Old/Young Friendship

Elders and the Republican Healthcare Plan

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.

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Healthcare introduction

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.”


I think it should be called the Gullible American Healthcare Act or by its acronym GACHA.

It's Trumpcare... the "T" is silent, by the way.

"The Republican bill to repeal the ACA drains Medicare to gives tax breaks to wealthy Americans and corporations." That sentence explains the entire philosophy of the movement to change the Affordable Care Act. The politicians doing this are without shame or conscience. They are set on a path of destruction and no argument seems to touch them.

I finally turned 65 last December, and was so happy to get medicare. My husband died 11 years ago, and as a freelance writer/author, I had to buy insurance. It was a ten-year patchwork of care: COBRA, state high-risk pool, then thankfully the ACA went into effect. Even so, I've spent a small fortune on premiums over those years, and luckily, never had to use it for serious illness.

I really think this new health care plan will come as a huge surprise to some of the Trump supporters. They won't really get that it is ruinous for them until it kicks in, and then they will realize they've been had. When the majority of posters on Breitbart HATE it though, you can sense Trump's base is about to turn on him. Sigh.

Good one, Florence!

I do not understand why Republicans (speaking generally about politicians and those who vote for them because they agree with their philosophy) seem to hate poor people and others who cannot afford the high premiums, and don't think they are entitled to health care (among other necessities). To me this is foolish. It's like having a hole in your roof & not repairing it because you don't want to spend the money. Your roof is not going to repair itself, and the cost to repair it will just go up with time. In my state (Florida), people who cannot afford insurance (thank you Governor Scott) have to go to the hospital emergency room , where they are treated. The hospital doesn't get paid & the property taxes increase to cover that unreimbursed cost. (I sometimes think that some voters don't understand that piece of it.) Ask not for whom the bell tolls.

Trump has no clue as to what life is like for the average person, nor does he really care. All he wants is for the crowds to cheer for him; it's like a drug to him, which he craves.

Anyway, the sun is shining here, and the high is predicted to be 86 degrees. I cannot imagine what the temperature will be in August! (I tell myself that it is better than shoveling snow.)

I have been dumbstruck as to why we haven't been talking to England and Canada about how they manage healthcare for all - and for far less. No hope of that with this administration. I thought it a shame Obama's Democratic majority didn't press for single payer, but at least he got a plan through, and the GOP can't take all of it away without paying the price they deserve.

I wish Cara was right about Trump's base, but I continue to hear nothing but praise from the people I know who voted for him. It baffles me because these voters seem kind, caring and compassionate, but they all seem to have a bizarre fear of a trans-gender person walking into 'their' bathroom, and an illegal immigrant taking away their grandkid's job at McDonalds.

The gullible loons that get their news from FOX TV and Rush Limbaugh swallow whole fake news and vote accordingly. If only it were possible for all citizens to be forced to study the Constitution of the United States and the platform of the parties before casting their votes.

An informed electorate might have saved Democracy from the uninformed who are now amazed that that the government is not the one they thought they were voting for, but is cutting their benefits. If only they had paid attention to what has been happening for 50 years. If only they had listened and used their brains. If only ---.

Those of us who paid attention knew the Republican party have been determined to do away with S. S. and Medicare for years and because of the popularity of these programs have failed to do so. But they never give up and they have adopted the strategy of chipping away at them; thus eroding their popularity.

This is the first salvo to eliminate any kind of government health insurance (except, of course, their own Cadillac plans). If we don't fight for the ACA and stop this train wreck it will only get worse.

In my more advanced senior years I've come to believe the only people that Washington Republicans represent is themselves (and maybe their wealthiest donors) and their only purpose is to enrich themselves. As nearly as I can tell, that's what their healthcare bill is all about. They should be required to use whatever insurance plan they create.

Throwing the baby out with the bathwater is a horrible idea.

Sadly, many seniors (maybe not the ones on this site but a majority in many states) voted for Trump, Ryan, McConnell, Rand and other Republican candidates who are driving this repeal. They continue to vote against their best interest, failing to see beyond 1-2 issues. Now we will all suffer......the Republican party is not your friend. VOTE in 2018 and change the course.

The Republican (Ryan) health bill is designed to make Medicare insolvent as soon as possible.

The entire purpose of the Republican party these days is to lower taxes on rich people. They simply don't care when this hurts everyone else. I thought "tribal" societies at least took care of their own. Apparently no one is part of "their own" except rich people.

Of course the Repugnicans want to take us backward. That's the only direction they understand. They really don't give a rat's a** about anyone but their own fellow million- and billionaires. I think many residents of tRumpistan still don't fully realize what The Orange Apparition has in mind for them. They may not "get it" until they need healthcare--and it's just not there for them. Unfortunately, what affects tRumpistanians also affects the rest of us.

I agree that many of the 55-64 tRump voters will likely get hit the hardest under the proposed AHCA. Somewhere along the line, surely it will dawn on them that the Repugs definitely are NOT their friends, but by then it may be extremely difficult to undo the damage done.

The American Health Care Act, also known as ACHA? No, it also should be known as GOTTCHA!

As they insisted on calling the previous plan ObamaCare, perhaps you should call the new one, not TrumpCare, but TrumpCareless. Thus it could be interpreted as both Trump Careless and Trump Care Less.

Hello Ronnie -- Your post included a quote about the high cost of nursing home care, which few people want to have to endure, but given the weakness of aid in dying laws, even in states that allow it for critical illnesses, many people, especially Alzheimer's patients, will spend years in expensive nursing homes.

I don't know if you have the time or the inclination to do a post on the issue of costs of long term nursing home care. I have gathered (in an unsystematic way) that to qualify for government coverage of long care, a person &/or their spouse, has to have "spent down" their assets to something under $5,000 total, perhaps not including their house (unless the house is worth more than some amount). And if you try to "spend down" by giving away money to a child or a homeless sibling, the government counts that money as funds you could have saved and spent on the nursing home, so you need to wait five years after giving away any money to qualify even if you have gotten under the $5,000 asset bar.

Anyway if you ever felt like looking into this, some of us would be interested.

Smiling men with bad reputations. Ryan's Unaffordable healthcare. What an evil little creep. I sure hope he get his big cut under the table.

All good points Ronni. Sadly, things get passed and not until too late do people realize or sometimes never realize what they have lost.

And Darlene has a great paragraph that needs to be repeated.

"Those of us who paid attention knew the Republican party have been determined to do away with S. S. and Medicare for years and because of the popularity of these programs have failed to do so. But they never give up and they have adopted the strategy of chipping away at them; thus eroding their popularity."

I know its tough for aging, I am 62, but it takes a long time to fix this, if it can....

help seniors first, they suffer most from this horrible healthplan, check didabiled or ss through no choice of thei own first!! They are not rich, living on a fixed income. np ot or different jiob, they wait to die!!

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