American Health Care in Crisis

[joan1984]

Lois, If you like your Obamacare, you may keep your Obamacare!

Indeed, their free market based ideology makes it impossible for them to see that some things can be done more efficiently and better by the government. 

[Northwest]

Lois is right, of course, and Joan's silly troll makes it obvious she doesn't have an adequate response other than to attempt to divert attention.

Health care for profit is a fundamentally flawed idea because corporate profits will always be in opposition to the health of the users. It's that simple.

[Elizabeth]

It's cheaper for insurance companies to let you die, than to pay out huge sums of money to keep you alive.
 

Love,
Liz
 

[Lois]

Economist shows that single-payer health care in California would protect business and save the public money
A new analysis offers a counter narrative to existing propaganda
STEVEN ROSENFELD, ALTERNET

The California Senate Appropriations Committee has vastly overstated the new costs of creating a single-payer health system for the Golden State, according to a national authority on healthcare spending.

Last week, the Committee released its analysis of SB 562, The Healthy California Act. It said the total cost of providing health care to all 37 million Californians was $400 billion a year. Half of that comes from an array of government programs — Medicaid, Medicare, Obamacare, etc. That means Californians would have to raise the payroll tax by 15 percent to pay for the difference, it reported.

“About $200 billion in additional tax revenues would be needed to pay for the remainder of the total program cost. Assuming that this cost was raised through a new payroll tax (with no cap on wages subject to the tax), the additional payroll tax rate would be about 15% of earned income,” the Appropriations analysis said. “It is important to note that the overall cost of those new tax revenues would be offset to a large degree by reduced spending on health care coverage by employers and employees. Therefore, total new spending required under the bill would be between $50 and $100 billion per year.”

That assessment filled a void in the political debate surrounding SB 562, because the bill does not specify a revenue stream and its sponsors have not released their analysis of how Californians would pay for it and gain health security under a single-payer system. But according to Gerald Friedman, a University of Massachusetts economist who conducted that very analysis for a single-payer system in New York and has studied health costs in other large states, California’s analysts erred by understating health care cost savings and failing to subtract current health care spending from their projected payroll tax increase.

“I read the legislature’s analysis and was disappointed,” he said. “First, it has a high number for total costs because it assumes no savings from bulk purchasing of drugs and medical devices even though the rest of the world buys these at barely 70 percent what Americans pay, and the VA [Veterans Administration] buys drugs at 59 percent. Second, it assumes very small savings from lower administration (among both providers and insurers).  Finally, it assumes a very large increase in utilization, which is a cost but also a benefit since going to the doctor saves lives, and barriers to access are associated with about 200,000 extra deaths in the U.S. each year. (This figure is from a county-level analysis of mortality versus the proportion reporting they could not go to a doctor because of costs.)”

But the analysts’ bigger mistake was on the spending side — by omitting any mention that Californians would subtract current health spending from any tax increase. For example, the average Californian earned $64,500 in 2015. At first glance, a 15 percent payroll tax increase appears to add an additional tax of $9,675 a year or $806.25 monthly. However, if one is already paying $650 or so monthly for a health plan and several thousands more on deductibles and co-pays, then one can see how that current figure is actually more expensive than what would need to be raised under a single payer system. Friedman said this omission was crucial.

“The analysis does not discuss the different burden of health care with a payroll tax (or an income tax) compared with the current system which works like a lump-sum tax: everyone pays the same amount regardless of income,” he said. “In California in 2015, family insurance premiums (employer and employee) cost $18,045. For a worker earning $64,500, that is 28 percent of earnings, plus the cost of co-pays and deductibles. Indeed, at $18,000, workers would do better even with a 15 percent payroll tax up to earnings of $120,000. And, if we assume the employer plan had an actuarial value of 90 percent, and out-of-pocket costs are $2,000, workers are better off with a 15 percent payroll tax up to $133,333.”

Friedman said single-payer would save the public and businesses money via cutting bureaucratic costs and negotiating for drugs.

“The major criticism of these single payer plans is that we won’t get the savings that we anticipate from reducing administration—and I think that’s just crazy,” he said. “Because why would people employ all these people in billing and insurance processing if all you have to do is swipe a card in the right type of reader and it all goes to Sacramento where somebody will type in the diagnostic code and cut a check. In Toronto General Hospital, they have about 400 beds. It’s the size of Massachusetts General Hospital. And they have two people who do billing. Massachusetts General has about 400 people doing billing. That’s about one person per bed . . . I don’t see why we wouldn’t get large savings. Maybe not as large as I am anticipating. But much larger than they’re talking about.”

