The Senate Republicans’ Better Care Reconciliation Act takes federal money dedicated to America’s poor and gives it to the rich. While Obamacare raised taxes on high-income Americans to subsidize insurance for the poor, the Republicans intend to cut those taxes and reduce federal funding to insure low-income Americans.

So instead of insuring the most Americans and lowering the collective tax burden of uninsured hospital visits, the Republicans’ plan is to insure fewer Americans and increase that collective burden for which we all pay. Those visits by uninsured Americans cost $900 each.

Those likely to be hit hardest are those on Medicaid, which includes nearly 40 percent of all American children. The Republicans are proposing a maximum payment to states per enrollee, and while it’s set to increase annually, it will be at a lower rate than medical costs increase. So Medicaid enrollees will be forced to flip more of the bill or go uninsured. As time goes by, fewer and fewer Americans will be insured, and we’ll be right back in the mess Obamacare fixed.

I realize the Republicans are all about personal responsibility, but they have to realize that many Americans are not personally responsible. A 30-year-old, healthy American who doesn’t partake in dangerous activities (i.e. driving, which is the most dangerous activity) could likely go uninsured and not cost the American taxpayer a dime during the year. But those aren’t the people that caused the health insurance mess in the first place. Insurers have caused this mess, and the Republicans just want to keep paying them more.

The moment this idea for private health insurance came about the average American was screwed. Profiting from people’s health is not unlike the undertaker profiting from death. People will pay anything to live longer, and people will pay just about anything for someone to “make the arrangements” for loved ones who have died. “Just because we’re bereaved doesn’t make us saps!” says Walter Sobchak in The Big Lebowski. Well, people are saps when faced with death, which is exactly why private insurance is wrong on every level.

Faced with death, money's no object. It doesn’t matter how rich or poor you are, you’d give anything you had to live longer. Republicans realize this and intend to take everything you have so you have nothing to give when faced with death. It’s why they take affordable insurance plans and make them unaffordable behind the guise of “personal responsibility,” and it’s why they move federal dollars from benefiting those who need them most to people who don’t need them at all.

I am one of the 74 million Medicaid enrollees that only has insurance because of Obamacare and because my home state expanded Medicaid. I feel sorry for the states that have elected not to expand Medicaid. I pay $264 annually for health insurance. I have made two doctor’s visits in the last year. Before that I was uninsured and paid nothing. At least now I’m creating revenue and saving the American taxpayer money by not making hospital visits while uninsured.

I will lose insurance because of the Republicans’ bill and won’t feel guilty about costing the American taxpayer money if I’m forced to see a doctor while uninsured. Nobody should. This bill will be a disaster for America, and in five years or so, we’ll be attempting to fix the same problem Obamacare fixed. Hopefully, next time, a Medicaid-for-all plan will be the only one considered. Until then, low- and moderate-income Americans will either pay a higher percentage of their income to private insurance companies or go without, raising the tax burden for all Americans. How is this bill supposed to help everyone again? Oh, right. It’s not about everyone for the Republicans. It’s about them and their deep pockets, and the rich people like them.

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If you like this, you might like these Genesis Communications Network talk shows: USA Prepares, Building America, Free Talk Live, The Easy Organic Gardener, American Survival Radio, Jim Brown’s Common Sense, Good Day Health, MindSet: Mental Health News and Information, Health Hunters, America’s Health Advocate, The Bright Side, The Dr. Daliah Show, Dr. Asa On Call, The Dr. Bob Martin Show, Dr. Coldwell Opinion Radio, The Dr. Katherine Albrecht Show

 

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On Thursday, by a slim margin, the vote of 217-213 was one over the 216 votes needed to pass the bill.

 

The AHCA includes an amendment that includes $8 billion in spending over 5 years to subsidize high risk pools that could be affected by the “waivers” offered to states who wished to opt out of requirements that insurance companies cover preexisting conditions.

 

Freedom Caucus members who opposed the first draft of the bill, supported this new bill, crucial to allowing President Trump to make good on his promise to “repeal and replace” Obamacare.  Representatives Fred Upton and Billy Long switched their vote from “no” to “yes” bolstering GOP support for the bill that could not lose more than 22 votes.

 

The American Health Care Act has had to appeal, not to Democrats, but to GOP members who were split on whether the AHCA repealed too many popular components of Obamacare.

 

The original AHCA including the following:

  1. Eliminate the tax penalties, “individual mandate” and “employer mandate” imposed on those who don’t purchase health insurance for themselves or employees.

