Tuesday, January 28, 2014

At Last a GOP Alternative to Obamacare - Which Leaves Many Kicked to the Curb


For years we have heard members of the GOP whining and belly aching about the Affordable Health Care Act , a/k/a Obamacare, and seeking its repeal.  During the same period we never had any definitive alternative proposed by the GOP.  Now, the outline of a GOP proposal has been brought forth and (i) it keeps many of the Obamacare provisions and (ii) leaves many more uninsured.  Once again we see that in the eyes of the GOP many Americans are simply disposable trash.  This from the political party pretends to honor Christian values.   A column in the New York Times looks at the proposal and its negatives.  Here are some excerpts:
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.

[W]hile 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.

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. 

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. 

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. 

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. 

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.

The plan would bring back many insurance company shenanigans.  . . . . 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 . . .
There is more, but the bottom line is that the GOP plan would cost citizens more for less coverage. And some would be thrown on the trash heap. 

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