Monday, June 26, 2017

Health Care Reform Rhetoric

The Health care reform bills currently being considered in Congress have generated an avalanche of political posturing and outrageous claims on the part of the Democrat opposition. Even though they tacitly and sometimes openly admit that the ever increasing premiums and deductibles of Obamacare are unsustainable, they argue that the Republican reforms are even worse.

Let’s examine some of their objections.

Both the bill passed by the House of Representatives and the one now under consideration in the Senate came under severe criticism because of reports from the Congressional Budget Office (CBO) that between 15 and 20 million people would lose their health insurance. Political commentators and Democrat politicians were quick to jump on this estimate and paint the Trump administration and the Republicans as big, bad, meanies out to pull the rug out beneath the Nation’s needy.  

Yet, even the CBO admits that the majority of those who will lose their coverage will voluntarily drop their coverage once they will no longer be forced to buy it or pay a cash penalty. President Obama promised people they could keep their policies if they liked them, but Obamacare forced them to surrender those policies. Obamacare then forced millions of people who did not want medical insurance or felt they did not need it to buy it. It is hard to blame them since the high deductibles and premiums seemed a bad deal. In fact, millions of people chose to pay the tax penalty rather than buy those Obamacare policies.  

Opponents of the Republican bills also claim that millions of American currently on Medicaid will lose their medical benefits. However, it would appear that they are not talking about the poor and needy. Apparently, those threatened are former members of the upper and middle classes who now reside in nursing homes and whose care is paid for by Medicaid.

For decades eldercare lawyers and financial planners have been advising well-to-do clients to give away their assets to family members or family trusts before they get infirm enough to go into a nursing home. Since the government will pay their costs, their families can retain the often considerable assets of their elderly parents. Why, these advisors reason, should such assets be used for nursing home care, when, if done properly, the government will pick up the cost.

States have been long aware of these tactics and though they have tried to restrict their use and prevent last minute asset giveaways. Some States have even given tax incentives to residents who purchase nursing home care insurance policies in the hope that these insureds will stay off the Medicaid rolls. Nursing home costs are the largest part of any State’s Medicaid bill. So, who is the real victim here? It’s too bad that when people think the government will pick up the tab, it never occurs to them that their neighbors are footing the bill, or that the money could have been used for the real poor.

Actually, it does not appear that the Republican bills will directly deal with this practice. Rather, they want to give block grants to the States so that the States themselves can decide how best to deal with their poor and elderly.

Finally, how can anyone with a straight face claim that the Republican health care reform efforts lack transparency? The proposals are out there for anyone to see and criticize even though Democrats like my own Senators and representative in Connecticut have made it clear that they oppose any reform measures. What ever happened to the Nancy Pelosi strategy of passing the bill before reading it?


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