The Senate Republican health-care bill would not repeal and replace Obamacare. The federal government would remain the chief regulator of health insurance. No state would be allowed to experiment with different models for protecting people with pre-existing conditions. Federal policy would continue to push people away from inexpensive catastrophic coverage. The bill also seems unlikely to stabilize insurance markets, even though their current instability is one of the main Republican talking points for passing it. The legislation gets rid of the “individual mandate” — Obamacare’s fines for not buying insurance — but keeps the regulations that made the mandate necessary. The result is likely to be that healthy people leave the market and sick people face much higher premiums.
.. From a conservative perspective, the chief selling point of the bill is Medicaid reform.
.. But the reform is delayed until after the 2024 presidential election.
.. We suspect that the Congressional Budget Office will find that most of the reduction in insurance rolls results from people’s choosing not to buy insurance when they’re not being threatened with fines.
.. The bill’s subsidies for people outside of Medicare, Medicaid, and the employer-based insurance system could simply be given to the states to distribute to that population without having to comply with Obamacare’s regulations.
$45 Billion to Fight Opioid Abuse? That’s Much Too Little, Experts Say
According to the National Household Survey on Drug Use and Health, there were roughly 1.35 million low-income Americans in 2015 with an opioid use disorder. Only 25 percent of those people get treated in a year
.. Richard G. Frank, a health economics professor at Harvard Medical School, has estimated that last year, people who enrolled in expanded Medicaid incurred about $4.5 billion in costs for mental health and addiction treatment.
.. calculated it would cost $14 billion in the first year and more than $183 billion over a decade to treat addiction and related illnesses in low-income people who would lose coverage under the Republican plan.
.. “One of biggest reasons for the gap in treatment is there aren’t enough trained doctors to deliver the medicine, trained therapists to deliver the therapy,” said Mr. Mendell, who was invited to testify at the first meeting of President Trump’s commission on the opioid crisis this month. “Who’s going to enter the work force knowing the funding is going to run out in 10 years?”
How the G.O.P. Health Bill Would Change Medicaid
- 4/10 children
- 5/10 births
- 2/3 nursing homes
These policies will make the next recession both more likely and worse
But at least we’ve got the automatic stuff that kicks in when people start falling through the cracks, right? Not if anything like the proposed cuts to the safety net go through. Medicaid, SNAP (food stamps), employment programs, infrastructure spending — they’re all on the chopping block in both Republican budgets and health-care bills. One of the worst things they’re trying to do in this space is turn safety net programs, like SNAP and Medicaid, into block grants, which would end those programs’ critical countercyclical function
.. Another Republican initiative in this space that would compound the damage to vulnerable people in recessions is the intention to add work requirements to safety net programs. Even in strong recoveries, that’s a terrible idea — do you really think less than $5 a day in food stamps is what’s keeping someone from working? But in recessions, when unemployment is rising quickly, work requirements make even less sense.
.. There’s a cost to dysfunctional, unrepresentative government. It may take a while to show up, but trust me, it will.