Home
Log in / Sign Up
    Private Messages   Advanced Search   Rules   New User Guide   FAQ   Advertise   Contact Us  
Forum -> In the News
Rand Paul reveals PPACA replacement.



Post new topic   Reply to topic View latest: 24h 48h 72h

MagentaYenta




 
 
    
 

Post Wed, Jan 25 2017, 2:52 pm
This is from The Hill. I will copy it here for ease of access and supply a link to the actual proposal when I find it.

______________________________

Sen. Rand Paul (R-Ky.) unveiled an ObamaCare replacement bill Wednesday as part of his effort to urge the GOP to speed up work on an alternative to the healthcare law.

Paul has been pushing his colleagues to have a replacement plan ready to pass simultaneously with repeal of ObamaCare, a demand that has recently been gaining support inside the party. His office noted that President Trump and Speaker Paul Ryan (R-Wis.) have also reacted favorably to that idea.

“There is no excuse for waiting to craft an alternative until after we repeal Obamacare, and the Obamacare Replacement Act charts a new path forward that will insure the most people possible at the lowest price,” Paul said in a statement.

Paul’s plan comes the same week that two other Republican senators, Bill Cassidy of Louisiana and Susan Collins of Maine, introduced a different ObamaCare replacement, also with the hope of spurring their party to move forward on an alternative in addition to repealing the Affordable Care Act. That plan was more centrist, keeping ObamaCare’s taxes and letting states choose to keep the existing healthcare law if they wanted.

Paul’s plan includes a tax credit of up to $5,000 per person to use as part of a Health Savings Account to pay for medical care. That tax credit appears to be larger than those offered in other Republican healthcare plans.
The plan would abolish many of the central elements of ObamaCare, including the mandate that everyone has coverage. It would eliminate the minimum standards for which health services an insurance plan must cover, which Republicans argue would allow for cheaper, less comprehensive plans.

It would also eliminate some of ObamaCare’s protections for people with pre-existing conditions. Instead, Paul proposes a two-year period where people with pre-existing conditions could get coverage. After that, people with pre-existing conditions would be protected if they continuously maintained coverage. ObamaCare, on the other hand, also protects people who are uninsured and signing up for the first time.

The plan would end the exclusion of employer-sponsored health plans from taxation, a politically fraught move because it would affect the coverage of millions of people with employer-sponsored plans. In its place, Paul’s plan would provide a universal tax deduction for health insurance.

http://thehill.com/policy/heal.....ement
Back to top

MagentaYenta




 
 
    
 

Post Wed, Jan 25 2017, 2:59 pm
Here is the link with the text of the bill.
https://www.paul.senate.gov/im.....s.pdf
Back to top

SixOfWands




 
 
    
 

Post Wed, Jan 25 2017, 3:05 pm
I just randomly chose a plan currently available through an organization with which I am associated. With a $13,000 annual family deductible, the cost at age 26 is $970 per month (just south of $12,000 per year). With a modest $2600 deductible, the cost is about $1630 a month (just south of $20,000 per year). Edited to clarify this is for a family, not an individual.

The $5000 isn't going very far for low income families.

I hasten to add this is good insurance, not junk, catastrophic care insurance.
Back to top

MagentaYenta




 
 
    
 

Post Wed, Jan 25 2017, 3:12 pm
SixOfWands wrote:
I just randomly chose a plan currently available through an organization with which I am associated. With a $13,000 annual family deductible, the cost at age 26 is $970 per month (just south of $12,000 per year). With a modest $2600 deductible, the cost is about $1630 a month (just south of $20,000 per year). Edited to clarify this is for a family, not an individual.

The $5000 isn't going very far for low income families.

I hasten to add this is good insurance, not junk, catastrophic care insurance.


That $5k in tax credits, which most poor or working poor families won't use.

What bothers me is that under this plan states will have little regulatory capacity when it comes to insurance companies selling policies within a state. Some states insurance commissions regulate costs and coverage. This will be gone and the Ins. companies will be unregulated free agents.
Back to top

Fox




 
 
    
 

Post Wed, Jan 25 2017, 3:56 pm
I like the changes regarding Association Health Plans, and I'm not necessarily opposed to so-called "junk plans" if they get people to sign up for insurance instead of going without.

However, the tax credits seem relatively worthless in solving the problem, though maybe I just don't know the underlying economic facts.

