- Jun 6, 2007
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In the public debate on the Graham-Cassidy (healthcare reform) bill it really hasn't been emphasized enough that this bill is much much worse than the Senate Republicans prior effort in July the "Skinny Repeal" bill. That bill was projected by the CBO to result in fifteen million less Americans having health insurance when it became law, the Graham-Cassidy bill if it became law would probably at least double that number because it eliminates the ACA (Affordable Care Act) federal subsidy program for American families whose income is four hundred percent of the poverty rate or less which capped their insurance premium cost at affordable levels and this bill critically weakens the community pricing mandate of the ACA thereby allowing states to allow insurance companies to charge older Americans instead of three times the premium costs of younger Americans four, five or more times that costs.
The Graham-Cassidy bill is an extreme disgrace and bad effort by the Senate Republican leadership. This bill undercuts the major thrust of the Republican Party's criticism of the ACA which they say is the law implements the principle that Washington knows best it restrict the states ability to design a healthcare system that is best for their citizens. It undercuts this argument by repealing the ACA's individual mandate the mandate that requires everyone to carry health insurance if you have a certain income or pay a fine. Doing this realistically takes away the power of the states to effectuate one of the two options (and incidentally the wisest option) that are possible to address the key and crushing problem in creating a health care system how to provide health insurance to people with serious health problems "pre-existing condition enrollees". There exists two viable options to address this problems: one, create large insurance pools of people who are mostly healthy and as such don't cost a lot to insure and spread the costs, in the premium charge, of the pre-existing condition enrollees across the entire pool it is the Obamacare and Romneycare models; second, create a "pre-existing condition pool" insurance program where people with such a problem health status can go and buy health insurance the challenge with this option is that the state and/or federal government has to come up with a huge amount of money to help this program pay medical claims for their expensive enrollees so that the premiums these enrollees are charged is affordable. The Graham-Cassidy bill eliminates the first option because it repeals the individual mandate and insurance companies have been saying loud and clear since 2009 that they are not participating in insurance programs where you have community pricing for premiums and the requirement that people with pre-existing conditions be offered insurance without the individual mandate which will drive the creation of large pools of enrollees; some Republicans to this argument might say states are free to enact their own individual mandate law if they want this option - is this really a politically viable option considering that the Republican Party has across the nation spent the last seven years loudly proclaiming that such a mandate is an egregious violation of people's rights. Not only will the Graham-Cassidy law force states to create pre-existing condition insurance pools but it does not guarantee federal support for the financing of these pools which will be crazy expensive over time it dumps the problem on the states most of which are and will be woefully unable to handle the problem. The wisest option the easiest to financially manage for the government is the first option with large pools including everyone with a government "reinsurance" commitment for these pools for enrollees who turn out to be extremely expensive from a medical claims generation standpoint because the government is still availing themselves of the spread the cost of these health challenged people to healthy people attribute of this option but it is not so onerous this cost shift on healthy people that they find it intolerable.
The Graham-Cassidy bill will leave a large demographic of American, American families whose income is 400 % of the poverty level or lower, that now get vital help to have affordable health insurance premiums through the ACA's tax credit premium program in the lurch those Americans should expect to pay more for their health insurance premiums if they can find insurance plans they can afford to pay the premiums on. This ACA program capped these American's insurance premiums at a level from 2% to 9.5% of their income. This bill which eliminates this ACA program does not target help for this demographic group. As the public has been repeatedly told the thrust of the Graham-Cassidy bill is to take all the money that the ACA requires the Federal Government to spend to provide health care for the American people wrap it all together cut a big chunk off (this cutting has been downplayed in the sales campaign) and hand the remaining wrapped bunch to the states to spend on healthcare because the states know best. The bill's provisions [Sec. 106 ] which addresses how this block grant is spent by the states is really weak in the area of helping this group. The bill could be construed as authorizing the states spending a portion of this block on making HMO's in the states individual market affordable to this demographic group but many families have relationships with specific doctors they deem important and HMOs often do not include such doctors. The bill does allow the states to use the money to lower premiums in the individual insurance market but that would be for premiums for people of all income levels in the market. In fact, I believe the Administrator of Medicaid and Medicare would be on solid ground in construing the relevant provision, as prohibiting a state from directing the grant money to an insurance premium reduction program for the individual market where only lower and middle income people in their state were getting their insurance premiums reduced from the grant monies.
