Healthcare spin wars: Republicans vs. professionals

Posted 3/16/17

Congressman John Faso has not publicly committed to voting for the American Health Care Act, which has been put forward by House Republicans in Washington, DC as the replacement for Affordable Care …

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Healthcare spin wars: Republicans vs. professionals

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Congressman John Faso has not publicly committed to voting for the American Health Care Act, which has been put forward by House Republicans in Washington, DC as the replacement for Affordable Care Act, but he is clearly leaning in that direction. The acronyms for the two plans (ACHA and ACA) are confusing—perhaps deliberately so, as neither Speaker of the House Paul Ryan nor Donald Trump has been willing to step forward and accept ownership of the plan by donating their name to it in analogy to Obamacare. But to lay attribution where it is due, we will hereby term it “Ryan/Trumpcare.”

Faso wrote of Ryan/Trumpcare, “This legislation is part of the larger multiphase process I have described before as an effective path to provide our 19th District families with affordable, patient-centered health care.” He continued, “Regulatory changes and legislative fixes will have to accompany this measure, but I am heartened to see the immediate inclusion of two provisions to provide families with peace of mind: insurance coverage for children up to age 26 and protections for patients with pre-existing conditions.”

He then encourages his constituents to learn details on a Republican house webpage, tinyurl.com/zeo4gv4, where the first line is “Obamacare is hurting more people than it is helping...”

Clearly this page carries the Republican spin on Ryan/Trumpcare, which is fine as far as it goes, but if readers are going to consider that message, they should also read what the professionals are saying about Ryan/Trumpcare.

The American Medical Association, one of the most prestigious medical organizations in the country, does not agree that the Republican plan will be an improvement over Obamacare. Andrew W. Gurman, MD, president of the organization, wrote to two of the House committees working on the new bill (tinyurl.com/hxe2jrw) and said, “While the [Obamacare] is imperfect, the current version of the [Ryan/Trumpcare] is not legislation we can support. The replacement bill, as written, would reverse the coverage gains achieved under the [Obamacare], causing many Americans to lose the health care coverage they have come to depend upon.”

The American Nurses Association has also come out against the Republican proposal (tinyurl.com/j5oke2r) writing, “[Ryan/Trumpcare], as drafted, would jeopardize the health of Americans with pre-existing conditions, eliminate the Prevention and Public Health Fund, which has effectively helped reduce chronic disease rates, and result in millions of Americans losing critical coverage for mental health and substance-use disorders... As it is currently written, the [Ryan/Trumpcare] restructures the Medicaid program, restricts millions of women from access to health care, and repeals income-based subsidies, which will disrupt health care coverage for millions of Americans.”

The president of the American Academy of Pediatrics (AAP), Fernando Stein, MD, also weighed in, (tinyurl.com/gt37gjl) writing, “Medicaid has been a crucial source of health care coverage for children for over 50 years. Today, approximately 36 million children rely on Medicaid for their care each year. [Ryan/Trumpcare] would end the federal government’s commitment to state Medicaid programs as we know it. The AAP opposes per capita caps and other mechanisms that would shift costs to states and seriously jeopardize the comprehensive benefits offered to children through the Early and Periodic Screening, Diagnostic and Treatment.”

That’s just a sampling of the professional medical groups that have registered an opinion on the question, and they don’t agree with the Republican view that Ryan/Trumpcare will provide as many people with healthcare or that the cost won’t increase.

As to economic impacts, the Congressional Budget Office reported that Ryan/Trumpcare would subtantially reduce the federal deficit over the next decade, but at the cost of 14 million Americans losing their healthcare by 2018, compared to staying with Obamacare.

The Joint Committee on Taxation, a congressional committee that “operates with an experienced professional staff of Ph.D. economists, attorneys and accountants” estimated that the repeal of various taxes enacted to pay for Obamacare will mean a loss in federal revenue of $600 billion through 2026 (tinyurl.com/j6j599c). The committee said that while it’s not clear if the cuts will be fully paid for by changes in Ryan/Trumpcare, “it is clear that the inclusion of these tax cuts will leave less revenue available to finance any coverage provisions. It also seems that the legislation will worsen the financial state of the Medicare Hospital Insurance trust fund.”

So, what kind of impact will adoption of Ryan/Trumpcare have on health insurance companies? According to an analysis Standard and Poor’s (tinyurl.com/gwvp8la) because many sick people will not have coverage, “profitability will likely improve, as the replacement plan can result in an improved risk pool in the individual market.” But the story for low-income residents and those who rely on Medicaid is not so rosy: “We expect a decline in enrollment in the individual (2 million–4 million) and Medicaid (4 million–6 million) segments.”

So, President Donald Trump’s promise that the new plan will be better than Obamacare appears to be true only if you are wealthy or own stock in an insurance company.

As to Faso’s invitation to learn about the Ryan/Trumpcare and then let him know how you feel about it, we heartily endorse that proposal, as long as you’re reading not only the Republican spin, but also the concerns like those detailed by the above organizations. Then do email your thoughts to his website: https://faso.house.gov/contact.

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