Medicaid was created in 1965 as a safety net for the poor. But Obamacare distorted it, edging the U.S. closer to a Medicaid-for-all or single-payer system. Swelling the Medicaid rolls — not making private insurance affordable — is the main way Obamacare dealt with the uninsured.
Almost 75 million people are now enrolled, 20 million more than in Medicare, the program for the elderly. If the repeal bill doesn’t pass, Medicaid enrollment will soar to 86 million by 2026, according to a Congressional Budget Office analysis released Monday.
Who’s picking up the tab for this vast Medicaid expansion? You. Worse, you pay twice — once as a taxpayer, and then again as an insurance consumer. Families with private insurance pay $1,500 to $2,000 or more in added premiums yearly already to keep Medicaid afloat. The more Medicaid expands, the higher their premiums will go. That’s because Medicaid shortchanges hospitals and doctors, paying less than the actual cost of care. They make up for it by shifting the costs onto privately insured patients. Ouch.
That cost shifting only works until Medicaid enrollment grows too large. The Mayo Clinic warned three months ago that Medicaid enrollment has reached the tipping point. The renowned clinic announced it will have to turn away some Medicaid patients or put them at the back of the line, behind patients with commercial insurance.
Years earlier, when Obamacare was still being debated in Congress, the dean and CEO of Johns Hopkins Medicine, Dr. Edward Miller, issued a similar warning: Allowing a vast expansion of Medicaid could have “catastrophic effects” at places like Hopkins.
His dire prediction came true. Obamacare loosened Medicaid eligibility rules and urged states to enroll as many people as possible, with Uncle Sam paying 100 percent of the tab until 2016 and 90 percent or more thereafter.
Medicaid enrollment spiked in many states, including New York, where it skyrocketed up by a third to 6.3 million. Blame the incentive to rake in federal dollars.
And waste money. Roughly 10.5 percent of Medicaid payments are in error. Any company with that record would be out of business….
In fact, quite the contrary. The Senate bill will codify and make permanent the Medicaid expansion, and will, in fact, have the federal government pay the lion’s share of the cost. Remember, ObamaCare created a new category of eligibility. Working age, able-bodied adults with no dependents for the first time became eligible for Medicaid if their income is below 138 percent of the poverty level. [editor’s note: which is why it (the ACA) should be repealed completely, not replaced!]
The Left’s rhetoric is legend, here you can see it in action regarding Medicaid:
…It doesn’t help that news reports criminally misrepresent the CBO score, stating flatly that 22 million people will “lose” insurance under the plan. Or when ostensibly neutral news articles announce that Medicaid will be “slashed” or “gutted” under the Senate bill.
In fact, the bill merely slows Medicaid’s rate of growth. Under the Senate plan, federal Medicaid spending would still increase $73 billion by 2026 — and while that’s well below the scheduled amount of spending under Obamacare, conservatives maintain the current law’s trajectory is unsustainable…
This remind’s me of when the Democrats said Bush was cutting benefits to veteran’s, but in fact he was raising them mroe than during Clinton’s tenure:
Only in government does slowing the growth of spending mean “cuts”
FORBES deals with a couple of the lies/myths by the Left in regard to “cuts.”
False claim: Growing costs are the main problem & per capita cap funding will not be enough
Reality: Enrollment growth is driving spending increases and per capita caps are a good first step towards reform
When the Congressional Budget Office (CBO) scored these bills, the projected savings from changes in Medicaid were almost entirely related to Medicaid enrollment changes– not capping the program. In fact, analysis by my colleague Jonathan Ingram at the Foundation for Government Accountability has shown that, historically, almost all states would not have exceeded the caps set in the House bill. Just 0.4 percent of spending would have exceeded the cap.
Actually, the caps are projected to grow at a higher rate than projected spending for seniors and the disabled. (4.8% projected for 2019 and beyond vs. 4.6%)
Altogether, if the caps had been in place starting in 2000, actual spending growth would have remained lower than the targets set by BCRA.
