Tag Archives: Obamacare

Trump tried to burn down Obamacare. He set his hair on fire instead | Ross Barkan

Burning Obamacare to the ground was always a House Republican obsession that Trump, in the heat of the campaign, took up to spite the president while tossing a little red meat to Republicans. “Repeal and replace” is alliterative, after all: it sounds nice enough on an arena stage. It’s just hard to pull off in the real world, as Donald Trump found out on Friday.

Blessed with total control of government, Republicans can only think of how best to burn the house down – and they’re not even doing a good job at that. The House speaker, Paul Ryan, unjustly heralded as a policy wonk, tried to rush his healthcare bill to the floor for a vote on Thursday, only to find the moderates and extremists in his party rebelling. On Friday, Donald Trump was forced to pull the bill, due to lack of support from his own party.

It was a humiliating defeat, which he tried to blame – unbelievably – on the Democrats.

Paul Ryan on failed healthcare bill: ‘This is a disappointing day’

Ryan’s Trumpcare was a horrendous concoction and should disabuse fawning congressional reporters of the notion that the speaker is a man of deep intellect and self-reflection. Had the bill not fallen flat on its face this Friday, it would have had little chance of passing the Senate.

What remains is the fact that Donald Trump couldn’t close the deal. He is hoping everyone blames Ryan, and Trump is lucky that his supporters might do just that. The diehards, inhabiting his post-factual universe, will simply write Ryan off as a loser – they hated him anyway – and hail their king for the bounties he’s still promising.

But healthcare will ultimately be Donald Trump’s problem. That’s how our politics work. So far, the president has been more fatuous than fascistic, though he belatedly realized what an albatross the bill had become. His negotiating powers, whatever they ever were, failed.

Were Trump the deal-making genius his ego tricked himself into believing he was, he would never have taken up this healthcare venture. A recent Quinnipiac University poll found that only 17% of Americans approved of Trumpcare. Trump’s poorest and least educated supporters had much to lose and nothing to gain from the legislation.

That’s why demolishing Obamacare never made sense. After all, Trump, via Steve Bannon, promised economic nationalism, a robust spending plan for those who he believed deserved it most: the white and native born. Trump wasn’t going to lose any votes by focusing on immigration and infrastructure spending at the expense of Obamacare, which rank-and-file conservatives resent less now that Obama himself has been removed from the equation.

President ‘pulled out every stop’ to pass healthcare bill, Spicer says

Far from upholding the most basic protections for the working-class, the Trump administration has, instead, evolved into one of the most rightwing in recent memory. It is stocked with the kind of appointees (Mick Mulvaney, Tom Price) who could have been plucked from Congress by Presidents Ted Cruz or Marco Rubio.

This is the difference between Trump and someone like the French presidential candidate Marine Le Pen, the Front National leader who identifies closely with the billionaire. Le Pen’s fiscal platform is unapologetically leftist, rejecting the austerity measures embraced by Europe’s financial class.

Trump rages with all the hate of Le Pen and none of the savvy. Blaming Ryan for Trumpcare’s failure will not absolve him of trying to do a very stupid thing. If he chooses to weaken healthcare in other ways – to somehow prove Obama left the country with a self-destructing system – he’ll still be the president when premiums skyrocket as insurers struggle to adapt to this instability.

In 2018, 2019, and 2020, screaming Obama’s name won’t matter anymore. The country will just know President Trump and the damage being done.

Most Still Don’t Know ObamaCare Penalties Waived by Trump Executive Order

The I.R.S has been instructed by the Trump Administration via Executive Order  not to collect ObamaCare Penalties. Giving millions of Americans and small businesses a huge break and boosting the economy. Ordering the I.R.S. not or ask about your healthcare situation makes sure no further penalties can be assessed. Effectively throwing a monkey wrench into the ObamaCare tax and penalty system that has wrecked the American economy. As Congress sits on their hands and does nothing this one act alone has given millions of families much needed help. Millennials who don’t get ObamaCare will actually get a tax return this year. Small business can expand not having to worry about the mandates. Majorly boosting the consumer confidence and adding to the stock market rally. Trump can do this because the President has the responsibility to direct all employees of the federal government. Congress may wait and try to introduce ObamaCare Lite but Trump has beat them to the punch back on January 20th.

