PPACA Repeal and How to Make Reconciliation Work for You.
In this post, I am going to expand upon the impact of the new House Rules H. RES. 5 upon the Repeal of the PPACA. As I explained here Paul Ryan deliberately changed the House Rules and the Republicans following party line approved them with the exception of 3 who voted with the Democrats. The House Rules went from just this:
“The Director of the Congressional Budget Office shall, to the extent practicable, prepare an estimate of whether a bill or joint resolution reported by a committee (other than the Committee on Appropriations), or amendment thereto or conference report thereon, would cause, relative to current law, a net increase in direct spending in excess of $5,000,000,000 in any of the 4 consecutive 10 fiscal year periods beginning with the first fiscal year that is 10 fiscal years after the current fiscal year.”
plus this additional statement:
“This subsection shall not apply to any bill or joint resolution, or amendment thereto or conference report thereon—
(A) repealing the Patient Protection and Affordable Care Act and title I and subtitle B of title II of the Health Care and Education Affordability Reconciliation Act of 2010;
(B) reforming the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act of 2010.”
neatly hidden away on pages 25 and 26 of 115th Congress House H. RES. 5.
Ok, so the Republicans are up to their old craftiness of slipping it to the Democrats when they want to block something the Democrats have done in the past. There is reason to why Congressman wants to block the CBO from reporting on this. It deals with making it more difficult 10 years down the road to change the repeal.
If you remember, Bush’s tax cuts were passed using Reconciliation and the CBO did a cost analysis showing it would create a deficit. Using Reconciliation to pass a bill, the legislation passed and creating a deficit must expire in 10 years. Bush’s tax cuts did create a deficit and a big one much of which was reversed by Obama.
For sure, Congressman Paul Ryan knows the repeal of the PPACA will create a deficit and Republicans know the repeal will create a large deficit. To make sure no one else knows, Mr. Ryan has blocked the CBO from analyzing it before repeal. Also unbeknownst to many, if the CBO does not do its typical independent analysis of the costs (if any) created by the PPACA repeal and how much it increases the deficit, there is no requirement for the legislation to expire after 10 years. Republicans would have repealed the PPACA as they have wanted to do since 2010, and would have blocked it from ever coming back after 10 years.
Crafty little weasel that Mr. Paul Ryan!. Then too Mr. Rand Paul is ready to sell you his healthcare policy (Obamacare Replacement Act) which does cover pre-existing conditions up to a guaranteed two years. After two years, and miss a payment or your healthcare insurance lapses and the healthcare insurance company can charge you the going rate just like the good-old-days. Also keep in mind, “Americans will never learn how devastating the PPACA repeal will be to Medicare’s long term solvency that was extended a couple of decades because of the Affordable Care Act’s execution.”
Where are the Democrats in all of this?
GOP Prohibits CBO From Reporting How Much ACA Repeal Blows Up the Deficit RMuse, Politicus usa January 11, 2017
I really don’t understand all of this, and yet I feel I do. As I see it, the entire federal medical care system is just a mechanism to funnel money from the federal government into insurance companies, pharmaceutical companies, medical device manufacturers, and yes, into an infrastructure that also delivers services to people who need healthcare. Given that we spend twice as much per person as any other developed economy on healthcare, we must have enough stuff in place to give healthcare to all our “persons’. We can clearly deliver high quality healthcare to everyone in the country. The problem the Republicans have is how to force the payment for this system onto a segment of the economy that already is flat broke. They clearly cannot walk away from funding the industry, and the poor have nothing left to give. Simplistic, but that’s how I see things.
Linus:
Typical insurance company profit is 3%. Insurance companies are a reflection of the healthcare market “the pharmaceutical companies, medical device manufacturers, and yes, into an infrastructure that also delivers services to people who need healthcare.” We do not pay for high quality in the US, we pay for services which the healthcare industry is geared to. The Republicans will walk away from the poor. This is Paul Ryan’s plan.
Now, what don’t you understand about what I wrote which is different than what I went over. 🙂
Crystal clear! The poor need to require the healthcare we are able to provide, and be damned happy to pay for it. Have I got it?
