Florida Obamacare hike now 45%, yet most pay same or less, OIR says

The vast majority of more than 1 million Florida Obamacare customers will pay about the same or less in 2018, state regulators said Tuesday, but about 7 percent without government subsidies could pay a whopping 45 percent more.

Insurers more than doubled their 2018 increases filed just a few months earlier, with some citing the administration’s reluctance to continue billions in “cost sharing” money that president Donald Trump has called “bailouts” for insurers.

Most consumers with a benchmark “silver” plan “will not see an out-of-pocket change, as the federal premium subsidy will also increase to absorb this extra cost,” the state’s Office of Insurance Regulation said in a statement.

In fact, a family of four earning $53,000, as well as an individual earning $27,000, may see a slight decrease in their out-of-pocket health insurance premium in 2018, officials said.

Only customers who buy Affordable Care Act marketplace plans and get no government subsidy — fewer than one in 10 in Florida — potentially face the full premium increase. And they will have off-marketplace options that could be significantly less expensive, officials noted.

Florida’s largest health insurer, Jacksonville-based Florida Blue, said it has close to 1 million customers on ACA market plans. About 66,000 of them have silver plans without government subsidies, with about 19,000 of those in South Florida including Palm Beach County. They potentially take the worst hit if premiums go up 38 percent for a Florida Blue plan, or an average of 44.7 percent for a half dozen companies offering plans on the ACA exchange.

Florida Blue officials urged those consumers to check “off-marketplace” plans once the enrollment period begins in November because they might find a significantly better deal.

The big rate increases, still awaiting final federal approval, “will look surprising on the face of it, but in fact most, if they take care to understand their individual situations, should not see a large out-of-pocket change,” said  Penny Shaffer, market president in South Florida for Florida Blue.

Still, the 45 percent jump makes for an eye-grabbing headline, even as GOP Senate leaders concluded once again Tuesday they do not have the votes to repeal or overhaul the law.

“Years before the Trump Administration came to office, Obamacare’s double-digit rate increases and onerous mandates have been squeezing the pocket books of families in Florida,” said U.S. Health and Human Services press secretary Caitlin Oakley. “Under Obamacare, premiums for individual healthcare plans available in Florida surged by more than $2,400. Floridians are once again facing skyrocketing costs and plummeting choices because of Obamacare’s fundamental failures.”

Opponents of the health law make other points: As of March 15, 93 percent Florida residents who bought health insurance on the federally facilitated exchange received a premium tax credit subsidy. That still left about 100,000 Floridians on the exchanges who don’t currently receive any subsidy and thus potentially face the full impact of rate increases.

Then there are the penalties for not having insurance: In 2015, nearly 535,000 Floridians paid $250 million in penalties to the IRS for the right to go without Obamacare.  And approximately three-quarters of Florida’s counties are projected to have two or fewer insurers offering coverage on the exchange during the upcoming plan year.

An average of 45 percent is more than double what Florida insurers were asking for 2018 just months earlier. Why?

Many insurers’ filings now assume the Trump administration cannot be counted on to continue billions of dollars in cost-sharing payments to help consumers reduce co-pays and deductibles. President Trump has called these “bailouts” for insurers. Yet in this case, squeezing the balloon in one place just increases other government subsidies and may actually increase the net amount taxpayers pay for Obamacare in 2018, according to the Kaiser Family Foundation.

The administration is also shortening the sign-up window to six weeks for 2018,  slashing 90 percent of the advertising budget to tell consumers about the marketplace and reducing money for in-person assistance to get coverage. All of that will likely reduce the number of people who enroll and affect the rates of those who do sign up, insurers figure.

Rate increases for 2018

State-approved premium increases for Affordable Care Act marketplace plans. More than 90 percent of Florida consumers will see little difference in what they actually pay each month after government subsidies, though those with government aid could face the brunt of higher prices.

