Monday, October 22, 2018

The Con Man TrumpCare plan blasts off....feeling lucky? You'll need lots of it.

Officially, TrumpCare is here, ready fix what it has already broken:
New State Relief and Empowerment Waiver Guidance Gives States Tools to Help Fix Broken Health Insurance Markets-Clear vision from President Trump: Make health insurance more affordable and accessible by expanding choice, reviving competition, and deregulating and devolving to the states the authority and flexibility ... and promote consumer-driven healthcare.
This plays on the theme that people are biologically different once you step over the state line. As I recently posted regarding "States should tailor their own plans:" Nothing could sound dumber. Is cancer in Iowa different from cancer in Wisconsin or Texas. That's because it's laughably ridiculous.

48 Million Uninsured before the ACA/ObamaCare: The ACA knocked that down to 28.5 million. Trump's CMS claimed, "a one-size-fits-all set of federal regulations put a straightjacket on state innovation," what that meant was instituting costly high-risk pools, stripped down junk insurance policies, lifetime caps, and a whole maze of exceptions and requirements you'll only learn about once you get sick or turn in a claim. And "innovation" has nothing to do with curing diseases, they were talking about making money on the sick and dying.

Here's the breathtaking step back to a time when 48 million didn't have health insurance and millions more would be added each year. I will provide the "result:"
1. The new guidance implements an access standard requiring states to provide access to the same level of coverage. Thus, if someone freely opts for coverage with a lower premium, the guardrails remain satisfied even though the chosen coverage might be less comprehensive.
Result: The Grand Illusion...a person with barely any coverage counts as a person with health care insurance, skewing the numbers so that it looks like a greater percentage of the population has insurance.
2. The Departments will judge a waiver for how it impacts the population as a whole, which will free states from the impractical, virtually unattainable standards on covering specific populations the previous guidance required.
Result: Segregating the sick and dying from the healthier pool of Americans.
3.  The new guidance continues to require that a comparable number of people remain covered, but the guidance broadens the definition of coverage to include more types of coverage, such as more affordable, short-term plans.
Result: IMPORTANT: This rule eliminates coverage for preexisting conditions. Again, you're considered covered even with a temp or stripped down version of insurance. Trump will be able to manufacture the illusion that more people have insurance.
4. States can now consider options to create and implement a new subsidy structure that changes the distribution of subsidy funds compared to the current federal Premium Tax Credit (PTC) structure. A state may design a subsidy structure that meets the unique needs of its population in order to provide more affordable healthcare options for a wider range of individuals and address structural issues that create perverse incentives, such as the “subsidy cliff.”
Result: The tax credit your getting may be changed. It could get a lot smaller for those with lower incomes spreading the credits out to higher incomes, which would make tax credits inconsequential for all premiums while including higher incomes.
5. More affordable health insurance is, of course, more accessible health insurance, which should help drive down the number of people that continue to go uninsured.
Result: This upside-down nonsense passes for policy? Sounds more like a line from Humpty Dumpty in Alice through the Looking Glass. Sadly, voters will only gasp in panic when it's already too late to change what they didn't understand the first time.