Why is this not more widely reported on mainstream fake news? Nothing on nightly news. A couple begrudging mentions in the national papers. Local or city newspapers and television? Forget about it. Alternative sources and conservative economic media have reported on it. The answer is obvious. It is not politically convenient.

This is such cause for celebration for all Americans yet almost nothing is being done by the 5th column to advertise the fact to the people. This is important. A lot senior citizens who rely on these “news sources” are not even aware of this. Lower income people and even low information consumers are still making financial and healthcare decisions based on old information.

Executive Order Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal

Section 2 of the Executive Order of Jan 20th reads.

Sec. 2.  To the maximum extent permitted by law, the Secretary of Health and Human Services (Secretary) and the heads of all other executive departments and agencies (agencies) with authorities and responsibilities under the Act shall exercise all authority and discretion available to them to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.

Small businesses over 50 people that don’t comply with the Obamacare can pay as much as $ 5000 per employee as places like Macdonalds get waivers. The penalty to an individual can be as high as $ 2800 in the higher tax brackets. Even at the lower end even $ 600 can be be a low income earner’s entire tax return. The effect goes far beyond that.

Now families and individuals can effectively ignore the disastrous law all together. No longer saddled with having to get useless health insurance with high premiums. Saving many hundreds of dollars a month for an average family. Choosing alternative means of healthcare not prescribed under the draconian ObamaCare. If they know about it.

Sources:

RaptormanReports

https://www.whitehouse.gov/the-press-office/2017/01/2/executive-order-minimizing-economic-burden-patient-protection-and

https://www.forbes.com/sites/kellyphillipserb/2017/01/20/trump-signs-executive-order-to-roll-back-obamacare/#7858a7643eeb

How Obamacare could be dismantled by Republicans

Having won control of the House, the Senate and the White House, Republicans are gearing up to make good on a long-standing promise: to repeal the Affordable Care Act – or Obamacare, as it’s commonly known.

Republican Senate majority leader Mitch McConnell said on Monday he would introduce legislation to repeal Obamacare as soon as the new Congress convenes, shortly after 1 January, then work “expeditiously” to replace the law.

Senate Republicans don’t have the 60 votes needed to outright repeal the ACA. Instead, they are likely to use a budgetary strategy to dismantle key provisions of the law. The maneuver, known as a budget reconciliation, only requires 51 votes to pass.

President-elect Donald Trump has said he would consider keeping some of the more popular pieces of the law in place, including a provision that lets young adults stay on their parents’ health insurance until age 26 and another that prohibits insurers from denying coverage to people with pre-existing medical conditions. But these provisions rely on other, less popular parts of the ACA that Republicans have pledged to cut.

Here’s your guide to how key parts of the ACA might fare. Major provisions and public opinion ratings (net favorability) are from the Kaiser Family Foundation’s health tracking poll from November 2016.

Public favorability

Individual mandate

Requires Americans to have health insurance

How it works now: This provision requires citizens and legal residents to have health insurance coverage or pay a tax penalty. The individual mandate is unpopular – but it makes many other parts of the ACA possible. To cover sick people without charging exorbitant prices, insurers need to balance enrollment with young, healthy people too. But those people might not get health insurance if they weren’t required to.

How it could go: Republicans need a Senate supermajority (60 votes) to repeal this requirement outright – an unlikely scenario. But they can eliminate the tax penalty associated with the mandate through a simple majority (51 votes) using budget reconciliation. Americans would still be required to purchase insurance, but there would be no consequences if they did not.

Public favorability

Employer mandate

Requires medium and large businesses to offer health insurance coverage for employees

How it works now: This provision requires businesses with more than 50 employees to provide affordable health insurance or pay a penalty determined through a complex formula.

How it could go: Republicans could repeal the penalty businesses pay, while leaving the requirement to provide health insurance through a simple majority vote. This would give businesses little incentive to comply with the mandate, leaving many workers uninsured – especially if subsidies for non-employer plans are eliminated.

