aside President’s Health Care Bill May Not Include Protection For Pre-existing Conditions

Source: VOX

Here we go again with another broken promise. The republican President Donald Trump has consistently over many months while on the campaign trail, promised his loyal followers that he favored the repeal of Obamacare but only with a replacement of a better healthcare plan.

Source: VOX

As of today’s (2/27/17 ) Ali Velshi of MSNBC reported on an outline of the President Donald Trump’s ACA replacement bill, where one major change under consideration would be the elimination of guaranteed coverage for consumers with pre-existing conditions. This is a big deal.

There was also discussions regarding an increase in tax credits, healthcare savings accounts and block granting Medicare monies to the states. The ending of any future funds for Planned Parenthood would also be included in this bill.

As per a 2/10/17 draft (not finalized) obtained by NBC News and posted on its website on 2/24/17, the wording as follows, is sketchy. “They have also carved out exceptions for some medicaid recipients with pre-existing conditions to ensure they keep their medicaid coverage, including cervical and breast cancer or are blind, which are specifically noted.” Why would any pre-existing conditions need to be carved out and specified?

I will update this blog as additional news becomes available.

Source: VOX

It is definitely time for those who are part of “The Resistance” to get into gear to address this issue of the new healthcare plan v the current ACA.

Here are some resources:

The main US Senate phone line 202-225-3121 (202-224-3121) or  YOU CAN FIND PHONE NUMBERS FOR EVERY SENATOR HERE. 

Find Your Representative · House.gov – U.S. House of Representatives

Michael Moore’s Calendar of resistance events’ reference: https://www.resistancecalendar.org

“The Michael Moore Easy-to-Follow 10-Point Plan to Stop Trump.”

THE INDIVISIBLE GUIDE: Read the text of the how-to anti-Trump manual

Image result for PHOTO OF PRESIDENT OBAMA SIGNING ACA BILL

Here is the appropriate response to the republican talking point that the public was misinformed about the the Affordable Health Care Act (ACA), when consumers were promised that they could keep their current doctors:

Unless the consumer has Medicaid, this person will be choosing among private insurance policies like folks do through their employers. But just like with the employer paid for health insurance policies, the consumer will be limited by the insurance company to a select list of doctors.

When the consumer changes jobs, or for other reasons is presented with a different health insurance plan, the consumer will be given the options of another select list of doctors. If the consumer is lucky, he/ she may find a favorite doctor on both lists, but frequently the consumer will have to develop a relationship with a new physician. This is the current standard when one has employer compensated health insurance or if one purchases health insurance via ACA, the Affordable Healthcare Act or Obamacare.cartoon-aca-dt-gopputitbacktogether

Another republican talking point is that the ACA insurance premiums have increased dramatically and are no longer affordable.  

Appropriate response:

A fellow blogger, Keith of Musingsofanoldfart.com commented as to how it was the republicans who by their actions, contributed to making Obamacare more expensive, so that they can now use it as a favorite talking point. He suggested that “one key improvement would be to fully fund the risk corridors to help insurers with adverse selection.” These were deliberately not funded by Congress to help strangle it and to be the catalyst for today’s problems.

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Senator Marco Rubio

On 2/25/16, Joshua Gillin of PolitiFact fact checked Senator Marco Rubio when he bragged about the above tactics, “Marco Rubio: We ‘wiped out’ Obamacare ‘bailout fund’ for insurance companies:”

“Florida Sen. Marco Rubio took an outsize swing at a provision of Obamacare as GOP presidential candidates hammered their favorite target during the CNN debate in Houston.” “When they passed Obamacare, they put a bailout fund in Obama-care,” Rubio said while addressing front-runner Donald Trump on Feb. 25, 2016. We led the effort and wiped out that bailout fund.”Editorial cartoon on the Republican Party and Obamacare“Did Obamacare contain a bailout for insurance companies, and did Rubio and congressional Republicans get rid of it? In short, they postponed a provision of the law, but it wasn’t a bailout.

Risky business

“What Rubio calls a bailout is actually a part of the Affordable Care Act known as “risk corridor.”

“When the health care law started requiring insurance companies to sell policies to everyone (even sick people with pre-existing conditions), those companies were caught in a tough spot. They didn’t know how much to charge in premiums to cover expenses for all those new policies.”

“So the law set up a three-year period, from 2014 to 2016, during which the government would spread the risk for insurers in the new law’s marketplaces while they adjusted premiums. This program is known as risk corridors.”

Editorial cartoon on the Republican Party and Obamacare

“If a company is good at setting its rates and make more than a certain amount, they pay Washington some of their extra money. These are called user fees. If a company is not so good at setting rates and loses money, the government would cover some of their losses.”

“Rubio started calling it a “bailout” for unsuccessful insurance companies in 2013, the same year he introduced an ill-fated bill in the Senate to repeal the program.”Editorial cartoon on Republican Party and Obamacare

“But let’s be clear: Several experts told us risk corridors aren’t a bailout. A bailout is usually a program that saves a company after the fact. Risk corridors are a mechanism that was put in place to deal with a problem that everyone assumes could occur.”

“And they aren’t new, either. The risk corridors program was modeled after a successful plan that was part of George W. Bush’s Medicare Part D drug coverage, albeit slightly different than the Obamacare version. No one referred to that as a bailout.”Editorial cartoon on Republican Party and Obamacare

Finding money for payments

“Now, part of the problem is that the health care law didn’t say where it would get the money for any risk corridor payments. Remember those user fees from successful insurers? The Centers for Medicare and Medicaid Services, or CMS, later decided they would use that money to make any payments owed to insurers that weren’t so successful.”

