Republican alternatives to the ACA

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First, see here on their efforts to repeal the ACA and the alternatives they proposed. Now the full repeal has gone sour (at least for now), there are some alternatives the Trump government is working on (apart from sabotaging the ACA). 

Association healthcare plans is one such alternative, but as usual, Trump is talking out of his..

During a roundtable event on workforce development in Iowa on Thursday, President Trump touted association health care plans. “[Secretary of Labor] Alex Acosta has come up with incredible health care plans through the Department of Labor, association plans, where you associate, where you have groups, and you go out and get tremendous health care at a very small cost,” Trump said. “It is across state lines. You can compete all over the country, they compete, they want to get it.”  Association health plans are not required to cover basic health benefits, leaving many open to high costs and little protection. “And Alex, I hear it’s like record business that they’re doing,” Trump continued. “We just opened about two months ago and I’m hearing that the numbers are incredible, the numbers of people that are getting really, really good health care, instead of Obamacare, which is a disaster.” There’s just one problem — association health plans won’t even be available until September 1 at the earliest, so Trump’s claim about “record business” is a complete fabrication. The White House announced the creation of such plans on June 19.

As the New York Times puts it, the availability of such plans could “draw healthy people out of the Affordable Care Act marketplace, driving up costs for those who need comprehensive insurance.” Trump, however, has repeatedly insisted association plans will provide “tremendous health care.”

Trump’s poor grasp of health care policy was on full display in Iowa – ThinkProgress

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This might actually be a decent plan (not a whole solution, needless to say), which is quite surprising..

Right now, a Medicare patient could go to a health care provider for a routine check-up — and the federal government might end up paying a totally different price, depending on whether the provider is considered a physician’s office or a hospital’s outpatient department. This week, the Trump administration released new proposed rules for Medicare payments to fix that. They want to expand so-called site neutrality, which, in brief, attempts to ensure that doctors and hospitals are paid the same price for the same procedure, no matter the setting.

So whether you have an appointment at a doctor’s office or at an outpatient department, Medicare would pay your health care provider the same price. The idea has gotten a lot of support from all sides over the years — Congress endorsed it in 2015, the Obama administration followed through on the wish in 2016 regulations, now the Trump administration is embracing it too — though hospitals really hate it.

Site neutrality: the new Medicare policy on hospital costs, explained - Vox

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It's that time of the year again where Republicans blatantly lie about their own healthcare plans..

Mick Mulvaney, director of the Office of Management and Budget, claimed on ABC’s This Week on Sunday that no Americans would lose coverage if Republicans repealed the Affordable Care Act and replaced it with their own plan. Sen. Rick Scott (R-FL), who is leading Trump’s health care push, said onFace the Nation that maternity care would be covered.

But nonpartisan analysts expect the opposite. When the Congressional Budget Office looked at the proposed policy, it estimated the plan would cause millions to lose coverage. The plan would also give states the option to let insurers to return to discriminating against patients with preexisting conditions and allow states to give insurers flexibility in choosing what gets covered (and not covered), like maternity care..

Trump does have a health care plan. It would cause millions to lose coverage. - Vox

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How about this..

If the Trump administration has a domestic policy doctrine at this point, it could be described as the following practice: the appointment of industry insiders to Cabinet-level positions in order to deregulate or otherwise surgically dismantle the protections of a given department. In this spirit comes the announcement that Florida Senator Rick Scott intends to deliver on President Trump’s promise that the GOP “will soon be known as the party of health care.” On Thursday, Trump told reporters that Scott, and fellow Republican Senators John Barrasso of Wyoming and Bill Cassidy of Louisiana, will lead the party’s push on health-care reform.
“They are going to come up with something really spectacular,” the president said.