“And the other thing is the drug purchasing,” Friedman said. “California is the world’s seventh largest economy. If you guys just broke off, you would be as large as Italy. And Italy negotiates drug prices and drugs in Italy cost about half of what they cost in the United States. I don’t see why California wouldn’t get savings.”

What the legislative analysts should have done was compared what people now pay for their healthcare costs to the figure that would be needed to supplement the government’s subsidies for the poor, elderly, children, people with disabilities and veterans, he said. If they did that, they would have found that paying 15 percent of one’s income for health care is a very good deal.

“Fifteen percent [for a payroll tax increase] — I think that number’s too high, but 15 percent is less than what employer-provided coverage now costs in most states,” he said. “When you add in co-pays and deductibles, I would rather pay 15 percent than what I and my employer are now paying, because most people will be saving money. And people will have more security because they’ll get the care they need.”

[Northwest]

In the next week, or so, Senate leaders are going to try to put a bill on the floor, and vote on it immediately; before anyone has had a chance to read it, understand it or comment on it. This will be a remake of the rules which determine how one sixth of the economy works, and they want to make radical changes based only on backroom agreements by a handful of carefully selected politicos.

Sure...you can throw their asses out at the next election, after you find out what they have done to you and your health care. But think about how long it took Democrats to get the circumstances right that they were able to pass Obamacare to begin with. In our system of government, a very few players can prevent anything from moving forward, and we might be stuck with a terrible health care plan for a generation...or more.

It only takes three Republican no votes, or abstentions to defeat what's coming. If you live in a state where your Senator is on the fence about backing TrumpCare, let them know your feelings.


Senate leaders plan to rush a health-care bill to a vote, and there’s nothing Democrats can do about it


https://img.washingtonpost.com/wp-apps/imrs.php?src=https://img.washingtonpost.com/rf/image_960w/2010-2019/WashingtonPost/2017/05/26/National-Politics/Images/313838046_0-7.jpg&w=480

When the Republican-led Senate Rules Committee briefly flirted with the idea of restricting television interviews in the hallways of the Capitol last week, it became only the most obvious manifestation of how the party’s leaders were handling the development of a bill to overhaul Obamacare: out of the public eye.

While that effort was quickly sidelined after some outcry, the Republican leadership in the Senate was otherwise unfazed in its push to craft a bill that would expose its members to as little negative public attention as possible. No repeat of the town hall meetings that drew angry constituents who yelled at House Republicans and, they clearly hope, no weeks and weeks of swamped office phone lines.

In an article for the Monkey Cage, George Washington University’s Sarah Binder explained the four ways in which the Senate effort was unusually secretive. Sure, members of Congress would always rather pass legislation without dealing with negative criticism, but rarely have they gone so dark on such a big effort.

[Are Republicans leading the most secretive health-care bill process ever?]

The question that arises, though, is what Democrats could actually do about it. Binder told me that the answer was probably a simple one.

Nothing.

“I have a hard time seeing a real avenue for successful obstruction by the Democrats,” Binder said. The situation is unusual enough that making hard and fast predictions is tricky, she said, but “Republicans have been so aggressive on procedure here that I’d expect them to … get this through without any heed of what the Democrats were raising.”

In particular, Binder addressed a proposal outlined in a series of tweets last week by Ezra Levin, a former deputy policy director for House Democrats. Levin suggested that the Democrats could introduce an almost infinite number of amendments that would choke the Senate calendar indefinitely until they got what they wanted.

The plan hinges on the way in which the bill is being moved through the Senate. To avoid the need for Democratic votes — which the Republican majority wouldn’t get — the Obamacare replacement is being advanced using what’s known as the reconciliation process. That process involves a special set of rules that are meant to fast-track debate over the budget, but, given that it also means legislation can avoid a filibuster in the Senate, it has also been used to pass controversial bills. (Several fixes essential to the passage of Obamacare were moved using the reconciliation process, for example.)

Those rules, defined by law, include allowing only 20 hours for debate but it also includes a process called “vote-a-rama,” in which amendments may be proposed and must be voted on before the final passage of the bill. That’s where Levin’s idea comes in: He proposed introducing tens of thousands of amendments that would need to be voted on before the Senate’s bill could be passed. In theory, Levin figured, Democrats could introduce enough amendments to shut down the Senate for a year.

Binder disagrees.

“In reality, that’s not going to happen,” she said. What was more likely, she said, is that someone would make a point of order that the Democrats were being “dilatory” — that is, slowing down the process unnecessarily. The presiding officer — the Republican senator on duty to manage floor debate — would be asked to rule on whether that was the case and would likely agree. Democrats could appeal the decision, but a majority vote would end the process.

