Senate healthcare bill costs 15 million their health insurance next year, 22 million by 2026
One consequence of electing the popular vote loser is that the official winners act as if they have a mandate for the most extreme version of their policies. Thus, we have proposed legislation, the misleadingly titled Better Care Reconciliation Act, that will not only roll back Obamacare’s expansion of Medicaid, but impose further large cuts on the program in addition. In total, the Medicaid cuts will come to $772 billion through 2026.
As a result primarily of ending the individual mandate, the Congressional Budget Office (CBO) estimates that 15 million fewer people will be insured in 2018 than would be the case with current law. As healthier people remove themselves from the individual market, this will cause increases in insurance premiums and the likelihood of further collapse of the market. As Tierney Sneed points out, there will be some premium reductions in the individual market, but this will be due to the plans being much less generous and having higher out-of-pocket costs. Tellingly, the CBO report judges that low-income people will not buy insurance under these circumstances. As a result, by 2026 there will be 22 million fewer people without insurance.
On the revenue side, of course, the Republican bill cuts taxes on the rich by $541 billion.
It’s hard to know where to begin. The chutzpah of such a gigantic transfer from the poor to the rich staggers the imagination. As with everything surrounding Trump, this is completely surreal.
The good news is that it’s not a done deal. Three Republican Senators (Collins, Paul, and Heller), one more than McConnell can afford to lose, are currently opposed to the bill in the Senate. Republican governors who have expanded Medicaid (Sandoval of Nevada and Kasich of Ohio), plus Baker of Massachusetts (which expanded Medicaid under former Governor Deval Patrick) have also come out against the bill.
It’s no secret, then, what to do. Keep the pressure on your Republican Senators. If there is no vote this week, you’ll have the opportunity to see them over the July 4th recess as well. The stakes have never been higher.
Cross-posted from Middle Class Political Economist.
Under the Senate Plan, the actuarial value of a Silver Plan would fall from 70% to 58% or less than what a Bronze plan has today and cost more than a Silver Plan costs today also.
I still believe McConnell one-upped The House. He really does not want the Repub Plan passed. It is far easier to undermine the ACA as they did with the Risk Corridor Program and threaten the CSR thereby forcing more insurance companies out of the exchanges and increase premiums. People will not understand the Repubs doing this and the Press will blame the ACA.
The bad news is the Reoubs can still cause the ACA to fail and Dems take the hit.
Michigan Governor Snyder (Repub) wants to keep the ACA also .
Run,
You beat me to it.
EM:
McConnell is still strutting like a peacock. He has something else in mind.
I think you have his plan outlined pretty well.
They will make some changes to get to 50. I am thinking that may include garbage insurance(for Rand Paul), selling across state lines(for the true imbeciles), tort reform(for those that cannot read), and perhaps even an increase in subsidies(incidental, but “we’re trying!”).
The big money is in Medicaid. And after all, that is just “those people”. And for “those people” who are not actually black or brown they will just blame the black or brown people for their loss of health insurance. And those white people will still vote GOP.
Republicans have this permanent game on: they can’t explain why the most productive country in the world cannot afford what everybody else can afford today …
… so they project the “cost” 40 years out and pretend that your grandchildren wont be able to afford it. How many people can realistically forecast in their minds 40 years out? So they fall for it — the far distant mirage.
Assuming the debt does pile up — thanks to Republican tax cuts for the rich and our unwillingness to pork the poor over them — our grandchildren and great grandchildren will have more money than we have to pay it off thanks to decades of productivity growth — but they wont pay; they will leave it for their great grands — who won’t pay for … . Nothing that would get me up early in the morning to work on it.
PS. Just who would we owe all this money to — ourselves mostly? To the Chinese can only loan us money left over when we buy stuff but neglect to sell them anything back. Cumulative GDP over next two generations something over 1,000 trillion — that would be a lot of stuff. To the great grandchildren of the rich who loaned the government money rather than pay taxes? Once unions return rule to the average person we can just confiscatory tax most of that back.
