“We Made Certain they knew that”


I was always very candid with my patients. They want to know that you are working for them, not someone else. We made certain they knew that.” Tom Price, MD – Secretary of HHS

Republicans, the Trump administration, led by Graham and Cassidy are moving forward to defund and cripple the ACA bringing millions of people back to when states decided who could have a smidgen of healthcare and who could not. This comment by Dr. and Secretary of Health Tom Price in 2016 is priceless and is the opposite of what he said then. Both he and his fellow Republicans are deliberately misleading constituents and his patients about their intentions with the ACA. Tom Price is more concerned with the politics of the ACA rather than his constituents well being. Recently, commentator/comedian Jimmy Kimmel brought this to the forefront in his monologue about Senator Cassidy who was a guest on Jimmy’s show and made comments about the most recent Republican Healthcare bill.

The same as other recent healthcare bills by Republican, the Graham – Cassidy bill will return healthcare back to pre-2008 when states could deny able-bodied people healthcare, had limited funding, could allow denial of insurance based upon pre-existing conditions, eliminate premium subsidies, not subsidize out of pocket expenses, cap healthcare, etc. These are all the things Senators Graham and Cassidy claim will still be covered in their state block grant bill for healthcare. Except, there is no mandate by Washington forcing states to have the same as what is offered today. It is all a state rights gambit with some states being generous and many not being so generous.

Kimmel: “I don’t know what happened to Bill Cassidy, but when he was on this publicity tour, he listed his demands for a health-care bill very clearly. These were his words. He said he wants coverage for all, no discrimination based on preexisting conditions, lower premiums for middle-class families and no lifetime caps. Guess what? The new bill does none of those things.”

Cassidy “just lied right to my face” according to Kimmel.

Graham: “He didn’t give (Cassidy) the courtesy of hearing his side of the story. He went on national TV and called this man — who has worked for the underprivileged and health care all of his life — a liar, (Graham referring to Cassidy), who practiced medicine before he entered politics. And I think that’s inappropriate.

I don’t like the idea of calling this good man a liar without ever talking to him first. That really says more about Mr. Kimmel then it does Dr. Cassidy,'”

The Cassidy-Graham bill would do away with Obamacare’s Medicaid expansion, subsidies for private insurance, eliminate the requirement that Americans have insurance under the Affordable Care Act, and reduce payments to insurers for out-of-pocket costs. In their place, it would offer states a block grant they could use to spend on health care as they saw fit. The block grant would be 17% less than what total federal spending would be in 2026 meaning states would struggle to cover the same number of people.

There is nothing to talk about with Mr. Cassidy or even Mr. Graham both of who are indignant at being called out by Kimmel.

There will be resources in your state; but, those resources may not be of the same value as under the ACA. The Graham – Cassidy plan will favor states which did not expand Medicaid or have not had higher premium/csr subsidies. It is obvious what Graham and Cassidy are doing. Punish states which expanded Medicaid and reward states which did not expand Medicaid. California would lose $27 billion in funding, New York would lose $18 billion in funding while Texas would be rewarded with $8 billion in funding.

In a letter to both Senators Graham and Schumer, this is what the America’s Health Insurance Plans (Modern Healthcare, September 20, 2017, Matthew Weinstock), the industry’s “main lobby group” had to say on the Graham-Cassidy legislation. The Graham – Cassidy healthcare plan fails to meet five crucial tests:

• stabilizing the insurance market;
• ensuring Medicaid reforms meet beneficiaries’ needs;
• guaranteed access to coverage for all Americans, including those with pre-existing conditions;
• time for the industry to prepare for any changes to existing law;
• and getting rid of health insurance and excise taxes.

The last item called out by the America Health Insurance Plans is the Cadillac tax, which was meant to tax excessive executive healthcare plans and also force “consumers to have more skin in the game” with higher co-pays and deductibles. People would then decide if they really needed to go to the doctor or not avoiding cosmetic or unneeded doctor visits. The attempt on the later is misguided as the commercial healthcare industry has a much larger impact on rising healthcare costs than consumer doctor visits. The emphasis needs to be on controlling the commercial healthcare industry and how healthcare serves are delivered to patients with better outcomes. Most of the burden of controlling healthcare costs has been shifted to the consumer through this tax by Congress and for-profit healthcare insurance companies.

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