Tuesday, February 21, 2017

How The Repukes Plan To Eviscerate Obamacare

As I wrote in my post from December, 2nd, the way forward to the  demolition of the Affordable Care Act was cleared by the  appointment of Tom Price (R, GA) to the Dept. of Health and Human Services. Now, with his nomination secured, the Repukes have their "replace and repeal" deal all but drafted - needing only the legislative cooperation between Paul Ryan's anti- Obamacare gang on the Hill and the Trumpites. 

We also know Price, along with Paul Ryan,  wants to replace Medicare with a "voucher" system where each person gets a small amount per year ($10k is often cited) to buy whatever insurance possible - and to cover all medical incidents, emergencies. If I'd been reduced to such a yearly voucher I'd have had to file for bankruptcy since getting cancer treatment 4 years ago and having gall bladder surgery (which came to $28,000 ) this year.

Meanwhile, many experts as well as independent groups,  have warned of the economic fallout if a $3 trillion total market (involving insurance companies and total stock capitalizations) were to suddenly be eviscerated with no genuine support for the 20 million on the ACA. Already Trump, using an "executive action",  has wiped out the enforcement aspect for the individual mandate. This was by no longer requiring the IRS to monitor or impose annual penalties for those who eschew health insurance.  Without that mandate, certainly enforcement of it, too many will avoid getting any insurance and thus the best aspects cannot be preserved. Those included the one for pre-existing conditions (insurance companies had to accept them), and also enabling adult children to stay on their parents' plans until age 26. Now those goals are no longer feasible, minus the mandate.

We knew, given Dump's bloviations on the campaign trail,  that the ACA would be in danger. Now we know how bad it will be.   In his half-baked policy paper released on Thursday, Ryan trotted out washed-up, recycled ideas (originally proffered in his 2010 'Path to Prosperity'),   for “improving” the country’s health care system..  The problem? His plan would actually make things a thousand times worse.

 For example, Ryan's paper calls for reducing spending on Medicaid, which now provides insurance to more than 74 million poor, disabled and older people. If enacted, many millions of these vulnerable citizens would be cast out of the program. The Republican plan also forces most people who don’t get their health insurance through an employer to pay more by slashing subsidies that the A.C.A now provides. The same proposal also allows families to sock away more money in health savings accounts (HSAs).  This  may sound good in theory, but it won't really help the 4 to 5 million lower class Trump voters whose fate and future now hinges on ACA changes. The reason is that the HSAs would primarily benefit affluent people who can afford to save more.  In other words, you need to have ample disposable income to shell out of pocket for your care, and then you can make effective use of the HSAs. But if you're a Walmart or Burger King worker, that's about as pie in the sky s expecting to win your state lotto just as your health care is demolished.

Price hasn't even entered the picture but we know from his own history and statements that he has a fondness for tax credits and high deductible plans. At the same time no surprise Ryan’s blueprint for repealing and replacing Obamacare offered no estimates of how many people would lose coverage or how much premiums and deductibles would rise for middle-class and poor families. But hey, what are a few niggling missing details?  Those didn't stop the new HHS head Tom Price, - a former Ryan lieutenant in the House - from embracing the Ryan plan. According to BLOTUS Price:  “is all in on this.”

Well, God help all the Trump voters and other poor or unemployed if he is. They will now face steep costs for dealing with everything (in the coming years) from antibiotic resistance, to worm infestations of their brains, to new drinking water threats given that coal companies - thanks to a Trump "executive order" can now dump coal waste into fresh water streams at will.

This will be reminiscent of the 2014 Elk River (West Virginia)  chemical spill -  of  the coal cleaner  methylcyclohexane methanol (MCHM).)  which caused enormous problems and a massive cleanup effort.

This time there will be no cleanup efforts because Trump doesn't give a crap. So all the millions who stand to be affected ought to brace for the many cancers now ready to be unleashed upon them, including of the pancreas, liver, kidneys, stomach, testes, breast and prostate. According to one of the West Virginia families affected in 2014, they were  informed their water was "so contaminated it was only fit for flushing toilets." 

Alas, when all those cancers, skin diseases, gastro intestinal reactions and others break out, people will no longer have the ACA to help carry the costs of their infirmities. Thank Mr. Dump!

The Grand Old Party wants to slash spending on Medicaid over all by giving states the option of a "block grant" or a per capita allotment. So here in Colorado, for example, that may mean allocating the state a fixed amount for next year of $100m. That then will have to suffice to cover the needs of some 125,000  citizens, mainly frail elderly, poor, unemployed or under-employed. But if those people normally need some $4,000 a year each for their medical needs, just doing the math discloses the shortfall will be nearly a factor 5 less than needed ($500m vs. $50m).

The current program pays for the health care of everyone who is eligible. During recessions, when the number of people in poverty increases, the government spends more. Without that flexibility built into Medicaid, Congress would have to vote to give states more money when health care costs rise. (Say if there is an outbreak of Avian flu).  But politically, that's in the “impossible dream” category. So most health care experts worry that, over time, states will just cover fewer people and cut benefits. Or, they may make the thresholds for care so low that few qualify: say not earning more than $300 a month - for a family of four.


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