The effects of a repeal of ACA

[stpioc]

The most significant change in the CBO's score was that the reduction of the federal deficit the CBO projected would be less with the amendments than under the previous version of the AHCA. According to the report, the updated AHCA would reduce the deficit by $151 billion between 2017 and 2026, less than the $337 billion projected in the original CBO report.

CBO score on AHCA, Trumpcare after amendments says 24 million could be uninsured - Business Insider

Ironically, on the same day the review of fuel standards was announced, 11 respected American medical societies, including the American Academy of Pediatrics and the American College of Physicians, released a report on the health effects of climate change. The news is far from great — climate change is real and is making us sicker. American doctors are seeing more heat-related illness, an uptick in asthma, an increase in flood-associated deaths, and a rise in insect borne infectious diseases such as Lyme Disease and the Zika virus. Like the right hook thrown by the health-care bill, this environmental punch lands directly on the most vulnerable — children, pregnant women, the elderly, low-income families, and those with chronic illness. Even if we are not worried about the lack of ice for polar bears, we should certainly be worried about our health and that of our children.

Trump and GOP deliver one-two punch to Americans’ health - MarketWatch

Most insurance industry executives have been circumspect about the repeal of the Affordable Care Act and its proposed replacement, the American Health Care Act. Mario Molina is an exception. “I think this bill is terrible,” Molina, the CEO of Molina Healthcare, told The Huffington Post in a lengthy interview Friday. The company covers more than 4 million people scattered across 13 states ― including California, where it’s headquartered, as well as Florida, Michigan, New York and Texas. That makes it the 10th-largest health insurance company in the U.S., according to a 2015 government survey. Molina’s main argument against the bill is the same one critics have been making for months ― that the measure would expose millions of lower-income Americans to crippling medical bills, by taking away their Medicaid coverage or the federal tax credits that make it possible for them to buy private insurance.

Insurance Executive Blasts GOP Health Care Proposal: 'This Bill Is Terrible' | The Huffington Post

House Oversight Committee Chairman Jason Chaffetz faced immediate ridicule early this month after he said that Americans should forego their iPhones to afford health insurance. Critics rushed to point out that the about $700 cost of an iPhone comes nowhere near the average annual cost of health-care spending, or about $10,000 per person. As if to drive home that point, a new survey shows that Americans have trouble affording most unexpected medical bills, even in smaller amounts. For a majority, or 52%, an unexpected medical bill that cost more than $500 would be out of reach. And unexpected medical bills that cost more than $100 would be unaffordable for 37%, or more than a third, of Americans, the survey, released Tuesday, found.

Forget iPhones — many Americans can’t pay a $100 medical bill - MarketWatch

[stpioc]

I keep thinking about something that New York Times columnist Ross Douthat wrote today. “Republican politicians may offer pandering promises of lower deductibles and co-pays, but the coherent conservative position is that cheaper plans with higher deductibles are a very good thing,” he said. It’s a gently written sentence, but it’s damning beyond measure. Republicans have been promising the literal opposite of the bill they are trying to pass. Trump swore he’d oppose Medicaid cuts — but this law has more than $800 billion of them. He said everyone would be covered — but the CBO estimates this bill will push up the ranks of the uninsured by 24 million people. Republicans everywhere said they would replace Obamacare with a plan that ensured more competition, lower premiums and deductibles, and an end to skyrocketing annual increases — but this bill will have the opposite effect for most of those affected.

The new Republican health care bill doesn't fix the old bill's problems - Vox

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.

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

Researchers have consistently found giving people Medicaid improves their access to health care compared to those who go without insurance. This has been true in the primary-care and hospital settings. It’s also been true on self-reported measures of access to care. People even like their Medicaid, according to surveys. “To make the argument that Medicaid doesn’t improve access compared to being uninsured is completely false,” said Benjamin Sommers, a health economist and physician based at Harvard University. “There’s no ambiguity on access to care. Medicaid unequivocally improves access to care for people.”

If Sean Spicer talked to someone on Medicaid, he’d probably find out they love it - Vox

What critics don't mention is that CBO also underestimated how many people Medicaid expansion would cover. The two have essentially offset each other. Obamacare is covering just about as many people as CBO expected back in 2013, before the expansion started.

CBO estimates 24 million lose coverage under GOP plan. The devastating report, explained. - Vox

[stpioc]

Hmm, perhaps the public has become aware just a little bit more about what the ACA actually does, and more importantly, what it does better than Trumpcare..

