2.28.2017 Trump address to congress – repeal and replace ACA Obamacare

President Trump says Obamacare is more complicated than we knew.

Published on Jan 20, 2017 President Trump Inauguration Address | Donald Trump – The 45th president of the United States speaks outside the Capitol building on Inauguration Day. View Giant Panorama Picture. During his inaugural address, Trump told the American people that this was “their celebration.”He echoed themes that were repeated throughout his campaign, promising not to leave “the forgotten men and women” behind, and calling for a return of power to the people as

Summary of process so far – New York Times 2.10.2017

Donald Care – Trumpcare vs. Obamacare

View our page on AHCA of 2017, which just passed the House

Click here for the status of the budget reconcillation bill that just passed both houses on Friday the 13th, 2017.  It’s going to committee.  See the menu at the top for more details of what the players, Paul Ryan, Mike Enzi, Tom Price, etc. in the administration have stated as their agendas on health care and analysis of them.  Learn more about the 1.20.2017 Executive Order to minimize costs of ACA – Obamacare – no new regulations to expand ACA. Watch the Senate Hearing 2.1.2017 it seems that EVERYTHING that might be on the table gets discussed!

Trump concedes ACA Obamacare is unbelievably complex New York Times 2.27.2017

1. Repeal Obamacare

The first point, which needs no comparison, involves repealing and replacing Obamacare in its entirety. Chances are that any sort of repeal and replace wouldn’t involve a sudden loss of insurance for the millions of Americans currently insured through Obamacare. More than likely we’d see a one- or two-year transition away from Obamacare and toward Donald Care – Trumpcare.

2. Allow insurance to be purchased across state lines

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3. Full premium tax deductions

Trumpcare: According to Trump’s proposal, one of the primary incentives of purchasing health insurance would be the ability to write off the full amount of your premiums come tax time. Admittedly, this also means wealthier individuals who can afford costlier, but more encompassing, health coverage would get a bigger tax break than lower-income adults who could presumably only afford a lower-cost plan.

Business can do it under Section 106.   Self – Employed Line 29 of 1040.

Obamacare: Under Obamacare, medical expenses have to exceed 10% of your adjusted gross income before you can claim them as a deduction. Taxpayers need to fill out a Schedule A should they claim this exemption.

4. Emphasize the use of Health Savings Accounts

Trumpcare: Another component of Trump’s healthcare plan involves emphasizing the use of Health Savings Accounts, or HSAs. To be crystal clear, HSAs already exist, so what Trump is proposing is something most Americans already have access to. An HSA is a tax-deferred plan open to individuals and families enrolled in high-deductible health plans. The allure of these plans is that withdrawals can be made at any age for qualifying medical expenses on a tax-free, penalty-free basis.

Obamacare: HSAs are also available right now for Obamacare enrollees, so there’s nothing essentially different from what Trump has proposed and what’s currently available under Obamacare.

5. Require price transparency from health insurers

Trumpcare: Trump’s proposal also vaguely calls for increased pricing transparency from health insurers so that consumers can make more educated purchasing decisions. No specific mention is made as to what aspects of the health insurance buying process would need to be more transparent.

Obamacare: Obamacare does the exact same thing through its online marketplace exchanges. In other words, Obamacare and Trumpcare are identical in calling for better price transparency. It should be noted, though, that having better transparency doesn’t mean consumers are using the data afforded to them very well. Well over a million people automatically enrolled in Obamacare last year, possibly signifying that they didn’t take the time to shop around for the best deal.

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6. Block-grant Medicaid – Medi-Cal to the states

Trumpcare: One of Trump’s unique healthcare proposals involves block-granting Medicaid to the states. Trump believes that state and local governments have a far better idea of what their needs are than the federal government, meaning block-granting federal money should result in less waste.

Obamacare: Under Obamacare, states have the right to decide whether they want to accept federal aid to expand their Medicaid programs — 31 states have chosen to do so. This Medicaid expansion covers people earning less than 138% of the federal poverty level. By 2020, the federal government is expected to phase down its contribution to 90%, putting the onus of the remaining 10% of revenue generation on the participating states.

7. Remove barriers to entry for overseas drug providers

Trumpcare: Finally, Trump’s healthcare plan involves breaking down the barriers to entry for overseas drugmakers. It’s no secret that pharmaceutical companies rely on high branded-drug pricing in the U.S. to subsidize their ventures in less profitable countries. If Americans were able to look outside the U.S. to, say, Canada, for their pharmaceutical purchases, they may be able to save money.

Obamacare: Obamacare has no specific provision designed to reduce prescription-drug prices. However, its transparent marketplace platform, and the introduction of the risk corridor  [which ended 12.31.2016?] — a type of risk-pooling fund that collected money from profitable insurers and redistributed it to money-losing insurers that priced their premiums too low — were aimed at keeping premium inflation to a minimum.

Three more big differences

Beyond Trump’s seven-point healthcare plan, there are three other, potentially major, differences between Obamacare and Trumpcare.

First, Obamacare’s individual mandate, which is the actionable component of the health law of the land, requires consumers to purchase health insurance or face a penalty come tax time. This penalty, known as the Shared Responsibility Payment, works out to the greater of $695, or 2.5% of your modified adjusted gross income in 2016. If Obamacare is repealed, there would presumably no longer be a penalty imposed for not purchasing health insurance.

Do our representatives understand the principles of Insurance?  The law of large numbers?   With no mandate will we get only the people that know they are going to have claims and get their money’s worth?

Secondly, Obamacare requires insurers to accept all applicants, even if they have pre-existing medical conditions. Repealing Obamacare would, in theory, mean that insurers would be allowed to once again pick and choose whom they insure. It’s possible Trumpcare could add in a similar provision, but Trump hasn’t suggested that one would be in his health plan.