Ultimately, I think we have to find a way to get meaningful tort reform at the state level along with a more competitive or at least realistic model for drug pricing.
Back to top

SixOfWands




 
 
    
 

Post Wed, Jan 25 2017, 4:31 pm
Fox wrote:
I like the changes regarding Association Health Plans, and I'm not necessarily opposed to so-called "junk plans" if they get people to sign up for insurance instead of going without.

However, the tax credits seem relatively worthless in solving the problem, though maybe I just don't know the underlying economic facts.

Ultimately, I think we have to find a way to get meaningful tort reform at the state level along with a more competitive or at least realistic model for drug pricing.


How "junk" is the "junk" plan you'd be OK with (for others, presumably).

No prescription drug coverage?

No maternity benefits?

No mental health benefits?

OK, some of these might be reasonable for an informed consumer.

But what about a policy that pays $50 towards doctor's visits, and some limited well-care items, but nothing else?

A policy with annual limits of $1,000 a year for outpatient treatment and $2,000 for hospitalization?

(Real examples, BTW.)

These are problematic, IMNSHO. At least if you don't have insurance, you know where you stand. People bought these things, or got them from insurers, and naively believed they had real coverage. They didn't.
Back to top

Fox




 
 
    
 

Post Wed, Jan 25 2017, 5:11 pm
SixOfWands wrote:
How "junk" is the "junk" plan you'd be OK with (for others, presumably).


Can we limit the snark and stay friendly?

Every health insurance plan is a "junk" plan when your care costs more than the insurance company expects to pay.

You can sign up and pay premiums for the most deluxe plan available, and if you encounter catastrophic health care costs, you will become familiar with a whole slew of people with law degrees whose entire job is to find and/or activate loopholes that prevent them from having to pay.

Now, you can take them to court, and you can win. Insurance companies are not popular. But you have to stay alive long enough to do that and you have to hire your own lawyer.

How about if the situation isn't quite "catastrophic"? Let's say you just need an expensive drug. No insurer just says, "Oh, sure! Here's $75 a day for that pill your doctor prescribed." Instead, they deny coverage. And you appeal. And they deny again. And you appeal again. And everyone writes letters and gets lawyers involved. Eventually, if you're still alive and haven't alienated your physician with requests for reams of paperwork, you will probably win.

I used to say that the only people who have "good" insurance are people who haven't needed it.

I agree that consumer protection is a huge problem, but it's usually better to legislate disclosure versus legislating what can be sold.
Back to top

SixOfWands




 
 
    
 

Post Wed, Jan 25 2017, 5:27 pm
Fox wrote:
Can we limit the snark and stay friendly?

Every health insurance plan is a "junk" plan when your care costs more than the insurance company expects to pay.

You can sign up and pay premiums for the most deluxe plan available, and if you encounter catastrophic health care costs, you will become familiar with a whole slew of people with law degrees whose entire job is to find and/or activate loopholes that prevent them from having to pay.

Now, you can take them to court, and you can win. Insurance companies are not popular. But you have to stay alive long enough to do that and you have to hire your own lawyer.

How about if the situation isn't quite "catastrophic"? Let's say you just need an expensive drug. No insurer just says, "Oh, sure! Here's $75 a day for that pill your doctor prescribed." Instead, they deny coverage. And you appeal. And they deny again. And you appeal again. And everyone writes letters and gets lawyers involved. Eventually, if you're still alive and haven't alienated your physician with requests for reams of paperwork, you will probably win.

I used to say that the only people who have "good" insurance are people who haven't needed it.

I agree that consumer protection is a huge problem, but it's usually better to legislate disclosure versus legislating what can be sold.


No snark intended. I simply meant to convey that I thought that you were likely to have good health insurance, as I view you as intelligent enough to know what you're getting for yourself. But I agree that it was very worded poorly, so I apologize for any offense I may have caused.

What you describe is what I see as the problem with the entire US insurance industry. Obamacare had some provisions to curb the worst abuses (such as trying to find omissions in applications that would allow coverage denial). The insurance companies balance whether it is cheaper to pay for our care, or to let us die and absorb the costs of the lawsuit. That simply should not be. (Although, TBH, we've gotten some coverage for expensive meds without a fight. And we've had to fight for others.)

