The Dismantling of ObamaCare - Ongoing Updates.

[AllenChicago]

Thursday, February 16, 2017

Before leaving for one of many "holiday breaks", House GOP published a final outline of the process they will use to Repeal-Replace ObamaCare. The process will begin in earnest at the end of February, after they return from celebrating President's day.

Here's a description of the outline, obtained today by PBS News Hour.

House GOP documents outline plan to replace Obamacare | PBS NewsHour

Looks like HSA plans will be a HOT commodity.

 

[kgmom219]

Thursday, February 16, 2017

Before leaving for one of many "holiday breaks", House GOP published a final outline of the process they will use to Repeal-Replace ObamaCare. The process will begin in earnest at the end of February, after they return from celebrating President's day.

Here's a description of the outline, obtained today by PBS News Hour.

House GOP documents outline plan to replace Obamacare | PBS NewsHour

Looks like HSA plans will be a HOT commodity.

Thanks AC! This is great info.

Love how they talk about the Co-Op failure. But not how they stripped the money in the Summer of 2014 that was supposed to fund them.

And there is still NOTHING that is going to lower the rates. #whatsnext

 

[AllenChicago]

Thanks AC! This is great info.

Love how they talk about the Co-Op failure. But not how they stripped the money in the Summer of 2014 that was supposed to fund them.

And there is still NOTHING that is going to lower the rates. #whatsnext

Our Land of Lincoln Co-op was run so inefficiently, that even if they got the $31 million "help" from the government in 2015, it was DOA. CEO and top 3 executives had zero Insurance company experience. Was the best health insurance in the state, and the least expensive. Recipe for KA-BOOM.

I don't care if what they convert ObamaCare over to (TrumpCare?) fails to lower the rates. Having medical underwriting again, with 15-20% commission will be wonderful!

 

[Ann H]

Thursday, February 16, 2017 Before leaving for one of many "holiday breaks", House GOP published a final outline of the process they will use to Repeal-Replace ObamaCare. The process will begin in earnest at the end of February, after they return from celebrating President's day. Here's a description of the outline, obtained today by PBS News Hour. House GOP documents outline plan to replace Obamacare | PBS NewsHour

Thank-you, Allen. This is a real indication of where the GOP is headed at this time. It's a must read. It leans heavily in favor of Paul Ryan's original proposal (A Better Way) but has a few elements of Tom Price's proposal (Empowering Patients First), as well as other proposals. Here are some key takeaways, but, if you are serious about going into the next market, it's a must read document. I'm really disappointed that they did not discuss whether this includes underwriting or GI, pre-ex, etc. It also does nothing to address root drivers of escalating costs, but it rearranges the deck chairs. Nonetheless, this is the first indication we have had that the GOP is unifying around a particular path to repeal/replace.

1 - Pages 1-7 Intro, and eviscerating Obamacare. Pages 1-7

Page 7 - Three methods of reaching the goal, which are Repeal/Replace legislation, Trump administration actions, and "Regular Order".

Page 8 - Four major segments of their plan, which are:

* Medicaid - more details later, but in summary, they plan to give it back to the States
* States Grants to control their own markets - more details later, but this summary said it includes high-risk pools, Cost-sharing reductions, etc.
* Enhance HSAs - more details later
* Portable Tax Credits - more details later​

Page 10 - Brief Summary of the Portable Tax Credits:

* They are refundable (if you don't owe taxes, you get the tax credit anyway, and if you are eligible for more tax credit than you received, you get it on your refund.)

* They are advanceable (it offsets monthly premium, rather than requiring you to wait until tax filing time to receive it.)

* Arguments to support that this was a GOP idea first, not an Obamacare invention! LOL​

Page 12 - PORTABLE TAX CREDITS DESCRIBED IN MORE DETAIL
* It's for the IFP market, not those with Employer Sponsored coverage.

* VERY IMPORTANT INDICATORS - "The Obamacare subsidy system did not work because the law required the subsidies only be used to purchase expensive, one-size fits all coverage. Further, the subsidies could only be used on the government exchanges." This seems to indicate that the exchange is gone, hallelujah!

* Relief from:

The tax on health insurance premiums
The medicine cabinet tax
The tax on prescription drugs
The tax on medical devices
The increased expense threshold for deducting medical expenses​

* VERY IMPORTANT information about the transition between now & the time the new system is ready, "To provide relief during the transition period, the penalty taxes for the individual mandate and the employer mandate are zeroed-out immediately. Additionally, Americans eligible for the Obamacare subsidy will be able to use their credit for expanded options, including currently prohibited catastrophic plans. To promote market stability and premium stabilization during the transition period, the Obamacare subsidies are adjusted slightly to provide additional assistance for younger Americans and reduce the over-subsidization older Americans are receiving."

* VERY IMPORTANT - "Our proposal will then create a new, advanceable, refundable tax credit to assist with the purchase of health insurance on the individual insurance market. The legislation creates a new code section – 36C— to do this. The credit is Universal for all citizens or qualified aliens not offered other qualifying insurance, Age-rated, Available for dependent children up to age 26, Portable, Grows Over Time." So, this appears that they are "repealing" by creating a new tax code, with new subsidies that swallows up the old subsidy regulations. I'm not sure, but that's what I take away from this.

