Proposed Obamacare Replacement Hammers Early Retirees

Category: Health Issues

Update March 24: At the last minute when it appeared the votes weren’t there for passage, the President and Speaker Ryan pulled the bill and it was not voted on. Apparently the issue is moot for the time being. So as Ryan said, “Obamacare is the law of the land”.

March 22, 2017 – The Republican controlled Congress and our new President have come out with their proposed replacement to the Affordable Care Act, aka Obamacare. Unfortunately for its proponents, the new bill, the American Health Care Act (AHCA), has run into considerable headwinds. The American Medical Association (AMA), hospital groups, the Heritage Foundation,the AARP, as many as 18 Republicans in the House and Senate, several Republican governors, and virtually every Congressional Democrat do not like the bill. In this article we will review how the proposed bill would affect baby boomers 50-64 who are not eligible for Medicare. Unfortunately, many of the folks in this group are retired (often involuntarily) and have very low incomes.

The Congressional Budget Office estimates that 14 million Americans of all ages would lose health insurance coverage in 2018 under the bill, rising to 24 million by 2026. On the plus side, about a third of a trillion dollars would be saved during that period, mainly because subsidies to lower income folks would be replaced with less generous tax credits. Although younger people would probably see net health premiums (after tax credits) go down with the Republican plan, people age 50-64 would see increases in premiums that are so high that many will have to go uninsured. At the same time the proposed bill gives wealthy people a big tax break by eliminating two Affordable Care Act taxes – increased capital gains taxes and a Medicare surcharge. The Joint Committtee on Taxation, a nonpartisan panel, estimates that people making over $200,000 a year would save $274 billion in the next decade with the provisions in the new bill.

Here is how the Republican bill affects people age 50-64:
– Under the proposed bill the CBO estimates that after any subsidy/tax credit the net annual premium for a single 64 year old with income under $26,500 would go from $1700 to $14,600 – more than half their income! A single person with income of $68,200 would see their net premiums go down slightly – $15,300 under the ACA vs. $14,600 under the new plan. (Note, not all plans would be this expensive, but the relative disparity would remain the same).
– If you have a very high income the new bill will save you some money in taxes, because you won’t have to pay the Obamacare surcharge (although insurers can charge you more).
– The AARP uses a slightly different scenario to arrive at similar results: they predict the average older American would pay $8400 more for health insurance under the Ryan/Trump bill. By their estimates a 64 year old making under $26,500 would see a premium increase of $12,900 by 2026.

– Part of the reason for the increase is that under the ACA, insurance companies could only charge older people up to 3 times the rate they charge younger ones; under the new plan the maximum goes up to 5 times.
– Tax credits under Obamacare gave more help to people with lower incomes and in higher cost areas. The Republican plan only considers age.
– Although coverage for pre-existing conditions cannot be denied under the new plan, if there is a 2 month gap in coverage insurers could charge up to 30% more. This is a potential problem for older people who might have let their coverage lapse due to money problems.
– The CBO estimates that the AHCA would cut Medicaid funding by $880 billion. Many seniors are already on Medicaid due to their low incomes, so they could lose coverage unless the states step in to make up the difference. An unseen threat that hasn’t been mentioned much is the effect it will have on low income seniors currently in nursing homes whose monthly charges are paid by Medicaid. Presumably many of those people could lose that support, and many more would never get enrolled in the program (better tell the kids to keep that spare room ready!)

What happens next
The President and House leaders say they are willing to make changes to the bill to get it to pass, which is scheduled for a vote on March 23. Both Speaker Ryan and the President are working hard for passage. Minor changes announced on March 20 were mostly concessions to get conservatives behind the bill. One potentially helpful change mentioned would increase tax credits for older people, although details on this would be pushed to the Senate for resolution. Note that tax credits do not help people who have little income.

The problem is that any changes to make the bill even more strict to get conservatives on board will probably drive more moderate Republican Senators further away from it. Although the House might be able to pass a replacement bill, the votes are probably not there in the Senate. While that might be viewed as a good thing for those who would be grateful to see their coverage continue under Obamacare, it might not be. That is because if the Congress keeps chipping away at the underpinnings of the ACA, it, and the private insurance market, could be further undermined.

AARP Not Happy
The AARP published results of a poll conducted by the Benenson Strategy Group of people over age 50 who voted in the last election. More than half of all respondents (55%) — including a majority (51 percent) of older Trump voters — agree that allowing insurance companies to charge people ages 50-64 five times as much as younger adults for the same coverage amounts to an age tax on older Americans. “Older Americans want affordable health care, including less-expensive prescription drugs and continued protections for the most vulnerable,” said AARP Executive Vice President Nancy LeaMond. “When Americans over age 50 look at the details of the House health care reform plan, they don’t like what they see. They don’t want big insurance and drug companies to reap massive profits at their expense.”

Photo courtesy of Wikipedia and SSgt. Derrick C. Goode, U.S. Air Force

What should you do?
Don’t get sick. Sure, many if not most health issues are due to back luck and genetics. But you can control a lot of things about your health. Eat healthy, lose that extra weight, quit smoking, control your drinking, and get some exercise. Invest in a physical to get an early warning on any possible risks.
If you are working and have company health insurance, try to keep working until you can get onto Medicare. Likewise, if you have private health insurance, hang on to it as long as you can. A lapse in coverage could be disastrous.
Make your voice heard. This article has tried to give you the facts about the new plan as it affects people age 50-64. However you feel about the bill, let your elected representatives know if you support or do not support the bill. Calling their Congressional offices or attending town hall meetings are probably the most effective way to state your position.

