GOP may have bitten off more than it can chew

Josh Kim
March 3, 2017

The Maryland Health Insurance Coverage Protection Act is part of a package of bills that Democrats are backing out of concern for how policies supported by President Donald Trump and the Republican-led Congress could hurt Maryland. "We must work together to save Americans from Obamacare", he said.

"Action is not a choice; it is a necessity", Trump said Tuesday.

Listen to the broadcast version of this story. One of the major changes already seen is the repeal of the Affordable Care Act (ACA), to which the GOP offers no clear alternative.

Jamie Raskin (MD-08) and John Sarbanes (MD-03) at a media availability this afternoon following a Maryland delegation meeting to discuss how Republican efforts to repeal the Affordable Care Act will severely impact Marylanders. "Earlier in March is better, but we need to know something in March", said Marilyn Tavenner, CEO of America's Health Insurance Plans, a health insurance industry trade group.

But in IL, which did extend Medicaid to almost all poor adults, patients at Perry Memorial have gained coverage under the Affordable Care Act and many hospitals have found firmer footing. The most popular mid-level silver plan, for example, would see a deductible increase from $4,000 to $5,000 for individual coverage.

If large numbers of people lose their insurance under the Republicans' replacement, the hospital's finances - and those of its patients - would be at risk, especially after the hospital invested so much money and time in complying with the health law, said chief executive Annette Schnabel. Reform should focus on making health insurance more attractive to healthy consumers, and simultaneously making sick consumers more attractive to insurance companies.

He also mentioned that as insurance costs rise, which they are likely to do with or without the ACA, providing employees with access to an HSA will help them pay for increasing health care costs. And she says many are low-income and have no other options.

Second, the tax credit does not adjust for the costs of plans available to the consumer. Our healthcare system has moved from one that rewards quantity of care to one that rewards quality of care - reducing costs and providing better care for patients.

In his speech to Congress last night, Trump insisted that the government shouldn't mandate coverage. There were also huge spikes in cost in Minnesota (55%) and Oklahoma (67%), among other markets.

Roughly 85 percent of the 239,000 individuals with Obamacare in 2016 had premium subsidies, reducing their coverage costs by $332 monthly on average.

Their signs ranged from keeping Medicaid and Medicare intact to keeping - and not decreasing - the Affordable Care Act. A 40-year old resident would pay $267 per month today, compared to $289 per month in 2014.

The most recent draft of the Republican's proposal would eliminate the Medicaid expansion, which covers 14 million people, by 2020.

Another quantifiable cost is Medicaid Expansion, which New Hampshire has agreed to through 2018. Those payments from the federal government used to make up for the cost of caring for the uninsured but largely were phased out when more people became insured.

That generosity is about to expire, however.

Estimates right now put the bill for expanded Medicaid in the state at just under $1 billion for the federal government, and for New Hampshire, at around $44 million over the next two years.

Health and hospital experts Nicholas W. Stine and Dave A. Chokshi: "The opportunity to reinforce a common agenda for medicine and public health is perhaps the greatest promise of health care reform ..."

If you don't spend a lot on health care, the expansion of HSAs could be an advantage, depending on how the expansion is accomplished. Will as many or more people be covered under an Obamacare replacement plan? Conservatives are objecting to new tax credits that would help consumers buy health care, arguing they amount to a costly new entitlement.

Other reports by MyHealthBowl

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