Pensacola Discussion Forum
Would you like to react to this message? Create an account in a few clicks or log in to continue.

This is a forum based out of Pensacola Florida.

You are not connected. Please login or register

The republican proposal to repeal and replace Obamacare

3 posters

Go down  Message [Page 1 of 1]




ppaca wrote:

This ought to fly. lol! lol! 

Yikes . . . folks will scream tyranny . . .



And Obamacare hasn't been a tax hike? Lol roflmao



FROM the moment the ink dried on March 23, 2010, Republicans said they intended to “repeal and replace” the Affordable Care Act. They have voted more than 40 times to wipe the law from the books. But Republicans have never gotten around to describing, in detail, the set of policies they believe should replace Obamacare. That is, until yesterday.

After nearly four years, we finally have a Republican counterproposal: the Patient Choice, Affordability, Responsibility and Empowerment (or Patient CARE) Act.

Senators Tom Coburn, Richard Burr and Orrin Hatch deserve credit for developing this plan. Putting together a proposal to reform the American health care system is hard and politically courageous. And while it is lacking in important details, this plan contains some interesting ideas that might have enabled bipartisan compromises had they been offered in 2009, when I was a health care adviser to the Obama administration and the Affordable Care Act was being debated. For instance, the plan would shift many low-income adults from Medicaid to subsidized private insurance. There are some Democrats who could certainly have supported such a proposal, if it had been offered as part of a deal to enact a bipartisan bill.

Despite all the heated rhetoric from Republicans about Obamacare laying ruin to America, the plan would actually keep some of the law’s key provisions. It would preserve some subsidies for lower-income people to buy private insurance, though it would change the way they are calculated. Those $700 billion worth of Medicare savings Mitt Romney denounced during the 2012 campaign? Republicans would keep them. Allowing young adults to stay on their parents’ plan until age 26? Republicans would keep that, too. And the ban on lifetime insurance caps, so people with very expensive diseases don’t lose insurance? Republicans wouldn’t touch it.

But in other crucial ways, the Republican plan is different. First, Obamacare’s absolute ban on withholding coverage from people with pre-existing conditions would be rolled back. Those who remained continuously insured would stay protected, so they couldn’t be charged higher rates or be excluded entirely. But if their insurance lapsed, health insurance companies could charge more or refuse to cover them.

Second, it would shrink the Medicaid expansion. Pregnant women, children and families below the poverty line would still be eligible, but childless adults would not. States would be given a fixed amount per person enrolled in Medicaid to reduce spending.

Third, the Republicans would provide tax credits for people to buy insurance, but only for families earning up to $70,650 per year. (The Affordable Care Act’s subsidies go to families earning up to $94,200.) And employees of large companies, even if those companies did not offer health insurance, would be exempt, regardless of income.

The largest difference is in cost control. Currently, employer-sponsored health insurance is tax free; the Republican plan would make employees pay income tax on at least 35 percent of what their company pays for their plan. The idea is to make patients pay more for their coverage, giving them an incentive to choose cheaper health insurance plans with more deductibles and co-payments, which, in turn, would encourage them to shop around for cheaper tests and treatments and forgo unnecessary ones.

On a more individual level, this is what the Republican plan means: If you are one of the 150 million Americans who get their health insurance through an employer-sponsored plan, get ready for a big tax increase. For a family in the 28 percent tax bracket (earning around $150,000 per year), according to my calculations, it would add up to about $1,470 per year.

Here’s how you get that number: In 2013, the average employer-sponsored insurance plan cost $16,351 for a family of four. On average, employers pay 72 percent of that premium, or $11,786. The Republican plan taxes 35 percent of the employer contribution, meaning that an additional $4,125 would be counted as income and subject to both payroll and income taxes. So that family would pay about $1,154 in income taxes and $316 in payroll taxes — $1,470 per year. Obviously, people would pay even more if their health-insurance premium was higher, if they were in a higher tax bracket, or if their state had an income tax.

People who don’t get insurance through their employer would also be likely to pay more. The Republican plan would provide the unemployed, people in the individual market and those working for small businesses that don’t provide health insurance a tax credit to buy private insurance. But the credit increases only by age, not by need — which means people with lower incomes would pay much more than they would under Obamacare. For example, under the Republican plan, a 30-year-old man living in New York City earning $35,000 a year would pay the full price of insurance, roughly $4,383 for a typical plan. Under Obamacare, he would pay $3,325. A 30-year-old earning $25,000 would get a $1,560 tax credit and pay roughly $2,823 under the Republican plan, but pay only $1,728 under Obamacare.

In addition, the proposed plan would take us back to the old days when insurance companies could charge women more than men for the same health plan. And older people would also be penalized. Under the Affordable Care Act, insurance companies are allowed to charge 64-year-olds only three times what they charge 21-year-olds. But the Republican plan allows insurance companies to charge 64-year-olds five times more. So a 64-year-old individual could pay as much as $21,900 for a plan that costs a 21-year-old only $4,380.

The plan would bring back many insurance company shenanigans. For instance, the decision to roll back the ban on excluding those with pre-existing conditions sounds O.K. in theory: “individuals moving from one health plan to another — regardless of whether it was in the individual, small group, or large employer markets — could not be medically underwritten,” meaning charged higher premiums based on a disease, and “denied a plan based on a pre-existing condition if they were continuously enrolled in a health plan.” So if you lose your job and therefore your employer-sponsored health insurance, you would not be excluded for a pre-existing condition if you immediately bought your own insurance. But if there were a gap in coverage, insurance companies could deny you coverage.

What if the paperwork you filled out is “lost”? The history of insurance companies’ tricks for denying coverage to high-cost patients — like revoking the insurance of a cancer patient who failed to disclose that she had back problems — does not inspire confidence.

Finally, there is the issue of prevention. The Affordable Care Act made preventive services free. To save money, Republicans want to reverse that, so that Americans will behave like cost-conscious consumers — getting their blood tests at a cheaper laboratory or their CT scans at the cheaper imaging center. The problem is that mountains of evidence show that when patients have to pay, prevention is the first thing to go, in part because people aren’t suffering pain or other symptoms, and the benefits of preventive services are typically years away. Saving money by cutting back these services makes no economic sense in the long-term.

There are many other problematic things the Republican plan does, like eliminate the health law’s taxes on health insurance, drug and device companies; allow insurance companies to sell plans that don’t cover maternity, mental health or other types of care; and allow insurance companies to impose annual limits on benefits.

We finally got the “replace” part of the Republicans’ pledge to “repeal and replace” the Affordable Care Act. Now that Americans have the chance to examine the alternative, it might help them see the advantages of Obamacare.


Shifting costs back to patients; penalizing someone with a pre-existing condition if their premiums aren't paid on time (what if they're in the hospital?); TAXING the employer's portion of health insurance premiums as INCOME to the employee; getting rid of those pesky medical device taxes...yeah...this is just great.  How about a poke in the eye?



Obama is now taxing healthcare premiums as well. And if you don't pay for your insurance of course it will be cancelled... Duh



obamacare is a failure. deal with it.

something is going to have to be done.

and since when is it a bad thing for people to pay for services they receive?

Sponsored content

Back to top  Message [Page 1 of 1]

Permissions in this forum:
You cannot reply to topics in this forum