It’s not just partisan politics that would lead to that outcome, either, Binder said. If the presiding officer were to appeal to the Senate parliamentarian — the resident expert on the rules of order — the recommendation would likely be the same. “The parliamentarian’s job is really to make the Budget Act work, and everybody knows that the Budget Act has time limits in it,” she said. An infinite vote-a-rama might be in keeping with the letter of the law, but not, importantly, the spirit.

“The weight of the law here is toward no filibusters,” she said. But she also noted that there was no “hard and fast precedent” for such a scenario since, normally, the two parties agree in advance on how long the process will extend.

Asked if the Democrats had any other recourse, Binder was skeptical.

“I don’t really see an escape valve for Democrats to delay it,” she said. The only question is whether the Senate bill — once it’s finalized — meets the rules for reconciliation and if the House accepts it as written. If it’s not eligible for reconciliation or if the House doesn’t want to agree to the Senate bill as written, then more traditional minority obstruction efforts might kick in. If, however, the Senate Republicans pass a measure that the House Republicans agree to in whole cloth, that’s it.

Senate Majority Leader Mitch McConnell (R-Ky.) is no doubt very well aware of his options. He’s betting that drafting the bill in secret and pushing it through the Senate with limited debate will give his caucus enough cover to vote yes — and that the House will agree to the bill. If he’s right, that means that only one group could stand in his way: Republicans on Capitol Hill, by defecting in the Senate or objecting in the House. The Democrats can probably only watch.

https://www.washingtonpost.com/news/politics/wp/2017/06/19/senate-leaders-plan-to-rush-a-health-care-bill-to-a-vote-and-theres-nothing-democrats-can-do-about-it/

[Northwest]

GOP's secret Trumpcare bill will impact a sixth of the U.S. economy. What could possibly go wrong?
The Times Editorial Board



Senate Majority Leader Mitch McConnell (R-Ky.) is pushing for a vote next week on a bill to repeal and replace Obamacare despite having held no public hearings, obtained no feedback from budget analysts and taken no testimony from doctors, patients or hospitals.

That’s a recipe for disaster.

Senate Republicans have been inundated with complaints about the secret negotiations over the bill, which took as a starting point the House Republican leadership’s execrable American Health Care Act. So far, their negotiators have not been deterred by the accusations of recklessness (healthcare spending accounts for about a sixth of the massive U.S. economy), heedlessness (dozens of groups representing doctors, hospitals and other healthcare professionals say their input has been ignored) and hypocrisy (this is, after all, a group that complained for years about Democrats “rushing” the passage of the Affordable Care Act in 2010 after months of hearings and weeks of debate on the Senate floor).

This bill needs maximum public exposure and scrutiny, not the see-no-evil treatment it’s getting from the Senate GOP.

Instead, the only thing holding the Republicans up has been the splits within their own caucus over a few key policy issues, such as how much of the cost of healthcare to shift onto the states and their taxpayers. There’s no point in involving Democrats — or the public — in shaping the bill, some Republicans say, because only Republicans will vote for it at the end of the day. Funny, but Republicans were involved in much of the wrangling over the bill that became the Affordable Care Act, even though Democrats saw early on that Republicans were determined to vote no.

This time around, the process has not only been maddeningly partisan, but it’s also been willfully blind to the real problems in the U.S. healthcare system, as well as the steps insurers and providers have been taking to address those problems. As a consequence, Senate Republicans are on the verge of moving the country backward, and significantly so, when it comes to reducing healthcare costs, improving quality and broadening availability.

McConnell said Tuesday that a “discussion draft” of the bill would be released this week, first to Republican senators, then to the public. Still, we already know that the bill won’t simply repeal Obamacare or magically restore the healthcare market to what it had been before — a market plagued by rapidly rising costs, double-digit increases in insurance premiums and a large and growing population of Americans without coverage. That’s largely because the legislative shortcut the Republicans are taking to prevent a lethal Democratic filibuster also prevents them from changing any provision of the Affordable Care Act that doesn’t directly affect the federal budget. But it’s also true because Republicans want to cut the taxes the ACA imposed — on high-income Americans and an assortment of health industry groups — while offering their own version of subsidies to help consumers pay for insurance.

In order to do that, they have to cut something else. And that would be Medicaid, the health insurance program for impoverished Americans. Like their House counterparts, Senate Republicans are reportedly seeking to end the federal government’s promise to cover at least half the cost of Medicaid enrollees’ healthcare expenses, shifting instead to block grants tied to population and state healthcare spending. It’s a huge change in policy that’s fraught with risk for the poor and state governments, especially ones like California’s that have already pushed through reforms to cut spending per enrollee. And rather than give the industry more incentive to improve the quality of care, it would simply give states an incentive to offer fewer services to fewer people — including optional services such as in-home care that actually save money over the long term.