Page 13 - NOT BASED ON INCOME, BUT BASED ON AGE -

* The credit is not based on income. This will help simplify the verifcation process and expand access for Americans who have been left behind by Obamacare. Additionally, a universal credit does not create the same labor market distortions and perverse incentives as President Obama’s law did: according to CBO, the Obamacare income-based subsidy system resulted in so many lost labor hours it would be as if 2 million full-time equivalent workers left the labor force in 2025. A universal credit fixes this unnecessary disincentive to work and makes sure our tax code is built for growth.

* Older Americans will receive a higher credit amount than younger Americans, reflecting the higher cost of insurance for older Americans. Taxpayers can receive credits for their dependents including children up to the age of 26. The credit, however, is limited only to citizens or qualified aliens. Incarcerated individuals are not eligible for the credit.

* For IFP market - not for those eligible for Employer or Govt sponsored insurance.

* Is for any eligible plan approved in your state and sold in the IFP market, including Catastrophic plans. Can be used for COBRA premiums.

* VERY IMPORTANT - Unused tax credit can be put into an HSA.

* Portable - but they don't explain this much at this point.
​

Pages 13-14 - History of HSAs

Page 14 - HSA reform:
* Increase contribution to match the max out-of-pocket allowed by law (in 2017 that is $6550 individual and $13,100 family.

* spousal catch-up contribution flexibility

* 60 day window to open your HSA account and retro fund your expenses for those 60 days.

Page 15 - Medicaid reform.
* Under our proposal, Obamacare’s Medicaid expansion for able-bodied adults enrollees would be repealed in its current form. There would be a period of stability to ensure we are not pulling the rug out from underneath States or patients. States that chose to expand their Medicaid programs under Obamacare could continue to receive enhanced federal payments for currently enrolled beneficiaries for a limited period of time. However, after a date certain, if states choose to keep their Medicaid programs open to new enrollees in the expansion population, states would be reimbursed at their traditional match rates for these beneficiaries."

* Block grants based on "per capita".

Page 16 - VERY IMPORTANT - State Innovation grants. "Here is how it works. These funds will help repair state markets damaged by Obamacare. States can use the pool to cut out-of-pocket costs, like premiums and deductibles. States may also use these resources to promote access to preventive services, like getting an annual checkup, as well as dental and vision care. And if they choose, states could funnel the money through a now-dormant high risk pool to achieve the same goals of the dated program.Among other purposes, states could use these creative State Innovation Grants to:

* Reduce patients’ out-of-pocket costs, like copayments, coinsurance, premiums, and deductibles
* Lower the cost of providing care to high utilization patients
* Stabilize the individual and small group markets
* Access preventative services, like an annual checkup
* Promote participation in private health care plans"​

​

 

[AllenChicago]

Great Summary Ann! Thank-you. Section 13 (age-based tax credits) is already coming under fire from liberal publications, because a 50 year old making $1 million a year, would get the same tax credit as a 50 year old making $30,000 a year.


"Both Obamacare and the Republican replacement plans provide tax credits to help make insurance more affordable. But while Obamacare’s credits are based on income, meaning poorer people get more help, the Republican plan would base them on age. The result would be regressive: Wealthy people would get more help buying insurance, while poor people would likely get less assistance."

Source: http://www.vox.com/policy-and-politics/2017/2/17/14648222/obamacare-wealthy-tax-credits

 

[junkman]

Great Summary Ann! Thank-you. Section 13 (age-based tax credits) is already coming under fire from liberal publications, because a 50 year old making $1 million a year, would get the same tax credit as a 50 year old making $30,000 a year.


"Both Obamacare and the Republican replacement plans provide tax credits to help make insurance more affordable. But while Obamacare’s credits are based on income, meaning poorer people get more help, the Republican plan would base them on age. The result would be regressive: Wealthy people would get more help buying insurance, while poor people would likely get less assistance."

Source: http://www.vox.com/policy-and-politics/2017/2/17/14648222/obamacare-wealthy-tax-credits

Of course, Repubs proposed it. Dems would have made it free.
Reminds me: Stop the world. I want to get off. Summer is almost here. Think I'll go ride my bike. Rubber side down, don't bounce off a car. Stay out of the hosp s I don't have to prove how crappy my STM is. It's time to clean up the boat too.

 

[Yagents]

What a concept, everyone treated the same vs a system of picking some winners and more losers

 

[junkman]

What a concept, everyone treated the same vs a system of picking some winners and more losers

Depends. If the objective is to provide healthcare and pay via insurance, that proposal won't work. If on the other hand the objective is to let the insurance industry make money, anything that allows product to be sold will work.

I have my preference but am getting to the point where I don't care. I'll adjust and take whatever I think is the best option. I haven't "liked" paying premium ever and usually wish it were lower.

I expect the Republicans to talk "free market, give people control, HSA, taxes, bla, bla, bla. At the end of the day, they want bigger government that they control. The key objective with ACA reform is to look like they're doing something while not getting blamed.

I have a friend that used to say "it's Obama's fault". He got his wish and Obama is gone. What did Trump say? You guessed it......Obama left a mess.

Dad used to say "you shot it, you eat it". Let the Great, Magnanimous, Narcissistic, tiny handed Trump handle it. It's time to **** or get off the pot.

 

[hamben]

Molina to exit exchanges who could have seen that one coming

 

[papercutter]

Molina to exit exchanges who could have seen that one coming

Is it true that the only carrier that's doing well on the exchange is Ambetter, and that's because no providers actually accept their plans and therefore they have few claims to deal with?