Showing posts with label Healthcare. Show all posts
Showing posts with label Healthcare. Show all posts

Thursday, February 23, 2017

Democrats: Talk To Older Voters About GOP Plan To Repeal Medicare Benefits

The Affordable Care Act (ACA)  not only provides affordable access to health insurance for working-age Americans and their families, it also provides older Americans covered by Medicare and Medicaid a list of additional covered benefits. The ACA, a.k.a.Obamacare, improved Medicare coverage, boosted taxes and reduced program spending. Older Americans on Medicaid also would face a significant loss of benefits, because any effort to repeal Obamacare would affect the law’s major expansion of Medicaid, including how Washington pays states for administering the program.

For starters, the ACA greatly expanded the roster of tests and procedures that Medicare enrollees can get with little if any cost to make sure enrollees are healthy and to help them stay that way. Medicare’s list of so-called wellness provisions includes many items added by the ACA:
  • Abdominal aortic aneurysm screening
  • Alcohol misuse screening and counseling
  • Bone mass measurements
  • Breast cancer screening (mammograms)
  • Cardiovascular disease (behavioral therapy)
  • Cardiovascular disease screening
  • Cervical and vaginal cancer screening
  • Colorectal cancer screening
  • Depression screening
  • Diabetes screening and self-management training
  • Glaucoma tests
  • Hepatitis C screening test
  • HIV screening
  • Lung cancer screening
  • Medical nutrition therapy
  • Obesity screening and counseling
  • Prostate cancer screening
  • Sexually transmitted infections screening and counseling
  • Shots (flu, pneumococcal, and Hepatitis B)
  • Tobacco use cessation counseling
  • “Welcome to Medicare” preventive visit
  • Yearly “Wellness” visit
Good health does cost money, of course, but so does having to treat people who have not been taking care of themselves. Perhaps all of these measures would survive the repeal process. However, considering that some of these benefits might disappear, Medicare enrollees ought to work with their doctors right now to make sure they’re taking full advantage of these wellness benefits.

Another main Obamacare feature has been its reduction in out-of-pocket spending in Part D Medicare prescription drug plans. This has been accomplished through the elimination of the so-called “donut hole” by 2020. Medicare says enrollees have saved more than $2,000 per person, on average, because of this single change.

It’s quite possible, of course, that the donut hole will be totally gone by the time the “replace” components of “repeal and replace” actually have taken effect. Given the shouts from both parties about high drug prices, it seems unlikely that Republicans would have much appetite for being tagged with efforts to make people spend more money on prescription medicines.

Obamacare’s other big Medicare impact came via financial improvements it put in place to help the program. It raised a bunch of taxes, including requiring high-income wage earners to pay higher Medicare payroll taxes and stiff premium surcharges for Medicare Part B and D premiums. Health providers and Medicare Advantage insurance plans were also willing to accept lower payment levels from Medicare in exchange for the law’s provisions that would expand their access to more insurance customers.

Before the passage of the ACA, the Medicare trust fund that pays claims for Part A hospital and nursing home expenses had been projected to run short of funds by 2017. The ACA has pushed that date out more than 10 years.

Republicans reportedly want to do away with many of these taxes. Unless other funding streams are created to replace them, the longer-term finances of the program would be at greater risk. Ironically, these actions would “force” Republicans to cut health care spending to curb runaway deficits.

As actual GOP plans come into sharper focus, sharp Medicare battle lines will form for politicians and the public alike.  Expect the proposals to come coated in friendly sounding packages that tout health care improvements. But it will be crucial to look inside the packages to get an understanding of whether the Medicare program that would emerge from their enactment is one you want to have.

READ MORE: How plans to repeal the Affordable Care Act could affect Medicare

Monday, February 13, 2017

GOP Bill To Repeal ACA - Obamacare

Republicans in the House (Tea Party) Freedom Caucus voted among themselves Monday night to band together and support only a 2017 Affordable Care Act (ACA) "Obamacare" repeal bill that is at least as comprehensive as the repeal bill passed by the Republican controlled House and Senate in 2015.
“If it’s less than the 2015 [bill], we will oppose it,” Freedom Caucus Chairman Mark Meadows (R-N.C.) told a small group of reporters Monday night.
By insisting the 2015 repeal bill effectively be copied as the initial 2017 repeal bill, the GOP again confirmed the party's hard line intent to repeal affordable healthcare for millions of Americans.

