One thing Hillary Clinton does well is say a whole lot of nothing. We heard her stumbling attempt to discredit the questioner at the CNN Town Hall when her advice boiled down to, "Keep shopping," http://conoutofconsumer.blogspot.com/2016/03/hillarys-idea-for-obamacare-reform-keep.html.
While the Republicans implode, handing Clinton the presidency, consumers must prepare for more of the same and worse when it comes to Obamacare. That's not political, it's fact. The flaws in the law that have amply evidenced themselves in the years since its passage promise to further reveal the misguided philosophies of Obamacare moving forward.
By now, we do or should know that Obamacare's affordability concerns focus on how much is paid out on behalf of consumers, not on how much is paid BY consumers. While depending on your view you argue that things WOULD HAVE been worse without it or WOULD NOT HAVE been worse without the law, it is clear that the law neither held costs for consumers of needed health services down nor held the costs to consumers for health insurance down.
Though this is not what we were told, this is what Obamacare is and every success cited by Obama's Administration about how per capita spending by payers on patient consumers is down is based on that motivation---saving them, not us--money. Hillary plans to perpetuate the cost-saving strategies and tactics used to reduce spending on patient consumers for health care, "building on delivery system reforms in the Affordable Care Act that improve value and quality care for Americans."
Hillary plans to lower the out-of-pocket expenses for Obamacare exchange users by providing "enhanced relief for people on the exchanges, and provide a tax credit of up to $5,000 per family to offset a portion of excessive out-of-pocket and premium costs above 5% of their income," https://www.hillaryclinton.com/issues/health-care/.
First, you should notice that the relief is only for exchange users. Second you can't help but notice the use of the term "credit." "...tax credits directly reduce a person’s tax liability and hence have the same value for all taxpayers with tax liability at least equal to the credit. In addition, some credits are refundable; they are not limited by the taxpayer’s tax liability," http://www.taxpolicycenter.org/briefing-book/background/issues/credits.cfm.
The Obamacare exchange entitlement expands. But there is no "promise" or "plan" to make those Obamacare entitlement payments based on total ASSETS rather than income so that even millionaires who are currently eligible for Obamacare if they can fudge their income to fall within Obamacare income requirements can currently get the federal entitlement, but now under Hillary these same individuals would be eligible for a $5,000 tax credit, not available to the rest of us outside the exchanges. We know that the rich got richer and everyone else's lifestyle dropped under Obama, this is one reason why.
Clearly aware that she's omitting the population NOT on Obamacare exchanges, Hillary's "plan" ends with her goal to "…fix the 'family glitch' so that families can access coverage when their employer’s family plan premium is too expensive."
Beware the words "can access coverage" which to me are obviously indicative of an effort to move MORE people onto exchanges by creating an opportunity for individuals to opt out of employer provided health insurance that charges too much for family members since there are only limits on what percentage of an employee's income can be taken for health insurance, not on how much can be stolen from the employee for family coverage.
This "can access coverage" will do two things for Clinton and against consumers, one, incentivize employers to continue family glitch practices so that individual employees cannot afford health insurance for their families by creating an "opportunity" to move those families to exchanges AND forcing more individuals onto exchanges will boost those Obama enrollment numbers that the government relies on to prove "success."
What Clinton fails to consider is one of the reasons Obamacare fails--by forcing us all to purchase the financial product of health insurance, an idea originally created by health insurers as a means of making covering pre-existing conditions possible because they'd be getting more money from a bigger pool of people, we've ALREADY SEEN that those guaranteed customers were good for a single year of controlling health insurance costs as greedy insurers cried poor and raised Obamacare plan rates overall about eight percent just this year.
Clinton's idea for forcing more families onto exchanges as a "fix" to the family "glitch" will also result in more rate hikes of plans on exchanges because after forcing new populations onto exchanges insurers will again cry poor and raise rates. The only fix is to remove the individual mandate to incentivize insurers to provide plans that people can vote for with their dollars and their feet.
Hillary's next idea: Extend the massive payouts of the Federal government for Medicaid by incentivizing late adoption of expanded Medicaid with a promise to "…allow any state that signs up for the Medicaid expansion to receive a 100 percent match for the first three years." The deal the states got under Obamacare was similar with the proviso that federal payments would never be LESS than 90 percent of the costs from 2020 on (http://www.cbpp.org/research/how-health-reforms-medicaid-expansion-will-impact-state-budgets).
Hillary intends to duplicate the Obamacare expanded Medicaid offer for late adopters except as she offers her 100 percent reimbursement, first she doesn't have a bottom number, how low the reimbursement will drop after the first three years (Obamacare permits down to 90 percent and no further) and second, she doesn't address the MANDATORY recovery of Medicaid expenses from the estate of those who use Medicaid after the age of 55 ("For individuals age 55 or older, states are required to seek recovery of payments from the individual's estate…" https://www.medicaid.gov/medicaid-chip-program-information/by-topics/eligibility/estate-recovery.html).
Remember, states NOW have the option to pursue the estate of anyone who uses Medicaid but because those recovery payments are shared with states and federal government though the state incurs the expense of going after the money, states have not previously exercised this option because prior to Obamacare Medicaid was typically used by people with limited assets. Under Obamacare, by expanding Medicaid, the likelihood that those with assets will somehow be eligible is more likely which might incentivize states to go after everyone. Regardless of a state's desires to go after everyone on Medicaid's estates, they are obligate by law to go after the estates of those 55 and over who use Medicaid.
In terms of lowering out-of-pocket costs to consumers, there are no plans--simply a statement, "Hillary believes that workers should share in slower growth of national health care spending through lower costs." Obamacare has proven without imagination that the old insurance practice of either reducing coverage or raising prices or both is the way they protect their bottom line and Hillary Clinton is silent on meaningful cost controls such as changing the 80-20 rule to incentivize insurers to actively reduce payer spending on fraud.
Clinton also omits any discussion of a promise to go after fraudulent payments made by the government including those under Obamacare.
Underinsurance is NOT addressed by Clinton. An out-of-pocket maximum that is burdensome to Americans is NOT addressed by Clinton (except for exchange users who get the $5,000 credit). Millionaire handouts under premium assistance because those payments are based on income rather than assets are not addressed by Clinton. Covering male physicals is not addressed by Clinton. She is truly going to perpetuate and expand Obamacare if she has her way, not address a single problem in a meaningful way.