1 Blue Cross & Blue Shield of Florida Inc. 38.1%
2 Celtic Insurance Co.  46.1%
3 Florida Health Care Plan Inc.  26.5%
4 Health First Commercial Plans Inc. 39.3%
5 Health Options Inc.  36.0%
6 Molina Healthcare of Florida Inc.  71.2%

Source: Florida Office of Insurance Regulation

 

NEW: Better? Senate health plan doubles many Palm Beach Co. premiums

President Donald Trump pledged “much less expensive and much better” health care in January, but a Senate bill would more than double premiums for a 60-year-old in Palm Beach County making $50,000 a year, a new analysis shows. Added premium costs annually: $6,910, or a 135 percent hike.

(Getty Images)

It’s a double whammy for a 60-year-old making $20,000 a  year. Premiums paid out of pocket more than double to $2,080, and the consumer would also lose by 2020 government help of about $4,800 this year to cover co-pays and deductibles, according to the Kaiser Family Foundation. The consumer would have to cover that shortfall herself.

“In a very real sense, the Senate bill offers you less coverage and costs you more,” said Dave Bruns, AARP Florida communications manager. “That is borne out by the Kaiser Family Foundation data and by our analysis of the bill.”

Others could come out ahead under the Senate bill. A 27-year-old living in Palm Beach County and making $50,000 would save $260 a year on 2020 premiums in a silver healthcare.gov plan under the Senate’s Better Care Reconciliation Act, according to Kaiser’s analysis.

Trump tweeted Monday, “Republican Senators are working very hard to get there, with no help from the Democrats. Not easy! Perhaps just let OCare crash & burn!” OCare would be shorthand for Obamacare, or the Affordable Care Act.

Senate bill supporters say it protects those with pre-existing conditions, but the bill could let states waive rules that could make such coverage much more costly to the consumer, said Michelle Long, policy analyst for the foundation’s Health Care Marketplace Project. Potential changes include letting insurers reimpose annual or lifetime caps on benefits or opt out of certain “essential benefits” they must cover now, she said.

“I don’t see anything in the language to prevent that,” Long said.

Senate leaders have said they hope to vote on the bill as early as this week.

“The American people deserve #BetterCare, which is exactly what we’re working to bring them,” Senate Majority Leader Mitch McConnell, R-Ky., tweeted Monday.

Though it offers more subsidies for low-income consumers than the House bill does, the Senate plan still lets insurers charge older consumers five times as much as younger ones. Advocacy group AARP has staunchly opposed this as an “age tax.”

Both the House and Senate versions would cut about $1 trillion in taxes on corporations and individuals making more than $200,000 a year.

On Monday, the American Medical Association announced its opposition to the Senate bill in a letter to McConnell. “Medicine has long operated under the precept of . . . ‘first, do no harm.’  The draft legislation violates that standard on many levels,” said the letter from James L. Madara, AMA’s CEO and executive vice president.

Palm Beach County premiums

This shows annual premiums in 2020 for a healthcare.gov silver plan, comparing the Affordable Care Act to the Senate’s Better Care Reconciliation Act. Amounts reflect the net amount the consumer pays. It does not include the impact of cost-sharing subsidies, which are eliminated by 2020 in the Senate plan. That means total out-of-pocket costs will rise further for lower-income consumers under the Senate bill than shown here.

Age  /  Income / ACA premium  / Senate premium / Change

60      $20,000       $950                          $2,080           Costs $1,130 more

60      $50,000      $5,100                       $12,010           Costs $6,910 more

60      $100,000    $8,940                      $12,010           Costs $3,070 more

40       $20,000      $960                         $1,290             Costs   $330 more

40      $50,000       $4,210                     $4,210             No change

40       $100,000      $4,210                   $4,210             No change

27       $20,000        $950                       $1,160             Costs $210 more

27       $50,000         $3,450                   $3,190            Costs $260 less

27     $100,000         $3,450                   $3,190            Costs $260 less

Source Kaiser Family Foundation

Senate health care bill details start to emerge as Florida waits

Update: It’s out. The full text of a “discussion draft” is here.

