High Deductibles or Health Savings Account = Huge out-of-pocket costs under TrumpCare making Insurance unaffordable.

Not many reporters know enough about the ACA, or health care in general, but CNN's Bob Acosta does.

Sean Spicer scrambled at today's press briefing after getting peppered with legitimate questions and criticisms of the GOP health care plan and the CBO's devastating report.

Throughout the debate, Spicer continued to bash the ACA's high deductibles, clueless to the fact that the GOP plan leans on them heavily on them. They're called "Health Savings Accounts." HSA's don't automatically come with thousands of dollars in them. It's not a pot of gold at the end of Paul Ryan's rainbow. Americans everywhere will have to put the money in them, just like deductibles, cash they probably won't have. Again, it's no different than being stuck paying a high deductible. Spicer continues to use the words "product" and "buy" as well. Our health is not a product.



By the way, the White Houses Office of Management and Budget did project how many people would lose insurance, 26 million, more than the CBO. Spicer denied they did, "not something OMB does," at the end of the clip. He lied.

The Director of Office of Management and Budget, Mick Mulvaney, treated health savings accounts like they're already filled with money, that they are somehow completely different from high deductibles. You'd think he would know better. Both require out-of-pocket costs that make health insurance unaffordable. Note: The ACA also provided an extra subsidy to help low income families pay for deductibles and copays, dramatically reducing them:

Conservative think tanks seek to empower us...by shifting health care costs our way!

Republicans have an odd way of putting you in charge. If you don’t mind paying a whole lot more out of pocket, then being empowered is a great idea. You’re in control when and if you ever decide to seek health care, based on what you can afford. If you make a bad decision, you have only yourself to blame. It’s guilt free politics that negatively affects every family member in the country.

This is how conservative thinks tanks are packaging the cost shift to public employees as rugged individualism:

A report by the Wisconsin-based MacIver Institute and the Dallas-based National Center for Policy Analysis  Argue State-Run System Should Be Closed To New Workers, People Under 45 … state Legislature should require younger public employees to use health savings accounts instead of the state's current health insurance system.

“Once it gets done and the actual employee and the actual retiree see that they're controlling more of their health-care dollars, they accept it and they find it empowering,” researcher John Graham said.

What they're really selling? 

Citizen Action's Robert Kraig (said) it would merely shift more of the financial burden of health care onto employees. “Their same report also concedes that this is going to shift a lot more of the financial burden onto the employee. So to then turn around and say that it's empowering because you control your own account, I think it's misleading.”

Just another liberal understatement that does nothing to energize our Democratic legislators to speak out…we are so bad at this. 

Republicans liked Health Savings Accounts, before they were against Health Savings Accounts...in ObamaCare.

Beating me to the punch, Ezra Klein wrote about the Republican hypocrisy and outrage over ObamaCare’s high deductible plans: The GOP has been pushing high deductible plans, health savings accounts (HSA’s) for years as the solution to our health care problems.

Every conservative, including our own Dumb Ron Johnson, had been pushing HSA’s. Now they hate it.

I had a health savings account for nearly 10 years, and believe me, they were a complete scam. Year after year insurers increased the deductible as a way to soften the blow of increased monthly premiums, sometimes in the middle of the policy. I couldn’t handle it anymore once they raised it to $10,400. And that about 10 years ago. Here’s what Ezra dug up:

Republicans have zeroed in on two things that people really will hate about insurance under Obamacare: The high deductibles and the limited networks. Brendan Buck, press secretary for House Speaker John Boehner, tweets... 
What's confusing about this line of attack is that high-deductible health-care plans -- more commonly known as "health savings accounts" -- were, before Obamacare, a core tenet of Republican health-care policy thinking. In fact, one of the major criticisms of Obamacare was that it would somehow kill those plans off. "Obamacare may be fatal for your HSA," warned the Heritage Foundation on 2010. "Health Savings Accounts Under Attack" blared Red State.

When Republicans were forced to come up with alternatives for Obamacare, high-deductible plans were core to those proposals. "Conservatives have suggested deregulating Obamacare’s exchanges to make it easier to provide policies with high deductibles," wrote Ramesh Ponnuru. One of those conservatives was right-wing darling Dr. Ben Carson. "In order to right the ship, we need to return the responsibility for good health care to the patient and the health care provider," he said. "One of the best ways to do this is through health savings accounts, which patients can control."

This always baffled Obamacare's supporters. "The minimal, or bronze, insurance option allows out-of-pocket spending of up to $12,500 for a family of four," wrote Jonathan Cohn. "Those are some pretty high deductibles!"

Now that those high deductibles are here, Republicans have decided that they are, if anything, too high.

"As I travel across Kentucky, I hear from many constituents who are seeing premiums increase along with higher co-pays and higher deductibles as a result of Obamacare," wrote Mitch McConnell in an op-ed for the New Democrat Leader. "Adding insult to injury, these constituents are discovering that despite these higher costs, they have no guarantee that they will be able to continue using the hospital of their choice." 

How dare Democrats implement these policies Republicans have been pushing for years! 

Republican backed Health Savings Accounts and Sequester driving doctors and hospitals out of Medicare.

My conservative friend in Milwaukee likes to blame Obama for making cuts to Medicare that will drive hospitals and doctors out of the program. But Obama and the Republicans are both trying to rein in costs by cutting payments to hospitals and doctors.

But surprise, it looks like Republicans are now in the driver’s seat when it comes to stripping Medicare of provider hospitals and doctors. With their backing of high deductible Health Savings Accounts and the sequester, folly they said would not result in anything dramatic, providers are losing hundreds of millions of dollars. Here's the audio:

Like I've been saying for years because I've had them, HSA’s discourage the insured from seeking care, which is great for insurers but lousy for the sick and medical community.

