- Hey, don’t blame us
- You try to be brief on healthcare policy
We have avoided commenting on the specifics of current ‘mark up’ of the health care bill proposed by Paul Ryan and Mitch McConnell, the “binary choice” that Ryan punkishly said we have. The reasons for our paucity on something so important are that the effect of the specifics are murky at best, including for commentators we trust on the subject. Indeed we have read conflicting analysis about what is in it. And we don’t like the excuse making as regards why it can’t be better and more consistent with promises made and conservative market based doctrine.
We don’t know that there might be opportunities presented to either improve the Ryan/McConnell or that might take off on their own, should it pass, not anticipated by the drafters of the overall strategy. So we have avoided dealing with it, waiting for more to unfold. One aspect about it we are pretty sure of though is not to trust that the promised latter stages of repeal and replace will happen.
Here are some links and excerpts highlighting the CBO predictions about the current Ryan/McConnell bills “cost and effects” and the bad aspects that are reasonably predictable.
The CBO vs. Reality — Gary Bauer at Campaign for Working Families_
Late yesterday, the Congressional Budget Office (CBO) released its “score,” or report on the House leadership’s bill to repeal and replace Obamacare. The results were mixed. But the headlines today highlight the report’s determination that the GOP bill would likely result in millions of uninsured individuals.
Most Americans don’t know and don’t care what the CBO is. The only thing that matters at this stage is the narrative, and the Republican Party is in danger of losing control of the narrative due to united Democrat opposition and a hostile media.
Every Republican today should point out two things:
First, the CBO’s record on budget projections is terrible. It is like climatologists who claim to know the mean temperature in 2075.
One of major drivers of America’s drift toward socialism is that every new entitlement program costs vastly more than projected. So if the Congressional BUDGET Office can’t get budget estimates right, why would anyone trust it to predict insurance enrollment?
In fact, when Obamacare was debated, the CBO made a number of projections that turned out be wildly off base. For example, the CBO estimated that 22 million people would gain coverage through Obamacare’s individual exchange markets. In reality, just over 10 million people bought their coverage through the Obamacare exchanges. That’s more than just a rounding error.
The CBO also estimated that by 2016, 201 million people would have private health insurance. But the actual number was 177 million — off by 24 million people. So when the CBO says the GOP bill will cause 24 million to lose insurance, take it with a big grain of salt.
The second point that needs to be emphasized is something that the CBO doesn’t necessarily measure. One of the biggest problems with Obamacare has been rising deductibles.
While some people may have gotten insurance, thanks to the subsidies, the deductibles are so high that some families were paying thousands and thousands of dollars out-of-pocket before Obamacare even kicked in. In other words, they had insurance, but they didn’t have healthcare.
One final point: For the vast majority of people, cost is more important than coverage. The left likes to make a big deal about “universal coverage.” Thus, all of today’s negative headlines focusing on the number of potentially uninsured individuals.
But polling finds that 62% of voters feel controlling healthcare costs is more important than ensuring coverage (34%).
More reading on the CBO predictions:
The CBO: The Government’s Favorite Psychic — Patriot Post
On Monday, the Congressional Budget Office released its report on the projected impact of the House Republicans’ American Health Care Act (AHCA). The CBO estimated the law would result in a reduction of budget deficits by some $337 billion over a 10-year period, as well as up to 24 million more uninsured Americans by 2026. House Speaker Paul Ryan predicted that the report would estimate an increased number of uninsured. He said Sunday, “The one thing I’m certain will happen is CBO will say, ‘Well, gosh. Not as many people will get coverage.’ You know why? Because this isn’t a government mandate. This is not the government that makes you buy what we say you should buy, and therefore the government thinks you’re all going to buy it.”
It’s always easier to insure more people by forcing them to buy insurance.
Barack Obama’s goal with the Affordable Care Act was not affordable health care, but socialized health care — the first step toward a single-payer system similar to those found in many European nations. Republicans are in the unenviable position of solving a difficult two-part problem. The first task is repealing and dismantling ObamaCare, while the second is to find an effective solution to skyrocketing health care costs. . . .
