The first 100 days
under the Trump reign have seemed like a thousand years of muffled screams and
insults, which at times were hilarious because of the inaccuracies and
grammatical errors. However, as William O. Douglas, former supreme court
justice, once said, "freedom steals away in the night while we are
sleeping." This article reviews the thrust of the Trump Administration and
the Republican majority's stabs at "healthcare reform." Round deux,
dos, or two, depending on your preference, of the attempt to repeal the Patient
Protection and Affordable Care Act has slunk away in the night, lacking the
requisite number of votes for approval. However, this latest iteration provides
a glimpse at the approach the Republicans will apply to future legislation, in
healthcare, and many other programs. Essentially, the R's want to shirk
national leadership and have the states assume responsibility for more programs
and consumer protections. The only area in which they shrink from this is for
gun proliferation, where the Trump Administration wants to force all states to
accept looser standards for transporting weapons across state lines, including
concealed weapons.
Trump Posturing
Right up until the federal government deadline for shutting down,
Trump threatened to withhold the tax credits which provide 20 million middle
class and low-income Americans with medical insurance. This is of course,
an administrative maneuver to choke the life out of the act, since he hasn't
been able to gain agreement from his own party. It should be noted however,
that Trump has already cut funding mechanisms which flow to the program,
including a 3% tax born by the lucrative medical device industry, which will
flow directly to their executives and NOT reduce the cost of your cardiac or
orthopedic devices. And of course, let's not forget his forgiveness of the
"tanning bed" tax, which has zero health benefits and does contribute
to skin cancer.
Regarding the thousands of people who hate the Affordable Care
Act, there are exemptions for those who don't want to participate, and about 20
million folks have made this election or paid the tax penalty. Though the
Affordable Care Act is not beloved and is flawed legislation, as they all are,
it is still a starting point from which to make further reforms. This chart
shows provisions of the act which are now being targeted by the Trump goon
squad and what the impact may be on your health care.
Provision
|
Affordable Care Act
|
Trump Round 2
Health Plan
|
Protection from Pre-existing Medical Condition Exclusions
|
Insurance companies are prohibited from denying coverage
or reducing benefits to persons with existing medical conditions
|
The Republicans are proposing that individual states
decide how they want to handle insurance offerings to those who need it
most-including being able to charge astronomical prices, limit benefits, and
deny coverage
|
Lifetime Limits for Benefits
|
Insurance companies are prohibited from limiting benefits
|
The Republicans think states should be allowed to offer restricted
programs, contracts with minimal benefits, instead of comprehensive medical insurance
|
Standardized Benefit Levels Nationally
|
In the insurance exchanges, participating insurers must
offer benefits which adhere to certain benefit designs and guarantees
|
The Republicans see no advantage in mandating benefit
standards and wish to leave this provision up to the states
|
Protection from Predatory Pricing Based on Age or Need
|
In the insurance exchanges, there are tiers of rates and
people who are in the older tiers cannot be charged more than 3 times the
rate of the younger tiers
|
The Republicans want to allow strict age rating, which
means if you are over 50, it will be a long expensive wait until age 65 when
you can join America’s national healthcare plan, Medicare
|
Birth Control Coverage
|
The insurance exchanges require plans to offer birth
control in all plans
|
The Republicans are opting to use streaming videos of talk
show host Alex Jones as birth control
|
Mental Health Services Coverage
|
Included under the ACA, as any other benefit
|
More homeless people, which impacts cities, who didn’t
support Trump anyway, so a win for them
|
Chemical Dependency Treatment
|
Covered under the ACA, which is critical with the opioid
crisis
|
You are on your own
|
To all the winners who voted for Trump, stop whining about
the millions of engaged citizens who are demonstrating against his horrible
policies, the first amendment guarantees their right to free speech, and this
is part of a real democracy.
And this is the
healthpolicymaven signing off wishing you all informed consent. Also, TIP OF
THE DAY-don’t sign blanket authorizations at hospitals or medical facilities,
please add the words,“I agree to pay charges for in-network providers”, which
can save you a mint. Those words of wisdom come from Dr. Elizabeth Rosenthal,
author of An American Sickness-How Healthcare Became Big Business and How You Can
Take It Back. Please do buy and read her book.
Roberta Winter is the author of Unraveling U.S. Healthcare-A
Personal Guide, published in 2013 by Rowman and Littlefield.
https://www.amazon.com/Unraveling-U-S-Health-Care-Personal/dp/1442222972