The Graham-Cassidy bill really highlights that the American people have a problem with the Republican Party over the abortion issue we really cannot trust them with the power to solely govern the country because of their ruthless curtailment of abortion. I am not talking about their enforcement of the Hyde Amendment that it completely legitimate behavior to prohibit taxpayer revenue to directly pay for abortion because some Americans view abortion as the moral equivalent of murder and their monies should not be used to do what they perceive as such an extreme moral wrong. But the Republicans today don't stop with the Hyde amendment they want to stop any federal monies being used to help people pay for health insurance that covers abortion, health insurance is too important to people to tolerate the Republicans interference with a governments critically important work to help people acquire health insurance and health care. The Graham-Cassidy bill blocks the ACA federal subsidy program for premiums from allowing the tax credits to be used on insurance plans that cover abortion, it blocks the ACA's small business tax credit from applying to insurance plans that cover abortion, it blocks Health Saving Account funds from being able to be used to pay premiums on insurance plans that cover abortion and it blocks for a year federal funding going to health care providers that provide abortion like "Planned Parenthood". The people in the Republican Party responsible for this fanaticism need to cut it out. These people need to stop hijacking the Republican Party to largely serve the interests of the Party's christian extremist base the majority of the American people do not think first-term abortions are murder that a first term fetus is a human being or is an entity with a human soul. The Republican Party is a mainstream party and its leaders have a duty to act mainstream and stop doing the bidding of this extremist base on these important issues which would cause major harm in the country if your plans are executed.
The Graham-Cassidy bill reveals that the Republican party doesn't hold a good plan for fixing America's health care system, leaders in the party need to embark on a major soul searching effort and have a dramatic conversion on this topic. This bill wreaks that the Republican Party thinks the answer to America's health care crisis is high deductible insurance plans (HDIPs). What are your Republicans "tone" deaf many American's hate these plans because they cannot afford to pay for health care they need until they reach the deductible limit. HDIP are great for higher income American that can afford to contribute a lot of money into their Health Savings Accounts but most Americans cannot do that because they need their income to live on. The Republican Party needs to decide are they going to be the party for all Americans or only for segments of the American people like the wealthy their future won't be good if they choose the latter course. The full and complete answer to America's heath care problem is America needs its government to look at every aspect of America's health care system to look at the details and take out the costs that don't make sense from a goodness standpoint through legislation. The jury is in Republicans repeal and replace is a bad outcome for America because the Republicans don't have and never will have a better replacement the correct course is to improve the ACA it is a good framework. Fixing laws to the ACA will be a lot of hard work but it can succeed and succeed great. The work can garnish bipartisan support because it is the right and only right course. The Republican Party needs to wake up quickly and get on this path because there is a Democrat Party train that has been put on the tracks and it is coming up fast and what it is carrying is a plan consisting of a government sponsored health insurance provider with price fixing power to set the price it pays health care providers which will address America's insurance premium and deductible problem and if this train gets to the station first America will be stuck with a poor quality health care system.
