Congress was filled with a fair number of never-Trumper Republicans. Those idiots stalled much of Trump's agenda.
We already know the House Dems' first vote in the new Congress will be to defend the ACA against the GOP lawsuit to end pre-existing condition protections. But what then?
The package of reforms with the most support in the Dem caucus in the current Congress (H.R.5155 - Undo Sabotage and Expand Affordability of Health Insurance Act of 2018) is the obvious starting point.
What are those reforms?
Premium relief through more generous premium subsidies
How it works now: The ACA provides subsidies to people under 400% of the federal poverty line for their premiums: once they've put a certain percentage of their income toward a benchmark silver plan, the subsidy pays the rest of the cost of the plan.
How it would change: The Dem reforms would make the premium subsidies more generous by (1) lowering the percentage of income an individual or family has to contribute, and (2) making premium subsidies available to people over 400% FPL, eliminating the "cliff" some have criticized.
To put this in concrete terms, let's imagine the example of a family of four (two 40-year-olds with two young kids) buying the national average 2018 benchmark plan.
If that family makes $30K, its monthly premium falls from $50 under the ACA to $25 under the proposed reforms.
If it makes $50K, its monthly premium falls from $263 to $167.
If it makes $75K, its monthly premium falls from $595 to $438.
And if it makes $105K, its monthly premium falls from $1,494 to $744.
Out-of-pocket spending relief through more generous cost-sharing reductions
How it works now: The ACA requires insurers to reduce out-of-pocket limits and spending (e.g., deductibles, copays, etc) for low-income people, effectively making their coverage more generous. This is referred to as cost-sharing reduction (CSR).
While silver plans normally have 70% actuarial values (actuarial value being a measure of plan generosity that indicates how much the insurer shells out vs. how much enrollees have to pay out of pocket when people get services), under the ACA people with lower incomes get silver plans of 73% actuarial values, 87%, or even 94%.
These reductions are the reason that, despite all the hoopla about high deductibles in the exchanges, the median deductible actually faced by consumers in the marketplaces in 2016 was $850.
How it would change: The Dems would make the CSRs both more generous and more widely available. The CSR94 plans are currently reserved for only the poorest segment of marketplace shoppers; the Dem bill would make them available to everyone currently eligible to buy a CSR plan (i.e., those at or below 250% FPL). And while shoppers above 250% FPL currently aren't eligible for CSR plans at all, the Dems would make CSR87 plans available to those above that income level but below 400% FPL.
Household income Plan Generosity for CSR Plans (ACA) Plan Generosity for CSR Plans (H.R. 5155) 100%-150% FPL 94% 94% 150%-200% FPL 87% 94% 200%-250% FPL 73% 94% 250%-400% FPL - 87%
Oh, and they permanently make appropriations available to reimburse insurers for those cost-sharing reductions. The GOP has refused to appropriate funds to fulfill the government's obligation to make insurers whole for the CSRs, which led to large premium hikes in 2018 to make up for the lost revenue.
According to widespread reports, the government's cost for affordable healthcare for all will be somewhere around $30 trillion over 10 years. That is a huge cost for free healthcare.
According to widespread reports, the government's cost for affordable healthcare for all will be somewhere around $30 trillion over 10 years. That is a huge cost for free healthcare.
U.S. health care spending increased 4.3 percent to reach $3.3 trillion, or $10,348 per person in 2016. Health care spending growth decelerated in 2016 after the initial impacts of ACA coverage expansions and strong retail prescription drug spending growth in 2014 and 2015. The overall share of gross domestic product (GDP) related to health care spending was 17.9 percent in 2016, up from 17.7 percent in 2015.
Obamacare was a horrible horrible law that threw people off their plans, and made other people accept plans with features they did not want. Obama LIED when he said you could keep your doctor. Why anybody would want to save that foul law is beyond me.
Hmm... we (as in the US popualtion) are spending (at least) that much now.
https://www.cms.gov/Research-Statis...onalHealthExpendData/downloads/highlights.pdf
Democrats passed the ACA with glee thinking Americans would love it. They did not love it. They rejected it by the tens of millions. They hated its high costs and high deductibles. Not a single DC politician wanted it for themselves.That is not this topic. You're talking about the feds taking on all private health spending to become the sole buyer of health care services. That is not what is on the table here, nor is it what this thread is about.
This is about making more generous the financial support available to buy private insurance in the marketplace, so that families can more easily afford their premiums and deductibles. Feasible, relatively simple, incremental improvements to make the markets function better and to improve people's lives.
Hmm... we (as in the US popualtion) are spending (at least) that much now.
https://www.cms.gov/Research-Statis...onalHealthExpendData/downloads/highlights.pdf
Probably not going to happen. They're mutually exclusive.What ransom will the GOP demand for more affordable plans and lower deductibles?
Who's going to pay for this premium relief?
Yep. The taxpayers.
Don't care about that deficit anymore, do we?
Anyway, this won't get past the Senate...let alone the President.
Why are the Dems wasting their time?
President Trump Leads a Listening Session on Healthcare
Democrats passed the ACA with glee thinking Americans would love it. They did not love it. They rejected it by the tens of millions. They hated its high costs and high deductibles. Not a single DC politician wanted it for themselves.
President Trump Leads a Listening Session on Healthcare
They made such a stink over the tax rate cuts not being paid for - I just expected that some additional revenue would be proposed to fund this give away.
arnt we paying are medical bills now any way
Come on. Focus, eh?
We aren't talking about "medical bills". We are talking about this plan from the Dems to subsidize medical insurance premiums.
But hey...if you want the government to pay people's medicals bills...on top of their premiums...you should just quit *****footing around. Cut to the chase and pass total government health coverage. Put hundreds of thousands of people out of work and blow up the deficit.
Hell, not even the Dems wanted to do that back in 2009.
actually i would like total government health coverage
seems like a larger pool of people paying for healthcare on a regular basis would cut costs what with a smaller percentage of people needing it at any one time to paying for it
No. It won't cut costs. The costs will remain the same or increase. Now...the amount the government pays might be reduced. That won't cut costs. It'll only reduce supply. This is simple economics.
This would be the first time he has listened.
the costs each person will need to pay on a regular basis should be cut got a deeper pool to draw from
Ah. So you are talking about different costs than I am.
Anyway, you are wrong again. Oh...sure...you could reduce the taxes people pay. Do that enough and you'll eventually get into that "free stuff" territory. For some people. But bottom line, the government has two choices:
Raise taxes to pay for the costs of health care.
Deficit spending.
Which do you prefer?
I prefer neither.
That is not this topic. You're talking about the feds taking on all private health spending to become the sole buyer of health care services. That is not what is on the table here, nor is it what this thread is about.
This is about making more generous the financial support available to buy private insurance in the marketplace, so that families can more easily afford their premiums and deductibles. Feasible, relatively simple, incremental improvements to make the markets function better and to improve people's lives.
Hmm... we (as in the US popualtion) are spending (at least) that much now.
https://www.cms.gov/Research-Statis...onalHealthExpendData/downloads/highlights.pdf
Who's going to pay for this premium relief?
Yep. The taxpayers.
Don't care about that deficit anymore, do we?
Anyway, this won't get past the Senate...let alone the President.
Why are the Dems wasting their time?
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