The healthcare bill the Senate released yesterday had surprisingly few changes from the House bill that passed last month. But maybe you didn’t read that one either. So let’s do a quick summary of both, and ask the all important question: How much should I worry about this?
- Medicaid – Takes a lot of cuts in both bills. This version starts the following cuts in 2021: Cuts coverage for long term care assistance, cuts coverage for people with disabilities, cuts federal funding for Medicaid expansion from Obamacare days, and cuts requirement in 2019 for Medicaid to cover mental health services.
So what happens when Medicaid (aka the Government) stops paying for all these programs? We the People get to pay for them of course. Medicaid and Medicare have always been the Elephant in the room as far as I’m concerned. The government is the largest consumer of services by far, however according to any healthcare provider you ask they only pay $0.20 on the $1.00 for how much things actually cost. So I’m torn on this issue. I believe lower income people should be provided access to care and services, however the rest of us have been subsidizing this for years by paying much more than the cost of services at an alarming and increasing rate. I’d prefer it instead if they increased how much Medicaid actually paid for the services rather than cutting it. That would provide a lot of relief to everyone involved. Of course- that will never happen. But a girl can dream.
- Planned Parenthood – Both bills block any federal funding for services provided by the organization for one year.
What is this about???? Certainly not saving money. This looks like a nod to conservative Republicans, in hopes they’ll get more of them behind this bill by saying “don’t worry- we’ll pause covering abortions for a year”. The ridiculous truth is abortion accounts for about 3% of the organization’s services. Really this is just more of the same- taking services away from low income people.
- Pre-Existing Conditions – Unlike the previous bill, this one requires insurers to provide insurance to all. BUT – does not require them to cover everything aka ‘essential health benefits’ we all got through Obamacare.
Remember back in the day when you could buy a health insurance policy that excluded maternity coverage? Yup. Let’s bring back those days. When ‘pregnancy’ was a pre-existing condition. This makes me absolutely furious as a woman. Furious I tell you!
- Individual and Employer Mandates – Both bills throw these away. No one would be ‘penalized’ for not buying insurance, as an individual or an Employer.
I’m on the fence on this one. The problem with throwing away the mandate is a logistical one for me, as someone in this industry. I am fine with throwing away the mandate (it’s incredibly unpopular), but you can’t force insurers to GIVE insurance, and not force healthy people to also BUY it. That is called ‘Adverse Selection’. It’s like saying you’re allowed to buy car insurance after you wreck your car. If we all paid one month’s premium in order to get a new car once ours was totaled- this whole insurance business would go belly up in a hot second. And then we’d all be totally on our own- having to afford everything 100% all the time. Do you have money for that? I certainly don’t. So either throw away the mandate AND requirement for insurers to provide insurance, or keep both. It’s math, people.
There’s a lot more to the whole thing but these are some of the big pieces. Now let’s ask the most important question of all:
How much should I worry about this? Is this bill even going to pass? Or is Trump going to lose support again like he did in March and walk away?
Odds are roughly 50/50 right now. They are certainly hard at work, and set to have another vote before July 4th. They are a lot of sticky politics inside this question including, but not limited to the fact that they need 50 out of 52 Republicans to vote “YES!”, and 9 Republicans have already said “not sure”. They are calling this a ‘reconciliation’ bill in order to pass it with a simple Republican majority (and avoid a Democratic filibuster), but the Senate parliamentarian has not even ruled they can do that yet, and won’t until the Congressional Budget Office releases numbers on how much this will cost…and yet…Obamacare exchanges are in trouble currently and premiums are rising as I type. The pressure is intense to push this through. Republicans have won 3 special elections last month enforcing the idea that America is still very much on board with all of this.
I’m certainly paying attention to this. It absolutely affects all of us no matter which way the votes go. But what do you think?