President Trump called my cellphone to say that the health-care bill was dead
President Trump called me on my cellphone on Friday afternoon at 3:31 p.m. At first I thought it was a reader with a complaint since it was a blocked number.
Instead, it was the president calling from the Oval Office. His voice was even, his tone muted. He did not bury the lede.
“Hello, Bob,” Trump began. “So, we just pulled it.”
...The Democrats, he said, were to blame.
...Trump said he would not put the bill on the floor in the coming weeks. Instead, he is willing to wait and watch the current law continue and, in his view, encounter problems. And he believes Democrats will eventually want to work with him on some kind of legislative fix to Obamacare, although he did not say when that would be.
The original version of the AHCA would have resulted in older Americans having to pay exhorbitant premiums due to the idiotic restructuring of the tax credit system and the 5:1 age band change. This led the AARP to unleash their army to understandable scream bloody murder at Congressional town halls nationwide.
In response, the GOP added an oddly-worded amendment which "instructed" the Senate to pony up $85 billion which would be used to "increase tax credits for 50-64 year olds" in some vague fashion. Why they didn't simply cross out "$4,000" and replace it with "$10,000" in the language of their own text I have no idea, but whatever. The point is that they gummed up the works for older enrollees, got screamed at for it, and responded by throwing a boatload of cash at those folks to get them to STFU.
UPDATE: 7:42 p.m.: President Donald Trump is demanding a vote Friday in the House on the Republican plan to repeal and replace Obamacare, White House Budget Director Mick Mulvaney said. If the bill fails, Trump is prepared to move on and leave Obamacare in place, Mulvaney said.
In the case of Donald Trump, however, he could mean it. He doesn't actually give a rat's ass about healthcare or helping people anyway; the only reason he wants to repeal the ACA is because a) it'd let him stick it to Barack Obama; b) it'd give him another tax cut and c) he'd get to brag about "winning" by finally slaying the mighty Obamacare Beast, etc.
A couple of weeks ago, the Congressional Budget Office projected that Trumpcare 1.0, aka the "American Health Care Act" or AHCA would kick 14 million people off their healthcare coverage next year alone, followed by an additional 10 million getting the boot by 2026. It would, however, save the federal government around $336 billion over that time period, which was pretty much the only positive part of their analysis.
This didn't go over too well with the "moderate" wing of the House GOP, as the AARP crowd wouldn't stop screaming at them during town halls nationwide. Meanwhile, the "Freedom Caucus" (basically, the ultra-batcrap insane wing as opposed to the only-kinda-insane members) was angry because the Trumpcare bill didn't hurt enough people quickly enough.
House leaders postponed a vote Thursday on their plan to overhaul the nation’s health care system, as they struggled to meet demands of conservative lawmakers who said they could not support the bill.
Earlier Thursday, conservative House Republicans had rebuffed an offer by President Trump on Thursday to strip a key set of mandates from the nation’s current health-care law, raising doubts about whether House Speaker Paul D. Ryan (R-Wis.) had the votes.
Trump met at the White House with the most conservative House Republicans, hoping to close a deal that would help ensure passage of the party’s health-care plan by shifting it even further to the right. But the session ended with no clear resolution, and some lawmakers said they needed more concessions before they would back the bill.
March 23, 2017 - U.S. Voters Oppose GOP Health Plan 3-1, Quinnipiac University National Poll Finds; Big Opposition To Cuts To Medicaid, Planned Parenthood
American voters disapprove 56 - 17 percent, with 26 percent undecided, of the Republican health care plan to replace Obamacare, the Affordable Care Act, according to a Quinnipiac University national poll released today. Support among Republicans is a lackluster 41 - 24 percent.
If their U.S. Senator or member of Congress votes to replace Obamacare with the Republican health care plan, 46 percent of voters say they will be less likely to vote for that person, while 19 percent say they will be more likely and 29 percent say this vote won't matter, the independent Quinnipiac (KWIN-uh-pe-ack) University Poll finds.
(Granted, most of the 46% who say they're less likely to vote for them are most likely Democrats anyway, but still).
The changes in question appeared to include a) hurting even more poor/disabled people more quickly than before by speeding up the Medicaid expansion cut-off and block-granting non-ACA Medicaid...but also a vague reference to beefing up the individual market tax credits for older enrollees.
