The Latest Repeal, Partial Repeal, and Replace Plans

3/6/2017 update: The first official look at the GOP repeal and replace plan is out.

The Hill has links to the two portions of the legislation in their story here:
http://thehill.com/policy/healthcare/322609-gop-releases-bill-to-repeal-and-replace-obamacare

CLICK HERE for a two-page summary and CLICK HERE to read a section-by-section summary.

Many of the mandates are killed by the bill, for example the individual and employer mandates.  However the pre-existing coverage mandate remains. The taxes are mostly repealed. The infamous “Cadillac Tax” is kicked further down the road until 2025.

Medicaid expansion would be rolled back over several years and a per-enrollee capped allotment will be paid to states.

Subsidies are rearranged to be mostly age-based instead of income based and will be in the form of refundable tax credits.

Michael Hurd, PhD has a review of the plan: Obamacare Repeal: A Good Thing, But Still Not a Free Market https://drhurd.com/2017/03/06/63226/

2/27/2017 update: The alleged GOP repeal and replace plan under consideration has been leaked.  Highlights/Lowlights: it would repeal various mandates including the individual mandate; states would receive a capped per-enrollee federal contribution for Medicaid; current ACA income-based tax credits would transition to credits allocated by age of enrollee; and tax breaks would be limited for high-dollar employer-based coverage.

For more details and a link to the draft bill see: http://www.politico.com/story/2017/02/house-republicans-obamacare-repeal-package-235343

There are a few notable newcomers since our previous post on replacement plans:

  1. Ted Cruz has introduced a full repeal bill:S. 106, a bill to repeal the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 in its entirety was introduced by Sen. Ted Cruz (R-TX) and referred to the Senate Finance Committee.”
  2. S. 222 the ObamaCare Replacement Act by Dr. Rand Paul which repeals parts of ACA and replaces with more flexible HSAs (no HDHP requirement) and $5000 tax credits to fund the HSA. Read more at Reason.com: http://reason.com/blog/2017/01/25/sen-rand-paul-introduces-replacement-for
  3. Rep. Darrell Issa’s “Access to Insurance for All American’s Act” would offer federal employee health plans to all Americans  http://www.nbcsandiego.com/news/local/Congressman-Darrell-Issa-Proposes-Plan-to-Replace-Affordable-Care-Act-412059253.html.
  4. Cassidy/Collins contains portions of Cassidy/Sessions and would be a partial repeal tied to provisions that allow states to keep ObamaCare on a state by state basis or fund state-based market-oriented reforms: https://www.collins.senate.gov/newsroom/cassidy-collins-introduce-comprehensive-obamacare-replacement-plan
  5. AEI’s “Improving Health and Healthcare Plan” utilizes tax credits and expands HSAs to some extent. It also has an “auto enroll” feature that places non-enrollees in an HDHP.  http://www.forbes.com/sites/theapothecary/2016/12/30/how-aeis-improving-health-and-health-care-plan-would-repeal-and-replace-obamacare/#68d118953be6

And, of course, President Trump has started the ball rolling with his Executive Order on ObamaCare: http://www.cnn.com/2017/01/20/politics/trump-obamacare-executive-order/

Previously announced plans:

Congressman Tom Price’s plan

http://www.washingtonexaminer.com/prices-obamacare-replacement-would-shift-power-to-patients-which-is-why-special-interests-will-hate-it/article/2609165?custom_click=rss

Speaker Paul Ryan: A better way

http://abetterway.speaker.gov/

Congressman Sessions/Cassidy plan

http://www.goodmaninstitute.org/topics/health-reform-bill/

(Former Congressman) Dr. Paul Broun plan (needs new sponsor)

http://www.paulbroun.com/issues/health-care

Brat/Flake “HSA Expansion Act” would eliminate the “mandate” that HSA holders purchase a government-designed high-deductible health plan. “As a replacement for ObamaCare, Large HSAs would encourage innovative products like pre-existing conditions insurance that make coverage more affordable and secure.”

http://www.forbes.com/sites/michaelcannon/2016/06/02/five-things-you-need-to-know-about-the-bicameral-legislation-creating-large-hsas

The 2015 Burr, Hatch, Upton Patient Care Act could make a return:

http://www.forbes.com/sites/theapothecary/2016/12/28/how-the-patient-care-act-would-repeal-and-replace-obamacare/#7152a38a1805

Ideals and principles

National physicians’ coalition for freedom in medicine 2015

https://drive.google.com/file/d/0B6mnHrSAs12lUHhzS0ctMHFVRG1pMXZhZFVkbnFwWDVhNzNV/view

D4PC Rx for Healthcare Reform https://d4pcfoundation.org/about-us/the-physicians-prescription-for-health-care-reform/

Real Stories of the ACA Obamacare nightmare #1

Quoted with permission from anonymous source. This is a real physician, a single mom, in private practice who cannot afford ACA. She gave up her foreign citizenship to become an American citizen and vote against Obamacare. And on a personal level, she ROCKS and I wish her the best:

“It’s embarrassing to explain to the people at Pfizer how a physician doesn’t have insurance and cannot afford their medications…. yet I write medications for my Medicaid kids that will get covered no questions asked. I hate having arthritis. I also hate that because of the goddamn ACA I’m still uninsured. And I’m paying down on a several thousand dollar tab at the rheumatologist… while criminals in jail are getting better health care than our veterans!! And many illegal aliens are getting very expensive medical care at our expense!”

 

Real Stories of the ACA nightmare #5

“A 44 year old self-employed man with Crohn’s Disease has to get on the ACA exchange on January 1st. The cost? $26,000 out of pocket. He is going to start getting his medications in Canada because the only option he can get through Obamacare does not pay for his Crohn’s meds. He will also lose his neurosurgeon and gastroenterologist. Instead of driving 30 minutes to see his current doctors, he has to drive 2 hours to the nearest doctors under his new plan.”

Real life Stories of the ACA nightmare #4 – The Employer struggle is Real

From a small business owner of a financial services company:

“We have 4 employees and pay $3,200 a month for average Blue Cross insurance. Our policy was going up about 20% for the same coverage, so we took the deductible from $2500 to $5000 to keep the payments the same.”

Real Stories of the ACA nightmare #3 – Tale of 3’s

“I have 3 middle class friends whose ACA premiums are more than their mortgages. These are hardworking people who are relatively healthy but all have young children so (they) didn’t want to opt out/pay the penalty (which is the most ridiculous thing). Yea, millions more people are insured under the ACA….because you fine them if they aren’t 🙄. One of their plans also includes a $6500 deductible so the “affordable” care act isn’t exactly so. Two of the families are looking for a second job with the added expense and one is opting out and paying the penalty next year and taking a chance. From what they tell me their penalty is a percentage of their income which is insane.”

Posted with permission

Real Stories of the ACA nightmare #2 –What’s it like in Canada with a peanut allergic child?

An 8 month old develops an allergic reaction and shortness of breath after exposure to egg and peanuts. The symptoms are relieved with Benadryl, and the baby is managed with egg and peanut free diet until the 9 month check up with GP. The GP refers the baby to the allergy clinic at the children’s hospital. When the baby turns ONE year old, the mom asks the pediatrician if they can expedite the allergy referral appointment. A week before the baby’s SECOND birthday, the allergy clinic calls the family to tell them they have an appointment one month later. The family goes without even trying to reschedule because the next available appointment is 6 months later. By the time the child sees the allergist, they pass the food challenge and had outgrown the allergy.