Oh. My. Gosh.
It is so difficult to make heads or tails out of the current healthcare debate. Both sides of the aisle have “facts” that say opposite things. Did you know that was possible? Did you realize that you can find “facts” to back up any side of any issue? Which of those “facts” are true and which are not? It is difficult-to-impossible to tell.
According to an article written by Charles Ornstein, ProPublica, on March 22, 2017, for Kaiser Health News, millions of previously uninsured people now have medical coverage – coverage that cannot be denied because of pre-existing conditions, and coverage that allows adults under the age of 26 to continue on their parent’s health plans – thanks to Obamacare.
Obamacare promised that people could keep their current health care plans and their doctors, and the cost of premiums would decrease. We know that these promises were not able to be kept. What did, and is still happening, is that insurers are leaving the market, deductibles and premiums are increasing, and providers are opting out of accepting many of health care plans those insured have in place.
In the state of Ohio, the state in which I live, 23% of the counties have only one insurer participating in Obamacare. Is this choice?
According to this Kaiser Health News article, there is an indication that the quality of healthcare has improved since the institution of Obamacare. The article cites a decrease in 30-day hospital readmission rates, and a nebulous statement, “payments have been increasingly linked to patients’ outcomes rather than just the quantity of services delivered”. I would suggest that these statistics have little to nothing to do with Obamacare, and more to do with Medicare and hospital accreditation oversight. Medicare long ago implemented a program that links payment with patient outcomes. Attributing this success to Obamacare is ludicrous
This same article states that the number of uninsured dropped by 12 million from 2013 to 2015. That is significant. However, what this article doesn’t state is that there are fewer providers accepting many of the health insurance that these previously uninsured carry.
Do I dislike Obamacare? Yes, I do. Vehemently.
Do I support Trumpcare? Nope. I don’t like it either.
The American Healthcare Act (aka, Trumpcare) would, in fact, increase the amount insurance companies can charge older adults to five times what they charge young adults, from the three times they charge now. Do I like that? I’m 65 years old (young), and no, I don’t like it. Do I understand it? Yes, I do. We are generally sicker than our younger counterparts. It’s a fact.
Block Grants? The concept of giving a lump sum, based on the state and federal Medicaid spending in each state, to manage Medicaid on the state level. Currently, the amount of federal funding is based upon the financial need of the state. The qualifications for services would be decided by each state.
Is block granting a bad thing? Well, it depends on who you ask. While this idea has been tossed around for decades, it has never been done before. The consequences of block granting is pretty much speculation at this point.
According to another article from January 24, 2017, in Kaiser Health News, Shefali Luthra says that the Congressional Budget Office (CBO) estimates block granting could cut Medicaid spending by one-third over the next decade, starting small and growing larger over the years. Block granting could affect the 10+ million who began receiving Medicaid under Obamacare.
Tax Credits? Both Obamacare and Trumpcare provide tax credits to help folks pay insurance premiums not provided for by employer or government programs. While the Obamacare credit was tied to income (the less you made, the more credit you got), Trumpcare is tied to age (older people getting twice as much as younger). The credits phase out beginning with annual incomes of $75,000 for an individual to $150,000 for families.
Under Trumpcare, many of the taxes increased under Obamacare would be repealed. This would decrease Medicare taxes on high-income earners, taxes on healthcare providers, insurance companies, investment incomes. It would allow additional monies to be saved in pre-tax health savings accounts and decrease penalties when those accounts are used for non-medical needs.
Trumpcare would, in effect, reverse the mandate requiring the purchasing of healthcare coverage for individuals, or for employers to provide it. According to the Urban Institute, the employer mandate had little effect of insurance coverage.
Trumpcare would however, charge a penalty (30% increase for 12 months) for coverage that was discontinued for greater than 63 days.
I am no closer to understanding either of these healthcare options than I was a month ago. The more I read, the more confusing it gets. I honestly don’t think any of the politicians, nor their constituents understand it either.
I don’t believe the federal government should be in the healthcare business. I believe it needs to be handled at the state level. I do believe, however, that however healthcare law comes to be, those politicians should be required to live with the same outcomes as do we the people. A lot would change in the manner healthcare is determined and managed if that were the case.
What is interesting about this article, A Fact Check Finds Many Misleading Letters From Lawmakers On Health Care, is the fact that it debunks many of the ways in which politicians on both sides of the aisle are misrepresenting the facts about Obamacare and Trumpcare. I suggest you give it a read.