Senate Healthcare Bill Released (zombied for now)

CharminTide

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We're still waiting on details. There's been no mention of pre-existing condition coverage yet, but most assume it will scrap those protections, like the House bill. As folks get to analyze the bill and the CBO releases its score (which is required if the bill is to pass via reconciliation), we'll find out more.

Here's an initial summary, with full text of the bill: LINK

After weeks of secret negotiations, the US Senate has released an anticipated draft of a bill that could upend the healthcare system for millions of Americans.

The Senate’s 142-page proposal unveiled Thursday would eliminate or reduce key benefits provided by the Affordable Care Act, strip funding from the women’s reproductive health provider Planned Parenthood and dramatically cut and restructure Medicaid, America’s public health insurance program for low-income and disabled Americans.

The legislation mirrors the House bill that narrowly passed last month, but with modest changes intended to win support from moderate Senators. Meanwhile, Republican leaders emphasize the legislation is subject to change as they negotiate details of the proposal in an effort to win 50 votes, the minimum required to pass.

Experts believe the bill could leave millions of Americans without health insurance, and could have a stark impact on vulnerable populations such as recovering drug addicts, aging middle-class baby boomers and women and children.

That impact is likely to prompt questions about how senators can sell voters on a bill that left the House with a 17% public approval rating, and the expectation that 23 million Americans will lose health insurance.

Senators want to give the middle-class tax credits to buy insurance, but the tax credits would still be worth less than those currently provided by the Affordable Care Act, better known as Obamacare. People would also need to earn less money to quality for them.
The bill would also slash Medicaid, a program that pays for half of all births in the United States and provides health insurance to one in five Americans. If passed, changes in the Senate bill would be some of the most significant health reforms for low-income Americans in more than 50 years.

The bill would change Medicaid from a program that matches states’ contributions, no matter the spending, to one with a capped budget called “per capita” spending. The House bill would have cut more than $800bn from the program. Those levels of cuts were expected to result in 14 million people being pushed from the program. As states look for ways to save money, they could be pushed to cap levels of spending on individual recipients, impacting costly beneficiaries like the elderly and disabled.

Some especially vulnerable populations could also see major changes to their healthcare. An estimated 220,000 recovering drug addicts depend on Medicaid for drug treatment, an analysis by the left-leaning Center for Budget and Policy Priorities found. That could worsen America’s ongoing opioid overdose crisis, which killed more than 50,000 Americans in 2016.

The bill would also prohibit Planned Parenthood from participating in Medicaid for one year, forcing hundreds of thousands of women to find a new source of reproductive health care.

Each year, about 1.6 million patients, mostly women, receive sexually transmitted infection tests, contraception and cancer screenings at Planned Parenthood through federal programs like Medicaid. Planned Parenthood, in return, receives roughly half a billion dollars annually in federal Medicaid reimbursements.
 

CharminTide

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Re: Senate Healthcare Bill Released

Senators are saying the votes aren't there for this bill. Trump is saying it's in need of some renegotiation. And to top off McConnell's morning of great political optics:

Disabled Protesters Carried Away From McConnell's Office


Capitol Police removed protesters, many of whom are disabled and use wheelchairs, from outside Senate Majority Leader Mitch McConnell's office after text of the GOP Senate health care bill was released Thursday.

Protesters were organized by a group called ADAPT, which identifies itself as a nonprofit for people with disabilities.

Video of the protest shows the protesters being carried away by police officers as they chanted "no cuts to Medicaid." Empty wheelchairs remained in the hall after the arrests, the video shows.
 

Bazza

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Re: Senate Healthcare Bill Released

Heard bits and pieces on the radio today.....did I understand correctly that there will no longer be an individual MANDATE....nor will there be a PENALTY for not enlisting?

If so.....:party:
 

CharminTide

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I'll never understand how the Democratic party is so terrible at messaging. Producing a unified and effective message isn't exactly hard right now. Let's just quickly synthesize two horribly unpopular GOP policies into a single talking point:

1) Healthcare reform. It's been released, but we still don't know what's in this Senate bill since McConnell apparently drafted it himself in a locked closet without even input from his own party. But the initial impression is just as a horrible as the House bill, one of the most unpopular pieces of legislation in generations. By all accounts, the Senate bill looks very similar and will be just as unpopular once more details emerge.

