Universal catastrophic coverage would offer protection from those expenses that are truly unaffordable.
Universal catastrophic coverage (UCC) would make an excellent centerpiece for the next round of healthcare reform. In fact, UCC is not even particularly new to the conservative playbook. Respected thinkers like Martin Feldstein, who would go on to serve as Ronald Reagan’s chief economic adviser, promoted the idea already in the 1970s. In 2004, Milton Friedman, then a fellow at the Hoover Institution, also endorsed the concept. UCC would make healthcare affordable, both for the federal budget and for American families. And because it would throw no one off the healthcare roles—not 22 million people, not 2 million, not anyone—it offers a realistic chance of the bipartisanship that polls show both the Republican and Democratic rank and file want.
.. the deductible might be set equal to 10 percent of the amount by which a household’s income exceeds the Medicaid eligibility level, now about $40,000 for a family of four. Under that formula, a middle-class family earning $85,000 a year would face a deductible of $4,500 per family member, perhaps capped at twice that amount for households of more than two people. Following the same formula, the deductible for a household with $1 million of income would be $96,000.
.. Very likely, many middle-class families would forego supplemental insurance and cover all of their routine health care costs from their regular household budgets, the way they now pay for repairs to their homes or cars. Doing so would be easier still if they took advantage of tax-deductible health savings accounts—a mechanism that is already on the books, and could be expanded as part of reform legislation.
.. UCC would mesh seamlessly with Medicaid, since anyone not on Medicaid or Medicare would automatically be covered. There would no longer be acoverage gap, as there is in many states under the ACA. If workers on Medicaid got new jobs or promotions that raised their income above the Medicaid limit, the transition would be painless, since the UCC deductible for households just above the Medicaid cutoff would be low. The tremendous work disincentive that now exists for workers approaching the Medicaid “cliff” would disappear.
Return Medicaid to Its Rightful Role
The program should provide poor Americans with quality care, not shoddy coverage.
Over the same period, enrollment in Oklahoma skyrocketed from just under 500,000 to over a million. This means one-quarter of the state’s population is on medical welfare. Medicaid covers 57% of all births in Oklahoma, according to the Oklahoma Health Care Authority. Up to 72% of all children are on Medicaid at some point in their first five years, according to the authority. Government dependency expanded during a period of significant income growth here. Per capita income in Oklahoma grew 70.9%, from $26,720 in 2003 to $45,682 in 2016
The Cruelty and Fraudulence of Mitch McConnell’s Health Bill
the bill would allow people to use tax-favored health savings accounts to pay insurance premiums. This effectively creates a big new tax shelter that mostly helps people with high incomes
.. So this is still a bill that takes from the poor to give to the rich; it just does so with extra stealth.
.. So how does he address the two big problems with the original bill —
- savage cuts to Medicaid and
- soaring premiums for older, less affluent workers?
He doesn’t.
.. The most important change in the bill, however, is the way it would effectively gut protection for people with pre-existing medical conditions.
.. the new Senate bill gives in to demands by Ted Cruz that insurers be allowed to offer skimpy plans that cover very little, with very high deductibles that would make them useless to most people.
.. The main answer, I’d argue, is that what would happen if this bill passes — a big decline in the number of Americans with health insurance, a sharp reduction in the quality of coverage for those who keep it — is what Republicans have wanted all along.
.. the Republican elite considered and still considers people on Medicaid, in particular, “takers” who are effectively stealing from the deserving rich.
And the conservative view has always been that Americans have health insurance that is too good, that they should pay more in deductibles and co-pays, giving them “skin in the game,” and thus an incentive to control costs.
.. So what we’re seeing here is supposed to be the last act in a long con, the moment when the fraudsters cash in, and their victims discover how completely they’ve been fooled. The only question is whether they’ll really get away with it. We’ll find out very soon.
Mitch McConnell just blew up one of Trump’s biggest lies
McConnell will be employing at least two tactics. First, he will use several hundred billion dollars that CBO says the bill would save to try to buy off moderate opponents with side deals, such as increased funding for Medicaid or opioid treatment.
Second, McConnell will press the argument that if this bill does not pass, Republicans will have no choice but to negotiate over the future of the Affordable Care Act with Democrats. Multiple reports have said that McConnell has privately warned Republicans that failure would mean they must enter into talks with Democrats on ways to shore up the individual markets, which would effectively mean that a chance to pass a partisan repeal bill is gone... But, in making this latter argument — which will likely gain more scrutiny in the days ahead — McConnell is effectively destroying one of President Trump’s most cherished false narratives... Trump has spent months making several intertwined claims. He has relentlessly asserted that Obamacare is collapsing on its own. He has offered a variation on this by threatening to cut off the cost-sharing reductions to insurers that subsidize out-of-pocket costs for lower-income people, which would drive insurers out of the markets; Trump has said this threat will force Democrats to the table to “deal” with him... concedes a number of points. It concedes that, despite Trump’s claim of a desire for talks with Democrats, Republicans cannot work with Democrats, as long as Republicans remain wedded to their own priorities — that there is simply no bipartisan consensus possible.. McConnell is basically conceding that Republicans can’t just let the ACA implode, as Trump seems to believe... The Trump administration is likely to continue trying to sabotage the exchanges if this happens, by employing, among others, tactics such as continually refusing to clarify whether it will renew cost-sharing reductions and generally sowing uncertainty over the ACA’s future.