What it says on the tin. Thoughts USMB?
Speaker Johnson says GOP working on Republican health care plan amid shutdown
Speaker
Mike Johnson (R-La.) on Monday said House Majority Leader
Steve Scalise (R-La.) is working with the chairs of three House committees to compile a Republican health care plan as the government shutdown nears the one-month mark and Democrats demand action on expiring ObamaCare subsidies.
“Republicans have been working on a fix for health care, we’ve been doing this for years,” Johnson said in a press conference on Monday when asked about the coming “health care cliff.”
He held up a copy of a
policy framework developed when he was chair of the Republican Study Committee from 2019-2020, asserting that “these ideas have been on paper for a long time.”
The heads of those House committees of jurisdiction involved in the health care plans would be Ways and Means Chair Jason Smith (R-Mo.), Energy and Commerce Chair Brett Guthrie (R-Ky.), and Education and Workforce Chair Tim Walberg (R-Mich.).
Republicans have come under intense pressure from Democrats on the issue of health care, and there have been signs that some in the GOP see it as a vulnerability ahead of next year’s midterms. Enhanced subsidies under the Affordable Care Act (ACA) are set to expire at the end of the year and millions of Americans are receiving notifications in the mail about sharply rising premiums.
Prominent GOP lawmakers, including Rep.
Marjorie Taylor Greene (Ga.) and Sen.
Josh Hawley (Mo.), have sounded the alarm about the effects of rising insurance rates, which come after Republicans passed funding cuts to Medicaid as part of their “big, beautiful bill.”
Republicans, however, say they will not negotiate on the ACA subsidies until Democrats vote to reopen the government — and have never voted for the expiring subsidy plus-ups signed into law under President Biden.
There is a link to the background and plan proposals. What a bunch of horseshit. For instance,
Conversely, the ACA’s regulatory framework—namely its inflexible guaranteed issue and community rating provisions—incentivizes people in the individual market to act irresponsibly and to delay purchasing health insurance until after they develop a disease or illness. In other words, there is neither a carrot nor a stick for proactively and responsibly purchasing and maintaining insurance under
the ACA.
Well Duh Huh. As the ACA was originally structured, with penalties for those refusing to purchase health insurance, there were incentives encouraging healthy people to enroll. It was Republicans that removed those penalties and it is Republicans that bear the responsibility for the dysfunctional market they themselves created.
it is necessary to transform the individual marketplace’s current regulatory structure, unwind the ACA’s Washington-centric approach, and largely return regulatory authority to he individual states.113 As explained in the following section, protections pertaining to guaranteed issue and the prohibition on coverage exclusions would be retailored under the RSC plan to reward continuous coverage and promote portability in the individual marketplace. Additionally, in order to provide Americans with health insurance options that fit their individualized needs and do not add unnecessary expenses, the RSC plan would undo the ACA’s regulations on essential health benefits,annual and lifetime limits, preventive care cost-sharing, dependent coverage, and actuarial value. Each state would again be allowed to dictate the minimum attributes and cost-sharing parameters of plans to best meet the needs of their own citizens. The ACA’s medical loss ratio, along with its competition-killing
and premium-increasing effects, would be eliminated as well. In no case, however, would carriers be able to rescind, increase rates, or refuse to renew one’s health insurance simply because a person developed a condition after enrollment.
There is so much smoke being blown around here. Promote continuous coverage and portability in the individual market? How? Eliminate the ACA provisions on essential health provisions? Ah yes, the return to the mini-Meds. That is not going to help. We been down that road before. Remove the ban on annual and lifetime limits? Who the **** does that help? Tell me, how is it even called health insurance when after a certain amount is reached the benefits stop.
I have seen it. Hospital calls and tells you they can't continue your cancer treatment because you have maxed out your benefits. What do you do other than ******* DIE. Do we really want to return to that. And now, to some basics.
Actuarial value, the Republicans want to eliminate this provision. But I got to be honest, the Medicare Supplement market has been dealing with actuarial value requirements for thirty ******* years and that line has consistently been a profit driver for the insurance industry. Dependent coverage, oh well, guess you can't carry your kids until they are 26 anymore. Do Republicans really believe a 22 year old is going to purchase a mini-med? That single provision of the ACA has been one of its most appreciated benefit.
And then the last sentence in the quote,
In no case, however, would carriers be able to rescind, increase rates, or refuse to renew one’s health insurance simply because a person developed a condition after enrollment.
Hell, they couldn't do that before the ACA, outside of something called temporary health insurance. Guaranteed Renewability, a requirement for most health insurance. I mean here is what Republicans are proposing. Bring back mini-meds, that is health insurance that is extremely limited in coverage. Actually worse than a hospital Indemnity plan, rarely pay. Bring back caps on benefits. One million lifetime perhaps, two million in most cases was the norm. And it does happen. And when it does, not only does it exacerbate the health condition of the beneficiary, it tosses future costs on to taxpayers through emergency Medicaid.
I mean to me, intuitively, it is jarring. Insurance companies get a cap on their risk exposure while happily collecting premiums. The beneficiary pays a tremendous cost in mental stress if nothing else. And the taxpayers end up paying the tab.
Now here is the other thing the Republicans are not telling you. This is really only about one thing, employer sponsored health insurance. Back in the day, it was like eight to one. For every person that had an individual policy, eight were covered at work. And let me tell you something about that work coverage. Yep, they are required to have a minimum actuarial value, ironically, the same 60% Republicans want to rescind on the individual market. It makes the mind reel.
And here is the other thing. Those employer provided plans, they are guaranteed issue, no underwriting, other than flat demographics, sex and age, period. Well, for the first year anyway. After that, it is all claims history with that provider. What a shit show. The point is, if you can work, you can get health insurance. The point of the ACA, you don't have to be dependent on it. And yes, the ACA damn near destroyed the individual health insurance market, good riddance if you ask me. It was just nasty.
But boy howdy, did the ACA bring opportunity to those that needed it most. I don't think there is any doubt. GDP growth, under the first Trump administration, was anemic at best, even prior to Covid. And in the end, the only thing that turned it positive, the ACA, for ******* real. And sad to say, but that is salt in the wounds of the Republicans.
You don't have to dig deep in that report. Some of it is comical. They shoot themselves in the foot more than once. It is theater, nothing more. And the proposals, really, nothing more than back to the way it was, well, probably without the whole actuarial value thing, not like it meant anything anyway. Insurance is a scam, on all of us. Yes, you can win, but you can also win at the Blackjack table in Vegas. You got better odds there.
I mean I know. It looks like this is going to get us to the place the Republicans, and most certainly, the insurance companies, and the businesses, want it to be. And I am here to tell you, it isn't good for you or me.
