I’ve said this before, but it bears repeating.
Improvements in hospital care made as a result of the Affordable Care Act have saved the lives of 12,500 per year since 2010. In addition since about half of the people who were uninsured prior to the ACA have gained insurance it follows that about half of those who died each year due to lack of insurance — another 13,000 per year — have been saved by the ACA.
Uninsured adults are at least 25 percent more likely to die prematurely than adults who have private insurance. See state-level breakdowns of the 26,100 people between the ages of 25 and 64 who died prematurely due to a lack of health insurance in 2010.
Combined that’s 25,000 people per year, but even that estimate could be low as described by Thinkprogress.
Continued...
Nearly 36,000 people could die every year, year after year, if the incoming president signs legislation repealing the Affordable Care Act.
This figure is based on new data from the Urban Institute examining how many people will become uninsured if the law is repealed, as well as a study of mortality rates both before and after the state of Massachusetts enacted health reforms similar to Obamacare.
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The Massachusetts study examined how much mortality rates dropped after that state enacted its Obamacare-like reforms in 2006. It estimated that “for every 830 adults gaining insurance coverage there was one fewer death per year.” Applying this formula to Urban’s estimation that nearly 30 million people will become uninsured if the fiscal provisions of Obamacare are repealed indicates that about 36,000 will result ever year from such a repeal.
Alternatively, should Congress repeal the entire law, thus avoiding the collapse of many health insurance markets that will result from partial repeal, an estimated 22.5 million people will still become uninsured. In that scenario, the Massachusetts study suggests that more than 27,000 people will die every year who otherwise would have lived.
It should be noted that the bill that passed the House yesterday also completely gutted the Medicaid Expansion contained within the ACA which would take Healthcare away from another 6-8 Million beyond what was included in the Massachusetts study.
If we base this calculation from the CBO estimate of the prior version of this bill — which was that 24 Million people would lose their health insurance, that means that an average of 29,000 per year will die.
That’s not awesome. If this country was hit with a terror attack that killed 29,000 people every. single. year. we would absolutely lose our minds with grief, fear and outrage but because these deaths are occurring one by one to people in their own homes or shortly after they arrive at an emergency room after they’ve let a treatable illness grow into a terminal one, we don’t really even notice. We don’t even blink.
Oh, and that the last minute change on the issue of allowing states to wave the requirement to cover pre-existing conditions if they build their own high-risk death pools also causes another problem for their big “Three Step Plan.”
The Urban Institute examined how many people will lose insurance under one possible path for Obamacare repeal. Under the Senate’s current rules, legislation repealing regulatory reforms — such as the requirement that insurers cover people with preexisting health conditions — can be filibustered and thus effectively requires 60 votes to become law.
Yes, that’s right — the additional $8 Billion that was procured at the last minute for the MacArthur and Upton Amendments for HIgh Risk Death Pools essentially means that Senate Democrats have the last word on what will happen with this bill, because they overreached their original goal of only having “Step One” be a budget bill that could pass the Senate with only 51 votes under budget reconciliation rules.
Whoopsie!
There is also the point, noted by the Center for American Progress, that the $138 Billion that convinced Upton and other GOPers to sign on to this R.M.S. Titanic of a bill — is woefully inadequate to properly cover the cost of these plans.
The Center for American Progress found that the $130 billion of funding already in the AHCA would be insufficient to sustain even a small high-risk pool. Supposing the size of the pool was about 5 percent of the small-group and individual markets, the AHCA would need to provide a total of $327 billion to offer moderately subsidized high-risk pool coverage for those 1.5 million people. The current version of the AHCA falls $200 billion short of that, and the $8 billion promised to House Republican moderates would fill in just 4 percent of the funding gap.
Suppose that the high-risk pool’s enrollees would receive Affordable Care Act-like benefits, including limits on out-of-pocket costs, no rating based on health status, coverage of essential health services, no annual or lifetime limits, and a subsidy that covers 68 percent of the average premium. We start our calculations by assuming that the average high-cost enrollee has annual claims of $32,108, the average in the Affordable Care Act’s transitional Pre-Existing Condition Insurance Plan. We then subtract the consumers’ share of medical costs from the total claims cost and add health insurance companies’ administrative overhead. The resulting premium for the AHCA high-risk pool would be $31,000 per year. A 68 percent subsidy would be $21,000—hardly generous considering that the consumer’s share of the premium would be $10,000.