The Senate GOP also appears wedded to the House’s approach to lowering insurance premiums for those not covered by a health plan at work. Rather than trying to lower the cost of care, the focus is on letting insurers offer less coverage and cheaper plans that attract only healthy customers. Doing so would reverse efforts within the industry to spread risks and control costs, which is exactly the opposite of what Republicans say they’re trying to accomplish. These sorts of fundamental flaws are exactly why this bill needs maximum public exposure and scrutiny, not the see-no-evil treatment it’s getting from the Senate GOP.

http://www.latimes.com/opinion/editorials/la-ed-senate-secret-healthcare-bill-20170621-story.html

[Lois]

*Sigh*  Trump needs to shut his piehole.  He's in the big leagues now, and his words have consequences for all of us!

Trump's mixed signals on healthcare send premiums rising, study finds
Kaiser Family Foundation finds administration has created uncertainty ‘far outside the norm’, leading insurers to seek higher premium increases

The Trump administration’s own actions are triggering double-digit premium increases on individual health insurance policies purchased by many consumers, a nonpartisan study has found.

The analysis released Thursday by the Kaiser Family Foundation found that mixed signals from Donald Trump have created uncertainty “far outside the norm”, leading insurers to seek higher premium increases for 2018 than would otherwise have been the case.

The report comes with Republicans in Congress unable to deliver on their promise to repeal and replace the Obama-era Affordable Care Act. Trump, meanwhile, insists lawmakers try again.

“Can you believe that Mitch McConnell, who has screamed Repeal & Replace for 7 years, couldn’t get it done,” he tweeted of the Senate Republican leader on Thursday morning. “Must Repeal & Replace ObamaCare!”

The president says “Obamacare” is collapsing, but he’s also threatened to give it a shove by stopping billions of dollars in payments to insurers. Some leading Republicans are considering fallback measures to stabilize markets.

Researchers from the Kaiser Foundation looked at proposed premiums for a benchmark silver plan across major metropolitan areas in 20 states and Washington DC. Overall, they found that 15 of those cities will see increases of 10% or more next year.

The highest: a 49% jump in Wilmington, Delaware. The only decline: a 5% reduction in Providence, Rhode Island.

About 10 million people who buy policies through HealthCare.gov and state-run markets are potentially affected, as well as another 5 to 7 million who purchase individual policies on their own.

Advertisement

Consumers in the government-sponsored markets can dodge the hit with the help of tax credits that most of them qualify for to help pay premiums. But off-marketplace customers pay full freight, and they face a second consecutive year of steep increases. Many are self-employed business owners.

The report also found that insurer participation in the ACA markets will be lower than at any time since Obamacare opened for business in 2014. The average: 4.6 insurers in the states studied, down from 5.7 insurers this year. In many cases insurers do not sell plans in every community in a state.

The researchers analyzed publicly available filings through which insurers justify their proposed premiums to state regulators. To be sure, insurers continue to struggle with sicker-than-expected customers and disappointing enrollment. And an ACA tax on the industry is expected to add 2-3 percentage points to premiums next year.

But on top of that, the researchers found the mixed signals from the administration account for some of the higher charges. Those could increase before enrollment starts 1 November.

“The vast majority of companies in states with detailed rate filings have included some language around the uncertainty, so it is likely that more companies will revise their premiums to reflect uncertainty in the absence of clear answers from Congress or the administration,” the report said. Once premiums are set, they’re generally in place for a whole year.

Insurers who assumed that Trump will make good on his threat to stop billions in payments to subsidize copays and deductibles requested additional premium increases ranging from 2% to 23%, the report found.

Insurers who assumed the IRS under Trump will not enforce unpopular fines on people who remain uninsured requested additional premium increases ranging from 1.2% to 20%.

“In many cases that means insurers are adding double-digit premium increases on top of what they otherwise would have requested,” said Cynthia Cox, a co-author of the Kaiser report. “In many cases, what we are seeing is an additional increase due to the political uncertainty.”

That doesn’t sound like what Trump promised when he assumed the presidency.
In a Washington Post interview ahead of his inauguration, Trump said: “We’re going to have insurance for everybody.”

“There was a philosophy in some circles that if you can’t pay for it, you don’t get it,” he added. “That’s not going to happen with us.”

People covered under Obama’s law “can expect to have great healthcare,” Trump said at the time. “It will be in a much simplified form. Much less expensive and much better.”

