I’ll get into the weeds in a moment, but the key to this analysis, as golf pros say to putters who are over-focusing on the nuances of the green, is to “not give up the hole.”
The reason this bill is unfixable is because its basic structure will cause millions of economically vulnerable people to lose health coverage, raise individual premiums by 20 percent, and allow insurers to drop essential benefits like maternity care and substance abuse treatment, all while cutting taxes for the wealthiest households, drug companies and insurers.
Some of the tweaks will delay or slightly dampen those effects, but a slightly less terrible bill is still a terrible bill.
Here’s what’s changed in their new bill, along with brief commentary about why each change fails to solve a fundamental problem.
The Cruz amendment.
It’s a stone-cold recipe for adverse selection, as it allows states to revert to “medical underwriting” – i.e., charging higher premiums or denying coverage based on health history (including preexisting conditions), as long as they have at least one Obamacare-style plan in place.
“Under such a system, healthier people would naturally gravitate toward underwritten plans, which would offer them lower premiums. Meanwhile, the community-rated plans would disproportionately enroll people with expensive preexisting conditions, and insurers would price them accordingly.”
Adding $45 billion for treating opioid…
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