Public favorability

Medicare payroll tax

Increases rate for upper-income Americans

How it works now: Married couples that earn more than $ 250,000 a year pay an additional 0.9% payroll tax, which finances preventive services and provides prescription plan discounts for the elderly and additional resources to doctors. This tax extended the solvency of the Medicare trust fund by 12 years.

How it could go: Republicans could eliminate the Medicare payroll tax through a special budget maneuver. Eliminating the tax would cost the government $ 123bn in revenue over nine years.

Public favorability

Pre-existing conditions

Prohibits insurers from rejecting people with prior diagnoses

How it works now: The ACA bans insurance companies from declining to cover patients with previous medical diagnoses. In the past, even minor health blemishes could result in a rejection from the insurance market.

How it could go: Republicans, including President-elect Donald Trump, have embraced this popular provision. But the measure is financed through another less popular element of the ACA: the individual mandate. In order to cover sick and high-risk people at an affordable price, insurers need young, healthy people to sign up to balance out costs. But these people have less incentive to get health insurance without a mandate. Republicans have proposed high-risk pools as an alternative to guarantee coverage.

Public favorability

Insurance exchanges

Creates marketplaces for individuals and small businesses to buy coverage

How it works now: Probably the best known provision of the ACA, exchanges allow individuals and small businesses to compare and purchase health insurance online – the same way you would compare hotel rates or plan tickets. Previously, people who did not get insurance through their employer but wanted a plan had to call insurers directly.

How it could go: It would be hard to get rid of exchanges outright, but Republicans could eliminate the subsidies that make exchange plans affordable for most Americans with a simple majority vote. That would effectively kill exchanges by making the health insurance they offer unaffordable. The subsidies represent most of the federal cost of the program (more on subsidies below).

Public favorability

Health plan subsidies

Provides financial aid to low- and moderate-income Americans to buy coverage

How it works now: Individuals who don’t get insurance from their jobs can buy insurance through exchanges. The government provides subsidies to people with incomes between 100% and 400% of the federal poverty level ($ 11,880 to $ 47,520 a year for individuals, or $ 24,300 to $ 97,200 a year for a family of four).

How it could go: Republicans could eliminate these subsidies with a simple majority vote. 9.3 million Americans currently receive health plan subsidies, which average around $ 300 per month per household. Previous Republican repeal proposals have offered less generous subsidies or limited them to high-risk populartions.

Public favorability

Medicaid expansion

Provides coverage to more low-income adults

How it works now: The ACA expanded Medicaid to cover low-income adults earning up to 138% of the federal poverty limit ($ 27,821 for a family of three in 2016). To help states finance the expansion, the federal government picks up at least 90% of the tab. In June 2012, the US supreme court ruled that Medicaid expansion should be optional for states. To date, 19 states have not expanded Medicaid. In those states, a family of three must earn 44% or less of the poverty limit to enroll ($ 8,870 for a family of three), while low-income, childless adults are mostly ineligible for the benefit.

How it could go: Republicans fought this provision tooth and nail, bringing it all the way to the highest court. Nevertheless, many Republican governors found it practical to expand Medicaid to provide care for millions of residents. An estimated 11 million adults received health insurance through the expansion. Republicans want to end federal subsidies – and can do so with a simple majority vote.

Public favorability

Doughnut hole&39; rule

Closes the prescription coverage gap for Medicare patients

How it works now: Before the ACA, Medicare didn’t cover the costs of all prescription medicines – a gap known as the “doughnut hole”. The health law provides additional benefits to seniors and is designed to close the gap by 2020.

How it could go: Republicans could end this subsidy to seniors and reopen the “donut hole” through the budget reconciliation process. Millions of seniors would then need to pay more for prescriptions.

Public favorability

Free preventive services

Prohibits out-of-pocket costs for checkups

How it works now: Preventive health screenings are covered for free. This includes routine tests such as cholesterol screenings, vaccines for children and women’s health services.

How it could go: Republicans would have difficulty repealing this provision on their own; they would likely need Democrats to join in a supermajority vote – which is unlikely. But Republicans may not see a reason to scrap this popular part of the ACA anyway. Insurers may have a hard time paying for these services without the additional customers the ACA delivers through the individual mandate.

