COMPARE PROPOSALS TO REPLACE THE AFFORDABLE CARE ACT (Interactive)

The Henry J. Kaiser Family Foundation
(Interactive)
COMPARE PROPOSALS to REPLACE THE AFFORDABLE CARE ACT

President Donald Trump and Republicans in Congress have committed to repealing and replacing the Affordable Care Act (ACA). How do their replacement proposals compare to the ACA? How do they compare to each other?

Plans available for comparison:

• The Better Care Reconciliation Act of 2017 (PDF) – Updated 6.26.2017
• The American Health Care Act, as passed by the House of Representatives on May 4, 2017 (PDF)
• The Affordable Care Act, 2010 (PDF)

More plans for comparison:

• Rep. Tom Price’s Empowering Patients First Act, 2015 (PDF)
• House Speaker Paul Ryan’s A Better Way: Our Vision for a More Confident America, 2016 (PDF)
• Sen. Bill Cassidy’s Patient Freedom Act, 2017 (PDF)
• Sen. Rand Paul’s Obamacare Replacement Act, 2017 (PDF)
• House Discussion Draft, February 10, 2017 (PDF)

The most risky thing Trump will do and it's replacing Obamacare

Please take particular note of the last paragragh!

I've been following Robert Laszewski for several years. Many of his Health Care Policy & Marketplace Review posts are also cross-posted at Forbes.

I've posted his resume below first in order to show how important his qualifications are and then excerpted two things from his two most recent posts regarding the "replace" part of "repeal & replace" which includes the transition period...a VERY risky period for Trump, Republicans, and America and everything hangs on "us" getting this right!!!

I made this as short and clear as I could--read the full articles if you want. Obamacare was a "first" and getting us out of this mess will be a "first"--it's all uncharted territory. The fines, the rising monthly premiums, the soaring deductibles, and the damage to our healthcare system (shortages of doctors, unmanageable loads of regulations and paperwork, etc.) might not seem as bad to people as a collapse of the entire system would if all this goes South!

Robert Laszewski - Health Care Policy & Marketplace Review

I am one of a kind having spent 20 years in the health insurance marketplace and 20 years inside the Beltway. I ran two health insurance businesses before coming to Washington, DC to start my own health care policy and market consulting business. Over the last 20 years my clients have been the people who run insurance companies, hospitals, and physician practices. A long time ago, I made all of the money I will ever need and I keep doing this because I want America’s health care system to work for everyone.

The author is a Forbes contributor. The opinions expressed are those of the writer.

Excerpt from Obamacare Repeal, Transition And Replace: The Republicans Have A Tiger By The Tail!

But will there be any insurance companies in the exchanges come 2018?

The Obamacare individual insurance market was an unsustainable place for health plans before the Republicans won the 2016 election and reiterated their promise to end it.

Most carriers are now losing their shirts on their Obamacare exchange business. Some of the biggest carriers are exiting in 2017. Others decided to hang in for at least another year hoping the new Congress and President would fix it in 2017. Now, with the Republicans promising to kill Obamacare, there is little hope Obamacare will get better for the carriers in 2017 or 2018. Most in the insurance industry believe their losses will only increase as the sick stay in the pool and fewer healthy people, having been promised something better by Republicans, hold off on paying the big premiums and having to face the big deductibles in the current plan.

The health plans are committed for 2017. But no health plan is committed for 2018.

Faced with an expected worsening bottom line going into 2018 we cannot assume the insurers won't bail. What insurance company CEO will be willing to sustain the tens of millions, or in some cases hundreds of millions, of dollars in losses they now face, and expect to continue to face, to keep the dying Obamacare program afloat as a favor to Republicans?

And remember, about half of the current Obamacare compliant market does not get a subsidy and these folks are also at risk of not finding a carrier in 2018. If the health plans get out of the health insurance exchanges they will likely either get out of the entire individual market or dramatically increase the premiums for the off-exchange market. It would appear that many of these often self-employed folks outside the exchanges voted for Republicans over their anger at Obamacare's big premiums and deductibles and could be faced with fewer or even worse individual health insurance choices in 2018.

Excerpt from "Republicans Are Being Awfullly Naive" About the Transition Period in "Repeal and Replace"

[The following are responses to an interviewer's questions.]

What they have to do, and I don’t think they’ll do, is take the defunding bill they use to repeal Obamacare and reestablish the risk corridors and reinsurance fund. They have to do it inside the budget bill; otherwise they’ll need 60 votes.

I think what they have do is reestablish one of the parts of Obamacare that Republicans have hated the most, the so-called insurance company bailout, because if they don’t, they’re going to have a catastrophic result come 2018.