“selling across state lines(for the true imbeciles), tort reform(for those that cannot read)”
Can’t do that under 51-vote reconciliation rules. Of course, rules don’t seem to be much of an obstacle for Republicans.
Run, how did the GOP “undermine… the Risk Corridor Program” (SEC. 1342.)?
https://www.govtrack.us/congress/bills/111/hr3590/text
As you can read in the text of the bill, there was never a federal government funding mechanism. It is all done by the States.
Why not google my last posts on Risk Corridor and find out yourself or you can read the Washington Post also. I am not a librarian
Run,
I cannot say how much Warren’s “thought” is addressed to you.
Good luck. And may God bless you.
BillB,
I agree the rules don’t mean much. I find it hard to see how getting rid of lifetime caps doesn’t violate the reconciliation rules, for example. Do you know if there are legal remedies for breaking reconciliation rules, anyway? It seems that at the end of the day the Senate can change its rules with a majority vote, but perhaps I’m missing something.
They could change the rules for the budget and extent it. The parliamentarian could rule in their favor also. Nothing is cut and dried.
Or, Run, you could post a link to your article.
Warren:
No. Google Risk Corridor and Angry Bear together or you could just search on Angry Bear also.
Never mind — here it is: http://angrybearblog.strategydemo.com/2017/01/more-on-how-republicans-impacted-healthcare-premiums-and-companies-to-leave-the-exchanges.html
The upshot is, the PPACA did not allocate ANY funds to the Risk Corridor, and the CBO (erroneously) projected it would be a net plus. So somehow these egregious errors are the fault of the GOP. Got it.
“As a result primarily of ending the individual mandate, the Congressional Budget Office (CBO) estimates that 15 million fewer people will be insured in 2018 than would be the case with current law.”
So, those 15 millions people, who are getting shafted by the ACA mandate, will choose what is best for themselves. Horrible.
Warren, those 15 million people will be abdicating their personal responsibility (I thought Republicans believed in that?) and freeloading off of us when they only get insurance when they’re sick. That’s why the PPACA structure was created by Stuart Butler of the Heritage Foundation and passed by Republican Governor Mitt Romney in Massachusetts, to prevent such free riding. In MA, it created the lowest uninsured rate in the country prior to the PPACA.
One of the many weaknesses of laissez-faire/libertarian economics is that it ignores the widespread existence of free rider problems.
No, Ken, those 15 million people are being overcharged for their insurance so that others can do have to pay what their coverage is worth. Why should a young, healthy person have to pay as much as an older, unhealthy person? Should a young, inexperienced driver have his car insurance subsidized by older, experienced drivers with good records?
BTW, I’ll be at Webster University the last week of July (22nd-27th). Care to grab a beer somewhere?
Warren:
A little Ezra Klein for you. “’The whole scheme is enlisting young adults to overpay, so other people can have subsidies,’ Dean Clancy, vice president of public policy for FreedomWorks, told my Wonkblog colleague Sarah Kliff. ‘That unfairness reminded us of the military draft.’
Clancy is wrong: The subsidies are funded by taxes on rich people and by cuts to Medicare spending, not by the premiums paid by young people. In fact, young people are likely to be the biggest beneficiaries of the subsidies because they’re more likely than any other age group to be poor and uninsured.
‘The tax credit premium subsidies are disproportionately going to be helpful for the young adult population,” says Ron Pollack, head of Families USA. ‘They’ll get the largest tax credit subsidies of any age group.'” Why Obamacare is Good for Young People
Ken is correct. Get some skin in the game Warren like all the Republicans say you should.
Run,
Having fun with Warren yet?
Don’t get mad. English and Math are not his main strengths. I don’t know what those strengths are, but they sure are not Math and English.
Warren,
Thanks for the offer, but I no longer live in St. Louis; I am in Boston now. I teach one graduate course online and only have to go back a couple of times a semester.
Kenneth
So what you are saying then, Run, is that those 15 million people are just too stupid to know what’s good for them, so the government has to force them to do it?
