Tuesday, March 7, 2017

Trump and GOP Fail: ‘Obamacare Repeal/Replace’

So it’s out….. well, at least sort-of-out.
And let me point out a few things about this bill, at least as far as I can determine from reading and cross-referencing it:
  • Idoes not repeal the “penalty.”  It instead moves it to the back end; if you don’t have insurance (by choice) and then buy it, you get hammered with a 30% penalty for a year.  For most people that’s far more than the ACA penalty for not having insurance — it could easily be $3,000 or more!  This is outright fraud on the part of the GOP which said it was repealing the penalty.  Paul Ryan, Donald Trump and the rest are all ****ing liars.
  • Medicaid expansion is essentially ended and cost-pickup for the states is capped to CPI-U’s medical expenditures inflation index on a forward basis.  This will detonate State budgets within about 10 years as the current spend is expanding at ~9% a year but the CPI-U index is less than half that.
  • It does not repeal the prohibition on discrimination in price (or denial) for pre-existing conditions, but it does increase the multiplier for age to 5 (from 3.)
  • IT IS NOT A REPEAL OF THE ACA — not even close.  The vast majority of the ACA remains intact.  The “mandate” is gone but the penalty remains, just shifted to the back side and for many will be far worse than the penalty would have been.  The restriction on what plans you can sell is gone, subsidies are cut, indexed only to age and paid to HSAs instead of directly to insurers. It does repeal many of the “add-on” taxes that paid for the program previously as well.

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