The effects of a repeal of ACA

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At the same time, some estimates say millions of Americans could lose their insurance under the AHCA. And the AHCA is already facing backlash from conservative Republicans who have nicknamed the bill "Obamacare 2.0." Doctors' organizations, hospital groups, and patient advocacy groups also do not seem to be the biggest fans of the bill in its current form. Here's what some of the major groups have said.

What doctors think of House GOP Obamacare replacement plan - Business Insider

Yet the panel's approval of healthcare legislation only masked deeper problems Republican backers face. Hospitals, doctors, and consumer groups mounted intensifying opposition to the GOP healthcare drive, and the White House and Republican leaders labored to rally a divided party behind their high-stakes overhaul crusade. The American Medical Association, the American Hospital Association, and AARP, the nation's largest advocacy group for older people, were arrayed against the measure.

House panel nears health bill OK, industry groups say 'no' - Business Insider

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The Affordable Care Act, President Obama’s signature health reform, had one big goal: to make health insurance more affordable and accessible to those who had trouble getting coverage. In essence, that meant finding ways to get America’s poor — the millions who couldn’t pay for private health insurance or were ineligible for Medicaid — health coverage. The new GOP health reform plan, the American Health Care Act, is filled with provisions — some subtle, some not — that’ll undo that work.

7 details in the Republican health care bill that harm the poor - Vox

Trumpcare would result in millions more people going uninsured, but it would be particularly harmful for people who have substance abuse problems and depend on Medicaid expansion for treatment. The Affordable Care Act (ACA) required that Medicaid cover basic mental health and addiction services, but that requirement would be phased out in 2020. Medicaid expansion in 31 states and the District of Columbia increased access to substance abuse treatment for people addicted to opioids, since medicine to treat people struggling with the addiction is very expensive. Before expansion, Medicaid covered mostly pregnant women, poor children, and people with disabilities, and even those groups had to have very low incomes to be considered eligible. About 1.3 million people receive treatment for mental health and substance abuse disorders under the expansion, according to a recent estimate from professors at New York University and Harvard Medical School.

Trumpcare would ‘cause enormous human suffering’ for people with addictions

Republicans seeking to overhaul the Affordable Care Act face growing signs that there could be big increases in premiums for individual plans next year, which poses a challenge as the lawmakers try to rally support for the replacement legislation. According to a nonpartisan report released by the Congressional Budget Office on Monday, the House Republicans’ bill, known as the American Health Care Act, could raise premiums by 15% to 20% for individual plans in 2018, compared with rates without the bill.

Insurers See Health-Care Premiums Increasing Significantly in 2018 - WSJ

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Health care provider groups — representatives of America’s doctors, hospitals, and other caregivers — have generally been critical of the Republican American Health Care Act, but in a fairly restrained way. Bob Doherty, senior vice president for government affairs at the American College of Physicians, the trade group for internists and the second-largest association of doctors in America, is taking a different approach on Twitter this morning, blasting the bill as the worst measure he’s seen in nearly 40 years of advocacy work.

Doherty warns of “thousands of preventable deaths” if the bill passes (which checks out), as 28 million people lose coverage. He also makes the point that the long-term health consequences of the bill could be even more severe, as older people who lose insurance coverage due to skyrocketing premiums “will put off getting care until diseases are at more advanced, less treatable, & costly stage.”

American College of Physicians on AHCA: “I’ve never seen a bill that will do more harm to health” - Vox

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The lies of the Conservatives about the effects of their new healthcare law are really breathtaking. Here is an article that explains the biggest four lies:

If the House Republicans pass the American Health Care Act this week, as House Speaker Paul Ryan predicts they will, it’ll represent a major triumph of dishonesty over plain, if slightly more complex, truths.

At an obvious level, it will require Republicans to ignore, dispute or lie about the Congressional Budget Office’s conclusion that Trumpcare is likely to cause 14 million people to lose their insurance next year alone and reduce insurance rolls on the whole by 24 million over 10 years, relative to where they’d be if Republicans just administered the Affordable Care Act in good faith.

But at a more cynical level, it will be a victory for the false claims Republicans have made to paper over the fact that their Obamacare alternative would create a humanitarian crisis by cutting off health care assistance to the poor and elderly so that they can massively and permanently cut rich people’s taxes.