Senator McConnell has been a disgrace with the whole health care reform process this session of Congress. This Graham-Cassidy bill just underscores this behavior. Instead of using this bill to try to implement the good intentions, granted a plan bringing too much destruction, of its authors the intention to give the monies spent on the ACA and the mandate power to the states to come up with a better system he allowed the bill to be loaded up with Republican ideology goals that did not address the American people need to just lower the premium and deductible cost of insurance in America and expand choice and preserve the critical good protections in the system. Senator McConnell hasn't done his duty to look out for the interest of all the American people on this and other issues and so needs to go. Senator Schumer likewise has been a disgrace with this whole process. He has repeatedly essentially proclaimed on the Senate floor Republicans don't repeal the ACA we know it has major problems we know that the American people are greatly disgusted and disappointed with the law we the Democrats will help you fix it just give us a chance. Well anyone with a competent assessment on legislation knew that the Republican effort on repeal and replace of Obamacare was dead on July 28th of this year during the vote of the "skinny repeal" vote when Senator McCain walked to the front of the chamber and gave the thumb down motion. Where has Senator Schumer been with his plan to improve the ACA with a good cost cutting piece of legislation nowhere, MIA, don't know you don't want to know you! Senator Schumer this past Monday revealed his mindset on Americas healthcare system on the Senate floor in opposing the Graham-Cassidy bill when he said "The S&P has just come out with a study that estimates that Graham-Cassidy would result in 580,000 lost jobs and $240 billion in lost economic activity by 2027 -------- Under the latest version (of Graham-Cassidy), States could remove the benefit of getting preventive services at no cost, such as birth control, cancer screening, and immunizations." The American people need leaders in Congress that view the Healthcare system not as a means of jobs creation and means of economic activity for America but rather as a means to provide great healthcare for the American people at the lowest possible cost. The American people need serious and responsible leaders in Congress that are committed to passing legislation that lowers the claim cost on health insurance providers in the individual market so they can pass on the savings to American consumers in that market in the form of lower premiums and deductible. A serious and responsible leader would consider it so compelling that there is no issue that the ACA mandate on free preventive care is definitely being changed to just mandate that preventive care is excluded from the deductible but it is no longer mandated as free; health care providers don't provide the service for free America needs enrollees in the individual market to examine their family history and otherwise be thoughtful so that they don't overdue it on the utilization of this care thus holding down claim costs for insurance providers. Senator Schumer hasn't done his duty to look out for the interest of all the American people on this and other issues and so needs to go. Senator McConnell and Senator Schumer view their job as a competition to gain power for their party and implement their party's ideology into law and government policy not to do what is good not to consider all the American people's interest and as best as possible do what is right by all the people; America is teetering on the brink because of the likes of these two Senators and other politicians like them. America can no longer withstand leaders like McConnell and Schumer they must go!
The Graham-Cassidy bill is an extreme disgrace and bad effort by the Senate Republican leadership. This bill undercuts the major thrust of the Republican Party's criticism of the ACA which they say is the law implements the principle that Washington knows best it restrict the states ability to design a healthcare system that is best for their citizens. It undercuts this argument by repealing the ACA's individual mandate the mandate that requires everyone to carry health insurance if you have a certain income or pay a fine. Doing this realistically takes away the power of the states to effectuate one of the two options (and incidentally the wisest option) that are possible to address the key and crushing problem in creating a health care system how to provide health insurance to people with serious health problems "pre-existing condition enrollees". There exists two viable options to address this problems: one, create large insurance pools of people who are mostly healthy and as such don't cost a lot to insure and spread the costs, in the premium charge, of the pre-existing condition enrollees across the entire pool it is the Obamacare and Romneycare models; second, create a "pre-existing condition pool" insurance program where people with such a problem health status can go and buy health insurance the challenge with this option is that the state and/or federal government has to come up with a huge amount of money to help this program pay medical claims for their expensive enrollees so that the premiums these enrollees are charged is affordable. The Graham-Cassidy bill eliminates the first option because it repeals the individual mandate and insurance companies have been saying loud and clear since 2009 that they are not participating in insurance programs where you have community pricing for premiums and the requirement that people with pre-existing conditions be offered insurance without the individual mandate which will drive the creation of large pools of enrollees; some Republicans to this argument might say states are free to enact their own individual mandate law if they want this option - is this really a politically viable option considering that the Republican Party has across the nation spent the last seven years loudly proclaiming that such a mandate is an egregious violation of people's rights. Not only will the Graham-Cassidy law force states to create pre-existing condition insurance pools but it does not guarantee federal support for the financing of these pools which will be crazy expensive over time it dumps the problem on the states most of which are and will be woefully unable to handle the problem. The wisest option the easiest to financially manage for the government is the first option with large pools including everyone with a government "reinsurance" commitment for these pools for enrollees who turn out to be extremely expensive from a medical claims generation standpoint because the government is still availing themselves of the spread the cost of these health challenged people to healthy people attribute of this option but it is not so onerous this cost shift on healthy people that they find it intolerable.
