Tag: Obamacare repeal

So What Happens Next? Who knows?

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The  Senate Republicans finally managed to do it!  … Kind of, but not really.

“Do What?” you might ask, but only if you didn’t hear Tuesday’s news.

They managed to actually get a majority vote in favor of moving the repeal of Obamacare to the debate stage. Unfortunately, that is as far as they got. So, as far as I can keep track of after that, one comprehensive bill to repeal and replace Obamacare was voted down with a vote count of 43 to 57, according to an article by the New York Times (1).

It appears that the vote came not too many hours after the vote to approve moving the issue of repealing and replacing Obamacare to the debate stage. I wonder how much debate actually took place before the comprehensive repeal and replacement bill failed. Sometimes I get nervous about hearing the actual debate for fear that I will get so mad at something someone says that I will start foaming at the mouth.

Then the Senate went on to the strategy of trying to pass something called a “skinny repeal.”  According to an article on the website CNN Money (2), the main tenets of the “skinny repeal” included the following:

  • Elimination of the individual mandate to buy insurance. The bill set the tax penalty at zero, which basically means the mandate would be history.
  • Get rid of the employer mandate for eight years. I have to ask here, “Why eight years?” It’s probably just another instance of our “leaders” in government thinking they might have severe withdrawal symptoms if they cannot keep some sort of stranglehold on the people in the country.
  • Provide a lot more flexibility to states regarding Obamacare insurance regulations through waivers. However, the overall effect of those waivers appear to be unclear … more about that later.
  • De-fund Planned Parenthood and divert that money to Community Health Clinics that would care for a woman’s total health and is not involved in providing abortions.
  • Eliminate the medical device tax for three years. Here’s another one that is very tentative in letting go of government control.
  • Then finally, increase the contribution limit for Health Savings Accounts.

However, according to a Fox News Politics story (3), in the wee hours of Friday morning (around 2 a.m.), the “skinny repeal” failed to pass by a vote of 51 to 49. I regret to say, and I am sure that those of you reading this already know and may be spitting nails over it, Senator John McCain cast the final vote against it. I am looking into his “reasons.”

I am bitterly disappointed in the Republicans right now, and I agree with much of what Sean Hannity was saying on the radio this afternoon – that the Republicans seem to have abandoned all the vision that we thought they stood for. Now it’s hard to tell what they stand for unless it’s election time and they want votes to stay in power.  I was going easy on the Republicans a few months ago when people were attacking them for not having an actual Obamacare Repeal or Repeal and Replacement plan ready to get voted on and go to President Trump’s desk to be signed. However, I am agreeing with many pundits that the blasted Republicans really had seven years to pull a doable plan to repeal and replace Obamacare together, and they really squandered it.

Are they just incompetent … or have they lost all their “guiding principles?”

Sources for further reading:

  1. https://www.nytimes.com/2017/07/25/us/politics/senate-health-care.html
  2. http://money.cnn.com/2017/07/27/news/economy/senate-skinny-repeal-health-care/index.html
  3. http://money.cnn.com/2017/07/27/news/economy/senate-skinny-repeal-health-care/index.html

More Flaws in CBO Estimate History

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Last week I pointed out clear flaws in the way the Congressional Budget Office analyzed the effect of the Better Care Reconciliation Act, otherwise known as the Senate bill to repeal and replace the Patient Protection and Affordable Care Act. In analyzing three of the most recent legislative efforts to repeal and replace the ACA (otherwise known as Obamacare), the CBO has come out with estimates that are difficult to fathom considering the vast differences in assumptions each estimate makes.

There is apparently another plan that has come out that is really no better than the other plans from what I am hearing from Senator Rand Paul’s objections on the news, and no doubt, the CBO will get around to weighing in on that one too. Why bother though? I don’t doubt that the agency will pick a number, any number, somewhere between 22 and 24 million as their estimate on how many people will “lose” coverage if that particular Senate bill were to pass.

Then that “dire” number will be trumpeted all over the media as those who will be “losing” coverage as a result of that bill. As Avik Roy pointed out in the Forbes article to which I referred in my last blog post, approximately 15 million of those people are not “losing” their insurance, but REJECTING their insurance. The sad aspect of that is, there will still be no insurance to which they can flee, because the only plans allowed will still be Obamacare-type plans. The Senate rejected Senator Ted Cruz’s Consumer Freedom Amendment – more about that in a future blog post.

I would like to once again, demonstrate how faulty the CBO estimates are concerning any issue of coverage or non-coverage whether Obamacare is in effect or not.

