New GOP health-care plan is a starting point for a conversation, not a replacement
By Editorial Board, WashPost, Published: February 14
FOR YEARS, Republicans have sniped at the Affordable Care Act without offering a reasonable alternative. Three GOP senators are trying to change that. Richard Burr (N.C.), Tom Coburn (Okla.) and Orrin G. Hatch (Utah) have offered an outline of a health-care-reform package that they say could take the ACA’s place.
Given the shrill rhetoric from the GOP side, one might expect that Republican reform would have nothing in common with Obamacare. But there are only so many ways to preserve the patient protections that the ACA offers, which Republicans say they want to keep, while maintaining a private insurance market and assisting those who can’t afford coverage.
Like the ACA, the senators’ plan would insist that insurance companies sell policies to people with preexisting conditions. To keep insurers economically viable despite that demand, the senators, like President Obama, would press all Americans, healthy and sick, to buy coverage. The mechanism would be not an individual mandate but flexibility for insurance firms to charge unhealthy people more if those people hadn’t maintained coverage continuously. That’s arguably a sharper incentive to get covered than the relatively small fines the individual mandate applies to those lacking insurance.
Poor Americans would get smaller subsidies than the ACA offers to help them buy private coverage, but the senators would let them enroll in cheaper, less comprehensive plans. The senators also propose to “auto-enroll” poor people into plans that would cost no more than the subsidy the government would give them — for free, in other words.
(More here.)
FOR YEARS, Republicans have sniped at the Affordable Care Act without offering a reasonable alternative. Three GOP senators are trying to change that. Richard Burr (N.C.), Tom Coburn (Okla.) and Orrin G. Hatch (Utah) have offered an outline of a health-care-reform package that they say could take the ACA’s place.
Given the shrill rhetoric from the GOP side, one might expect that Republican reform would have nothing in common with Obamacare. But there are only so many ways to preserve the patient protections that the ACA offers, which Republicans say they want to keep, while maintaining a private insurance market and assisting those who can’t afford coverage.
Like the ACA, the senators’ plan would insist that insurance companies sell policies to people with preexisting conditions. To keep insurers economically viable despite that demand, the senators, like President Obama, would press all Americans, healthy and sick, to buy coverage. The mechanism would be not an individual mandate but flexibility for insurance firms to charge unhealthy people more if those people hadn’t maintained coverage continuously. That’s arguably a sharper incentive to get covered than the relatively small fines the individual mandate applies to those lacking insurance.
Poor Americans would get smaller subsidies than the ACA offers to help them buy private coverage, but the senators would let them enroll in cheaper, less comprehensive plans. The senators also propose to “auto-enroll” poor people into plans that would cost no more than the subsidy the government would give them — for free, in other words.
(More here.)
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RE : The senators also propose to “auto-enroll” poor people into plans that would cost no more than the subsidy the government would give them — for free, in other words.
So what’s the problem? The proposal would push people, particularly the poor, toward much skimpier coverage than the ACA offers. Since they could trade up when they got sick, people would have an incentive to avoid paying for more comprehensive plans until they needed them.
There is another problem that is just beginning to get some media attention ... people not realizing what the policy allows ... in other words, what hospital is included - or better stated, what hospital is not.
Case in point -- in New Hampshire, Anthem Blue Cross Blue Shield is the only insurer selling its products on the state’s independent exchange. They cover 16 of the state’s 26 hospitals in their reimbursement network. Among the excluded is Frisbie Memorial Hospital in Rochester, which serves about 75,000 patients a year, according to Al Felgar, the medical center’s chief executive officer.
“When we found out we weren’t in the network, we immediately contacted Anthem, and we were told it was not something they would discuss,” Felgar said.
Another one is in Seattle Children’s, excluded from five of seven plans on Washington’s state insurance exchange. The hospital, which has sued the state to be included in more plans, is struggling to get paid for care given to about 125 children since Jan. 1 ... and is appealing to get paid.
Conversely, the "big boys" may be the winners -- At HCA Holdings Inc., the biggest U.S. chain by market capitalization, 97 percent of the 165 hospitals it owns are included in Bronze and Silver plans on the Affordable Care Act exchanges, Chief Executive Officer Milton Johnson said last month. The Nashville, Tenn.-based operator expects “to get a lift” from the health law, as many of HCA’s most important markets, in Florida and Texas, had high levels of uninsured whose care will now be paid for by Obamacare.
HCA Holdings may be remembered for being started by former Majority Leader Bill Frist's family.
Our area does not have any Platinum plans and only two insurance companies participating ... if there are Death Panels, it is not the government but the insurance companies.
We need universal participation and universal coverage.
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