Which would be safer in the current climate, joining Medicaid in a Repub. Medicaid-expansion state or a Marketplace plan

Archived From: Finance
  • Page :
  • 1
  • Text Only
Voting History
rated:
I am asking this question for my neighbor's middle-aged son (single, no dependents).  He does not get health insurance through his current, low-paid job, and he needs to sign up for a 2017 health insurance plan.  Apparently his projected income is at the higher range of Medicaid income and the lower range of Marketplace income (which means that he has a choice between the two programs, I guess?), and he does not have a handle on which of the two programs might be safer at the moment to join.

He lives in Indiana, a Repub. state that was hostile to Medicaid expansion (although they did expand last year, after getting some concessions from the federal government), and he fears that the Medicaid expansion to childless, low-income adults will be pulled immediately by the new administration,
but he also fears that the monthly government contributions to the costs of the Marketplace plans (the cost-sharing subsidies for people who make under a certain amount of income) could also be pulled right away by the new administration.

He was originally thinking that he'd have until Jan. 31st to sign up for a Marketplace plan (or, alternatively, Medicaid), so he was waiting to choose a path until he saw what happened in Congress in the 10 days after the inauguration, but according to news reports this weekend, it seems that the Repub. lawmakers have decided to get a head start on changing regulations even before the inauguration and they have big plans for shaking regulations up in the next few days (first week of January when Congress resumes), so time might be of the essence.

If he ends up being offered a choice by the online application, does one of the two programs appear to be safer to sign up for (in terms of being more likely to provide him affordable coverage for all of 2017), or do both of the programs seem equally vulnerable at this point in time?

Member Summary
Most Recent Posts
I am specifically NOT a religious person and I am praying Trump stays in good health and the House doesn't go 50/50.  Pe... (more)

RedWolfe01 (Jan. 04, 2017 @ 7:24a) |

As an Indiana resident, I agree completely.  The political discussion at the end of that NYTimes link is completely accu... (more)

Infinion (Jan. 04, 2017 @ 9:06a) |

--------
"The Kaiser Foundation organized six focus groups in the Rust Belt areas — three with Trump voters who are enrol... (more)

oppidum (Jan. 06, 2017 @ 5:39p) |

Staff Summary
Thanks for visiting FatWallet.com. Join for free to remove this ad.

Any changes will likely take years to implement. They certainly won't be changing premiums/subsidies/coverage mid 2017.

Any changes most likely wont effect the 2017 plan year. So pick based on how the system is currently in place, and you should get ample warning of any changes ahead of the 2018 plan year.

There is not a choice per se between Medicaid and the Marketplace. However, it is determined by your estimated ACA MAGI. In a Medicaid expansion state the Medicaid cutoff is 138% of FPL. For a single person, the FPL number used for 2017 is $11,880. Therefore the Medicaid cutoff for him would be $16,394.

Personally, if I had the slightest means to afford afford the Marketplace plan, I would do so. Medicaid may be a great safety net, you get what you pay for. Medicaid reimbursement rates are ridiculously low for medical providers. Sure there may be a few noble altruistic medical providers, but the majority are hacks who can't get patients any other way.

I just helped someone who makes $7.50/hour. That is $15,600/year. Maybe she gets a raise that puts her over $16,484 and maybe not. I had her submit an estimate for $16,500 which got her a Marketplace plan for $40/month. With the additional cost sharing the deductible was reduced to $250 and the maximum Out-Of-Pocket (OOP)was $650.

She gets access to any number of excellent medical providers for $500 - $1000/year. Actually its family so I told her if she pays the premium, I will pay the OOP costs.

For the Marketplace he really should have signed up by 12/15 to get coverage by 1/1. If he signs up be 1/15 he will get coverage on 2/1. If he waits until 1/16 - 1/31 coverage will not start until 3/1. After 1/31 he will be out of luck.

btuttle said:   There is not a choice per se between Medicaid and the Marketplace. However, it is determined by your estimated ACA MAGI. In a Medicaid expansion state the Medicaid cutoff is 138% of FPL. For a single person, the FPL number used for 2017 is $11,880. Therefore the Medicaid cutoff for him would be $16,394.
He was under the impression that if you are between 100% and 138%, that you have a choice between the two?
...Maybe before Indiana expanded their Medicaid (which they did two years after the Marketplace started), that was the option.