Original post: A conservative think tank feared a whiff of Obamacare Lite. A West Palm Beach supporter of the Affordable Care Act compared it to a terrible Back To The Future scene that somehow crawled off the cutting-room floor.

Details of a U.S. Senate bill to replace Obamacare and roll back Medicaid began to emerge ahead of an expected meeting between Majority Leader Mitch McConnell and other senators Thursday morning, carrying big implications for the physical and financial health of millions in Florida.

Senate Majority Leader Mitch McConnell (R-Ky.)

The Senate plan would largely mirror the House bill, which cuts close to $1 trillion in taxes, but extend some subsidies to low-income people to lower their premiums, the Washington Post reported about a draft circulating among aides and lobbyists.

Florida leads all states using the federal Affordable Care Act marketplace with about 1.5 million customers, and nine out of 10 get subsidies. Under the Senate plan, government help to pay premiums would go to people making up to 350 percent of the poverty level, Axios.com reported, a continuation of controversial Obamacare subsidies but at a reduced level compared to the ACA’s 400 percent eligibility. For its part, the House bill replaces ACA subsidies with tax credits tied to age.

The Senate plan is said to wind down Medicaid expansion more gradually than the House version but there were reports Wednesday it could make deeper cuts in spending over the long run. Medicaid covers 4 million people in Florida, including about half the childbirths and 70 percent of seniors in nursing homes and 41 percent of Palm Beach County’s children.

The political goal is to come up with a plan that will get enough votes to pass muster with the GOP’s slim majority in the Senate and have a chance of passing the House on a return trip. There’s talk of a Senate vote as early as next week, though the question is just how much tweaking will do the trick to revamp a House bill President Donald Trump reportedly called “mean.”

“If the House bill was ‘mean,’ this bill is cruel,”  said Anna Galland, executive director of liberal advocacy group MoveOn.org, on Wednesday evening. “Shockingly, this bill’s cuts to Medicaid are even deeper than those passed by the House—at a moment when Medicaid and Medicare should be dramatically expanded.”

But groups on the other side of the ideological fence questioned whether the Senate bill will go far enough in undoing Obamacare.

Heritage Action’s chief executive officer Michael A. Needham said Wednesday, “Conservatives are rightly frustrated with the process of repealing and replacing Obamacare that has played out this year. It is clear that significant portions of the Republican Party have no intention of actually repealing Obamacare despite campaigning on that objective for years.”

He continued, “Conservatives will evaluate legislative language when it becomes available, looking particularly at whether the legislation empowers states to get out of the onerous insurance mandates imposed by Obamacare, maintains and improves the House’s Medicaid reforms, and repeals Obamacare’s stifling taxes.”

Also closely watched in Florida will be the impact on older residents, including those 50 to 64. The House bill would let insurers charge them five times more than younger people, up from three times now. Groups including AARP have been calling for more transparency this week. “When someone is being THIS secretive about a bill, it’s usually a bad sign,” AARP Advocates tweeted.

“It’s a like a Back To The Future episode they scrapped on the editing floor,” said Mark Pafford, a former Democratic state legislator from West Palm Beach who is a board member of the advocacy group Florida CHAIN (Community Health Action Information Network). “It will essentially return the health care system not just in Florida but around the country to the broken system we had before.”

On Thursday, Health and Human Services Secretary Tom Price issued a statement:

“Under Obamacare, premiums have skyrocketed across the country – on average doubling what Americans are paying for health insurance coverage. Because of these rising costs, millions of Americans have dropped their unaffordable coverage and others have been forced to pay a penalty to Uncle Sam just for the right to go without. Patients, doctors, job creators, and Americans from all walks of life are being harmed and losing access to affordable coverage and the care they need. We have heard their voices. Dudley Bostic, the owner of a local pharmacy in Tennessee, recently explained how access to affordable healthcare is disappearing for so many in her community. And Dr. Ryan Stanton from Kentucky shared the importance of putting patients and doctors in charge of healthcare, not Washington D.C., and protecting the doctor-patient relationship.