So sure, the House plan would provide “coverage” for those with pre-existing conditions — which by the way, is what could be called an almost “public option” or a nearly single payer for sick people — as long as they can afford at least $10,000 per year in premiums and/or deductibles out of pocket.
And if they can’t… oh well.
All of this is in addition to the $880 Billion that the House bill cuts from Medicaid.
One of Donald Trump's central campaign promises was that he would replace Obamacare with a system that provided "insurance for everybody." He moreover promised that he would not cut a cent from Medicare and Medicaid, the programs that provide coverage to older and lower-income Americans. He even got angry when other candidates promised not to cut Medicaid, because that was his thing, not theirs:
Unfortunately for the working-class Rust Belt voters who provided the crucial votes that made him president, Trump's new thing is cutting Medicaid. The American Health Care Act, which he and other Republican leaders are on the verge of pushing through the House (Update, 2:41 p.m.: The bill passed on a 217–213 vote), would eliminate a total of $880 billion in the program's funding between now and 2026. As a result, the Congressional Budget Office projected in March, 14 million people would lose Medicaid coverage. And while the current version of the AHCA hasn't been reviewed by the CBO, if anything, it will make things even worse for voters than the first one did because it also eliminates Obamacare guarantees of "essential benefits" coverage and coverage for pre-existing conditions.
And lastly it should be noted that Trump and GOP’s big “Market Solution” which is allowing insurance companies to violate local state insurance rules — for which they just generated a bunch of waivers — and sell insurance across state lines isn’t included in this bill because it was slated for “Step Three” since they didn’t want the Senate to be able to filibuster it. But because of the waivers they did include, THE SENATE CAN ALREADY FILIBUSTER IT.
Whoopsie! again.
That’s on top of the fact that idea simply will not bring down costs because insurance companies Don’t. Want. This.
The idea of developing a more national market for health insurance has become a major part of Republican health reform orthodoxy. A bill to allow interstate insurance sales was introduced in Congress in 2005, and, since then, has been a part of the platform of every Republican presidential nominee. Mr. Trump is not alone in his view: Scott Walker, Marco Rubio, Ted Cruz, Rand Paul, Rick Santorum and Bobby Jindal have all endorsed it. Aside from repealing the Affordable Care Act, allowing insurers to sell their products across state lines appears to be the most popular health policy idea among the G.O.P. candidates.
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The trouble is that varying or numerous state regulations aren’t the main reason insurance markets tend to be uncompetitive. Selling insurance in a new region or state takes more than just getting a license and including all the locally required benefits. It also involves setting up favorable contracts with doctors and hospitals so that customers will be able to get access to health care. Establishing those networks of health care providers can be hard for new market entrants.
“The barriers to entry are not truly regulatory, they are financial and they are network,” said Sabrina Corlette, the director of the Georgetown University Health Policy Institute.
Even if they really did this, which would mean setting up a Single National Exchange — which already exists as part of the Multi-State Plan Program and doesn’t work very well — It’s not really true that you could have one state that establishes a set of waivers where low cost junk plans can be offered that don’t include all of the ACA essential benefits and then magically you can buy that lousy cheap plan from others states that didn’t apply for those waivers — meaning you basically have a plan that violates your local state insurance rules —because that out-of-state insurer can’t really offer any plan to anyone if they haven’t already setup a local network of doctors and hospitals who are willing to accept that low cost lousy junk insurance plan.
This entire idea does not work. It can not possibly happen the way the GOP thinks it’s going to happen.
Sure, they may have gotten their little legislative first down and are doing a big giant ball spike and happy dance on for 40-yard line but in the end they’ve painted themselves into a dead end corner.
This bill isn’t getting through the Senate. But 217 of them are now on record for being willing to kill about 30,000 Americans per year in order to give rich people a $600 Billion tax cut.
And there’s no upside to any of that. None.