By picking Tom Price to lead HHS, Trump shows he’s absolutely serious about dismantling Obamacare
By Sarah Kliff
Vox, November 28, 2016
Rep. Tom Price (R-GA), President-elect Donald Trump’s pick for Health and Human Services secretary, already has a plan for how to abolish Obamacare.
Price will arrive with at HHS with a clear blueprint for what comes next. He is the author of the Empowering Patients First Act, one of the most thorough and detailed proposals to repeal and replace Obamacare.
It would replace the law with a plan that does more to benefit the young, healthy, and rich — and disadvantages the sick, old, and poor.
The biggest cut to the poor in Price’s plan is the full repeal of the Medicaid expansion, a program that currently covers millions of low-income Americans, which Price replaces with, well, nothing.
This change will likely make Price’s proposal significantly cheaper than those that do continue the Medicaid expansion, but it will come at the cost of throwing millions of Americans off of their health insurance.
The Empowering Patients plan, unlike Obamacare, would let insurers charge sick people more if they did not maintain “continuous coverage.”
It would invest $3 billion over three years in a high-risk pool to cover those with preexisting conditions who are unable to afford coverage on the marketplace.
Empowering Patients makes the individual market more advantageous for healthier people. It eliminates the essential health benefits package, which mandated that all insurers cover a set of 10 different types of care including maternity services and pediatric care. Empowering Patients would allow insurers to cut whatever benefits they no longer want to cover — they could stop covering maternity benefits, for example, to make their plans less attractive to women who plan to become pregnant. This would likely benefit healthy people, who generally want less robust coverage at a cheaper price. But it’ll send the cost of more comprehensive plans — the plans sicker people need — skyrocketing.
There are other ways Empowering Patients makes insurance better for young people too: by letting insurance plans charge them lower rates. It does this by allowing insurers to charge their oldest enrollees as much as they want.
Obamacare’s tax credits are based on income, with those who earn less getting more help. Empowering Patient’s tax credits would only be based on age, giving more help to those who are older (and who will presumably be charged higher premiums).
There is one important change the plan would make to employer-sponsored insurance: It would cap the tax exclusion for employer-sponsored coverage. Price’s bill proposes limiting the employer-tax exclusion for insurance to $8,000 for individual policies and $20,000 for families. As popular as this provision will be with economists, you can bet that the public will hate it, as it would make some health plans significantly more expensive — and face similar pushback to Obamacare’s Cadillac tax.
In choosing Price, Trump is signaling that he is serious about dismantling Obamacare. He has found one of the law’s most ardent, knowledgeable, and prepared opponents, and put him in charge of the effort.
H.R. 2300 – Empowering Patients First Act of 2015:
Trump to pick Seema Verma for Centers for Medicare and Medicaid Services
Reuters, November 28, 2016
U.S. President-elect Donald Trump is set to name Indiana health policy consultant Seema Verma as his pick for administrator of the Centers for Medicare and Medicaid Services, a transition official told Reuters on Monday.
Indiana’s phony Medicaid health savings accounts:
By Don McCanne, M.D.
President-elect Donald Trump is making good on his promise to repeal and replace Obamacare by appointing Tom Price as Secretary of Health and Human Services (HHS) and Seema Verma as administrator for the Centers for Medicare and Medicaid Services (CMS). There is trouble coming.
Tom Price was a co-founder of the conservative Congressional Tea Party caucus. He has long supported measures to reduce the role of government in health care, freeing himself and his fellow physicians to do whatever they want and collect whatever fees they desire. He has authored replacement legislation that has been included in House Speaker Paul Ryan’s “A Better Way” that will likely provide guideposts in the Republican effort to replace the Affordable Care Act. His legislation – Empowering Patients First Act of 2015 – is available at the link above.
Seema Verma worked with the Republican governors of Indiana, including Vice President-elect Mike Pence, to require low-income patients on Medicaid to establish POWER accounts – a bastardized health savings account – so that they would have “consumer empowerment” in shopping for health care. More information about these phony accounts is available at the link above.
It is likely that Trump will delegate these two to interact with the Republican-controlled Congress in designing the new way forward in health care. The only power Democrats have is to block onerous legislation through the filibuster, but several Democratic senators who are vulnerable in the 2018 elections have indicated a desire to work with Trump and their Republican colleagues in Congress in revising health care financing in the United States. That would give the Republicans enough votes to squelch a filibuster. This is a setup for compromise, but compromises that will be defined strictly on Republican terms.
What might we expect? Perhaps elimination of the Medicaid expansion, reduction in subsidies for private insurance, waiving of the requirement to establish minimal plan benefits, loss of guaranteed issue if unable to pay the premium, dumping high risk patients into pools with grossly inadequate funding, expansion of health savings accounts that remain unfunded or underfunded except for the wealthy, higher premiums for older and sicker patients, premium support vouchers to further privatize Medicare, and other measures that reduce the protections provided by insurance while reducing government funding of health care, thereby making insurance more affordable for the young and healthy while sending those with needs to health care purgatory.
We are told that conservatives are caring people who want to make America great again. But Trump and Pence and Price and Verma and Ryan are not caring people. They would abandon the poor and infirm, based on a combination of ideology and greed.
There will be those who will fight to keep what we have. There will be those who will compromise to reduce the losses. But they are supporting our current health care injustices that will only be made worse.
No compromises. No defense of the status quo. Gear up for an all out battle for health care justice for all. We’ll need to take to the streets for this one, literally and figuratively.