To have an orderly transition, I think Republicans need to reimplement the risk corridors by February or March. That is the only chance they have. I don’t think there is a single Republican member of Congress who has thought about this. I’m reading all these quotes and they’re completely blind to the fiasco on the individual market that they’re about to create.

KAISER - TABLE 1 - SUMMARY OF RISK AND MARKET STABILIZATION PROGRAMS IN THE AFFORDABLE CARE ACT:

The ACA’s risk adjustment, reinsurance, and risk corridors programs were intended to protect against the negative effects of adverse selection and risk selection, and also work to stabilize premiums, particularly during the initial years of ACA implementation:

Table 1: Summary of Risk and Market Stabilization Programs in the Affordable Care Act

Thoughts are welcome and please forward to anyone who can help or is interested!

Everything Will Be Fine As Soon As The Obamacare Market 'Stabilizes'--Not

FORBES - Robert Laszewski:

Goodness, this family already pays $11,760 a year for a plan with a $13,700 deductible and it could go up to $13,971 in premium next year based upon the 18% rate increase.

This is a “stable” health insurance market and there is no reason to “despair?”

What are these people thinking?

READ MORE

Americans need a bipartisan fix to our health care system. Here's how to do it.

Just a few common sense and practical steps can turn what we have now into a more bipartisan approach to health insurance reform.

Democrats need to admit Obamacare is unpopular because it is not meeting the needs of too many people.

Republicans need to admit we don't need to "repeal and replace" Obamacare with another complex ideological health insurance reform plan to make our system work a lot better.

Both sides should be willing to build on a list of bipartisan ideas they can both embrace.

THESE ARE WORTH READING - CLICK ON ARTICLE BELOW: USA TODAY: Customer-friendly Obamacare fixes: Column by Robert Laszewski 7:24 p.m. EST January 14, 2015

Robert Laszewski is president of Health Policy and Strategy Associates, LLC (HPSA), a policy and marketplace consulting firm specializing in assisting its clients through the significant health policy and market change afoot. Before forming HPSA in 1992, Mr. Laszewski spent nine years as a chief operating officer of a health and group benefits insurer. The majority of Mr. Laszewski’s time is spent being directly involved in the marketplace as it comes to grips with the health care cost and quality challenge.

HEALTH CARE POLICY and MARKETPLACE REVIEW

Everybody Has To Pay This New Obamacare Tax

THE DAILY CALLER:

This year the tax will cost individuals more than $500 in extra premiums according to one actuarial estimate. Families who purchased insurance will see their premiums go up by more than $700.

The new tax also hits senior citizens who rely on Medicare Part D and Medicare Advantage. It will land on the nation’s poor who depend upon Medicaid-managed care programs.

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HEALTH FREEDOM VS. OBAMACARE FASCISM

...there are three basic propositions of Health Freedom legislation:

1. Health Care is so incredibly expensive in America because of government intervention into the medical marketplace.

2. Health care costs can only be radically reduced by an equally radical reduction of government regulations and subsidies.

3. Just as health care costs will be radically reduced, both the availability and the quality of health care will be radically increased by such a reduction of government intervention.

Given this, here are:

Ten Specific Legislative Means By Which Health Freedom Can Be Achieved:

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WHAT HAPPENED ON JANUARY 1, 2015?

As a brief reminder for those Americans who forgot (or for the many who don't know), lgstarr presents this Public Service message:

Here is what happened, quietly, on January 1, 2015 in America:

• Medicare tax went from 1.45% to 2.35%
• Top Income tax bracket went from 35% to 39.6%
• Top Income payroll tax went from 37.4% to 52.2%
• Capital Gains tax went from 15% to 28%
• Dividend tax went from 15% to 39.6%
• Estate tax went from 0% to 55%
• A 3.5% Real Estate transaction tax was added.

Remember this fact: These taxes were all passed solely with Democrat votes--not a single Republican voted for these new taxes!

These taxes were all passed in the Affordable Care Act, aka Obamacare.

If you think that it is important that everyone in the U.S. should know this, and there are many millions who don't yet, then please pass it on.

The ACA’s overall impact on employment, however, will arguably be larger than that of any single piece of legislation since World War II.

Much of the ACA’s tax effect resembles unemployment insurance: both encourage layoffs and discourage people from returning to work.

Starting this year, the United States’ working population will face three major employment disincentives resulting from the very benefits the Affordable Care Act (ACA) provides: (1) an explicit tax on full-time work, (2) an implicit tax on full-time work for those who are ineligible for the ACA’s health insurance subsidies, and (3) an implicit tax that links the amount of available subsidies to workers’ incomes.