Readers will love the Ramirez cartoon posted with the article.
And from Investors Business Daily:
Don’t Trust Those CBO Health Care Numbers
The predictable effects as currently proposed – increased but unsustainable Medicaid expansion. Related reading:
Here’s How States That Expanded Medicaid Are Doing — Daily Signal / Heritage Foundation:
Our synopsis of the answer to the question — not well — and the trajectory is foreboding, not only for the states that expanded Medicare but the states that do not which will still end up subsidizing those that irresponsibly do. The next article has some recommendations:
Maine Rejected Medicaid Expansion and Found Success. Now, House Health Bill Would Send Us Backward.
Specifically, here are four actions Congress should take to reform federal Medicaid:
- Repeal the Medicaid expansion.
- Enact an immediate freeze on new enrollment.
- Roll back higher the Federal Medicaid Assistance Percentage by 2019.
- Mandate work requirements for able-bodied adults, similar to the Supplemental Nutrition Assistance Program.
The current House proposal that delays the repeal of the Medicaid expansion will absolutely trigger a push to expand Medicaid in nonexpansion states—Maine included—by the same advocacy groups that have been trying for the last several years.
Such an effort will bankrupt our state and send us backward from the economic stability we have achieved today.
This article at Heritage provides a broader critique:
House Republican Health Care Bill Misses the Mark – excerpts from Edmund F. Haislmaier article:
The key problem with the draft House health care bill is that it fails to correct the features of Obamacare that drove up health insurance costs. Instead, it mainly tweaks Obamacare’s financing and subsidy structure.
Basically, the bill focuses on protecting those who gained subsidized coverage through the law’s exchange subsidies and Medicaid expansion, while failing to correct Obamacare’s misguided insurance regulations that drove up premiums for Americans buying coverage without government subsidies.
That is both a policy problem and a political problem. . . .
There are a several significant problems with this new program.
First, it substitutes new funding for old Obamacare funding without adequately addressing the misguided Obamacare insurance market rules and subsidy design that made the exchanges a magnet for high-cost patients.
Those mistakes in Obamacare created an insupportable burden on the individual insurance market by concentrating expensive patients in only that small portion of the total market.
Second, like Obamacare, it doesn’t actually reduce premiums, but rather masks with subsidies the effects of Obamacare provisions that drove up premiums in the first place.
Third, it creates a new entitlement for states. Furthermore, without a resulting reduction in unsubsidized premium levels, future Congresses will likely face pressure from states and constituents to extend and expand the program. . . .
Unequitable Tax Treatment
Yet another policy mistake is the failure to take the first step toward providing more equitable tax treatment of health insurance.
The House version drops a proposed cap on the unlimited tax exclusion of employment-based health insurance contained in an earlier version, while retaining the so-called “Cadillac tax”—the 40 percent excise tax on so-called “high-cost plans”—and delaying its implementation until 2025.
Congress should kill that punitive excise tax and replace it with a cap.
While the Cadillac tax would force employers to alter the health benefit plans that they provide their workers, no such effect would result from the cap on the exclusion. It would simply limit the amount of employer health benefits that constitute pre-tax income to workers.
Such a change would make the tax treatment of employer-sponsored health benefits consistent with the tax treatment of other benefits offered by employers, such as retirement savings plans, group life insurance, and dependent care, to name three of the more common ones. . . .
There are numerous other issues with the bill. For example, while allowing insurance companies to charge a markup of 30 percent for delayed enrollment can help address continuity of coverage issues, mandating that penalty is not the way to proceed.
This bill misses the mark primarily because it fails to correct the features of Obamacare that drove up health care costs. Congress should continue to focus on first repealing the failed policy of Obamacare and then act to offer patient-centered, market-based replacement reforms.
Read Heritage’s more consistent plan: A Conservative Plan to Repeal and Replace Obamacare (in fairness to the Ryan/McConnell proposal, some aspects of the Heritage plan are arguably present, the problem in part is the bastardization.
R Mall with DLH