Public favorability

Coverage for young adults

Allows adult children to stay on parents’ health plans

How it works now: The ACA requires that insurers cover young adults as part of their parents’ health insurance plan through age 26. Previously, the cut-off age varied by state and by plan.

How it could go: President-elect Trump appears keen on keeping this provision, but Republicans have little power to cut it either way. The provision can’t be scuttled with a budget reconciliation, because it doesn’t rely on federal funding.

Public favorability

Ban on coverage limits

Prohibits annual and lifetime spending caps on most healthcare benefits

How it works now: Insurance companies are banned from placing a dollar amount on lifetime or annual coverage. The practice was common before the ACA, and tended to affect patients with complex or chronic illnesses, such as cancer or diabetes.

How it could go: Republicans are likely to keep this provision but if the individual mandate disappears, it’s unclear how insurers would finance it.

Illustration by Jan Diehm.

Doctors would all support Obamacare if they saw the vast inequality that I do | Celine Gounder

When Americans head to the polls in November, they’ll be deciding the fate of the Affordable Care Act, what Barack Obama has called “the most important healthcare legislation enacted in the United States since the creation of Medicare and Medicaid in 1965”. Over the past decade, healthcare providers have observed the rollout of Obamacare and its net-positive impact on their patients and their practice of medicine.

But how will they vote? Data reported by the New York Times last week suggests that different kinds of doctors tend to have very different political views. My experiences lead me to believe that this empathy gap can be traced to the mix of patients that clinicians care for. The more doctors get out of their privilege bubble, the more likely they are to support keeping, and strengthening, the ACA.

All doctors bear witness to the lives of others. But whom we meet depends in part on what insurance we accept. Medical specialists including cardiologists and orthopedic surgeons and are less likely to take patients on Medicaid than are primary care doctors, pediatricians and infectious-disease docs.

Poverty, discrimination and other social factors also increase the risk of certain diseases such as HIV, hepatitis, childhood asthma, obesity, high blood pressure and depression. So certain medical specialists, like me, see a higher proportion of patients from backgrounds vastly different from our own. Call it empathy boot camp.

One of my patients has been to the hospital six times in as many months because her asthma flares up every time she smokes crack cocaine. She lives with her elderly mother and can’t move, and it’s hard for her to quit when most of her neighbors smoke crack too. Another of my patients had PCP, a severe pneumonia related to HIV/Aids, which required treatment with multiple medications. She left the hospital against our advice because she doesn’t feel comfortable asking family, friends or neighbors to look after her kids.

I have another patient who bounces around from hospital to hospital looking for safety from her abusive partner. Another patient with advanced Aids refused to go to a nursing home where he would have gotten help taking his dozens of medications, three square meals a day, substance abuse treatment services and physical therapy. He was afraid of losing the apartment he shared with his HIV-uninfected girlfriend, leaving her homeless. He died. This is just a sample of patients I saw in one month.

My patients have shown me it’s nearly impossible to get someone healthy when they don’t have stable housing. I’ve learned that if my goal is to help people get better, I’ve got to be pragmatic. I’ve realized that most people with an opioid addiction will never be opioid-free. But with medication-assisted treatment (using substances like methadone, buprenorphine and naloxone), they can become functioning members of society, return to work and resume their roles as caregivers of children or ageing parents.

I’ve even come to believe in safe injection sites, where people can use heroin and cocaine under the supervision of healthcare workers. Not only are they less likely to overdose, but they’re also channelled into testing and treatment. I used to think it was unfair for transgender women to want their breast implants covered by insurance when equally flat-chested cisgender women have to pay for their own cosmetic surgery. But then I saw the harm that comes from injecting industrial grade silicone.

As doctors, we have the privilege of crossing social divides when most others don’t. With that comes a responsibility to our patients and our country that goes beyond our vote. We know all too well what’s at stake.

Obamacare Cadillac Tax Worries For 26% Of Employers

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The latest evaluation of the so-named &ldquoCadillac tax&rdquo on wealthy health care ideas projects a single in four employers giving health advantages &ldquocould be impacted&rdquo by the regulation in 2018 if they don&rsquot make adjustments to their benefit structures. The Cadillac tax was developed as component of the Reasonably priced Care Act largely as [...]