If by spectacular, he means a candidate who was at the helm of a company that pleaded guilty to historic efforts to defraud Medicare, the president has found his man. In the 1990s, Scott was the CEO of Columbia/HCA, a company that, under his direction, owned more than 340 hospitals, 135 surgery centers, and 550 home-health locations by the time Scott resigned in 1997. That year, federal agents announced an investigation into whether or not the company defrauded Medicare and Medicaid on a massive scale. Turns out, they did: According to Politifact’s summary of the settlement Columbia/HCA made with the Justice Department, the company took the following actions while Scott was CEO:

• Columbia billed Medicare, Medicaid, and other federal programs for tests that were not necessary or ordered by physicians;
  
• The company attached false diagnosis codes to patient records to increase reimbursement to the hospitals;
  
• The company illegally claimed non-reimbursable marketing and advertising costs as community education;
  
• Columbia billed the government for home health-care visits for patients who did not qualify to receive them.
  

As part of the settlement, Columbia/HCA agreed to plead guilty to 14 corporate felonies — charges that involve financial penalties, but no jail time. (Corporations are people, but they cannot be sent to prison.) Over two settlement rounds, Columbia/HCA wound up paying the government $1.7 billion in criminal fines, civil damages, and penalties, in what the Justice Department called “the largest health-care fraud case in U.S. history.

Rick Scott Is an Odd Choice to Lead GOP’s Health-Care Reform

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North Carolina Republican Sen. Thom Tillis — viewed as one of the most vulnerable GOP senators in 2020 — has found himself in an uncomfortable situation after a staffer’s excessively honest comments to a constituent were caught on tape. As first reported by WRAL, Bev Veals of Carolina Beach, a three-time cancer survivor, called her senator out of fear that her health insurance was at risk. She has previously faced medical bankruptcy and difficulty accessing care, WRAL said, and her husband was furloughed because of the pandemic. She wanted assurance that she’d have coverage if she lost her health insurance.

But Tillis’s office wasn’t helpful. While speaking to a dismissive staffer, Veals began to record their conversation, which was provided to WRAL and can be viewed above.
“You’re saying that, if you can’t afford it, you don’t get to have it?” she asked. “That includes health care?”

“Yeah, just like if I want to go to the store and buy a new dress shirt. If I can’t afford that dress shirt, I don’t get to get it,” the staffer explained.
“But health care is something that people need!” Veals said, clearly alarmed. “Especially if they have cancer.”

“Well, you got to find a way to get it,” the staffer said.
“So what do I do in the meantime, sir?” she asked, not hiding the irritation in her voice.
The response was snide: “Sounds like something you’re going to have to figure it out.”

Tillis’s office has apologized after Veals came forward about the exchange: “The way Mrs. Veals was talked to by a staff assistant in our Washington office was completely inappropriate and violates the code of conduct Senator Tillis has for his staff, which is why immediate disciplinary action has been taken.”

But the truth is that, insensitive and rude as the staffer’s comments to Veals were, they were simply a much more honest reflection of the Republican Party’s policies on health care than officials typically admit. But the truth isn’t hard to see. The Trump administration is currently arguing that the Supreme Court should overturn all of Obamacare, throwing millions of people off their insurance and invalidating protections for pre-existing conditions, along with other provisions that protect patients.

The unofficial Republican Party policy, though, is to lie about this fact. Trump is constantly telling voters that he protected pre-existing conditions — even though he has done nothing to ensure they’re covered — and that he’ll continue to keep these protections in place, even though he’s trying to destroy them. The Tillis staffer, apparently, didn’t get the message. He has imbibed the attitude at the heart of the GOP’s policy preferences. His mistake was being honest with a member of the public about the policy..

GOP senator apologizes after a staffer is caught on tape saying what Republicans actually believe on health care – Alternet.org

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CBS's Lesley Stahl said the giant book presented to her as the president's health care plan after President Trump walked out of a "60 Minutes" interview had "no comprehensive healthcare plan." The moment took place just after Trump cut short an interview last week. Press secretary Kayleigh McEnany then walked in to deliver what she said was the White House health care plan, warning it was a little heavy. Stahl can be heard saying "I can't lift it" in the interview. Then, in a voiceover for Sunday's "60 Minutes" episode, Stahl says the book lacked a health care plan. "Kayleigh McEnany, gave us a heavy book that she described as the president’s health care plan. It was filled with executive orders and congressional initiatives, but no comprehensive healthcare plan," she said.

Lesley Stahl: Giant health care book in Trump interview had 'no comprehensive health care plan' | TheHill