The Republicans have officially (and finally) released their long awaited Obamacare replacement. They are making history here. There is no precedent for repealing a major social benefits program that has already affected millions of Americans. Can the GOP not make history for something positive yet? I didn't realize it was that difficult -- but then again, we have different opinions on "positive."
Not to mention, the plan was released without a Congressional Budget Office score -- or CBO score -- which would tell us how much the plan costs and how many people would be covered.
The Bill dismantles Medicaid by transferring the program to the states, who will receive funding on a per capita basis. It also eliminates the "coverage mandate" that was quite a controversial aspect of Obamacare.
- The Bill provides tax credits for people to purchase insurance based on age.
- Example: Twenty-year-olds can receive a tax credit worth $2,000, and the credit grows the older a consumer gets. A 60-year-old can receive a $4,000 tax credit.
- The Bill accounts for income differences through tax credits.
- The tax credits start to be reduced for a person making more than $75,000 and a couple making more than $150,000 to ensure that high-income patients' insurance isn't being federally subsidized.
- The plan expands the potential use of Health Savings Accounts (HSAs).
- It raises the allowed contribution to over $6,000 per person and $13,000 per family.
- The Bad: HSAs. Take note, Republicans. HSAs are heavily weighted towards the rich. Lower income families cannot imagine $13,000. If they had $13,000 lying around, they wouldn't be relying on welfare programs in the first place.
- The replacement plan does not require insurers to cover preventative care.
- The Bad: Most health plans must cover a set of preventive services — like shots and screening tests — at no cost to you. Preventative medicine is a critical component of maintaining a healthy population. When preventative care becomes an added cost, these types of measures (think cancer or STD screenings, vaccines, etc) are less likely to be taken by the patient.
- Some Obamacare clauses remain: "pre-existing conditions" clause and young adults can remain on their parents' health insurance until they are 26.
- The Neutral: Insurance companies are still barred from denying those with pre-existing conditions (think diabetes, MS, etc.) from coverage, just like ACA/Obamacare. Same with staying on parents' health insurance.
- Under the replacement plan, Planned Parenthood is ineligible for Medicaid reimbursements or federal family planning grants.
- BAD BAD BAD: Think back to our #StandWithPP post on February 26th. 75% of Planned Parenthood's patients (that means about 3.5 million people) qualify as low-income individuals. Nationwide, about 1 in 5 people are 'low income.' Those are the patients for whom Planned Parenthood uses Medicaid reimbursements and other grants. Awesome.
- By 2020, Medicaid expansion will be completely frozen.
- BAD: No new people will be allowed to enroll under the income-based system; states would be given control to cap the number of enrollees based on population -- leaving many preivously eligible folks uninsured.
Two House committees, the Energy and Commerce & Ways and Means, will examine their portions of the Bill Wednesday, March 8th. Changes could be made at that time. The Bill must then go to a Budget Committee and the Rules Committee before heading to the full House, which Republicans hope will happen before Easter.
- Find out if your representative is on either the Energy and Commerce committee or the Ways and Means committee by following these links. Then call and lambaste them for not standing up against this bill.
If your senators and reps aren't saved in your phone yet, text your US postal address to (520) 200-2223 and get a text back with your STATE & FEDERAL legislative rep phone numbers.
- Sign this petition from Sen. Martin Heinrich (D-NM), my boi!
- If you're interested in the details of what we're losing, check out Politico's Guide to Obamacare.
- Here's a piece by the Washington Post, because they definitely understand this better than Callie and I (unless they're just sitting at their computers exchanging expletives via Google Hangout, too).
- Also linked above, you can read the entire replacement bill here.
- More on Health Savings Accounts and 45's impossible health care plan from the LA Times and ThinkProgress. In brief, HSAs are a bunch of Republican propaganda that operate as tax havens for the rich. Not to mention they are historically unpopular when citizens are given the option.
In the end, the OMB found the proposed replacement would not provide enough credits to sufficiently help lower-income people, AND the program is too expansive to slash federal spending as the GOP wanted to do by cutting the ACA.
In other news, I will pay a current Congressional intern to "accidentally" run into and step violently on Paul Ryan's toes in the halls of Congress. Contact me here.