Here are some key features:
Changing who gets financial assistance, and how much. People who buy private coverage would be eligible fixed tax credits that vary only by age, starting at $2,000 a year for people who are younger than 30, and peaking at $4,000 a year for people who are older than 60 ― with tax credits cutting out altogether at high incomes. This would replace the Affordable Care Acts tax credits, which are bigger for people with lower incomes and higher insurance costs. It would be a net transfer of federal resources from the old and the less affluent to the young and the more affluent ― and its a big reason that, according to several studies, such a scheme would lead to millions of newly uninsured.
Ending the individual mandate. The individual mandate would expire immediately. Insurers depend on the mandate to make sure healthy people dont wait until getting sick before buying coverage. So, going forward, insurers could charge higher premiums to people who did not maintain continuous coverage, meaning that they had let it lapse for more than 63 days. Its not clear that insurers would consider this adequate to protect against massive losses ― and that could mean a rapid destabilization of insurance markets, which in many states are already fragile, and a quick spike in the number of people without coverage.
Ending the Medicaid expansion. Federal funding for expanded Medicaid eligibility would end by 2020. States that expanded Medicaid would be free to continue offering it at that point, but theyd have to come up with the extra money with fewer federal funds. That would be a high hurdle for states. The Affordable Care Act provides federal dollars for at least 90 percent of the costs incurred by people enrolled in expanded Medicaid. The GOP bill would eliminate those extra dollars and offer states only the 50 percent to 75 percent funding available for other Medicaid beneficiaries.
Radically transforming Medicaid. Funding for the entire Medicaid program, including for people who were on the program before the health care law took effect, would change dramatically. Today, the federal government offers an open-ended guarantee: It promises to provide states with however much money it takes to guarantee comprehensive benefits for anybody who becomes available. Under the new legislation, states would get a lump sum per person, based on a pre-determined formula. Critics have warned that formula would not keep up with medical costs, forcing states to make deep cuts over time.
End of Obamacare taxes. Taxes to finance the Affordable Care Acts expansion, including new payroll taxes on the wealthiest Americans and taxes on the medical device industry, would expire.
I don't really think the 30% charge is that bad of an idea on its face. it seems like they're implementing it in the face of one of Aca's problems in people getting on coverage as soon as they're sick then bouncing off when they're healthy to avoid paying insurance premiums, which drove costs up for everyone. It's really the only way they can keep preexisting conditions gone while trying to stymie costs inflating into oblivion. Problem is I just don't think it's going to work. Without a hefty grace period to let people not on insurance ATM bounce into a plan it's going to be super rough on people, and even if they do have it costs will continue going up in the interim so you're hit with a chicken and egg scenario.
I don't really think the 30% charge is that bad of an idea on its face. it seems like they're implementing it in the face of one of Aca's problems in people getting on coverage as soon as they're sick then bouncing off when they're healthy to avoid paying insurance premiums, which drove costs up for everyone. It's really the only way they can keep preexisting conditions gone while trying to stymie costs inflating into oblivion. Problem is I just don't think it's going to work. Without a hefty grace period to let people not on insurance ATM bounce into a plan it's going to be super rough on people, and even if they do have it costs will continue going up in the interim so you're hit with a chicken and egg scenario.
I don't really think the 30% charge is that bad of an idea on its face. it seems like they're implementing it in the face of one of Aca's problems in people getting on coverage as soon as they're sick then bouncing off when they're healthy to avoid paying insurance premiums, which drove costs up for everyone. It's really the only way they can keep preexisting conditions gone while trying to stymie costs inflating into oblivion. Problem is I just don't think it's going to work. Without a hefty grace period to let people not on insurance ATM bounce into a plan it's going to be super rough on people, and even if they do have it costs will continue going up in the interim so you're hit with a chicken and egg scenario.
Not sure how this could pass the Senate. They need all Republicans plus 7 Democrats. Or they can nuke the filibuster for legislation, which they aren't crazy and desperate enough to do.
yes, it is the exact same thing with a worse calculation. The only other difference is you're allowed to buy shittier insurance with it than the ACA allows
from their talking points:
oh and if you have any leftover (lol) you can put it in your hsa
Yeah, that's why I said I don't see it working.The 30% charge incentivizes you to do just that, though. People are going to see the charge they probably can't afford and think nah I'll wait until I'm less healthy.