Let’s start with the CBO’s estimates in a 2012 report of how many people it predicted would sign up for Obamacare in advance of the sign-ups.

Here is a quote from that March 2012 report by the CBO entitled, “Updated Estimates for The Insurance Coverage Provisions of the Affordable Care Act,” (1) regarding how many people would gain coverage through the Obamacare exchanges.

“According to the current estimates, from 2016 on, between 20 million and 23 million people will receive coverage through the new insurance exchanges and 16 million to 17 million people will be enrolled in Medicaid and CHIP.”

So let’s look at how the numbers have actually shaken out so far.

An editorial in The Hill (2) about an early 2017 meeting of the House Budget Committee regarding the failures of Obamacare, says that Ed Haislmaier, senior research fellow with the Heritage Foundation, estimated that only 14 million people gained insurance through the Obamacare exchanges between 2014 and 2015. He added that early estimates of those receiving health insurance through the individual market for 2016 were another 842,028.

Other figures Haislmaier reported were as follows:

  • A decline of 1,128,597 individuals enrolled in fully insured employer health insurance plans.
  • Enrollment in self-insured employer plans increased by 776,780 people.
  • Individuals enrolled in Medicaid and CHIP (Children’s Health Insurance Program) increased by 2,044,809.

So, according to this editorial in The Hill, the approximated number of people that actually gained some form of health coverage in 2016 was 16.5. This number does not even come close to the 20 million to 23 million people the CBO estimated would gain “insurance” through the exchanges.

Clearly, there are no totals for 2017 yet as we are in the middle of the year. However, if the CBO did such a woeful job so far of predicting how many people would be covered from 2016 on, how can we possibly expect that office to provide any believable estimates for how many people might “lose” their insurance as the result of an Obamacare repeal with or without a replacement? Don’t forget that in its estimations of the people that would “lose” their insurance are an approximate 15 million who would not be losing it, but canceling it of their own free will and saying “Good riddance!”

My theory: the numbers that the CBO has been putting out regarding the number of people who would be without “coverage” are merely something the Democrat left and Republicans in Name Only (RINOS) can use as scare tactics – nothing more, just a useful propaganda tool.

Sources for further reading:

  1. http://www.cbo.gov/sites/default/files/cbofiles/attachments/03-13-Coverage%20Estimates.pdf
  2. http://thehill.com/blogs/pundits-blog/healthcare/320969-debunking-the-20-million-obamacare-myth

 


Who Believes the CBO? Not me!

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As the Senate is now in the heat of discussions regarding the changes it wants to make to the Republican repeal and replacement of the Patient Protection and Affordable Care Act (more like Unaffordable Care Act), the Congressional Budget Office came out with its estimation a couple of weeks ago of the effect the Senate Bill, which bears the name the Better Care Reconciliation Act, COULD have on the United States overall.

Ever since that publication of the CBO estimates, the Democrats and some Republicans In Name Only, lovingly called RINOS by true conservatives, have been shrieking that somewhere between 22 and 24 million people will lose coverage, depending on with whom one is talking. The Democrats and RINOS throw that number out with the express purpose of making people panic and call their Senators with impassioned pleas not to take away their “health care.”

A Forbes article entitled “CBO Predictions About the Senate Health Care Bill Are Deeply Flawed,” written by Avik Roy (1) explains that the absurdity of the CBO predictions can be demonstrated by the various predictions this “august” government agency has thrown out in reference to three different bills meant to repeal the Unaffordable Care Act in one way or another.

Those three bills include:

  • The Restoring Americans’ Freedom Reconciliation Act (H.R. 3762 – 2016)
  • The American Health Care Act (2017)
  • The Better Care Reconciliation Act (Senate version of the AHCA – 2017)

According to this article, the RAFRA bill, which was intended as a repeal of Obamacare with no replacement, was analyzed by the CBO to cause 22 million Americans to be uninsured by 2026 with no subsidy provisions for coverage.

The article then states that the American Health Care Act, which is the House of Representatives’ version of repealing and replacing Obamacare this year, contains a system of flat tax credits that are not dependent on income. This system of tax credits proposed to spend approximately $375 million over the next 10 years to subsidize the purchase of health insurance. Yet the CBO estimates that, even with that $375 billion in subsidies, there will be 23 million more people without insurance than are currently covered under Obamacare over that 10-year period.

