Trump Administration plans to ‘repeal and replace’ Affordable Care Act raises concern in Alabama

By: Mynecia Steele, Special to the Democrat

After two unsuccessful tries, the Trump Administration was able last week to convince the U. S. House of Representatives to narrowly pass, by a 217 to 213 vote, a measure to ‘repeal and replace’ the Affordable Care Act, sometimes called Obamacare.
Trump and members of the House Republican leadership celebrated victory last week in the White House Rose Garden. Trump called the legislation “a great healthcare plan that will give all Americans access to health care at lower premiums and better care.” But many questions and concerns remain before this legislation passes the U. S. Senate and reaches the President’s desk for final signature.
“The Trump administration may make changes in the ACA, but will not totally repeal it while President Trump is in office,” said Elmore Patterson, CEO of the Greene County Health System, which operates the hospital, nursing home and a physician’s clinic in Greene County.
“Eliminating the Affordable Care Act will leave even more Americans without healthcare,” said Patterson. He sees the attempts to repeal the ACA as a “waste of time.” There does not seem to be a thought-out replacement for the ACA. The repeal will only increase the number of uninsured citizens, and that is not what the country needs,” said Patterson. A study by the non-partisan Congressional Budget Office said as many as 24 million people will loose health care under the Trump proposal.
“The thing is, they would have to find a way to keep the good things about the Affordable Care Act, and get rid of the bad,” said Patterson.
Former Governor Robert Bentley never allowed the expansion of Medicaid in Alabama. So, Alabamians never reaped the full benefits of the Affordable Care Act, said Patterson. Many low income working people, who made more than the base minimum of around $5,000 annually to qualify for Medicaid and less than the $15,000 annually to qualify for subsidies on the ACA state exchange, were left out of care. The Supreme Court gave states the discretionary power to expand or not expand Medicaid for people up to 138% of the state poverty level ($11,000 for an individual in Alabama). Alabama did not expand Medicaid and over 300,000 people, some of the poorest and the sickest in the state, were left without insurance coverage.

Alabama healthcare will be further limited with President Trump’s plan, said Dr. Dedra Reed of the Franklin Primary Health Center, in Mobile, Alabama. “I don’t think Trump should repeal Obamacare, because millions of people would lose coverage. Medicaid won’t be expanded, and many rural hospitals will be forced close down because they will not have people who can pay for needed healthcare.”
In 2015, AP reported that eight rural Alabama hospitals were closed within the last 15 years. Many others are staying open with subsidies and support from sales taxes and other local non-healthcare generated support.
When former President Obama’s administration originally proposed the Affordable Care Act, and even after it was approved the public reacted in both negative and positive ways.
“Current health care with Obamacare has given many people healthcare coverage without being penalized for preexisting conditions,” said Dr. Dedra Reed of the Franklin Primary Health Center, in Mobile, Alabama. “I think it can be improved by lowering premiums and making it more affordable for everyone.”
Proposals for a new health plan have received similar reactions.  “I make so little money, I can’t qualify for subsidies in health care plans–at least as far as I’m currently aware,” said Lyra Galle, a senior Professional and Public Writing, and English major at Troy University. “The health care plan my mom has through work doesn’t allow family members on the plan, so that puts me in a sticky situation.” Obamacare does allow insurance companies to cover students and young adults, up to age 26, to be covered on their parent’s health care plans.
“Ultimately, before Obamacare, with Obamacare, or the Republican health care plan that recently passed wouldn’t have benefited me. I think it’s a bad idea to repeal Obamacare, and I think it’s a move purely to spite Democrats.” People are uncertain that President Trump will successfully pass a new healthcare plan while in office. And, some don’t want him to. Galle is one of those uncertain people. “I didn’t think Trump would win the election, but he did. At this point, I don’t know what to expect,” Galle said.

Obamacare repeal will increase the number of uninsured by 24 million by 2026, CBO says

             By: Erin Kelly , USA TODAY

 

 

 

WASHINGTON — A Republican bill to replace Obamacare would lead to 14 million fewer Americans with health insurance by 2018 and 24 million fewer by 2026, the non-partisan Congressional Budget Office said Monday in an analysis that could make the controversial legislation even tougher for GOP leaders to push through Congress.

Health and Human Services Secretary Tom Price said the projections of uninsured were too high and called them “just not believable.”

Most of the initial increase in uninsured people in 2018 would come from consumers deciding not to buy insurance because they would no longer have to pay a penalty for failing to do so, the CBO said in an analysis done with the Joint Committee on Taxation. However, others would stop buying insurance because premiums will go up over the next two years, the report said.

The bill is expected to raise the average premiums that Americans would have to pay before 2020, and then lower them after that, the CBO projected. In 2018 and 2019, the average premiums for single policyholders who do not get insurance from their employers would be 15% to 20% higher than under Obamacare, the analysis said. Starting in 2020, those premiums would begin to go down. By 2026, average premiums would be roughly 10% lower than under the existing Affordable Care Act, the CBO projected.

However, younger Americans would benefit more than older ones. The GOP bill would allow insurers to charge five times more for older patients than younger ones — rather than three times more as allowed under Obamacare, the report said. The effect, the report said, would be “substantially reducing premiums for young adults and substantially raising premiums for older people.”

“If ever there was a war on seniors, Trumpcare — this bill — is it,” said Senate Minority Leader Chuck Schumer, D-N.

The number of uninsured Americans would rise dramatically during that same period as the Republican replacement plan phases out Obamacare’s Medicaid expansion, the CBO said.

“In 2026, an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law,” the analysis said.

The Republican bill would reduce federal deficits by $337 billion over the 2017-2026 period, according to the CBO. The biggest savings would come from reductions in outlays for Medicaid and from the elimination of the Affordable Care Act’s subsidies for low-income Americans to buy insurance.

