Republicans Should Tell the Truth

September 27, 2017

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It’s not true. All claims about “repealing” the Affordable Care Act play loosey-goosey with the term “repeal” and they know it. None of the votes so far have been on a real repeal bill. This week, Senate Republicans wanted a political win, but they were not planning to repeal the ACA.
The Republican plan, now scuttled by dissension in the ranks, would have reshuffled the dollars, reconfigured the redistribution channels, and renamed the federal takeover.
The GOP Senate’s Graham-Cassidy (G/C) bill would have embedded federal control by establishing a new version of Obamacare subsidies. This federally-funded redistribution system, called the "Market-based Health Care Grant Program" (MHCGP), would have funded new state-subsidy programs for individuals outside of Medicare and Medicaid, including those who buy their own insurance.
Perhaps they’re clueless. “Our bill takes money and power out of Washington and gives it back to patients and state,” said Sen. Lindsey Graham (R-SC) in a statement. This too is an “alternative fact.” Our readers are smart. Take a look at just 11 provisions of the 140-page Graham-Cassidy bill and see how much control, freedom and flexibility states would have:
1)    The nearly $1.2 trillion in MHCGP funds (p. 16) are collected through ACA taxes and redistributed to states using a complex federal formula.
2)    These dollars over six years come with seven requirements (strings) attached (pp. 8-10).
3)    After the final $190 billion is doled out in 2026 and funding drops to zero, expect states to ask Congress for billions more to keep the program funded into the future.
4)    On top of the $1 trillion diverted to health plans by the ACA, MHCGP funds are only for managed care (health plan) coverage (p. 11); not indemnity health insurance.
5)    States may only use 15% of their share of MHCGP funds for Medicaid (p. 18).
6)    State waivers of costly ACA insurance requirements are available only if covered individuals receive a “direct benefit” under a MHCGP-funded state program (p. 15).
7)    Complex allocation specifications for states include: coverage value, risk-adjustment and population adjustment (pp 26-30).
8)    States are required to assign individuals to categories of clinical risk (p. 34).
9)    Access to the federal funds requires use of Obamacare exchanges (p. 124).
10) All people who choose Obamacare-style catastrophic coverage (run by health plans) will be pooled with people who have uninsurable (pre-ex) conditions (p. 139), keeping premiums high that should, in a true catastrophic plan, be low.
11) The federal government receives $2 billion to implement the G/C Act (p 44).
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A final word: Whether or not some new version of the G/C bill fails or passes in the future–the Senate says more attempts are on the way—Republicans are playing fast and loose with the law itself. Congress has given themselves an EXEMPTION to the high cost of Obamacare that you don’t have: a “special contribution” of up to $12,000 to cover the cost of their premiums in D.C.’s Small Business Obamacare exchange. It’s not legal and it’s not right.
Your pain is not their pain. Demand that Congress end the special treatment and pay the same high prices you pay. Suddenly, real repeal might become a priority!
Yours in freedom,
Twila Brase, RN, PHN
President and Co-founder