The Media’s Failure to Correct Republicans’ Obscene Trumpcare Lies | New Republic

The four biggest lies (see article for the details)

1. Trumpcare will reduce premiums
   
2. Trumpcare will stabilize the Obamacare death spiral
   
3. Trumpcare is advancing through a normal process
   
4. Trumpcare will restore "patient centered" care
   

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The American Health Care Act — House Speaker Paul Ryan's and President Donald Trump's proposal to replace Obamacare — was in its original form a truly massive cut to Medicaid. It slashed the program by $880 billion over 10 years, according to the Congressional Budget Office. It would eventually unwind the Medicaid expansion included in the Affordable Care Act and slash the yearly growth rate for Medicaid spending, forcing states to provide worse coverage or to kick people off the rolls.

Now it’s about to get harsher.

The “manager’s amendment” changing the legislation, which is set to be released Monday night by House leaders and expected to be adopted through a House Rules Committee vote before the full House votes on Thursday, includes new provisions cracking down on Medicaid beneficiaries. The changes would allow states to impose work requirements on able-bodied childless adults getting Medicaid, and to receive funding in a "block grant" that doesn't rise at all with enrollment, which would likely amount to a still-larger cut.

The amendment would also eliminate federal funding for Medicaid beneficiaries making over 133 percent of the poverty line — a cut that would hurt states like New York that have generous Medicaid programs. And it would cut off states’ ability to join the Medicaid expansion immediately, before phasing out the expansion for states that joined before March 1 of this year..

Republicans are making the American Health Care Act even crueler to Medicaid recipients - Vox

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Little in politics shocks me. The process House Republicans want to use for their health care bill does. After literally years of complaining Obamacare was jammed down the American people’s throats with insufficient information or consideration, the GOP intends to hold committee votes on their bill two days after releasing it, and without a Congressional Budget Office report estimating either coverage or fiscal effects. It’s breathtaking. 

“In general,” writes Peter Suderman, “it's not clear what problems this particular bill would actually solve.” This is a profound point. It is difficult to say what question, or set of questions, would lead to this bill as an answer. Were voters clamoring for a bill that cut taxes on the rich, raised premiums on the old, and cut subsidies for the poor? Will Americans be happy when 15 million people lose their health insurance and many of those remaining face higher deductibles?

The GOP health bill doesn’t know what problem it’s trying to solve - Vox

It's actually not that hard. Here is what Trumpcare is for

• Tax cuts for the rich
  
• Even more tax cuts for the rich (as explained here)
  
• Nominally keeping the promise to repeal and replace Obamacare
  

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Even faster relieve in Trumpcare2.0 for the wealthy..

But amid the 21 pages of changes to the bill that lawmakers released Monday night, one clear winner stands out: rich people.
The last amendments on the list would end Obamacare taxes this year instead of in 2018, a victory for conservatives who have criticized GOP leadership for not phasing out the law fast enough. But what exactly are those Obamacare taxes?

One is an extra 0.9 percent Medicare payroll tax on high-income earners. It applies to individuals making more than $200,000 and couples earning more than $250,000. The Tax Policy Center estimates that 99 percent of households won't be affected by this change. But the top 1 percent will enjoy an average tax cut of $7,300.

Another Obamacare tax that takes a big bite out of the bank accounts of the wealthy is the tax on net investment income, or money earned outside of salary or wages. This is separate from the capital gains tax and was estimated to cost the top 1 percent of households an average of nearly $25,000 a year, according to the Tax Policy Center.

Adding up those two tax cuts alone provides the richest Americans an average annual savings of $33,000. That compares with an average of $180 for all households, the Tax Policy Center estimates.

The disparity is partly by design: The point of Obamacare was to expand health coverage for the poor by taxing the rich. So it's no surprise that dismantling the law would benefit the wealthy even as the Congressional Budget Office estimates that 24 million people would lose insurance coverage by 2026 and that premiums for older Americans would rise.

Wealthy households get tax cut under GOP health-care plan

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In an effort to blunt the American Health Care Act’s disastrous effect on older Americans, House Republican leaders are adding a provision that would set aside $75 billion to do ... something unspecified. 