For further reading:
Proposed Health Care Bill Hammers People Over 50
AARP Opposes Health Care Bill
Kaiser Health News on CBO Estimates
Barely 1 in 3 Can Afford Medical Care
Trumpcare Big Bills Small Towns
Compare ACA vs. GOP Healthcare
GOP Plan Would Hit Rural Areas Hard



Posted by Admin on March 18th, 2017

71 Comments »

  1. Would the Republicans also introduce a law that prevents lay-offs and severances of employees in their early 60’s? Especially longtime employees who then have to scramble to pay for healthcare until 65 years old!

    by SandyZ — March 19, 2017

  2. Interesting piece, but what is not presented, and should be for a complete picture, is what has happened to health insurance premiums since the passage of Obamacare. The premiums for those of us in the private marketplace purchasing insurance from private carriers have increased by double digits nearly every year. The reasons are simple…our insurance premiums were raised to subsidize the plans that carriers were offering in the Obamacare system (that were experiencing substantial losses). This hidden tax was inherent to the design of the Obamacare legislation, but rarely discussed when the impact of Obamacare on the (pre-Obamacare) health care financing/insurance system is described.

    by Jim — March 19, 2017

  3. Yes it is true that in many markets private insurance premiums increased a lot, as they did before Obamacare. Along with 20 million more Americans got health insurance for the first time. But the point of the article is that if passed, Obamacare is history. Trump/Ryancare will be on the hook for what happens next with the plan the President promised would be “something terrific”. As I see it, almost everyone aged 50-64 is much, much worse off with the proposed plan – not so terrific.

    by Fred — March 19, 2017

  4. This is definitely NOT a viable plan. The Insurance companies had a big hand in writing this bill–they have got to go. Medicare for all is what is needed …if I am advised to keep private insurance until I can get on Medicare–then Medicare MUST work. Why not include those in 50-64 age group?

    Call your representatives, and keep calling….this is unfair to those facing retirement in the near future. Obamacare is a disaster as well and did nothing for the self employed small business people who needed coverage. It also raised insurance deductibles so high that it almost seemed no one had insurance. What a mess this new proposal also is.there will be a big fight in Washington, DC. I have a front row seat since I live in DC.

    by Jennifer — March 19, 2017

  5. I am 60, if Medicare becomes the insurance for “all” then the premiums will have to skyrocket. Is that fair to those 65 and older who played by the rules all their working years? If you are under 65, is it not your responsibility to work out someway to cover yourself and your family? Where did this recent phenomenon that healthy working people expect the government to save them if they cannot meet their responsibility in this and many other issues come from?

    by Bob — March 19, 2017

  6. Trump played everyone: http://www.huffingtonpost.com/entry/trump-insurance-mulvaney_us_58cea736e4b00705db502fef?mvq1e5ddvz6txd2t9&

    by Louise — March 19, 2017

  7. Ditto. Thanks Louise.

    by Bob — March 19, 2017

  8. In all of my life I have never seen a U.S. president and congress sell out the majority of Americans for the sake of a handful of very wealthy people! The proposed Trumpcare eliminates the tax levied on the very wealthy and on the Insurance companies that benefited from the 20 -30 million new participants.
    I am ashamed to live in a country that puts money and power before its people. Most civilized countries are going to a no charge healthcare program that everyone participates and everyone benefits.
    Governments arte there for the people not to give giant tax loopholes

    Keep the ACA as it is! It is very workable. Improve it as needed and lets work towards all the people in the U.S having healthcare at an affordable price.

    by Ron — March 19, 2017

  9. Medicare and Medicaid cost will NOT go up as more people are added. Overasll the cost will go down as more and more people are insured as the ACA has proven over the past 7 years in existence.
    State manipulation of the increases granted to insurers has falsely led people to proclaim it was at fault. California for example only had a 2% increase as a Blue State the government did its job. Red states trying to cause the ACA to fail allowed double digit increases. Shame on them

    The cost of insurance is not supported by the expense. It does not cost the hospital 2000 a day for a bed! It does not Cost the Hospital 2000 for an MRI and on and on! The two drivers to medical costs are 1) Insurance companies wanting exhorbitant premiums and shareholder returns , 2)Hospitals charging ridiculous fees for mundane services. Finally the pharmaceutical companies charging U.S customer 10 to 20 times more than international countries for the same drugs.

    Don’t fall prey to lies our elected officials toss your way! Research them and understand this issue more deeply.

    by Ron — March 19, 2017

  10. Nobel Prize winner Angus Deaton stated clearly what is wrong. The American health care system “seems optimally designed for rent seeking and very poorly designed to improve people’s health.” And nothing is going to get better until we tackle that problem head on.

    http://www.nakedcapitalism.com/2017/01/debate-health-care-yet-omits-elephants-room-excessive-costs-due-terrible-incentives-pricing-administrative-costs-pharma-looting.html

    by Trout Chaser — March 20, 2017

  11. Louise, please take your political comments to another site. This is not a political site to express your resentment. This site is meant to be informative and helpful.

    by LMB — March 20, 2017

  12. LMB – Unfortunately, healthcare is the topic of this article and that IS a political topic. Should not be, but such is the sad state of affairs in our country. I would love to hear any fresh ideas for fixing the healthcare system from the medical field – any docs out there with thoughts? I have read that the American Medical Association does not support the Trump / Ryancare plan. They must have some ideas that would be more fair to all – docs, hospitals, drug companies, and most importantly, patients.

    by SandyZ — March 20, 2017

  13. LMB I am not the author of the article ‘White House Admits Trump ‘Insurance For Everybody’ Guarantee Isn’t Going To Happen’ posted in the Huffington Post. Also, I remember that President Trump promised us low cost, better insurance and it would cover everyone. It was going to be terrific. I don’t believe I am expressing my “resentment’ as you say. I am an Obamacare (ACA) insured person. Our President, when campaigning, said over and over again his new health care plan was going to cover everyone, be better and cost less. As it is written now, it will hurt Seniors and cost them 5 times more than it is costing them now. I can say that it is disappointment of promises not kept. Furthermore, this discussion is about ‘Proposed Obamacare Replacement Hammers Early Retirees’ so it brings up subject matter that is informative and also sparks opinions good and bad that everyone should be able to express. Others on this discussion topic have also expressed disappointment and are skeptical of the proposed TrumpRyan/care. By the way, raising the cost for insurance for seniors 5 times what they are paying now is a negative. Not keeping campaign promises is a negative.