House Republicans haven’t just failed to repeal Obamacare — their attempts to do so seem to have also caused the law’s popularity to skyrocket, making the path to future repeal even tougher to achieve. A new poll released on Friday by McClatchy-Marist found support for Obamacare repeal plummeting, particularly among Republicans. In just one month, the number of Republican voters who want the law abolished dropped from 68 percent to 57 percent — an 11-point swing. By contrast, a full 65 percent of the public want the bill to be either strengthened “so it does more” or left as is, according to the poll. A Quinnipiac poll last month found only 17 percent of the public supported Speaker Paul Ryan’s American Health Care Act.

Poll: GOP support for Obamacare repeal plummets by 11 points - Vox

Or perhaps people just started to realize this:

For conservative health care wonks, the failure of the American Health Care Act wasn’t just a missed opportunity or a broken campaign promise or a political defeat. It was proof that the Republican Party’s seven-year pledge to replace Obamacare was almost entirely a political gambit. According to Avik Roy, a reform-minded conservative and the president of the Foundation for Research on Equal Opportunity, “most conservatives didn’t think there was a moral case for replacing Obamacare” and accepted the idea only as a political imperative to avoid the consequences of completely abandoning the uninsured. In the end, the GOP couldn’t get the politics right to pass Trumpcare, but the blame cannot be pinned on Republican moderates or extremists. The entire party owns this failure because ultimately it was caused not by political divisions, but policy apathy.

The Republican Party’s Deadly Policy Apathy | New Republic

[stpioc]

After 7 years of riling, this is just extraordinary..

The third explanation, offered once the White House and conservative Republicans in the House Freedom Caucus started talking about going ahead and trying to gut all the offending provisions, was that, well, the core Obamacare insurance rules are good policy and should be maintained, even if it is technically possible to repeal them.

This is a shocking admission from the party that staked its reputation on opposition to Obamacare, and it came Wednesday.

Here's what Rep. Patrick McHenry, the chief deputy whip of the Republican conference, said about Obamacare's insurance regulations on Wednesday, by way of explaining why the House Freedom Caucus' vision for a bill to deregulate health insurance couldn't pass:

"There are a lot of provisions that are part of the law now that I want to preserve. So if you look at a cross-section of the conference, they have similar positions about similar provisions — preexisting conditions, guarantee issue, and medical underwriting are core components of that ... The core provisions here are really important protections."

What McHenry was saying there sounds technical, but it can be summed up in a three-word sentence:
Obamacare is good.

GOP admits it likes Obamacare - Business Insider

[stpioc]

An attack on the sickest and weakest in order to ram through a new healthcare plan that kicks 24M out of insurance just to be able to cut taxes for the rich:

Vice President Mike Pence also echoed Trump's point on high-risk pools when he was asked to address the issue of rising premiums for sicker people on Sunday's "Meet the Press" with Chuck Todd. 

"We're basically borrowing an idea from the state of Maine that has seen a significant drop in premiums for people on their health insurance, because you take people that have pre-existing and costly conditions and put them into a high risk pool," Pence told Todd. "And you subsidize that so that it is affordable to those individuals."
Although Republicans have championed the idea of state high-risk pools, critics say that an inevitable effect of isolating the sickest people into separate groups is skyrocketing premiums. 

The effectiveness of state high-risk pools has been contested, because the program's success depends on whether the federal government decides to adequately subsidize them — likely through raising taxes. Some notable high-risk pools have also failed in the past.

Trump says new healthcare proposal guarantees pre-existing coverage - Business Insider

[stpioc]

The Republicans are trying to jam their healthcare law through the House, Vox has a nice list of it's impact. It ain't pretty, here are just some of the effects:

• The Medicaid expansion would be phased out. Before the Affordable Care Act, it was difficult or impossible in many states for low-income adults without children to get coverage through Medicaid. The Affordable Care Act expanded the program to cover adults making up to 133 percent of the federal poverty line ($15,800 for one person, or $32,319 for a family of four), a change that helped drive down the rates of uninsured people in the US. Under the AHCA, the coverage expansion would stay in place until the end of 2019, but no newly eligible people could be added to Medicaid rolls after that. Because people on Medicaid often cycle in and out of the program as their employment situation and incomes change, that would lead to a drop in Medicaid coverage.
  