Administration officials said the CBO overestimated the number of people who would lose insurance and did not take into account future phases of the Republican proposal. However, unlike the current GOP bill under consideration, any subsequent legislation would have to attract support from Democratic senators, who are unlikely to provide it.

One of the subsequent steps that Republicans are pushing is for Price to use his administrative power to reduce regulations to inspire more insurance companies to participate, which Price said would give consumers more choices at competitive costs. “They’re going to be able to buy a coverage policy that they want,” Price said.

The CBO report came as Republican leaders in Congress were already scrambling to keep their fractious caucus together on the bill. Some conservatives have denounced the plan as “Obamacare lite,” arguing that it does not go far enough in scrapping the Affordable Care Act and creates new entitlements by replacing the current law’s federal subsidies for low-income people with tax credits. At the same time, some moderate Republicans in the Senate fear their low-income constituents and seniors in nursing homes will lose coverage because the legislation phases out the expansion of Medicaid that Obamacare helped fund in many states.

Democrats, who were already fiercely opposed to the legislation, said the CBO score underscores that President Trump was wrong when he promised “insurance for everybody” under the GOP plan.

“The CBO score shows just how empty the president’s promises, that everyone will be covered and costs will go down, have been,” Schumer said. “This should be a looming stop sign for the Republicans’ repeal effort.”

House Speaker Paul Ryan, R-Wis., is leading the push for the bill, saying it is the best hope that Republicans have of ending Obamacare and passing a replacement bill under a fast-track budget procedure that cannot be blocked by Senate Democrats.

“This report confirms that the American Health Care Act will lower premiums and improve access to quality, affordable care,” Ryan said. “CBO also finds that this legislation will provide massive tax relief, dramatically reduce the deficit, and make the most fundamental entitlement reform in more than a generation. These are things we are achieving in just the first of a three-pronged approach.”

 

House Minority Leader Nancy Pelosi, D-Calif., said Ryan is wrong when he says Republicans want to kill Obamacare as “an act of mercy” because it is in a death spiral of rising costs and decreasing insurance choices for consumers. She said that 24 million more uninsured Americans by 2026 is “a remarkable figure” that underscores the need for GOP leaders to scrap their bill. “It speaks remarkably to the cruelty of a bill that the Speaker calls an act of mercy,” she told reporters Monday. “In terms of insurance coverage, it’s immoral.”

The Congressional Budget Office, which was created by Congress in 1974, is a non-partisan group of economists and analysts that produces hundreds of cost estimates for Congress on proposed legislation each year. The office has a reputation for being impartial and its cost estimates — or “scores” — of bills are taken seriously by lawmakers as they decide whether to support legislation.

Republican leaders unveiled the American Health Care Act last week, and it has already been approved by the House Ways and Means Committee and the House Energy and Commerce Committee. It is scheduled to be taken up by the House Budget Committee on Wednesday, unless an expected snowstorm forces the Capitol to close. The bill will then go to the House Rules Committee, followed by a vote on the House floor as soon as next week. If the House passes the bill, it will be sent to the Senate for approval.

The GOP bill would no longer require Americans to buy health insurance. It also would replace direct federal subsidies with tax credits to help low-income people buy insurance, phase out the expansion of Medicaid, and allow insurance companies to charge older Americans more for their coverage. It increases the amount of money people can contribute to Health Savings Accounts, which are tax-exempt accounts that can be used to pay medical expenses.

Contributing: David Jackson

10 million may lose health insurance coverage under GOP’s Obamacare replacement plan, S&P says

By: Dan Mangan | CNB

Between 6 million and 10 million people would lose health insurance coverage if a Republican proposal to replace the Affordable Care Act becomes law, a new report estimates.
The top end of those losses, or 10 million people, is equal to half of the 20 million or so people who have gained coverage in the past seven years under Obamacare.
The sobering estimate came from S&P Global Ratings on Tuesday, less than a full day after House GOP leaders released their plan for gutting key elements of the ACA, and replacing it with new rules.
S&P Global Ratings said it expected that if the plan were approved, there would be a decline in enrollment in the individual health insurance plan market of between 2 million and 4 million people.
There also would be a decline of between 4 million and 6 million people in the nation’s Medicaid system after 2020 to 2024, according to the report.
But profitability among U.S. insurers “will likely improve,” the company said, pointing to the fact that the replacement plan “can result in an improved risk pool in the individual market.”
The report said that the replacement plan would likely increase the affordability of individual insurance plans for younger adults, and reduce the affordability of those plans “for the older population.”
S&P Global Ratings also said it expected there would be a “large difference between states both in terms of insured rates,” that is the percentage of people with health coverage, “and benefits covered by insurance plans.”

The report is certain to be used by supporters of Obamacare in their efforts to defeat the Republican plan and keep most, if not all, of the ACA intact as the law of the land.
The nonpartisan Congressional Budget Office has yet to “score” the plan, which would analyze both the proposal’s costs to the federal government, and its effect on the number of people insured in the United States.
The ACA has been credited with driving down the nation’s uninsured rate to record low levels through the creation of government-run marketplaces for individual insurance plans, and by expanding Medicaid eligibility standards to more poor adults than previously were covered.
The GOP proposal calls for ending the ACA rule requiring most Americans to have some form of health coverage or pay a fine. It also calls for replacing Obamacare’s system of subsidies for premiums for plans purchased on government-run marketplaces with refundable tax credits that can be used to buy coverage both on and off those marketplaces.
And the proposal would freeze the ACA’s expansion of Medicaid benefits to nearly all poor adults in 31 states by 2020, and switch the way the federal government funds the Medicaid programs of states to a block grant system.