“That’s why we welcome the Senate’s proposal to provide Americans with much needed relief from Obamacare. The Senate’s proposal is built on patient-centered reforms that put the American people in charge of their healthcare decisions, not government, protecting patients, bringing down the cost of coverage, and expanding choices.

“The Trump Administration is committed to the health of all Americans. Here at the Department of Health and Human Services, we have already taken steps to reduce Obamacare’s burdens for the American people.”

Trump moves threaten 20% health spike as key Florida insurer returns

The state’s largest Affordable Care Act insurer Florida Blue plans to return in 2018, but warned rates could jump 20 percent higher than expected if the Trump administration and Congress end payments designed to bring down costs for more than 1 million Floridians.

President Donald Trump (Getty images).

Florida’s Democratic congressional delegation told President Trump in a letter he is responsible if his “deliberate sabotage” destabilizes the market and makes care more expensive or harder to get.

Trump’s health secretary Tom Price on Monday characterized the real problem as “fewer Americans can afford to pay more and get less for healthcare,” noting not all who signed up for 2017 are paying their premiums.

Marketplace leader Florida Blue says it will be back in the state’s ACA marketplace in 2018, but company officials said premiums could be 20 higher than they otherwise would be if federal “cost-sharing” help for consumers to cover co-pays and deductibles is discontinued.

Trump has cast doubt on continuing such subsidies by calling them insurer “bailouts,” though they have been part of the ACA since its inception and Florida Democrats said they are an obligation under current law. They are estimated to be about $10 billion in 2018.

The Senate is now considering a major health overhaul that the House passed.

The House  bill would wipe out ACA subsidies and close to $1 trillion in taxes on high earners and corporations. It would replace them with limited tax credits that could make lower-income, older people and those with pre-existing conditions pay more but potentially bring down costs for younger, healthier and higher-income people. About 23 million fewer people would be covered in 10 years compared with leaving Obamacare in place, the Congressional Budget Office said.

Florida Blue spokesman Paul Kluding declined to discuss the specific rate proposal that will be filed by June 21, but said “it is important to note that our rate filing assumes that cost-sharing reductions will be in place for 2018. Without CSRs, we estimate that, on average across the state, our rates would be an additional 20 percent higher than our originally submitted rates.”

Insurers face a June 21 deadline to file rates for 2018 markets.

If cost-sharing payments end, Trump will be responsible for “the destabilization of the marketplace and the deliberate sabotage of our neighbors’ health and financial well-being,” Florida’s Democratic delegation told the president in a June 8 letter. Signing members included U.S. Rep. Lois Frankel, D-West Palm Beach, and Rep. Ted Deutch, D-Boca Raton.

Trump’s Health and Human Services department said Monday that new numbers show declining enrollment in Affordable Care Act markets.

After taking office, the new administration slowed or stopped efforts to promote sign-ups, and GOP leaders crafting legislation signaled their intention not to enforce a penalty for failing to buy insurance.

The HHS report showed that 12.2 million individuals selected a plan at the end of open enrollment, and 10.3 million followed through to pay the premiums necessary to maintain coverage as of March 15, 2017.

“Consumers are sending a clear message that cost and affordability are major factors in their decision to cancel or terminate coverage,” said CMS Administrator Seema Verma in a statement.

In Florida, more than 1.4 million enrolled and more than 1.3 million in the marketplace paid premiums by March, with 93 percent of these getting premiums subsidies and 75 percent qualifying for cost-sharing reductions, the report said.

Ironically, ending the cost-sharing payments has been estimated to increase overall costs to taxpayers by $2.3 billion, because other subsidies designed to lower premiums would go up.

Making headline rates go up would most hurt the fewer than one in 10 Florida customers who make too much money to qualify for subsidies on marketplace plans.

The way the law works, monthly premiums for more than nine of 10 Florida customers probably will barely budge, staying near $84 a month on average, but those without subsidy help will bear the full brunt of rate increases that could top 20 percent.

