Do Republican Health Care Changes to Repeal Obamacare Impact You?

7 comments

The Senate has announced their health care plan –  the BETTER CARE RECONCILIATION ACT (BCRA) – which is in line with the house bill, with key changes being made to appease more moderate Republicans. NPR had a nice summary comparing Obamacare, AHCA (House bill) and BCRA (Senate bill) shown in the graphic below.


In general the bill does cut the individual mandate that forced people to buy health insurance of face a penalty, but does benefit the healthy and well-off the most with the various tax cut rollbacks that were used to fund Obamacare. Lower income and those with serious pre-existing conditions face the largest loss of benefits under the Republican proposals.

What are your thoughts on the health care debate to date? Does it make you mad or do you want Obamacare repealed asap?

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{ 7 comments… read them below or add one }

Brian June 27

Back to the original question –> yes, the Rs health care changes to repeal Obamacare do impact us.
My wife and I retired in 2010 (at 55y/o) – small pension, lots of savings, investments, IRAs, etc…..
Our company’s retiree medical healthcare plan charged pre-Medicare age retirees $700/mo premiums (for both of us). Those rates are now about $900/mo.
However, in 2014, the ACA became available. Reviewing it as an alternative to what we had, we saw that the ACA was an income-based system that used the modified AGI (MAGI) to calculate premiums.
What we found was that if we could lower our MAGI by tax-efficiently withdrawing from our investments, that it worked to our benefit in obtaining very affordable coverage. (You’ve probably discussed tax-efficient withdrawals elsewhere in your forums?)
We weren’t able to “keep our doctors” but besides that drawback, the ACA has worked out very affordably for us. (We have purchased a Silver HMO “benchmark” plan.)
All these changes that are being proposed with both the AHCA and the BCRA will certainly impact us. But, from what we can tell, the majority of the impact will occur in 2020, just as we’re Medicare-eligible.
If things get really crazy, we can always return to our retiree-medical plan as a fallback.
We’ll see what happens.

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Brian June 26

The problem that the ACA, AHCA, and BCRA all have in common is that they’re all constructed on the premise that there is actually a competitive market of suppliers to sell to the remaining 15% of our population that, for whatever reason, currently have no access to affordable, quality healthcare.
There is no such competitive market.
Due to the subsidizing of health insurance for the 85% of insured Americans – whether employer-subsidized or government-subsidized – the competitive market is distorted for those trying to purchase health insurance on their own.
The basic principles of a competitive market – “willing, knowledgeable, unpressured buyer; willing, knowledgeable, unpressured seller, ….” make it clear that none of these recent plans (ACA/AHCA/BCRA) as they are designed could have a successful outcome.
Again, it’s the subsidizing of the 85% that distorts the market for those trying to purchase health insurance on their own. So, the 85% must be part of the solution.
Part of the solution would include ending the tax exclusion of employer-subsidized health benefits The elimination of employee health benefit tax breaks – which would be taxed at employees’ marginal tax rates – would generate significant revenue to subsidize those shopping the marketplace for their own insurance (who would also be taxed, at their marginal rates, on those subsidized benefits). There’s no free lunch for anyone.

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Andy (Author) June 26

Thanks Brian, good argument and some solid points. I do think there is some merit to the employer-subsidized health benefits tax exclusion removal, but that would be very politically tough to pass. And politics, more than common sense, is driving the health care debate in America today.

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Brian June 27

True. “Politics is the art of what’s possible.” The problem now is not that we have a problem that can’t be solved. The problem is that we’re at a political impasse.
– We have Ds not wanting any solution remotely resembling a market-based (competitive) insurance
– We have Rs not wanting any solution remotely resembling a single-payer (socialized) insurance
Both systems have their intrinsic strengths; both have their intrinsic weaknesses.
We need to accept the fact that any solution is going to cost – in increased premiums (as we are now seeing in the ACA), in increased taxes, in fewer insurers remaining in volatile markets, or in fewer people covered.
Covering the remaining 15% — the uninsured, which include the sickest of the sickest — is not something that can be done cheaply.

And remember that for now, we’re only looking at the insurance side. If health care costs — what is charged by the providers — continue to increase, we’ll still see higher and higher insurance costs, no matter what the acronym is (ACA/AHCA/BCRA/etc).

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Andy (Author) June 27

Well said Brian…we should have people like you in politics or at least trying to putting in place common sense health care rules. Like you said, its never going to be a win-win for any one party. It is a lot about compromise and right now neither party is likely to budge.

Ron June 26

Repeal the AHCA immediately.
Stop the guaranteed government payments and insurance that drive costs. Make the healthcare market competitive.

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Andy (Author) June 26

Repealing without a better solution is not the answer. We could end up in a bigger hole than exists today. Instead they should try and reach a bi-partisan deal to really improve health care over the long term. No plan will make everyone happy, but as the richest country in earth with the best medical facilities, we need to do better around affordable health care for all.

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