New Orleans The nonprofit Congressional Budget Office had a more leisurely schedule in costing out the latest, zombie Republican Senate effort to replace Obamacare with something, almost anything more draconian. The numbers were the usual at one level: 22 million would lose coverage by 2026, 15 million of them immediately. Medicaid would be hammered with a 26% cut over the next decade. Like I said, the usual.
There were a couple of new twists though that caught my eye.
The CBO number also took a look at the impact of going all-Trump on a repeal now and punt down the field until some later date. 32 million Americans would lose coverage on that less than brilliant, but certainly spiteful, bitter pill strategy. That’s 10 million more than under the original Senate slice. Majority Leader Mitch McConnell is pressing for a vote on something, in fact just about anything, next week so that he can count the bodies and move on or move home. That’s going to be a hard bill to force feed.
The other factoid that caught my eye went to my long term grievance: no cap on deductibles.
Just to reprise my constant complaint. In bargaining union contracts for lower waged service employees, all of the companies had compliant plans under the Affordable Care Act, but they also included deductibles that ranged from $4000 to $6000 on top of the 9% monthly payments for coverage. The result for lower waged workers making less than $20,000 per year is that there was almost zero participation, but they were also excluded from any of the subsidies or cost-sharing of Obamacare, even though they could participate in the marketplace and pay full price, because they technically had coverage under their employers miserable plans. We found ourselves having to advocate nonparticipation and paying the fine.
The CBO noted that under Obamacare the average deductible for single person coverage was in fact $5000. Under the Republican Senate bill they estimated that the average deductible would soar to $13,000 per person on individual coverage. Remember that’s a deductible, meaning the individual would shell out $13,000 before getting any benefits from the so-called health insurance and after paying a monthly premium. Who is going to buy that pig in a poke? Eliminating the mandatory requirement means that’s an easy guess with the answer being: nobody!
Face the facts. At this level of deductible, this is nothing more than catastrophic care. Why would anyone sign up if they felt kind of healthy, and kind of lucky, unless they were suddenly feeling a little woozy, or a fortune teller told them to look out.
Meanwhile what we have, warts and all, is becoming more popular, up to 60% support, and the Trump Administration is debating outright sabotage, as distinguished from Congressional sabotage, I guess.