Tuesday, November 29, 2016

Dems discussing merits of competing GOP Obamacare replacements

[Trump's HHS nominee, Rep. Tom] Price’s Empowering Patients plan, like Obamacare, requires insurance plans to offer coverage to any patient regardless of how sick they are. But the Empowering Patients plan, unlike Obamacare, would let insurers charge sick people more if they did not maintain “continuous coverage.”
This continuous coverage policy shows up in a lot of the Republican replacement plans, and is likely something we’ll hear lots of debate about in the coming months. It’s part of House Speaker Paul Ryan’s Obamacare replacement plan, as well as Sen. Finance Chair Orrin Hatch’s proposal.
Here’s how it works: If a cancer patient goes straight from insurance at work to her own policy, her insurer has to charge her a standard rate — it can’t take the cost of her condition into account.
But if she had a lapse in coverage — perhaps she couldn’t afford a new plan between jobs — and went to the individual market under Empowering Patients, insurers could charge her up to 150 percent of the standard premium for her first two years of coverage (you can read this section on page 151 of the bill).
A patient can once again qualify for the standard rate if she maintains 1http://www.vox.com/2016/11/28/13772342/trump-tom-price-obamacare8 months of continuous coverage — although that would likely be with premiums set at the higher rate.
Empowering Patients does have a safety net for people like this: It would invest $3 billion over three years in a high-risk pool to cover those with preexisting conditions who are unable to afford coverage on the marketplace. This is significantly less generous than other Republican proposals for high-risk pools. Ryan’s Better Way plan, for example, would put $25 billion toward the high-risk pools over a decade ($2.5 billion per year) and keep them running indefinitely. In that way, Price’s bill has a much weaker safety net than his House colleagues envision.

36 comments:

deborah said...

It must be a relief to a lot of Dems that there are plans for replacement. If you make enough money, you pay full price. How many will pull for Obamacare overhaul?

Evi L. Bloggerlady said...

Tom Price is an almost perfect pick for President Elect Trump!

deborah said...

Agreed, Trump is playing for realz.

edutcher said...

We'll see.

I'd just like to see the thing pulled. Why have another government program?

That said, Surber makes the point everything Price said would happen with PissyCare has.

I do get the impression a lot of these picks are for one job only and then he gets somebody else; the way Lewandowski was for the primaries, Manafort for the convention, and Bannon and Conway for the final run.

deborah said...

It must be a relief to a lot of Dems that there are plans for replacement. If you make enough money, you pay full price. How many will pull for Obamacare overhaul

Those whose district went Trump, for starters. This is where The Art Of The Deal comes in.

deborah said...

Good point. Then those who do their job well may receive a plum appointment elsewhere.

Sixty Grit said...

What existed prior to Obamacare? Didn't we get along just fine without paying tens of thousands of bureaucrats to prevent people from getting treatment?

Why not go back to that system - you know, where the feds keep their nose out of the medical business and illegals don't get care paid for by citizens.

MamaM said...

It must be a relief to a lot of Dems that there are plans for replacement.

I haven't seen or heard "a lot of democrats" expressing relief or acting relieved about anything since Trump's election, and can't imagine where that supposition is rooted.

This, however, brought a sense of relief to me, reinforcing my belief that Trump is committed to finding and matching the right people to the job:

But in choosing Price, Trump is signaling that he is serious about dismantling Obamacare. He has found one of the law’s most ardent, knowledgeable, and prepared opponents, and put him in charge of the effort.

ndspinelli said...

deborah, you have been making some good posts. One of the most important changes is something that can be made easily and a change Trump has trumpeted often. Make insurance companies compete interstate like ALL other insurance we purchase. Well paid insurance lobbyists have always stopped this. Putting this into law is part of draining the swamp. If lobbyists can't influence legislation, they go out of biz.

bagoh20 said...

The stupid price increases are likely locked in now. When do prices ever go down on things, especially things the government has its nose in.

The are only two possibles controls on prices: 1) forced price controls (stupid and always counter-productive) 2) competition.

Despite its amazing record of success, real competition is rarely encouraged by government policy. Trump understands the value of competition in lowering prices, but nearly everyone in government works against it by nature, and the public mostly just wants free stuff. When was there ever a protest or movement for increasing personal responsibility, demanding people pay their own way, or taking away a safety net, regardless of cost? Good luck. May Trump turn out to be the nightmare the left imagines, but that's a just my hope and change fantasy.

deborah said...

Thanks, Nick. What is the logic for insurance companies not crossing state borders?

deborah said...

Agree, Sixty. All that was needed was to put the people with pre-existing conditions on Medicare.

Evi L. Bloggerlady said...

ed, I concur with your assessment less government is better. But I also understand why there is hesitation, if you just eliminated it would cause more turmoil which will be blamed on Trump (the old system is not there yet, Obamacare destroyed those prior insurance options). Some things do better with "cold turkey" but this one probably would need some transition.

Tom Price is a good man for this. He does want to kill Obamacare and has said so repeatedly (and not just lip service like some of the GOPe).

Evi L. Bloggerlady said...

I concur with what Sixty said too.

Rabel said...

"What is the logic for insurance companies not crossing state borders?"

An excellent question. I've done my research and the answer is - it's complicated. But here's a brief overview:

In 1944 the Supreme Court said, "We, The Court, have been stupid and wrong all these years. The sale of insurance actually IS commerce and selling it across state lines IS interstate commerce which subjects it to federal regulation."