  2. Tax credits will be based on age rather than income ranging from $2000/year for those younger than 30 to $4,000 a year to those who are older than 60. A family would receive up to $14,000 in tax credits a year. These tax credits would start phasing out when income becomes  $75K individually or $150K as a family. For every $1,000 in earnings above those thresholds, the value of the credit phases down by $100.

  3. Allow insurance companies to charge a 30% surcharge to those who have gaps in insurance longer than 63 days.

  4. Maintain coverage, preventing denial, to those with pre-existing conditions

  5. Maintain coverage for children under age 26 who wish to stay on their parent’s plans.

  6. Maintaining the bans on caps on annual or lifetime coverage

  7. By 2020, ACA promised federal funds for Medicaid expansion will stop.  Funds will continue for current Medicaid recipients

  8. Create a Patient and State Stability Fund, which provides states $100 billion to use as they wish for their underserved populations, hospitals, providers or programs that would provide direct care.

  9. States will receive money for Medicaid in a lump sum per person rather than an open-ended promise of funds.

  10. Taxes on medical device industry will expire as will those on pharmaceutical companies and indoor tanning services.

  11. Planned Parenthood is “defunded” as AHCA funds cannot be used to pay for services at their clinics.

  12. HRA increase – starting in 2018 individuals could contribute pretax dollars to their Health Savings Account up to $6550 individually and families up to $13,100.

The bill is being analyzed by the Congressional Budget Office (CBO) and will need to be approved by the Senate to move forward.

 

LearnHealthSpanish.com / Medical Spanish made easy.

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00am-2:00pm and Saturday from Noon-1:00pm (Central) at GCN.

 

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Republicans are again trying to repeal and replace Obamacare, but what they’re really doing is attempting to alter the Affordable Care Act just enough so they hold onto their jobs and fulfill a promise made by Donald Trump to repeal and replace Obamacare “one Day 1.” We are nearing Day 100, and the House Republicans can’t even agree amongst themselves let alone get enough votes in the Senate to pass their American Health Care Act.

The best thing that could have happened for Republicans with regard to the Affordable Care Act would have been to accomplish the goal announced by House Majority Leader Mitch McConnell just after Barack Obama was elected president. "The single most important thing we want to achieve is for President Obama to be a one-term president,” he said. They failed, and so will their attempt to repeal and replace Obamacare.

The problem for Republicans, and specifically Southern Republicans, is that Obamacare is working for some and would work for most of their constituents. In fact, the South had the highest rate of uninsured people in 2012 at 18.6 percent. And it’s not all Hispanics. Over 68 million of them are white.

Southerners are also the least healthy of all Americans, with 20 percent reporting fair or poor health in 2014. Southerners are also the most impoverished Americans, with 17 percent of Southerners living below the poverty level in 2014. The South also has the highest rates for diabetes, obesity and infant mortality in the nation. The South accounts for nearly as many uninsured people as the rest of America combined, and 17 percent of the uninsured fall into the coverage gap for Medicaid expansion.

Yet Southerners have taken advantage of, or actually, been disadvantaged by the Supreme Court decision to not force Medicaid expansion upon all states. Had all states been required to expand Medicaid, 7 million people would gain coverage, 4.3 million fewer people would be uninsured and states would see between $5 and $10 billion in uncompensated care savings over the next 10 years, which would offset increased state spending by between 13 and 25 percent.

Of the 19 states resisting Medicaid expansion, 14 are in the South. The states with the most people who stand to gain insurance through expansion are Florida (1.253 million), Texas (1.186 million) and Georgia (.682 million). Georgia nearly elected a Democrat to the house just a few days ago, Texas is turning blue, and two Republican incumbents lost House seats to Democrats in Florida last November, while Democratic incumbents retained all six of their seats.

In short, Southerners need Obamacare and the subsidies that come along with it. They’re just starting to realize it. Now, if America adopted a Medicare-for-all system that Bernie Sanders has proposed, maybe we could stop spending nearly $3 quadrillion on health care as a nation.

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If you like this, you might like these Genesis Communications Network talk shows: USA Prepares, Building America, Free Talk Live, The Easy Organic Gardener, American Survival Radio, Jim Brown’s Common Sense, Good Day Health, MindSet: Mental Health News and Information, Health Hunters, America’s Health Advocate, The Bright Side, The Dr. Daliah Show, Dr. Asa On Call, The Dr. Bob Martin Show, Dr. Coldwell Opinion Radio, The Dr. Katherine Albrecht Show, Drew Pearson Live

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