The House of Representatives narrowly passed
H.R. 1628
, aka the American Health Care Act, in a 217-213 vote. If you think that bill sounds familiar, you would be correct - it's the same bill
from March that was pulled from a vote by House Majority Leader Paul Ryan, because too many far-right voters were opposed to it. The main
difference between then and now is the presence of the
MacArthur Amendment
, so named for it's creator and sponsor, Representative Tom MacArthur (R-NJ). In the amendment, states are allowed to request issuance of a
waiver that would allow them to eliminate Obamacare constraints placed on insurers in the individual marketplace if an individual's coverage
has lapsed for a minimum period of time. They would be allowed to gouge the price on the individual, for one year after the policy is re-
activated. This would include the ban on discriminating against people with pre-existing conditions, as well as the list of
essential health benefits
that must be included in all plans, such as emergency services, pregnancy/maternity/newborn care, prescription drugs, laboratory services,
etc. Theoretically, there are
restrictions in the amendment
on applying for the waivers that maintain protections for these possibly jeopardized elements, since they keep claiming that they will
protect those with pre-existing conditions. But the availability of a waiver means, if a state were to obtain one, the premiums for those
in the high-risk pools that would be created could climb so high as to price everyone out of the ability to pay for their coverage. Also,
there is no mechanism for enforcement, which is, not so coincidentally, what one would expect from a bill/amendment that was passed with no
debate and no Congressional Budget Office (CBO) score. Of course Ryan did it this way - his last go-around with this got shot down. And,
not for nothing, the
CBO score for the previous iteration of the bill
is still problematic, because this new iteration does nothing to improve that score - 24 million insured are still at risk of losing their
coverage, and now the waiver could price high-risk pools out of the market. And this says nothing for the 150-200 million people who get
their insurance from their employer. If waivers are issued to allow states to define "essential health services," employers would then be
free to choose which services are the most fiscally beneficial to the company and elect to offer them instead, which could cut or eliminate
services , or place annual limitations on coverage costs. The potential for greater negative impact is pretty high, but there is no way to
have accurate adjustments because, again, the CBO was ignored for this go around.
There is also the Upton Amendment , introduced by Rep. Fred Upton (R-MI), which would provide $8 billion in assistance to cover premium increases and out of pocket costs for anyone who is placed in high risk pools, or loses their coverage under the AHCA. This is little consolation, however, when considering $8 billion covers less than 2% of the potential premium hikes that could occur.
The main points are as follows. And remember, most of the original bill remains intact:
It feels as though we crossed a threshold. Politicians used to have to at least pretend to care about the people, because the people could vote someone out - and a much more informed electorate had no problem doing that. That's not a problem anymore, thanks to gerrymandering. As the electorate has become more ignorant and uninformed, their dedication to party has only grown more unyielding, it would appear almost out of spite. And politicians love that, because it only further bolsters their methods of pitting one against the other. They don't care about the people, because they no longer have to. It's about us vs. them, and the goal is not to do the work of the people - it's to win, no matter the cost. And that's why we get bills so atrociously put together, and why no one reads them, and why potentially hurting tens of millions of people feels like a such a victory, they need the Rose Garden at the White House to party in celebration of it, despite knowing how bad it is - remember they've exempted themselves from this bill, thanks to arcane Senate rules concerning the MacArthur Amendment - though, to be fair, the House version denies the exemption. No surer sign of how bad something is than to watch Congress exempt themselves from having to abide by it - we'll see if the Senate's version of the bill keeps the exemption. And they've got the Barnum and Bailey Circus ring leader in Donald Trump there to - as expected - ignorantly take credit for this idiocy, and then later praise Australia's prime minister for their health system - a universal health care system that our Congress would burn the Capital building to the ground before they would ever seriously consider.
We have moved beyond serving the people. These politicians, with few exceptions think we live in a capitalist/market-based economy - we don't. Cutting taxes for the rich will not make them expand and hire people. The biggest companies stopped expanding years ago. Increased revenues don't drive up their employment - it simply increases their P/E ratio, and thus their stock value. Tax cuts for the super rich do not drive up employment. Consumers do. Companies don't take tax cuts and expand. Tax cuts go in their coffers. Expansion only happens if they are selling more products or services that cannot be met by current staffing and physical facility levels, which then demands the need for more employees or facilities. That's not what we have nowadays. Most companies "maintain" their business models, and demand more from existing employees to maintain any increases. If tax cuts serve any purpose, it's to upgrade in automation, which ultimately eliminates jobs. Even Trump doesn't understand this. He still thinks coal jobs are coming back.
And this is where the two-party system has gotten us: limiting options to bolster power in small groups. And they will ruin your lives if they can win one more election. It's about winning, not serving. When Mitch McConnell publicly chastises Elizabeth Warren while she's trying to speak on the floor of the Senate one day, then lets a handful of men read the same material the next day and says nothing about any of them, that's the sign. It wasn't about what was right or wrong. It was about the fact that it was Elizabeth Warren, arguably the most powerful woman in the country, and the face of opposition in the Democratic party. He was making sure she knew her place - and the other women in the Democratic party as well. Misogyny is okay, so long as you win. And Mitch McConnell saw to it that every cabinet position was a victory, even changing Senate rules to remove debate. Didn't matter that half of the nominees were wholly unqualified, some not even knowing what their own agencies did. This is about winning. And no uppity woman, like Elizabeth Warren, is going to get in the way of Mitch McConnell's victory, no matter how small. Health care is just one more thing. And whatever the Senate comes up with will be as self serving - and rich serving - as the House version. Count on it.