    by Louise — March 20, 2017

  14. Comments to all. Frankly, everyone’s comments are all well informed and thoughtful.
    As a recently retired provider and now atypical Medicare care patient, healthcare Is, as they say, ,as they say, very conplicated. I personally support the ACA, but, IMHO, it has been a financial problem for a number of reasons.
    One of the biggest has been the plan’s inability to attract more healthy, younger subscribers, whether it be throughl better incentives or harsher penalties. Result, an unbalanced high risk pool.
    I still believe in it and just think it needs tweaks.
    I use the analogy of car insurance. In most states, if you own and drug a car, you have to carry insurance on it, for collision, liability. It’s basically sacrificing a bit of personal n freedom for the sake of security of the overall population.
    Imagine you are in a car accident in a state without mo fault.your Car gets wrecked, but the other driver is uninsured. Get it. You’re screwed.
    That’s what will happen if this replacement deal goes through. In the end, many will not get insurance. They will just go to the Emergency room, hospitals will go back to the free care pool, that will raise our taxes anyway, not to mention, have a lot more for sick people.
    You are all going to pay either way. Don’t kid yourselves.
    I am a free market capitalist, but this has gotten to the point if my next w leaning towards a Medicare for all option, that is age and income based, with incentives for the private sector to compete against.
    The sea of too much central government power troubles me greatly, but the politicians have driven me to this position. All thoughts welcome.

    by Steven Kaufman — March 20, 2017

  15. Thank you Steven, I agree with you 100% Also, healthcare is very complicated but why do most countries outside of the United States able to make it less complicated? ?

    by lela1955 — March 20, 2017

  16. Here’s a thought – maybe the resources in the government that develop these healthcare plans are not experts? How about we ask representatives from United Healthcare Group, Aetna, Humana, Anthem and Cigna to get together and come up with a comprehensive medical, dental, prescription plan at a reasonable premium to people? Of course, their plan will provide ways for them to maximize their earnings – that is why they are in business – they are not non-profits. Then let the so called government experts use that plan as their basis and tear into it to remove/reduce SOME of the profit to insurance, drug companies, hospitals, doctors and all type of providers and provide even lower premiums. Having just retired from working many years at one of these large healthcare insurance companies, I am confident there are a lot of great strategic minds there and they probably know better than any of us what is really needed to make healthcare work for all.

    by BeckyN — March 20, 2017

  17. The problem is also that medicine is a “business” in the USA and not a right. I am a former nurse and I must tell you that I know not one Canadian or European would trade places with us when it comes to healthcare coverage. Only in the USA can one go bankrupt by getting sick through no fault of your own…why should one have to give up a business or a livelihood to a greedy insurance/healthcare system? Everyone deserves basic benefits–the best doctors do not have to even accept insurance as it now stands. First in line to have to deal with this proposed coverage is the elected officials who think it is good enough for everyone else as they enjoy their gold plated insurance plans paid for by us, the taxpayers! They should have to use whatever they propose for any common American. People better start looking into alternative medicine and eating healthy, getting sleep and exercise..it is their only hope not to end up thousands of dollars in debt.

    by Jennifer — March 20, 2017

  18. BeckyN, I agree with your suggestion that politicians are not experts in healthcare and that they should put their heads together with representatives from health insurance, physicians, hospitals, drug companies.

    by Louise — March 21, 2017

  19. Steven, this why I believe in a single payer system for hospitalization as in Part A of medicare. I also believe that we desperately need to address the cost of prescriptions. But I do not believe in forcing citizens to buy health insurance. I do not know if many of you are aware that for over 50 years the United Kingdom has had socialized medicine but it is also possible to pay for medical services outside the socialized system and receive care. For me, this is definitely a separation of the classes. But regardless, my point is that socialized medicine does not ensure the best or immediate care. As witnessed by our own VA system which next to Medicaid is the closet to socialized medicine we have. Medicare you can still choose between traditional and advantage. BTW, in England there is a waiting list not based on need but by age. My mother -in-law who loved the system when she was a young adult changed her thinking when she entered her 60’s.

    by LMB — March 21, 2017

  20. Sandy Z, I disagree. Health care should not be a political topic and that is why we all are in this pickle now. People want the government to do everything for them. Where did this thinking come from and why? Growing up in the 50’s my parents only had hospitalization not full coverage. Somehow, and believe me I lived in the inner city with one part time working parent, my parents paid the doctor. I do admit we did not go to the Doctor for every ailment or for every fever. One time not even a broken ankle. Maybe we need to rethink going to the Doc and the mal practice insurance they must carry. I understand that this is not the 50’s and we must live in the present but maybe we need to rethink what the government’s role really should be.

    by LMB — March 21, 2017

  21. What is the best Medicare company to go with in Fla? They each push their own…isn’t there an agent who represents all and can give you honest answers? We just moved from another state and were told we have to switch and haven’t a clue who to go with. thank you WE are just on A, B and D

    by Brenda — March 21, 2017

  22. Brenda,
    Ehealth.com https://www.ehealthinsurance.com/medicare is wonderful website to help with choosing a Medicare plan. After you explore it, call the number given and a counselor will answer and help with all of your questions. It was recommended to me a few years back and it made this process almost stress free. They will send you emails with plans for your state and comparisons, or if you talk with them on the phone while you are on their site they will explain what you are looking at. What was the greatest was the counselor who answers the phone is one you can stick with through the whole process, and I called her several times over the course of a week. I even applied for Part B over the phone with ehealth. They filled out the application electronically with me on the phone and I got a welcoming email from the insurance company I chose and my insurance card in the mail soon after. The first phone call took about 40 minutes, they don’t rush you and I had a million questions. So best to have your questions ready and a cup of coffee in your hand because it does take time but it does get done.

    by Jemmie248 — March 21, 2017

  23. LMB healthcare should not be a political topic is an opinion, healthcare is a political topic is a fact.

    by Debra — March 22, 2017

  24. Yes, the healthcare in the US is political. I think the big reason is the huge cost of healthcare. Other countries negotiate healthcare and pharma prices. Trump promised that everyone would have healthcare. And he promised he would get the healthcare and pharma companies to lower prices. Well he met with them and changed his mind. The politicians are getting money from these companies so they are working for them – not us.

