The Battle of the WHAT IFs is the Democrats' STRONGEST argument for the failed policy of Obamacare and on July 8, 2016, The Huffington Post did not disappoint: "18 Million People COULD Lose Health Insurance Under President Trump," Jonathan Cohn, http://www.huffingtonpost.com/entry/donald-trump-obamacare_us_577f0925e4b01edea78d4d8d. [Skip to the bottom of the story and the editor adds: "Donald Trump incites political violence, is a serial liar, rampant xenophobe, racist, misogynist and birther," that should clarify what you're getting.]
Consumers SHOULD neither be baited by nor afraid of the What Ifs, but persuaded and guided by the WHAT IS when it comes to Obamacare. Mr. Cohn's story has one valuable point to make for consumers: Donald Trump must clarify how pre-existing conditions will impact the availability of health insurance. That's it.
Working from the original false promise of getting the alleged 47 million uninsured insurance, we've seen years of misstated, restated and guesstimated number of people who have gotten health insurance "thanks" to Obamacare. It is in this fanciful world of be-afraid-of-anything-but-Obamacare that Mr. Cohn concocts his 18 million in jeopardy of maybe losing health insurance without Obamacare.
OK, so we'll forget the original scam of the 47 million and go to the new proposal of the 18 million---18 million out of 47 million, apparently at its best Obamacare is the 38% solution.
So what's Mr. Cohn basing his WHAT IF scenario on? A single-page campaign outline of ideas for reform by Trump https://www.donaldjtrump.com/positions/healthcare-reform and a WHAT IF consideration of possible outcomes offered by the CENTER FOR HEALTH AND ECONOMY (http://healthandeconomy.org/healthcare-reform-to-make-america-great-again/) that warns that its report is based on Trump's proposal which is "vague on the specifics," and that its results are "associated with some degree of uncertainty."
Back to Mr. Cohn and his story. Clearly unable to commit to 18 million, (18 million COULD,) Mr. Cohn is also seemingly unable to discern WHICH individuals are in peril but as with all Obamacare Enrollment Fetishists, those resorting to enrollment as the ultimate "proof" of Obamacare, Mr. Cohn lumps all those people of uncertain number together to come up with 18 million.
Naturally, not all 18 million people would lose health insurance without Obamacare simply because 18 MILLION haven't gained health insurance because of Obamacare. Even this paltry number is not confirmed.
We know that SOME people who have health insurance who might not without Obamacare because the law FORCES people with income to purchase the consumer financial product of health insurance or face a fine, that's the individual mandate. Conceivably, without Obamacare some might choose to NOT purchase health insurance once the penalty of a fine was lifted.
We also know that Obamacare boosted "enrollment" by providing that employed parents could pay for and carry their adult children on their policies up through the age of 26. Considering the unemployment situation, if getting people insured was the consideration, ANYONE should have been allowed to pay for another adult's health insurance and deduct the COSTS of health insurance they purchase for another, that would have boosted enrollment and encourage people to "care about each other."
Instead, Obamacare included the family glitch which allows insurers to charge employed individuals up to 9.5 percent of their income for their own health insurance and includes NO LIMIT on how much they can charge to those employees to cover their family members--sky's the limit with the result that employed Americans can sometimes not afford to purchase family health insurance--the family glitch. Further, the up to age 26 provision was already in place in many states and under many policies BEFORE Obamacare.
Then there's the number of individuals who benefited from expanded Medicaid, which like the number of uninsured (remember the 47 million?) was an inflated number as reported in May, which number has now been changed downward because it turns out that MILLIONS of those people were eligible before Obamacare for Medicaid, (http://www.usnews.com/news/articles/2016-05-02/obamacare-rolls-swell-with-sign-ups-who-didnt-need-the-law).
Finally, the serially disappointing number of enrollees in exchange plans which this year is estimated by the government to be "about 10 million people for the end of 2016," https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-06-30.html.