In 1945 the U.S. Congress said, "Fuck you, Supreme Court. We're granting an exemption to the insurance biz freeing them from federal control and giving that control back to the States."

That held up until Obamacare sorta, kinda, but not completely changed the 1945 law which is still on the books. I think it's why we have state run exchanges under the ACA. Maybe.

One other point. There was a time when insurance salesmen were the equivalent of today's Nigerian Princes. Widespread scammery led to regulation and eventually the fight over who got to do the regulatin'.

bagoh20 said...

I too agree with Sixty. By comparison, the pre-Obamacare system was simply marvelous: it was pretty good and the new thing is extremely bad. It's absolutely depressing that all those endless billions of tax dollars were spent to build and rebuild lousy websites, hire armies of bureaucrats with all their offices, and all the mousepads just to create stacks of dumb documents that would reach to the moon - where we still can't return as we did 40 years ago SIX TIMES. Both seem impossisble now: making it to the moon then, and spending so much for nothing now. But hey, we did sign up some people for Medicare. Amazing accomplishment at a discount price. Yeaaaaa!

Sixty Grit said...

Greetings and salutations,

My name is Hon. Justice Roberts, and I write to you with heavy heart in my time of need. The NSAs have got the goods on me and now I needs you to help me with the estate of my long lost brothers. It is 1 million pounds $ in US currency and it is stuck in bank in Colombia, district thereof. Please to sending me your information, regarding name, ID, DoB, SS# and many more and I will depositing said monies in your account forthwith. All in the name of Obama, PBUH, our beloved sainted fearless leader.

Thanking you again for many troubles. May we both not die in our sleeps like my colleague.

John

Rabel said...

ISWYDT

Rabel said...

And you did it well.

Evi L. Bloggerlady said...

You can repeal, with say 12 month window to allow the insurance industry to respond, give individuals the ability to buy insurance over state lines, etc. That solves most of the transition problems.

The big hangup remains pre-existing conditions. If you make it a mandate it drives the rates up as we have seen. Without a mandate they become uninsured. But if you role these pre-existing folks into medicare, then you have kicked the can down the road and just expanded medicare.

Leland said...

Combining two topics; I would like some sort of speech law; call it a marketing thing: Healthcare is not financial insurance. Healthcare is what a medical professional provides directly to a patient. If you are an insurance company or government official, you should not be able to claim you provide healthcare to anybody unless you are doing basic first aid at the time. Obamacare has very little to do with healthcare and nearly everything to do with a specific form of financial insurance.

Rabel said...

OK. That's it. I'm done with Trump. It's over. I take back my vote.

He's putting an Asian female in charge of Transportation. This will not stand. Especially if it stands anywhere near the road.

ndspinelli said...

deborah, There is no interstate competition on health insurance because insurance companies don't want to compete. So, they buy off politicians so that there is no interstate health insurance exchanges. Alleged capitalists like insurance companies hate competition.

Rabel said...

Maybe, ND. But why wouldn't the larger companies be lobbying for interstate sales because it would open more markets to them and allow them the opportunity to dominate nationally? That's a serious question.

AprilApple said...

Leland -

Exactly. Healthcare is not health insurance.

I want to pay for my own healthcare and my own insurance. DAmn it.

deborah said...

Thanks Rabel and Nick. Trump has put an anti-trust lawyer on his team, slated for DOJ, I think. The article I read on that said he would be more sympathetic to mergers than Obama has been.

Good pickup on Chao :)

Sixty Grit said...

Chao time.

Trooper York said...

Look appointing the chink was just a payoff to Mitch McConnell. Now Trump has a hostage. It is the art of the deal.

Plus she is only the Secretary of Transportation. It is also a twofer. A broad and a slant to stop the only white man bullshit. He has a slope and a dot head now. And white guys handling all the important stuff as it was meant to be.

As long as she doesn't force us all to ride bikes like take out delivery guys we are way ahead of the game. Just sayn'

Trooper York said...

I don't care if she stands Rabel.

Just as long as she doesn't drive.

If we do institute rickshaws in Uber we could put a lot of people back to work. Just sayn'

edutcher said...

SecTrans is another of those Cabinet posts we'd all like to see go bye-byes.

As I say, I'm wondering if his picks for these Lynnon and Bucketmouth era posts - Education and HHS (the old HEW, one of Ike's bigger fox paws), Trans, and HUD - are with an eye toward dumping them. All we need is a nonentity at Energy.

PS For those who don't get Troop's "hostage" reference, Ms Chao is the wife of 23 of Mitch McConnell.

edutcher said...

s/b 23 years

edutcher said...

Results.

Carrier Corp stays here, thanks to Trump.

Rabel said...

Winning. And he's still a private citizen. Imagine what he could do if he were President.

Rabel said...

Three days ago:

"President-elect Donald Trump must be held "accountable" for his promise to stop jobs at a Carrier air conditioning plant in Indiana being moved to Mexico, says Senator Bernie Sanders."

Bernie gets results.

ndspinelli said...

Rabel, The health insurance people have done so well over the decades they are quite comfortable w/ the status quo. Yes, competing interstate would mean there will be big winners. But, there really aren't that many health insurance providers compared to auto, casualty, life, etc. Some new companies wanting a piece of this lucrative pie would jump in and the current dominant boys fear that competition and downward pressure on rates. Imagine having as many choices for health insurance that you have for auto coverage.

Methadras said...

I saved on a cliteroectomy by switching to Geico. Oh wait.

ndspinelli said...

LOL!