Medical professional Demand Undercuts Trump’s, GOP’s Obamacare Task Killer Theories

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Search no additional than the U.S. physician as an instance of how the Inexpensive Care Act has not only turned into a work creator for the wellness sector, but created physicians between the most in-demand of workers. Opponents of the well being law for years have bemoaned its regulations and costs saying [...]

How Obamacare Adds $a hundred A Month To Your Spouse’s Coverage

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To steer clear of the Inexpensive Care Act&rsquos so-named &ldquoCadillac tax&rdquo on rich benefit programs, companies are incorporating surcharges of $ 100 a month or much more to wives and husbands of staff, hoping spouses will seek coverage elsewhere, new employer information demonstrates. The Cadillac tax was developed as element of the Cost-effective Care Act [...]
English: Barack Obama signing the Patient Prot...

In spite of Obamacare Guidelines, Employer Value Trend Slows In 2015

Health benefit costs for large employers are expected to rise 6.5 percent next year, a slower rate of increase than this year as companies implement myriad new ways to mitigate medical inflation, according to a new analysis.

The National Business Group on Health, an association of about 400 large employers, said companies are dangling more incentives in front of their workers to stay healthy, using “narrow networks” known to limit doctor choices and increasing cost-sharing via higher co-payments and deductibles for worthers. The national business group said the rate of increase was 7 percent this year and could even be lower next year, falling to 5 percent if employers implement various cost-containment strategies.

Many of these changes are being implemented to comply with the Affordable Care Act, particularly an excise tax that will be implemented in 2018. The tax, also known as a fee on “Cadillac” health plans is levied when benefits exceed a predetermined threshold. Here’s one insurer’s more detailed explanation of such plans linked here.

“Despite the many distractions that the Affordable Care Act (ACA) has created, large employers haven’t lost sight of the fact that rising health care costs remain a significant issue that needs to be constantly addressed,” said Brian Marcotte, president and chief executive officer of the National Business Group on Health in a statement accompanying the new analysis.

NBGH’s membership is diverse, including employers like Boeing Boeing (BA), Pfizer Pfizer (PFE) and Coca-Cola Coca-Cola (KO) along with health insurers Aetna (AET), Humana (HUM), UnitedHealth Group (UNH) and most Blue Cross and Blue Shield plans. Most of the members surveyed, or about 83 percent, are companies with more than 10,000 employees.

English: Barack Obama signing the Patient Prot...

English: Barack Obama signing the Patient Protection and Affordable Care Act at the White House (Photo credit: Wikipedia)

“Many employers are, in fact, taking necessary steps to rein in costs,” Marcotte said. “This includes partnering with workers to engage in health care decisions and educating them to be better health care consumers, as well as sharing more costs with workers and narrowing their benefit options.”

For example, more than half, or 57 percent of employers are expanding consumer-directed health plans. These plans often come with a high deductible and a contribution from the employer for employees to put toward their costs. But they generally lead to lower costs when employees, faced with the financial implications of their health benefit choices, tend to shop for better deals.

National Business Group on Health said the survey showed a “nearly 50 percent increase in the number of employers that plan to offer a (consumer-directed health plan as their only benefit plan option next year.” All told, 32 percent plan to offer a consumer-directed plan in 2015 compared to 22 percent this year, the business group said.

Wondering how Obamacare will affect your the cost of your health care? The Forbes eBook Inside Obamacare: The Fix For America’s Ailing Health Care System answers that question and more. Available now at Amazon and Apple.

English: Barack Obama signing the Patient Prot...

In spite of Obamacare Rules, Employer Expense Trend Slows In 2015

Health benefit costs for large employers are expected to rise 6.5 percent next year, a slower rate of increase than this year as companies implement myriad new ways to mitigate medical inflation, according to a new analysis.

The National Business Group on Health, an association of about 400 large employers, said companies are dangling more incentives in front of their workers to stay healthy, using “narrow networks” known to limit doctor choices and increasing cost-sharing via higher co-payments and deductibles for worthers. The national business group said the rate of increase was 7 percent this year and could even be lower next year, falling to 5 percent if employers implement various cost-containment strategies.