There is also the Upton Amendment , introduced by Rep. Fred Upton (R-MI), which would provide $8 billion in assistance to cover premium increases and out of pocket costs for anyone who is placed in high risk pools, or loses their coverage under the AHCA. This is little consolation, however, when considering $8 billion covers less than 2% of the potential premium hikes that could occur.
The main points are as follows. And remember, most of the original bill remains intact:
Individual Mandate/Funding
- The Individual Mandate is repealed, retroactive to 01/01/2016.
- The tax penalty for non-compliance with the mandate is repealed, retroactive to 01/01/2016.
- Establish State Patient and State Stability Fund of $130 billion/9 years, and an additional $8 billion/5 years for states that elect to use the community rating waivers. These funds are intended to mitigate the impact of increased premiums and out of pocket costs for the high risk pools.
- Funding for Prevention and Public Health Fund is repealed, end of FY2018.
- Supplemental funding of $422 million for community health centers provided for FY2017.
- Establishes a state option to require work as a condition of eligibility for nondisabled, nonelderly, nonpregnant Medicaid adults.
Subsidies
- The subsidies are repealed, effective 01/01/2020.
- Income-based premium tax credits are replaced with age-based flat-tax credits, increasing the percentage above the federal poverty level (FPL)for younger adults, decreasing it for older adults, but the credits are not adjustable by area or region of the country. If you are in New York or Oklahoma, regardless of the cost of living. Eligibility for these credits phase out at income levels between $75,000 and $115,000.
- The credits begin at $2,000 for young people, up to $4,000 for older people. And that's it. You get the same credit no matter how expensive insurance is in your area, which is a large part of the disconnect by politicians to recognize how much they are potentially hurting people with the plan as it is.
- Families can claim credits for up to the five oldest members, capped at $14,000/year total.
- Amounts are indexed annually to the Consumer Price Index (CPI) plus 1%.
It feels as though we crossed a threshold. Politicians used to have to at least pretend to care about the people, because the people could vote someone out - and a much more informed electorate had no problem doing that. That's not a problem anymore, thanks to gerrymandering. As the electorate has become more ignorant and uninformed, their dedication to party has only grown more unyielding, it would appear almost out of spite. And politicians love that, because it only further bolsters their methods of pitting one against the other. They don't care about the people, because they no longer have to. It's about us vs. them, and the goal is not to do the work of the people - it's to win, no matter the cost. And that's why we get bills so atrociously put together, and why no one reads them, and why potentially hurting tens of millions of people feels like a such a victory, they need the Rose Garden at the White House to party in celebration of it, despite knowing how bad it is - remember they've exempted themselves from this bill, thanks to arcane Senate rules concerning the MacArthur Amendment - though, to be fair, the House version denies the exemption. No surer sign of how bad something is than to watch Congress exempt themselves from having to abide by it - we'll see if the Senate's version of the bill keeps the exemption. And they've got the Barnum and Bailey Circus ring leader in Donald Trump there to - as expected - ignorantly take credit for this idiocy, and then later praise Australia's prime minister for their health system - a universal health care system that our Congress would burn the Capital building to the ground before they would ever seriously consider.
We have moved beyond serving the people. These politicians, with few exceptions think we live in a capitalist/market-based economy - we don't. Cutting taxes for the rich will not make them expand and hire people. The biggest companies stopped expanding years ago. Increased revenues don't drive up their employment - it simply increases their P/E ratio, and thus their stock value. Tax cuts for the super rich do not drive up employment. Consumers do. Companies don't take tax cuts and expand. Tax cuts go in their coffers. Expansion only happens if they are selling more products or services that cannot be met by current staffing and physical facility levels, which then demands the need for more employees or facilities. That's not what we have nowadays. Most companies "maintain" their business models, and demand more from existing employees to maintain any increases. If tax cuts serve any purpose, it's to upgrade in automation, which ultimately eliminates jobs. Even Trump doesn't understand this. He still thinks coal jobs are coming back.
And this is where the two-party system has gotten us: limiting options to bolster power in small groups. And they will ruin your lives if they can win one more election. It's about winning, not serving. When Mitch McConnell publicly chastises Elizabeth Warren while she's trying to speak on the floor of the Senate one day, then lets a handful of men read the same material the next day and says nothing about any of them, that's the sign. It wasn't about what was right or wrong. It was about the fact that it was Elizabeth Warren, arguably the most powerful woman in the country, and the face of opposition in the Democratic party. He was making sure she knew her place - and the other women in the Democratic party as well. Misogyny is okay, so long as you win. And Mitch McConnell saw to it that every cabinet position was a victory, even changing Senate rules to remove debate. Didn't matter that half of the nominees were wholly unqualified, some not even knowing what their own agencies did. This is about winning. And no uppity woman, like Elizabeth Warren, is going to get in the way of Mitch McConnell's victory, no matter how small. Health care is just one more thing. And whatever the Senate comes up with will be as self serving - and rich serving - as the House version. Count on it.