But here is the line of cutting spending overall… remember, not by capping the program:
But in reality, the benefits of Medicaid is lacking, as any government program:
Medicaid is a program that is rife with inefficiency. A 2015 study found that recipients derived only 20 to 40 cents of benefit for every dollar governments spend on it. Researchers have struggled to find any positive effects Medicaid has on beneficiaries’ physical health. — Ramesh Ponnuru
“If enacted, the President’s budget would be a major down payment on federal entitlement reform. It cannot be overemphasized that analysts and economists, often of very different political persuasions, are united in their conviction that policymakers must take decisive steps to slow the growth of federal entitlement spending. By putting Medicaid on a budget—either through a fixed allotment to the states in the form of a block grant or a per capita cap—the Trump budget would give state officials much needed flexibility in managing the program and better target services to the poorest and most vulnerable of our citizens.” — Robert Moffit
In September, the Department of Health and Human Services sent out a warning that improper payments under Medicaid have become so common that they will account this year for almost 12 percent of total Medicaid spending — just shy of $140 billion. (Total improper payments across federal programs will come to about $139 billion this year, according to estimates that have proved too generous in the past, and almost all of that is Medicaid-driven.) That rate has doubled in only a few years, driven mostly by the so-called Affordable Care Act’s liberalization of Medicaid-eligibility rules. — Kevin D. Williamson
And there is waste in other areas as well. CNS-NEWS has an article on how many children are born on Medicare…
New Mexico led all states with 72 percent of the babies born there in 2015 having their births covered by Medicaid.
Arkansas ranked second with 67 percent; Louisiana ranked third with 65 percent; and three states—Mississippi, Nevada and Wisconsin—tied for fourth place with 64 percent of babies born there covered by Medicaid.
New Hampshire earned the distinction of having the smallest percentage of babies born on Medicaid. In that state, Medicaid paid for the births of only 27 percent of the babies born in 2015.
Virginia and Utah tied for the next to last position, with 31 percent of the babies born on Medicaid.
However, according to KFF, some of the nation’s most populous states shared the distinction of having 50 percent or more of the babies born there born on Medicaid.
In California, Florida and Illinois, for example, 50 percent of all babies were born on Medicaid in the latest year on record.
In New York, 51 percent of the babies were born on Medicaid.
In Ohio, 52 percent of babies were born on Medicaid.
The Kaiser Family Foundation gathered its data on the number of babies born on Medicaid in each state by surveying the state Medicaid directors.
“Medicaid directors were asked to provide the most recent available data on the share of all births in their states that were financed by Medicaid,” said a KFF report.
“About half of the states were able to provide data for calendar 2015 or fiscal year 2015,” said KFF. “Other states generally provided data from 2013 or 2014. On average, states reported that Medicaid pays for just over 47 percent of all births.”
“Eight states (Arkansas, Louisiana, Mississippi, Nevada, New Mexico, Oklahoma, South Carolina and West Virginia) reported that Medicaid pays for 60 percent or more of all births in their state,” reported KFF.
By 2010, according this report, the percentage of births in the United States covered by Medicaid had risen to 47.75 percent—or 1,805,151 out of 3,780,519 total births.
Another report, published by the Centers for Disease Control and Preventionlater in December 2013, looked at the form of payment for births in the 33 states and the District of Columbia that as of 2010 had adopted the 2003 version of “U.S. Standard Certificate for Live Birth.” This certificate specifically asks the mother to say which of four categories the payment for her child’s birth falls into: private insurance, Medicaid, self-pay, or other.
This data, according to the CDC, covered all 2010 births in the 33 states and the District of Columbia, which accounted for 76 percent of all births in the nation in that year. According to the CDC, this data revealed that 44.9 percent of the babies born in these jurisdictions in 2010 were born on Medicaid.
In this 2010 CDC data for 33 states, New Mexico also led with the highest percentage of births on Medicaid—with 57.5 percent of all babies born there that year having their births covered by Medicaid.
When I see this it is the same thing as the Pentagon buying a toilet seat for $640, I expect everyone to be besides themselves with that. The same thing I expect with the above list. The problem is that Democrats are pinning their single-payer hopes on Medicaid.
