Wednesday, March 01, 2017

House health-care draft suggests a plan that could leave rural areas short of coverage

Photo from The Atlantic
A 100-page draft of a House Republican plan to repeal the Patient Protection and Affordable Care Act suggests that "millions of people in rural areas where it’s already hardest to find doctors might no longer be able to afford health insurance in a few years," Van R. Newkirk II writes for The Atlantic.

"The basics of that plan, which was unveiled by House Speaker Paul Ryan two weeks ago, and the rough shape of which has the support of new health secretary Tom Price and the Trump administration, are known," Newkirk reports. "The plan removes the individual and employer mandates to purchase and provide insurance, respectively, and it would also repeal most of the taxes that fund Obamacare. It would roll back funding for the Affordable Care Act’s Medicaid expansion and dramatically restructure the Medicaid program’s funding. Further, the plan would replace the Affordable Care Act’s cost-sharing subsidies and premium tax credits with an age-rated tax credit, all while keeping Obamacare’s popular pre-existing conditions ban."

The draft was leaked to Politico last week. It "specifies that Obamacare’s Medicaid expansion for low-income able-bodied adults won’t be completely eliminated, but the eligibility and funding will be rolled back after 2020. The draft also contains a provision changing federal funding for Medicaid in 2020 onward from an open-ended obligation to a system where the per-person spending every year is capped based on spending levels in 2019 and increased annually to correspond with medical inflation," Newkirk says.

The draft plan repeals the tax-based individual mandate and replaces it with an incentive to maintain continuous health-insurance coverage. "For people not covered by employers or public insurance who have to purchase insurance on individual, small group, or exchange markets, this proposal would allow insurers to charge up to 30 percent more in premiums to people who go without coverage at any point for more than two months, and also for young adults who don’t enroll in coverage as soon as they age out of their parents’ plans, a surcharge that would not be remitted as taxes to sustain the system, but would be paid as profits to insurers. The effects of this potential measure on individuals’ pockets are potentially limited by a reduction of federal oversight over what can be considered health-insurance coverage, which would allow people to avoid penalties by purchasing barebones coverage," Newkirk explains. (Read more)

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