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Washington - Bids To Curb Health Care Costs Offer Little More Than Talk

Published on: March 12, 2018 09:35 PM
By: AP
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Dawn breaks over the Capitol in Washington, Tuesday, Feb. 6, 2018, as House GOP leaders are proposing to keep the government open for another six weeks by adding a year's worth of Pentagon funding to a stopgap spending bill. But Senate Democratic leader Chuck Schumer says that approach, fully funding the Defense Department but only providing temporary money for the rest of the government, won't go anywhere.  (AP Photo/J. Scott Applewhite)Dawn breaks over the Capitol in Washington, Tuesday, Feb. 6, 2018, as House GOP leaders are proposing to keep the government open for another six weeks by adding a year's worth of Pentagon funding to a stopgap spending bill. But Senate Democratic leader Chuck Schumer says that approach, fully funding the Defense Department but only providing temporary money for the rest of the government, won't go anywhere.  (AP Photo/J. Scott Applewhite)

Washington - It started as a bipartisan attempt to curb soaring health care premiums.

But Congress’ effort to stabilize the nation’s insurance markets is faltering amid escalating demands by each party and erratic positions by President Donald Trump. Democrats want bigger federal subsidies for consumers under President Barack Obama’s health care law while Republicans, still fighting that statute, aim to relax its coverage requirements and win abortion restrictions.

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The bickering could collapse the whole effort, with each side blaming the other when next year’s expected higher insurance rates are announced — just weeks before Election Day, on Nov. 6.

Last week, Sen. Patty Murray of Washington, a lead Democratic negotiator, called GOP demands on abortion limitations “a complete nonstarter.” A spokeswoman for Rep. Ryan Costello, R-Pa., sponsor of the House GOP package, said if Democrats want to oppose the effort “by playing abortion politics, then shame on them.”

Some Democrats think they’d reap political gains if the talks collapse since polls show the health care statute is widely popular and the public would largely fault Republicans if consumer costs spiral skyward.

“Either Republicans help stabilize the market or they own these premium and deductible increases,” said Rep. Kurt Schrader, D-Ore. “And I’d be glad to help crucify them if they don’t want to do something very reasonable.”

The effort forces Republicans to choose between trying to avert bad news about premiums shortly before elections or standing by their opposition to anything that could be viewed as propping up “Obamacare.”

Trump hasn’t clarified things for his party. In a single day last October, he bounced from praising one bipartisan plan as “a very good solution” to labeling it “bailouts to insurance companies.”

Signs indicate insurance prices will likely continue upward. So try containing those increases, lawmakers crafted two bipartisan bills last year.

One by Sens. Susan Collins, R-Maine, and Bill Nelson, D-Fla., would provide billions to states for reinsurance. The funds would help insurers afford covering some of the sickest, costliest customers.

Another by Murray and Sen. Lamar Alexander, R-Tenn., would revive federal payments to carriers to subsidize discounts they give lower-earning consumers for costs like deductibles and copayments. Trump halted the subsidies in October as part of his effort to upend Obama’s law after federal courts said Congress hadn’t properly approved the money.

Providing ammunition for the sponsors, an analysis released Monday by Oliver Wyman Actuarial Consulting, a private firm, estimated that if Congress enacted the proposals, premiums could be at least 40 percent lower than if no legislative action was taken.

Obama’s statute requires insurers to provide those cost reductions, which last year cost the government $7 billion to help around 6 million people. Insurers boosted premiums to make up the difference.

Complicating what Congress might do, Trump’s halt of those subsidies to insurers has had an unanticipated, positive impact for low-income consumers.

Because of how most state regulators let carriers raise premiums, federal tax credits that help lower-income customers buy coverage grew so robustly that many were better off than before. Reviving the subsidies could actually increase out-of-pocket costs for at least 1.6 million people, the liberal Center on Budget and Policy Priorities says.

In other changes since last fall, the new GOP tax law has erased the tax penalties enforcing the “Obamacare” individual mandate, which requires most people to buy coverage. Trump has also proposed making it easier for insurers to sell policies that last less than a year and have fewer consumer protections than Obama’s statute imposes, like required coverage for people with pre-existing conditions.

Citing those blows to Obama’s law, Democrats say the tax credits that help millions pay premiums need to be more generous and cover more people. They want to restore spending that’s used to encourage people to buy coverage and block Trump from allowing the sale of low-cost, low-coverage plans.

Republicans have their own demands.

A White House memo says any effort to strengthen markets must have language that “ensures all federal dollars are life-protected” — a reference to restrictions on using the programs to finance abortions.

AshLee Strong, spokeswoman for House Speaker Paul Ryan, R-Wis., said last week that the effort to stabilize insurance markets must heed the GOP’s long-imposed legal bar against using federal funds for nearly all abortions.

“That is not negotiable for House Republicans,” Strong said.