The 2015 ACA repeal bill was passed by the Republican controlled House and Senate in late 2015, but was not signed by President Barack Obama when it reached his desk in January 2016.

The 2015 repeal bill rolled back Medicaid expansion funding to pre-2010 levels and ended the mandate for businesses over a certain size to offer group health insurance to employees along with the subsidies that helped pay for the mandated insurance, plus more...

Affordable Care Act (Obamacare) Repeal Bill of 2015 (December 7, 2015 @ healthaffairs.org).


Friday, February 10, 2017

Republicans Looking For Obamacare Replacement Should Work With Democrats


NY Magazine: "The Republican Party, faced with the catastrophic real-world consequences of repealing the Affordable Care Act, is divided over how to proceed. Some nervous Republicans want to figure out what they want to put in place of Obamacare.

Senator Mike Lee insists that Republicans repeal Obamacare first, before they decide on an alternative. And his reason is straightforward: If people saw the Republican alternative, they might not like it! “There is a lot less agreement about what comes next,” he tells Julie Rovner. “If we load down the repeal bill with what comes next, it’s harder to get both of them passed.”

A Republican ad promises, “Health insurance that provides more choices and better care at lower costs, provides peace of mind to people with preexisting conditions … House Republicans have a plan to get there, without disrupting existing coverage.”

But when people find out what Republicans plan to put in place of Obamacare they will see the Republican "Repeal and Replace" ads were less than empty promises. It's time for Democrats to promise their "replacement" for Obamacare - Medicaid for All.


Congressman John Conyers (D-MI) has introduced his bill, The Expanded and Improved Medicare for All Act," in every Congress since 2003. It is co-sponsored by more than 50 Members of Congress and support continues to grow. If Republicans want to repeal and replace Obamacare, tell them to replace it with Medicare for All.

Rep John Conyers: "Half a century ago, addressing the convention of the Medical Committee for Human Rights, Martin Luther King Jr. declared, "Of all the forms of inequality, injustice in health care is the most shocking and inhumane."
"I strongly agree with Dr. King, which is why I have been a firm supporter of President Obama’s landmark Affordable Care Act (ACA). The ACA has resulted in 17.6 million uninsured people gaining health coverage as the law’s coverage, and minorities have seen the largest increase in insurance coverage: About four million Latino adults gained coverage, an 11.5% drop in the uninsured rate, while nearly three million African-Americans gained insurance, a 10.3% reduction. Another seven million white adults became insured, representing a 6% drop.

But there is still much more to be done to eliminate injustice in health care in the United States, while making our system more cost-efficient. The United States still spends almost twice as much per person on health care as any other country, yet our key outcomes – life expectancy, infant mortality and preventable deaths – too often lag behind our peers. A recent Commonwealth Fund study ranked the U.S. healthcare system dead last among 11 highly developed countries in terms of quality, efficiency and access to health care.

That is why I am leading the charge in the House of Representatives for single-payer, universal healthcare system.  By implementing a “Medicare for All" system – the standard for health care throughout the industrialized world – we can achieve hundreds of billions of dollars in cost savings that can be used to cover the nation's remaining uninsured and upgrade coverage for millions of underinsured citizens. More and more people across the country understand that a single-payer healthcare system is the only way to guarantee quality care and at the same time reduce medical costs. A poll from [date] showed that more than half of Americans -- including 80 percent of Democrats and a quarter of Republicans -- support expanding health reform to "Medicare for All."

That is why I have introduced my bill, The Expanded and Improved Medicare for All Act, in every Congress since 2003. It is co-sponsored by more than 50 Members of Congress and support continues to grow. "

Wednesday, February 8, 2017

Sanders And Cruz Debate Healthcare Repeal For American Workers

Senators Bernie Sanders and Ted Cruz debated the future of health care in the US Tuesday night. The town hall debate highlighted some of the issues surrounding the GOP's committment to repeal the Affordable Care Act -- a sweeping health care law that diectly covers some 20 million Americans as well as who have health insurance through their employers. The evening began with each lawmaker laying out starkly different views of the controversial law.

"If you are one of 20 million Americans who finally has received health insurance, forget about it -- you're gone," Sanders warned about repealing Obamacare. "That means when you get sick, you ain't gonna be able to go to the doctor. And when you end up in the hospital, you'll be paying those bills for the rest of your life, or maybe you'll go bankrupt."

