Hey Sean Duffy, State Regulated One-Size-Fits-All Health Care is not the "Free Market," and High Risk Pools aren't "Totally Affordable."

It's stunning really. Republicans are so against "health care for all" that they haven't even bothered to educate themselves about one of the most important economic issues of our times. This is life or death stuff.

One of the least educated people to sit on the House Financial Services and Joint Economic committees is Rep. Sean Duffy, and it shows. Despite plunging the nation further into debt with a tax cut to the rich, "In regard to the debt, I'm gravely concerned," Duffy revealed how little he cares about peoples health care.

The fact that angry "resentful" Republican voters are okay with paying for a politicians government-run health care while being told they aren't worth it is still a mystery to me.

TAKE NOTE: You'll notice that Sean Duffy, like every other Republican, wants us to believe that state-regulated health care is really a "free market" system. It's nothing like a federally regulated health care system, which Duffy calls a government takeover.

Rep. Sean Duffy said he believes a free market system, with regulations handled by the state rather than the federal government, is better than what he calls one-size fits all model paid for by the government. 

"In Wisconsin, we had a system... we were able to get those with preexisting conditions into a higher-risk pool, they paid a little bit more, totally affordable, and they were absolutely able to get health insurance. But also if I take them out of the healthy people's pool, I'm able to keep their rates lower, but also guarantee those with a preexisting condition insurance."

GOP Gift to Insurers is OK?: When did Americans agree to protect insurance company profits by putting sick people in a separate taxpayer/premium supported pools? Insurance is based on spreading risk and keeping rates low with large insurance pools, just like ObamaCare did but was bashed by Republicans because rates were a little higher, but nowhere near the cost of high-risk pool rates for preexisting conditions.

The Wisconsin Cancer Council has put together the best summary explaining our supposedly nationally admired high risk pools, HIRSP, or "health insurance risk-sharing pools." So did these pools lower regular insurance premiums? actually, no one knows. Also, think of these pools as a maze you're told to navigate if you want coverage bad enough. Don't forget, Duffy says it's "totally affordable:"

1. HIRSP offered seven plans with different premium and out-of-pocket cost structures. 

2. All HIRSP plans had high deductibles – 80% of enrollees were enrolled in plans with either a $2,500 or $5,000 deductible. There is no clear evidence showing the magnitude of the impact HIRSP had on premiums in the broader insurance market.

3. Premiums in HIRSP were an average of 15% higher than new policies sold in the regular market, and varied based on age and sex. Wisconsinites who could not afford the premiums or high out-of-pocket costs were priced out of HIRSP and were left without another coverage option.

4. Low-income enrollees – household below $34,000 for a family of two in 2012 – were eligible for income-based subsidies ... 25% of all HIRSP enrollees received a subsidy. 

5. To reduce costs, HIRSP had a lifetime limit on benefits ($2 million). No HIRSP enrollees reached this limit.

6. Enrollees who were eligible because of a medical condition had a 6-month pre-existing condition exclusion period during which no medical services related to their condition were covered by HIRSP (prescription drug coverage was not excluded).

When you're just talking about cancer patients, excluding everyone else with a preexisting condition...

More than 285,000 cancer patients and survivors currently live in Wisconsin and need reliable access to health insurance that is affordable and comprehensive – free of pre-existing condition exclusions, high out-of-pocket costs, and other elements that increase the financial burden of a cancer diagnosis. Providing this type of coverage would require that a new version of HIRSP be sufficiently funded in order to remain affordable and sustainable.

Check out the rates (don't forget high deductibles not listed here) way back in 2013, imagine what they might be today, and then tell me how "they're a little bit more, totally affordable."

ACA opponent Walker wants us to believe he'll protect the uninsured and lower insurance rates?

Scott Walker wants us to forget about "the devil in the details," like how he would end up covering pre-existing conditions...if at all.

Republicans hate "ObamaCare" because it does just that, creating a large pool that spread the cost to everyone. Is this another "good cop" Scott Walker vs "bad cop" legislature? And don't think for one minute Walker isn't aware of public opinion?

The Democrats' strategy to focus on health care in the midterm elections has helped crack open opportunities in states they wouldn't have dreamed of winning two years ago.

Doing this would be costly for taxpayers and raise premiums for the insured, just so insurance companies could make money instead of spending it;

Would the Wisconsin Legislature be willing to adopt many of the provisions in the Affordable Care Act? That would have to happen ... The Trump administration is asking the court to strike down the protections for people with pre-existing conditions...

Insurers would have multiple ways to avoid covering people with pre-existing health conditions, even if required to sell them insurance.

If a health insurer didn’t want to attract people with high medical costs it could exclude expensive specialty drugs from its benefits or not cover drugs at all ... Impose limits on annual and lifetime out-of-pocket expenses.

Like Walker, Republicans on a national level are repeating the same lie. WaPo:

The Pinocchio Test: In many ways, the GOP pledge on preexisting conditions is the equivalent of Obama’s infamous pledge that under Obamacare, “if you like your plan you can keep it.” It may look great on paper, but the reality is that it is not a sustainable pledge. That was apparent with Obama’s promise when the ACA was being debated — as The Washington Post highlighted three times in 2009and 2010 — and that’s also the case here. The problems inherent in the structure are well documented in the CBO report.

Thus Cramer goes too far to claim that in the AHCA, there are “safeguards to make sure that there’s not price discrimination as a result of preexisting conditions.” In a state that did not seek a waiver, that might have been correct. But the proposed law gave states the option to seek waivers that would in effect nullify those promises, and it is quite possible North Dakota would have been one of those states. He earns Three Pinocchios

And funding those high-risk pools?

