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Politics : Formerly About Advanced Micro Devices -- Ignore unavailable to you. Want to Upgrade?

To: i-node who wrote (1005971)	3/14/2017 1:33:33 PM
From: bentway	Read Replies (1) \| Respond to of 1575190

No Magic in How G.O.P. Plan Lowers Premiums: It Pushes Out Older People Margot Sanger-Katz @sangerkatz MARCH 14, 2017 There are a lot of unpleasant numbers for Republicans in the Congressional Budget Office’s assessment of their health care bill. But congressional leadership found one to cheer: The report says that the bill will eventually cut the average insurance premiums for people who buy their own insurance by 10 percent. House Speaker Paul Ryan pressed that point in a series of appearances Monday night, suggesting that the budget office had found that the House bill would increase choice and competition and lead to lower prices. The Senate majority leader, Mitch McConnell, issued a statement saying, “The Congressional Budget Office agrees that the American Health Care Act will ultimately lower premiums and increase access to care.” But the way the bill achieves those lower average premiums has little to do with increased choice and competition. It depends, rather, on penalizing older patients and rewarding younger ones. According to the C.B.O. report, the bill would make health insurance so unaffordable for many older Americans that they would simply leave the market and join the ranks of the uninsured. The remaining pool of people would be comparatively younger and healthier and, thus, less expensive to cover. Other changes would help make health insurance skimpier — cheaper, but with deductibles that are higher than those criticized by Republicans under Obamacare. Photo Speaker Paul Ryan at a news conference on the Affordable Health Care Act last week. He has said that increased choice and competition will lead to lower prices. Credit Gabriella Demczuk for The New York Times Under the G.O.P. bill, the C.B.O. finds that insurance premiums would first spike, by 15 percent to 20 percent more than under Obamacare over the next two years. But by the end of a decade, the average plan would cost 10 percent less than it would under the Affordable Care Act. (Over all, though, 24 million fewer people would have insurance, it found.) Insurers price their products by spreading out the cost of care for their customers. In general, older customers cost substantially more to cover than younger ones because they have more health needs and use their insurance more. By discouraging older people from buying insurance, the plan will lower the average sticker price of care. But that doesn’t mean prices will get lower for everyone. Currently, the subsidies under Obamacare are devised to help limit how much low- and middle-income Americans can be asked to pay for health insurance. The Republican plan works differently. It increases the amount that insurers can charge older customers, and it awards flat subsidies by age, up to an income of $75,000. On premiums alone, prices would rise by more than 20 percent for the oldest group of customers. By 2026, the budget office projected, “premiums in the nongroup market would be 20 percent to 25 percent lower for a 21-year-old and 8 percent to 10 percent lower for a 40-year-old — but 20 percent to 25 percent higher for a 64-year-old.” But the change in tax credits matters more. The combined difference in how much extra the older customer would have to pay for health insurance is enormous. The C.B.O. estimates that the price an average 64-year-old earning $26,500 would need to pay after using a subsidy would increase from $1,700 under Obamacare to $14,600 under the Republican plan. Share Your Story: Replacing the Affordable Care Act The Times would like to hear from Americans who purchased health insurance under the Affordable Care Act. Perhaps unsurprisingly, the C.B.O. concludes that many, many fewer 64-year-olds will continue buying insurance in this market. By 2026, the uninsured rate for those 50 to 64 earning less than about $30,000 would more than double, from around 12 percent to around 30 percent. Those older customers who would lose out on insurance coverage are more likely than the young customers who would buy it to need help paying big medical bills. Mr. Ryan has said that it is appropriate that the G.O.P. plan will cause more Americans to go without health insurance because it doesn’t have a mandate that people buy coverage or pay a penalty. “We’re saying the government’s not going to force people to buy something that they don’t want to buy,” he said on Fox News Monday afternoon. “And if we end an Obamacare mandate that says you must buy this government one-size-fits-all plan, guess what? People aren’t going to buy that.” But the C.B.O. did not conclude that insurer competition would increase in this new policy environment, or drive down premium prices. And poor, older customers whose insurance costs more than half their income may not really have much of a choice. The Republican plan is designed to pass using a special budget procedure requiring only 50 votes in the Senate. As a result, it doesn’t do much to change the regulations on health insurance that many Republicans believe have made insurance costly under Obamacare. Insurers will still need to charge sick and healthy customers of the same age the same price. And all plans will still need to cover a minimum package of benefits that include maternity care and treatment for drug addiction.The bill does make some changes to how much health insurance plans can ask customers to pay before their coverage kicks in. Under Obamacare, poorer customers get help not just with their premiums but with deductibles and co-payments for their plans. That means that even the hypothetical older customer who could pony up $14,600 for insurance under the G.O.P. plan would also pay substantially more out of pocket for any health care services. And changes to the requirements for health plans mean that, across the board, deductibles and cost-sharing will increase. So the average plan that the C.B.O. says will be cheaper will also be less generous than a comparable Obamacare plan. Finally, the C.B.O. concludes that new funding in the law, intended to compensate insurance companies for the cost of caring for the sickest patients, may also help stabilize premiums. That provision is set to expire after 2026, just after the C.B.O.’s evaluation period ends.