“One popular Republican talking point is the so-called ‘implosion’ of the Healthcare.gov marketplace,” the Florida Democrats’ letter to Trump said. Florida has led states using the federal exchanges with as many as 1.7 million enrolled in recent years, the letter said, so “it is clear that the marketplace is not ‘imploding,’ but could be crushed from the outside if you continue the assault on the ACA and pull the rug out from under our neighbors.”

 

 

 

Medicaid fight hits 41% of Palm Beach Co. kids, up to 64% nearby

A battle in Washington over money for Medicaid affects 41 percent of Palm Beach County children, or more than 116,000, research released Wednesday says.

It’s an even bigger share in rural counties. For example, Medicaid covers 64 percent of the children in Okeechobee County, according to research announced by Georgetown University, the University of North Carolina and the Florida Policy Institute.

“When Florida children and families have health insurance coverage, the whole state benefits,” said Joseph F. Pennisi, executive director of the Lake Mary-based Florida Policy Institute. “Providing greater access to care can equate to fewer visits to emergency rooms, less uncompensated care and more people getting—and staying—healthy.”

The American Health Care Act passed by the House would cut more than $800 billion from Medicaid over a decade compared to leaving the Affordable Care Act intact. The Senate is considering the biggest legislative issue of President Trump’s early term now.

U.S. Rep. Brian Mast, R-Palm City, faced mostly hostile questions about the AHCA in a town hall meeting in Stuart Monday. He told questioners Medicaid spending will still rise and that what are called reductions include a winding down of Medicaid expansion that Florida chose not to pursue in the first place: “This is not a cut.”

Critics of the House bill counter that Floridians on Medicaid —  who also include 70 percent of the seniors in nursing homes — stand to lose if Medicaid funding is capped and handed to the states in block grants.

If Florida’s Medicaid money from the U.S. government had been capped to grow no more than the inflation rate from 2001 to 2011, the state would have received 17 percent less money than it actually did, an analysis by the Kaiser Family Foundation  found in March. That’s not precisely the formula the House bill would use, but the analysis highlighted the challenges of getting a capped amount right in a state where a lot of new people tend to move in, or live longer, or need more services than forecast. That would have left Florida among the 10 states hit hardest with billions of dollars in shortfalls, the analysis said, forcing tough choices to cut coverage or services, slash other spending or raise taxes.

“Medicaid provides critical access to life-saving treatment and protection from rising health care costs to many children and families living in small towns and rural America,” said Joan Alker, executive director of the Georgetown University Center for Children and Families. “Cuts to Medicaid and other health care programs would take those protections away from many and risk financial ruin, denial of health care, or both.”

By 2015, the share of Palm Beach County’s children covered by Medicaid grew to 41 percent from 27 percent six years earlier, officials said. In the same span, the number of children lacking insurance in Palm Beach County was almost cut in half to 24,480, the research showed.

Overall, 57 percent of children in Florida’s small towns and rural areas receive Medicaid coverage and 44 percent do so in urban areas, the research found.

Children on Medicaid

County / Number / % of co. children on Medicaid

Palm Beach  116,570    41%

Martin          9,470        35%

St. Lucie     34,450       54%

Indian River   13,110    49%

Okeechobee  6,090      64%

Hendry         6,750        61%

Broward     179,900     43%

Miami-Dade 293,300  50%

Notes:  2014-5 data

Source:  Georgetown University Center for Children and Families, University of North Carolina Rural Health Research Program, Florida Policy Institute

Trumpcare: Sick could face ‘extremely high premiums,’ CBO report says

States that opt out of Obamacare rules under a House bill could make sick people pay “extremely high premiums” if they could afford coverage at all, the new Congressional Budget Office report this week says.

HHS Secretary Tom Price

It’s not known if Florida would join states seeking a waiver of rules to let insurers charge sick people more — potentially lowering costs for healthy people — but CBO projected about a sixth of the U.S. population would live in states doing so. The bill would have to pass the Senate and be signed by President Trump to become law.

People with conditions such as cancer, asthma and diabetes could face much higher costs if states choose to let insurers charge them more, compared to current rules that force them to charge sick people the same way as healthy ones in a given territory.