The White House memo also demanded that insurers be allowed to charge older customers higher premiums than Obama’s law permits and get more leeway to renew short-term, low-coverage policies.

An agreement would likely be included in a government-wide spending bill Congress wants to finish by March 23. It’s probably the year’s last must-pass measure, so proposals left behind will face difficulties becoming law.



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Read Comments (6)  —  Post Yours »

1

 Mar 12, 2018 at 11:21 PM Educated Archy Says:

If you really want to reduce health costs get rid of the pre existing requirement. Thats the real sad answer that no politician including Trump wants to do.
Many jews are now signing yo for this new health cost sharing program run by Christians. An odd alliance. And you can hate it and denounce it but many are doing it. Costs are peanuts compared to any insurance. The big difference you can't have a pre existing condition for 3 years prior. Since its a helath cost sharing program not insurance its not bound to insurance laws

Note I am not advising others whether they should or should not sign up for the plan. And there maybe other downsides and risks. I merley pointing out the most of the insurance costs are for pre existing and its a chutzpah that we have to subsidize it.

2

 Mar 12, 2018 at 11:25 PM Educated Archy Says:

Why can't health insurance be like auto and life insurance? If you make unwise choices you pay for it. If you are fat or smoke you should pay for it. And medicad should surely charge people who are fat. They should charge an annual premuim of $1,000 a year. If you go to your annual check up and your wieght is good and you don't smoke you get back the $1,000. Its called work on wellness and it will redcue costs.

They should also charge copays. Not more than the price of a chesseburger but at least that.

And why not make people pay what they'd pay for an i-phone. Everyone can contribute $500 a year.

3

 Mar 13, 2018 at 03:15 AM grandbear Says:

The healthcare 'industry;' owns washington. period.

4

 Mar 13, 2018 at 10:59 AM Educated Archy Says:

Reply to #3  
grandbear Says:

The healthcare 'industry;' owns washington. period.

Do you have a more efficient system? At the end of the day our health care system is second to none and top notch. Look around at all the frum yidden from Israel here in the USA for cancer treatment and collecting money lo alinu . They can't get that kind of care in Israel .

5

 Mar 13, 2018 at 02:14 PM Geulah Says:

Reply to #4  
Educated Archy Says:

Do you have a more efficient system? At the end of the day our health care system is second to none and top notch. Look around at all the frum yidden from Israel here in the USA for cancer treatment and collecting money lo alinu . They can't get that kind of care in Israel .

Yes, it's called Direct Primary Care where you pay the doctor directly. The costs are transparent and comparable between doctors. You only insure for catastrophic issues, not chronic care issues as chronic care becomes part of primary care, where it always belonged. We have an out of control system due to GREED on the part of specialists and insurance companies that pay out to specialists and not to primary care doctors. We don't have a health care system, we have a chronic care system which is perpetuated by the cabal of insurers, food producers (who have to use 5 lbs of sugar in your babka), and pharma companies. Sorry Archy, when you were a kid these health issue weren't a pandemic because primary care doctors weren't greedy and insurers were for hospitalization, not primary care. Cash for Care is less expensive than insurance, much less. Educate yourself on DPC.

6

 Mar 13, 2018 at 05:58 PM Educated Archy Says:

Reply to #5  
Geulah Says:

Yes, it's called Direct Primary Care where you pay the doctor directly. The costs are transparent and comparable between doctors. You only insure for catastrophic issues, not chronic care issues as chronic care becomes part of primary care, where it always belonged. We have an out of control system due to GREED on the part of specialists and insurance companies that pay out to specialists and not to primary care doctors. We don't have a health care system, we have a chronic care system which is perpetuated by the cabal of insurers, food producers (who have to use 5 lbs of sugar in your babka), and pharma companies. Sorry Archy, when you were a kid these health issue weren't a pandemic because primary care doctors weren't greedy and insurers were for hospitalization, not primary care. Cash for Care is less expensive than insurance, much less. Educate yourself on DPC.

re primary care, they are actually not greedy at all. Do you know how much primary care dr's get from insurance companies? I see the bill. My kids pediatrician earn $48 a visit. That's greed? In fact it too little and forces them to institutionalize their practice to the point where you get the PA and never get the dr. they are looking in one ear as they write the prescription and move in to the next kid. So no greed there at all.

Re specialists you have a point. But will specialists really be specialists if they can't make big bucks?
Also costs do vary based on location. There re many factors that go into dr costs.

You certainly have a point on big phrama. But again if they won't get rich they won't research cancer meds. For every one success there are 100 failures in medicine.

Most of your costs are actually for long term care/ end of life and chronic illnesses. Consumers can't pay cash for that and I don't see how you propose to make that cheaper. Should people pay cash for stem cell transplants?

Your proposal may result in some cost decrease but nothing substantial. Its the pre existing that's a killer

7

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