Roy describes the final kicker in these rather strange CBO calculations: the Senate bill that rejected the flat tax credits offered in the AHCA and spends $616 billion for means-tested tax credits over 10 years (which means that these tax credits/subsidies are directed toward low-income people), still results in a coverage loss for 22 million people in comparison to the number that are presently covered. Ironically, it appears that no matter how much money the federal government coughs up to make sure that as many people as possible are covered, there is very little improvement on the numbers of those who would ostensibly “lose” their coverage, at least according to the CBO.

The explanation Roy offers for these rather strange calculations is the individual mandate imposed by Obamacare that requires all U.S. citizens (with few exceptions) to consistently buy health insurance. So the CBO estimates that if the individual mandate is repealed, 15 million people will cancel their health insurance (or that which they are currently stuck with) in 2018. Clearly this is not a case of people being “thrown off” their insurance, but of reveling in the freedom of not being forced to buy insurance that they despise anymore. By my own calculations, this 15 million people is slightly short of 70% of the total amount of people who might be expected to be without health insurance coverage by 2026, and that would be immediately in 2018.

There are some other aspects of these suspect CBO calculations to be considered such as the question of whether 15 million people celebrating their freedom might not acquire some other form of coverage as a substitute for the burdensome Obamacare. What if all the essential benefit mandates were removed as a result of the repeal and replacement of Obamacare and people are free to buy the insurance of their choice?

According to an article by Justin Haskins in “theblaze” (2), Senator Ted Cruz (R-Texas) has proposed an amendment to the Senate bill since the CBO estimates that could provide many people with the flexibility they are looking for.  This amendment would allow insurers to offer a wide variety of plan types as long as they offered at least one plan with all the required Obamacare mandates. This is intended to create the ability for insurance companies to offer much more flexible plans and benefits than Obamacare provides. This newly acquired freedom could result in many of those 15 million canceling their expensive plans in favor of lower-cost plans being made available without all the required bells and whistles.

I would conclude, from all I have read so far, that the CBO is making some very loose assumptions with very little qualification that are being used by leftist groups to spread misinformation and panic about the real intent of the Republican proposals to repeal and replace Obamacare.

Sources for further reading:

  1. https://www.forbes.com/sites/theapothecary/2017/06/27/cbo-predictions-about-the-senate-health-care-bill-are-deeply-flawed/#321ea90779d4
  2. https://www.theblaze.com/news/2017/07/02/ted-cruz-could-save-the-senates-health-care-bill-and-some-conservatives-arent-happy-about-it

*I plan on using the next few posts, at least, to analyze the various facets of the debate regarding the proposed repeal and replacement of Obamacare. If you would like to be notified of future posts on the subject, please sign on to my email list to the upper right side of this post, and you will receive any new posts every Thursday morning. I am also planning a new offer in the near future.

Photo attribution:

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Where is Obamacare Repeal Going?

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There seems to be a temporary lull, as far as I have been hearing, regarding the progress of the American Health Care Act. This is mainly because a whole host of scandals are swirling around Washington, D.C. regarding a Russian connection to the Trump campaign, the firing of FBI Director Jim Comey, and one about whether President Donald Trump gave away some classified information to Russian officials during a meeting.

I think Senate Majority Leader Mitch McConnell is right in saying that less drama from the White House would help the Senate to concentrate on matters that affect the everyday lives of American people.

One of those issues would be health care in the United States and how to repair this very broken system that has become far too dependent on insurance coverage and government intervention. Although the talk in the media for the last week and a half has discussed the scandal du jour ad nauseam, it looks like there is a little bit of work regarding the nation’s health care policies going on in the background. Once again, it seems like some kind of “deadline” looms that is making Senate Republicans think that they may have to do something before June 21.

Why?

According to an article in the online publication Axios (1), this is the date by which insurers have to make a final decision regarding whether or not they will sell insurance  for 2018 on the federal Obamacare exchanges. I am not sure if the states with their own exchanges have alternate deadlines.

So, if the Senate can ignore the White House drama and plug away at the American Health Care Act that is now before it, they have a tough choice to make because they are faced with either passing a short-term stabilization bill of some kind to make sure that there actually insurers on most of the exchanges or try to work on the larger package of health care reform in a way that it could be passed and signed into law in time for that deadline. With all the deep division between the two major parties, as well as between different positions within the Republican party, I am not placing any bets on passing a larger package of sensible free market reforms that could be signed into law by the president in time for the June 21 decision crunch.

So what’s the Senate to do?