Cruz, a Texas Republican who made his name in national politics by fiercely opposing the health care law, said former President Barack Obama made a series of promises that were broken.

"If you like your doctor, you can keep your doctor ... Millions discovered that was not true," Cruz said.



Related:

Thursday, February 2, 2017

GOP Agenda To Cut Seniors' Healthcare


Republicans working to repeal the Affordable Care Act are working to stick it to one of the most important voting blocks within the GOP base - Senior Citizens. Based on exit polling, many of the demographics that would be hit hardest by the repeal voted for Trump in the presidential election.

A sizable minority of Americans don’t understand that Obamacare is just another name for the Affordable Care Act, according to a Morning Consult survey. In the survey, 35 percent of respondents said either they thought Obamacare and the Affordable Care Act were different policies (17 percent) or didn’t know if they were the same or different (18 percent). This confusion was more pronounced among people age 18 to 29 and those who earn less than $50,000 — two groups that could be significantly affected by repeal.

Among Republicans, a higher percentage (72 percent) said they knew Obamacare and the A.C.A. were the same, which may reflect the party’s longstanding hostility to the law. Though Republicans were more likely to know that Obamacare is another name for the A.C.A., only 47 percent of them said expanded Medicaid coverage and private insurance subsidies would be eliminated under repeal (compared with 79 percent of Democrats), while 29 percent said Medicaid and subsidies would not be affected and 24 percent said they didn’t know. A large block of Republican voters do not understand repealing Obamacare will affect the popular provisions of the A.C.A. AARP is working to change that political equation.

AARP, the nation’s largest organization of senior citizens, with a membership of 38 million older Americans age 50 and older, announced Monday it was launching a comprehensive campaign to protect Medicare and Medicaid from the GOP's chopping block. Repealing "and replacing" the Affordable Care Act also takes big bites out of Medicare and Medicaid.
“The average senior, with an annual income of under $25,000 and already spending one out of every six dollars on health care, counts on Social Security for the majority of their income and on Medicare for access to affordable health coverage,” wrote AARP CEO Jo Ann Jenkins in a recent letter to Congress. “We will continue to oppose changes to current law that cut benefits, increase costs, or reduce the ability of these critical programs to deliver on their benefit promises. We urge you to continue to do so as well.”
The GOP's wish list for radical restructuring America's Social Security, Affordable Care, Medicare, and Medicaid benefit programs will literally destroy the quality life earned by America's retired seniors. Here are just two examples of how the GOP's restructuring goals will hit seniors hard with their repeal and replacement of the Affordable Care Act. One of those proposals would relax or eliminate the ACA’s “age bands” cap. The other would transform Medicaid into a so-called block grant.

Saturday, January 28, 2017

GOP Hit Seniors With Higher Healthcare Costs

NPR: Republican lawmakers meeting in Philadelphia this week say they want their replacement of Obamacare's Affordable Care Act to be done by spring. There is no consensus on a plan yet, but several Republicans in Congress have already circulated proposals that could reduce or eliminate features of the federal health law that have benefited older Americans. Here are some examples:

Prescription drugs

The Affordable Care Act expanded Medicare's prescription drug benefit. Before the ACA, people on Medicare had to deal with a gap in that insurance coverage that came to be known as the doughnut hole. That's the point at which Medicare would stop paying part of the cost of drugs, and beneficiaries would have to buy them at full price. Then, when the patient's out-of-pocket costs reached a level deemed to be "catastrophic," Medicare would start paying most of the cost of the drugs again.

A 2011 study from the Kaiser Family Foundation showed that when patients had to pay full price, they'd skip some of their prescribed medications — and that could, potentially, result in sicker patients and higher costs for Medicare.

Gradually, the ACA has been closing the doughnut hole coverage gap. According to the Center for Medicare and Medicaid Services, beneficiaries have saved more than $23.5 billion in prescription drug costs. It's unknown if this program would be maintained in a Republican plan that replaces the ACA.

Medicaid

Medicaid is commonly thought of as the program that provides health care for the poor. But it also pays for long-term care for a lot of older people, including the majority of nursing home residents.

One idea in some of the Republican proposals for replacing the Affordable Care Act is to turn Medicaid from a guaranteed benefit into a block grant to states. States would get a fixed amount of money from the federal government, and could make their own decisions on how to spend it.

That's an idea that's been popular for some time among conservatives such as House Speaker Paul Ryan. They argue that states know their needs better than Washington does, and the block grant would give states flexibility in meeting those needs.

