Here is a link to an official summary and full text of the
Health Care Act of 2017 that the House passed.
SUMMARIES are here:
Clic on the drop down box to read the second summary.
ACTUAL TEXT OF THE BILL is here:
WHAT THE REPUBLICAN
BILL DOES:
Here is my summary of the key provisions of the bill
The bill eliminates funding for the Prevention and Public
Health Fund that invests in programs to improve health and restrain the rate of
growth of health care costs. This fund
currently provides about 12% of the funding for the Centers for Disease Control
and is an important funding mechanism for public health departments. The CDC’s former director, Tom Frieden, said
that if the prevention funding is lost, “Americans will be at greater risk from
vaccine-preventable disease, food-borne infections, and deadly infections
contracted in hospitals.” https://www.washingtonpost.com/news/to-your-health/wp/2017/03/08/obamacare-repeal-guts-crucial-public-health-funds/?utm_term=.3db5f2c7cad9
The bill eliminates funding for Planned Parenthood for one
year.
The bill fazes out funding for the Medicaid Expansion between
now and 2020 and eliminates the requirement that Medicaid provide “Essential
Health Benefits”-- ambulatory patient services, emergency services,
hospitalization, maternity and newborn care, mental health and substance use
disorder services, prescription drugs, rehabilitative services, laboratory
services, preventative and wellness services, and pediatric services.
The bill changes and limits the Federal funding for
Medicaid. Instead of picking up the full
cost, the Federal Government will now provide a fixed amount per enrollee or a
block grant. States will have to make up
the difference or limit enrollment. Long
term this may result in a substantial cut in the number of people eligible for
Medicaid that states can cover. Millions
who might otherwise be covered with Medicaid will have no health insurance.
If a person seeking insurance in the individual or small group
market has a break in coverage (no health insurance) for more than 62 days in the
previous year, then the Republican laws says insurance companies MUST charge
them 30% extra for their insurance for a period of one year.
Beginning in 2020, health insurance benefits no longer must
conform to actuarial tiers (e.g., silver benefits, gold benefits, etc.) These “actuarial tiers” provide a comparison
of how good a plan is relative to the approximate amount of a person’s health
care expenses the plan will cover. The
least expensive Bronze plan under Obamacare has an actuarial value of 60%-in
other words covers about 60% of an average enrollees health expenses. Under the Republican plan, Health insurance
companies could offer much less generous plans—for example, a Coal Plan that
would cover 10% or less of the average person’s health expenses. See more about the actuarial tiers here: https://kaiserfamilyfoundation.files.wordpress.com/2013/01/8177.pdf
Insurance companies may charge older individuals up to five
times more than younger individuals. The
current ratio is three times more. People
over 60 would pay much more than under Obamacare for the same level of coverage. People in their 20s would pay less.
The fine for not having health insurance is reduced to 0% or
$0.00 compared to 2/5% and $695 under current law. This is the Republican way of eliminating the
Individual Mandate. The mandate remains,
but the fine is $0.
The bill repeals almost all taxes imposed by Obamacare
designed to pay for the cost of the program. Eventually, whatever is left of
Obamacare will be starved for lack of funding.
The bill ties tax subsidies (really advanced tax credits)
for the purchase of insurance strictly to age without consideration of the
actual cost of insurance for an individual in a market and/or the individual’s
income and ability to pay. Individuals
in their 20s are eligible for a $2,000 supplement. The supplement increases by $500 per age
bracket (people in their 30s get $2,500 but to a maximum of $4,000 for individuals
in their 60s. The supplement is reduced
by 10% for individuals with a Modified Adjusted Gross Income over $75,000 ($
150,000) for couples. Supplements are limited
to $14,000 per year per family and the maximum amount the five oldest
individuals in the family (husband, spouse and dependents) are eligible to
receive based upon age. Older Americans
will find their out-of-pocket cost for health insurance on the individual
market increase dramatically. For
example, the CBO in scoring an earlier version of the Republican plan said the out-of-pocket
cost of premiums after the subsidy for a 64 year-old with an income of $26,000
a year could rise from $1,700 to $14,000, making the insurance unaffordable.
The bill allows states to request a waiver from Obamacare
requirements for insurers to cover everyone at the same price regardless of pre-existing
conditions and the requirement to offer Essential Health Benefits (see
above). While insurers in states with
the waiver would still have to cover people with pre-existing conditions, they
could charge those individuals substantially more thus, in effect, making
health insurance unaffordable for them. States would be required to set up High-Risk
pools to cover people with pre-existing conditions who can’t afford
insurance. The bill provides around $138
billion dollars through 2026 to help these Waiver states pay for the costs of these
High-Risk pools, thus holding down premiums for people with pre-existing
conditions who are forced into these pools.
Note: State High Risk Pool have not worked in the past because the funds
provided to insurers to hold down the cost of premiums for individuals with
pre-existing conditions did not keep up with the ever increasing costs of the
pools. States with waivers could also
allow health insurers to once again place annual and/or lifetime limits on the
amount policies would pay.
THAT’S IT FOLKS. The
elderly and the poor are going to take it on the chin.
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