Disclosure, IMNSHO, doesn't help. First of all, many of the "junk" policies were employer-provided. Minimum wage employees aren't going to be able to get anything better. Second, people, especially young people, are falsely optimistic. They think nothing can happen to them, until it does. The issue is compounded due to pre-existing condition preclusion (if they exist) -- oh nothing could happen to me, SHOOT, who can believe ....; whadaya mean I can't get insurance to cove that, ever. Third, there are people who just plain old won't understand, and they need to be protected from themselves.
Back to top

MagentaYenta




 
 
    
 

Post Wed, Jan 25 2017, 6:11 pm
Between high risk pools and pre existing conditions, lots of individuals will be priced out of the insurance market. The plan I linked to has a couple of different takes on pre existing conditions. Supposedly they could be covered with a waiting period, this was something that traditional insurers used prior to the PPACA. In this case you will have a three year wait for a pre existing condition and during that time you will have to have continuous coverage from the same insurer. Since Rand Pauls plan isn't really fleshed out it's hard to know that if you seek treatment via a private pay option during the waiting period will you still get coverage after the waiting period is over. This too was an issue prior to the PPACA and was addressed in many instances via state regulation. Under RPs plan the state insurance regulatory agencies will no longer have much say in how a company operates within a particular state. Regulation will be on a federal level. States will not have the power to rate review, or make coverage requirements.

Limits on pre existing conditions are not just a bugaboo for older patients but for children with chronic illnesses (think asthma), and women who have had prior complicated pregnancies. (Two examples.)
Right now RPs plan seems to be a nonstarter. It's likely to get more detailed if he can muster some support for it. As it stands now, it's a nonstarter for me as it is.
Back to top

Fox




 
 
    
 

Post Wed, Jan 25 2017, 6:26 pm
MagentaYenta wrote:
Regulation will be on a federal level. States will not have the power to rate review, or make coverage requirements.


Actually, I think this may be an advantage. It will allow insurance companies to be taken to federal court. I'm not a lawyer, but I've been told that this is a huge advantage for consumers. The judges are appointed rather than elected (varies by state) and are generally of a higher caliber. In addition, there are apparently various legal maneuvers available at the federal level that can force the matter into court quickly.

In general, I am loathe to give the federal government too much power, but this might be an exception.
Back to top

MagentaYenta




 
 
    
 

Post Wed, Jan 25 2017, 7:01 pm
Fox there are a couple of reasons I'm not sweet on removing a states power to regulate business. Besides it being contradictory to RPs small govt. position, it is also contrary to his states rights position. Aside from his positions on the matter, I've seen how a well regulated insurance industry can benefit consumers and citizens of a state. Where I live our insurance industry is well regulated. If a company wants to sell insurance here they have to comply with minimum standards of coverage (not junk policies, but catastrophic policies are allowed, within limits). Premiums are also contained, because they are based on costs within the state. That means if a company that sells in NY can justify a higher premium because of NY rates it won't fly here. If rates are increased they have to be justified based on local costs, not the cost of delivery in another state. My state did have some premium increases from for some insurers, but not all. And the increased premiums they asked for were not always granted in the amounts requested. Interestingly enough there wasn't a mass exit of insurance companies from the state.

State boards also limit the licensing of agents and brokers who sell within that particular state. From a small govt. position, that just doesn't work. Fed employees (under hiring freezes) will have to assume the roles/responsibilities of state boards. That requires more departments/personnel to cover the work done by these boards. It's a huge undertaking on a nationwide basis, when there are already local entities doing this job. Say if I had a complaint about my ins. carrier, I'd complain to the state board. Turn around time to resolve these issues would be increased since the Feds would now be dealing with the complaints coming in from all the states.

Ok sorry if this was so long. I think if we are going to eliminate the PPACA these conversations are necessary in order to avoid some of it's pitfalls.
Back to top
Page 1 of 1 Recent Topics




Post new topic   Reply to topic    Forum -> In the News

Related Topics Replies Last Post
Who does Liftmaster Garage Door Battery Replacement?
by amother
0 Tue, Feb 27 2024, 11:32 pm View last post
Paying for Septic Field Replacement with a credit card, does
by amother
3 Tue, Feb 06 2024, 5:04 pm View last post
Anyone did a field replacement with Champion?
by amother
12 Thu, Feb 01 2024, 7:49 pm View last post
Time Sensitive: When doing a Septic Field replacement,
by amother
0 Wed, Jan 31 2024, 6:56 pm View last post
My dryer broke.. please recommend a good replacement
by amother
9 Sun, Jan 07 2024, 8:24 pm View last post