A new study published by the Mercatus Center at George Mason University advances the understanding of how much these ACA taxes will reduce overall employment, and why. It concludes that the reduction will be nearly double that projected by previous analyses. Labor markets ultimately will reduce weekly employment per person by about 3 percent—translating to roughly 4 million fewer full-time-equivalent workers.

Below is a brief summary of this important update. Please see “The Affordable Care Act and the New Economics of Part-Time Work” to read the entire study and to learn more about author Casey B. Mulligan, a professor of economics at the University of Chicago.

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GruberGate: Everything he said compiled into one, short video

Watch this rich (Democrat) man laughing at all the poor, stupid American people!

* 2.5 million from the NIH
* 1.7 million from the Justice Dept.
* $392,600 from HHS
* $103,500 from the State Dept.

Does this matter...or not?

You'd think it would. Even ABC NEWS is now reporting on what Jonathan Gruber previously said in his FIVE videos prior to 2014.

Two New Studies Raise Red Flags on Obamacare

The Fiscal Times:

When the next round of premium increases hits over the summer, and the market for employer-provided health insurance undergoes the same kind of massive disruption as the individual market did over the last six months, the debate over the honesty and integrity of the Obama administration may hit new levels of intensity.

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Supreme Court may invalidate Obamacare sometime before June, 2015

"...an inevitable Supreme Court review in the coming term, with a decision assured no later than June 2015 and possibly earlier given that federal funds are quite possibly being disbursed illegally."

Powerline:

The little case that could, Halbig v. Sebelius, is one of four lawsuits challenging the government’s authority to pay subsidies under Obamacare to anyone enrolled in the federal exchange. The case just took a giant step forward in oral argument last week before the D.C. Circuit Court of Appeals.

READ MORE

Centers for Medicare and Medicaid Services (CMS) has taken a major step toward rationing medications to the elderly.

Thanks to Obamacare: READ MORE

Affordable Care Act Scam named Better Business Bureau’s 2013 ‘Scam of the Year’

The Better Business Bureau announced its “Top 10 Scams of 2013.” Leading the pack, believe it or not, was the Affordable Care Act Scam, which most would refer to as the Obamacare scam.

As much as he may want to differ, CBS late night host David Letterman didn’t invent the idea of a “top 10 list” — it’s been around for a long time, and that includes the 102 year-old Better Business Bureau, which has published a top 10 scam report for years.

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Social progress?

The old employer sponsored system forced people to stay in jobs they didn’t like because they needed the health insurance coverage. The new Obamacare system will force people to stay out of jobs they do want because they need to maximize their subsidies. And this is social progress?

READ MORE

CALIFORNIA: OBAMACARE TURNING CANCER PATIENTS AWAY

There are two reasons patients will be turned away: one that President Barack Obama hid, and one that he lied about.

READ MORE

U.S. intelligence agencies warn Obama administration about new security threat to Obamacare website

U.S. intelligence agencies last week urged the Obama administration to check its new healthcare network for malicious software after learning that developers linked to the Belarus government helped produce the website, raising fresh concerns that private data posted by millions of Americans will be compromised.

READ MORE

NOTICE OF TERMINATION

With a deep sense of sadness, I must inform you that I will no longer serve as a physician for Aetna patients under the terms of our contractual agreement, which you most recently unilaterally changed...

Read this shocking letter here!

Obamacare, the vision, is now beyond rescue - UPDATE

By Megan McArdle
Jan 21, 2014

Last Wednesday, Scott Gottlieb and I debated Jonathan Chait and Douglas Kamerow on this proposition: “Resolved: Obamacare Is Now Beyond Rescue.” I was feeling a little trepid, for three reasons: First, I’ve never done any formal debate; second, the resolution gave the “for” side a built-in handicap, as the “against” side just had to prove that Obamacare might not be completely beyond rescue; and third, we were debating on the Upper West Side. Now, I grew up on the Upper West Side and love it dearly. But for this particular resolution, it’s about the unfriendliest territory this side of Pyongyang.

Nonetheless, I greatly enjoyed the debate. I’m not ashamed to admit that the other side had a lot of powerful moments. Kamerow, a doctor who is also a former assistant surgeon general, made good points about the problems with the previous status quo. In the other seat, Chait was as passionate, witty and well-reasoned in his arguments as ever. (You can read his account of the debate here.) Given the various difficulties, we went in assuming that we would lose, so we were pretty surprised and pleased when we won.

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UPDATE: POWERLINE COVERS THIS DEBATE HERE.

And, it is "Update #17" here.

Death spiral

OBAMACARE:

A death spiral - the insurance pool equivalent of bankruptcy - occurs when too many older and sicker people sign up for insurance relative to the number of younger, healthier people, Goodman explained, forcing everybody’s premiums up. But as premiums rise, even less young people sign up for coverage.

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