    This proposed plan is just going to take from the poor and give to the rich. Why in the world would we give tax breaks to the wealthy and the insurance companies in a health care plan? My guess is because that is who the GOP is working for.

    The big part of having good health care is that preventive care is much less expensive than the care after you are sick. If this plan goes through I guess more people will be using the ER as their primary doctor. It seems to me that we are going backwards with almost everything today. For a wealthy country we surely do not take very good care of our citizens who need help. And it looks like it will get worse rather than better.

    by elsie45 — March 22, 2017

  25. I think Elsie pretty much summed it up
    I’m a free market capitalist thinker, and do believe that the ACA needs tweaking, but I’ll only bore you with some of the details.
    For the ACA to continue to function, a lot of moving parts need to be addressed.there are too few young, healthier people to balance out the high riskers,due to poor incentives, small penalties, take your pick.
    The r latiobship to having an individual mandate and Medicaid expansion upsets the republicans, etc.
    After years asa solo practitioner, now retired I’m so sick of it all, that is just Medicare available to all, rates based on age and income, provide the private sector incentives to compete and treat it like car insurance. You own and drive a car, you have to have insurance.

    by Steven Kaufman — March 22, 2017

  26. LMB,
    Good points, particularly noting that tortxreform is another part of this crazy puzzle. Docs are stuck between”cost control” and knowing that if they don’t order every rest, there’s a lawyer out there, justrwady to question their thoroughness.
    Your comments are very detailed, but left me a bit confused. First you say single payer, then you imply having competition.
    I believe in choice, I don’t trust big govt, but Medicare works. The pay is mediocre, but one can earn a decent living if they work hard. But the private sector needs to have enough incentives to offer a competitive oeuvre, I.e, Medicare advantage plans. What not make all of this available to everyone?

    by Steven Kaufman — March 22, 2017

  27. Trumpcare must be put down! This poorly thoughout POS needs to be scrapped! Not only does it harm millions of Americans it will result in the loss of thousands of good paying healthcare jobs. Jobs that our corporations have not figured away to outsource yet!

    The ACA was a great document that over time needs to be massaged and improved upon! I am afraid that the republicans hatred for our President Obama cast lies and distortions regarding the healthcare delivered by the ACA!

    Bottomline the ACA (Obamacare) is a much better and much fairer plan than the ill thought out Trumpcare.

    Demand your congressman vote DOWN the Trumpcare joke of a “healthcare” plan… it is a death sentence for the elderly and poor!

    by Ron — March 22, 2017

  28. I trust the federal government much more than the State governments State governments are to easily bought and paid for by special interest… Just look at North Carolina as an example!

    by Ron — March 22, 2017

  29. What bothers me is that they are rushing this repeal and replace thing so fast that there isn’t enough thought on what will make it a great replacement. Two months into his presidency and they have a plan? It took a long time to get the kinks worked out of Obamacare and it still needs work.

    All should be required to participate in it as this is the only way insurance works to keep down costs. Most people are going to have a need for health insurance during their lifetime. Old people aren’t the only ones with health issues. Plenty of young people come down with cancer, broken bones, problem pregnancies and on and on. One other thing that is a bit puzzling is why do they allow parents to carry a child on health insurance till age 26? The age of a legal adult is 21.

    You’d think President Trump would want this health reform to be a glowing triumph to his presidency. From what I have been hearing it will forever tarnish his legacy. His attitude towards this repeal and replace is ‘just get it done’ and move onto other things. This is far too important to spend a total of 8 weeks to come up with a glowing new plan that is “going to be better, cost less and cover everyone and is gong to be terrific” President Trumps words, not mine.

    by Louise — March 22, 2017

  30. Steven K and Ron, I am in agreement with your thoughts. The Advantage plan makes sense. It is in place. It isn’t a Gold plan but it is a start. From there it could be expanded. So frustrated they are in such a hurry to make bad decisions. I will be on Medicare in 16 months so it may or may not affect me personally. However, Obamacare was there when my Hub and I needed it and I would like to see other people be secure knowing they have health insurance when they need it.

    If a car needs a muffler replacement you typically don’t junk the car if it is only a few years old, you FIX IT! Is fixing it such a hard concept to understand.

    by Louise — March 22, 2017

  31. For Jemmie on 3/21/17 RE : https://www.ehealthinsurance.com/medicare
    Please note you are recommending a “for profit” website, their advice is designed to sell you something.

    From the disclosure at the above website:
    eHealth Medicare contains information and access to Medicare insurance plans for people who are eligible for Medicare. It is operated by eHealthInsurance Services, Inc., a licensed health insurance agency certified to sell Medicare products.
    Medicare.com is a non-government resource that is privately owned and operated by eHealthInsurance Services, Inc.
    The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.

    by Trout Chaser — March 22, 2017

  32. I would be cautious in promoting the conclusions from the CBO. To begin with, the AHCA is a 3 part legislative process. The real meat of the legislation which will reduce costs through more competition and have more plans to chose from will be coming in the later sections. If nothing is done, Obamacare will self implode.

    by Charles Dennis Roney — March 22, 2017

  33. The AHCA is not perfect but the alternatives are worse. In this period of political polarization, what chance is there in the near future that the Democrats are going to control both houses of Congress and the Presidency? Nothing better than the AHCA is on the horizon. Our choices are 1. Obamacare being repealed with no replacement being passed for the foreseeable future. 2. Obamacare not being repealed but dying off with no replacement. 3. A more Draconian Plan being passed by Republicans. If politicians, including Democrats, truly care about citizens that are in need of insurance coverage and some assistance, they will support the AHCA passage. When the make-up of Congress and/or the Presidency changes in the future then the AHCA can be revisited. Something is better than nothing in the interim for those in need. Put politics aside for now.

