Republicans release Obamacare replacement bill

originally posted by: DBCowboy
When they eliminate the ban on interstate competition, it should lower the costs so everyone gets to pay less.

That was already functionally eliminated years ago. Many states have agreements with each other to sell insurance across state lines. Basically, this was already answered through state choice. Here's an article on it

www.forbes.com...

The cliff notes version is that having large enough risk pools in states to make insurance work hasn't happened even though the competition is only among a few states. Furthermore, building doctor/hospital networks is a time consuming and expensive process and the insurance companies just can't do it. Building state networks is hard enough as it is, building interstate networks is even worse, because you also need to sell policies in high enough number that you have the population density to use the network.

a reply to: Aazadan

Thanks for the reply!

It seems the best option would be to save premiums in an HSA, then pay the 30% if necessary or go overseas.

originally posted by: AutonomousMeatPuppet
a reply to: Aazadan

Thanks for the reply!

It seems the best option would be to save premiums in an HSA, then pay the 30% if necessary or go overseas.

I don't know if that will be possible. It does seem that if you go overseas you can't use your HSA without facing some pretty severe withdrawl penalties. But for HSA's themselves, search wasn't being all that kind to me in the document and when I skimmed through it I didn't see specific mention of it (the document is also 130 pages though in my defense). So we'll probably have to wait on a summary for the answer to that.

It's all going to come down to if you're allowed to use HSA's on the fine or not.

The best option is going to be to have health insurance. The problem is that that's not an option for many people (who are also going to lose their subsidies in this). Those same people don't have the money to meaningfully contribute to an HSA either.

originally posted by: trollz

House Republicans have released the American Health Care Act, legislation to replace Obamacare.

The legislation keeps President Barack Obama's signature health care reform's protections of pre-existing conditions, but strips away mandates on individuals and employers, as well as some taxes and subsidies.

House Republicans on the Energy and Commerce Committee also released plans to repeal and replace Obamacare in a document titled, "Budget Reconciliation Legislative Recommendations Relating to Repeal and Replace of the Patient Protection and Affordable Care Act."

Source

Excellent news here. I'll be excited to see how this shapes up. I'm one of the many people who haven't been able to have health insurance since Obamacare, so hopefully there will be some major changes.

Sad you had to join our group.

Just came across this article

www.nbcnews.com...

Slightly different details but it's making similar claims to what I saw when reading through the bill earlier.

They're going to try to fund health care through an age based $2000-$4000 tax credit (aka entitlement), for healthy people and then a state subsidized high risk pool for sick people. The subsidy for the high risk pool is 15 billion for now, and will drop to 10 billion after 2021. Which is very underfunded, currently the expectation is that the high risk pool needs to be atleast $178 billion. Anyone with a preexisting condition goes into the high risk pool.

In my case, I have sleep apnea, as well as something else I don't want to disclose. That puts me in the high risk pool which means (once I start working atleast, which could be pretty soon) I could be facing premiums as high as $1000/month.

Aside from the tax credit though, they're looking at HSA's and expanding their role. Currently HSA's allow for a maximum of $9000/year placed into them. I think those limits are remaining in place, but what they can be used on is expanding. In the average case of someone in the 30k income range, they'll typically be able to put in about $1000 tax free if my understanding is right ~13% in federal tax on 30k is $4000. $3000 (if over 30, under 60) goes back in your refundable tax credit, which means $1000 in tax credits are available to put into your HSA, for "free".

So, we're looking at an annual health care budget for such a person of $4000. I think that's doable, but I don't have enough grasp of the insurance industry to state what type of benefits that will present.

I will say, I like parts of this plan. I like that the money isn't (mostly) coming from the government, and that people are free to choose or not choose whoever they want to deal business with (that penalty rate was well chosen). Parts I dislike though, are that if you're in the 25% of the population who cannot afford any care... you're in trouble. The other part I dislike is that this is being funded by redirecting income tax money to the private sector. That's 47% of the nations income. I want to stay as non political as possible here, but we have a lot of proposed spending increases coming up soon, and even some proposed tax cuts. How can we afford this?

The answer, is that we can't. I don't see how these numbers work out. If implemented in this fashion, more revenue will need to be raised through hidden taxes and fees. Like sales taxes, VAT's, higher court costs, policemen being tax men, etc...

I'm open to the idea but I don't see how this program is getting funded as it's written.

Could anyone explain that to me?

a reply to: trollz

I Also Hear that the Congress and Senate get to Read it BEFORE it becomes a Bill . Ain't Freedom Great Again ?

They get to read it? really, no like We have to pass it to know what's in it?

What a victory.



The bill still let the corrupted Insurance companies dictate policies.

I don't like it.

a reply to: marg6043


Some People are Still Protesting the End of Obamacare , but Not that Much.........

a reply to: Logarock

letting people keep more of the money that they work for isn`t a handout.

a reply to: Zanti Misfit

Ha, ha, to bad I am stuck with a higher insurance bill, that is not going down for sure.

But at least the mandate is gone.

a reply to: marg6043

The " Mandate " By the State was Communistic in Nature . It Did Violate the Constitution .The Supreme Court Knew this , and the Excuse that it was a " Tax " Left them out of the Loop to Strike it Down .

This is aweful. You have to pay insurance companies for the time you didn't have their service? Who the # thinks that's a good idea?

I hope I'm misunderstanding because I refuse to believe that someone could be so #ing stupid.

originally posted by: Tardacus
a reply to: Logarock

letting people keep more of the money that they work for isn`t a handout.

I disagree. Making everything a tax rebate is the very definition of a handout.

Wait!!!!