Many of these changes are being implemented to comply with the Affordable Care Act, particularly an excise tax that will be implemented in 2018. The tax, also known as a fee on “Cadillac” health plans is levied when benefits exceed a predetermined threshold. Here’s one insurer’s more detailed explanation of such plans linked here.

“Despite the many distractions that the Affordable Care Act (ACA) has created, large employers haven’t lost sight of the fact that rising health care costs remain a significant issue that needs to be constantly addressed,” said Brian Marcotte, president and chief executive officer of the National Business Group on Health in a statement accompanying the new analysis.

NBGH’s membership is diverse, including employers like Boeing Boeing (BA), Pfizer Pfizer (PFE) and Coca-Cola Coca-Cola (KO) along with health insurers Aetna (AET), Humana (HUM), UnitedHealth Group (UNH) and most Blue Cross and Blue Shield plans. Most of the members surveyed, or about 83 percent, are companies with more than 10,000 employees.

English: Barack Obama signing the Patient Prot...

English: Barack Obama signing the Patient Protection and Affordable Care Act at the White House (Photo credit: Wikipedia)

“Many employers are, in fact, taking necessary steps to rein in costs,” Marcotte said. “This includes partnering with workers to engage in health care decisions and educating them to be better health care consumers, as well as sharing more costs with workers and narrowing their benefit options.”

For example, more than half, or 57 percent of employers are expanding consumer-directed health plans. These plans often come with a high deductible and a contribution from the employer for employees to put toward their costs. But they generally lead to lower costs when employees, faced with the financial implications of their health benefit choices, tend to shop for better deals.

National Business Group on Health said the survey showed a “nearly 50 percent increase in the number of employers that plan to offer a (consumer-directed health plan as their only benefit plan option next year.” All told, 32 percent plan to offer a consumer-directed plan in 2015 compared to 22 percent this year, the business group said.

Wondering how Obamacare will affect your the cost of your health care? The Forbes eBook Inside Obamacare: The Fix For America’s Ailing Health Care System answers that question and more. Available now at Amazon and Apple.

Obamacare Patients Boost Tenet To Ideal Overall performance In CEO Memory

Tenet Healthcare (THC)  chief executive officer Trevor Fetter named the hospital chain’s 2nd quarter efficiency, which was driven largely by newly insured individuals beneath the Affordable Care Act,  “the best” he could remember.

In an hour-extended conference phone this morning to discuss second-quarter earnings, Fetter stated sufferers who obtained coverage below the overall health law contributed to a single-third of the company’s adjusted admissions development.

The expansion of health benefits to uninsured Americans has been a boon to insurers, and providers of health-related care. Hospitals, in specific, have been hit hard due in element to the slow economic climate, but also due to modifications in how insurers pay out hospitals, encouraging wellness and outpatient care to hold sufferers away from inpatient settings.

But Tenet executives this morning outlined a bullish scenario they mentioned “improved sequentially from month to month” as much more Americans gained coverage starting Jan. one of this yr.  Although executives wouldn’t predict regardless of whether 2nd-quarter development would replicate in long term quarters, they stated volumes grew once more in July, which is the first month of the third quarter. Fetter spoke this morning following yesterday’s release of the 2nd-quarter earnings report, which can be witnessed right here. 

Tenet supplied a excellent snapshot into growth prospective customers under the health care law offered the organization operates 80 hospitals and far more than 190 outpatient centers.

Right here are some highlights of Tenet’s bettering balance sheet (the whole report can be viewed here):

  •  total surgeries jumped 14 % to 124,152 in the quarter from 108,669 in the second quarter of 2013
  • charity and uninsured hospital admissions have been down 10 percent
  • paying out admissions jumped four.8 percent on a “pro forma basis”
  • outpatient admissions had been up 6.three percent to one.14 million

Pondering how Obamacare will affect your overall health care? The Forbes eBook Inside Obamacare: The Repair For America’s Ailing Wellness Care Method answers that question and a lot more. Accessible now at Amazon and Apple.