Warren:
I gave you an answer which you choose to look beyond. That is the only answer you are going to get. Go to the open thread Dan puts up if you wish to babble. You are not going to hijack the thread.
Congratulations, Ken. I used to get up to Tewksbury every month to work with Ray the only on a radar system. But no more. That contract ended. Was up there for the Patriots 18-1 season!
“Why should a young, healthy person have to pay as much as an older, unhealthy person?”
Makes you want to laugh. Or weep.
This is all about the individual market, not the group market. I worked for the same employer for 40 years and we always had group insurance coverage and I and my employer paid my premiums which were way too high when I started as a young man and way too low when I retired as an old man. There is simply nothing wrong with treating the nation’s health insurance as the largest group policy out there particularly when the higher income earners–which might well be the older, unhealthy income earners–are subsidizing the cost to the younger, healthier and lower income earners. We could eliminate the issue entirely by going to a basic, single payer plan and tax every dollar of income in this country to pay for it. We could also use the power of that single payer to ratchet down the cost curve.
It is called community rating. 8% of the insured are in the individual market.
Terry,
The point is that younger people DO NOT PAY as much as older people. Warren has no clue what he is talking about, again.
“How premiums are set
Under the health care law, insurance companies can account for only 5 things when setting premiums.
Age: Premiums can be up to 3 times higher for older people than for younger ones.
Location: Where you live has a big effect on your premiums. Differences in competition, state and local rules, and cost of living account for this.
Tobacco use: Insurers can charge tobacco users up to 50% more than those who don’t use tobacco.
Individual vs. family enrollment: Insurers can charge more for a plan that also covers a spouse and/or dependents.
Plan category: There are five plan categories – Bronze, Silver, Gold, Platinum, and Catastrophic. The categories are based on how you and the plan share costs. Bronze plans usually have lower monthly premiums and higher out-of-pocket costs when you get care. Platinum plans usually have the highest premiums and lowest out-of-pocket costs.”
https://www.healthcare.gov/how-plans-set-your-premiums/
I cannot imagine talking about something I know absolutely nothing about, like radar. Warren seems to violate this on a constant basis. From reading legal statutes( which he cannot), to the ACA, he does not care that he is almost always totally wrong, yet insists on conversing based on his ignorance.
Here Warren, play with this calculator. Keep the income steady and just change the age.
http://www.kff.org/interactive/subsidy-calculator/#state=&zip=&income-type=dollars&income=50000&employer-coverage=0&people=1&alternate-plan-family=individual&adult-count=1&adults%5B0%5D%5Bage%5D=60&adults%5B0%5D%5Btobacco%5D=0&child-count=0&child-tobacco=0
This is not rocket science.
“[Those] 15 million people will be abdicating their personal responsibility (I thought Republicans believed in that?) and freeloading off of us when they only get insurance when they’re sick.”
I do, which is why pre-existing conditions should not be covered. The costs for pre-existing conditions should be covered by the policy that was in force when the condition was diagnosed.
Laughing and weeping again.
Then again, I was responding to another offensive post that seems to have disappeared.
Can we make that disappearance a permanent feature of the blog?
What did you find offensive about it?
When you channel Paul Ryan you are offensive. The difference is that Ryan knows he is lying, you don’t.
You cannot control costs in a system when people outside of the system can access the system.
Then don’t allow people outside the system to access the system.
Warren,
That’s enough. Let me know when you see a hospital turn down an uninsured patient that needs medical care.
Warren,
Would you say that you believe in “live and let live”…. and if you can’t afford to stay alive, then you should just die? or what?
Or if your hip is causing you too much pain, just sit in a rocker on the porch or in the couch in front of the TV until somebody brings you food, helps you to toilette, or shower and cleans you occasionally?
Or about he person that suffers a heart attack … but can’t afford the ambulance service or hospitalization or drugs … it must have been their own fault, I suppose because they ate too much fatty meat or something I suppose, so they should just die where they lay.