How is this better?
Seems like even more people will be uninsured....as the fines will make sure those at the low levels of income cannot afford to get insurance should they get sick.
And the platinum plan as the "gold standard"....WTF???? Some states/areas don't even offer that now!!!!!
IF you make $15,000 or less, I guess you are just not important enough to get medical care with this now bill.

Getting rid of subsidies in favor of tax credits? If a person cannot even afford the current subsidized premiums and HUGE deductibles, they sure as hell cannot afford the full premium...usually at least $500. a month....with the promise of a tax credit. *spit*

And what are "pre-existing" conditions? Occasional life-long migraines? Controlled epilepsy? Diabetes? Flat feet? Glaucoma? Allergies? OCD? IBS?
Seems like almost everyone has something, especially as we age.

Only good thing I see so far, at least they are not lying as before and calling it "affordable"

Imagine that. A short bill released to the public before being voted on and made law.

That is how it's done Democrats. Please take notes.

a reply to: DontTreadOnMe

Bronze plans, assuming you even consider them insurance (with a 60% copay and $10,000 deductible I certainly don't), run about $2000/year according to the site I linked earlier. How much they actually are, I'm not sure so I'll go with that value. Assuming you're in the 30-60 range you'll get a $3000 tax credit. Of course, in order to get a tax credit you need to have made that much money in the first place. $2000 at a 12% effective federal rate corresponds to making $17,000 per year. If you make less than that, as about 20% of people do, you basically won't be getting insurance.

Furthermore, since you won't be able to buy insurance, you'll start accumulating a fine which locks you out of buying it in the future. And most low income coverage like Medicaid is going to disappear since the expansion is being defunded. Essentially this plan is going to take approximately 20% of people off insurance with no way to get it. And another x% of people off insurance when they decide it's a better risk to pay a backdated 30% penalty rather than 100% of a plan because they're healthy. Basically, the people who are healthy and make enough to get the subsidy can stick the subsidy and a portion of their income in an HSA ($3000 subsidy, up to another $6000 from income), and then when they do develop something serious, pay the fine out of the HSA, and then have insurance to cover it.

I suppose that's all fine, but it's going to have a significant impact on our taxes. You can't just redirect the 47% of federal income that's currently obtained through income taxes to health care, and not have a plan to add more revenue generating taxes into the fold. Especially in a time where the President is proposing numerous spending increases.

Like I said in the other one...

Neither party has truly addressed the elephant in the room (insurance industry) and yet people will still argue by who's side is better.

There are better options out there... one example is the Surgery center in Oklahoma that has drastically cut costs if you have private insurance or will pay in cash. (obviously this will not work for all people with long term health problems)

Surgery Center of Oklahoma

Surgery Center of Oklahoma started posting their prices online about four years ago. Click here to see the online prices at Surgery Center of Oklahoma. The prices are all-inclusive quotes and they are guaranteed. "When we first started we thought we were about half the price of the hospitals," Dr. Lantier remembers. "Then we found out we're less than half price. Then we find out we're a sixth to an eighth of what their prices are. I can't believe the average person can afford health care at these prices." Their goal was to start a price war and they did. Their first out-of-town patients came from Canada; soon everyday Americans caught on. Matthew Gang, 22, tore his patella tendon, dislocating his knee-cap playing basketball earlier this year. Gang is from California and he is uninsured. Surgery in his home-state was going to be about $30,000. The posted price at Surgery Center of Oklahoma was $5,700, one-fifth the price. Matthew and his father Tom Gang flew from California to Oklahoma for surgery. "It was well worth it," Tom Gang said. "I need a rotator cuff surgery right now. I'm thinking about flying out there and having my surgery because it was such a positive experience for us." A handful of other Oklahoma medical facilities have started joining Surgery Center of Oklahoma in price transparency: McBride Orthopedic Hospital Oklahoma Heart Hospital Cancer Specialists of Oklahoma Breast Imaging of Oklahoma Comprehensive Diagnostic Imaging Surgery Center of Oklahoma does accept private insurance, but the center does not accept Medicaid or Medicare. Dr. Smith said federal Medicare regulation would not allow for their online price menu. They have avoided government regulation and control in that area by choosing not to accept Medicaid or Medicare payments.

Maybe instead of continuing to follow the old model we need to start trying (I hate this term) thinking outside the box for a new way to do things.

If surgery can be done at an affordable level for cash paying customers, what other areas can the cost be adjusted?

Now obviously not everyone cant shell out a couple grand in one go to pay for surgery, and there should be a system for those people... But the place in my example has been doing this for at least 4 years now so they must be having success, so maybe that is an avenue that needs to be explored.

a reply to: Irishhaf

there are current laws with Obamacare that punish medical facilities if they charge less. They would not get reimbursed if they didn't get charged the prescribed amount determined by the government.

I haven't read all of it, but I hope things like this get addressed.

a reply to: Aazadan

Although I still have no way to know how doable it is, I still like my idea best.
Make something separate from Medicare, but modeled on it.

Make cover 60-75% of coverage. Make it less than x% of income.....VERY affordable....like $200 a month. Anbd like with Medicare, the premiums go up with income.....say $275 after $50,000 and double after $100,000.....

You want more? You go to Blue Cross or Humana.....and buy a supplemental policy. Different policies for different needs and ages.

And ANY plan that does not deal with the horrible rise in drug costs....is not going to help the HC crisis in America.

a reply to: DBCowboy

yep that is one of the reasons they do not take medicare or medicaid, if they took that insurance they would be bound by the federal regulation, by restricting it to private insurance or cash payments they technically are not bound.


but I have trouble following the legal speak so I may be misunderstanding, for the most part I assume their lawyers went over the regulations with a fine tooth comb before they tried this.