    by DW — March 22, 2017

  34. I agree with Steven Kaufman. We are trying to reinvent the wheel by passing this bill as well as continuing to use Obamacare.
    We have a single payer system in place already. It’s called Medicare and while not perfect, it works pretty well. Plus we eliminate all the bureaucracy by having state run plans that include multiple insurers and types of plans.
    I suggest devise a subset of Medicare for those under 65 that provides affordable base coverage with options that include lower income based premiums as well as “supplemental plans” for those who can afford more coverage. Bringing private insurers into this type plan would help them to gain critical mass (a national plan) and build historical claims experience that helps them stay in for the long run.
    I’d forget tax credits – lower income, lower premium.

    by Howard Atkinson — March 22, 2017

  35. To me the tragedy in this latest plan is that nobody in government is trying to think out of the box. We are the only major industrial country in the world that does not have some kind of universal health coverage for all citizens. Yet we pay far more on health care than any other country per capita, with often middling results and millions left uncovered. Republican plans cut taxes for the wealthy while depriving anyone with less than middle income of health insurance. In addition to the tragedy of unnecessary deaths and suffering, we all pay when people have no recourse but to go to the ER, often for life threatening illnesses that a preventative care visit could have detected in time and cured for far less money. Democrats want universal coverage for everyone, a worthy but more expensive goal than many in the country are willing to pay for. They need to move toward the center to help find a solution.

    Why not think a little different, or smaller. Smaller: consider mandatory catastrophic coverage for everyone – it wouldn’t be that expensive – Kip Hagoplan and Dana Goldman in National Affairs think 209 million Americans could be covered in such a plan for $2000 a person. Individuals would be responsible for routine medical expenses/insurance. This is similar to what works very well in Singapore. Or different: Provide a basic counterpart to Medicare for everyone not in that system. Everyone must participate, but you can add on optional coverages like you can get with Medicare. Or not so different, study the ways Obamacare could be improved and make those fixes.

    The point: We need some type of universal health care coverage, it is a basic human right in a developed country of ours. Lets put aside the set positions and try to find a creative way to do it.

    by Fred — March 22, 2017

  36. If you look at the numbers for 2015 for Medicare the total cost was $646.2 billion. Based on the 2015 enrollments numbers of 54.3 million Medicare recipients, the average annual cost per person was $11,900 for Medicare As a 57 year old if I were to lose my employer coverage I don’t think I could get a comparable policy for much less than $11,900 per year and if rates rise as expected I certainly won’t be able to. Why not open Medicare up to folks under 65 at the full cost to operate. Even if costs per person didn’t come down with additional enrollment (which they likely would as younger healthier folks joined), if I had the option to buy into Medicare at that price at least there would be some competition that the private insurers would have to recognize and respect.

    by John C — March 22, 2017

  37. Howard and Fred – sorry to be somewhat redundant, I didn’t see your comments before posting mine.

    by John C — March 22, 2017

  38. Maybe they need to start thinking about the excess costs of funding American health care, and proceed by means of heavily taxing the “sin trades,” for instance, setting up national lotteries, taxing marijuana etc (whether or not they make it legal), adding taxes to anything that is currently not a life necessity, is addictive and harmful to health and personal and public safety, and that makes a lot of money with the result that it negativelyaffects the health and financial balance of the indulger . Take all that un-taxed illegal money away from ALL the underground “sin” economies, take all the net worth of those illegally gaining from the running of such businesses that are not paying their US taxes on it (whether foreign or domestic sourced people or products brought and sold here in the US, and whether considered legal or illegal) and put it all into a decent low-cost healthcare system that everyone in the US can afford. The crooks and their illegal enterprises thus unwittingly get to subsidize that part of our healthcare that isn’t affordable by paying taxes set by the government and that depend on how much the healthcare system needs to be cheap and functional.

    For instance, Colorado is awash in funds from “medical marijuana” which is, as everyone knows, not really always used for real medical issues by most who are able to gain access to it.. Take the gains from all of this stuff, whether drinking, gambling, the drug trade, etc. and turn the situation around to where it is doing the public some good as a whole instead of it paying for cartel Maseratis parked at billionnaire villas in the Caribbean.

    The funding exists for all that is needed, it just needs someone with the guts to do the re-appropriation via common sense and lawmaking that makes a positive impact on the general public.

    by Khem — March 22, 2017

  39. Over the past few years I have come to understand AARP and its soleless methods of selling their insurance. I have not nor would I ever trust AARP or any survey conducted by them since they have a built it prejudice. Actually, I am surprised that this site chose to even discuss this issue since I always considered it to be a non-political site. I guess I was wrong after all.

    by art — March 22, 2017

  40. Higher income people already pay all the Federal taxes asking people to responsible for themselves is not a tax cut for the rich.
    Doctors are paid $400,000-$500,000 per year and don’t want to take a cut in pay. Of course they oppose less funding for healthcare. AARP sells healthcare insurance and is a liberal lobby group of course they like subsidies and Obamacare. Live healthy
    stop smoking, lose weight, exercise and don’t be an necessary burden on society so the truly needy (disabled) can get help.

    by Joe — March 22, 2017

  41. Khem.

    Interesting thinking!!

    by Steven Kaufman — March 22, 2017

  42. You all don’t realize how HORRIBLE Obamacare is until you’ve been slammed by it. My husband was out of work for 14 months at age 60, MADE to take that crap insurance in 2015 and then when he got a job and had insurance for the last 3 months of 2015, we are now being made to pay back over $4600 for it. What a scam – what a horrible plan and President. Not supposition and fake news but a real life tragedy.