I'll see if the Indiana website gives the percentages they use, because maybe he doesn't even have a choice now.
.
.
btuttle said:   Medicaid reimbursement rates are ridiculously low for medical providers.
I think that in Indiana, the Medicaid expansion program is paying 130% the Medicare rates, or something like that (I don't remember exactly).

It's why a lot of providers in Indiana signed up to take the new Medicaid expansion population.

(I learned that either in an article on the Kaiser Family Foundation website, kff.org, or the New York Times site.)
.
.
btuttle said:   Sure there may be a few noble altruistic medical providers, but the majority are hacks who can't get patients any other way.
In Indiana, a surprising number of decent providers do take the new Medicaid expansion program.  (It's because the reimbursement rates are generous.)

Yesterday in the online doctor-finder facilities provided by the various organizations, I looked up about 8 names of his prior, decent/successful/mainstream doctors that he has gone to in the past, and they were all accepting patients from the Medicaid Expansion program.
.
.
btuttle said:   Personally, if I had the slightest means to afford afford the Marketplace plan, I would do so.
Yes, he would rather have a Marketplace plan.

He just doesn't know if one or the other program might be more vulnerable to being cut straightaway, and would rather pick the safer of the two
(if he were offered a choice, but maybe he is not going to be offered a choice).

I have to agree with him from what I have read in the national press that I would expect them to aggressively go after at least one of the plans, if not both, sooner rather than later.

(Indiana Governor, now Vice President, Pence certainly hates the whole concept, so if anywhere might drop their Medicaid Expansion like a hotcake, it would probably be Indiana.)

oppidum said:   
Yes, he would rather have a Marketplace plan.
He just doesn't know if one or the other program might be more vulnerable to being cut straightaway, and would rather pick the safer of the two
(Indiana Governor, now Vice President, Pence certainly hates the whole concept, so if anywhere might drop their Medicaid Expansion like a hotcake, it would probably be Indiana.)

  
I vote for the marketplace plans as the safest bet if he's got a choice.  The marketplace plan is going to be a private agreement between him and the insurance company, so it's not going to disappear.  The subsidies might be up for the axe, but it's unlikely that happens for a couple years.  

Honestly, if federal changes result in some wiggle room for states, and someone is going to do something really stupid, Indiana will be right there ready to beat poor people down in the gutter.  I'd suggest moving.  (I'm in IN too...it's a gross place).  
 

Depends on the state, where I live and for my specialty almost nobody takes Obamacare plans.

Infinion said:   if...someone is going to do something really stupid, Indiana will be right there ready to beat poor people down in the gutter.
I agree; it is quite sad.
.
.
Infinion said:   The marketplace plan is going to be a private agreement between him and the insurance company, so it's not going to disappear.

The subsidies might be up for the axe, but it's unlikely that happens for a couple years.

I am going on my memory here of what I read last week in reputable sources...

I think that a court last year ruled that the cost-sharing subsidies were illegal.

The outgoing administration and the Marketplace people have been fighting that legal ruling on appeal for many months.

After the Nov. election, the Repubs asked the court to stay those appeal proceedings, because they knew that a lot would be changing anyway with the health stuff.

Then at the end of December (last week), two members of the public petitioned something or other and asked the court to lift the stay.

The judges agreed, I think 2 to 1; therefore, the court is going to rule this month (maybe next week) on whether the cost-sharing subsidies are illegal.

If the current court concludes that the cost-sharing subsidies are illegal, and the govt. immediately stops giving that money to the insurance companies, the insurance companies can say that the plan has significantly altered, and their contracts say that they can leave the Marketplace if something radically changes.

