Posted on 05/03/2017 7:38:47 PM PDT by 2ndDivisionVet
House Republicans look to have the votes they need to pass their embattled health care bill. All it took, apparently, was adding a few billion dollars to the bill, to provide cover to moderate lawmakers who had been reluctant to support it.
This latest change, added to the American Health Care Act on Wednesday night with a vote expected less than 24 hours later, steers an additional $8 billion to reduce insurance costs for people with pre-existing medical conditions. Experts say the funding is still short of what is actually necessary to keep many of those patients from experiencing insurance price spikes if the bill becomes law.
The provision appears to do enough to satisfy the concerns of a handful of moderates who helped doom the bill in late March, when House leaders had to scrap a planned vote at the last minute. Those moderates, combined with conservatives won over by a separate amendment last week, appear to have given leadership just enough votes to advance the bill out of the House after a months-long slog.
The amendment appears to have won over crucial moderate lawmakers
The latest amendment, pushed by Rep. Fred Upton (R-MI), is intended to fend off accusations that the bill guts Obamacare’s protections for people with pre-existing conditions.
It is co-sponsored by three congressmen — Jeff Denham of California, David Valadao of California and David Young of Iowa — that the best whip counts had as ‘Lean No’ votes. By, presumably, flipping those three votes to ‘Yes’, the amendment appears likely to be sufficient to pass the bill in the House, even though it could still lose upwards of 20 Republicans.
Upton’s role here is crucial. He is the former chairman of the House Energy and Commerce Committee and an experienced health care legislator. His defection to ‘No’ on Tuesday suggested that even the revised version of AHCA could be in real trouble.
But after a dramatic trip to the White House on Wednesday, Upton reversed himself and said he would support the bill with his amendment. He later told reporters at the Capitol that he had actually started working on the amendment on Monday night, the day before he publicly announced his opposition.
Upton’s conversion — along with that of Missouri Republican Billy Long, another surprising defection earlier this week — seems to have persuaded enough wavering Republicans to come onboard.
The amendment provides more money to lower costs for sick people
The Upton amendment follows from the earlier MacArthur amendment, which wooed conservatives but spooked moderates. That earlier amendment allows states to opt out of the Obamacare rule that prohibited health plans from charging people more for their insurance because of their existing health conditions.
In order to allow insurers to opt out of those rules, states have to meet certain conditions, such as setting up a “high-risk pool” for people with high medical costs, and people could not be charged more as long as they maintained coverage.
But many experts believed that the funding available under AHCA would not be sufficient to pay for those high-risk pools and prevent major price hikes for the patients with pre-existing conditions.
So the Upton amendment pushes even more funding — $8 billion over five years — toward those costs. It is an addition to the $100 billion-plus fund originally included in the bill for states to create programs that reduce insurance costs.
The new money is designated specifically for states that seek a waiver under AHCA and for people in those states who would see higher insurance premiums or out-of-pocket costs because of that waiver.
States could use the money to pay insurers directly to keep costs down, to help people buy insurance in the high-risk pool, or to provide direct subsidies for people to buy their own insurance, Larry Levitt at the Kaiser Family Foundation told me.
But, Levitt said, “There is still nothing in the bill that guarantees people with pre-existing conditions will have access to affordable coverage if states waive community rating.”
The problem is that the bill neither specifies how the money should be spent nor provides enough of that money, Levitt said. People in states with the AHCA waivers could see “massive premium increases,” he told me: “There's no way a reinsurance program or direct subsidies could ever fully offset that for everyone, and states aren't required to do so.”
As for high-risk pools, which Vox’s Sarah Kliff explained here, Levitt said the funding is “inadequate” and “there are no requirements for what the eligibility, premiums, or benefits in high-risk pools would have to be.”
There could still be another fight over funding
Republicans are rushing the bill through the House before the Congressional Budget Office can tell them how much it would cost and how many people it would cover. So moderate Republicans who reluctantly got onboard with AHCA could end up coming back later to ask for more money, Upton said Wednesday.
“Is it enough money? I don’t know. That’s the question that I asked,” Upton told reporters. “I was led to believe that $5 billion would be enough, which is why it’s $8 billion, to make sure that in fact it’s more than enough.”
“If it’s not,” he said, and CBO comes back with a report that shows that, “then a number of us, including me, will seek more money.”
Which, presumably, would require a whole new — and difficult — vote.
I guess the question is, how much is the fee that insurance companies can charge you under this bill if you’ve had a lapse in coverage of more than 63 days?
You are correct.
Having said that, I’m not sure we have time to educate the population at large about it, and removing it from the bill as-is will just leave us with Obamacare still as it loses most of its support.
Of course, this current bill sucks too, but as I’ve said before it may be the best thing we can get out of these congressional cucks. For now, at least.
This is still an insurance company boondoggle and another program designed for fraud. Only a straight repeal followed by interstate insurance and medical competition oversight can work.
