|Don't see how this ends well for Republicans. See any "liberal activists?"|
First, the tweet that tells the protesters they're on the right track.
The so-called angry crowds in home districts of some Republicans are actually, in numerous cases, planned out by liberal activists. Sad!— Donald J. Trump (@realDonaldTrump) February 21, 2017
The problem for Trump is that they're not "so-called." They're freaking angry, and they're not "liberal activists," they're called constituents. Also, they're angry about losing Obamacare. And the Republicans are intent on taking it away and giving back a shittier plan.
WASHINGTON — House Republican leaders on Thursday presented their rank-and-file members with the outlines of their plan to replace the Affordable Care Act, leaning heavily on tax credits to finance individual insurance purchases and sharply reducing federal payments to the 31 states that have expanded Medicaid eligibility.
Speaker Paul D. Ryan and two House committee chairmen stood with the new secretary of health and human services, former Representative Tom Price of Georgia, preparing Republican lawmakers for a weeklong Presidents’ Day recess that promises to be dominated by angry or anxious questions about the fate of the health law.
But the talking points they provided did not say how the legislation would be paid for, essentially laying out the benefits without the more controversial costs.
It also included no estimates of the number of people who would gain or lose insurance under the plan, nor did it include comparisons with the Affordable Care Act, which has extended coverage to 20 million people.
With the House proposal’s rollback of Medicaid payments to the states, it appears likely that the number covered would be smaller.
House Republican leaders asserted in a document describing their plan that they would not “pull the rug out from anyone who received care under states’ Medicaid expansions.”
But Kenneth E. Raske, the president of the Greater New York Hospital Association, expressed alarm, saying the proposals would “put a huge amount of pressure on state budgets and put many Americans at risk of losing health care coverage.”
Sketchy as the outline was, it envisions major changes.
It would fundamentally remake Medicaid, a Great Society program that provides health care to more than 70 million Americans, not just the poor, but also middle-class people who have run out of money and need nursing home care. Under the plan, Medicaid, an open-ended entitlement program designed to cover all health care needs, would be put on a budget.
The Affordable Care Act’s subsidies, which expand as incomes decline, giving the poorer people more help, would be replaced by fixed tax credits to help people purchase insurance policies. The tax credits would increase with a person’s age, but would not vary with a person’s income.
And new incentives for consumers to establish savings accounts to pay medical expenses still assume that workers would have money at the end of a pay period to sock away.The picture so far:
- The essential features right now of the Republican plan is to remove the original funding for Obamacare and pay for it with reduced spending on Medicaid. That can only reduce the number of people who can get Medicaid and/or reduce the amount of care available.
- Also, they want to block-grant Medicaid money to the states and cap it for the future.
- Next, they want to remove subsidies and replace them with tax credits that favor age over income. That leaves the young and middle-aged poor and lower-income people with reduced care.
- And they want to push health savings accounts, which working-class people have little or no money to invest in, though it's a boon for the wealthy who can use them as tax deductions.
- They also are proposing that we tax work-based health insurance previously protected. That will increase the costs for people currently getting their insurance from work.
- They also want to reintroduce insurance plans that offer bare-bones coverage that young shoppers favor. The problem is that the income from these plans don't help pay for high-risk customers like those with preexisting conditions.
- Those with preexisting conditions they want to put into high-risk pools with subsidy support. Those were tried before and mostly became prohibitively expensive.
- They also won't promise coverage to those with preexisting conditions unless they have "continuous coverage," which looks to be a mechanism for letting people lose their coverage.
- When the risk pools get out of whack, insurers will drop out of the insurance exchanges, leaving some with few or no choices, leading to the collapse of the exchange system. But that's feature, not a bug, of the Republican plan.