But the White House never produced the health care proposal Trump promised. And the failed GOP bills in Congress would have left millions more uninsured, a sobering side-effect that contributed to their political undoing.

The Trump administration sidestepped questions about its own role raised by the Kaiser study.

Spokeswoman Alleigh Marre said rising premiums and dwindling choices predate Trump.

“The Trump administration is committed to repealing and replacing Obamacare and will always be focused on putting patients, families, and doctors, not Washington, in charge of health care,” Marre said in a statement.

The political turmoil for people who buy individual health insurance stands in sharp contrast to relative calm and stability for the majority of Americans insured through workplace plans. The cost of employer-sponsored coverage is expected to rise around 5 or 6% next year, benefits consultants say.

https://www.theguardian.com/us-news/2017/aug/10/trump-healthcare-premiums-insurance-study

[Katiebee]

Just remember, trump can't close a deal unless he holds all the cards and deals from the bottom of the deck. He is an incompetent, and poor businessman, and a snake oil salesman.

[Lois]

From the article below:

Ironically, cutting off these payments to health insurance companies will actually cost taxpayers more than continuing them. Because higher premiums mean bigger subsidies, federal spending will rise by almost $200 billion, according to the nonpartisan Congressional Budget Office.

This is Trumpcare folks!  Make sure you use this name whenever referring to the changes in your healthcare plans!


Trump To Cut Off Billions In Key Obamacare Payments To Insurers
The sabotage continues.
By Jeffrey Young

President Donald Trump plans to halt payments to health insurance companies serving the poorest customers on the Obamacare exchanges, the White House announced Thursday.

Trump has threatened to withhold these funds, valued at $7 billion this year, since shortly after his election victory last November. The threats alone have roiled the health insurance market, and if he follows through, it promises to be significantly disruptive. Trump will make an announcement Friday, according to Politico, which first reported the news.

In Trump’s mind, dealing damage to the Obamacare market is a means to achieve leverage he believes will force congressional Democrats to cooperate with replacing the Affordable Care Act, the law President Barack Obama signed in 2010 that has brought the number of uninsured Americans to a historic low.

Trump has been undermining the law and its programs since he took office in January, and he has ramped up his efforts in recent weeks in the aftermath of his failure to get the Affordable Care Act repealed by Congress. Earlier Thursday, Trump signed an executive order directing federal agencies to change regulations to allow insurers to sell policies that exclude people with pre-existing conditions and have skimpier benefits than insurance governed by the Affordable Care Act.

The mere possibility that Trump would refuse to pay money owed to health insurance companies created additional instability in market. Insurers are raising premiums for next year even more than they would have as they try to protect themselves against financial losses if the federal government reneges on its obligations.

The open-enrollment period on health insurance exchanges, such as HealthCare.gov and Covered California, begins Nov. 1, less than three weeks from now.

The payments Trump plans to end are related to so-called cost-sharing reductions offered to insurance exchange enrollees who earn up to 250 percent of the federal poverty level, which is $30,150 for a single person. These subsidies serve to reduce out-of-pocket expenses for low-income people by shrinking their deductibles, co-payments and the like.

Almost 6 million people, or 57 percent of Obamacare enrollees, qualified for these subsidies when they enrolled this year, according to the Department of Health and Human Services.

Under the Affordable Care Act, health insurance companies are required to reduce this cost-sharing. The federal government is supposed to reimburse them for the cost, and it has since exchange plans went live in January 2014.

Trump will change that soon. He has the authority to do so because of a lawsuit then-House Speaker John Boehner (R-Ohio) brought against Obama in 2014. House Republicans claimed Obama illegally made these payments without an explicit congressional appropriation of the funding.

A federal judge sided with House Republicans last year but allowed Obama to continue paying back insurers while the case went through the appeals process.

But when Trump succeeded Obama as president, his administration became the defendant in the case, raising doubt about how Trump and House Republicans would proceed. The parties in the lawsuit have obtained several delays in the proceedings in the meantime. The appeals court ruled in August that the attorneys general from 17 states and the District of Columbia are permitted take up the defense, based on the state officials’ concerns that the Trump administration would fail to do so.

New York Attorney General Eric Schneiderman announced Thursday that he and those other attorneys general are prepared to sue Trump over the cost-sharing reduction payments.

White House press secretary Sarah Huckabee Sanders issued a statement on the president’s decision Thursday night.

