Friday, December 23, 2016

Hospitals, Insurers and Actuaries Warn GOP of Economic Calamity By Repealing Obamacare

Health care industry groups and lobbyists -  firm capitalists-  are now warning the Trump Brigade and  GOP to tread very cautiously in terms of trying to repeal Obamacare. This has now seen 6.4 million people signed up before this year's deadline despite the Trump threat to chuck it. But as Chris Hayes' guest put it last night, it would be most unwise to leave some 20 million without health care - then just itching to get revenge at the next election.

Incredibly, many of the Trump voters - namely in Kentucky- never believed Trump's words that he'd dismantle their health insurance, but now they are taking them seriously. What they took to be mere beer talk and rhetoric is now turning out to be too real, as his new HHS pick (Tom Price (R, GA) has vowed to moved expeditiously on tearing the ACA down.

Meanwhile, as recently reported  in The Denver Post ('Health Care Industry Groups Warn of Consequences for Nixing ACA') we are alerted that "hospitals, insurers, actuaries and health networks are telling the incoming Republican administration and Congress that it's not a good idea to repeal the 2010 health care law without clear plans to address the  consequences".

What are they worried about? Well, the sudden dislocation of 20 million people who had finally signed onto insurance plans and were making payments. In other words, a not insignificant part of the economy. While the hysteric Right branded Obama as a "socialist" for creating the plan, it was in reality a takeoff on Mitt Romney's "Romneycare" in MA, as well as an earlier GOP invention from the mid-1990s. While the GOOPrs hate the ACA, Obama's genius was in tying the plan to for profit insurance companies which will not take a slowing of their profits kindly.

Of course, the traditional Left hated the ACA for the very reason that for- profit insurance companies were a major part of it. But hey, maybe Obama was playing 4- dimensional chess all along and we just didn't see it. Didn't see how the inclusion of the insurance industry would make it much more difficult to get rid of by a future demagogue, say like Trump.

To  fix ideas, the Post article notes that "hospitals say a stand alone repeal would cost them billions, compromising their ability to serve local communities".

Not to be outdone, "insurers say congress must be careful not to create even more uncertainty and instability."  while "actuaries worry that the mere promise of an eventual replacement won't be enough to sustain the individual health insurance market"

In other words, the Repukes are playing at unraveling the entire individual health insurance marketplace in their yen to remove Obama's centerpiece legacy.

Meanwhile, "the American Cancer Society Cancer Action Network reminded lawmakers that lives are at stake". The network is concerned that "protection for people with pre-existing conditions might be undermined or lost".  This recognizes that before the ACA it was common for insurers to deny coverage to anyone with cancer. Even now, under a supplemental Medicare program, I am not permitted to change to another supplemental once  having been diagnosed with cancer -- and facing further treatment. But unlike those on Obamacare, my  further choice is taken away, not the coverage.

At the same time, while 'pukes insist they are determined to still repeal Obamacare, they are also "mindful of the political risks".   The Post noted:

"The basic plan under GOP consideration involves repealing the health law next year but delaying the effective date to allow congress time to pass a replacement"

But can that work? Not really, not at any practical level. Any such replacement legislation on the same scale would require billions in government financing and extensive regulations - which most repukes hate.

Hate it though they may, their hands may be tied. That's because the two main hospital lobbies - the American Hospital Association and the Federation of American Hospitals-- have released dovetailing studies that their members will suffer more than $200 billion in potential losses if the health care law is repealed without restoring funding cuts that were used to finance coverage expansion.

In other words, the GOP and Trumpsters are in a real hammerlock. You can't just dismiss $200b in losses to one market sector and not create stock market instability. You can't just take away the coverage of 20 million people and not expect political blowback.

But perhaps the most sobering assessment is from the American Academy of Actuaries. Why so? Because unlike the insurers and hospitals they have no financial stake in the issue. Hence, their position is as close to an objective and independent one that you can get. The organization said that delaying the effective date of a repeal while developing a replacement would trigger a crisis for the individual health care market.  This is where millions who don't have job-based coverage (including many unemployed Trump voters) can buy policies. This includes more than 10 million with current access to

By any reckoning it isn't clear the GOP won't overplay its hand and claim more political capital (based on Trump's electoral win) than they actually earned. We are reminded here that Hillary won the actual vote by nearly 2.9 million. By "actual vote" I mean the vote that 99 percent of nations use to determine a leader.  By this standard the GOOPrs don't have any kind of a mandate to do whatever the hell they want. If they do overreach, they are sure to learn the political costs very quickly.

Yep, it will be an interesting new year indeed.

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