The Graham-Cassidy bill will leave a large demographic of American, American families whose income is 400 % of the poverty level or lower, that now get vital help to have affordable health insurance premiums through the ACA's tax credit premium program in the lurch those Americans should expect to pay more for their health insurance premiums if they can find insurance plans they can afford to pay the premiums on. This ACA program capped these American's insurance premiums at a level from 2% to 9.5% of their income. This bill which eliminates this ACA program does not target help for this demographic group. As the public has been repeatedly told the thrust of the Graham-Cassidy bill is to take all the money that the ACA requires the Federal Government to spend to provide health care for the American people wrap it all together cut a big chunk off (this cutting has been downplayed in the sales campaign) and hand the remaining wrapped bunch to the states to spend on healthcare because the states know best. The bill's provisions [Sec. 106 ] which addresses how this block grant is spent by the states is really weak in the area of helping this group. The bill could be construed as authorizing the states spending a portion of this block on making HMO's in the states individual market affordable to this demographic group but many families have relationships with specific doctors they deem important and HMOs often do not include such doctors. The bill does allow the states to use the money to lower premiums in the individual insurance market but that would be for premiums for people of all income levels in the market. In fact, I believe the Administrator of Medicaid and Medicare would be on solid ground in construing the relevant provision, as prohibiting a state from directing the grant money to an insurance premium reduction program for the individual market where only lower and middle income people in their state were getting their insurance premiums reduced from the grant monies.
The Graham-Cassidy bill really highlights that the American people have a problem with the Republican Party over the abortion issue we really cannot trust them with the power to solely govern the country because of their ruthless curtailment of abortion. I am not talking about their enforcement of the Hyde Amendment that it completely legitimate behavior to prohibit taxpayer revenue to directly pay for abortion because some Americans view abortion as the moral equivalent of murder and their monies should not be used to do what they perceive as such an extreme moral wrong. But the Republicans today don't stop with the Hyde amendment they want to stop any federal monies being used to help people pay for health insurance that covers abortion, health insurance is too important to people to tolerate the Republicans interference with a governments critically important work to help people acquire health insurance and health care. The Graham-Cassidy bill blocks the ACA federal subsidy program for premiums from allowing the tax credits to be used on insurance plans that cover abortion, it blocks the ACA's small business tax credit from applying to insurance plans that cover abortion, it blocks Health Saving Account funds from being able to be used to pay premiums on insurance plans that cover abortion and it blocks for a year federal funding going to health care providers that provide abortion like "Planned Parenthood". The people in the Republican Party responsible for this fanaticism need to cut it out. These people need to stop hijacking the Republican Party to largely serve the interests of the Party's christian extremist base the majority of the American people do not think first-term abortions are murder that a first term fetus is a human being or is an entity with a human soul. The Republican Party is a mainstream party and its leaders have a duty to act mainstream and stop doing the bidding of this extremist base on these important issues which would cause major harm in the country if your plans are executed.