According to the Axios article, the Senate has the following options to consider:

  • Go ahead and fund the subsidies so the few remaining exchange insurers would know what they are dealing with in 2018 and would remain on the exchanges, at least for the coming year. (Hopefully such an action would only be considered temporary to provide a “bridge,” so to speak, as the Senate gives more in-depth consideration concerning the best way to repeal and replace Obamacare.)
  • Pass a bill by Senators Lamar Alexander and Bob Corker that would allow people to use premium subsidies to buy health care insurance not offered on the exchanges, which looks like it would only be available in areas where there are no insurance companies on the exchanges. (Once again, I hope this would only be a band-aid solution while the Senate mulls over the best way forward for a free market in health care.)
  • They could always just take their time to put out a bill, regardless of insurance decision deadlines, that allows a free market in health care that can really make health care and insurance affordable for the average person. (There is a great risk of widespread chaos in this scenario, but then maybe it is time for many people to have the government pacifier yanked out of their mouths; they may cry a lot for a while, but then those who know better could direct the ones being broken of their dependency into health care options that are so much better than what we have now.)
  • There may also be another option because Axios also reported that Senator Claire McCaskill has indicated she is planning to introduce a bill as well, but has not revealed anything about it.

Maybe I was at least partially wrong in one of my earlier blogs, when I said Congress needs to take their time to get health care reform right. On the other hand, the Senate cannot slap something together that can get passed and claim they have done the job for the American people. When that happens, I fear that people will just get used to the “new normal” and expect to always be able to buy insurance whenever and wherever they want with a subsidy from the government, which could be just as destructive as Obamacare.

The Senate prospects also look difficult because Republicans only have a narrow majority, so there will be very intense division in trying to repeal a law that Democrats doggedly defend.

For my part, I am going to try my best to communicate with my Utah senators, as well as other key senators, to impress upon them the necessity of getting health care reform right, and familiarizing them with some free market innovations they may not know about that can drive down health care costs without the involvement of insurance.

Source:

  1. https://www.axios.com/senate-grapples-with-looming-health-care-deadline-2411779537.html

Photo Attribution:

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It’s Here! The First Draft of the American Health Care Act

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Well, the Republicans in Congress finally rolled out legal language (and I do mean legal language) outlining their plan for repealing and replacing the Patient Protection and Affordable Care Act of 2010. Now there were outlines of a plan for a long time, and people could get a glimpse of what a replacement plan might entail in everyday English, but this plan is now codified into barely decipherable legalese so only lawyers can tell us exactly what in means. Believe me on that count because I have started to read it.

On the plus side, any citizen can actually download a copy of the proposed bill, which is known as the American Health Care Act. Fortunately, we are not going to revisit the Rep. Nancy Pelosi line, “We have to pass it to find out what’s in it.” Therefore, any citizen who can read and gets a kick out of legalese headaches, can “find out what’s in it.” If someone does not like what is in it, he or she can contact their elected representatives at the federal level to register their comments.

Basic Principles

First, the basics in real English. I found what is being called a fact sheet from the office of Rep. Paul Ryan, Speaker of the House of Representatives. This fact sheet outlines the fundamental principles of the American Health Care Act. Here they are as presented in this fact sheet with a little bit of editorializing from me.

  • The new bill keeps the promise made by Republicans and President Donald Trump to repeal and replace Obamacare.
  • This bill provides for a stable transition from the Unaffordable Care Act as the country (hopefully) transitions to health care policies that encourage individual choice and less government interference in personal health care decisions.
  • Finally, this bill aims to lower health care costs, allow more choices, and provide individuals with more control over their health care. (I really hope this one happens!)

So What’s Next?

Needless to say, I have been hearing a lot of bellyaching about this plan by people from every political stripe – yes, Republican and Democrat. The most important issue though is whether this plan has a chance to succeed in lowering costs and providing more choices in health care while protecting the most vulnerable in our society.

I have just begun to read the repeal and replacement bill, which seems to have a strong predilection for punctuation directives. But I am getting through it. Wow, I should have tried to read it when I was having trouble falling asleep last night!

In future posts, I am going to try to describe my impression of the bill for you, and whether I think there is a chance that it may accomplish the goals that Rep. Ryan expects it to.

If you are interested in being notified of future posts and other offers, please subscribe to my email list (the form is located to the top right side of this post), and be sure to contact me and let me know your thoughts about all of this. I’d love to read about what you are thinking.

Photo courtesy of canstockphoto.com.


