Charles Gaba's blog

NOTE: I'm adding some additional commentary to this post throughout the day, so reload it later on if you're curious about my thoughts, but I wanted to at least get the main info out there early.

Regular readers of this site know that I'm a big fan of Reps Rosa DeLauro & Jan Schakowsky's "Medicare for America" universal coverage bill, which is scheduled to be officialy re-introduced later on today (with some significant changes from the original version introduced back in December).

However, "Medicare for America" and "Medicare for All" are not the only "major healthcare reform" bills being tossed around DC these days. There's actually eight of them total (technically nine, but two of those are the House & Senate MFA versions, which are nearly identical). Of the eight, only two of them actually guarantee 100% universal healthcare coverage, which is part of the reason #MFA and #Med4Am receive so much attention.

Back in February, I issued a strong warning to House Democrats to proceed with caution when it comes to the prospect of agreeing to reinstate the Cost Sharing Reduction (CSR) reimbursement payments which Donald Trump cut off back in October 2017:

  • Had CSR reimbursement payments continued to be paid over the next decade, the CBO projected that it would have cost the federal government $118 billion between 2018 - 2026, or around $13 billion per year on average.
  • Cutting off CSR reimbursement payments saves the federal government that $118 billion over 9 years. HOWEVER...

 

Regular readers know that I'm a strong supporter of going with the "Medicare for America"-style approach to achieving universal heatlhcare coverage as opposed to the "Medicare for All" proposal. Regardless, this is still an historic moment in U.S. history:

Chairman McGovern, Congresswoman Jayapal, and Congresswoman Dingell Announce Historic Rules Committee Hearing on the Medicare for All Act

WASHINGTON, DC — Rules Committee Chairman James P. McGovern (D-MA), Congresswoman Pramila Jayapal (D-WA), and Congresswoman Debbie Dingell (D-MI) announced today that the House Rules Committee will hold an original jurisdiction hearing on the Medicare for All Act of 2019 on Tuesday, April 30th at 10am ET in H-313, The Capitol. It marks the first time Congress has ever held a hearing on Medicare for All. Witnesses will be announced later this week. 

Last week, Joan Alker of the Georgetown University Center for Children and Families noted that a whopping 840,000 children lost Medicaid or CHIP coverage in 2018:

We've taken a closer look at these #'s - check out your state below.
The net national # is 840k kids losing Medicaid/CHIP in 2018 not 860k as we said initially
But in the 39 states losing kids on Medicaid the net total # is worse -- 920,000

https://t.co/dOOD4gyAOw https://t.co/jhs22mNc0w

— Joan Alker (@JoanAlker1) April 26, 2019

There's a link to a whole analysis which breaks the numbers out by state:

We’ve been anxiously awaiting the release of final Medicaid and CHIP enrollment data for 2018, which was expected to be posted almost a month ago. The wait is finally over but not our concerns about what’s happening.

I'm a little late to the party on this one, but a week or so ago, the Congressional Budget Office released their own report breaking out estimates of just how many Americans have different types of major helathcare coverage (public or private) for each of the past four years (2015 - 2018).

Their conclusions show a far less dramatic change compared to the survey released by Gallup back in January, which claimed that the uninsured rate for adults over 18 increased from 10.9% at the end of 2016 (just as President Obama left office) to 13.7% at the end of 2018. Based on their estimates, that amounts to around 6.8 million adults losing coverage over that time...and that doesn't include children, so the Gallup estimates, if accurate, would top 7 million people losing coverage.

Instead, the CBO report shows a far lower, but still troubling, trend since the day Donald Trump took office:

A couple of weeks ago I wrote an extensive piece laying out what seemed, at first glance, to be a bona fide state-level Public Option bill quietly working its way through the Washington State legislature:

Democrats in Olympia push through governor’s 'green' agenda and public healthcare coverage bills

...Another key item on the governor’s agenda is the so-called “public option” socialized health care coverage measure, SB 5526. This bill would create subsidized state-funded public health plans managed by regulated insurance companies. It would require the State Insurance Commissioner and the Health Care Authority to set up the socialized plans by 2021.

,,,These plans would be available through the state’s health care exchange to all residents, but the state would pay subsidies to individuals with incomes of up to five times the poverty level. Premiums would be limited to no more than ten percent of adjusted gross income, and payments to doctors and other health care providers would be restricted to Medicare-level limits.

Saturday, May 18th, 9:00am: Fems for Change: Healthcare, Who Knew It Could Be So Complicated?

  • Birmingham First United Methodist Church, 1589 W. Maple Rd., Birmingham, MI 48009

Turn on the TV, open a newspaper, browse social media: everyone is talking about new ideas for expanding American healthcare coverage. As consumers and voters, it can be hard to know which option is best for our families, our neighbors, and our nation.

This timely forum will help you make sense of Medicare for All; Medicare and Medicaid Buy-Ins; adding public plan features to private insurance; improving the Affordable Care Act (ACA); and other options discussed in the media.

 

I've included the transcript below, but words can't accurately describe the tone of voice or the body language of Grassley in the actual video, so I'll just urge everyone to watch it.

WOMAN: "What is your plan to keep millions of Americans like myself covered? Those of us with pre-existing conditions, people who are on their parents insurance, and again, people like myself who need life-guaranteeing medication? We could lose our insurance and I'd probably be dead in 2 months."

GRASSLEY: "Well, there's a...there's a lot of, uh...and she's asking only because the courts may declare [the ACA] unconstitutional. Now, I don't think that the courts are going to declare it unconstitutional..."

WOMAN: "You voted seven times to repeal it."

GRASSLEY: (pause) "Yes."

WOMAN: "Why? What are you going to do for people on the ACA?"

Just a few minutes ago I noted that the state of Oregon is once again strongly considering taking a second crack at establishing their own, fully state-based ACA exchange after spending the past five years piggybacking on top of HealthCare.Gov.

Well, the Oregon State Public Interest Research Group just published an extensive report in which they urge the state to do just that...along with several other key changes which I also strongly agree with:

Steps like a mandate for Oregon residents to buy health insurance and relief for exchange customers who earn too much to receive tax credits under the Affordable Care Act could help reverse premium hikes that have shot up amid attempts by the Trump administration to roll back the law, OSPIRG, the Oregon State Public Interest Group, argued in a report released Wednesday.

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