“Based on guidance from the Department of Justice, the Department of Health and Human Services has concluded that there is no appropriation for cost-sharing reduction payments to insurance companies under Obamacare. In light of this analysis, the government cannot lawfully make the cost-sharing reduction payments. The United States House of Representatives sued the previous administration in federal court for making these payments without such an appropriation, and the court agreed that the payments were not lawful. The bailout of insurance companies through these unlawful payments is yet another example of how the previous administration abused taxpayer dollars and skirted the law to prop up a broken system. Congress needs to repeal and replace the disastrous Obamacare law and provide real relief to the American people.”

Congress could address the cost-sharing reduction payments issue by authorizing the spending in legislation but has not done so.

The immediate effect of Trump pulling the cost-sharing reduction payments will be mixed. Health insurance exchange customers who earn too much to qualify for subsidies will have to bear the full brunt of the premium increases insurers instituted to protect themselves. Those customers who receive subsidies will mostly be shielded from the rate hikes because their subsidies will rise along with the premiums.

Ironically, cutting off these payments to health insurance companies will actually cost taxpayers more than continuing them. Because higher premiums mean bigger subsidies, federal spending will rise by almost $200 billion, according to the nonpartisan Congressional Budget Office.

The news about the cost-sharing reduction payments comes just hours after Trump signed an executive order that could shake up the Affordable Care Act’s insurance markets ― and quite possibly hobble them more.

Looking ahead, however, ending the payments jeopardizes the future of the exchanges. Many major health insurance companies already have pulled out of the marketplaces, citing financial losses. In future years, it’s likely fewer companies will want to participate in the exchanges knowing might not get expected payments. Some parts of the country would have no health insurance carriers in operation under this scenario, the Congressional Budget Office predicted.

Experts and a variety of health care groups immediately warned that the new insurance plans the executive order might allow would also draw healthy people out of the Affordable Care Act markets, forcing insurers to raise premiums or shut down plans altogether ― leaving the people who want or need comprehensive coverage with fewer, more expensive options, or none at all.

These are the latest moves Trump has made to weaken the health insurance exchanges:

The administration has severely cut back on the Department of Health and Human Services’ programs to promote health insurance enrollment, including major reductions in advertising and in-person assistance. The administration also halved the sign-up period to six weeks and plans to take the HealthCare.gov website down for as long as 12 hours every Sunday during the enrollment campaign.

The Department of Health and Human Services also spent money intended for enrollment support on a campaign that criticizes the programs it’s supposed to be managing.

Jonathan Cohn contributed to this report.

https://www.huffingtonpost.com/entry/trump-obamacare-payments-insurers_us_59e01859e4b03a7be57f71a9?ncid=inblnkushpmg00000009

[joan1984]

A federal judge found such subsidy payments to be unconstitutional. Thus the action by Executive Order, to counter former Executive Action by predecessor.

So, Obamacare being unconstitutional in another issue, strikes again. Dems crafted Obamacare in every detail, not a single Republican vote, nor were Republicans allowed to confer on the bill details by Nancy and Harry. Of course the least involved in Obamacare being the way it is was President Trump.

Good President Trump is there when we need him. Maybe will spur action by legislators to finally repeal this turkey and craft necessary (if it is needed) any replacement bill(s).

From the article below:

Ironically, cutting off these payments to health insurance companies will actually cost taxpayers more than continuing them. Because higher premiums mean bigger subsidies, federal spending will rise by almost $200 billion, according to the nonpartisan Congressional Budget Office.

This is Trumpcare folks!  Make sure you use this name whenever referring to the changes in your healthcare plans!


Trump To Cut Off Billions In Key Obamacare Payments To Insurers
The sabotage continues.
By Jeffrey Young

President Donald Trump plans to halt payments to health insurance companies serving the poorest customers on the Obamacare exchanges, the White House announced Thursday.

Trump has threatened to withhold these funds, valued at $7 billion this year, since shortly after his election victory last November. The threats alone have roiled the health insurance market, and if he follows through, it promises to be significantly disruptive. Trump will make an announcement Friday, according to Politico, which first reported the news.

In Trump’s mind, dealing damage to the Obamacare market is a means to achieve leverage he believes will force congressional Democrats to cooperate with replacing the Affordable Care Act, the law President Barack Obama signed in 2010 that has brought the number of uninsured Americans to a historic low.

Trump has been undermining the law and its programs since he took office in January, and he has ramped up his efforts in recent weeks in the aftermath of his failure to get the Affordable Care Act repealed by Congress. Earlier Thursday, Trump signed an executive order directing federal agencies to change regulations to allow insurers to sell policies that exclude people with pre-existing conditions and have skimpier benefits than insurance governed by the Affordable Care Act.

The mere possibility that Trump would refuse to pay money owed to health insurance companies created additional instability in market. Insurers are raising premiums for next year even more than they would have as they try to protect themselves against financial losses if the federal government reneges on its obligations.