CBO found “less healthy people would face extremely high premiums, despite the additional funding that would be available under HR 1628 to help reduce premiums. Over time, it would become more difficult for less healthy people (including people with preexisting medical conditions) in those states to purchase insurance because their premiums would continue to increase rapidly.”

One of the amendments to the American Health Care Act that the House passed May 4 would provide $8 billion to help states cover costs for those with pre-existing conditions.

But for every dollar the amendment spends on people with pre-existing conditions, the bill spends $29 on tax breaks for people with income above $200,000, said former Obama health spokesman Ben Wakana.

That’s in addition to $4 on a tax break for the pharmaceutical industry, $5 on a tax break for health savings accounts that largely benefit high-income people and $18 on a tax break for the health insurance industry, he said.

“This reflects the overall choices that House Republicans made in this bill: provide hundreds of billions in tax breaks for the wealthy and corporations at the expense of people with pre-existing conditions, tax credits for people purchasing coverage in the individual market, and people with Medicaid,” Wakana said. “It remains to be seen whether Senate Republicans will make the same choice.”

CBO warned individual markets could become “unstable” for people with higher-than-average expected health care costs in states that opted out of Obamacare mandates.

The report said a revised House bill could cover 23 million fewer people over a decade compared to leaving current law intact, down slightly from 24 million on the original March bill.

House bill supporters have said up to $138 billion would be available to help states in the next 10 years, though there’s no guarantee more than $8 billion would specifically help people with pre-existing conditions.

“Look, nobody wants folks who have a pre-existing illness or injury not to be covered,” Trump administration Health and Human Services Secretary Tom Price said earlier this month. “We want to make certain that we can do it at a lower price and broader choices for patients.”

 

 

 

Trump payments ‘critical’ to avoid consumer health disaster, NAIC says

In new letters in the last 24 hours, insurance regulators warn the Trump administration and U.S. Senate it is “critical” that they commit to pay billions of dollars that help health consumers — or insurers are likely to pull out or raise premiums across the country.

Trump administration budget director Mick Mulvaney

As The Palm Beach Post has reported, the average rate increase projected in Florida to make up for the money is 25 percent, among the highest in the nation.

A May 17 letter from top officials at the National Association of Insurance Commissioners tells Trump budget director Mick Mulvaney it is essential to commit to paying money that helps consumers cover co-pays and deductibles.

“On behalf of the nation’s state insurance commissioners, the primary regulators of U.S. insurance markets, we write today to urge the Administration to continue full funding for the cost-sharing reduction payments for 2017 and make a commitment that such payments will continue, unless the law is changed,” the NAIC letter said. “Your action is critical to the viability and stability of the individual health insurance markets in a significant number of states across the country.”

An attempt to seek comment from a White House spokeswoman was not immediately successful.

The House passed a bill to end the Affordable Care Act’s taxes and subsidies and replace them with a plan that gives states more say, but the Senate has only begun to consider it. In addition, a court hearing is expected next week in a House lawsuit that seeks to block the payments.

Trump threatened to withhold the cost-sharing payments in an effort to get Congressional Democrats to commit to paying for a border wall.

“I don’t want people to get hurt,” Trump said in April. “What I think should happen — and will happen — is the Democrats will start calling me and negotiating.”

When that didn’t work out, Trump tweeted  May 7,  “Republican Senators will not let the American people down! ObamaCare premiums and deductibles are way up – it was a lie and it is dead!”

The letter from NAIC president Theodore K. Nickel of Wisconsin and colleagues from Tennessee, Maine and South Carolina tells the administration and Congress there’s no time to wait to stabilize markets.

“The time to act is now,” the letter said. “Carriers are currently developing their rates for 2018 and making the decision whether to participate on the Exchanges, or even off the Exchanges, in 2018. Assurances from the Administration that the cost-sharing reduction payments will continue under current law will go a long way toward stabilizing the individual markets in our states while legislative replacement and reform options are debated in Congress.”