Not sure how this could pass the Senate. They need all Republicans plus 7 Democrats. Or they can nuke the filibuster for legislation, which they aren't crazy and desperate enough to do.
I'm confused. So they're keeping protection for people with pre existing conditions but implementing high risk pools?
So if you have a pre existing condition, you will get put in a high risk pool but the provider won't be able to deny you coverage? So doesn't that just mean your premium will go up?
And now it makes even more sense to stay off while healthy because there's no penalty and you can save up that money to pay the 30% increase if you do need to. With mandate, you were paying for nothing, which was a stronger incentive to go ahead and pay for something.Explain how a 30% charge will help. It's still going to be less expensive to just pay the charge later than paying for insurance all the time.
I'm confused. So they're keeping protection for people with pre existing conditions but implementing high risk pools?
So if you have a pre existing condition, you will get put in a high risk pool but the provider won't be able to deny you coverage? So doesn't that just mean your premium will go up?
I'm confused. So they're keeping protection for people with pre existing conditions but implementing high risk pools?
So if you have a pre existing condition, you will get put in a high risk pool but the provider won't be able to deny you coverage? So doesn't that just mean your premium will go up?
Wouldn't this need to be scored then?They can pass this through reconciliation with 50 votes.
They can't do a straight repeal that way, but they can amend the ACA so long as it can be shown over the next 10 years to not fuck with the deficit.
Yes. it will.
If I'm rich and have employer insurance will my cost go down?
Yeah I'm confused about this. Can someone explain how pre existing conditions would work under a plan like this and what high risk pools even are.
Wouldn't this need to be scored then?
I'm god awful with legalese, can someone let me know if it affects people under 26 on parents health insurance? Are they changing that?
I'm god awful with legalese, can someone let me know if it affects people under 26 on parents health insurance? Are they changing that?
Is there any place to see the positive side of this 30% surcharge because I don't see it.
Is there any place to see the positive side of this 30% surcharge because I don't see it.
Awful for the American people.
No. If your insurance is through your parents' employer, there is almost no change.
If you are through individual marketplaces, you can still be on it, but expect premiums for everyone to rise.
Assuming these companies even offer you insurance at all.
No. This is one of the few holdovers from the ACA.
Making medicaid a block grant would most likely get a positive score.Wouldn't this need to be scored then?
The insurance companies cannot deny you access to their products for pre-existing conditions, still.
That part is unchanged. Premiums will be higher because less people will be buying insurance and those that are will be sicker under this plan, but that is a different issue.
A high risk pool is when you are put together with a lot of other likely sick (or definitely sick) people to socialize the costs. These are often run by the state itself. These are very expensive to be a part of. This is insurance for people who aren't insurable.
The ACA did have high risk pools prior to the marketplaces kicking in.
They failed. Because they're too fucking expensive for the user and state.
This bill allocated $15 billion per state for 2 years, then $10 billion after. Which is like 10% of what it would cost to fund this properly.
High risk won't be for someone with say, high blood pressure.
But you have prostate cancer and just lost your job? Good luck!
Yes, to go through this way.
So say I had a two month gap and then got a job and got insurance I'm now paying 130%. Now if I get prostate cancer I'm shifted to a state pool instead of my employer? Do premiums then go up?
So say I had a two month gap and then got a job and got insurance I'm now paying 130%. Now if I get prostate cancer I'm shifted to a state pool instead of my employer? Do premiums then go up?
I would think if you move into an employer group plan none of these provisions would apply. Someone can correct me if I'm wrong.
Did they release any of their own estimates of cost or coverage? Do they even care?
Vox put out a good explainer:
http://www.vox.com/2017/3/6/14829526/american-health-care-act-gop-replacement
On the surface, the tax credits for the oldest Americans seem the most generous. People in their 60s, for example, get twice as much help as those in their 20s.
But under the Republican plan, insurers would be allowed to charge the oldest Americans five times as much as the youngest Americans. Their financial help would not scale nearly as much as their premiums would.
Welcome new healthcare systemMaking medicaid a block grant would most likely get a positive score.