Thursday, May 4, 2017

Here's what Nebraska's GOP death panel did to you today in DC

TrumpCare (the AHCA) barely passed the House today, with the unanimous support of Nebraska's GOP representatives, Don Bacon, Jeff Fortenberry and Adrian Smith, with:
  • No hearings
  • Content hidden until just before vote
  • Passage before the Congressional Budget office scored it
Above: one thing, a huge thing, not mentioned in Waldman's excellent piece
The bill will kill significant numbers of Americans. Here's how, according to Paul Waldman's piece in the Washington Post's web site:

  • Takes health insurance away from at least 24 million Americans; that was the number the CBO estimated for a previous version of the bill, and the number for this one is probably higher.
  • Revokes the Affordable Care Act’s expansion of Medicaid, which provided no-cost health coverage to millions of low-income Americans.
  • Turns Medicaid into a block grant, enabling states to kick otherwise-eligible people off their coverage and cut benefits if they so choose.
  • Slashes Medicaid overall by $880 billion over 10 years.
  • Removes the subsidies that the ACA provided to help middle-income people afford health insurance, replacing them with far more meager tax credits pegged not to people’s income but to their age. Poorer people would get less than they do now, while richer people would get more; even Bill Gates would get a tax credit.
  • Allows insurers to charge dramatically higher premiums to older patients.
  • Allows insurers to impose yearly and lifetime caps on coverage, which were outlawed by the ACA. This also, it was revealed today, may threaten the coverage of the majority of non-elderly Americans who get insurance through their employers.
  • Allows states to seek waivers from the ACA’s requirement that insurance plans include essential benefits for things such as emergency services, hospitalization, mental health care, preventive care, maternity care, and substance abuse treatment.
  • Provides hundreds of billions of dollars in tax cuts for families making over $250,000 a year.
  • Produces higher deductibles for patients.
  • Allows states to try to waive the ACA’s requirement that insurers must charge people the same rates regardless of their medical history. This effectively eviscerates the ban on denials for preexisting conditions, since insurers could charge you exorbitant premiums if you have a preexisting condition, effectively denying you coverage.
  • Shunts those with preexisting conditions into high-risk pools, which are absolutely the worst way to cover those patients; experience with them on the state level proves that they wind up underfunded, charge enormous premiums, provide inadequate benefits and can’t cover the population they’re meant for. Multiple analyses have shown that the money the bill provides for high-risk pools is laughably inadequate, which will inevitably leave huge numbers of the most vulnerable Americans without the ability to get insurance.
  • Brings back medical underwriting, meaning that just like in the bad old days, when you apply for insurance you’ll have to document every condition or ailment you’ve ever had.  
Naturally the GOP bill contained a provision exempting Congress and its staff, as if anyone needed to ask.

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