“In 2013, CMS said insurers who said they needed money would get it, regardless of the balance of payments and receipts” in the program. Rubio took this to mean that if there wasn’t enough money from user fees to cover the payments, the White House would ask Congress for money — that is, tax revenue.”Editorial cartoon on Republican Party and Obamacare

“CMS said in April 2014 it wouldn’t ask Congress for an appropriation, but instead would make up the difference in later years if the marketplace didn’t bring in enough user fees. Rubio went to work, urging then-Speaker of the House in October 2014 to block potential tax money appropriations for risk corridor payments.”

“That’s what Congress did. When lawmakers passed a spending bill in December 2014, it included special language called a “rider” that said the CMS’ parent agency, the U.S. Department of Health and Human Services, could not use any extra money in its budget to pay risk corridor expenses. That effectively locked CMS into its stated plan of using user fees. (The same rider was in the 2015 spending bill.)”

“By October 2015, it became apparent the risk corridors program didn’t work so well in the first year. CMS announced the program took in $362 million in user fees for 2014, while less successful insurers asked for a total of $2.87 billion, leaving a $2.5 billion shortfall CMS can’t pay.”Editorial cartoon on Republican Party and Obamacare

“CMS said it would pay out 12.6 percent of claims from 2014, then wait to see next year’s results. Some insurers left the marketplaces or even collapsed altogether, leading Rubio to crow his actions have been “a big part of ending Obamacare for good.”  (We likely won’t know what the program took in for 2015 until fall 2016, and 2016’s totals until 2017.)”

“Whether it will really kill Obamacare is up for debate. Some legal scholars have said all the rider did was highlight a problem the law already had and prevent a workaround. Two years ago, the Congressional Budget Office said the risk corridors will likely eventually break even by 2016.”

“If the program doesn’t, CMS will have to find the money somehow or ask Congress to make an appropriation to pay insurers. Otherwise, insurers could sue to get those payments. An Oregon insurance company that is no longer offering marketplace plans did just that on Feb. 24, suing the government for the $5 billion over missed risk corridors payments.”Editorial cartoon on Obamacare and the Republican PartyOur ruling

“Rubio said, “When they passed Obamacare, they put a bailout fund in Obamacare. … We led the effort and wiped out that bailout fund.”

“The “bailout fund” is actually a provision in the Affordable Care Act called risk corridors, designed to temporarily aid insurers as they adjust premiums. Rubio helped persuade Congress to prevent Health and Human Services from being able to cover expenses its own budget.”

“But experts have said Rubio is wrong to call the program a bailout, and that the program is supposed to pay for itself through fees from insurers.”

“Furthermore, the program hasn’t been “wiped out.” At best, Rubio and Congress have temporarily limited one potential way CMS could have covered insurance companies’ losses. We’ll have to see what happens when the program expires after 2016 — then any outstanding bills will be due, one way or another.”Editorial cartoon on Republican Party and Obamacare

“We rate Rubio’s statement Mostly False.”

We all now know the results in that in 2017, insurance premiums have increased dramatically, some by double digits, and some major insurance companies have pulled out from servicing Obamacare in certain markets, which republicans are now using as a talking point, even though their actions were the catalyst for these problems.

This post was updated on 2/27/17.

6 comments

  1. It’s annoying that someone like Rubio will probably be voted back in next year and will never have to suffer the consequences of his actions in making it more difficult for normal people to get good medical care. If Obamacare care been allowed through in it’s original version everything would no doubt be running smoothly now. The actions of the whole Republican senate were terrible and never got better. They weren’t there for the people of the U.S. they were just there to thwart anything Obama did. So petty.Next year should bring some retribution.
    xxx Huge Hugs xxx

    • Dear David Prosser,

      You are right. The US House republicans did their best to insure the demise of the Affordable Healthcare Act, and the heck, with those who are harmed.

      What’s worse is that it is not easy to explain to peoples who don’t understand the insurance business why funding risk corridors is important especially when insurance companies were initiating new plans from scratch.

      Most insurance companies purchase something called reinsurance to help cover unexpected losses.

      Ciao, Gronda

      • Thank you Gronda. Your explanation of the funding risk corridors is very helpful, particularly why the Government was providing this liability to help.
        In the UK healthcare is provided via the Government through taxation rather than through Insurance companies. This means Healthcare is free and that no limits on necessary medical treatments are set as they can be when Insurance company funded. I always thought the US should have the same system but make it better and remove the Insurance Companies from the equation altogether. Putting medical decisions in front of doctors rather than paid accountants.I thought Obama might do this.
        xxx Huge Hugs xxx

  2. Dear David Prosser,

    I couldn’t agree more. I only wish the U.S. would cut out the insurance companies and go to a single payer system but that is not a real possibility in the U.S. at this time.The powers to be will not let it happen.

    Between you and me, Senator Marco Rubio is not that smart to think of the concept of not funding risk corridors.He probably had help from insurance industry executives.

    The number one issue that the protesters are fighting over with their legislators is that of health coverage. Let’s see who wins this battle.

    Ciao, Gronda

  3. At Trump’s age, he automatically has Medicare Part A. No doubt he has insurance through his company to cover physician visits and supplement his Medicare coverage. He’s out of touch with what the average American experiences without affordable insurance.

    • Dear Xena,

      It is not just DT. These U.S. Congress representatives are all clueless.Senator Marco Rubio is my Florida representative. Heaven help him should I ever get near that man.

      Hugs, Gronda

Comments are closed.