So I don't think it's beyond the pale to wonder if the Marketplace plans might become either totally unaffordable for the people who were expecting to get all the Silver-tier subsidies, or might shut down mid-year because of fundamental changes in the functioning of the plans which cause the providers to totally pull out.

dhodson said:   Depends on the state, where I live and for my specialty almost nobody takes Obamacare plans.
For the gentleman in question, we checked out the provider situation yesterday using the online doctor-finders (which aren't always accurate, but it's the best we could do),

and the Medicaid Expansion option includes ALL of his potential doctors and potential facilities. 

Of the approximately 10 silver-tier plans in his county that could be bought through the Marketplace exchange, the plans of one insurance company include approx. 80% of his doctors/facilities, and the plans of the other insurance company include approx. 30% of his doctors/facilities.  So he would go with the 80% company if he chose a Marketplace plan.

It was surprising to me that the Medicaid Expansion plan had better coverage/acceptance (apparently) than any of the silver-tier Marketplace plans (at least, the ones in his county).

oppidum said:   Apparently his projected income is at the higher range of Medicaid income and the lower range of Marketplace income (which means that he has a choice between the two programs, I guess?)
At least in my state, there is a fixed amount, around $16,500, above which you can't get Medicaid and below which you can't get a marketplace plan. If you really have a choice, go for the marketplace plan even if you have to pay since you'll only have access to a limited number of providers that accept Medicaid.

It isn't surprising to me. I will also add that I've found that those databases are extremely inaccurate meaning you call and they say they are not accepting new for that plan or no longer accepting it. But as you mentioned that's the best you can do.

One of the reasons why they aren't readily accepted besides pay is that the makeup is generally people with health problems that have gone untreated. The person previously couldn't afford insurance so lived with their problem. So they are in my experience some of the hardest cases to help medically. It becomes more risky as well from a malpractice/lawsuit standpoint and to boot if you need multidisciplinary help from another specialist then good luck finding one who will also take the plan.

Wouldn't loosing medicaid coverage qualify as an event, allowing him to sign up for aca outside of. Open enrollment if it drops? Something to think about and research.

At least for INDIANA things are getting better with Pence being VP...

Nothing should change this year, and if it DOES then it should trigger a qualifying event. (loss of coverage, ect...) Texas did the same thing, but didn't expand medicare - they did their best to kill the subsidy and sharing so that nobody could afford Obmacare to starve the program. (they claimed that without a state exchange the subsidy was not applicable -- since the law specified state and not federal exchanges)

At least TX kept the plans moderately reasonable in cost compared to many other states. No way can I afford the NC version.

One advantage of Medicaid is the network is statewide or maybe even national. Not so with most narrow-network ACA Exchange plans. But if you're eligible for Medicaid, it's not likely you travel much anyway. But something to think about.

RedWolfe01 said:   At least for INDIANA things are getting better with Pence being VP...
 

Or, maybe things for the other 49 states will be dropping down to match Indiana's experience. 

===============================================================
Thank you to everyone for your information and viewpoints regarding my question!
===============================================================

I have Medicaid. I had no choice. If you are below the income level, you got expanded Medicaid, if you were above, then you could take a marketplace plan.

I have to disagree with the Marketplace crowd. As a Medicaid patient, I have access to what I think are great doctors, and I don't have to worry about balanced billing. Since the doctor knows I'm on Medicaid, they can't then later say, "oh, your insurance didn't pay for this procedure. You need to pay," and expect that I'll pay. I'm 100% protected and there is not a dang thing the doctor can do. That gives me enormous piece of mind when I read the threads about going to an in-network facility and then getting a bill from an out-of-network doctor.

Chyvan said:   I have Medicaid. I had no choice. If you are below the income level, you got expanded Medicaid, if you were above, then you could take a marketplace plan.

I have to disagree with the Marketplace crowd. As a Medicaid patient, I have access to what I think are great doctors, and I don't have to worry about balanced billing. Since the doctor knows I'm on Medicaid, they can't then later say, "oh, your insurance didn't pay for this procedure. You need to pay," and expect that I'll pay. I'm 100% protected and there is not a dang thing the doctor can do. That gives me enormous piece of mind when I read the threads about going to an in-network facility and then getting a bill from an out-of-network doctor.

  
Thank you for your perspective, Chyvan. 