Here are two interview with Rep. Cathy McMorris Rodgers, who wrote an important piece. She is the highest ranking House [female] Republican, mother of three, and one of her children ihas a special needs child with a pre-existing condition. Her op-ed in the Washington Post can be found on her site, and is entitled:
Here are the interviews that include some description underneath. Anjoy:
I attach the previous call to the interview, as, it dove tails nicely into the the topics discussed. It is key to hear the concerns of people — often misinformed, as my post on the issue makes clear. I set the time on the video to start at the opening of the interview. The mainstream media’s narrative is sickening, BTW.
Cathy McMorris Rodgers honestly states that rates will still rise a bit… but that this is a three-part “dealing with” Obama-Care. Hugh Hewitt fleshes out some strategy and other issues that plague the GOP in a polite professional matter in this all-too-important [HOT] topic of health-care.
I will first post a serious challenge/worry that the MSM (mainstream media) will be using as “special cases.” BUT FIRST, why is this not a good way to write law? That is, write law using special cases. Being that I am “conservative” and lean towards this bias, I will use some examples from these similar thinking people. The first zeroes in on a separate issue, but in regards to writing laws, it is the same:
…Proponents of gay marriage fail utterly to comprehend the idea that laws are made with society, not the individual, in mind. That is why they also fail to grasp the idea that law is predicated upon averages, not outliers. Interestingly, both libertarians and progressives suffer from this lack of understanding…
…But more often they try to undermine the link between marriage and childrearing by pointing to outliers—marriages in which couples choose not to have children or cannot have them because at least one partner happens to be infertile. But this argument only reveals the weakness of the progressive understanding of the law. Put simply, rules that are justified by the average case cannot be undermined by the exceptional case, otherwise known as the outlier. Thus the old maxim, “Hard cases make bad law.”…
Mike S. Adams, Letters To A Young Progressive (Washington, DC: Regnery Publishing, 2013), 81, 82.
The following two media files are the same analogy of car insurance explained by Dennis Prager, but two different times:
With the above in mind, here is my first response via Facebook to a thoughtful post:
This is a thoughtful and understandable challenge by a single mother who is on a fixed income… she asks a question about her child with a malady and what the change in “pre-existing” is according to the current bill (remember, it will go through the senate, then most probably “conference,” reconciliation [by this time the CBO will have gone through the bill then — which will be tweaked from the one we are speaking to currently], and then be re-voted on)…
…here is her concern:
✦ My child’s digestive and respiratory issues caused by her being born prematurely and her grief depression caused by her farther dying when she was 5 are all considered pre-existing. As a single mother on a fixed income, her health care is an issue I do get very excited about!
With the AHCA, and the future fixes, premiums will fall dramatically. If you are caught without insurance for 63-days, you will pay about 30% more, but again, the overall payment will be much lower. Due to Obama-Care imploding (the latest example out of the many is Iowa having zero insurance coverage options, in other words, if you are a single mother on a fixed income in many states, you have zero options.
This was and is untenable. One of the GOP’s goals is to allow cross state competition for insurance groups that will increase pool sizes and lower costs dramatically. This has been illegal. Also, tort reform would be the single most beneficial thing that could be done… This is hard because injury lawyers are the first or second largest donors to the Democrat Party, so until we get enough conservative and other Republican’s to take this part of the issue seriously, the Democrats will continue to stand in the way of effective ways to lower your cost and increase your coverage options.
ADDENDUM 1 Just to add to make what I said clear (wanting clarity to reign). If you have not had insurance for 63-days — and AFTER this point you get an illness, this is when “pre-existing” kicks in. You see, I run a warehouse, and while the owner (a close friend) could afford the rise in his premiums, and I had insurance through my wife, the responsible young man who made $12 bucks an hour had insurance through Blue Cross on his own, lost his insurance because of Obama-Care. When he could find a policy again, it was more expensive. Two years after this it was more than twice as expensive as he was paying before O-Care. And he made the least in the warehouse. Why was it so expensive? His plane included pregnancy tests, Pap smear, mammogram, etc.
This way, through this legislation, the premiums should drop (esp. through more free market options in the future), but the cost won’t be a burden to poorer responsible people who have health insurance.
