Senate Republicans on Thursday unveiled a sweeping draft bill to roll back the Affordable Care Act, including a drastic reduction in federal healthcare spending that threatens to leave millions more Americans uninsured, drive up costs for poor consumers and further destabilize the nation’s health insurance markets.
The legislative outline, which Senate Majority Leader Mitch McConnell’s team wrote largely behind closed doors, hews closely to the Obamacare repeal bill passed last month by House Republicans, though it includes important differences. The House version was first celebrated by President Trump in a White House Rose Garden ceremony, though he later criticized the bill as “mean.”
A conservative group funded by the Koch brothers is pushing for high-risk pools and a freeze on Medicaid expansions as lawmakers try to coalesce around a replacement for ObamaCare.
Freedom Partners began circulating a memo on Capitol Hill Monday with specific reforms it thinks should be included in the healthcare law’s replacement, including: the creation of high-risk pools at the state level to cover people with pre-existing conditions; the elimination of the ObamaCare mandate, which required everyone buy insurance or pay a penalty; and the expansion of access to health savings accounts, so people can save and pay for healthcare with pre-tax dollars.
The recommendations fall in line with what top Republicans in Congress have indicated they support.
Poor Americans in states that have expanded Medicaid through the Affordable Care Act are going to the doctor more often and having less trouble paying for it, new research finds.
At the same time, two years of experience with the expansion offer additional indications that the improved access to care will ultimately improve patients’ health, a key goal of 2010 law, often called Obamacare.
A new government report shows that the average ObamaCare Medicaid expansion enrollee costs the federal government $6,366 in 2015, 49% above the per-person cost of $4,281 projected a year ago.
The surprising cost overrun is likely to result in increased scrutiny of Medicaid program expenses by Congress and could pose a risk to insurer profits in the one area of ObamaCare that has provided a reliable boost for their bottom lines.
UnitedHealth (UNH), which is pulling out of the individual health insurance exchange business in most states amid growing losses, is among companies profiting from the Medicaid expansion. Public companies vying for the Medicaid managed care business include Centene (CNC), Anthem (ANTM) and Molina (MOH).
One reason John Kasich was unacceptable to many conservatives as this year’s GOP standard bearer involves his acquiescence in Obamacare’s expansion of Medicaid. Many believe that, as Governor of Ohio, he has squandered the hard won 2012 Supreme Court victory concerning a provision of the “reform” law that granted the President and his apparatchiks the power to coerce the states into compliance. Despite the 7-2 SCOTUS ruling that such coercion is unconstitutional, Kasich and a few other GOP governors have voluntarily colluded with the Obama administration on Medicaid expansion. Among these Republican sell-outs was the Governor of Indiana — Mike Pence.
John Nolte writes in a posting for Breitbart (online, Oct. 6) that in a recent “appearance before the Hispanic Chamber of Commerce, Ohio governor and Republican presidential candidate John Kasich offered to buy Bibles for those of us who don’t agree with his decision to increase the welfare state.”
Some may recall it was Kasich who acquiesced to the Affordable Care Act’s Ohio Medicaid expansion. At the Chamber of Commerce gathering, Kasich retorted (for the benefit of his healthcare adversaries), “Look at Medicaid expansion. Do you know how many people are yelling at me? I go out to events where people yell at me. You know what I tell ‘em? . . . I say, there’s a book. It’s got a new part and an old part; they put it together, it’s a remarkable book. If you don’t have one, I’ll buy you one. It talks about how we treat the poor. Sometimes you just have to lead.”
Nolte’s Breitbart article poses this food for thought, “I don’t mean to argue with Brother Kasich, but I must have missed the part where the Christian thing to do is to use the punitive power of The State to force your personal Christian values on others.”
While 2016 GOP presidential hopeful John Kasich has previously said he’d scrap Obamacare entirely, it may actually be a case of Kasich picking and choosing which facets of the ACA he likes, and those he doesn’t.