To: i-node who wrote (1005971)	3/14/2017 1:38:04 PM
From: koan	1 Recommendation Recommended By bentway Read Replies (2) \| Respond to of 1575190

How come you can't understand that young people paying for all peoples insurance is how insurance works. Safe drivers pay for unsafe drivers. There has to be a pool of people to spread out the cost. I can see your problem now you don't understand how insurance works and you don't understand how insurance works in relation to keeping society healthy wealthy and wise. You can't have people running around with any health insurance any more than you can have people driving around without car insurance.

To: i-node who wrote (1005971)	3/14/2017 1:47:01 PM
From: bentway	Read Replies (1) \| Respond to of 1575190

Republican Sen. Tom Cotton dismisses 3-phase health-care plan: It's just 'spin' One of President Donald Trump's allies in the Senate just took another swipe at Republican health-care plans. Sen. Tom Cotton, a Republican from Arkansas, cast doubts Tuesday on the GOP's "three-phase" plan to repeal and replace the Affordable Care Act. Cotton, a conservative who said the ACA replacement bill cannot pass the Senate without changes, called talk of a three-step process "political spin." "There is no three-phase process. There is no three-step plan. That is just political talk. It's just politicians engaging in spin," Cotton told radio host Hugh Hewitt. Andrew Harnik \| AP Sen. Tom Cotton, R-Ark. The White House and House Speaker Paul Ryan have outlined three phases for their plan to repeal and replace the ACA, also known as Obamacare, and fulfill a key GOP campaign promise. First, the GOP wants to pass the American Health Care Act, the bill working its way through the House that faces opposition from both moderate and conservative Republicans in Congress. Republicans are using budget reconciliation, meaning it only requires a 51-vote majority in the chamber, where the GOP holds 52 seats. It then would involve administrative actions by the Trump administration and Health and Human Services Secretary Tom Price. That would be followed by more legislation, possibly including a law allowing insurance sales across state lines. Cotton contended that the second step would face court challenges and likely get hung up in the judicial system. The third phase, meanwhile, could not use the budget reconciliation process the GOP is using for its current bill and would need Democratic support to clear the Senate. Cotton thinks clearing all of those hurdles is unlikely. "If we had those Democratic votes, we wouldn't need three steps. We would just be doing that right now on this legislation altogether. That's why it's so important that we get this legislation right, because there is no step three," Cotton said. Enough Republican senators have opposed the bill in its current form that passage in the chamber seems unlikely. At least 12 GOP senators have already objected to portions of the bill, according to Vox.

To: i-node who wrote (1005971)	3/14/2017 2:21:59 PM
From: bentway	Read Replies (1) \| Respond to of 1575190

"Whoever is careless with the truth in small matters cannot be trusted with important matters". Albert Einstein

To: i-node who wrote (1005971)	3/14/2017 2:26:57 PM
From: bentway	Respond to of 1575190

