Repeal and Replace with stale and fail

There is a sort of, kind of, GOP pn to replace the Affordable Care Act, it’s the set of proposals from Tom Price. [Some discussion available at Forbes] Essentially this version of the ‘replacement’ is a collection of the frail, the failed, and the stale. Some items of note:uran

  • It gives the insurance companies a loophole to reintroduce exclusions for preexisting conditions.
  • It encourages health savings accounts, another way of giving the well to do another tax break.
  • It offers subsidies which would likely only help with the low coverage health insurance plans that could be advertised as ‘comprehensive’ before the ACA.
  • Just about anything on a piece of paper would qualify as an insurance policy, opening loopholes for the creation of ‘place holder policies,’ and the life time limit junk insurance which could be sold before the ACA.
  • Portability is shorthand for the elimination of consumer protection enforced by state insurance officials. If almost anything qualifies as an insurance policy then such policies would be allowable in all states, regardless of state requirements.

This, of course, isn’t the only set of proposals out there. However, it does contain some common GOP ideas about how to get back to those not so wonderful days when junk insurance could pass for the real thing, and when insurance corporations could use all the premium money they wanted on executive compensation or other shenanigans.

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2092 days

The Trumpster promised that if President Obama would release his birth certificate he would release his tax returns.  So, as of April 27, 2011 Trumpster was on record … Not that keeping his word is of much importance.  It’s been 2092 days since the promise was made and subsequently ignored.

It’s not just the returns. Build a wall?  Well, maybe a bit of fencing. Mexico will pay for it? No, that would be the American taxpayers. Now, the Trumpster announces health insurance for everyone,  Everyone!  Well not unless the old ideas like health savings accounts, portability, high risk pool can do the job. That these haven’t worked in the past is conveniently omitted.

It appears the only words which tend to hold are the Kremlin talking points. NATO is obsolete. (Unless you happen to be in Estonia, Latvia, Lithuania, Poland…) The European market is failing. (Unless you happen to be in Germany, France, Spain…)

At least some questions might be addressed by releasing the tax returns, but until such time as they appear in public the obvious conclusion is that there are “foreign entanglements” enveloping the president-elect.

2092 and counting.

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Who loses their ACA marketplace health insurance in Nevada?

Interesting numbers from the Kaiser Family Foundation on the people in Nevada’s congressional districts who have health insurance through the ACA exchange.

District 1, represented by Rep. Dina Titus (D) as of December 2016, about 19,300.

District 3, represented by Rep. Jackie Rosen (D), 19,300.

District 4, represented by Rep. Rubin Kihuen (D), 18,700

And, the District with the most people who stand to lose their marketplace coverage with the repeal of the Affordable Care Act?  District 2, represented by Rep. Mark Amodei  (R) with 22,500 who have purchased their insurance through the ACA exchange.

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Unanswered Questions

It’s lovely to listen to melodic phrases like “patient centered care” and “freedom of choice,” as well as all manner of other Republican catch all incantations…but none of these address practical questions Representative Mark Amodei  (RNV2) needs to answer about the replacement of the Affordable Care Act.  A few examples:

The extension of health care insurance and Medicaid helped reduce the level of uncompensated care for which hospitals could ultimately be liable. How will a GOP plan reduce the level of uncompensated care? How will rural hospitals be affected? How will hospitals in Lander, Pershing, and Humboldt counties be affected?

Prior to the Affordable Care Act there was only one health insurance company selling individual policies in large swaths of District 2. How will the GOP replacement legislation insure competition for those seeking to purchase individual health insurance policies for their families?

Prior to the Affordable Care Act insurance companies could market policies with lifetime limits.  These were certainly cheaper than comprehensive policies, however they never seemed to be adequate for serious and chronic illnesses or very serious accidents with long term recovery and rehabilitation.  In fact, many respected consumer advocates called these “junk insurance.” What will the GOP replacement do to prevent the reintroduction of junk insurance?

Before the Affordable Care Act Republicans touted health savings accounts as an alternative. How would a GOP replacement for the Affordable Care Act address the health care needs of those whose wages and salaries are insufficient to sustain the contributions needed to establish an adequate health savings account level?

Prior to the Affordable Care Act insurance corporations could refuse policies for those with preexisting conditions and to those engaged in what the companies categorized as high risk occupations.  How will a GOP replacement prevent a reintroduction of these practices?

Before the Affordable Care Act insurance corporations were allowed to charge higher premiums for policies sold to women, or which covered female members of families. How will the GOP replacement address this issue?

The Affordable Care Act extended the viability of Medicare.  How will a GOP replacement extend the capacity of Medicare?

These are but a few of the questionsame raised by the GOP calls for repeal. They cannot be answered by pious recitals of Republican rhetorical flourishes. They cannot be addressed by reiterating Republican buzz words and phrases. They have to be addressed in the real world, of real people, with real health care needs.

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And so it begins

The Senate yesterday began the process of dismantling the Affordable Care Act.  With no replacement on offer.  With no publication of a plan to make it possible for every American to purchase health care insurance.  Please write or call your Congressional Representatives.

The Trumpster said Director Clapper called him to denounce the release of information about his possible compromise by Russian agencies.  No, the Director called to say the agencies had issued no conclusions.  Another day another lie. We need a select committee investigation into Russian activities in the 2016 election. Please write or call your Congressional Representatives.

Please keep writing. Please keep calling.

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Quick note: $29,400

That $29,400 figure is the new average student debt, via NPR.  Money spent paying off student debt is money not spent on transportation, clothing, housing, and other basic elements of the economy. It’s rising, and the question is whether there’s the political will to do something about it.

Meanwhile,  the technical issues persist so posts will be short. Thanks for your patience.

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Oops technical issues

Many apologies to regular readers, but we’re having major weather related difficulties, one of which has the computer down and disconnected — for its own protection.  Blogging is at a standstill for the time being, although posts will continue on Twitter and perhaps Facebook.  Thanks for your patience yet again.

 

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