2) Tax cuts for the extremely wealthy. The GOP healthcare reform bill is actually a tax reform bill, aimed at massive (and retroactive) tax cuts for the extremely wealthy at the expense of health coverage for the poor and middle class. For example, Shelton Adelson's taxes would be cut by $44 million under this bill. Most people do not agree with the idea that tax cuts for the rich should be funded by cutting health coverage from the poor.

tl;dr The GOP wants to cut taxes for their wealthiest megadonors by taking away the ability for your sick mother to afford a doctor.
 

CharminTide

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not buying it, they will fall in line. thing is, this is going to impact red states the most.
I agree. There will be some token dissent and a few superficial tweaks. But nothing significant will change, and the GOP will fall in line.
 

CharminTide

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Re: Senate Healthcare Bill Released

Heard bits and pieces on the radio today.....did I understand correctly that there will no longer be an individual MANDATE....nor will there be a PENALTY for not enlisting?

If so.....:party:
It does look like the bill removes the tax penalty for not carrying insurance. I'm unclear how this marketplace will function under those conditions. If only sick people sign up, premiums will skyrocket. If you somehow keep protections on pre-existing conditions (one of the most popular ACA changes), the cost of a decent plan will honestly be stratospheric. The cost could be masked since this bill removes minimum coverage requirements, so you could sign up for a plan that costs only $10 a month, but only covers Benadryl. Overall, this seems to directly undercut Trump's campaign promises that he'll give universal coverage, premiums will go down, and Medicare/Medicaid won't be touched.

This bill is really no better than the House version. lt will force low- and middle-income Americans to pay significantly more in order to get significantly less coverage. Due to population dynamics, it will hurt rural America far, far more than major cities.
 

92tide

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Re: Senate Healthcare Bill Released

It does look like the bill removes the tax penalty for not carrying insurance. I'm unclear how this marketplace will function under those conditions. If only sick people sign up, premiums will skyrocket. If you somehow keep protections on pre-existing conditions (one of the most popular ACA changes), the cost of a decent plan will honestly be stratospheric. The cost could be masked since this bill removes minimum coverage requirements, so you could sign up for a plan that costs only $10 a month, but only covers Benadryl. Overall, this seems to directly undercut Trump's campaign promises that he'll give universal coverage, premiums will go down, and Medicare/Medicaid won't be touched.

This bill is really no better than the House version. lt will force low- and middle-income Americans to pay significantly more in order to get significantly less coverage. Due to population dynamics, it will hurt rural America far, far more than major cities.
there will probably be serious impacts on elderly living in long-term care facilities. it's ok, if their families really love them, they will let them move in the basement for their final years
 

Intl.Aperture

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Re: Senate Healthcare Bill Released

there will probably be serious impacts on elderly living in long-term care facilities. it's ok, if their families really love them, they will let them move in the basement for their final years
Kind of - yah.
Our country director in Liberia told me the one thing he didn't like about American culture was our retirement homes. He was a firm believer that sons and daughter should care for their parents later in life.
This precludes medical situations.
My parents are still quite young so I've not put much thought into it. But my Grandmother passed away in a home and I'm still not sure how I feel about it. Nobody was there - no familiar faces or acquaintances. Just alone in a strange room in an unfamiliar state...
Actually, I think I do know how I feel about it.
 

92tide

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Re: Senate Healthcare Bill Released

Kind of - yah.
Our country director in Liberia told me the one thing he didn't like about American culture was our retirement homes. He was a firm believer that sons and daughter should care for their parents later in life.
This precludes medical situations.
My parents are still quite young so I've not put much thought into it. But my Grandmother passed away in a home and I'm still not sure how I feel about it. Nobody was there - no familiar faces or acquaintances. Just alone in a strange room in an unfamiliar state...
Actually, I think I do know how I feel about it.
while the sentiment is nice, there are many old folks with no one who can or will care for them, and there are also many who need round the clock care (including diaper changes and bathing) that can't really be provided at home. many of those folks cannot afford that kind of care without assistance.

additionally, having an elder family member stay in home can be a large "burden" (please, no fainting couches ;) ) to families who may be trying to scrape by or have other challenges of their own.
 
