Yes, I'm still fiddling around with the 3-Legged Stool metaphor. I wasn't gonna mess with it any further, but gvien that Donald Trump has decided that making healthcare the biggest topic of the 2020 election cycle (again) is a brilliant strategy for the Republican Party, I figured it was time for an update.
The version below includes a bunch of changes; some are corrections; others are enhancements:
Moved "Maximum Out-of-Pocket Costs" to the Blue Leg, since that's really a carrier covrerage requirement.
Added "Stay on Parents Plan until Age 26" to the Blue Leg. I never had it listed before, not sure why.
Added "Health Insurance Exchanges" to the Green Leg. I never had them actually listed on the graphic, but they're an important Government Responsibility, after all.
Governor Andrew M. Cuomo, Senate Majority Leader Andrea Stewart-Cousins and Assembly Speaker Carl Heastie today announced an agreement on the FY 2020 Budget. The Budget holds spending growth at 2%for the ninth consecutive year and cuts taxes for the middle class.
The Budget includes several landmark policies that will bring sweeping transformation and social justice reform to the state with the passage of the permanent 2% property tax cap that has already saved New Yorkers $25 billion since it was first implemented in 2012; a strategic MTA reform plan and steady revenue stream to fund the next capital plan through Central Business District Tolling; an additional $1 billion to support education, bringing total education funding to $27.9 billion; and landmark criminal justice reforms, including reforming the cash bail system, speedy trial, and the discovery process for a more fair and just New York for all.
I swear to God, Thanos must have invoked the Time Stone, because we’re right back to two years ago with this crap. I could just re-promote old blog entries from April 2017 and no one would know the difference:
The White House is quietly working on a healthcare policy proposal to replace the Affordable Care Act, according to multiple sources with knowledge of the matter.
...The analyst said the administration has been “having conversations” on healthcare policy and has reached out to numerous think tanks, including the Heritage Foundation, the Mercatus Center, and the Hoover Institute.
There's over a half a dozen major healthcare reform bills swirling around the Democratic side of the aisle these days. The two biggest contenders at the moment are the universal, 100% mandatory single payer "Medicare for All" bill being pushed by the Progressive Caucus in the House (led by Pramila Jayapal) and, of course Bernie Sanders in the Senate; and the universal, 50% mandatory (over time) "Medicare for America" being championed by Reps. Rosa Delauro and Jan Schakowsky in the House and Presidential contender Beto O'Rourke.
Regular ACA Signups readers know that I'm a huge fan of the Medicare for America approach (although I think we also need a robust ACA 2.0 upgrade to tide things over until Med4Am can be ramped up). However, there are still a bunch of other proposals out there, and there's nothing wrong with any of them; it's mostly a question of how far you want to set your marker.
Virginia Governor Ralph Northam has been out of the national news for the past month or so, keeping a low profile since the media frenzy over the "med school blackface photo" debacle subsided. Rightly or wrongly, in the end, in spite of pretty much everyone under the sun demanding that he resign, he stuck it out and outlasted the scandal by simply...not.
He isn't up for reelection (and in fact under Virginia law he can't run again anyway), he didn't actually commit any crimes or anything else impeachable, so it sounds like the state has pretty much just sort of accepted that he's gonna stick it out for another couple of years. In fact, according to this article in the Virginian-Pilot, he seems to have regained some of his pre-scandal stature:
Two months after a blackface photo in an old yearbook nearly ended the political career of Virginia Gov. Ralph Northam, his life seems mostly back to normal.
Over the past week or so, I've written several posts explaining how the new ACA 2.0 bill rolled out by the House Democrats would improve the law. So far I've mainly focused on the impact on health insurance policy premiums, since that's the single most obvious improvement.
In particular, I posted an extensive explainer, with colorful graphs and tables, showing how single adults at various ages would fare under ACA 2.0 compared to current law (households with more than one person would follow a similar patter, with the dollar amounts simply being higher across the board).
However, it's probably a good idea for people to also understand how age bands work. The age band is the reason an (unsubsidized) 64-year old pays so much more than a 21-year old.
The full expansion initiative passed last fall, of course, is supposed to cover Utah residents earning up to 138% of the poverty line, or around 150,000 people...without any work requirements.
The bill barreling through the Utah Legislature was “an effort to override the will of the people,” said Matthew Slonaker, the executive director of the Utah Health Policy Project, a nonprofit group that supported the full expansion of Medicaid.
Utah lawmakers, worried that the sales tax increase might not fully cover the costs, are rushing through a bill that would limit the expansion of Medicaid to people with incomes less than or equal to the poverty level, about $12,140 for an individual.
State officials say that the bill, which is estimated to cover 90,000 people, could be on the desk of Gov. Gary R. Herbert, a Republican, in a week or two.
The Trump appointee who oversees Medicare, Medicaid and Obamacare quietly directed millions of taxpayer dollars in contracts to Republican communications consultants during her tenure atop the agency — including hiring one well-connected GOP media adviser to bolster her public profile.
Lost amidst all the other overwhelming ACA-related news this week is one other important nugget: The Affordable Care Act's "individual mandate penalty", which was lowered to $0 in December 2017, was still the law of the land until December 31, 2018. It may have been changed at the time, but that change didn't become effective until January 1, 2019.
I left out one tidbit in my latest post, however: There's been a lot of speculation the past two days about the timing of both Trump's DOJ memo formally asking the 5th Circuit Court of Appeals to repeal the entire Affordable Care Act on Monday the 25th and the timing of the House Democrats' ACA 2.0 press conference/bill rollout the very next day on March 26th.
The House Dems announced on Saturday the 23rd that they were scheduling their big ACA 2.0 rollout on Tuesday the 26th.
The other six are directly related to the ACA...these are the six "mini ACA 2.0" bills which cover six of the eleven ACA repairs & improvement provisions included the the larger ACA 2.0 bill introduced yesterday. Here's summaries of all twelve bills being debated today:
Most people know that over the past three years, I've gone from being a fan of Vermont U.S. Senator Bernie Sanders to...well, not being a fan; let's just leave it at that. They also know that while I support an eventual move towards a single payer-based healthcare system, I simply feel that it will have to be achieved via incremental steps (preferably large steps, not baby ones).
I addressed this point at the time in response to earlier attacks on me by MFA purists:
I need to take a moment here to call out progressives who badmouthed and scolded me last week for promoting the House ACA 2.0 bill by insisting that ONLY Bernie's M4A bill will do, and ANYTHING short of that--even in the short term--is unacceptable.
(sigh) Naming-wise, this is actually worse than the title of last year's ACA upgrade bill ("The Undo Sabotage and Expand Affordability of Health Insurance Act", or #USEAHIA), H.R.5155, which I didn't think was possible.
In any event, last year I went with simply calling it "ACA 2.0", which seems even more appropriate today. Others seem to agree:
The bill Democrats are rolling out to shore up Obamacare is called the Protecting Pre-Existing Conditions and Making Healthcare More Affordable Act. I think @charles_gaba calling it ACA 2.0 is going to catch on pretty quickly.