The average premium increase to make up for the loss of perhaps $7 billion to $10 billion in annual “cost-sharing” payments in Affordable Care Act markets has been projected at 19 percent nationally and 25 percent in Florida, according to Kaiser Family Foundation.

That’s assuming insurers even sign up for 2018 at all. Assurance the money will be there matters not just in 2017 but 2018, because insurers must decide by June 21 whether to file rates for 2018 and what premiums to charge.

Insurers have already begun pulling out in states including Iowa.

“As you know, there is increasing concern that more carriers will pull out of this market and rates will continue to rise, leaving consumers with fewer and more expensive options, if they have any options at all,” the NAIC letter to Mulvaney said. “This is not a theoretical argument – carriers have already left the individual market in several states, and too many counties have only one carrier remaining. The one concern carriers consistently raise as they consider whether to participate and how much to charge in 2018 is the uncertainty surrounding the federal cost-sharing reduction payments.”

Ryan touts choice, Frankel says AHCA will ‘kill a lot of people’

Speaker Paul Ryan on Monday promoted “choice and competition” he said will be fostered by the GOP House overhaul of Obamacare, but a West Palm Beach congresswoman warned of deadly consequences for people needing help from opioid addiction, mental illness and pre-existing health conditions.

“The problem is the states are not going to have enough money to fund a better system,” said U.S. Rep. Lois Frankel, D-West Palm Beach. “This bill is going to kill a lot of people.”

U.S. Rep. Lois Frankel, D-West Palm Beach, speaks Monday near St. Mary’s Medical Center about the GOP House health bill surrounded by health advocates concerned about its effects. (Charles Elmore/Palm Beach Post)

Just last week Florida Gov. Rick Scott recognized a statewide emergency with the opioid epidemic, she noted.

U.S. Health and Human Services Secretary Tom Price said the American Health Care Act does not permit health insurers to deny coverage to people with pre-existing conditions, though it can charge them 30 percent more if they do not maintain continuous coverage.

On NBC’s “Meet The Press” Sunday, Price responded to critics: “What I believe they are not recognizing is this is a different and we believe better way” to cover individuals with pre-existing conditions or injuries.

The bill provides about $138 billion over 10 years to help states if they choose to set up “high risk pools” to cover people with pre-existing conditions, but many analysts said that likely will not be nearly enough.

The issue is not just being able to get a policy, but at what cost, said Brent Schillinger, a medical consultant on the board of Florida CHAIN (Community Health Action Information Network).

It does little good “if the premium, or the co-pays and deductibles, are so high you cannot afford it,” Schillinger said.

The bill, which awaits consideration by the Senate, is really designed to fund a roughly $1 trillion tax cut for companies and wealthy people, Democrats in Congress say. The original March version of the bill would push 24 million people out of insurance coverage, the Congressional Budget Office found. A score on the revised bill is expected as early as this week.

Local representatives from groups including the National Alliance on Mental Illness, The American Heart Association and the Leukemia & Lymphoma Society attended Monday’s gathering near St. Mary’s Medical Center in West Palm Beach.

Younger, healthier and higher-income people could save money under the House bill, which eliminates Obamacare taxes and subsidies, replaces them with tax credits from $2,000 to $4,000 available to a broader range of income levels, and allows states to let insurers offer less comprehensive plans.

“Obamacare is collapsing,” Ryan tweeted Monday. “This bill brings back choice and competition in our health care system.”

 

HAPPENING NOW: Obamacare replacement passes House

Update 2:17 p.m.: House gets to 216 votes to pass American Health Care Act, for a final tally of 217-213. Now it goes to the Senate.

Update 1:50 p.m.: House Speaker Paul Ryan said the House cannot fail to act with insurers pulling out of states including Iowa and Virginia.

“We will not falter,” Ryan said. “We will replace. Today is the day we’re going to do this.”

Original post: Freedom Caucus Chairman Mark Meadows predicted Thursday morning the GOP plan to overhaul Obamacare will pass later in the day “by a very narrow margin,” while opposing groups including AARP said it will make coverage unaffordable for millions.