Then there’s the lady who cut herself ever so slightly on the thumb while cooking. When it got red and real sore and began to swell she put iodine on it and some alcohol over it, and used a Band-Aid. because she couldn’t afford to pay a doctor to prescribe Amoxicillin or Penicillin and she died two days later of massive infection. She was just negligent while cooking or too careless I guess and so should die because she was too poor to get medical treatment when she knew she needed it?
For those people the community of people who give a shit, make sure those who cannot afford medical costs get care at the emergency room and who are then admitted to the hospital to treat the condition. Somebody pays .. it’s called the premium we pay on our own insurance to cover the necessary and expedient care others can’t afford.
But if you ascribe to the “dog-eat-dog” variety of mammalian survival methods, then of course none of this is your problem to be concerned with unless you have to pay… and while you don’t know it apparently, you’re paying anyway.
The difficulty you and others like you are having is where to draw the line on providing socially paid for services to others who can’t afford what you can afford.
Like what about public education? That’s a socially provided service paid for by taxes (income and property taxes in most states). If you don’t believe there’s a public benefit that serves your own personal interests, then you’re opposed or prefer to pay less than you’re paying to provide those public services.
Now of course it you don’t think you should pay, then the same applies to everybody else so then nobody should pay for anything that doesn’t serve their own personal interests. That’s nice as long as the vast bulk of the public also agrees with you…. but if they don’t then they take matters into their own hands and you have a revolution or civil war or coup that upends your own entire life and everybody else’s that think they shouldn’t have to pay as much as they pay.
We call it “civilized life” … it necessarily includes those who have pay for those that don’t…. it’s the only way to maintain civilized life… barring a police state .. think North Korea, or Pol Pot’s regime, or the National Socialists in 1930’s and 1940’s Germany.
Warren,
Then there’s the other part you seem to be ignoring or “something”.
In the course of one’s life (short or long) due to the nature of human evolutionary events, as one ages there’s an increase in one’s condition that make life far more difficult than during those years before 40 or 50 or 60 or 70.
Among humans there’s a distribution of health related events though out one’s life… beginning at birth, ending at death (whenever that occurs).
For females there’s a spike in health related events due to an increase in pregnancies between ages of ~15 to 35 or so… those pregnancies require some health care in some form to maximize the probability of giving birth to a live, well and healthy infant who subsequently grows to provide new productive value to the society.
For males there’s other types of issues .. sports injuries, accidents due to recklessness and testosterone secretions, fights that result in broken jaws, broken arms, severe cuts and blood loss, etc… Whether one suffers from these things or not is a matter of pure chance and natural and inherited dna, plus societies’ love of sports games, fast driving, taking risks, and “winning”.
But by age 40, to 60 other things start happening in health… and these are also pretty random chance among the population of humans.. so will have almost nothing occur and others will have multiple things occur one right after or non top of another….but as a population of humans the occurrences of health related events increases dramatically.
When you’re 20 or 25 or 30 or 40 you have no clue yet and no way to predict what level of health events will occur to you later as you reach 50, 60, & or 70. It’s random chance on a population basis.
So you will pay for massively more health related events when you’re older … at much greater costs because those health related events can’t all be treated by your local family physician… you’ll need various specialists, surgeons, special medications, etc. to keep you functioning at all and especially not becoming a major burden to your spouse or younger family members, or even remaining healthy enough to work longer if you wish, or volunteer for a local charity group or your church group or public volunteer services..
So when you amortize your own life-time health care events and their costs, you find that you will need to be paying for your future costs fro the day you’re born. . unless you were just a lucky one. .. but you have no idea of whether you will be lucky or not.
So lets say you bet that you’ll be a lucky one.. .that 0.25% of the human population that will remain healthy and kick the bucket at 85 or whenever without having had anything seriously go wrong before that.
But what if you bet wrong? The who should pay for those massively increased health events that occur as you age beyond 50.
And because you were betting you would be a lucky one, you there was no need to put any money aside just in case you weren’t lucky so you wouldn’t have saved to pay for all those costs that you’ll incur.