The Graham-Cassidy bill reveals that the Republican party doesn't hold a good plan for fixing America's health care system, leaders in the party need to embark on a major soul searching effort and have a dramatic conversion on this topic. This bill wreaks that the Republican Party thinks the answer to America's health care crisis is high deductible insurance plans (HDIPs). What are your Republicans "tone" deaf many American's hate these plans because they cannot afford to pay for health care they need until they reach the deductible limit. HDIP are great for higher income American that can afford to contribute a lot of money into their Health Savings Accounts but most Americans cannot do that because they need their income to live on. The Republican Party needs to decide are they going to be the party for all Americans or only for segments of the American people like the wealthy their future won't be good if they choose the latter course. The full and complete answer to America's heath care problem is America needs its government to look at every aspect of America's health care system to look at the details and take out the costs that don't make sense from a goodness standpoint through legislation. The jury is in Republicans repeal and replace is a bad outcome for America because the Republicans don't have and never will have a better replacement the correct course is to improve the ACA it is a good framework. Fixing laws to the ACA will be a lot of hard work but it can succeed and succeed great. The work can garnish bipartisan support because it is the right and only right course. The Republican Party needs to wake up quickly and get on this path because there is a Democrat Party train that has been put on the tracks and it is coming up fast and what it is carrying is a plan consisting of a government sponsored health insurance provider with price fixing power to set the price it pays health care providers which will address America's insurance premium and deductible problem and if this train gets to the station first America will be stuck with a poor quality health care system.
Senator McConnell has been a disgrace with the whole health care reform process this session of Congress. This Graham-Cassidy bill just underscores this behavior. Instead of using this bill to try to implement the good intentions, granted a plan bringing too much destruction, of its authors the intention to give the monies spent on the ACA and the mandate power to the states to come up with a better system he allowed the bill to be loaded up with Republican ideology goals that did not address the American people need to just lower the premium and deductible cost of insurance in America and expand choice and preserve the critical good protections in the system. Senator McConnell hasn't done his duty to look out for the interest of all the American people on this and other issues and so needs to go. Senator Schumer likewise has been a disgrace with this whole process. He has repeatedly essentially proclaimed on the Senate floor Republicans don't repeal the ACA we know it has major problems we know that the American people are greatly disgusted and disappointed with the law we the Democrats will help you fix it just give us a chance. Well anyone with a competent assessment on legislation knew that the Republican effort on repeal and replace of Obamacare was dead on July 28th of this year during the vote of the "skinny repeal" vote when Senator McCain walked to the front of the chamber and gave the thumb down motion. Where has Senator Schumer been with his plan to improve the ACA with a good cost cutting piece of legislation nowhere, MIA, don't know you don't want to know you! Senator Schumer this past Monday revealed his mindset on Americas healthcare system on the Senate floor in opposing the Graham-Cassidy bill when he said "The S&P has just come out with a study that estimates that Graham-Cassidy would result in 580,000 lost jobs and $240 billion in lost economic activity by 2027 -------- Under the latest version (of Graham-Cassidy), States could remove the benefit of getting preventive services at no cost, such as birth control, cancer screening, and immunizations." The American people need leaders in Congress that view the Healthcare system not as a means of jobs creation and means of economic activity for America but rather as a means to provide great healthcare for the American people at the lowest possible cost. The American people need serious and responsible leaders in Congress that are committed to passing legislation that lowers the claim cost on health insurance providers in the individual market so they can pass on the savings to American consumers in that market in the form of lower premiums and deductible. A serious and responsible leader would consider it so compelling that there is no issue that the ACA mandate on free preventive care is definitely being changed to just mandate that preventive care is excluded from the deductible but it is no longer mandated as free; health care providers don't provide the service for free America needs enrollees in the individual market to examine their family history and otherwise be thoughtful so that they don't overdue it on the utilization of this care thus holding down claim costs for insurance providers. Senator Schumer hasn't done his duty to look out for the interest of all the American people on this and other issues and so needs to go. Senator McConnell and Senator Schumer view their job as a competition to gain power for their party and implement their party's ideology into law and government policy not to do what is good not to consider all the American people's interest and as best as possible do what is right by all the people; America is teetering on the brink because of the likes of these two Senators and other politicians like them. America can no longer withstand leaders like McConnell and Schumer they must go!