Really. According to Politico, the new version of the bill will not say at all what to do with the $75 billion. Instead it will just “instruct the Senate” to come up with a plan to use the money to help people between the ages of 50 and 64.

This is a very unusual way to legislate and reflects House Republicans’ desperation to push through basically anything as soon as possible and pass the buck to the Senate.

Republican leaders are adding a $75 billion magic asterisk to their Obamacare repeal plan - Vox

The American Health Care Act, the GOP's bill to repeal and replace Obamacare, does not seem to be winning over the American public. Republican Rep. Justin Amash, a critic of the AHCA since its introduction, tweeted Monday that the bill was the most "universally detested piece of legislation" he has seen as a lawmaker. And recent polling hasn't done much to dispute that narrative, showing a clear trend indicating that a plurality of Americans are against the AHCA in its current form. According to Nate Silver at FiveThirtyEight, the most recent six polls from firms such as Fox News, Morning Consult, and YouGov/CBS News showed that an average of 30% of Americans support the American Health Care Act, while 47% of people surveyed were against it.

GOP Obamacare replacement bill, AHCA, Trumpcare unpopular polls - Business Insider

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Democrats will point to the insurance coverage loss number — 24 million more Americans without insurance — as evidence that this bill is terrible. Republicans will respond that if people were only buying insurance because of the individual mandate, what's so great about that? The goal isn't to force people to buy coverage — it's to give them choices so they can do what they like. The big problem with the "choice" argument is this: If their plan is all about choices, how come they couldn't come up with choices that appeal to those 52 million Americans who won't buy coverage under their plan?

There are a lot of people who don't like the insurance plans offered to them. But the number of people who would say, in the abstract, "I would prefer not to carry health insurance," is very small. They want to be offered health insurance that they find to be a good value. In practice, people who go uninsured under the Republican plan will do so for one of two reasons. One is that they won't be able to afford to buy an insurance plan. In some cases, insurance under this plan will be eye-poppingly expensive: Even after a tax credit, CBO estimates a single-coverage premium of $14,600 for a 64-year-old — even if his or her income is as low as $26,500.

Other people will go uninsured even though they could afford to pay for insurance because they will decide the available insurance does not provide a good value. Under the Affordable Care Act, many people complain about high deductibles and co-payments that mean their health insurance does not seem to actually pay for the healthcare they need. This proposal would lead to even more "cost-sharing" — which is to say, higher co-payments and deductibles.

The problem with House GOP health plan's CBO score - Business Insider

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The American Health Care Act passed out of committee exactly 58.5 hours after it was introduced on Monday evening. The committee voted in the bill’s favor without knowing how much it costs or whom it covers because they voted before the Congressional Budget Office — or any other credible authority — had time to assess the bill’s likely impacts. And Republicans preferred it that way. They didn’t want to know what their bill was likely to do, and they didn’t want anyone else to know, either. 

I covered the first Obamacare debate back in 2009 and 2010. And this week, one thing has become quite clear: Republicans plan to move more quickly and less deliberatively than Democrats did in drafting the Affordable Care Act. They intend to do this despite repeatedly and angrily criticizing the Affordable Care Act for being moved too quickly and with too little deliberation.

The first draft of the law that became the Affordable Care Act — at least on the House side — was introduced on June 19, 2009. This was a discussion draft from the office of House Speaker Nancy Pelosi. This draft came after many white papers, debates, and hearings that stretched back to a few months before President Barack Obama’s election. John Canaan’s legislative history of the Affordable Care Act is an invaluable guide to that period, as well as what happened next in the House.

Republicans’ rushed health bill is everything they said they hated about Obamacare - Vox

The speaker claimed the bill was being progressed transparently, as opposed to the ACA, which he said was "jammed through to an unsuspecting country." The new plan, however, has not yet received a score from the Congressional Budget Office to assess its budgetary or coverage effects. Ryan said he plans to have the bill for a floor vote in two weeks. By comparison, Timothy Jost — a professor of health policy at Washington University in St. Louis who favors the Affordable Care Act — documented that the House had 79 hearings on the ACA over a year, heard from 181 witnesses during that time span, and added 121 amendments to the law..

Paul Ryan defends Obamacare replacement as 'act of mercy' - Business Insider