Close Trump friend says ditch Paul Ryan's plan and embrace universal health care Newsmax CEO Christopher Ruddy calls for Medicaid for all. Updated by Matthew Yglesias @mattyglesias matt@vox.com Mar 14, 2017, 1:30pm EDT A key Trump friend and ally is urging the president to dump Paul Ryan’s Affordable Health Care Act and embrace something that sounds sort of like a lightweight version of a single-payer health care system. Christopher Ruddy, CEO of the conservative Newsmax brand, isn’t normally considered a major thought leader on policy issues, but he is a longtime friend of Trump’s, and counts as one of a relatively small number of conservative players who have closer ties to Trump than to congressional Republican leaders. And he is warning loud and clear that Trump “could inherit the bad political baggage of both Obamacare and the House Republicans” if he insists on going along with Ryan’s version of repealing and replacing Obamacare. Instead, Ruddy puts forward the rather radical notion that Trump should attempt to live up to his campaign promises on health care rather than signing on to legislation that betrays them all. To do it, he encourages Trump to ditch his effort to court the Freedom Caucus and instead come up with a bipartisan plan that accepts a large government role in providing insurance coverage. The Ruddycare seven-point plan In an op-ed published Tuesday, Ruddy argues that Trump “should be sticking to his own gut on healthcare reform.” He did this during the campaign, which helped him “win Democratic states like Wisconsin, Michigan and Pennsylvania.” And he offers the following seven-point “game plan for Trump to regain the initiative”: 1. Ditch the Freedom Caucus and the handful of Senate Republicans who want a complete repeal of Obamacare. They don't agree with universal coverage and will never be placated. 2. Find a few parts of Ryancare II [i.e., the AHCA; Ryancare I refers to Paul Ryan’s longstanding desire to privatize Medicare] that can win passage in the House and Senate with either GOP support or bipartisan support. Declare victory. 3. Rekindle the bipartisanship in Congress that President Obama destroyed. Impanel a bipartisan committee to report back by year's end with a feasible plan to fix Obamacare. 4. Reject the phony private health insurance market as the panacea. Look to an upgraded Medicaid system to become the country's blanket insurer for the uninsured. 5. Tie Medicaid funding to states with the requirement that each pass legislation to allow for a truly nationwide health care market. 6. Get Democrats to agree to modest tort reform to help lower medical costs. 7. While bolstering Medicare and improving Medicaid, get Republicans and Democrats to back the long-term fix of health savings accounts. This allows individuals to fund their own health care and even profit from it. As a pure political strategy, the key elements here are probably the first three points. A commission probably won’t lead to any major changes, but that’s okay. According to the Congressional Budget Office, the Affordable Care Act exchanges will probably stabilize in the next year or two even if nothing changes. Trump can do nothing and fix it. But steps 4 through 7 do suggest a route to a possible future vision of American health care. Medicaid for all? The standard progressive prescription for American health insurance has, for decades, been that a Medicare-like program should cover all Americans. That’s what Harry Truman proposed, but interest group politics eventually led Medicare to be defined down to a seniors-only program in order to secure passage in the early 1960s. But while Medicare is the gold standard of government-provided health insurance for the United States, there is also the cheaper Medicaid for low-income families. Medicaid offers stingier reimbursement rates to health care providers, which makes it less costly to the government. But it also makes Medicaid patients much less desirable to doctors and other providers, many of whom don’t accept Medicaid patients. Yet despite the program’s limitations, the evidence is overwhelming that people who receive Medicaid like it. Indeed, surveys tend to show that people who obtained Obamacare coverage via Medicaid are happier with their coverage than those who get subsidized private insurance on the new marketplaces. One could thus imagine “Medicaid for all” as a lower-cost alternative to “Medicare for all.” More affluent people would probably find Medicaid coverage to be excessively restrictive for their taste, in which case they would probably seek to obtain supplemental insurance — a practice that’s common in France and some other countries with national health care systems. But the private insurance system would exist as a layer on top of a basic blanket of security that guarantees health care fundamentals for everyone. You could certain tack health savings accounts (Ruddy’s point 7) on top of this as well. Now, needless to say, embracing this idea would be a huge break with the ideological orthodoxy of the Republican Party. But Trump really did campaign on a promise of universal coverage. And as he told CBS’s Scott Pelley back during the primary, “the government's gonna pay for it.” The GOP establishment’s bet since Inauguration Day has been that Trump didn’t really mean it when he said that. And so far, their bet has paid off. Ruddy is suggesting that maybe Trump should stick to the ideas that let him beat the establishment and win the election. It’s an idea that’s so crazy it just might work.

To: i-node who wrote (1005971)	3/14/2017 2:30:52 PM
From: bentway	1 Recommendation Recommended By Land Shark Respond to of 1575190