Finally, after dithering for eight years, House Republicans are showing their cards. What is being referred to even by some Republicans in a not flattering way as “Ryancare” repeals most of the benefits from the Affordable Care Act and has now been fully embraced by the president, making it — I suppose — more properly “RyanTrumpcare.”
It probably should come as no surprise that the proposal is not only a threat to the 20 million Americans who finally got health care because of the Affordable Care Act, but now poses a direct threat to millions of pre-Medicare senior Americans and also to those of us already insured through Medicare.
RyanTrumpcare lifts the cap on the amount that seniors can be surcharged for health insurance from three times the rate charged to younger insureds to five times that rate, so a 60-year-old now paying $900 per month for health insurance can expect her bill to rise to $1,500! Aside from excluding potentially millions of lower income insureds, this is a direct 66 percent health insurance tax on 50- to 64-year-olds designed to go into the pockets of insurance companies!
Add to that the fact that the bill removes the mandate that everyone purchase insurance or pay a tax penalty, a public health requirement essentially intended to urge younger, healthy and presumably employed people to insure against accidents and unexpected illness and which generated some tax revenue to pay for the benefits of the ACA. It replaces it with a new 30 percent penalty on people whose health insurance has lapsed and then who try to re-enter the insurance market.
Aside from the fact that this removes the additional tax income under the current law and instead just adds to the profits of private insurance companies, this penalty more likely will fall upon those with limited income who cannot afford the new RyanTrumpcare premium structure, meaning more heavily on seniors.
Focusing directly on Medicare clients, it’s obvious that if premiums on the pre-65s are hiked 60 percent, the premiums on Medicare supplemental policies must likewise climb steeply. Moreover, provisions of the ACA and Medicare currently require health insurers to cover the full cost of many essential preventive care services like colonoscopies, mammograms and flu shots (among many others) now appear likely doomed in favor of allowing cheap low-coverage policies to be sold to unsuspecting purchasers. The president’s representatives call this “choice,” in fact, Medicare overnight risks becoming Medicare-light.
Let’s not overlook the fact that for years Paul Ryan has been trying to sell the idea of replacing Medicare entirely with vouchers, what he prefers to call “premium support” (and who can really tell the difference). RyanTrumpcare is a direct assault on the idea of insuring more people in a way to improve the health of more Americans. It is a large step a half-century backwards, before we had Medicare.
Almost half of all senior Americans in 1962 had no health insurance, and the coverage afforded seniors who could afford insurance then was paltry by Medicare standards. Twice as many people with chest pains didn’t even seek medical help in those days; many more just died. Hospital stays for seniors often meant bankruptcy. So let us not be fooled by extremists who try to claim, falsely, that privatization will take us back to golden days of quality health care.
As an attorney most of my 50-year career involved representing people who had suffered physical or economic injuries dealing with the health care or insurance industries, and later on my focus was on senior care issues. So I think I am well justified in wanting to sound an alarm at the current congressional proposals to repeal the ACA and moves to privatize Medicare.
This is the moment to put a stop to this foolishness. If we hold the line at cutting back on health care, maybe — just maybe — we can get the federal government to focus on issues which will improve our lives rather than endanger them.
Arne Werchick is a resident of Kailua-Kona