Sunday, April 23, 2017

TrumpCare 2.0 -- even worse than first version

Some details of the revised TrumpCare bill that came out of negotiations between some of the Freedom Caucus and the Tuesday Group (moderate Republicans) are being revealed.   (See yesterday's ShrinkRap on the context for this DOA charade.)

Essentially, as I understand what's known, this bill has just put in some tricks that make it look like one thing, when actually it does something even worse.

1.  Unlike TrumpCare 1.0, this version requires that the "essential health benefts" in the Affordable Case Act (like hospitalization expenses, emergency care, maternity) be included.   BUT, then it says that states may obtain waivers to omit such services in their state.

2.  Children can stay on parents' policies until age 26 -- except, like essential services, states can get waivers to exempt policies in their state from that requirement.

3.  Also, like the ACA, TrumpCare 2.0 says that insurance companies cannot refuse to cover people with pre-existing conditions.   However, rather than being included in general coverage, they will get insurance as part of a "high risk pool."   Insurance companies can raise rates on that group to offset their greater use of insurance.   In other words, this undermines the whole concept of insurance -- covering a large pool to spread out the cost to patients and the risk to insurance companies.

So, this is no fix at all.  It's just some stage tricks -- like the magician's show.  Use distraction to keep people attention off what you're really doing.

There is no consideration for what health insurance is for.   Because, you see, the Ryan-Trump plan isn't a health care plan at all, although it tries to fly under that banner.   It's actually a tax cut plan (or rather it's the elimination of the tax in the ACA imposed on wealthier people to help pay for the plan).   But all this trickery is to maintain their getting rid of the tax -- and I think it's fair to call it a tax cut, because it is currently part of the law.   So their only offsetting option is to reduce services.

Ralph

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