With Trumpcare seemingly dead in the House of Representatives after Speaker Ryan pulled the American Health Care Act from a floor vote, the dismantling of Obamacare is now left to Health and Human Services Secretary Tom Price. Secretary Price is showing himself to be an able-bodied hatchet man as his minions have already proposed new rules to the Affordable Care Act that gut consumer protections. There is also the introduction of bills in the House of Congress to further gut health plans issued under Obamacare.
Secretary Price Tasked With Killing Obamacare
One of the most infamous lines uttered about the ACA was when then Speaker of House Nancy Pelosi said, “We have to pass the bill so that you can find out what is in it, away from the fog of the controversy.” This statement is true for every bill because once a bill is signed into law it is then sent to appropriate federal agency for rule making. In the case of the ACA, the Department of Health and Human Services proposed the rules to implement the intent of congress as outlined in the legislation. It is the interpretation and rule making that is the heart of how each law gets put into practical application in the market place or industry.
Proposed Rules To Gut ACA Health Plans
HHS has already launched a new page aimed at touting their latest attempts to revise the Affordable Care Act. Providing Relief Right Now for Patients links to initiatives HHS hatchet man Price has started to improve (gut) the ACA. The page states, “We are going through every page of regulations and guidance related to the Affordable Care Act to determine whether or not they work for patients and whether or not they are making our health care system better.”
HHS has now announced a firm commitment to letting states develop new solutions that work for their unique Medicaid populations.
This flawed reasoning assumes that somehow poor people on Medicaid are different between states. The human condition is not changed by which state a person resides in. A disabled person or individual of modest income is the same whether they live in California or Florida. States should not be able test Medicaid rules on people like guinea pigs. But some of the other ideas Secretary Price has floated are-
- Introducing plans that include Health Savings Account–like features, to give Medicaid patients real control over their health care spending and choices;
- Finding ways to encourage people on Medicaid to secure employer-provided insurance;
- Breaking down barriers that force members of the same family onto different Medicaid plans;
There’s a provision in the Affordable Care Act, called Section 1332, that allows states to be exempted from some of the law’s burdens if they come up with their own way to provide their citizens with access to quality, affordable coverage choices.
One man’s burden is another man’s godsend. There is nothing wrong with innovation. But if the innovation is good for one state, it is mostly good for other states. That is unless the innovation is directed at reducing benefits or denying insurance to people through additional hurdles to enrollment.
This initiative should be re-titled the Giant Gift To Insurance Companies. The proposed rules will allow health plans to shift more of the cost sharing on to the members while labeling the plan as compliant with a specific metal tier level. In geek-speak, HHS would allow a health plan to be labeled Silver 70% actuarial value when it might only be 66% actuarial value. This will bring down the monthly premium, but only because the member has to fork over more money on health care expenses.
HHS also wants to compress the open enrollment from three months to six weeks. The twisted logic as expressed on the website states,
The proposed period would provide plenty of time for Americans to buy the coverage they need, while discouraging healthy people from putting off insurance purchases until the last minute. This would mean a better-functioning market, which would mean better options for patients.
A better functioning market for the health insurance companies, not necessarily the consumer. There is no guarantee that better options would be offered to patients as a result of a smaller window for enrollment.
Secretary Price also wants insurance companies to force consumers to pay for health insurance they dropped in the previous year.
If someone purchased coverage but chose not to pay for it in the past, and then wants to buy new coverage from the same insurer, the company would be allowed to collect the past unpaid premiums.
This is just another way to allow health insurance companies to extract premiums from people for which no health coverage was provided.
If you look at Secretary Prices proposals and rule changes, you’ll see the common thread of pushing people off Medicaid health insurance or erecting higher hurdles to participate in subsidized private insurance. The end result is that people with the fewest resources, and possibly the most health challenges, will be excluded from the health insurance pool. That’s what the health insurance companies want. They don’t want to insure people with health conditions that lead to claims. Secretary Price is giving them the healthier pool for higher profits.
Amendment To Gut Essential Health Benefits
But the effort to repeal or gut Obamacare won’t stop with the proposed rule changes put forth by HHS. Before the AHCA died for lack of votes, an amendment was inserted to allow states to determine their which essential health benefits could be included in health plans qualifying for the tax credits. While this amendment may have died with Trumpcare, you can bet it will be introduced later in the session. As a matter of fact, now that Trumpcare is dead, we will undoubtedly see several bills aimed at chipping away at the foundation of Obamacare which is health insurance with real coverage and benefits.