Freedom Caucus Chairman Mark Meadows

The revised American Health Care Act has not been scored by the Congressional Budget Office, but Rep. Meadows, R-N.C., told CNN it will “drive premiums down” for many people.  The original plan would have pushed 24 million out of coverage, CBO projected, but Meadows said numbers in the revised bill could look “more attractive,” though the House is not waiting for them before voting.

Senior advocacy organization AARP warned before the vote that people with pre-existing conditions, including 3.1 million in Florida, could face additional costs of up to $25,000 or more a year in high-risk pools, based on past experience.

In addition, people 50 to 64 on lower incomes could pay up to $13,000 more each year in premiums and deductibles in what AARP officials call an age tax.

“These are unaffordable amounts,” AARP legislative policy director David Certner said in a conference call Thursday.

About 454,000 Floridians ages 50 to  64 enrolled and receiving tax credits in the Affordable  Care Act marketplace stand to see higher health-coverage premiums than they pay under current law, AARP officials have said. That’s more than any other state.

The bill would let states allow insurers to charge older and sicker people more and offer less comprehensive plans, potentially bringing down costs for healthier, younger and higher-income people.

Under the ACA, Florida receives the most money of any state, $5.2 billion, in federal subsidies to make premiums more affordable for lower-income consumers, the Kaiser Family Foundation calculated.

AARP officials said Thursday an additional $8 billion over five years for high-risk pools included in the latest version falls well short of a filling a need they say studies put at more than $100 billion.

On the floor, House Democrats blasted the original plan in March as a $1 trillion tax cut for corporations and the wealthy dressed up like a health care bill.

Democratic leader Nancy Pelosi, speaking on the House floor Thursday, said, “Forcing the vote without a CBO score shows the Republicans are afraid of the facts.”

Trump said today he hopes for a “wonderful vote.”

 

After Kimmel health plea, AMA head sees ‘huge step backward’ for Fla.

Late-night comedian Jimmy Kimmel tearfully spoke of his son’s heart surgery and asked Congress not to raise costs on sick people, rousing Obamacare supporters and irking backers of a proposed GOP health overhaul — with one calling it “cheap.”

On Wednesday, American Medical Association president Andrew W. Gurman said that Florida’s 3.1 million people with pre-existing conditions could find themselves priced out of coverage  under the latest proposal.

Proposals such as letting states allow insurers to charge sick people more in “high-risk pools” darken the picture for millions in Florida who have heart problems, diabetes and other conditions, he said.

Jimmy Kimmel

“These people, our family members neighbors and friends, would take a huge step backwards,” Gurman said.

Kimmel recounted on the air how heart surgery saved his young son’s life, and he urged legislators not to take away protections that make covering costly illness more affordable for families who don’t have the resources he does.

“If your baby is going to die and it doesn’t have to, it shouldn’t matter how much money you make,” he said. “I think that’s something that whether you’re a Republican or a Democrat or something else, we all agree on that, right?”

That did not sit so well with conservative pundit Matt Lewis, talking on CNN.

“I thought it was cheap,” Lewis began. “As a father, I can understand, I can try to understand. President Obama said being a dad and  having a child is like having your heart living outside your body. So I completely understand where Jimmy Kimmel is coming from, the passion I think is sincere. I don’t think that this is the right move for him to do to politicize this. This is a guy who is incredibly rich, of course, he’s not going to have a problem.”

Discussions about boosting proposed federal support by an extra $8 billion to help states with high-risk pools still don’t resolve fundamental issues with the House GOP’s American Health Care Act,  Gurman said. The Congressional Budget Office projected it would push 24 million people out of health insurance. In addition, many people, such as those 50 to 64 with lower incomes, could pay thousands more each year in premiums and co-pays under the plan.

“These changes could make coverage completely unaffordable for people with pre-existing conditions,” Gurman said.

Proponents say it would lower premiums for many healthy people.

The latest plan has “much lower premiums & deductibles while at the same time taking care of pre-existing conditions!” President Trump tweeted Sunday.