Critics fear this could do away with many protections that federal law currently provides for vulnerable older people. They also worry about what might happen in an economic downturn, when the demand for Medicaid goes up, but the amount of federal money allocated for it stays the same. For example, would states have to choose between cutting services for poor children versus cutting programs for the frail elderly?

Limiting the cost of insurance premiums for older adults

Before the Affordable Care Act, insurance companies could charge people in their 50s and 60s many times more than they'd charge a younger person for the same policy. The affordable care act put a limit on that. Now Insurance companies can only charge older people three times as much as they charge people a few decades younger. But the various GOP replacement proposals either set higher limits — five or six times higher — or they don't have any limits at all.

A study sponsored by the Rand Corporation and the Commonwealth Fund found that if older Americans were charged five times more for insurance than younger people, about 400,000 would no longer be able to afford to buy health insurance.

Friday, January 27, 2017

GOP Looking For A Healthcare Strategy

The Washington Post has obtained a secret recording of a closed-door meeting between Republican lawmakers – and it reveals them expressing serious doubts about how they are going to live up to their promises to the American people of getting rid of Obamacare, while at the same time initiating a replacement without creating chaos.

In the recording, a number of concerns were raised, but chief among them was how they were going to do this in a way that wouldn’t hurt them when the next election comes up.

What’s most striking about the conversations, however, was that key Republicans admitted that they didn’t know what to do as far as a replacement plan is concerned.

Thursday, January 19, 2017

Economics of the Affordable Care Act

Any effort to replace the Affordable Care Act will be confronted by the same structural imbalances in the health care economy that the legislation’s authors faced.

The Affordable Care Act (ACA), which President-elect Donald Trump and the Republican-controlled Congress have vowed to repeal, was crafted to overcome two basic problems in the provision of health care in the United States. First, the costs are incredibly skewed, with just 10 percent of patients accounting for almost two thirds of the nation’s healthcare spending. The other problem is asymmetric information: Patients have far more knowledge about the state of their own health than insurers do. This means that the people with the largest costs are the ones most likely to sign up for insurance. These two problems make it impossible to get to universal coverage under a purely market-based system.

The problem with the skewing of health care costs is that while most people’s health spending is relatively limited, it remains very expensive to provide care for the costliest 10 percent. The Centers for Medicare and Medicaid Services projects that per capita spending on health care in the US will average $10,800 in 2017. But the cost for the most expensive 10 percent of patients will average $54,000 per person, compared to an average of just $6,000 for everyone else. The cost for the healthiest 50 percent of patients averages under $700 per person.

Covering the least costly 90 percent of patients is manageable, but the cost of covering the least healthy 10 percent is exorbitant. Very few people could afford to pay $54,000 a year for an individual insurance policy. Furthermore, if insurers were to set their premiums in accordance with overall averages, they could anticipate a skewed patient pool. The more healthy half of the population, with average costs of less than $700 a year, would either limit their insurance to catastrophic plans that only cover very expensive medical care, or go without insurance altogether.

Click here to read the rest of the story:

Tuesday, January 17, 2017

Even Most Republican Voters Say Government Has Responsibility For Healthcare

For Democrats, public policy for using the federal government to make affordable health care available to American workers is an election winner! More than eight-in-ten Democrats and Democratic-leaning independents (85%) say the federal government should be responsible for health care coverage, compared with just 32% of Republicans and Republican leaners.

Democrats can win by promising American workers a Medicare-for-all "public option" health care coverage. As the debate continues over repeal of the Affordable Care Act and what might replace it, a growing share of Americans believe the federal government has a responsibility to make sure Americans have health care coverage, according to a new Pew Research Center survey.

AARP: GOP Plan To Convert Medicare From “Defined Benefit” To “Defined Contribution” Program

As news of Republican Speaker of the House Paul Ryan’s proposed conversion of Medicare from a “Defined Benefit” to a “Defined Contribution” program spreads, it is stirring fears among the 57 million beneficiaries who rely on it to cover prescription drugs, doctor visits and hospitalizations. Democrats and consumer groups, including AARP, have pledged their opposition Ryan's plan.

Ironically, Ryan is proposing to convert Medicare into the very system he is rushing to repeal — the Affordable Care Act (“ACA” or “Obamacare”) — but without its protections, such as the requirement that private insurers cover those with pre-existing conditions.