I just wanted clarify the above, as, I feel for you. Your concern is real! The call at the end of this interview is similar to your case (via my YouTube upload):
ADDENDUM 2 Sorry, one last thing, and this is to help you get through the weeds of Main Stream Media and all the other sources you will come across — yes, even me. The best non-partisan summary is this:
➤ States may opt-out of requiring premiums to be the same for all people of the same age, so while individuals with pre-existing conditions must be offered health insurance there is no limit on the cost of that insurance. A new $8 billion fund would help lower premiums for these individuals.
So even with the “ding” against “pre-existing” cases, there is money set aside for people just like you… if your state chooses to participate. BTW, this is called Federalism light… it is more Constitutional than the previous plan. Something we should all be moving towards.
Hearing late-night host Jimmy Kimmel’s emotional monologue this week about his son’s condition and his family’s experience in the moments after his birth, I had a flashback to the day my son was born and we learned he had Down syndrome.
My husband and I had a lot of questions about Cole’s future. Whether he’d have health care shouldn’t have had to be one of them. When you’re facing years of doctor’s appointments, you want to know that having a preexisting condition, such as an extra 21st chromosome or a heart defect, won’t prevent you or your loved ones from accessing the care you need.
Protections for children such as Cole Rodgers and Billy Kimmel have long existed, as they should. And despite what people are saying, House Republicans aren’t seeking to strip these protections — or anyone’s protections — away.
To me, protecting people with preexisting conditions isn’t just good policy — it’s a personal mission.
All across the country, families like mine have real concerns about the future of health care, and they are why we’re focusing on results and working on these reforms. Obamacare is wrong for America. It has failed, and it’s only getting worse — making health care more expensive and less accessible. To stand by and do nothing would be irresponsible. The AHCA is a monumental step forward that trusts the American people — not the federal government — to make the best decisions for themselves and their families….
She does state elsewhere that for two years premiums will still rise, but that this is a “PART 1” of a three-part “fix,” and from all I have read, they will not rise nearly as fast as under O-Care.
OTHER NATIONS OFFER HEALTH-CARE…
…EXCEPT THE FASCIST GOP…
Here is another challenge, albeit not so thoughtful:
The United States Government is stupid… every civilized nation on the globe offers citizens health care…this country can’t and won’t because of greed and big business! Fuck Trump and the fascist GOP!
Just a quick note… Hitler’s Germany offered single-payer health care… speaking of “fascists.” Here is my FB response, I will add something a bit later:
Canada, the UK, Norway, etc., Are all moving toward free-market health-care as their single payer systems fail… I have read quite a few books on this over the years (a classic I recommend is “Code Blue: Reviving Canada’s Health Care System”) dealing with the issue, it is a bit more complicated than your “erudite” synopsis. For instance, to exemplify my point a bit, here is some commentary by the guy who is the founder of the Canadian model of health care, which the UK also used for their model:
“Back in the 1960s, (Claude) Castonguay chaired a Canadian government committee studying health reform and recommended that his home province of Quebec — then the largest and most affluent in the country — adopt government-administered health care, covering all citizens through tax levies.
The government followed his advice, leading to his modern-day moniker: “the father of Quebec medicare.” Even this title seems modest; Castonguay’s work triggered a domino effect across the country, until eventually his ideas were implemented from coast to coast.”
Four decades later, as the chairman of a government committee reviewing Quebec health care this year, Castonguay concluded that the system is in “crisis.”
“We thought we could resolve the system’s problems by rationing services or injecting massive amounts of new money into it,” says Castonguay. But now he prescribes a radical overhaul: “We are proposing to give a greater role to the private sector so that people can exercise freedom of choice.”
But that is why most insurance companies backed O-Care to begin with, as a way to weed out competition. Private practices could not compete, other option (that allowed for groups of private citizens to form their own catastrophic care groups became illegal), etc… So greed plays a part, but not the way you think. Here are a couple of short examples of Econ 101 to make my point on my site: BAM! WHAT IS CRONY CAPITALISM
Here Is My Addition Here On My Site
One can read and listen/watch all the media on my main post about “
…From 1970 until 1989, taxes rose exorbitantly, killing private initiative, while entitlements became excessive. Laws were often altered and became unpredictable. As a consequence, Sweden endured two decades of low growth. In 1991-93, the country suffered a severe crash in real estate and banking that reduced GDP by 6 percent. Public spending had surged to 71.7 percent of GDP in 1993, and the budget deficit reached 11 percent of GDP.