I think that there might be, or maybe there used to be and there isn't anymore, a choice to be in the Marketplace for those between 100% and 138% in the states that have not expanded Medicaid.  There's still quite a number of states that don't allow poor adults with no dependents to be covered by Medicaid, unfortunately.
Anyway, it's likely now that in Indiana (which only expanded Medicaid after wrangling with the govt for a couple of years about their "waivers" to do things differently than everyone else) there is not a choice when you are in the 100-138% zone.  So that was probably a misperception on the part of the fellow I'm helping.  I have not had the time yet to look into it myself, but it seems that most people here are saying that in expansion states, it's 138% full-stop. 

I did not realize that customers who have Medicaid were immune from "balance"/"surprise" billing!  That is great.

As I wrote earlier, when I looked up doctors for my friend's son, every single doctor and facility in Indiana that he could come up with were on the list as taking the expanded Medicaid plan.  (I don't know if they really would end up taking actual new Medicaid patients in the next few months, but at least they were on Indiana Medicaid's official list of participating providers.)  But none of the Marketplace plans in his county covered every doctor and facility that he was looking for.  It was impressive to me that in only a year and three-quarters, the expanded Indiana Medicaid program has amassed such a deep roster of providers.

One or two days ago, there was a New York Times article about Indiana's experience with the Marketplace and with the Medicaid Expansion: 
http://www.nytimes.com/2017/01/02/us/politics/obama-health-care-...

It would be such a shame if this were dismantled/destroyed.

As I am visiting the New York Times' site just now, I have seen an article about something I mentioned in an earlier post on this thread -- the lawsuit about whether the cost-sharing subsidies paid out by the govt to the Marketplace insurance companies are, and have always been, illegal,
which is an important factor in this overall situation.

Here's an excerpt from the article, which was published Dec. 28:

"Congressional Republicans have a new fear when it comes to their two-year-old health care lawsuit against the Obama administration: They might win.

The incoming Trump administration could choose to no longer defend the executive branch against the suit, which challenges the administration’s authority to spend billions of dollars on health insurance subsidies for low- and moderate-income Americans, handing House Republicans a big victory on separation-of-power issues.

But a sudden loss of the disputed subsidies could conceivably cause the health care program to implode, leaving millions of people without access to health insurance before Republicans have prepared a replacement.
That could lead to chaos in the insurance market and spur a political backlash just as Republicans gain full control of the government.


To stave off that outcome, Republicans could find themselves in the awkward position of appropriating huge sums to temporarily prop up the Obama health care law, angering conservative voters who have been demanding an end to the law for years.

In another twist, Donald J. Trump’s administration, worried about preserving executive branch prerogatives, could choose to fight its Republican allies in the House on some central questions in the dispute.

[...] It is a complicated set of dynamics illustrating how a quick legal victory for the House in the Trump era might come with costs that Republicans never anticipated when they took on the Obama White House."

source: http://www.nytimes.com/2016/12/31/us/politics/house-republicans-... 

Here are some excerpts from a NYT article about today's (Jan 3rd) activities in Washington on the health insurance front:

"[...] As Democrats in both chambers seethed, Senator Mitch McConnell of Kentucky, the majority leader, unveiled the legislative language that could decimate the Affordable Care Act before the crocuses start to bloom in the spring, even if any replacement of the law could take years.

Budget language released on Tuesday gives House and Senate committees only until Jan. 27 to produce legislation that would eliminate major parts of the health care law.
Under arcane budget procedures, that legislation would be protected from a Democratic filibuster and could pass the Senate with a simple majority.
And debate will begin on Wednesday, before senators have even moved into their new offices.

The dueling over the health law’s fate will pull in both the departing and incoming White House administrations as well.
On Wednesday, Mr. Obama will visit with congressional Democrats to plot how to resist the planned repeal, and Mike Pence, the vice president-elect, will meet with Republicans to gird them for the fight ahead.

[...] On Tuesday, the House also adopted rules clearing the way for legislation to roll back the health care law.