CA has – had MR MIP – Major Risk Medical Insurance Program – Might that come back?

Finally, Obamacare ensures that Americans earning less than 400% of the federal poverty level (about $47,500) have access to the Advanced Premium Tax Credit (APTC), and that those earning less than 250% of the federal poverty level receive cost-sharing reductions (CSR) [Enhanced Silver] if they purchase a silver level plan.

Adverse Ruling on Cost Shareing Reductions – Enhanced Silver – House v Burwell

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The APTC is the subsidy that lowers what low- and middle-income individuals and families pay for their premium, while CSRs help cover the cost of receiving medical care (i.e., deductibles, copays, and coinsurance).

Trump has signaled via his Medicaid block grant proposal that lower-income folks would still be taken care of, but anyone earning between 138% and 400% of the federal poverty level could (note the emphasis) lose the financial assistance they’ve become accustomed to with Obamacare.

Again, it’s important to point out that Trump’s proposals could change between now and his first 100 days in office. Even members of Trump’s own party in Congress have been critical of his healthcare plan, so some degree of compromise may be in order. But, it’s pretty clear that Trumpcare is headed down a markedly different path from where President Obama took healthcare over the past few years.   Donald Trump.com  https://www.donaldjtrump.com/positions/healthcare-reform

This wildest presidential election possibly ever is now in the books. Donald Trump, a man who has never held political office and has no military background, stands ready to head to the Oval Office in roughly two months to become the 45th president of the United States.

But what’s most notable about this election is that the Republican Party also held on to the majority of both houses of Congress. This essentially means that we have a government unified under a single party, which could allow for new laws to be passed with greater ease compared with the Washington gridlock we’ve witnessed for many years.

According to President-elect Trump, who released his 100-day plan once he’s in office shortly after his victory, repealing and replacing Obamacare (officially known as the Affordable Care Act), the flagship healthcare law of Barack Obama’s presidency, sits near the top of his list. With a Congressional majority that has also shared an unfavorable view of Obamacare behind him, a repeal and replace seems quite possible.  Source Fool.com 11.14.2016  *  7 Things to know about the future of Obama Care  LA Times 1.5.2017

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Think Progress.com  1.14.2017 Everything you need to know about the GOP plan to reveal ObamaCare – ACA

Related Pages

PPACA -ObamaCare & Health Insurance Law

Dave Fluker Blog – Trump Care

9 comments on “Donald’s 7 Point Plan Intro

  1. Check this out from Town Hall https://townhall.com/columnists/brucebialosky/2017/02/19/fixing-health-care-n2286865

    Here are some suggestions for the Republicans while they are recreating the system bludgeoned by ACA:

    1. Get the government out of the private sector health care. Too many requirements for people to have too many criteria loaded on their health insurance. Just require a clear, concise statement by the insurance companies of what is included and what is not included in a policy. Let the companies develop their options to meet the marketplace.

    2. The only insurance people should be required to buy is catastrophic insurance or what was referred to as hospitalization (if you end up in a hospital from a traffic or skiing accident.) A 26-year-old should not be required to buy comprehensive insurance that will never be used. That is why they have not participated in Obamacare. That grand experiment failed. If the 20-somethings do not get insurance through work, they are not going to pay exorbitant rates to subsidize their parents and grandparents.

    3. Dispense with the penalties and the enforcement by the IRS — a despicable aspect of Obamacare. A lot of people got hit with penalties this past year and the Obama administration did not tell the world how many owe the government money because of premium supports that were overstated. Stop with the punishment. Emphasize rewards for acquiring insurance.

    4. Let’s get real about FDA approval of drugs. Not allowing legalization of medications tested and used in Europe is absurd. Not allowing people with virtual death sentences from disease to try an experimental process or medication is near criminal. Having drug tests taking eons and costing hundreds of millions is government in overdrive.

    5. For the 9,548th time, the biggest problem with Obamacare was it increased demand, but did nothing about increasing supply (doctors, nurses, hospitals). There may not be a need for more hospitals as stays are shortening, but it does no good to have insurance if you cannot see a practitioner. We need to push down some services that do not need doctors or dentists to lower-level practitioners to increase the supply, especially in primary care. We need to address this issue and no one is looking at it. We keep building law schools to create lawyers to sue doctors, but few, if any, new medical schools.

    6. Pricing for services has to become more of a marketplace. People need to know what the cost of their services are going to be before they are incurred. Being told not to worry because insurance will pay for your medical services is not good enough.

    7. Please, please, please stop this nonsense that you have to be at a doctor’s office to get medical advice. In an era where we have modern communication including Skype where a doctor can physically see a patient why does everyone need to travel across town, sit in a waiting room with people coughing and sneezing to get a diagnosis on simple matters as if it is still 1966? The government insists on doctors only billing for office visits. I beg my doctor to just tell them I was there, give me the prescription and bill me, but no. That is what happens when government bureaucrats and policy wonks make up health care rules.

    8. Reasonable levels of deductibles have to be established. Having significant deductibles is good to put the power of decision making back into the hands of the consumer. But $10,000 deductibles do not cut it for average Americans. This is where Health Savings Accounts need to come back into play after being attacked by Obamacare.

    9. We need to consider high-risk pools for people with significant pre-existing conditions. These people are the most challenging part of the medical system and the reason people not in this group have the greatest fear. They fear becoming part of this group and not having proper coverage.

  2. Hi Steve,

    Please keep me updated on the new Administrations impact on my insurance through the ACA.
    I’m quite concerned.

    Thank you,

    L B

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