The open-enrollment period on health insurance exchanges, such as HealthCare.gov and Covered California, begins Nov. 1, less than three weeks from now.

The payments Trump plans to end are related to so-called cost-sharing reductions offered to insurance exchange enrollees who earn up to 250 percent of the federal poverty level, which is $30,150 for a single person. These subsidies serve to reduce out-of-pocket expenses for low-income people by shrinking their deductibles, co-payments and the like.

Almost 6 million people, or 57 percent of Obamacare enrollees, qualified for these subsidies when they enrolled this year, according to the Department of Health and Human Services.

Under the Affordable Care Act, health insurance companies are required to reduce this cost-sharing. The federal government is supposed to reimburse them for the cost, and it has since exchange plans went live in January 2014.

Trump will change that soon. He has the authority to do so because of a lawsuit then-House Speaker John Boehner (R-Ohio) brought against Obama in 2014. House Republicans claimed Obama illegally made these payments without an explicit congressional appropriation of the funding.

A federal judge sided with House Republicans last year but allowed Obama to continue paying back insurers while the case went through the appeals process.

But when Trump succeeded Obama as president, his administration became the defendant in the case, raising doubt about how Trump and House Republicans would proceed. The parties in the lawsuit have obtained several delays in the proceedings in the meantime. The appeals court ruled in August that the attorneys general from 17 states and the District of Columbia are permitted take up the defense, based on the state officials’ concerns that the Trump administration would fail to do so.

New York Attorney General Eric Schneiderman announced Thursday that he and those other attorneys general are prepared to sue Trump over the cost-sharing reduction payments.

White House press secretary Sarah Huckabee Sanders issued a statement on the president’s decision Thursday night.

“Based on guidance from the Department of Justice, the Department of Health and Human Services has concluded that there is no appropriation for cost-sharing reduction payments to insurance companies under Obamacare. In light of this analysis, the government cannot lawfully make the cost-sharing reduction payments. The United States House of Representatives sued the previous administration in federal court for making these payments without such an appropriation, and the court agreed that the payments were not lawful. The bailout of insurance companies through these unlawful payments is yet another example of how the previous administration abused taxpayer dollars and skirted the law to prop up a broken system. Congress needs to repeal and replace the disastrous Obamacare law and provide real relief to the American people.”

Congress could address the cost-sharing reduction payments issue by authorizing the spending in legislation but has not done so.

The immediate effect of Trump pulling the cost-sharing reduction payments will be mixed. Health insurance exchange customers who earn too much to qualify for subsidies will have to bear the full brunt of the premium increases insurers instituted to protect themselves. Those customers who receive subsidies will mostly be shielded from the rate hikes because their subsidies will rise along with the premiums.

Ironically, cutting off these payments to health insurance companies will actually cost taxpayers more than continuing them. Because higher premiums mean bigger subsidies, federal spending will rise by almost $200 billion, according to the nonpartisan Congressional Budget Office.

The news about the cost-sharing reduction payments comes just hours after Trump signed an executive order that could shake up the Affordable Care Act’s insurance markets ― and quite possibly hobble them more.

Looking ahead, however, ending the payments jeopardizes the future of the exchanges. Many major health insurance companies already have pulled out of the marketplaces, citing financial losses. In future years, it’s likely fewer companies will want to participate in the exchanges knowing might not get expected payments. Some parts of the country would have no health insurance carriers in operation under this scenario, the Congressional Budget Office predicted.

Experts and a variety of health care groups immediately warned that the new insurance plans the executive order might allow would also draw healthy people out of the Affordable Care Act markets, forcing insurers to raise premiums or shut down plans altogether ― leaving the people who want or need comprehensive coverage with fewer, more expensive options, or none at all.

These are the latest moves Trump has made to weaken the health insurance exchanges:

The administration has severely cut back on the Department of Health and Human Services’ programs to promote health insurance enrollment, including major reductions in advertising and in-person assistance. The administration also halved the sign-up period to six weeks and plans to take the HealthCare.gov website down for as long as 12 hours every Sunday during the enrollment campaign.

The Department of Health and Human Services also spent money intended for enrollment support on a campaign that criticizes the programs it’s supposed to be managing.

Jonathan Cohn contributed to this report.

https://www.huffingtonpost.com/entry/trump-obamacare-payments-insurers_us_59e01859e4b03a7be57f71a9?ncid=inblnkushpmg00000009

[Northwest]

[_priapism]

It's completely fucked now, and millions are going to lose coverage.  Primarily so Trump can wipe his ass with Obama's greatest legislative achievement.  We are FUCKED.  There's not going to be much left to pick up and fix by 2020.  Basically set the clocks back a few decades and start all over.