OK, so the 18 million number COULD be and is likely WRONG, just as the 47 million uninsured was exaggerated according to the government "…CBO and JCT estimate that fewer people would be uninsured in the absence of the ACA…” (Pub. 49973 page 22, 2015), just like the number who COULD be denied coverage based on pre-existing conditions was exaggerated, (February 4, 2011, Lori Robertson for Factcheck answered the question: "Is it true — as the Obama administration claims — that '129 million Americans with a pre-existing condition could be denied coverage without new health reform law'?" Answer: "No." http://www.factcheck.org/2011/02/millions-with-preexisting-conditions/.)
Cohn does point out a point worth pinning Mr. Trump down on which is including a prohibition for denials of health insurance for those with pre-existing conditions. So far, this has been a fiasco and neither Republicans nor Democrats have addressed it reasonably.
The deal (created by insurance companies in 2008) was that insurance companies wouldn't deny those with pre-existing conditions as long as the government forced everyone who could to buy health insurance--the individual mandate. The Republican plan preserves this coupling by talking about "continuous coverage," but does mention that in the event of a lapse that those with pre-existing conditions could not be denied insurance but would pay more (See the Better Way Plan). But Mr. Trump doesn't address pre-existing conditions so let's push for RATIONAL coverage.
Obamacare originally promised no denials for pre-existing conditions but then created the upside down world of Obama with a PREFERENCE for those with pre-existing conditions, choosing to PROHIBIT higher premiums charged to individuals based on anticipated insurance costs and INSTEAD deciding to single out tobacco users, old people and younger people (whose premiums are a 1:3 ratio based on what's charged to older people) for higher premiums.
Obamacare left us with the weird discriminatory situation where people with PROVEN higher costs, women of childbearing age, those with pre-existing conditions, prescription and non-prescription drug addicts, the obese, alcoholics, and those with pre-existing conditions COULD NOT be charged more in premiums but those whose costs were ANTICIPATED TO BE MORE, older people and tobacco users COULD BE.
In plain English, the discriminatory preference for those with pre-existing conditions under Obamacare and the continuous coverage or pay more provision under the Republican Better Way plan both are bad for consumers.
Instead there should be mandatory coverage of those with pre-existing conditions, no one can be turned down, but those with pre-existing conditions, like other statistically more expensive groups including women of childbearing age, obese people, drug addicted individuals (legal or illegal drugs), drug using individuals, as well as older people and tobacco users will pay more within limits, 1.5 times premium or something like that.
Trump MUST clarify his approach to pre-existing conditions.
Mr. Cohn reluctantly acknowledges that the WHAT IF report he relies on predicts, on the positive side, a result that "Premiums for people buying coverage on their own would generally come down, the report says, while insurers would probably give beneficiaries access to more doctors and hospitals than the plans currently on the market do."
So, like any good Obamacare fetishist, Mr. Cohn resorts to the same old ENROLLMENT fallacy to scare people away from these positives back to the "Obamacare 38% or less enrollment solution."
Mr. Cohn worries that "Older people, as well as people with pre-existing conditions, would end up paying more for insurance. And many of them couldn’t get coverage at all." I've already stated that Mr. Trump must commit to a prohibition against DENIAL of insurance coverage.
Regarding OLDER PEOPLE, it's hard to believe that Mr. Cohn had the ignorance, nerve or both to assert that OLD people should be more afraid than now.
Obamacare and the Obama Administration have been singularly hostile to older people who are ALREADY paying more as per Obamacare's special provision that OLDER people can be charged more in health insurance premiums.
Mr. Cohn obviously hasn't read through the provisions of the PPACA designed to reduce Medicare spending (and increase consumer out-of-pocket spending by older people for health services) over the next 10 years.
Mr. Cohn obviously didn't notice that CMS has decided to PAY Medicare providers to counsel old people on end of life including a consideration of whether fighting for their lives is worth it, (http://www.medscape.com/viewarticle/853541, October, 2015).
Mr. Cohn obviously didn't notice that after forcing old people to spend more on their health insurance (not crack users, heroin addicts, morbidly obese, women having children, just old people and tobacco users), slashing Medicare by demanding more old people pay-in (yeah, entitlement after a lifetime of paying in), and paying providers to tell old people to die, that Obama still wasn't done with his hatred and under his leadership this year there was no Cost of Living Adjustment for Social Security recipients: "It is only the third time in 40 years — all of them during the Obama administration — that the Social Security Administration has not increased its payments," Washington Post , Lisa Rein, 10/15/2015.