The budget blueprint introduced on Tuesday in the Senate is not sent to the president and does not become law, but still clears the way for subsequent legislation that Republicans say will repeal major provisions of the Affordable Care Act.

Republicans bypassed the Budget Committee so they could immediately bring the measure to the floor.
Such resolutions are normally developed after weeks of work in the Budget Committee.

Under the plan, four congressional committees — two in the House and two in the Senate — have until Jan. 27 to develop legislation that will be the vehicle for repealing the health care law.

The document does not specify which provisions of the law may be eliminated and which ones may be preserved.
Nor does it specify or even suggest how Republicans would replace the Affordable Care Act....

Republicans have said they may delay the effective date of a repeal bill, to avoid disrupting coverage for people who have it and to provide time for Republicans to develop alternatives to the 2010 health law.

The budget blueprint allows Republicans to use savings from repealing major provisions of that law to help offset the cost of future, unspecified measures to help people obtain coverage.

[...] The American Medical Association urged Congress on Tuesday to explain how it would replace the Affordable Care Act.  “Before any action is taken through reconciliation or other means that would potentially alter coverage, policy makers should lay out for the American people, in reasonable detail, what will replace current policies,” the chief executive of the association, Dr. James L. Madara, said in a letter to congressional leaders."

source: http://www.nytimes.com/2017/01/03/us/politics/congress-biden-rya...

oppidum said:   maybe there used to be and there isn't anymore, a choice to be in the Marketplace for those between 100% and 138% in the states that have

I've been on expanded Medicaid since Jan 1, 2014. When I went to the marketplace, my application didn't go through because I'm very much in the 130% of FPL. I have full control of my income. I deliberately made it be in that range because there was no reason to pay for something I can get for free. I never had a choice.

My cousin is in FL that did NOT expand Medicaid. She is excluded from Medicaid for that reason, and she doesn't make enough to be it the marketplace (again, another example of there was no choice). However, she doesn't have to pay the mandate for that reason.

After reading that last article, I think that,

with the Jan 27 deadline's having been fixed today, and with 4 congressional committees weighing in,

it sounds like it is likely that nothing in the present system will be changing at least within the next week and a half -- by which I mean, up through the Jan 15th deadline to get Marketplace coverage that will start on Feb 1.

But all bets are off for the days after that... they might come to an agreement earlier than the Jan 27 deadline, and they might decide to go full throttle with taking the prior Marketplace/Expanded Medicaid system apart.

Chyvan said:   
oppidum said:   maybe there used to be and there isn't anymore, a choice to be in the Marketplace for those between 100% and 138% in the states that have _not_ expanded Medicaid.
My cousin is in FL that did NOT expand Medicaid.
She is excluded from Medicaid for that reason, and she doesn't make enough to be it the marketplace (again, another example of there was no choice).

Does she make below 100% poverty line, or between 100 and 138% poverty line?

By saying that there was a "choice" in non-expanding states, I meant that the people between 100 and 138% in non-expanding states had the option to go into the Marketplace and get an insurance plan, since Medicaid did not expand in their state. 
(I realize that the people earning below 100% never have been eligible for anything in the non-expansion states.)

(This use of "choice" regarding non-expanding states is somewhat different than how I meant the word "choice" when talking about my neighbor's son's situation in my original post; I have already acknowledged that it seems like he would not have a choice in a state that has expanded Medicaid, like his state has.  Please don't be hung up on the word "choice"; it's clear that there isn't much choice at all, for people earning below the poverty line.)

I thought this was initially how they were handling eligibility to use the Marketplace in non-expanding states, that they dropped it down to 100% to legally help as many people as they could, within the existing Medicaid/ACA law, who desperately needed health insurance. 

What I am saying is that maybe in your state, which expanded Medicaid, the cut-off is 138%, but in her state, which did not expand Medicaid, the cut-off might be 100%... that was how I thought it worked!
But I only have patchy knowledge of the situation and could very well be wrong....

=====
UPDATE:

Okay, to see what would happen, I have just filled out the 2017 Marketplace eligibility calculator at KFF.org (a very reputable site)
for an imaginary single woman aged 40 with no dependents who lives in Orlando, Florida and makes $12,000 a year (which is 101% of poverty level).