TURNING POINT The combination of the crisis and the non-socialist government under Carl Bildt from 1991 to 1994 broke the trend and turned the country around. In 1994, the Social Democrats returned to power and stayed until 2006. Instead of revoking the changes, they completed the fiscal tightening. In 2006, a non-socialist government returned, and Finance Minister Anders Borg, with his trademark ponytail and earring, has led further reforms. Sweden successfully weathered the global financial crisis that started in 2008, and the Financial Times named Borg Europe’s best finance minister last year.
Before 2009, Sweden had a budget surplus, and it has one again. For the past two years, economic growth has been 4 percent on average, and the current-account surplus was 6.7 percent in 2011. The only concerns are the depressed demand for exports caused by the current euro crisis and an unemployment rate that is about 7.5 percent.
Sweden’s traditional scourge is taxes, which used to be the highest in the world. The current government has cut them every year and abolished wealth taxes. Inheritance and gift taxes are also gone. Until 1990, the maximum marginal income tax rate was 90 percent. Today, it is 56.5 percent. That is still one of the world’s highest, after Belgium’s 59.4 and there is strong public support for a cut to 50 percent.
The 26 percent tax on corporate profits may seem reasonable from an American perspective, but Swedish business leaders want to reduce it to 20 percent. Tax competition is fierce in some parts of Europe. Most East European countries, for example, have slashed corporate taxes to 15-19 percent….
Finland is joining military exercises with other Scandinavian countries, as well as several members of NATO, in late May, Finnish media report. The maneuvers called Arctic Challenge will span 12 days, starting May 25, and include nine countries and close to 100 planes. The drills, over Sweden and northern Norway, come amid increased tensions between Russia and its Baltic and Nordic neighbors.
Sweden and Switzerland, which like Finland are not members of NATO, are expected to join the exercise, along with NATO members Norway, the Netherlands, Britain, France, Germany and the United States. Finland plans to send 16 F-18 Hornet fighter jets, while the other countries will supply Gripen “multirole” fighters, F-16s, Eurofighters and Jet Falcons, as well as transports and tankers, Russian news agency Sputnik reported. The Norwegian armed forces said the purpose of the Arctic Challenge exercise is to “learn to coordinate efforts in complicated flight operations conducted in cooperation with NATO.”
Russia has ramped up military activity along its borders with northern Europe, causing consternation in several Baltic and Nordic countries and pre-emptive actions to head off — or prepare for — a possible military crisis. Latvia, which reported a Russian submarine near its coast in mid-March, is beefing up security on its eastern border, while Finland recently began a letter campaign notifying some 900,000 reservists of their duties in a potential crisis. Sweden also intercepted four Russian planes flying over the Baltic Sea in March with their radios off. Russian jets have been intercepted in other instances while flying in European international airspace….
I also pointed out that this promise went back to the Cold War, and was not known about till a Swedish defense think-tank/security firm uncovered the agreements in 1994. The original story’s link has been lost, but it is here on FOI’s site. FOI’s “about us” page has this:
FOI is one of Europe’s leading research institutes in the areas of defence and security. We have 1,000 highly skilled employees with various backgrounds. At FOI, you will find everything from physicists, chemists, engineers, social scientists, mathematicians and philosophers to lawyers, economists and IT technicians…. The Armed Forces and the Swedish Defence Material Administration are our main customers. However, we also accept assignments from civil authorities and industry. Our clients from the defence sector place very high demands on advanced research, which also benefits other customers.
