right.
>

F* ‘em, even IF they had a ‘mandate’. They still have *NO* Constitutional authority to do so.

One can prattle off a few extra Amendment’s text to solidify the position as well (4th - medical records, 5th - Takings, 13th - welfare).

Course, nobody in D.C. is talking ‘bout no Constitution anywho (elections past, far in future).


53 posted on 04/06/2017 12:40:06 PM PDT by i_robot73 ("A man chooses. A slave obeys." - Andrew Ryan)
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To: Mr. Douglas
About the movie, sadly, I think there is actually a lot of truth in it, and I base it on what I see where I live. The drug abuse here, and people living off disability is shocking.

The drug abuse and the people living on disability are two separate things. I don't look down on someone living on disability - there but for the grace of God holds true for all of us and we take care of our own that find themselves in dire straits. Now drugs on the other hand, that's not acceptable. You give in to that demon then you are no longer one of us. Keep it within the bounds and we'll put up with a lot but if you cross the line too many times then you've got to go. In the last twenty years I know of two violent, thieving, drug addicted families (like the Whites in that DVD) that were burned out. They crossed the line too many times and then they had to go - most likely to the big city where things like that are put up with. If you are running into a lot of druggies in your neck of the woods you might want to think about moving farther out - or making your neighborhood less hospitable to those in the drug culture...
54 posted on 04/06/2017 12:54:56 PM PDT by Garth Tater (What's mine is mine.)
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To: Garth Tater

I know too many people who get disability because you can actually live on it here. My neighbor fought for years to get it and kept searching for a doctor that would sign off. He finally found one. He and his wife are late 40’s, she works at McDonalds or something like that and he gets disability for a minor skin condition. They live in a dumpy trailer that looks, literally, like a garbage dump inside. but he keeps his yard in excellent shape. At least, it’s clean and always mowed.

And they have no indoor plumbing.

Yes, there are those on disability that really need it, but when you can live on it, there is an amazing number of people that will do all they can to get it. And lets be frank, all it does is pigeon hole them, at least in their minds. They are forever stuck in a life of below mediocrity.


55 posted on 04/07/2017 5:14:32 AM PDT by Mr. Douglas (Best. Election. EVER!)
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To: WENDLE

Medicare and Tricare Life or Prime are dictatorships where your health is concerned. I tried getting as much done before DUMBOCARE screwed up things, but more keep popping up. Getting old is not for the faint of heart. Not only worse but more expensive. Which is why we doubled house payments, 6 months will see the house paid for.

And I’m caught in the DEA pain mess to boot. And all I take is Valium for Meniere’s and Fibromyalgia, yet PCP is terrified to script for the dosage I need, the max FDA allows, Pain doc set the dose years ago, I don’t get high or giggly on it, it just takes a level 10 pain to a 5. The normal drug for Meniere’s is Meclizine and it is a total failure. Only Valium stops the attacks. The 9th Peripheral Neuropathy drug’s side effects finally kicked in, not ones you can tolerate. If I were a Diabetic all the PN needs are taken care of, but since I’m not they only cover Neurologist and meds.

GOP is starting to unearth the waste and fraud in Medicare.
This is just 1 drug, no one has followed the money trail that leads back to some congress critters. Just like the waste and Fraud Dr. Carson is discovering in HUD. Private ins won’t even cover this dubious drug. Side effects are real bad according to RXList.com

http://www.businessinsider.com/tim-scott-letter-on-acthar-and-medicare-waste-2017-4

Wikipedia has more info on the companies, but don’t tie it to Big Pharma super pacs funding congress critters.


56 posted on 04/07/2017 5:32:44 AM PDT by GailA (Ret. SCPO wife: suck it up buttercups it's President Donald Trump!)
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To: GailA

First, I am sorry about your pain. I learned that you had to be VERY tough to get old. I am old. I spent 48 days in ICU from May 2019 to Feb 2012. I was stage 3 , total laregectomy and 4 separate heart procedures ( One open heart) and 10 shock treatment for arrhythmia/tachycardia. So I hear you. On this new crap,I cannot go to MD AnDERSON again. $5000 deductible— what a dammed joke. Just take us bac to 206 and leave us the hell alone!!

I see a total capitulation to the communist principals of obamacare by the republicrats. I think they are screwing us worse . The premiums dont go down!! are you kidding me. More people dependent on government rather that standing on their own.


57 posted on 04/07/2017 7:30:57 AM PDT by WENDLE (WTF??)
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