WPR: Ministry Health Care plans to cut between 225 and 250 full-time-equivalent workers at its 15 hospitals and 47 clinics. In a news release, two factors were cited: high deductible health insurance plans that are keeping people from seeking medical care, and federal sequestration budget cuts, which include a 2 percent reduction in Medicare payments to hospitals and physicians. Ministry officials say those cuts are costing them $10 million.

Steve Brenton, president of the Wisconsin Hospital Association, says Ministry is not the only medical organization being hurt by sequestration. “We have estimated that the one-year impact of sequestration — these Medicare budget cuts — is about $100 million for Wisconsin's 140 hospitals.”

I actually talked my doctors ear off asking him questions about the fate of Medicare, and he pretty much said the following:

Brenton there's another $30 million dollars in Medicare cuts for the physicians who are employed by those hospitals. He says other Wisconsin medical facilities may have to join Ministry in laying off workers.  “I would not be surprised at all. I know based on anecdotal information that many organizations have implemented targeted hiring freezes. And the bottom line is, if your revenues are going to be down $130 million dollars, it's going to have an impact on your ability to pay for expenses.”

South Carolina Rations Health Care to Elderly and Disabled. Republicans who Cried the Loudest about Rationing…are Rationing.

Gov. Mark Sanford doesn't believe in government, despite taking his paycheck and benefits, and apparently doesn't believe the elderly and disabled are important enough to help:

CNBC: COLUMBIA, S.C. - The state's Medicaid program plans to stop paying for adult dental, vision and hospice services and cut home health visits by a third for the state's elderly and disabled in February … the agency plans to eliminate routine infant circumcisions, cut prescription drug benefits and shoes for diabetics … even include umbrella and crutch holders for people who use wheelchairs while telling people to use powered wheelchairs for seven years instead of five before they can be replaced.

That’s not all. While Republicans push for tax cuts for the wealthy, the poor aren’t so lucky: The Department of Social Services has a $29 million deficit even after announcing plans to cut 20 percent from welfare checks beginning in February and the Department of Corrections is $7.5 million in the red and will close a prison if it doesn't get an OK.

The free market ability to negotiate is not applicable, for some reason, to government:

South Carolina is the only state in the nation where legislators have barred reducing payments to doctors and hospitals. Columbia dentist Jim Mercer, questioned plans to save $3.6 million by eliminating that care for 43,500 people. "Those emergencies aren't going to go away," he said. Instead those people will likely seek care at an emergency room, which can be more expensive.”

Low tax states have a problem don’t they? With “no new tax” promises from conservative politicians, and no flexibility to change with the times, rationing is the only option.

Health and Human Services director Emma Forkner said, "Yes, people will shift. Yes, care will have to move about. There's just simply is no more money in the state to pay for these things. I just can't reiterate it enough."

Health Savings Accounts Attract Healthy Wealthy! That raises costs for everyone else in traditional plans.

Again, rummaging through a few old saved doc's, I ran across the GAO study that basically destroys the argument for health savings accounts. Supported by Republicans, is it any wonder HSA's benefit the wealthy? They really are the party elite.

Yubanet.com: Senior House Democrats Pete Stark and Henry Waxman released a report by the Government Accountability Office (GAO) comparing enrollees in Health Savings Accounts (HSAs) and High-Deductible Health Plans (HDHPs) with enrollees in the traditional Federal Employees Health Benefits Program (FEHBP). During his State of the Union Address earlier this week, President Bush signaled that expanding HSAs and HDHPs would be a centerpiece of his domestic agenda.

Health policy experts are concerned these will attract only the healthiest participants, raising costs and risking coverage for other individuals and families who remain in traditional plans. The GAO report appears to validate these concerns. "This report screams 'buyers beware', verifying what we have suspected all along:

• HSAs and high-deductible health plans proposed by President Bush and the Republicans are designed for healthy, wealthy people.
• Despite this reality, President Bush is pushing them on low-income workers -- not to provide them with better health insurance, but to meet his long-term goal of dismantling employer-provided health care.
• HSAs are another way for the GOP to benefit their special interest friends -- in this case, the insurance industry, corporations, and wealthy taxpayers -- at the expense of America's workers."
• The President's Health Savings Account plan combines the worst elements of the President's failed Social Security privatization plan and his Medicare Prescription drug fiasco.
• HSAs would increase healthcare costs for many consumers, and force others to ration care, embroiling them in a confusing morass of accounts and bills when they should be focused on their health. Unfortunately, they have the potential to increase the number of uninsured."
GAO found:

* HSA enrollees are younger than enrollees in traditional healthcare plans. According to GAO, "individuals with certain demographic characteristics" - younger enrollees who have lower healthcare costs - "may be disproportionately attracted to these plans." The average age of HSA enrollees was 46 years old compared to an average age of 59 for enrollees in traditional plans. The oldest enrollees, those who were retired, were only one fourth as likely to sign up for HSAs

* HSA enrollees are wealthier than other FEHBP enrollees. HSA enrollees in the highest income bracket analyzed by GAO (those with incomes over $75,000) were over three times as likely to sign up for HSAs.

* HSAs and HDHPs failed to provide adequate information to enrollees. According to GAO, "HDHPs ... are premised on the notion that enrollees will become more actively involved in making health care purchase decisions .... To do so, enrollees need information to help them assess the cost and quality trade-offs between different health care treatments and providers. However, the extent to which FEHBP HDHPs made such information available to enrollees was varied and limited."

Critics of HSAs and HDHPs have long held that their expansion would jeopardize health insurance coverage for the more than 160 million Americans who are currently covered through their jobs. This could translate into a massive shift in costs to consumers who - in addition to having to pay more for coverage - would be left on their own to try to bargain with insurance companies for needed medical care.