Also need tort reform in there too.
With “pre-existings” in the same pool as everyone else, “age 26”, and the “EHB provisions” still in there, and a lot of the taxes/fees removed, AHCA will death spiral faster that the original Obamacare! No premium relief for hardworking Americans who need to purchase insurance.
The whole problem with the first round of negotiations on this bill was that the House Freedom Caucus deemed it inadequate, and demanded several concessions. At the time, many around here applauded the HFC for their courageous stand. Once the bulk of those were granted, the support of some GOPe moderates began to peel off and the vote was canceled.
Subsequently, a consensus began to form in this community among those who were opposed to the bill—such as myself—that once it met with the approval of the House Freedom Caucus, that would represent some minimal level of adequacy that might actually be a bona fide step in the right direction towards the eventual repeal and replacement of Obamacare.
Therefore, if this bill passes in the next day or so—with the critical support of the House Freedom Caucus—I sincerely hope that the same people who applauded the HFC for their courage will now accept their collective judgement regarding the propriety of what ends up being passed.
We all know it won't be ideal, but it will—hopefully—signify the start of a process that will ultimately accomplish the goals which President Trump outlined during his campaign.
So I sincerely hope that this amended bill passes, and I trust President Trump to use his best judgement to shepherd the process going forward. It will represent an important "win" for the Trump agenda, with the added benefit that the Democrats and Media (but I repeat myself) will be—as Scotty from Star Trek would say—"mad enough to chew neutronium".
Let's give Congress a little pat on the head, and congratulate the President—who has worked very hard—and celebrate this significant victory with him, and hopefully enjoy a moment of unity together as we see a few "baby steps" being taken in the right direction on the Obamacare issue.
Hopefully, that's not too much to expect...
Funding for pre-existing conditions will always be necessary. Trump should continue to promote natural gas production and then add a 5% surcharge to it to fund pre-existing conditions. It would solve the funding problem and Democrats/Environmentalists couldn't oppose natural gas production any longer.
H.R.2192 voting today
prevents Congress+staff from exempting themselves from AHCA
scheduled vote between 12:30-1:30
http://abcnews.go.com/Politics/house-hold-vote-gop-health-care-bill-thursday/story?id=47191544
Could it work to have government paid catastrophic coverage (yearly & lifetime) for everyone and let insurers provide everything below that? I’m assuming a pretty high yearly limit guaranteed by gov’t so insurers are still needed (i.e. multiples of $100k, not $5000) and can provide everything from complete care to mini-catastrophic (up to govt limit) policies.
Anyone could have a health catastrophe today. There’s a low chance but high cost that we all face. The risk is known to be greater for some people who’s pre-existing conditions have been diagnosed. But there are plenty of undiagnosed issues and plenty of people who will randomly get something like cancer. It doesn’t seem unreasonable to share that risk through taxes, especially if we are saying the government is paying a significant amount for health care/insurance anyhow. It seems far better to share that risk through federal taxes than through the complex system of money transfers/payments/taxes/fines/etc that we are setting up.
Insurers’ risk would be limited for both known and unknown pre-existing conditions. They’d be much better able to calculate their risk/cost and provide a range of policies for different people based on how much risk/cost I want at any point in my life. We are moving away from anything resembling insurance with these proposals, into a system where “those who can afford it” pay medical costs for “everyone”. The single-payer is “ those who can afford it” rather than the government, with a complex system for their money to go through the system. It is single-payer even if politicians won’t admit it and have all the payments go through the government.
The purpose of the mandate, subsidies, fines, and all the other complexities that Ds and Rs are putting in place is to hide the fact that they are setting up a single-payer system where there is little/no insurance in the traditional sense, just a complex system to get money from some people who can afford it to anyone who needs it. Companies who provide insurance for other things happen to be the ones who handle distributing money to health care providers, but the “insurance” part of their role is being greatly reduced.
On another note, is any politician ever again going to talk about HEALTH CARE COSTS rather than how to pay?
Show me that in the legislation.
Wow. But I’d need to get many done at once or the airfare and hotel would eat up any savings.
interesting though, because Hungary was probably one of the most backward of the communist bloc countries. Maybe retribution from the uprising? I was in Budapest in the 90’s and they were farming with horses. They’ve come a long way.
Republicans now own it. They’re fools.
Government is insane when it comes to “insurance”. They never get it right. Case in point, the so-called “Federal Flood Insurance”. It is not insurance but rather an agreement between the federal government and someone that says that in the event of a flood money will be paid out. The premiums charged have no sound actuarial foundation and because of that the “claims” always exceed the losses to the point that FEMA/NFIP take money directly out of the US treasury to make up the shortfalls. That means that a taxpayer sitting on a mountain in the desert subsidizes the “claims” of someone sitting on the beach on the Gulf Coast in a low lying area who is going to have a flood.
We don’t elect the smartest among us and certainly not people with any common sense. Most of the turds in Congress are worthless.
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