Mr. Cohn's adolescent Dystopia goes further whining that maternity care and mental health benefits would no longer be deemed "essential." The "essential health benefits," of which Mr. Cohn speaks are part of the special legislative and discriminatory legislation of Obamacare, requiring everyone to pay more for health plans so that all insurance plans cover these 10 essential health benefits (http://obamacarefacts.com/essential-health-benefits/).
While STANDARDS are good, discriminatory standards are not. Under Obamacare, older people who can be charged 1.5 times more than anyone else AND have to also pay more so that their health insurance pays for MATERNITY coverage for women of child-bearing age is absurd. (essential benefit 4). Why should PARENTS who have to purchase FAMILY insurance in order to get their children covered also have to purchase individual health care plans that cover PEDIATRIC SERVICES? (essential benefit 10). Why should males who are ineligible for an annual physical have to pay for FEMALES to have one? Or males who have to PAY for sterilization be required to PAY for health insurance that covers female sterilization? (essential benefit 9 of PREVENTIVE SERVICES which are free to users).
Under Obamacare the out-of-pocket expenses that consumers must pay for medical services has gone up and up every YEAR, next year's number of $7,150 (for an individual) $14,300 for a family which often excludes your premium expense, the amount of money you pay each month to keep your health insurance in force.
Vaguely, Mr. Cohn argues that "People relying on either federal assistance or federal programs for health insurance WOULD see that help dwindle or vanish altogether." No, as already established, FEWER PEOPLE THAN WE WERE CONNED INTO THINKING GOT health insurance from either expanded Medicaid OR Obamacare.
Medicaid already existed and would be unaffected by a repeal of Obamacare though naturally, states and the federal government could make changes to that law as they have always done.
What Mr. Cohn's really worried about is the demise of the ENTITLEMENT payments of Obamacare premium assistance and cost-sharing established under Obamacare that allows even the richest who can make their income fit within guidelines eligible for the government handout--You know the 10 million enrolled on Obamacare exchanges, 85 percent according to the government get the handout, or 8.5 million, meaning 18 percent of the original lie of 47 MILLION UNINSURED.
For this 18 percent solution, Mr. Cohn dismisses the needed tax relief that would come from Trump's proposal that allows EVERYONE to deduct health insurance expenses from their taxes, because "it would mean less federal money to help people get coverage."
Mr. Cohn goes into an argument against allowing insurance companies to sell insurance across state lines (effectively undermining any state regulations designed to make insurers live by the same sorts of rules). This idea has been floated before but the important issue is that STATES for DECADES have failed consumers in the health insurance area which is why there was an opening for NATIONAL laws to begin with. Just look at Obamacare's significant omission of reforming balance billing which allows non-network providers known or unknown to charge patients for amounts not covered by health insurance and see how many states have addressed this.
Naturally, Mr. Cohn throws in that medical debt seems to have gone down for which you should go no further than searching "Medical debt," to form your conclusions. Only if you've been lucky enough not to have become sick so that you've enjoyed the illusion of great coverage with your free stuff and never had to use health insurance as a financial product to help pay for NEEDED medical services might you be dumb enough to buy into this.
Mr. Cohn randomly throws in that in MA preventive care saves lives which under Obamacare I've also addressed where it's used as an excuse for insurers not only to justify premiums (in order to cover the free stuff) but often exposes the healthy to unnecessary and cascading referrals for testing, Forced Wellness, (http://conoutofconsumer.blogspot.com/2016/01/obamacares-forced-wellness.html).
Further, Mr. Cohn neatly avoids as does the CDC the recent confirmation that MEDICAL ERRORS are the third leading cause of death in the US (https://www.washingtonpost.com/news/to-your-health/wp/2016/05/03/researchers-medical-errors-now-third-leading-cause-of-death-in-united-states/, and elsewhere), more medical services, more odds you're affected.
In summary, yeah, Martians COULD land on Earth, Dogs COULD discover a cure for cancer, Meteors COULD wipe the EARTH out, and yes, Mr. Cohn, I suppose 18 million COULD lose coverage without Obamacare. Ridiculous.
