“insurance for everybody,” Trump prepares to escalate attack on health care
By Kate Randall
17 January 2017
he is close to completion of a plan to replace the Affordable Care Act that
will include “insurance for everybody.” In comments to the Washington
Post late Saturday,
the president elect said of his proposal, “It’s very much formulated down to
the final strokes. We haven’t put it in quite yet but we’re going to be doing
that under his plan people “can expect to have great health care” that is “much
less expensive and much better” as so much hogwash. He has not provided any
specifics on how he will achieve a replacement plan with “much lower
deductibles,” and a simplified and less expensive system in which all Americans
are “beautifully covered.”
secretary of Health and Human Services, Rep. Tom Price, Republican of Georgia,
to be confirmed. Price’s hearing before the Senate Finance Committee has yet to
be scheduled. Trump said he would present his plan alongside Republicans House
Speaker Paul Ryan of Wisconsin and Senate Majority Leader Mitch McConnell of
passage Friday by the Republican-controlled US Congress of a budget resolution
that will be used to roll back the health care legislation popularly known as
Obamacare. Votes in the House and Senate, largely along party lines, have
cleared the way for ending major funding provisions of the ACA through the
filibuster-proof “budget reconciliation” process.
ACA put forward so far, including Trump’s, call for drastic cuts to Americans’
health care coverage. These include the elimination of modest government
subsidies to help defray premiums costs, and attacks on benefits through
Medicaid, the health insurance program for the poor jointly administered by the
federal government and the states.
Medicare, the government health insurance program for the elderly, targeting
the program used by some 55 million seniors and the disabled for privatization
and ultimate dismantling.
pro-corporate, pro-health care industry law, designed to cut costs for the
government and boost the profits of the private insurance companies. The ACA’s
“individual mandate” requires those without insurance from their employer or a
government program to purchase coverage from private insurers or pay a tax
come with deductibles in excess of $5,000 and other high out-of-pocket costs,
and premiums have risen an average of 20 percent this year.
the Republicans, with Trump at the forefront, from denouncing Obamacare from
the right as a bureaucratic and repressive government dictate against patient
“freedom.” In its place, they seek to fashion legislation even more heavily class-based,
in which health care is rationed for the vast majority of the population while
the private health insurers, pharmaceuticals and giant health care chains
continue to boost their profits.
hold the pharmaceutical industry’s feet to the fire to lower drug costs cannot
be taken any more seriously than his claims that everyone will be insured, with
“better,” “less expensive” coverage under his Obamacare replacement plan.
claims, here’s some of what we do know about the Republicans’ proposals for
health care “reform”:
Medicaid block grants
block-granting Medicaid. All of their plans advocate rolling back the expansion
of Medicaid that has taken place under Obamacare, and transforming federal
support for the program into fixed grants to the states to administer the
program as they see fit.
gained insurance under the ACA, an estimated half of these did so through
Medicaid and CHIP (Children’s Health Insurance Program). Under current law, the
federal government picks up a percentage of states’ Medicaid costs, about 57
percent on average.
capped dollar amount, which would increase by a fixed amount, tagged to
inflation or another measure. These increases would not keep pace with health
care costs, e.g., when enrollment is greater than expected due to rising
unemployment in a recession, or with increased medical costs as a result of
epidemics or new illnesses like Zika.
either through raising taxes on their residents (an unlikely scenario) or by
making draconian cuts to eligibility, benefits and provider payment rates. The
cruelest result would be that some of those who should be eligible for
Medicaid—the very poor, as well as some pregnant women, seniors and the
disabled—would not receive any benefits.
block grant proposal found that between 14 and 21 million people would
eventually lose their Medicaid coverage. This would come on top of those losing
coverage through a repeal of the expansion of Medicaid under Obamacare.
Priorities, the House Republican budget plan for fiscal year 2017 would have
cut federal Medicaid funding by $1 trillion—or by nearly 25 percent—over 10
years, on top of the government savings from repealing the ACA’s expansion of
the program. By 2026, federal funding for Medicaid and CHIP would have been
about 33 percent less than under current law.
Mandates and subsidies
the “individual mandate” to purchase insurance and the ACA subsidies to offset
the costs for consumers. They also simultaneously relieve businesses of the
responsibility to provide insurance to their employees.
regard beyond calling for a repeal of the mandate. Price’s “Empowering Patients
First Act” would provide fixed tax credits pegged to age instead of income.
These would range from $1,200 for people aged 18-35 to $3,000 for those 51 and
older, for an entire year. This
would barely begin to cover premiums and out-of-pocket costs for a relatively
comprehensive insurance plan.
Cut-rate plans, rising premiums
his version of Obamacare replacement on Sunday, saying that he and other
congressional Republicans have all made attempts to “insure the most amount of
people, give access to the most amount of people, at the least amount of cost.”
we’re going to legalize the sale of inexpensive insurance,” Paul told CNN.
“That means getting rid of the Obamacare mandates on what you can buy.” In
other words, “access” to health care would mean health coverage that may be
lower cost, but offers scant benefits.
population—who may take a chance on such coverage, which may not offer basic
preventive and other services—while making more comprehensive plans needed by
the less healthy and older population expensive and out of reach.
while eliminating the individual mandate he would still require insurance
companies to continue covering people with pre-existing conditions, which would
either cause premiums to skyrocket or cause insurers to pull out of the
insurance market altogether.
of “universal access” to health insurance coverage, such “access” does not
necessarily mean everyone will be able to afford it. In particular, in the case
of those thrown off Medicaid, they would be “free” to buy insurance on the open
market at a cost that’s far out of reach.
presidential campaign when he promised to “not have people dying on the
street.” That the president-elect felt obliged to point this out should provide
cold comfort to those threatened with loss of their health coverage. Who can
believe this charlatan when he says: “They’ll be beautifully covered. … What I
do want is to be able to take care of people”?