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uafanataum

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Re: Senate Healthcare Bill Released

It does look like the bill removes the tax penalty for not carrying insurance. I'm unclear how this marketplace will function under those conditions. If only sick people sign up, premiums will skyrocket. If you somehow keep protections on pre-existing conditions (one of the most popular ACA changes), the cost of a decent plan will honestly be stratospheric. The cost could be masked since this bill removes minimum coverage requirements, so you could sign up for a plan that costs only $10 a month, but only covers Benadryl. Overall, this seems to directly undercut Trump's campaign promises that he'll give universal coverage, premiums will go down, and Medicare/Medicaid won't be touched.

This bill is really no better than the House version. lt will force low- and middle-income Americans to pay significantly more in order to get significantly less coverage. Due to population dynamics, it will hurt rural America far, far more than major cities.
If you could write a healthcare bill that allowed everyone to have coverage but did not have higher premiums for people with pre-existing conditions and also did not unfairly make healthy people eat the cost of unhealthy people's health coverage, how would you accomplish this?
 

CharminTide

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Re: Senate Healthcare Bill Released

If you could write a healthcare bill that allowed everyone to have coverage but did not have higher premiums for people with pre-existing conditions and also did not unfairly make healthy people eat the cost of unhealthy people's health coverage, how would you accomplish this?
You can't. The bolded part is a necessary part of risk pooling, whether we're talking about home insurance, car insurance, or health insurance. We've known that from the beginning.
 

seebell

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Re: Senate Healthcare Bill Released

President Trump is kind enough to send me a daily briefing.

https://www.whitehouse.gov/repeal-a...dium=email&utm_content=20170622_ADM_1600-Dail

OBAMACARE FACT OF THE DAY

FACT: The American people know a bad deal when they see one. The most recent data shows that around 6.5 million Americans paid $3 billion in penalties (2015)to the IRS rather than buy unaffordable Obamacare plans.

I wonder if this 3 billion is plowed back into ObamaCare or sucked up somewhere else?
By my math, that means the 6.5 million each paid about $4600 in penalties. I thought the max penalty was $695?

The Senate bill is not quite as bad as the House plan.
 

jthomas666

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Re: Senate Healthcare Bill Released

AAFP: Better Care Reconciliation Act Poses Serious Threat To Americans’ Health Security

American Academy of Family Physicians

"The Senate’s Better Care Reconciliation Act of 2017 reflects many of the same flawed concepts that are in the American Health Care Act. In many ways, it poses a graver threat to millions of Americans, particularly children, people with disabilities and older Americans.

“The bill would phase out the Medicaid expansion and cap the federal commitment, ultimately starving this vital program of federal funds needed to provide meaningful coverage to vulnerable beneficiaries and shifting insurance risk entirely to the states. It does so by limiting Medicaid funding to the Consumer Price Index for urban consumers, which has grown by an average of 1.7 percent since 2007, rather than the increase in medical costs, which has grown at nearly twice that rate -- an average of 3.3 percent from 2007 to 2016. With time, federal Medicaid payments to states will fall, greatly eroding their ability to provide comprehensive, high-quality services to the most vulnerable Americans who depend on Medicaid for access to necessary care.

“The possible damage goes deeper, because the bill allows states to opt out of important consumer protections that prevent discrimination against patients based on their gender, age and health status. Furthermore, states choosing to opt out would no longer be required to adhere to essential benefits such as prescription coverage, ambulance services or maternity care. Allowing annual and lifetime caps on benefits diminishes the value of every policy sold in the future.

“This bill’s tax credits, although better than those of the AHCA, still do little to help low-to-middle-income families with increasing premiums and deductibles.
 

92tide

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Re: Senate Healthcare Bill Released

President Trump is kind enough to send me a daily briefing.

https://www.whitehouse.gov/repeal-a...dium=email&utm_content=20170622_ADM_1600-Dail

OBAMACARE FACT OF THE DAY

FACT: The American people know a bad deal when they see one. The most recent data shows that around 6.5 million Americans paid $3 billion in penalties (2015)to the IRS rather than buy unaffordable Obamacare plans.

I wonder if this 3 billion is plowed back into ObamaCare or sucked up somewhere else?
By my math, that means the 6.5 million each paid about $4600 in penalties. I thought the max penalty was $695?

The Senate bill is not quite as bad as the House plan.
i don't buy that 3 billion # for a second.
 

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