This is what the result was:

"Based on the information you provided, you are likely eligible for financial help through the Health Insurance Marketplace.

Because your income is equal to 101% of the poverty level, you may be eligible for tax credits in the exchanges. This type of financial help is only available to people who cannot get Medicaid and whose incomes are between 100% and 400% of the poverty level.

The information below is an estimate of your cost if you buy subsidized Marketplace coverage in 2017:Estimated financial help: $343  per month ($4,114 per year) as a premium tax credit. This covers 94% of the monthly costs. Your cost for a silver plan: $20  per month ($245 per year)  in premiums (which equals 2.04% of your household income). The most you have to pay for a silver plan: 2.04%  of income for the second-lowest cost silver plan"

===
Therefore, Chyvan, if your cousin lives in a non-Medicaid-expansion state but she makes above 100% of poverty level, she should definitely apply through the Marketplace and see what it says!

Here is the calculator at KFF.org, you can punch in some numbers and see for yourself:

http://kff.org/interactive/subsidy-calculator/#state=fl&zip=3280... 

oppidum said:   
RedWolfe01 said:   At least for INDIANA things are getting better with Pence being VP...
Or, maybe things for the other 49 states will be dropping down to match Indiana's experience. 

  
I am specifically NOT a religious person and I am praying Trump stays in good health and the House doesn't go 50/50.  Pence as president scares the crap outta me.  I dunno WHAT Indiana was thinking...  (at least Texas has the excuse that our Governor has no power)

RedWolfe01 said:   
oppidum said:   
RedWolfe01 said:   At least for INDIANA things are getting better with Pence being VP...
Or, maybe things for the other 49 states will be dropping down to match Indiana's experience. 

  
I am specifically NOT a religious person and I am praying Trump stays in good health and the House doesn't go 50/50.  Pence as president scares the crap outta me.  I dunno WHAT Indiana was thinking...  (at least Texas has the excuse that our Governor has no power)

  
As an Indiana resident, I agree completely.  The political discussion at the end of that NYTimes link is completely accurate.  People here have no idea what they're voting for, so it's no wonder how people like Pence get where they do.  People here are still waiting for their coal mines to come back, and vote based on what so-and-so told them they'd heard from such-and-such.  I've coached numerous people about how to get insurance coverage.  They won't even attempt to see if they could maybe get a subsidy, or to call some companies up, or go on the exchange to see how much it costs.  I've heard so many times, "But there's no way I can pay $500/m for insurance.  I'll just keep going to the ER."  Me: "Listen, you qualify for subsidies, but even ignoring that, the mid-tier plans are only $200/m, so shut it, and figure it out."  

On a bright note, we've all been getting automatic refunds for unspent tax revenues for a few years now because of large surpluses.  But I'd gladly give them back my $200 if they'd fix the roads and bridges, or maybe install some sidewalks so we're not all fat, or perhaps teach our children to be less dumb.  

 

Infinion said:   The political discussion at the end of that NYTimes link is completely accurate.  
People here have no idea what they're voting for, so it's no wonder how people like Pence get where they do.  
People here are still waiting for their coal mines to come back, and vote based on what so-and-so told them they'd heard from such-and-such.  

I've coached numerous people about how to get insurance coverage.  They won't even attempt to see if they could maybe get a subsidy, or to call some companies up, or go on the exchange to see how much it costs.  I've heard so many times, "But there's no way I can pay $500/m for insurance.  I'll just keep going to the ER."  Me: "Listen, you qualify for subsidies, but even ignoring that, the mid-tier plans are only $200/m, so shut it, and figure it out."