    by Dian — March 22, 2017

  43. Dian, sorry to hear you have to repay but the Federal Poverty Levels (guidelines) are very straight forward in how much you can earn (family income) to receive subsidies. If you go over that income cliff, you have to pay back. That is why those who are receiving subsidies must be very aware of every penny of income. You are also required to call your Marketplace to report a change in income or other changes. Not sure if there is anything you can do now, but my tax person who is a CPA told me that if we should go over the income cliff, we could open IRA’s to divert some money. If your husband had a 401K he could have diverted money there. Also, Health Savings Accounts (HSA). Maybe charitable donations, not sure about that one. I am on Obamacare and can only withdraw a certain amount out of my IRA’s per year along with my SS and Hubs SS and small pension. All I can say is anyone on obamacare who receives a subsidy must be very aware of every penny of income to stay under the radar screen and not to go over the income cliff. This is the 2015 federal poverty levels for 2015. https://obamacare.net/2015-federal-poverty-level/

    http://time.com/money/4650470/obamacare-marketplace-plan-subsidy-save-taxes/

    by Louise — March 23, 2017

  44. Howard, Goid points.when I was on Medicare st 65 and still working, my premium was 3x higher,based than n my income, which was only fair. After a year of retirement, it dropped down to the standard rate, I do gave a A and B , a medigapplan and a part d drug plan, as well.
    I chis Medicare care for the choice. There are two Kentucky if advantage , one stop shopping plans, from m private insurers, that are available. That’s a personal choice.’anyway, like I said, it seems so much ch easier than just st tweak what has been out there for years.
    This repeal and replace is just not necessary. FWIW.

    by Steven Kaufman — March 23, 2017

  45. I don’t think of health care/insurance as so much of a political issue, but, most importantly, as a moral issue. A decent society should provide for its poorer and elderly populations, especially as their health and medical needs are concerned. It’s been said in this discussion that the U.S. is the only major country that doesn’t provide universal health care. That is true. Why is that? Why do some people with good health insurance, including Medicare, not want that to also be available to those less fortunate? I hope we would all abide by the Golden Rule: do unto others as you would have them do unto you.

    by Clyde — March 23, 2017

  46. I find it totally repulsive that millions of poor citizens with Medi-Cal { California } and Medicaid throughout the country could lose their coverage. This is not who we are as Americans.

    by Bubbajog — March 23, 2017

  47. I’m surprised there are people who don’t think the insurance companies have already had input into this bill! That’s what lobbyists do! As “60 Minutes” reported some years ago, the members of Congressmen and their staff members who wrote the horrible Medicare Part D legislation signed into law by George W in 2003 got 6-figure jobs with drug companies a few years later. That legislation actually FORBIDS the Federal govt from negotiating lower prices with drug companies.

    by Jeab — March 24, 2017

  48. Dian: That doesn’t sound like a tragedy to me. If you had a health crisis when he was out of work, being made to carry insurance would have been a blessing for you (and for taxpayers and others using the health care system who would have ended up paying for your medical costs if you didn’t have insurance). When he got a job, you then paid a fair cost based on the program. The repayment obigation based on income wasn’t a secret, so it shouldn’t have been a surprie to either of you.

    You didn’t HAVE to pay for Obamacare. You could have paid a small penalty for not carrying health insurance at all, or chosen COBRA or to buy other coverage. No medical insurance is free (heck, my own copayment for medical insurance is about $600 a month for one person, and I work for a large company). The ACA guaranteed that you’d be able to get coverage, and didn’t claim to be a welfare program that would provide you with cheap coverage and no pain. And I bet you were happy that it was available as an option. If your spouse loses his job again, what will you do without its availability?

    I obvously agree with Clyde, Bubbajog and others. I’ll be paying close attention to the votes on this issue. I don’t think it’s a Party issue. In my view, it’s an American issue, and I will be watching who votes to make life harder for Americans.

    by Kate . — March 24, 2017

  49. I am appalled that the GOP is trying to slip this so called healthcare plan into law. They just keep saying the same thing over and over. Why haven’t these politicians worked to fix the ACA? The American people do not want this GOP plan. It will hurt the poor, disabled, seniors and the very young. And the tax breaks for the wealthy and the insurance companies – why is this in a healthcare plan? Why isn’t this money going into the healthcare plan?

    I find it very interesting that most people do not want this plan. They want ACA fixed.

    I live in a fairly rural area. I have always had difficulty finding a medical provider in my insurance. ACA didn’t change that at all. All of that is decided by the insurance companies. I wonder how this plan will change that so everyone can see whoever they want? That is not going to happen.

    Now with the changes they are making an insurance policy does not have to cover maternity, pediatric, prescription drugs or hospitalization. And the GOP thinks that is what people want? What would the insurance cover? For a group of mainly old white men who want to get the federal government out of healthcare they sure have a lot of things that won’t be important to be covered. And a lot of that has to do with woman’s healthcare.

    This frantic race to repeal ACA on the anniversary of the ACA is just pitiful. Shame on the politicians who are supposed to be working for us. Hmm after 7 years – who knew health insurance was so difficult.

    Sorry this is so long. I am so upset over these awful laws they are trying to pass. I am one of those retirees who aren’t eligible for Medicare yet. I have a whole lot to be worried about.

    by elsie45 — March 24, 2017

  50. I was generally very happy with the ACA. It provided affordable insurance for my wife and I after a job loss about a year before we got on Medicare. It has been demonized for years by the GOP. They keep telling us there trying to save us from this “horrible” law!! Fix it don’t replace it!

    by Jim C — March 24, 2017

  51. “they” had to pass obamacare to see what was in it. What the media?… says, and what is real, are likely to be two different things. It’s never-the-less, a wait and see for us out here, It’s too bad it’s politics,

    by Jeff L — March 24, 2017

  52. The American Health Care Act is a disgrace. Hopefully Washington D.C. and all Congressional Districts are listening to the roar of the American people. Now is the time for Republicans and Democrats to work together towards adjusting and strengthening The Affordable Care Act.

    by Bubbajog — March 24, 2017

  53. I agree with Clyde and that is why from a nurse who has seen it all from the seventies until now in the medical world, I had to leave medicine as it got me so depressed. I have heard of doctors who made sick children on Medicaid wait longer for treatment than a well insured child–made me angry!! Not everyone has good insurance that pays well. if we all had the same coverage–then it would be a non issue. We all should have good coverage and we as Americans deserve that. Universal insurance such as Medicare for all. Coverage and premiums could be tweaked for younger Americans. BY the way, old age does not equate to sickness. I have seen many older people who are in much better health than the young kids who were raised on diet coke and McDonalds hamburgers. We saw and were shocked by young high school football players who dropped dead on the football field in my nursing career. Many of the men in their twenties required a cardiac clearance before a surgery! I also saw a tri-athlete die after competing in the third phase of the competition, the swimming portion. He was not yet 35. So don’t buy it–just because you have aged does not mean you are sick or will get sick. We all need insurance coverage and a requirement that physicians’ must accept the insurance as a condition for licensure. Otherwise they will always choose to accept only higher paying plans. My husband was a physician and a surgeon. I have seen it on both sides of the fence. A universal system is the way to go.