Initially after the end of World War II, Sweden quietly pursued an aggressive independent nuclear weapons program involving plutonium production and nuclear secrets acquisition from all nuclear powers, until the 1960s, when it was abandoned as cost-prohibitive. During the Cold War Sweden appeared to maintain a dual approach to thermonuclear weapons. Publicly, the strict neutrality policy was forcefully maintained, but unofficially strong ties were purportedly kept with the U.S. It was hoped that the U.S. would use conventional and nuclear weapons to strike at Soviet staging areas in the occupied Baltic states in case of a Soviet attack on Sweden. Over time and due to the official neutrality policy, fewer and fewer Swedish military officials were aware of the military cooperation with the west, making such cooperation in the event of war increasingly difficult. At the same time Swedish defensive planning was completely based on help from abroad in the event of war. Later research has shown that every publicly available war-game training, included the scenario that Sweden was under attack from the Soviets, and would rely on NATO forces for defence. The fact that it was not permissible to mention this aloud eventually led to the Swedish armed forces becoming highly misbalanced. For example, a strong ability to defend against an amphibious invasion was maintained, while an ability to strike at inland staging areas was almost completely absent.
In the early 1960s U.S. nuclear submarines armed with mid-range nuclear missiles of type Polaris A-1 were deployed outside the Swedish west coast. Range and safety considerations made this a good area from which to launch a retaliatory nuclear strike on Moscow. The submarines had to be very close to the Swedish coast to hit their intended targets though. As a consequence of this, in 1960, the same year that the submarines were first deployed, the U.S. provided Sweden with a military security guarantee. The U.S. promised to provide military force in aid of Sweden in case of Soviet aggression. This guarantee was kept from the Swedish public until 1994, when a Swedish research commission found evidence for it. As part of the military cooperation the U.S. provided much help in the development of the Saab 37 Viggen, as a strong Swedish air force was seen as necessary to keep Soviet anti-submarine aircraft from operating in the missile launch area. In return Swedish scientists at the Royal Institute of Technology made considerable contributions to enhancing the targeting performance of the Polaris missiles.
After a friend posted something asbout the house passing the American Health Care Act (AHCA), his own flesh and blood… his mother… wrote:
American Health Care Act (AHCA),
If their legislation is so great why did they vote themselves exempt from it? Good enough for us – not ok for them…🤔
Yes, this is a great example of misinformation via the MSM [the Left]. But the reason that separated the two is explained well in this article…. BUT BEFORE THAT EXCERPT, which is more in-depth, let’s go barney style first:
NYT CORRESPONDENT FALSELY REPORTS HOUSE MEMBERS VOTED TO EXEMPT THEMSELVES FROM GOP HEALTH CARE BILL
A New York Times correspondent falsely reported Thursday on Twitter that members of the House of Representatives unanimously voted to exempt themselves from the Republican health care bill.
A day earlier, reporters noticed that a provision in the American Health Care Act would exempt lawmakers and their staff from losing some of the repealed Obamacare provisions. In response to the criticism, House leadership announced they would vote separately on the issue.
The House voted 429-0 to pass a bill rectifying the mistake, preventing lawmakers from being exempted. But the New York Times‘ chief White House correspondent, Peter Baker, apparently misunderstood the vote…..
HERE’S WHY CONGRESS EXEMPTED ITSELF FROM THE NEW HEALTHCARE BILL
Last week, Vox dug into the Republican healthcare bill and found a provision that would exempt Congress and its staff from many of the bill’s effects.
This provision was bad “optics,” as they say in Washington.
But instead of taking it out — like you would usually do with a provision you aren’t wedded to and can’t defend politically — the House passed the American Health Care Act with the exemption intact after first passing a separate bill that would repeal the exemption that would be created by the AHCA if both bills became law.
There’s a reason for this mess, and it’s not about Republicans in Congress not wanting to be subject to their law.
It’s about Senate procedure.
Republicans are attempting to pass the AHCA through a process called reconciliation. This process, created by the Congressional Budget and Impoundment Control Act of 1974, allows the Senate to pass certain bills relating to the federal budget with just a simple majority. There is no need to get 60 votes — and, in this case, some Democratic support — as there is for other legislation.
A variety of complex rules govern what matters may and may not be considered through reconciliation.
One of those is that reconciliation must be conducted pursuant to reconciliation instructions passed by both chambers of Congress. That happened earlier this year — Congress sent reconciliation instructions to two Senate committees (finance; and health, education, labor, and pensions) that were designed to allow those committees to write bills making changes to healthcare policy.
The problem, as the Committee for a Responsible Federal Budget explains, is that Congress’ healthcare is governed by the Senate Homeland Security and Governmental Affairs Committee, and that committee was not sent any reconciliation instructions.
