Medicine

Pros and cons to latest GOP health care proposal

Pros and cons to latest GOP health care proposal

Each time a draconian plan pops up, advocates for healthcare and seniors - and grassroots opponents - grab their mallets and pound them back into their holes. "The proposal fails to protect the health care coverage and consumer protections available under current law".

The mallets are already pounding on this one - and that should be no surprise.

The Affordable Care Act was not flawless, but it was a big step in the right direction. Sixty percent of the public thinks it is a "good thing" that the last Senate plan failed, and almost as many (57%) want Republicans and Democrats to work together on improvements to the ACA, according to the latest Kaiser Health Tracking Poll. Lindsey Graham, R-S.C.; Bill Cassidy, R-La.; Dean Heller, R-Nev.; and Ron Johnson, R-Wis. would focus on block grants to the states. The grants would replace the funds now being used for the ACA's Medicaid expansion and for subsidies to help people buy insurance via the marketplace exchanges. "I think the price will actually be lower". And the key differentiator is very simple: states that accepted the ACA's Medicaid expansion are going to lose to one extent or another, and states that Just Said No will be (relatively speaking) rewarded. However, the Center on Budget and Policy Priorities, which has been critical of GOP plans, says taking the block grant and per capita provisions together, Iowa would lose $525 million in 2026. The initial cap would rise more slowly than the projected growth in per-beneficiary spending states will experience.

Approved by the state's Republican-controlled Legislature and then Gov. Mike Beebe, a Democrat, in 2013, Arkansas' Medicaid expansion took advantage of enhanced federal funding under the Affordable Care Act to extend insurance coverage to adults with incomes of 138 percent of the poverty level: $16,643 for an individual, for instance, or $33,948 for a family of four.

That was Hutchinson's primary objection to earlier legislation this summer, known as the Better Care Reconciliation Act, that would have phased out federal support for Medicaid expansion. Also, waivers of essential health benefits will mean patients may not have access to coverage for services pertinent to treating their conditions. "We sincerely urge the Senate to take short-term measures to stabilize the health insurance market by continuing to fund cost sharing reduction payments".

The block grants would come with few strings.

Hutchinson, who said he helped craft the legislation along with fellow Republican Govs.

Some Republican governors who rejected BCRA have embraced Graham-Cassidy because it would give them greater control of their Medicaid programs.

It would weaken protections for people with pre-existing conditions, by allowing states to waive the ACA's prohibition against charging higher premiums based on those conditions - including maternity care, hospitalization, mental health, and substance abuse - which would allow insurers to market junk policies to their customers.

We have seen the effects of this kind of reform here in Kansas with the Brownback tax cut experiment over the last five years, and the effects on state services do not give reason for hope for states to save us from hard choices on health care.

"The states are enticed by the notion of flexibility", said Rosenbaum. But many others have said they are still considering it, and it's won favor with numerous conservatives and moderates.