Linus:
There will be limited tax subsidies (~$5,000) for people. Rand Paul’s plan has a guarantee of 2 years of covered pre-existing conditions. After the two years if your healthcare insurance lapses, the insurance company can charge whatever rate they choose to.
Some Info:
“This did not play a major overt public role in the 2009-’10 debate about the law, but the Affordable Care Act’s financing rests on a remarkably progressive base. That means that, as the Tax Policy Center has shown, repealing it would shower money on a remarkably small number of remarkably wealthy Americans.
For the bottom 60 percent of the population — that is, households earning less than about $67,000 a year — repeal of the ACA would end up meaning an increase in taxes due to the loss of ACA tax credits.
But people in the top 1 percent of the income distribution — those with incomes of over about $430,000 — would see their taxes fall by an average of $25,000 a year. ” http://www.vox.com/policy-and-politics/2017/1/17/14263918/affordable-care-act-tax-cut
and a pic:
Now does this answer your questions on who the PPACA helps? For a family of 4 the 400% FPL stops at ~ $96,000. The ones doing the most squawking are over the 400% FPL.
“And for the true elite in the top 0.1 percent — people like designated White House senior adviser Jared Kushner, Treasury Secretary Steve Mnuchin, Education Secretary Betsy DeVos, Commerce Secretary Wilbur Ross, and many major campaign donors — the tax cut is truly enormous. Households with incomes of more than $1.9 million would get an extra $165,000 a year in take-home pay. That’s obviously more than enough money to make these hyper-elite families come out ahead regardless of what happens to health insurance markets.”
Run,
Over my head in terms of the effects of this change in House rules, but I believe the Senate would have to pass this same change to keep the CBO out of doing an analysis.
Meanwhile, have you noticed this from Drum?
“I’ve written before about the possibility that repealing bits and parts of Obamacare—which is all Republicans can do—will destroy the individual insurance market. Not just the Obamacare exchanges, but the entire market. Insurers would still be required to insure everyone who applies for coverage, but there would be no subsidies and no mandate. The result would be a flood of super-expensive patients like me, and virtually no healthy people to balance out the pool. If that happens, insurers will simply exit the individual market rather than take huge losses……
Here’s the only reaction I could find from the insurance industry:
“At a time when the individual market faces challenges, we need as many people as possible to participate — so that costs go down for everyone,” said Kristine Grow, spokeswoman for America’s Health Insurance Plans.
This wasn’t even a reaction to Obamacare repeal, either. It was a reaction to the Trump administration’s childish attempt at sabotaging signups for 2017. Basically, the insurance industry has been curiously quiet about the whole thing.
Why? They know the stakes better than anyone. Recent premium hikes hold out the promise that after years of losses, their Obamacare business will finally turn profitable this year or next. But a ham-handed repeal effort does just the opposite. The individual market would become massively unprofitable, and insurers would have to decide whether to ride it out for a year or two, or simply abandon the individual market altogether. These are really lousy alternatives.”
I think both you and I know the reason for the insurance company’s silence. They want to go back to the old way. Sure, if the ACA stays in place as it is, they are OK and will profit once they find the proper premium levels. But with what the Reps have already done to the ACA they doubt the program can move forward, especially now.
But even if the Reps just let it stand(which they won’t), the insurance companies have figure out that they would be far better off with the old private markets of high deductibles, pre existing condition bans, recissions and cancelling of policies once the holder gets sick.
Combine that with losing medical loss ratios on both private and employer provided insurance and it would be a bonanza for health insurance companies.
So they stay silent(in public anyway) cause no matter what happens they make out, and this way it seems like they are just following orders and working to “help” the public.
Just wondering, what is it with “Medicare Insolvency”? When the Federal Government pays my doctor, or even pays me my Social Security check they don’t dip into a bucket of coins that have been accumulating. They just have the Fed credit Wells Fargo, and instruct Wells Fargo,to credit my account. There is no money anywhere. There is no reason (other than limitations imposed by Congress) that the Federal Government cannot continue to pay my doctor until the cows come home. Medicare Insolvency is a Congressional Invention.
Linus, is that your approach to using your credit cards?
Jerry, it would be if I were monetarily sovereign.