Therefore, if a reconciliation bill makes changes to the way Congress gets its healthcare, it might become subject to a 60-vote threshold because it addresses a matter that is supposed to be the purview of a committee that doesn’t get to participate in reconciliation this year.
Here I add some information I came across a day later:
ADDENDUM 1 And also from FACTCHECK.ORG, there was this updated insight that confirms the above:
….Indeed, Republican Rep. Martha McSally of Arizona proposed a stand-alone bill to strike the exemption of Congress from state waiver provisions should the AHCA be enacted into law. From the House floor, McSally said that “due to very arcane Senate procedural rules within the budget reconciliation process,” the MacArthur amendment “does not and cannot apply to members of Congress.”
“I believe that any law we pass [that] applies to our constituents must also apply equally to members of Congress,” McSally said. “Individuals who are stewards of public trust must abide by the rules that they make.”
McSally’s bill passed on May 4 by a 429-0 vote. Unlike a reconciliation bill, the McSally bill would require 60 votes in the Senate to pass.
So there are now two bills that the House sent to the Senate. The AHCA — for esoteric procedural reasons — would exempt members of Congress and their staffs from state waiver provisions. But then there’s a bill that would strike that exemption if the AHCA becomes law. Clearly, based on the unanimous vote for the McSally bill, there is bipartisan agreement that a health care law Congress passes should apply in the same way to members of Congress.
NOW, to the last, and the worst of them all… and I will link to the many articles refuting it with a couple commentaries from a few.
RAPE AS A PREEXISTING CONDITION
It is the — yes crazy — understanding that RAPE is a pre-existing condition. Dumb! [<<< my commentary]. Here is the first “non-partisan” [left-leaning] POLITIFACT notes this claim is… WAIT FOR IT…
~ MOSTLY FALSE! ~
And the WASHINGTON POST gives it their MAXIMUM debunking rating of FOUR PINOCCHIOS
I know… crazy huh? Someone told my wife — roughly this:
“I hope you never get raped… because that is a pre-existing condition.”
I sent her this post from the not Trump friendly REASON.ORG website… to which yesterday the last article makes clear their bottom line:
If Democrats and progressives would just stick to actual details of the AHCA, they would still have plenty of material to make Republicans look bad (and the same goes for traffic-thirsty bloggers). But once again, that’s not enough for them. In their zeal to portray Donald Trump and the current GOP as worse than Nazis, the actual details of the bill don’t matter—and if that terrifies a ton of sexual-assault survivors and terrorizes American women in the process, so be it.
Since yesterday the article has been updated substantially, which I will post a portion of:
Update | May 6, 11:30 a.m.: Since I posted this, several other media outlets have investigated the rape-as-preexisting-condition claims and come to similar conclusions as mine. Politifact declared the claim “mostly false,” and The Washington Post—which yesterday morning published an op-ed yesterday perpetuating the rape claim—ran a Fact Checker column today giving it Four Pinnochios. “The notion that AHCA classifies rape or sexual assault as a preexisting condition, or that survivors would be denied coverage, is false,” wrote the Post’s Michelle Ye Hee Lee. In addition, “almost all states (at least 45 to 48) have their own laws protecting survivors of domestic violence and sexual abuse.”
“It takes several leaps of imagination to assume that survivors of rape and sexual assault will face higher premiums as a result of conditions relating to their abuse,” Lee continues.
A person would need to be in the individual or small-group market (most Americans under 65 are on employer-provided plans), in a state that sought waivers, and in one of two to five states that did not prohibit insurance-company discrimination against survivors of sexual abuse.
In other words, this claim relies on so many factors — including unknown decisions by a handful of states and insurance companies — that this talking point becomes almost meaningless.
We always say at The Fact Checker that the more complicated the topic, the more susceptible it is to spin. Both media coverage and hyperbole among advocates are at fault for creating a misleading representation of the House GOP health bill. We wavered between Three and Four Pinocchios, but the out-of-control rhetoric and the numerous assumptions pushed us to Four Pinocchios.
➤ States may opt-out of requiring premiums to be the same for all people of the same age, so while individuals with pre-existing conditions must be offered health insurance there is no limit on the cost of that insurance. A new $8 billion fund would help lower premiums for these individuals.