    by Jennifer — March 24, 2017

  54. So happy ACHA is not moving forward. It was a horrible bill that was in fact designed to provide tax relief to the wealthy. Too many would have lost, while too few would have gained. ACA should not be repealed, but reworked. We need the President to work on this, rather than hoping it will implode. So sad that so many hated Obamacare, but didn’t realize it was their own ACA health insurance. Ideology is dangerous.

    by Barbara Sprouls — March 24, 2017

  55. The proposed legislation is dead for now. However, we must remain vigilant because this President does not suffer defeat well. He says the ACA is imploding and, out of revenge, I believe he and the Congress will try to strangle the funding for the ACA so that it does fail. If you support the ACA, let your Congress member know that and that you expect Congress to keep their hands off of it unless they want to work to fix any issues and make it better.

    by LS — March 25, 2017

  56. My Congressman would have been a No voted had the bill come to the floor yesterday. Not because he thought it harmed the poor, the elderly, etc but because he is a Freedom Caucus member and he didn’t think the bill was harsh enough. It would be wonderful if they would work together on the ACA but I don’t see that happening.

    by Debra — March 25, 2017

  57. Well the GOP health care bill failed and Millions of people are now still forced to pay for health care they can not use while in fact they are buy health care for others. Unless you have experienced this you cannot relate what it feels like to be told you have to fork other 650 a month with a 6500k deductible before you are allowed to the 350 co payment for the ER what is more none of your lab work is covered. And for those of you who say that the GOP bill would have been worse for those 50 to 64, the new premiums for Obamacare have not come out for 2018. I agree the GOP bill was far from perfect and they did a lousy job of selling it, but with input from our age bracket we could have forced the GOP to tweek it. But now when those new premiums come out, let us see how many seniors choose to the penalty because the now 650 unaffordable premium is now 800 a month premium. Instead of making this a hate Rep bill why couldn’t all of us made this, “I cannot afford these premiums under either bill” Give us a bill we can live with! But again, unless you are directly affected by the unaffordable,” affordable health care ” you have no conception of what is like to be told by the government you can afford 650 for health care when you know you cannot because you still have a mortgage and a car payment all which is not taken in consideration when the government tells you what you can afford to pay for health insurance.
    So be proud of yourselves for sticking it to your fellow seniors who are living pay check to pay check or worse forced early retirement.

    by LMB — March 25, 2017

  58. LMB,
    Good comments as usual.
    The critical fork in the road is now here. Do the dems and reps get together to tweak the ACA’s problems, to serve the America people, or do we go back to the I won, you list nonsense iof this non functional government.
    I, for one, would recommend that a half dozen moderate governors, go down to D.C., and, in a bipartisan manner, help these fools out.

    by Stevenk — March 25, 2017

  59. The American Health Care Act went down in flames as it should have. They wanted to eliminate the 10 essential health benefits which is a provision of Obamacare. Here’s the full list, from Healthcare.gov:

    Outpatient care without a hospital admission, known as ambulatory patient services
    Emergency services
    Hospitalization
    Pregnancy, maternity, and newborn care
    Mental health and substance use disorder services, including counseling and psychotherapy
    Prescription drugs
    Rehabilitative and habilitative services and devices, which help people with injuries and disabilities to recover
    Laboratory services
    Preventive care, wellness services, and chronic disease management
    Pediatric services, including oral and vision care for children

    So, how is this an improvement over Obamacare? Yes, Obamacare needs tweeking and lower premiums but what they proposed would have made it very hard for seniors to afford. As it was predicted to increase prices for seniors by 5 times. Not to mention, what is the point of insurance if there is no hospital coverage, no prescription drugs, no lab services, no emergency service and the other things listed? This article will further explain the pitfalls of the American Health Care Act. http://www.vox.com/2017/3/23/15031322/the-fight-over-essential-health-benefits-explained

    I have Obamacare and it is working for me. My Hub went onto Medicare and I am actually paying more for it (for one person) than when the two of us were on it together. I am sucking it up till I am eligible for Medicare. Hub had major surgery while on Obamacare and although we did pay a chunk of medical costs ourselves, without it we would have been faced with close to $100K in medical bills. I agree 100% Obamacare needs a major tune up and I hope they start working on it sooner than later.

    by Louise — March 25, 2017

  60. ACA will implode on it’s own. The last few years foretell the future. My wife was forced on it when a major,international co. cancelled insurance for it’s retirees. She is not quite 65, she has a deductable of $7,500, a premium of $635 per month, so for $14,770 per year she has in effect, no insurance. Of course, we could have paid the penalty, but…..

    by Jeff L — March 25, 2017

  61. So many talk about the expense of ACA plans but dang, insurance is just plain expensive for everyone…businesses for their employees, and those like me who pay for private insurance. I elected to stick with my private insurance which I’ve purchased as a self employed person for 12 years. I am now 61 and thought of switching to ACA last year but due to election decided to stay with my grandfathered private plan thru Blue Cross. My insurance is $500/mo with a $10,000 deductible and I am a totally healthy person with very few claims in 12 years. ACA would save me about $100/mo but my options are so limited in AZ it was not worth the risk and I figured the Republicans would tear it apart if elected.

    I remember when I took out my private insurance the company made me sign a waiver on my entire spine from coverage for 5 years because 2 years earlier I had seen a chiropractor for adjustments to keep headaches away. So, when people talk about putting those with pre-existing conditions in a high risk pool, they are not talking about situations like mine where insurance companies just decide that they won’t cover due to such silliness. Someone had to take some power away from insurance companies regarding eligibility and coverage for basic benefits.

