_______________
"Right-wing critics
of Obamacare have been predicting for years that the law would enter an
actuarial 'death spiral,' in which healthy customers flee and insurers raise
rates to unsustainably high levels as only the most sick and expensive patients
remain. . . .When President Trump repeatedly insists Obamacare is 'collapsing,' 'dead,' or 'gone,' he is popularizing in vulgar form an analysis that people
like Paul Ryan have been spreading for years.
"The most obvious
sleight of hand in this argument is that, even if it were true that the
Obamacare exchanges were entering a death spiral and collapsing, it would
hardly justify the Republican health-care bill. The exchanges account for a bit
less than half the coverage gains in Obamacare. The rest of the newly insured
come from expanded children’s health insurance and, especially, Medicaid.
"Remember, Medicaid
expansion is how Obamacare provides insurance to the poorest Americans (those
with incomes up to 133 percent of the poverty level). The allegedly collapsing
exchanges only insure people with incomes above that level. And the spine of the
GOP plan is hundreds of billions of dollars in cuts to Medicaid. There’s not
even a patina of an argument that Medicaid is collapsing. The supposed 'death
spiral' in the exchanges is the Republican pretext for cutting a completely
different program.
"In any case, the 'death spiral' is a fiction. [A study found]. . . that health costs of people buying insurance on the exchanges have converged with health costs of people who get insurance through their employer.
"In any case, the 'death spiral' is a fiction. [A study found]. . . that health costs of people buying insurance on the exchanges have converged with health costs of people who get insurance through their employer.
"So why are we
reading all these stories about insurers pulling out of markets and premiums
going way up? Oliver Wyman, an actuarial firm, examines the markets and
concludes . . . two-thirds of the higher premiums next year are due to
political uncertainty created by the Trump administration and Congress. The
administration is threatening to withhold payments insurers are owed under the
law, and also not to enforce the individual mandate. These deliberate efforts
to subvert the exchanges are having their intended effect. But the underlying expected cost of insuring patients is low — without a government engaged in
deliberate sabotage, the firm estimates premiums would only rise 5–8 percent, a
very modest level by the historic standards of health insurance costs.
"Obamacare can be
improved, especially in rural markets where hospitals and doctors are spread
far apart and competition has always been difficult to produce. But the threat
to the exchanges is the same as the threat to Medicaid: not any inherent flaw
in the operation of the programs, but a governing party that ideologically
opposes the transfer of resources that is needed to make health care available
to the poor and sick."
_____________
"In a separate article, vos.com reporters asked a number of Republican senators what they were trying to accomplish with their health care bill. None really had a satisfactory answer -- except perhaps John McCain. The old maverick just said it: "They're trying to get to 51 votes."
And both of those were written before anyone saw the actual, awful secret bill that they've produced. This vote is going to be a test for those senators who have any integrity or human decency left.
Yes, Sen. Schumer is right. The Republicans were trying to keep the damned thing secret because:
"They . . . are . . . ashamed . . . of it."
Ralph
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