Friday, August 11, 2017

Republican Repeal and Replace schemes repeat of Failed Polices of the Past.

I've always thought of legislation as a show of values, especially the initial first draft, before saner heads prevail. And so it is again with another idea being floated by Sens. Bill Cassidy and Lindsey Graham. You know there's a problem right off the bat if "little dictator" Scott Walker signs off on the deal:

Imagine the governor holding each and every citizen hostage over their health care, that's what this means.

You’ll also notice in the Cassidy-Graham proposal below that if you are anything but a Republican living in a red state, you most certainly don’t count. You lost, winner take all, including your health insurance:
“We need to let states take care of themselves and give power back to patients,” Sen. Bill Cassidy (R-LA) wrote in a recent op-ed for the Washington Post. “Let a blue state do a blue thing and a red state such as mine take a different, conservative approach.”

The proposal would eliminate the subsidies for private insurance and end the Medicaid expansion ... marketplaces would no longer exist ... The federal government would convert some (but not all) of that spending into a lump-sum payment to states. States could choose to spend this money on providing insurance — or they could use it to fund high-risk pools, or do other activities to pay the bills of patients with high medical needs. 
But this new Cassidy-Graham bill would not allow a state like California to keep the Affordable Care Act in place unless it wanted to kick in significantly more money. Here’s why:
1. The complex funding formula used to divvy up the big pot of money would tilt more funding toward sparsely populated states ... than those with denser, more urban populations.

2. It would also take the current Medicaid expansion spending from the 30 states that participate in the program and divvy it up among all 50 states. For a place like Texas, which has not expanded Medicaid, this would be a windfall ... but California would be dramatically disadvantaged.

3. Cassidy-Graham includes a requirement that insurance plans accept all applicants regardless of preexisting conditions. 

4. Ends the two policies: the mandate to purchase coverage and the tax subsidies to make coverage affordable ... little incentive for those who are relatively healthy to purchase plans. 

The key points; no mandate or incentives to be insured, and a requirement to accept preexisting conditions. As explained below, this is an old failed idea we may be doomed to repeat on a national level. This also proves historically that politicians in the House and Senate never had a clue about how average Americans got their health care coverage in the past, or for that matter, even now in the Marketplaces: 
States have experimented with this combination of policies before. In the 1990s, Washington state ended preexisting conditions without a mandate or subsidies. Seattle Times journalist Carol Ostrom recounted what happened next:
1. Without any leverage to bring healthy people onto insurance rolls, insurers, left with the priciest patients, began a financial death spiral.

2. Ultimately, companies pulled out of the individual market and almost no one in Washington could buy an individual policy for any price.

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