[Northwest]

At least we've learned from the experience; no more half measures. Medicare for all, with cradle to the grave universal healthcare as a right of citizenship. Nothing less.

Let's quit kidding ourselves; Republicans would starve us just so they could take the few scraps we have to add to their coffers. They have become the merchants of death. It's time that we treated them accordingly.

[Lois]

A federal judge found such subsidy payments to be unconstitutional. Thus the action by Executive Order, to counter former Executive Action by predecessor.

WRONG! The judge found not going through Congress for the appropriations for the subsidy payments to be unconstitutional.

Get your facts straight.

Oh, that's right.  You don't know any facts.  *sigh*

[Athos_131]

Get your facts straight.

Oh, that's right.  You don't know any facts.  *sigh*

joan1984 is well versed in alternative facts.

#Resist

[Katiebee]

Did you know, the definition of alternative facts is fiction.

[joan1984]

A Judge found that President Obama's choices re: Obamacare funding of private insurance companies is unconstitutional. So be it. Funding stopped.

Fixed that for ya!

A federal judge found such subsidy payments to be unconstitutional. Thus the action by Executive Order, to counter former Executive Action by predecessor.

WRONG! The judge found not going through Congress for the appropriations for the subsidy payments to be unconstitutional.

Get your facts straight.

Oh, that's right.  You don't know any facts.  *sigh*

[Northwest]

This will hurt no group more than the "...average Trump voter", so I suppose that there's a certain poetic justice to it. Trump just went against a solid and clear majority of the people, of Congress, and most of the affected business and medical groups --  basically everyone -- to sabotage a program which covers one out of five dollars spent in the nation. Complete chaos is likely to ensue.

This is madness.

Retiring GOP lawmaker: Republicans now 'own' ObamaCare



Rep. Charlie Dent (R-Pa.) argued Friday that President Trump was “ill-advised” to end key ObamaCare payments, warning that the GOP now “owns” whatever happens to ObamaCare.

“I think the president is ill-advised to take this course of action because … we, the Republican Party, will own this,” Dent, a key House moderate who is retiring from Congress at the end of his term, said on CNN.

Asked about Trump’s previous comments blaming problems with ObamaCare on former President Barack Obama, Dent pointed out that Republicans currently control the White House and have majorities in both chambers of Congress.

“Barack Obama is a former president. President Trump is the president and he’s a Republican, and we control the Congress,” Dent said. “So we own the system now. We’re going to have to figure out a way to stabilize this situation … This is on us...”

Read the rest: http://thehill.com/homenews/house/355426-retiring-gop-lawmaker-republicans-now-own-obamacare

[joan1984]

  Insurance companies will now be required to compete, in order to attract the policies from people of incomes high and low, across the board, and creative plans offered to address the immediate needs and wants of the purchasers will fill in where imposed restrictions of the Obamacare rules/regs instead raised the premiums of the vast majority of the insured.

  How is it, that when the government 'gives' 10 Billion Dollars to Insurance Companies, we believe they will help the poor and needy with that largess, yet if a Tax Cut is proposed that helps the same Insurance Companies, there is all out warfare to stop the greedy rich from any benefit?

  Competition, Capitalism, freedom to insure Nationwide, as is now done with Unions, with Corporations, and larger company plans, offering few to no limits about pre-existing conditions as a part of such group plans, selling in various States and Territories/Districts without issue, at prices more affordable than under some government or quasi/government plan cannot be anything but good.

  AFL-CIO, or Teamsters, or SEIU members, whether in food service, welding, heavy equipment operators, manufacturing, whatever employment, are able to access the same plans via their Union, with common benefits, common limits to affect all in the respective group(s).

  What removal of restrictions for those not previously eligible to be 'groups' does, is make such coverage and plans, at similar shared costs, available to more Americans, who otherwise are limited by previous/current offerings, so as to reduce the individual's costs, lower the individual's co-pay, and increase the value to the individual and her family members.

  That looks like WINNING to me. We already have such plans, just eligibility to access existing plans limits how many of us can benefit.

  The legalization of the process, regarding the unconstitutional payment of subsidies to insurance companies under what has been recent (past 8 years) policy, is expected to affect individual copay, not access or coverage amounts.

  Competition among Insurance Companies should be enough to assure the practical reduction of co-pay, or other worthwhile benefit to encourage such co-pay, will provide for those truly unable to contribute to their own well being.

[Northwest]

Excuse me, Joan, but you are an uninformed moron who spouts off other people's spin as though it were fact. You don't have any idea what you are talking about.