--------
"The Kaiser Foundation organized six focus groups in the Rust Belt areas — three with Trump voters who are enrolled in the Affordable Care Act marketplaces, and three with Trump voters receiving Medicaid.
[...] Though the participants did not agree on everything, they expressed remarkably similar opinions on many health care questions.
They were not, by and large, angry about their health care; they were simply afraid they will be unable to afford coverage for themselves and their families.
They trusted Mr. Trump to do the right thing but were quick to say that they didn’t really know what he would do, and were worried about what would come next.
They spoke anxiously about rising premiums, deductibles, copays and drug costs.
They were especially upset by surprise bills for services they believed were covered.
They said their coverage was hopelessly complex.
Those with marketplace insurance — for which they were eligible for subsidies — saw Medicaid as a much better deal than their insurance and were resentful that people with incomes lower than theirs could get it.
They expressed animosity for drug and insurance companies, and sounded as much like Bernie Sanders supporters as Trump voters.

...[when] asked about policies found in several Republican plans to replace the Affordable Care Act — including a tax credit to help defray the cost of premiums, a tax-preferred savings account and a large deductible typical of catastrophic coverage — several of these Trump voters recoiled, calling such proposals “not insurance at all.”
One of those plans has been proposed by Representative Tom Price, Mr. Trump’s nominee to be secretary of Health and Human Services. These voters said they did not understand health savings accounts and displayed skepticism about the concept.
When told Mr. Trump might embrace a plan that included these elements, and particularly very high deductibles, they expressed disbelief.
They were also worried about what they called “chaos” if there was a gap between repealing and replacing Obamacare.

[...] If these Trump voters could write a health plan, it would, many said, focus on keeping their out-of-pocket costs low, control drug prices and improve access to cheaper drugs.
It would also address consumer issues many had complained about loudly, including eliminating surprise medical bills for out-of-network care, assuring the adequacy of provider networks and making their insurance much more understandable.

[...] In general, the focus among congressional Republicans has been on repealing the Affordable Care Act.
There has been little discussion of the priorities favored by the Trump voters who spoke to us.
But once a Republican replacement plan becomes real, these working-class voters, frustrated with their current coverage, will want to know one thing: how that plan fixes their health insurance problems.
And they will not be happy if they are asked to pay even more for their health care."

http://www.nytimes.com/2017/01/05/opinion/the-health-care-plan-t... 

--------
"...Republicans have put forward no coherent plan for what would replace the A.C.A.
To cope with that rather glaring omission, leaders like the House speaker, Paul Ryan, and Vice President-elect Mike Pence have discussed repealing the law but then delaying its end — claiming political victory while leaving Mr. Obama’s plan largely in place — to give Congress and the Trump administration more time to come up with a replacement.

This is cynical politics, of course, but it is also dangerously irresponsible governance.
Most experts and much of the health industry — including trade associations representing insurers, hospitals and doctors — have warned that repealing the law without an adequate substitute could be disastrous.
Health insurers that see no long-term future for the law will have little incentive to keep offering plans that it would support.
And the health insurance marketplaces set up by the A.C.A. will collapse in much of the country if Republicans repeal the individual mandate to purchase health insurance and get rid of or scale back the subsidies available to help people buy policies.

[...]A recent Urban Institute study estimated that 956,000 people in Pennsylvania and one million each in Georgia and North Carolina could lose coverage under a repeal done through a reconciliation bill. Most of them are among the very population Mr. Trump said he was running to give a voice to — nationally, 56 percent of those who would lose coverage are white, and 80 percent of adults who would lose insurance have less than a college degree."

http://www.nytimes.com/2017/01/04/opinion/republicans-are-courti... 

----------
"The American College of Physicians warned this week that the G.O.P. course could result in seven million Americans losing their health insurance this year alone, by causing parts of the insurance market to implode. ...calculations suggest that the upshot would be an additional 8,400 Americans dying annually.

[...]the American College of Physicians, the American Medical Association and even conservative health care analysts have warned Congress not to repeal Obamacare without stipulating what comes next."

http://www.nytimes.com/2017/01/05/opinion/the-gop-health-care-ho...



Disclaimer: By providing links to other sites, FatWallet.com does not guarantee, approve or endorse the information or products available at these sites, nor does a link indicate any association with or endorsement by the linked site to FatWallet.com.

Thanks for visiting FatWallet.com. Join for free to remove this ad.

While FatWallet makes every effort to post correct information, offers are subject to change without notice.
Some exclusions may apply based upon merchant policies.
© 1999-2017