The ugly:
The proposal retains Obamacare’s prohibition of exclusion or differential pricing for those with pre-existing conditions, but it eliminates the mandate that was supposed to prevent the whole structure from collapsing into a death spiral.
Their solution? Anyone who has a lapse in coverage of greater than two months, pays a 30% surcharge for the coming year.
Really?
You expect me to believe that this 30% penalty will be enough to compel people to stay consistently covered, despite the cost, rather than decide that, once coverage has lapsed, there’s little point in renewing, and they might as well save some cash to “pay for” the higher premiums later? It seems like wishful thinking that this’ll keep enough people insured to avoid the death spiral.
Oh, and the bill eliminates, so far as I can tell, pretty much every tax that was designated as paying for Obamacare. The tanning tax. The “Medicare surcharge” for high earners. The premium tax. etc. Perhaps there are other revenue sources, and I haven’t yet seen a working-out of costs, but there doesn’t seem to be even a pretense of paying for the new spending, however little that may be.
Oh, and by the way? All Trump’s mad rants about how he’s going to solve healthcare by “getting rid of the lines”? Don’t see anything about that here.
And, lastly, one big open question:
One item that is not at all clear to me is what happened to contraceptive mandates, or to coverage mandates in general.
CNBC says that “Insurers would still be required to include 10 essential health benefits in their plans.” Does this include contraceptives? Are all of Obamacare’s list of “preventive” benefits (including the free breastpumps) still included, and, if so, was this an intentional retention or just an oversight? The only mention of “essential health benefits” in the bill seems to be (if I understand it correctly) with reference to Medicaid plans.
So that’s my first reaction.
More to come! In the meantime, readers, your thoughts?
Image: from Wikipedia, https://commons.wikimedia.org/wiki/File%3ADoctor_examines_patient_(1).jpg; By Unknown photographer [Public domain], via Wikimedia Commons
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