Health and financial security Medicaid What's Buzzing

The latest on ACA, Medicaid and Medicare

Written by Diane Archer

This year, Trump’s budget does not include cuts to either Social Security or Medicare. But, sadly, that’s likely irrelevant given that the Republican leadership plans to repeal the Affordable Care Act, drive up costs for people with Medicareand jeopardize care for millions of people with Medicaid. While we still don’t know exactly when Republicans will focus on Medicare, we know Speaker Paul Ryan plans to gut Medicare, if not this year then next year or soon thereafter.

Here’s what we know about the Republican leadership’s agenda: A leaked copy of the Republican plan to replace the ACA reported in Stat, phases out Medicaid expansion by 2020 and turns Medicaid into a “block grant” program. Put differently, instead of Medicaid remaining a defined benefit program that covers everyone who qualifies and provides set benefits, each state would have a limited amount of money to spend on Medicaid. If the money is not enough to cover all benefits or all people who are Medicaid eligible, states would be able to decide what benefits to cut or could limit enrollment.

Who benefits from the Republican plan? Insurers, drug companies and device companies. The leaked Republican plan wipes out ACA taxes on drug and device companies as well as insurance companies. Moreover, as predicted, the Republican plan benefits insurers and puts people at risk by allowing the sale of insurance that does not cover all essential benefits. For example, states could decide that insurers do not have to cover mental health or substance abuse benefits.

Who loses from the Republican plan? McKinsey and Avalere Health estimate that about half of all people covered by the ACA would no longer have health insurance coverage if the leaked Republican plan were to become law. Moreover, the Republican plan allows insurers to charge older members five times more than younger members, meaning that people in their mid-50’s to early 60’s would see large premium increases. The ACA limited the difference in premiums for older adults to no more than three times those paid by younger adults. And, while some people may see premiums drop. they are likely to see their out-of-pocket costs rise when they need essential care that their health plan no longer covers.

It’s still hard to know what will happen on the health care front or when. Trump’s first priority is “tax reform,” which will mean cutting corporate taxes and taxes for the wealthy as well. And, according to his Treasury Secretary, Steven Mnuchin, “We are not touching [Medicare and Social Security] now. But, one thing we do know, big health care changes are in the offing.

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1 Comment

  • …this is totally unacceptable. As a senior on limited Social Security benefits there is no way I could afford a major portion of my meagre benefits a month for a programme that covers very little, has a “yuge” deductible, high copays and out of pocket expenses (before the subject of Medicare is brought up, Lyin’ Ryan and his Right Wing Posse want to gut that too). Block grants never work. In the past they went more to administrative and even unrelated costs than to those they were supposed to help. In states like Wisconsin which is led by a governor who would love nothing better than the destroy the social safety net, they could easily end up supporting private insurance and healthcare firms rather than residents who are in need of medical care. Keep in mind this man almost single handedly drove Wisconsin’s economy into the ditch, and felt that keeping a losing NBA team in Milwaukee was a bigger priority than public education and the state’s top notch university system. Putting someone like him in charge of block grants would be a very, very bad idea.

    While 45 (as many call out current president) keeps saying he will not cut or privatise Social Security, Medicare, and Medicaid, it is often hard to take his words beyond face value. Furthermore should he be forced to step down or do so on his own accord, that puts Mike Pence in the Oval office which would effectively give the greenlight to Lyin’ Ryan’s plans as he (Pence) is more in line with his party’s “slash and burn” policies with regards to social programmes (we could even see medical CBD cannabis threatened which has been proven to be a safe non debilitating alternative to dangerous addictive opioid pain killers or gut and heart rotting NSAIDs as he is on record as being strongly opposed to the plant’s use).

    The ACA may not be perfect but it is still a big step in the right direction. Many of the “undesirable” features came about through compromise to make it more appealing to the obstructionist Republicans in Congress, and even then, they rejected it. The entire issue was nothing more than partisan politic games with healthcare as the “football”, and in all those years, the Republicans never advanced a concrete alternate proposal (even though claiming they had one of their own). From the get go in January of 2009, a core of the party’s right wing set out to oppose and stifle anything and everything that Mr Obama proposed in an attempt to make him a “one term president”. This is why on measures such as the ACA he turned to issuing Executive Orders to make it so (of course now that 45 is in the white house many of the Republican majority has no problem with their boy signing a prolific number of EOs in just his first month in office).

    I have a meme that pretty much sums up what we are heading towards:

    “Due to Recent Cutbacks, The Light at the End of the Tunnel Has Been Turned Off”

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