But here is more of a response to the broader challenge at hand:
Myth #2: People with pre-existing conditions will lose their coverage or pay more.
In fact, people who have health insurance and want to make changes to their coverage during open enrollment or after a qualifying life event (birth of a child, job loss, marriage, death, divorce, move, etc.) cannot be charged more for health insurance because of a pre-existing condition.
That said, if someone went uninsured and waited until they got sick to enroll in a health insurance plan, the MacArthur amendment to the AHCAgives states the authority to try to prevent that from happening.
One of the things a state could do, under this amendment, would be to allow insurance companies to charge people with pre-existing conditions more money for their health insurance, if they’ve been uninsured for an extended period of time.
And finally, here are a repition of what is above, but for good measure:
1. The Upton Amendment: The Upton Amendment, named after Rep. Fred Upton (R-Mi.), adds another $8 billion on top of the aforementioned $100 billion to cover high-risk patients with chronic and/or pre-existing conditions. This amendment was put in place to help satisfy more moderate-leaning Republicans who felt the AHCA took too much away from their constituents.
Here is the final explanation to be clear:
….As the liberal Center on Budget and Policy Priorities puts it, without community rating, “Insurers could increase premiums by unlimited amounts for people with a history of cancer, hypertension, asthma, depression, or other conditions.”
Likewise, lifting the essential health benefits requirement would allow insurers to offer plans that don’t cover chemotherapy, maternity care, prescription drugs, or other expensive treatments.
In other words, insurers could effectively turn away the sick by refusing to sell policies that cover the services they need at any price, much less an affordable one.
These concerns are wildly overstated.
First, the only people supposedly at risk of being denied affordable coverage by these waivers are the 7 percent of Americans who buy coverage in the individual insurance market.
Insurers have long been banned from discriminating against the sick in the employer-sponsored market, where a little less than 160 million Americans get their coverage. Those with pre-existing conditions who get their coverage from Medicare, Medicaid, or another government program have nothing to worry about, either.
Second, the House-passed American Health Care Act would only allow insurers to base premiums on the health status of an applicant if that person went without coverage for 63 days or more the previous year. Those in waiver states who maintain continuous coverage could not be medically underwritten — and so would be protected from egregious premium hikes.
Further, pre-existing conditions are far less common than Rep. Pallone and his fellow travelers claim. A 2010 congressional investigation found that, pre-Obamacare, insurers denied just one in seven applicants in the individual market because of a pre-existing condition.
That means that about 1 percent of the total non-elderly population has a health problem serious enough to even need those pre-existing condition protections.
Even if we add the entire uninsured population to the individual market and assume the same denial rate, the share of non-elderly people declined coverage because of pre-existing conditions would be less than 3 percent. That estimate is almost certainly high, as a number of the uninsured are probably eligible for coverage elsewhere, whether through work or a government program.
For this small share of the population that could potentially be priced out of the individual market because of pre-existing conditions, the AHCA includes several additional layers of protection. The House bill seeds a Patient and State Stability Fund with $130 billion over ten years to reduce premiums and out-of-pocket costs for these folks.
A last-minute amendment to the AHCA provides an additional $8 billion over five years specifically earmarked to help those with pre-existing conditions in waiver states who let their insurance coverage lapse for more 63 days or more pay their premiums. Insurers can consider these folks’ health status when determining premiums — but only for one year. After that, they’d pay the standard rate for their age.
Many waiver states will choose to direct at least part of that $138 billion toward high-risk pools — programs that offer subsidized coverage to those rendered uninsurable because of a serious medical condition.
By removing these most costly patients from standard risk pools, high-risk pools would help keep premiums down throughout the insurance market — and ensure that younger, healthier patients have affordable coverage options.
The AHCA has plenty of flaws. But it’s dishonest to argue that it abandons individuals with pre-existing conditions.
The House of Representatives passed the AHCA (H.R. 1628: American Health Care Act of 2017) today, and Dennis Prager had Betsy McCaughey on his show today to discuss the bill and some of the media and Democratic distortions of it. (See her BIO) A great discussion about the bill and failures of the ACA.