Now the Medicaid cruelty aside, I've long been an advocate of beefing up the indy market subsidies myself, so this isn't necessarily a terrible idea, although the devil would be in the details. I assumed, for instance, that Ryan & Co. planned on changing the age-based structure from this:
UPDATE: If you scroll all the way to the bottom, I've added a completely updated state/national-level table as well, reflecting both the "clean repeal" and Trumpcare scenarios.
As I noted a few days ago, the Center for American Progress has outdone me. I crunched the numbers and broke out roughly how many people would lose healthcare coverage assuming the Affordable Care Act were to be fully repealed, with immediate effect and no replacement healthcare legislation whatsoever--that is, kicking nearly 15 million Medicaid expansion enrollees, over 750,000 Basic Health Plan enrollees and roughly 8.2 million significantly-subsidized individual market exchange enrollees off of their policies all in one shot. Add it all up and it comes to roughly 24 million people nationally.
UPDATE: After thinking about it all day, I've decided to remove the "scrotum" nickname from the headline. I reserve the right to keep it in the body of this and future posts, however.
After being lambasted by pundits, reporters and politicians across the political spectrum for pushing an ACA replacement bill which would effectively raise insurance premiums on older enrollees up to eight times higher than they would be otherwise (eating up over 50% of their annual income in some cases)...
My conclusion, after much analysis, double-checking and updating, is that the grand total would be roughly 24 million people: Around 8.2 million current exchange enrollees, nearly 15 million via Medicaid (expansion or otherwise), and the 750,000+ people enrolled in BHP programs in Minnesota and New York.
When I was 18 years old, my father died of a brain tumor.
A few weeks after the funeral, I left for college at Michigan State University. Freshmen were required to room blind, so I had no idea who my roommate would be. When I met him, a tall blonde guy named Brian, I was still wearing the Kriah ribbon--a small torn piece of black cloth.
We shook hands, introduced ourselves, and then Brian asked me what the torn ribbon was for. I explained that my father had recently passed away, and that Jewish custom was for mourners to wear torn black cloth as part of the mourning process.
"Oh, I'm sorry to hear that he's burning in hell right now."
I should note that this was less than 5 minutes after we had met. I was assigned to live in the same room as this guy for the next 9 months.
For 2017, the weighted, average, unsubsidized (that's critical!) premium rate increase for ACA-compliant individual market healthcare policies was roughly 25% nationally.
There were plenty of reasons for this, including normal inflation/healthcare costs; the discontinuation of two of the three stabilization programs (Reinsurance and Risk Corridors, although the RC program had already been sabotaged a year earlier anyway); correction for under pricing by many carriers in the first couple of years of the ACA exchanges; and, of course, the fact that the ACA exchange risk pool continues to be worse than hoped for in numerous states/counties.
Of course, for the roughly 10 million exchange enrollees who are receiving tax credits, this didn't really impact them much at all:
On average, ACA marketplace consumers receiving tax credits are literally paying exactly the same this year as last year -- $106 per month. pic.twitter.com/WzqA6DsWRN
You may have noticed that I haven't been posting as many blog entries the past week or two. This has been partly due to our 5-day power outage, of course, as well as various other personal odds & ends. The main reason, however, is that I've been driving around the metro Detroit area giving a PowerPoint presentation about the ACA and Trumpcare to various groups. Last night was my 4th or 5th presentation, and while it was kind of sloppy and scattershot the first few times, I'm streamlining and modifying for each new event.
Even so, I'm cramming a lot of information into an hour or so, and several people at each event have asked if I could upload the slideshow to the website for easy download.
Of course, it's impossible to prove that the Trump executive-order/ad-kill combo was the cause of the numbers petering out at the end of the enrollment period...but I have some pretty strong evidence that it did.
How? Well, remember, the 12 state-based exchanges, which cover around 1/4 of all Qualified Health Plan (QHP) selections nationally, were not hurt by the ads being killed. The executive order might have had some impact, but the actual HC.gov ads being yanked shouldn't have hurt them much since these exchanges have their own, separate branding, marketing budgets and outreach programs.
I therefore decided to compare how the 39 HC.gov states performed relative to the 12 state exchanges...the results are pretty telling.
...UPDATE 3/16/17: I've updated the tables and chart below with the final, official 2017 Open Enrollment Period numbers from CMS.