HIRSP also had a cost. It was funded by a tax on health insurance sold in Wisconsin. And health systems, physicians and other health care providers were paid rates slightly above those for Medicare but much lower than those paid by commercial insurers.

Walker's Reinsurance ploy likely won't get Trump's $150 million Funding help! Hello High Risk Pools!

After mentioning Scott Walker's supposed attempt to prop up the Affordable Care Act, my conservative Trumpian friend in Milwaukee said Walker's move to the middle was a bad idea.

But Walker isn't really budging from his radically right wing position.

To get reelected, grand illusionist Scott Walker is again saying he's trying to repair a problem Republicans in DC created, with his reinsurance plan, at the same time sending his AG out with a lawsuit to repeal the ACA...crazy right? That's what makes this a temporary election year ploy:

Reinsurance: What is it? A reinsurance fund helps insurance companies pay high-cost medical claims, to try to reduce premiums for everyone. In 2014 to 2016, the Affordable Care Act marketplace had temporary federal reinsurance, designed to stabilize premiums in the early years of the marketplace...premiums went up an average of 38 percent for the 225,000 Wisconsin residents.

"State" Reinsurance Con Game: It only looks like Walker is asking for the reinsurance funding Congress just stopped in its tracks. Here's the con: the "state" reinsurance program requires three fourths of money coming from Trump ($150 million)...so don't hold your breath. But it might get Walker votes and reelected.

What Walker is doing is setting up a move to bring back the states failed high-risk pools. Back in 2017...

Gov. Scott Walker, as part of his election-year health care plan, asked the state Senate to pass a pre-existing conditions bill approved by the Assembly in June amid some political maneuvering.

What’s the debate? The original bill, introduced by Democrats, banned lifetime caps on health insurance, which the Affordable Care Act also prohibits. Republicans stripped out that wording and inserted their own language. The new bill requires insurers to cover people with pre-existing conditions but allows the state insurance commissioner to alter protections, possibly by re-establishing a high-risk pool for such people. The bill is now in the Senate, where Sen. Jon Erpenbach, D-Middleton, introduced an amendment to remove the insurance commissioner provision.

Without the insurance commissioner, no high risk pools or lifetime caps. But nothing is stopping Republicans from passing this. So it's back to the way it was. Keep in mind, high risk pools are funded by you and me, taxpayer dollars. How effective was it? :

Wisconsin's high-risk pool insured about 21,000 people, with critics saying high prices kept tens or hundreds of thousands of others from accessing it. Those applying for the program had to wait six months before they were allowed into it and a lifetime cap of $2 million. Health Insurance Risk Sharing Plan lost $6.9 million in 2011, roughly a third of which was offset by a federal grant, according to the Wisconsin Legislative Fiscal Bureau. The same year, programs in the 35 states lost a total of at least $272 million.

 Here's the GOP health care reform scam:

The plan includes $10 billion per year in “state innovation grants,” which are a version of high-risk pools to help sick people get coverage and stabilize premiums but appear to allow for a broader array of uses for the money by states. Prior to the passage of the Affordable Care Act, however, many of these state plans ended up being so expensive, because they covered only sick patients, that they had to cap enrollment.

Also check this article out as well:

High Risk Pools make Taxpayers, not Insurance Companies, to pay for Preexisting Conditions.

You will be hearing a lot about high risk pools, but you won't be told how bad they are.

Even worse, it forces the public to pay for the sick, in tax dollars and higher insurance premiums, while private insurance companies rake in billions covering healthy people. Seriously, you buying this?

Democrats apparently have not done their homework, because otherwise they would shouting on every roof top blaming Republicans for shifting the cost of preexisting conditions off onto taxpayers. Yup, some of the same taxpayers who complained about paying for someone else's medical care with their hard earn money.

Here's the GOP health care reform scam:

The plan includes $10 billion per year in “state innovation grants,” which are a version of high-risk pools to help sick people get coverage and stabilize premiums but appear to allow for a broader array of uses for the money by states. Prior to the passage of the Affordable Care Act, however, many of these state plans ended up being so expensive, because they covered only sick patients, that they had to cap enrollment.

Think of how many people will be uninsurable each and every year. We're human, most of us will get sick. At a recent town hall, one constituent presented this angle:

To get a handle on just what this means...look at what happened before the ACA:

High-risk pools have been tried before, with mixed results. It worked like this: 

1. Sick people with problems ranging from arthritis to congestive heart failure were placed in a separate insurance pool, with government and insurance companies helping to cover costs. 

2. They were also charged higher rates, up to double the amount paid by consumers with no serious ailments.  

3. 30 states that had high-risk pools, net losses piled up to more than $1.2 billion in 2011, the height of the pools before the Affordable Care Act took full effect.

4. The programs covered about 225,000 Americans back then. 

5. Most pools had lifetime and annual limits on coverage. Some imposed waiting periods of up to a year for coverage of a pre-existing condition.

6. Some states offered income-based assistance. Most did not.

7. In every state that ran a high-risk pool in 2011, medical expenses outpaced premiums, and losses averaged $5,500 per enrollee. States used fees and taxes to make up the difference. 

Health care base on Ideology, not Reality: 

The nonpartisan Kaiser Family Foundation estimates that 27 percent of adults under age 65 have health conditions that would likely leave them uninsurable under practices that existed before the health care overhaul. Affordability is another matter, and would be handled differently in each state under the GOP plan.