{"id":32906,"date":"2017-06-23T05:04:43","date_gmt":"2017-06-23T05:04:43","guid":{"rendered":"http:\/\/www.biphoo.com\/bipnews\/?p=32906"},"modified":"2017-06-23T05:04:43","modified_gmt":"2017-06-23T05:04:43","slug":"shifting-dollars-from-poor-to-rich-is-a-key-part-of-the-senate-health-bill","status":"publish","type":"post","link":"https:\/\/www.biphoo.com\/bipnews\/news\/shifting-dollars-from-poor-to-rich-is-a-key-part-of-the-senate-health-bill.html","title":{"rendered":"Shifting Dollars From Poor to Rich Is a Key Part of the Senate Health Bill"},"content":{"rendered":"

Shifting Dollars From Poor to Rich Is a Key Part of the Senate Health Bill<\/span><\/strong><\/span><\/h2>\n

The Affordable Care Act gave health insurance to millions of Americans by shifting resources from the wealthy to the poor and by moving oversight from states to the federal government. The Senate bill introduced Thursday pushes back forcefully on both dimensions.<\/span><\/p>\n

The bill is aligned with long-held Republican values, advancing states\u2019 rights and paring back growing entitlement programs, while freeing individuals from requirements that they have insurance and emphasizing personal responsibility. Obamacare raised taxes on high earners and the health care industry, and essentially redistributed that income \u2014 in the form of health insurance or insurance subsidies \u2014 to many of the groups that have fared poorly over the last few decades.<\/span><\/p>\n

The draft Senate bill, called the Better Care Reconciliation Act, would jettison those taxes while reducing federal funding for the care of low-income Americans. The bill\u2019s largest benefits go to the wealthiest Americans, who have the most comfortable health care arrangements, and its biggest losses fall to poorer Americans who rely on government support. The bill preserves many of the structures of Obamacare, but rejects several of its central goals.<\/span><\/p>\n

Like a House version of the legislation, the bill would fundamentally change the structure of Medicaid, which provides health insurance to 74 million disabled or poor Americans, including nearly 40 percent of all children. Instead of open-ended payments, the federal government would give states a maximum payment for nearly every individual enrolled in the program. The Senate version of the bill would increase that allotment every year by a formula that is expected to grow substantially more slowly than the average increase in medical costs.<\/span><\/p>\n

Avik Roy, the president of the Foundation for Research on Equal Opportunity, and a conservative health care analyst, cheered the bill on Twitter, saying, \u201cIf it passes, it\u2019ll be the greatest policy achievement by a G.O.P. Congress in my lifetime.\u201d The bill, he explained in an email, provides a mechanism for poor Americans to move from Medicaid coverage into the private market, a goal he has long championed as a way of equalizing insurance coverage across income groups.<\/span><\/p>\n

States would continue to receive extra funding for Obamacare\u2019s expansion of Medicaid to more poor adults, but only temporarily. After several years, states wishing to cover that population would be expected to pay a much greater share of the bill, even as they adjust to leaner federal funding for other Medicaid beneficiaries \u2014 disabled children, nursing home residents \u2014 who are more vulnerable.<\/span><\/p>\n

High-income earners would get substantial tax cuts on payroll and investment income. Subsidies for those low-income Americans who buy their own insurance would decline compared with current law. Low-income Americans who currently buy their own insurance would also lose federal help in paying their deductibles and co-payments.<\/span><\/p>\n

The bill does offer insurance subsidies to poor Americans who live in states that don\u2019t offer them Medicaid coverage, a group without good insurance options under Obamacare. But the high-deductible plans that would become the norm might continue to leave care out of their financial reach even if they do buy insurance.<\/span><\/p>\n

The battle over resources played into the public debate. Mitch McConnell, the Senate majority leader, said the bill was needed to \u201cbring help to the families who have been struggling with Obamacare.\u201d In a Facebook post, President Barack Obama, without mentioning the taxes that made his program possible, condemned the Senate bill as \u201ca massive transfer of wealth from middle-class and poor families to the richest people in America.\u201d<\/span><\/p>\n

In another expression of Republican principles, the bill would make it much easier for states to set their own rules for insurance regulation, a return to the norm before Obamacare.<\/span><\/p>\n

Under the bill, states would be able to apply for waivers that would let them eliminate consumer protection regulations, like rules that require all health plans to cover a basic package of benefits or that prevent insurance plans from limiting how much care they will cover in a given year.<\/span><\/p>\n

States could get rid of the online marketplaces that help consumers compare similar health plans, and make a variety of other changes to the health insurance system. The standards for approval are quite permissive. Not every state would choose to eliminate such rules, of course. But several might.<\/span><\/p>\n

\u201cYou can eliminate all those financial protections,\u201d said Nicholas Bagley, a law professor at the University of Michigan. \u201cThat would be huge.\u201d<\/span><\/p>\n

Americans with pre-existing conditions would continue to enjoy protection from discrimination: In contrast with the House health bill, insurers would not be allowed to charge higher prices to customers with a history of illness, even in states that wish to loosen insurance regulations.<\/span><\/p>\n

But patients with serious illnesses may still face skimpier, less useful coverage. States may waive benefit requirements and allow insurers to charge customers more. Someone seriously ill who buys a plan that does not cover prescription drugs, for example, may not find it very valuable.<\/span><\/p>\n

Source:-\u00a0https:\/\/www.nytimes.com\/2017\/06\/22\/upshot\/shifting-dollars-from-poor-to-rich-is-a-key-part-of-the-senate-health-bill.html<\/span><\/p>\n

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