Then who should pay? Or should you just die or sit on the couch with a hip that won’t let you move without somebody helping you off the couch because you didn’t save for this normal occurrence of health events on a population basis? And if your spouse is also incapacitated or already passed away, then who should help you off the couch, and get your meals, and keep you clean and able to get to the toilette or shower or into and out of bed?
Or should a doctor do surgery, pay for a new hip and rehab afterwards so you can continue to be independent and even perhaps productive in some regard and not a burden to somebody else whom you can’t afford to pay for providing your specialized care. And who should pay for that surgery and rehab?
So humans devised this thing to deal with “luck” or “chance” and we call it insurance….the cost of insurance is the average actual cost spread over time among a population (called the actuarial probability cost basis) plus profit and overhead for the insurance company .. whether it’s automobile insurance (liability part at least), or homeowners, or fire insurance or flood insurance, or health insurance..
And if there are too few people in the insurance pool then the cost per person in the pool is much higher because the same costs will be incurred but having to be paid for by fewer people in the pool. The more people in the pool, the lower the insurance cost per person in the pool but the insurance cost is only low enough for people to pay for at all (thus an insurance industry) IF and only if the risks are spread over time on an actuarial probability basis.
Thus the young pay for the old until they young are also old and the young at that time pay for them when they’re old and health care occurrence events require more care and expense.
But if the insurance is optional then the young have no reason to join the insurance pool because they all think they’ll be the lucky ones (that’s just the nature of humans.. .we can’t change it… its the same reason young guys go to war… they think they’ll be invincible) besides which they also have other things they want at the time.. newer car, better wine, larger apartment, down payment on a house, nicer clothes, new kid (kids cost a lot of bucks), nice vacation to Hawaii or Europe or the Caribbean islands or Yellowstone, or Disney land or Las Vegas, etc.
So to minimize the costs of health related events costs for everbody, the young have to pay upfront for the costs they’ll incur when they age… the more people in the pool the less it cost everybody in the pool.
And yes, if chance turns out to give some people the luck and they need little or not health care costs when they age, they still paid for it. It’s the same when I buy automobile insurance … or homeowners, or fire insurance…. I hope I don’t need to use it, but I pay because I’m not at all sure I’ll be a lucky one and never need it.
So maybe you think luck and chance should dictate how one’s life turns out. But if that was what everybody thought, then there would be no such thing as insurance for anything. And you’d just say “tough luck”.
Warren,
I don’t think you’re too dumb to understand this stuff.
I do think you’re stuck in a paradigm when men were men and women were to raise babies, and pioneers carved lives out of the wilderness and prospered … the good ol’ right wing propaganda otherwise known as “individualism”.. and believe Jefferson’s utopian fantasy statements (also pure propaganda to insure plantation owners remained supreme) that a nation of small farmers was the best way forward.
Warren,
Just fyi, I was as healthy as the preverbal horse … probably saw a doctor once every 10 years or so for some minor infection. No broken bones, noses, or jaws. Before I was an adult, I had tonsils out at age 7 or 8, a hereditary birth condition (hernia) corrected at 10, and 20 stitches in my scalp because I was showing off to the girls while riding a horse bareback that decided not to make the jump, and I went headfirst into the edge of a disc (a kind of specialized plow if you’re a city boy).
While in the Army I developed a condition that required surgery due to being in the Army that the Army paid for when I got out of active duty (age 24)..
That was my total health care (other than 1/10 years doctor visit and costs of some aspirin) …. until I turned 66. Just one condition occurred at that age, total surprise, no prior incidences in my extended family or it’s history. To stay alive and fully functional, it’s cost more than both my houses are worth,
You’re paying part of my costs whether you know it or not. So I thank-you and my wife thanks you, and my kids thank-you, my brother and sister thank you, my nephews and nieces all thank you, my grandkids thank you, and my very close and long time friends thank-you.
And I’d hope that if that were to also happen to you or your loved ones, you would also thank me and my extended family and friends for helping you pay for some of those costs too.