I gave a talk to a Rotary Club in Reno last month in which I told my audience that Obamacare would become Trumpcare and look much the same, but with improvements.
The basis for my opinion was that President Donald Trump promised to make the health care plan better and more affordable in an interview on “60 Minutes” after his election. He also made the promise on the campaign trail which likely led to a lot of folks voting for him and getting him elected.
The fact he pushed a plan that would cut 24 million out of health care due to the cost, broke that promise and led to defeat of the plan.
As I said before the election, whoever gets in will have to tweak Obamacare and get rid of the flaws. But it could not dump 20 million from the health care rolls without a loud protest.
That loud protest care from the grassroots and also within the Republican Party itself. The Koch brothers, strong conservatives, were against it because it was not going to achieve what Trump had promised. The plan would cut subsidies, give the ultra-rich a tax rate by canceling funding for the health care plan that include a .9 percent tax on those making income over $500,000, and leave older Americans to pay far more for their insurance with less subsidy. It called for those over 55 to pay as much as fives times what those in their 20s would pay as opposed to no more than three times as stipulated in the Obamacare plan. It also would have cut millions out of Medicaid, leaving them uninsured.
When the Republicans pulled the plan on Friday, Speaker Paul Ryan admitted that Obamacare is here to stay, for now. The reason? Insurance companies need to file proposals for 2018 this spring and there simply is not time to push a plan through that would gain enough votes for passage before they file their proposals for 2018.
So they have to work within the framework of Obamacare, rather than canceling it.
What is needed is a bipartisan approach where the Republicans work with the Democrats to make it what Trump promised — better and cost less.
Having written plans on Obamacare for every year of its existence, I am in position to suggest some changes that are needed to make the plan better.
Come up with riders for coverage such as maternity care. Someone who is not likely to need maternity care should not have to pay for it. Those who are considering having children would gladly pay extra to make sure it is covered. The same could be true for preventive tests that are now a mandatory part of the plan. The idea was good on preventive tests — to catch problems early and save lives and avoid catastrophic expense, but the need is not as much for some as it is for others. Where a colonoscopy used to cost $3,000, it is now free under the plan. Those in their 20s would not need such test. Nor would men ever need mammograms or pap smears or women need a PSA test. Let each kind of test be a rider that folks would pay for, if they foresee a need. That, in itself, would reduce costs.
Another sticky issue was that if a spouse had coverage through his business and the insurance offered through that business was affordable to him, it would also be considered affordable to his wife and children. Often, the spouse is subsidized by his company but his wife and children would not be and the cost to them would be unaffordable.
An example: I had a customer in Winnemucca whose husband worked for the city and had his insurance for $100 a month, while the cost for the wife and one child would have been $800 — all on a family income of $40,000. While getting just over $3,000 a month, the insurance would have been $900 a month or 30 percent of the family income.
What needs to happen is that the spouse and children be given the choice of either buying the insurance through the husband’s company or be allowed to go the marketplace and be eligible for a subsidy — something that is not now allowed.
The Republicans need to regroup, invite the Democrats in and invite health care experts to testify as to what is needed to make things right.
Taking money away from Obamacare is not going to fix the problem. Only a serious, bipartisan approach will.
President Trump needs to lead this call and not try to force a bill that does not do what he promised down the throats of needy Americans.
Ron Bliss is an independent insurance agent who assists individuals with healthcare of all types. You can reach him at 775-224-7169.
