EDITORIAL NOTE: This is a busy week for me so I'm writing this on Wednesday. God knows what will happen regarding the new healthcare plan by Friday morning when this is posted to TGB. If anything important changes, I'll try to update it but no promises.

The ACHA, also known as the American Health Care Act (or Ryancare or Trumpcare if you prefer) released on Tuesday hit a firestorm of criticism from everywhere. That includes, according to ABC News,

”...AARP, the House Freedom Caucus, GOP senators including Rand Paul, Mike Lee and Ted Cruz, Heritage, the Club for Growth, tea party groups and even, yes, Breitbart News.”

In some circles, it was scorned as Obama Lite and that the “Obamacare cure is worse than the disease.” Other responses as reported in mainstream news media:

”Ryan disappoints his friends with Obamacare replacement bill. Close allies in conservative policies circles found little to love with the GOP's health care proposal.” (Politico)

”The GOP’s plan guts the Medicaid expansion, defunds Planned Parenthood, and sunsets a federal rule that requires that qualified insurance plans cover things like mental health care, maternity care, and pediatric dental and vision care, among other things.” (The Daily Beast)

”If you’re poor, you will not have the money to pay the premium, leaving you without insurance." (Newsweek)

And don't think that if you are 65 or older and a Medicare beneficiary that it doesn't affect you. As Social Security and Medicare/Medicaid expert, Nancy Altman, explains

”Seniors aged 65 and over, as well as people with serious disabilities, rely on Medicare for their basic health insurance. That program will be seriously weakened if the Republican plan to gut the ACA is enacted. It is estimated that Medicare’s revenue will drop by $346 billion.

“The Republican bill to repeal the ACA drains Medicare to gives tax breaks to wealthy Americans and corporations. In fact, even before Republicans pass a so-called 'tax reform bill,' this bill’s giveaway amounts to a whopping $525 billion tax break for the wealthiest among us.”

There is little doubt that the $346 billion drain on Medicare revenue would negatively affect these items that, with the passage of Obamacare, came into being for Medicare:

• the ongoing reduction of the donut hole in the Part D prescription drug program


• annual wellness visits without a copay


• free annual flu shot


• the extension of Medicare solvency to the year 2029.

The many TGB readers not quite old enough for Medicare would be hit particularly hard if this new healthcare bill is passed. Vox reports:

"In general, the impact of the Republican bill would be particularly severe for older individuals, ages 55 to 64. Their costs [of annual premiums] would increase by $5,269 if the bill went into effect today and by $6,971 in 2020. Individuals with income below 250 percent of the federal poverty line would see their costs increase by $2,945 today and by $4,061 in 2020."

Which brings us to effects of Medicaid changes in the bill. The estimable Nancy Altman again:

”The GOP’s bill, if enacted, will place caps on Medicaid spending, again shifting costs away from the federal balance sheet and to the balance sheets of states and individuals.

“If that is enacted, seniors needing long term care and their families may find themselves out of luck, since nursing home care is extremely expensive. It is estimated that the typical annual cost of a semi-private room in a nursing home is $80,300. Very few families can afford that huge cost on their own.

“And the impact on seniors not yet 65, and so, not yet on Medicare, will be the harshest of all. They will have more difficulty obtaining insurance and will face higher health care costs if this legislation is enacted and implemented.”

On Tuesday, the Chicago Tribune reported that Tom Price, Secretary of the Department of Health and Human Services and a physician,

”...would not commit to reporters that consumers would be able to keep their current doctors if the plan were passed, whether it would provide insurance at a lower cost, or that it would not add to the nation’s deficit. On each point he said simply that those were the administration’s goals.”

Of course not because no one knows, least of all writers of the bill. It was not been submitted to the Congressional Budget office for scoring, as is customary for any new bill.

Republicans, who control both the House and the Senate, expect Congress to vote on the bill by mid-April. President Trump supports it even though, as quoted by the Washington Post, he said in January:

“'We’re going to have insurance for everybody,' Trump said. 'There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.' People covered under the law 'can expect to have great health care. It will be in a much simplified form. Much less expensive and much better.'"

Which, like his other campaign promises so far, is apparently dead. Maybe he never meant it to begin with. It is said that the president will fly here and there across the country to promote the bill. I wonder what he will tell his voters who expected not the lose the coverage they have now.

Let's give Nancy Altman that last word today:

”The truth is that all of these cuts [in the healthcare bill] are entirely unnecessary. In fact, Medicare should be expanded to cover all of us.

“Medicare and Medicaid are more efficient than private insurance. Other nations are able to provide health care as a right, at a fraction of the cost with better health outcomes.

“We should be building on the successes of Medicare and Medicaid and the cost savings measures of the ACA. But instead, Republicans in Congress want to take us backwards.”