• The bill would also cut Medicaid in other ways. It changes how the federal government would reimburse states for Medicaid expenses, and introduces the option of states turning the money into a “block grant,” a lump sum rather than a per-person payment for each Medicaid patient, which would cut the program still further. The block grant would ease limitations on states’ ability to kick people off, charge premiums, and cut benefits for children. States, whether or not they take a block grant, could also add a work requirement for nondisabled adults, further limiting access to the program.
  
• The bill would cut taxes for the wealthy. Obamacare included tax increases that hit wealthy Americans hardest in order to pay for its coverage expansion. The AHCA would get rid of those taxes — tax cuts that add up to $883 billion, the majority of them benefiting the wealthy, according to the Congressional Budget Office. Obamacare was one of the biggest redistributions of wealth from the rich to the poor; the AHCA would reverse that.
  

The American Health Care Act: the Obamacare repeal bill the House will vote on, explained - Vox

All in all, in the order of 24M people risk losing their healthcare coverage, and this just to ram through tax cuts for the rich..

[stpioc]

In fact, the pain doesn't end with the 24M who risk losing coverage

The actual policies contained in the American Health Care Act — the Obamacare repeal-and-replace bill that the House is voting on Thursday — would help some Americans a lot. The biggest winners are households making $250,000 a year or more, who would see two different taxes targeting them repealed; households with millions in investment income would come out particularly far ahead.

But vastly more Americans would come out behind. The Congressional Budget Office estimated in March that 24 million people would lose health insuranceif the AHCA were to pass, and the changes made to the bill in the ensuing two months have only made it less generous and more likely to jeopardize coverage. And because the bill substantially weakens regulations for both individual and employer plans, millions of people who still get insurance will see the extent of their coverage shrink, and see themselves forced to pay out of pocket for expensive procedures that would otherwise be covered.

The list of people losing out from the bill doesn’t end there, though. Here are a few of the main groups that will be negatively affected if this legislation becomes law.

1) Working poor people who gained Medicaid under Obamacare

2) Seniors, disabled people, and others who qualified for Medicaid even before Obamacare

3) States hard hit by the opiate crisis

4) People in states that take a Medicaid “block grant,” who could see dramatic cuts in coverage

5) Pregnant women and new mothers

6) People with preexisting conditions

7) Families with chronic conditions

8) Low-income Americans not on Medicaid

9) Older people on the exchanges

10) Children in special education programs

11) Planned Parenthood patients

These are all the people the Republican health care bill will hurt - Vox

See article for the awful details..

[stpioc]

The AHCA also gives states the option of taking some high-cost enrollees with pre-existing conditions who may have to drop coverage, and creating a separate high-risk pool to cover them. The bill provides up to about $15 billion a year in funding for the high-risk pool through 2026.

Analysts at Avalere Health estimate that funding could cover about 600,000 people. Yet, in Texas alone, there are nearly 200,000 people with pre-existing chronic conditions who'd qualify.
"If any large states receive a waiver, many chronically ill individuals could be left without access to insurance," said Caroline Pearson, senior vice president at Avalere..

GOP celebrates passing health bill, but few cheers from health industry

[stpioc]

Republicans in the House voted to pass the American Health Care Act despite not knowing what the bill would do. They say they didn't wait for a Congressional Budget Office study because they don't put much stock in CBO's estimates of costs or coverage levels — but it's not like they have their own competing study they relied on. They just don't care. They know the bill cuts taxes on rich people. Those are the important numbers.

House Republicans should ask themselves: Was it worth it? - Business Insider

Indeed. But a little memory refresher is in order. Paul Ryan blasted the Dems for rushing Obamacare (which went through 14 months of drafting and hearing with experts and CBO estimates) arguing they were irresponsible for rushing a law which effects were unknown..

[stpioc]

It is a rare unifying moment. Hospitals, doctors, health insurers and some consumer groups, with few exceptions, are speaking with one voice and urging significant changes to the Republican health care legislation that passed the House on Thursday.

The bill’s impact is wide-ranging, potentially affecting not only the millions who could lose coverage through deep cuts in Medicaid or no longer be able to afford to buy coverage in the state marketplaces. With states allowed to seek waivers from providing certain benefits, employers big and small could scale back what they pay for each year or reimpose lifetime limits on coverage. In particular, small businesses, some of which were strongly opposed to the Affordable Care Act, could be free to drop coverage with no penalty.

In Rare Unity, Hospitals, Doctors and Insurers Criticize Health Bill - The New York Times.

Surprise surprise.. This is what happens when ideologues trump professionals.