The 2016 Republican Party Platform (.pdf) at page 31 declares:
Restoring Patient Control and Preserving Quality in Health Care
Any honest agenda for improving healthcare must start with repeal of the dishonestly named Affordable Care Act of 2010: Obamacare.
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We agree with the four dissenting justices of the Supreme Court: “In our view, the entire act before us is invalid in its entirety.” It must be removed and replaced . . .”
Well, Tea-Publicans have been saying “repeal and replace” for six years now and have yet to produce any actual “replacement” plan that is anything more than reverting to the failed system that everyone hated before the Affordable Care Act. Their only true objective is repeal, period.
Donald Trump’s healthcare “plan” (it’s a list of platitudes) retains some of the most popular provisions of ObamaCare, but nevertheless proposes to replace ObamaCare with the worn out GOP standards of health savings accounts and interstate sales of health insurance policies (a race to the bottom in coverage, and it creates a legal morass for consumers with “choice of venue” provisions where to sue your insurer when denied coverage).
The Rand Corp. and the nonpartisan Commonwealth Fund published an analysis of Democratic presidential nominee Hillary Clinton’s health agenda on Friday, along with a second analysis examining the proposals from her Republican rival, Donald Trump.
The big takeaway: 25 million people could lose health insurance under Donald Trump’s plan, analysis shows:
Trump’s proposal to repeal the Affordable Care Act, President Obama’s health-care law, would result in as many as 25 million Americans giving up coverage, depending on how the repeal is implemented.
As many as 9.6 million Americans could gain health insurance under Hillary Clinton’s proposal to provide families a tax credit to help them pay for premiums, deductibles and coinsurance, according to a new analysis. For a typical family in the lower-middle class, the credit would reduce health-care expenses by roughly a third, but it would come at a cost to taxpayers of roughly $90 billion in the first year.
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Clinton’s plan would expand coverage, but only by supporting the insurance market with substantial and expensive new subsidies. Trump, for his part, has not come up with a replacement that could maintain the same level of coverage, and millions who gained insurance under the Affordable Care Act would become unable to afford it again under his policies.
TRUMP’S PROPOSALS
The Affordable Care Act provides financial help to Americans purchasing insurance on the individual market if they are not covered through the government or their employers. The law also requires insurers to cover people whether or not they have existing illnesses.
Finally, to prevent newly covered unhealthy patients from increasing costs for insurers uncontrollably, the law requires nearly all Americans to buy insurance, in order to guarantee that the costs of caring for society’s unhealthiest members would be widely shared.
Despite its flaws, this system — along with the law’s expansion of the Medicaid program — has allowed millions of people to obtain insurance who did not have coverage before. Roughly 20 million would probably become uninsured again if Trump is elected and Congress votes to repeal the law, according to the report. Health-care costs for the typical family enrolled in the individual market would increase from about $3,200 to about $4,700 a year.
On top of that, according to the report, another 5 million Medicaid beneficiaries could lose coverage if Trump implements his proposal to convert the Medicaid program into a fixed annual grant to states to use as they see fit. The grant might not be sufficient for states to continue paying for those beneficiaries’ medical treatment.
Several of Trump’s policies could mitigate these effects on coverage. Trump has proposed allowing enrollees in the individual market to deduct their premiums from their taxable income, which would result in about 4 million more subscribers retaining coverage than in a scenario in which the Affordable Care Act is simply repealed.
The New York businessman has also proposed making it easier for insurers to sell policies across state lines, which the analysis predicts would allow about 2 million people to retain coverage.
These policies would have the greatest effect on poor and working-class Americans. Poor families are more likely to rely on Medicaid. Allowing policyholders to deduct their premiums would primarily benefit more affluent households, and more Americans in this group would become insured under Trump’s plan.
If Trump repealed the Affordable Care Act and replaced it with his proposed deduction, the number of Americans in poverty without insurance would roughly double from 12 million to 22 million. By contrast, the number of uninsured Americans with household incomes of between $61,000 and $97,000 for a family of four would decline from about 4.4 million to about 3 million, according to the report.
Like Clinton’s proposals, Trump’s would come at a cost to the federal government, because he would eliminate the increases in taxes under Affordable Care Act. Repealing the law would add roughly $33 billion in the first year to the federal deficit, and roughly $41 billion with the proposed deduction for premiums.
CLINTON’S PROPOSALS
Hillary Clinton has proposed a tax credit, worth up to $2,500 for individual taxpayers and up to $5,000 for families, that subscribers could use toward their medical costs, including premiums and other out-of-pocket expenses.
This credit would encourage some families that have not purchased insurance because of the costs of deductibles and coinsurance to join the market. Also, because this credit would be available to poor Americans that are ineligible for Medicaid because they live in states that rejected the program’s expansion. Overall, the credit could reduce the number of uninsured by 9.6 million.
The credit would be worth the most to the middle class. For a family of four with between roughly $34,000 and $61,000 in household income, health-care costs would decrease from about $1,700 to about $1,100 a year on average. For families with incomes between $61,000 and $97,000, costs would decline from about $3,100 to about $2,600.
Clinton has called for other policies that would also reduce the number of people without insurance.
She has proposed making the existing subsidies available through the Affordable Care Act more generous and making it easier for workers with subsidies to get those subsidies if the family plans offered by their employers are too costly. Together, these two policies would reduce the number of uninsured by about 2.8 million at a cost of about $10 billion in the first year to the federal government.
Creating a public option for insurance by allowing people who are not elderly to buy policies through Medicare would allow about 400,000 more people to obtain coverage.
The public option would modestly improve federal finances, the report projects, because private insurers would be forced to reduce premiums on the individual market to compete with cheap public insurance. The reduction in private-sector premiums would also reduce the subsidies the government is obliged to pay policyholders under the Affordable Care Act to help them afford coverage. These savings would total about $700 million in the first year.
So Americans can continue to move forward with improvements to the Affordable Care Act, including addition of the public option, or we can regress backwards and take away health insurance coverage from 25 million Americans who now have it — many of them for the first time in their life — while adding to the federal deficit to benefit the wealthy at the expense of the poor.
Remember that Senator John McCain and our Tea-Publican congressional delegation in Arizona (sans Martha McSally) have endorsed Donald Trump.
McCain has built his campaign for reelection around repealing the Affordable Care Act aka Obamacare. He is critical of Rep. Ann Kirkpatrick for having voted for the Affordable Care Act. Quite the opposite, the criticism should be directed at John McCain and his GOP colleagues for their moral depravity when it comes to providing health insurance for Americans.
The GOP health care plan is effectively “Perhaps you should die and decrease the surplus population” if you are not wealthy enough to afford health insurance. For the GOP, health care is a privilege of wealth, not a human right.
we need medicare for all.
AzBM, it is a mistatement to say the subsidies will be paid for by the Federal Government. The subsidies will be paid for by you and me and other taxpayers. The Federal Government has no money to “give” unless it takes money away from someone else first.
I was a big supporter of the ACA when it was proposed and I had high hopes it would work the way it was pitched. Unfortunately, it has not worked that way and it appears more and more that the ACA is just another wealth transfer scheme that is being used to force us into a single payer system. As Nancy Pelosy said about the ACA, “We will have to pass it to really see what is in it.” Well, we are finding out and, in general, it is more negative than positive.
As far as the differences between Hillary’s and Trump’s health care proposals are concerned: Hillary’s sounds like more of the same, or more expensive, and Trump’s sound pretty much the same, but at half the price. Either one is stupid.