Ryan claims that the ACA must be killed quickly because “we have to bring relief as fast as possible to people who are struggling under Obamacare.” Out of one side of his mouth, he asserts that young, healthy Americans are struggling to buy private health insurance, even though the government provides them with subsidies to help with the cost and requires that they can’t be turned down because of pre-existing conditions. Out of the other side of his mouth, Ryan claims that seniors and people with disabilities will be just fine with a government provided subsidy in the form of a voucher, and no other protection!

In a special report, AARP details what the state of Medicare is today and provides what you need to know about the upcoming debate in Washington over the nation’s most important health care program:
A Battle Looms by Bill Walsh

Republicans Plan To Destroy Social Security and Medicare

Republicans are desperate to destroy Social Security and Medicare. These two programs demonstrate government at its best. The federal government runs these two extremely popular programs more efficiently, universally, securely, and effectively than the private sector does with its alternatives — or indeed could, no matter how well those private sector programs were designed. This is in direct conflict with their fanatically-held beliefs that the private sector should run everything.

Republicans will do whatever they can, quietly, secretly, to destroy Social Security and Medicare. Republicans want to avoid political accountability by destroying Social Security and Medicare without leaving clear fingerprints.

When Republicans Repeal Affordable Healthcare

What happens when the Republican Party repeals the Affordable Care Act without enacting any kind of replacement? According to the Congressional Budget Office, the Republican-backed Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015 — which passed a Senate vote in late 2015 but died due to President Obama’s veto — would drastically slash the number of Americans who have health insurance, while at the same time ensuring higher premiums and chaos in the insurance market.

Here are the CBO’s five biggest reasons the GOP’s repeal plan is a disaster for American health care:
  1. 18 million Americans would lose their insurance in the span of a year. Under the bill passed by Republicans — which would keep insurance market reforms in place but would gut both the Medicaid expansion and subsidies for people to buy private insurance — an estimated 18 million people would lose their health insurance within just one year.
  2. An additional 9 million would lose their insurance shortly after the first year of repeal. Once the elimination of both subsidies and expanded Medicaid happen, the number of people who lose their insurance thanks to the legislation will total 27 million. Over the long run, the CBO projects that the number of uninsured in the U.S. would increase by 32 million by 2026 over what it would have been without repealing the ACA.
  3. Premiums on the individual market would skyrocket by 20% to 25% relative to where they’d be without repeal within a year. In part because the GOP plan still bars insurers from discriminating against people with preexisting conditions, insurance premiums on the individual market would increase by as much as 25% within a year of Obamacare repeal, as insurers would scramble to raise prices to cover the costs of insuring more sick people.
  4. Premiums would then go up by 50% after the GOP eliminates the Medicaid expansion and private insurance subsidies. Once people who buy insurance individually lose access to subsidies to help them offset the costs, insurers will raise prices even higher — in fact, the CBO estimates that “premiums would about double by 2026” under the GOP’s bill.
  5. Half the country would be stuck in an area where no insurers would offer them non-group coverage. As if the projected price increases for individual market buyers weren’t bad enough, the CBO also says that many insurers will simply pull out of individual markets in many places, as “about half of the nation’s population lives in areas that would have no insurer participating in the nongroup market in the first year after the repeal of the marketplace subsidies took place.”
Repealing Obamacare is a huge tax cut for the rich. This did not play a major overt public role in the 2009-’10 debate about the law, but the Affordable Care Act’s financing rests on a remarkably progressive base. That means, as the Tax Policy Center has shown, repealing it would shower money on a remarkably small number of remarkably wealthy Americans. Read more about the GOP's tax cut for the wealthiest 1 percent:

Thursday, December 29, 2016

What Working Class Americans Lose When Trump Scraps Obamacare

Republicans spent the last six years trying to repeal the Affordable Care Act (ACA), better known as Obamacare. Republicans have passed over 50 bills to repeal the ACA, since gaining control of the House in November 2010, but with Obama in the White House, those Republican Bills were nothing more than campaign rhetoric.

Republicans have warned their voters about the evils of Obamacare for years, calling it a job killer, and claiming it pushes health insurance premium costs sky high for everyone, among other evils. They promised to repeal it immediately if only their voters would vote to give them complete control of the federal government.

Republicans and Donald Trump promised voters their life would immediately improve once the healthcare law is repealed. Now they not only control the House and Senate, President-elect Donald Trump is set to take office, and the GOP may finally get its wish to repeal Obamacare.