According to USA Today (online 8/15), featuring a story by Chrissie Thompson of the Cincinnati Enquirer, this specifically means Kasich wants to be able to select the “facets of Obamacare he likes, with difficult agreements brokered by a hypothetical Kasich administration, but not mandated by law.”
Thompson’s account adds, “Kasich has insisted he wouldn’t cut back on the expansion of Medicaid to more low-income Americans. Instead, he says, he’d want to send the federal money back to states, with more freedoms on how to implement the program.”
Ideally, in Kasich’s world healthcare view, an unregulated marketplace or separate states “should be the vehicle for establishing the facets of Obamacare that he likes,” according to the Cincinnati Enquirer.
Thompson’ story continues, that Kasich “wants to ensure insurance coverage for people who have pre-existing conditions. He likes insurance exchanges. And he thinks everyone should have health insurance – even young, healthy people who need an incentive to sign up.”
Yet, the 2016 presidential hopeful has also argued for doing away with the Obamacare employer mandate, requiring businesses with 50 or more employees to provide healthcare coverage to full-time workers.
Will Kasich really be the one in the GOP to rid the American socio-economic landscape of Obamacare?
According to a recent report by Jason Hart in Florida Watchdog.org (online, 5/11) one hope the Obama administration had about Affordable Care Act implantation was that states would fall right into line, at least when it came to Medicaid expansion.
But, as the FloridaWatchdog.org account also says, “combined with nationwide spending and emergency room data, threats to existing Medicaid waivers are solidifying Obamacare opposition.” The result is a backfire on the Obama administration.
Christie Herrera, who is a senior fellow at Florida’s Free-Market Foundation for Government Accountability, is quoted by Watdog.org, as saying: “I think people are starting to see that it’s not the little guy pushing Obamacare in Florida. It’s big hospitals, big business, big insurance companies.”
One result, according to Florida Watcdog.org, is Florida gov. Rick Scott having filed suit against the federal Department of Health and Human Services (HHS). That suit is over “plans to stop funding the state’s Low Income Pool program, which compensates hospitals for seeing uninsured patients,” according to Hart’s Watchdog report.
Others suing HHS include Gov. Greg Abbott, R.-Texas, and Gov. Sam Brownback, R-Kan.
“Government overreach” frequently sparks lively debates about the proper role of federal, state and municipal ruling bodies. A report in The Washington Examiner (online Apr. 20, by Paige Winfield Cunningham) says, “The two biggest states to reject Obamacare’s Medicaid expansion are accusing the administration of trying to force them into it.”
Texas Gov. Greg Abbott, R-Texas, recently voiced his advocacy for a lawsuit filed by Florida Gov. Rick Scott. Scott initiated the litigation against the Obama White House “over ending federal funds to pay hospitals for caring for the uninsured,” according to The Washington Examiner.
The Feds have are saying they will stop such funding unless the Sunshine State grows its Medicaid program under the auspices of the Affordable Care Act. The Examiner report additionally explains, some U.S. states have “funding pools.” These reimburse hospitals – who would otherwise receive no monies for care dispensed. Yet as Cunningham’s article points out, Medicaid expansion, “would reduce the need for such funds.”
Gov. Abbott (speaking for Florida) is quoted by Cunningham as saying, “Florida’s approach should be determined by Floridians, not coerced by federal bureaucrats.”
Aimee Picchi, in a new CBS Interactive report (online, Apr. 13) tells of The Wall Street Journal account of Stephanie Graham, whose mother joined Medicaid in 2014. This was because of the Affordable Care Act’s requirement for healthcare coverage. Without it they would wind up paying an Obamacare fine.
The CBS report describes “The Estate Recovery Law,” which permits U.S. states “to recover Medicaid costs for patients who are older than 55 when they die, although some limits apply, such as exceptions for the disabled and hardship exemptions for survivors.” Picchi’s CBS report adds, “The law is taking some newly enrolled Medicaid patients by surprise, but it’s also prompting a few states to push back on the practice.”