EDITORIAL: New health plan still a ways off

May 09--President Trump and the House of Representatives congratulated themselves Thursday for passing an updated version of the American Health Care Act to replace Obamacare (the Affordable Care Act).

The bill is fraught with issues for the Senate. It guarantees even less coverage than the AHCA version abandoned a month ago with only 17 percent support. It was rushed through without any "scoring" -- costs and consequences -- from the Congressional Budget Office and hearings before the public could react.

To attract conservatives in the Freedom Caucus -- including Rep. Rod Blum R-Dubuque -- the AHCA would allow states to seek waivers so insurers could charge higher premiums for people with pre-existing health conditions, forgo coverage for the ACA's 10 health essentials (such as maternity, neo-natal and emergency care) and lift limits on annual and lifetime expenses.

Rather than universal coverage, healthy people could buy low-cost insurance suited to their needs.

To mollify moderates concerned about more people being uninsured, another $8 billion over five years was added to state pools to provide subsidies for people facing higher premiums for pre-existing health conditions. According to the Kaiser Family Foundation, 27 percent of Americans have pre-existing health conditions.

The waivers, though, presage a race to the bottom for states to entice businesses, using the low-cost health insurance policies as a magnet. According to the Wall Street Journal, the waivers would allow corporations to offer employees nationally the most barebones health insurance it can find in any state where it operates.

Republican governors were unhappy with the $880 billion, 10-year reduction in outlays to states for the Medicaid low-income health partnership and the reduced assistance for low-income recipients alienated some insurers as well.

"We feel compelled to oppose it," said Paul Markovich, chief executive of Blue Shield of California. "It raises the specter that the sickest and neediest among us will be disproportionately hit in losing access."

He's got a lot of company. The American Medical Association, American Hospital Association and American Nurses Association are among the health providers opposed.

Democrats derided the bill, although they have yet to offer potential fixes to Obamacare, apparently a sacred party scroll despite being rife with shortcomings.

The AHCA beneficiaries would be younger and wealthier, the losers older and poor. The previous CBO scoring estimate for the AHCA was 14 million more uninsured immediately and 28 million by 2016, which could rise if coverage for those with pre-existing conditions plummets.

Some of the AHCA's major provisions are:

Annual tax credits would be provided ranging from $2,000, for those younger than 30, to $4,000 for those older than 60 -- available in full for individuals earning up to $75,000 and couples up to $150,000, then gradually phased out. ACA subsidies are income-based.

Adult children younger than 26 could stay on their parents' policies.

Insurers could charge older Americans five times as much for premiums as young adults, rather than three times under the ACA.

ACA individual mandates requiring everyone have health insurance or face a tax penalty would end, replaced by "continuous coverage incentive" with a 30 percent penalty if it lapses.

Get news headlines sent daily to your inbox

1

html

subscribe

The Courier

CDT

[email protected]

Sign Up!

4EB045FEF6973258422D8D20F9799A61

WcfCourier.com Daily Headlines

4EB045FEF6973258509828871CF470A2

Obituaries

I understand and agree that registration on or use of this site consitutes agreement to its user agreement and privacy policy.

The ACA's 3.8 percent tax on investment income and 0.9 percent levy on income more than $200,000 for individuals and $250,000 for married couples filing jointly (the top 2.5 percent of taxpayers) would end, saving them nearly $300 billion over 10 years.

Health is fluid and fickle. Families should be shielded when it entails substantial financial hardship.

Kaiser Family Foundation found the healthiest 50 percent in any given year account for less than 3 percent of health care expenditures, while the sickest 10 percent consume nearly two-thirds. In the second year, though, 73 percent of the healthiest group remain and 45 percent of the sickest group.

Premiums paid by healthier people -- usually younger -- help offset costs incurred treating those with serious ailments, usually older people. A critical problem with Obamacare was its failure to entice younger enrollees.

Iowa is set to become the first state to lose all major health insurers. Wellmark, Aetna and UnitedHealth are gone. Medica has signaled it plas to leave the exchanges, leaving Gunderson in five counties.

With proposals for new plans due next month, one reason for the exodus was instability concerning Obamacare subsidies for eligible recipients, which Republicans successfully halted in a lawsuit. Their demise is pending upon appeal.

The bill now goes to a Senate, where it isn't expected to emerge intact even with Republicans holding a 52-48 edge. Moderates are concerned about ending the ACA mandates, while others are wary of a voter backlash with many constituents potentially losing health coverage or paying more for it.

But keeping the most popular ACA provisions intact requires a means to fund them, and it goes against party doctrine to raise taxes.

Whatever the outcome, it will remain an arduous process to get the dueling House factions onboard to resolve differences.

___

(c)2017 Waterloo-Cedar Falls Courier (Waterloo, Iowa)

Visit Waterloo-Cedar Falls Courier (Waterloo, Iowa) at www.wcfcourier.com

Distributed by Tribune Content Agency, LLC.