It’s A Brand New Day

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I watched the inauguration of President Donald Trump this morning as I worked at my laptop. I am always in awe of the moment of inauguration when the leadership of our country changes hands. President of the United States – what a huge responsibility for anyone to take on!

To be quite honest, I did not vote for Trump, nor did I vote for Hillary Clinton. I am afraid my vote was a protest vote because, in Utah, we had the opportunity to vote for conservative Evan McMullin if we were not crazy about either major party candidate. However, if I thought Utah was in real danger of going over to Clinton, I probably would have voted for Trump just to be on the safe side.

Why was I that opposed to voting for Clinton? There are many reasons, but not the least of them is that she would have continued and probably doubled down on Obamacare. There would have been even more government regulation of health care, hence even less freedom.

She was talking about increasing subsidies for health care plans, which only increases the government involvement in our personal business, not to mention an even more bloated national debt. I fear that she really does not understand the health care market and the fact that government has been the driver for more expensive health care, especially hospitals.

The crony capitalism that goes on between tax-exempt health systems, legislators and bureaucrats is one of those drivers. Large health care systems have the wherewithal to lobby and gain influence with our lawmakers. This is especially exemplified in an article I received from a new Facebook friend, Dr. Kathleen Brown who is a dermatologist in Oregon. The way these tax-exempt hospital systems are raking up bucks while providing fewer community benefits is disgraceful. I’ll let you read the article. Here’s the link.

http://www.wweek.com/news/2016/04/13/the-five-things-hospitals-dont-want-you-to-know-about-obamacare/

It looks like many lawmakers in Oregon are getting frustrated with that situation. I think the tax-exempt status of cash-heavy “health care” systems is a non-partisan issue for two reasons.

  • The way they come by all that surplus/profit (or whatever you want to call it) is by ridiculously overcharging insurance payers for patient services, but even the amount of reimbursement that is negotiated down leaves a profit margin for the hospital.
  • Additionally, the fact that these tax-exempt “health care” systems are amassing so much money, much of it not being sunk into charity care, while they are not paying taxes is robbery of taxpaying citizens.

Because of government involvement in health care, the system has become way too complex and cumbersome, which leads to expensive health care.

I will be discussing in future blog posts the negative effects our bloated government has had on the delivery and payment of health care as well as some important definitions in the world of health care that I don’t believe the average person understands because of how these terms are convoluted in the mainstream media.

I wish everyone a great weekend as we (hopefully) really do look to a brand new day in health care.


Socialist left says: “The Sky Is Falling!”

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To hear all the catastrophic laments of the left as President-elect Donald Trump prepares to take office as the 45th president of the United States, one would think Chicken Little’s prediction that “The sky is falling” was really about to happen.

Why are the Democrats, Socialists and those who follow them in such a tizzy? Besides the MANY issues that they have with Trump, one of the most valued promises I believe he made to the American people as he ran for president was that he would repeal and replace the Patient Protection and Affordable Care Act (fondly, or not so fondly, known as Obamacare).

During the past election cycle, Obamacare continued its death spiral, which seems to have  gone on steroids for the year 2017.

Here are a few of the conditions that are contributing to the unpopularity of Obamacare, except in the leftist circles that seem to prefer staying aboard the Titanic as it sinks.

  • Out of the 23 non-profit insurance co-ops that launched with the roll-out of Obamacare, only six remain standing. One of the most recent co-op failures is Health Republic Insurance of New Jersey with a whopping $46 million in debt, according to a September article by Fox News.
  • Insurers are claiming big losses and even leaving some state exchanges. The companies that are still operating in the state and federal exchanges are raising their premiums for 2017.
  • The average expected premium hike is approximately 8 percent. However, in some areas, according to Forbes Magazine, the average individual market will experience a premium increase of 24 percent.

This is just a thumbnail sketch of the miseries brought on to the average middle class American by Obamacare. I follow many people and groups on Twitter that talk about how worthless Obamacare is to them with its high premiums and deductibles.

However, this is what I hear from the Democrats and those who follow them- they say that if Obamacare is repealed, MILLIONS of people will go without health care. This just is not true. Although I have some rather anti-establishment views regarding any “replacement” of Obamacare that I will outline in future posts, the Republicans have made it clear that they have NO plans to pull the rug out from anybody, and they are discussing how to deal with challenges such as how to make sure that insurance for medical needs is available to everybody, including those with pre-existing conditions.

I have so much to say about this issue because it has been near and dear to my heart ever since the ACA was voted in, so stay tuned for more posts on this subject.