    We need a strong group of bipartisan representatives to strengthen ACA. We know what the issues are, so fix them! Republicans have been so focused on repeal and now they know how important insurance is – stop playing the partisan games. For 7 years all we have heard about is repeal, just think if they would have been working on viable solutions all that time! I think a buy in option to Medicare for those 60-64 might be good, I would do it today for $500/mo with a low deductible. Many in this age group are forced out of jobs and take part time jobs with no benefits. I do agree with President Trump that this is complicated, he seemed surprised by that….I think most people aren’t.
    I think this is “lesson learned” and will probably keep them from messing with Medicare.

    by ljtucson — March 25, 2017

  62. Jeff L. I have no idea how your insurance works but I am alone on my insurance like your wife as of March 1st. Hub just went on Medicare this month and also has Plan B, Plan F and Plan D so we hope to have all the bills covered for him.

    I have Anthem Blue Cross/Blue Shield
    This is what my insurance card says:
    Office visit (regular doctor) $35 per visit (I pay)
    Specialist $50 per visit (I pay)
    Deductible $4,000 (Individual) $8,000 (Family)
    Out of pocket max $7,150 (Individual) $14,300 (Family)
    Rx Tier 1 $5 (I pay)
    Rx Tier 2 $35 (I pay)
    Rx Tier 3 $60 (I pay)
    Rx Tier 4 20%

    Hub had a blood test in January and I have the bill in front of me. The test cost $102.71, Insurance paid $100.10 and we owe $2.61. We both have been to specialists and paid $50 each time and that is it. Sometimes the specialist includes some charges the insurance won’t pay so I have to cover that.

    So not sure why your wife wouldn’t get anything paid for. Maybe you should call your wife’s provider to see if there is some misunderstanding. Look to see if her insurance card has office visit information/Rx information.

    My insurance costs $950 a month, I get a subsidy of $440 a month and pay $510 a month for my policy.

    by Louise — March 25, 2017

  63. Don’t forget folks there is still private insurance for those who have lost coverage for one reason or another. It may be worth looking into for some. When I lost my coverage COBRA was cheaper than Obamacare.

    by Staci — March 25, 2017

  64. To add to Staci’s post, insurance from private companies must also abide by the ACA provision that pre-existing conditions cannot be used to raise rates or deny coverage. Under the ACA, pre-existing conditions cannot be considered, period, for Obamacare or any insurance you buy on the private market. Probably one of the best changes brought about by the ACA. So look at private insurance as well as Obamacare. We did, but found Obamacare less expensive, though not cheap.

    by Clyde — March 25, 2017

  65. Staci, That is not always the case. If you did not have COBRA then your options may have been very limited. And, when COBRA runs out you may also be limited. I only have private ins. because I had it before ACA and I elected to stay with a grandfathered plan rather than go with ACA. ACA plan would have been cheaper after the subsidy. If I had gone with ACA, I could not go back to private insurance plan. If I were in the market today, my options are ACA as an individual and in my county in AZ there is only one plan offered. There are definitely problems that need to be worked out with ACA.

    by ljtucson — March 25, 2017

  66. Louise, that is great that you can afford that premium. Perhaps you are still working or have no mortgage or car payment or somehow you are able to make it work, that is your personal business and I respect it as so. You may be able to suck it up but many of us cannot and are going with the penalty.
    And praying we do not get sick and need to go in the hospital.

    by LMB — March 26, 2017

  67. There are different plans available in different states, here, there is but one plan available. It’s blue cross/blue shield. There are too many disparities. There is no reason for such costs, things WERE cheaper before aca.
    My wife is NOT on medicare.

    by Jeff L — March 26, 2017

  68. Here is Washington DC, while the Congressmen have great healthcare, their staffs have been thrown on ACA. The problem is with a $5000-10,000 deductible, they still feel uncovered. To make it worse, if your physician will not accept ACA insurance policies–then what do you do? Here in DC most of the best physicians do not accept any insurance. Not even Medicare. They are still busy. Some are concierge doctors and charge a yearly fee.
    The Insurance companies call all the shots and the surgery practice I worked with got tired of it all and chucked all insurance plans and worked with the patients. Half of their fees were due prior to the surgery and the other half within 30 days after the surgery had been done and the insurance was filed. From the reimbursement, it was hoped the patient could pay the balance and any portion not covered.
    The first thing Canada did when they went to a Universal plan was to outlaw the insurance companies and they negotiate very strongly with the pharmaceuticals to keep costs down. If it works there, it can work here.

    by Jennifer — March 26, 2017

  69. No, LMB, I don’t work because I was laid off at age 58 and couldn’t find a job. So I was unemployed 4 1/2 years till I got on SS at age 62 1/2 much earlier than I wanted. No, I do not have a mortgage. We built our house in 1975 and had a 25 year mortgage. We have lived here ever since. No, I do not have a car payment. I have a 11 year old truck and an 8 year old car. We have 2 SS checks, one small pension and withdraw a small amount from IRA’s per year to stay below the 400% poverty level to receive the subsidy. Sorry you are having issues with the cost of your insurance. I don’t like the cost either and hope they can fix ACA.

    by Louise — March 26, 2017

  70. LMB – in an earlier post you were complaining about having to pay for other people’s healthcare while not getting any benefit yourself. Now you are saying you will opt out and hope you don’t need to go to a hospital. So which is it? Do you want to be able to show up at a hospital and get free treatment because you have no insurance (in other words let the rest of us pay for you) or do you prefer we change the law to allow the hospital to just say “sorry no insurance no treatment, you lose”

    by John C — March 26, 2017

  71. John C, in an earlier post you mentioned Medicare as an option for older adults to join in. Bernie Sanders was just on TV talking about Medicare for all and he also mentioned it when he was campaigning. I don’t know how all that will work out dut to the fact that we pay Medicare tax during our working years and get to use it at age 65. I really think that Medicare is a good footprint to base a new healthcare program on. It would solve some issues like buying what you wanted. Part A is free, Part B right now is $134.00 a month. Then if you decided to buy a drug plan or other medigap plans that would be up to each person to decide if they could afford it. Or, the Advantage plan which is more regimented.

    by Louise — March 26, 2017

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