Nice summary from Ways and Means on proposed changes to ACA released today...

[MBSC]

But I wonder if you have to have a high deductible plan to contribute to HSA account.

Once the 'new' tax credits start in 2020, if your premium is less than the credit you can direct the excess credits to an HSA account even if the health plan is not HSA eligible.

Regular HSA contributions will still require an HSA eligible HDHP that meets current guidelines. The proposed bill does not change the qualifying criteria of an HSA eligible HDHP. An amendment to the bill could change this.

The current proposal hastens the Medicare Trust Fund exhaustion by about 4 years.(snip) I just noticed that means the trust runs out of money before instead of after I qualify, and long before my wife qualifies. If I have to adjust our budget for no Medicare I should probably be working on my resume not posting here.

Medicare does not 'go away' when the Part A Trust Fund runs out. They will still collect payroll taxes (Part A) and premiums (Part B) beyond that point. Those revenue streams will allow Medicare to meet most of its Part A obligations and all of its Part B obligations after that time.

In their 2016 report, the Medicare trustees project that the HI Trust Fund (Part A) will be exhausted in 2028. At that time, HI (Part A) would continue to receive tax income sufficient to pay for 87% of Part A expenses.

Because of the way it is financed, the SMI Trust Fund (Part B) cannot become insolvent.

Reference: https://fas.org/sgp/crs/misc/RS20946.pdf

 

[zinger1457]

Once the 'new' tax credits start in 2020, if your premium is less than the credit you can direct the excess credits to an HSA account even if the health plan is not HSA eligible.

I'm guessing not too many people are going to end up with excess credits to deposit in their HSA, my current HSA HDHP premium is 2.5X what the maximum available tax credit would be.

 

[GTFan]

This was a real eye opener showing county by county differences ...

Tax Credits under the Affordable Care Act vs. the American Health Care Act: An Interactive Map | The Henry J. Kaiser Family Foundation

Yep, plug in the $20k a year 60-year old and you see how massive the impact will be no matter where you look. And that doesn't even factor in the new premiums with 5:1 or the elimination of CSRs.

<mod edit>

 

[Fedup]

The Brookings article was not about the current repeal plan - just what would happen if the taxes that extended the Medicare trust fund were repealed, which does seem to be in the current GOP plan. Are any of those ways of alternate funding in the current GOP ACA repeal plan? If so do you have a source? I've not read any articles that the Medicare funding would be replaced.

A former administrator of the Centers for Medicare and Medicaid Services wrote in the Chicago Tribune that the current GOP ACA repeal bill would cut several years from the life of the Medicare trust fund.

It's in your article, read the whole article. Yes it's .9% tax on Medicare is repealed but they also discussed many ways that the funding can be replaced.

 

[explanade]

AARP raises alarm about premium increases for seniors:

55-year-old first-time voter who chose Trump protests large increase in health costs - ABC News

AARP, a group that advocates for senior citizens and other older Americans, shares her concern. The organization sent a letter to Congress yesterday saying the proposed bill would "dramatically increase health care costs for Americans aged 50-64."

Many seniors could face a significant increase in health care premiums, since insurance companies will be allowed to charge seniors five times as much as for younger people for a comparable plan. Under the current Affordable Care Act (ACA), insurers are limited to charging three times as much. The tax credits proposed in the AHCA, which would be dispensed mainly on the basis of age and income, would be smaller for older Americans compared with under the ACA, making insurance even more expensive for them.

"Taken together, premiums for older adults could increase by as much as $3,600 for a 55-year-old earning $25,000 a year, $7,000 for a 64-year-old earning $25,000 a year and up to $8,400 for a 64-year-old earning $15,000 a year," AARP said in its letter. The group said a typical senior seeking insurance on a state exchange has an annual income under $25,000.

David Certner, the legislative counsel and legislative policy director for government affairs at AARP, said the plan will "stunningly raise" premiums for older Americans.

 

[daylatedollarshort]

It's in your article, read the whole article. Yes it's .9% tax on Medicare is repealed but they also discussed many ways that the funding can be replaced.

Those ways are not in the current repeal plan. The Brookings article was from December, 2016, before the current GOP repeal plan was released. If the funding that extended the Medicare Trust fund by four years is removed and not replaced, then I believe it is basic math, not speculation, that the Medicare trust fund will run out 4 years sooner (some articles quote a 3 year figure). As before, please let me know if you have any sources stating otherwise.

The AARP's position here:
"We have serious concerns that the American Health Care Act repeals provisions in current law that have strengthened Medicare's fiscal outlook, specifically, the repeal of the additional 0.9 percent payroll tax on higher-income workers. Repealing this provision could hasten the insolvency of Medicare by up to 4 years and diminish Medicare's ability to pay for services in the future.
http://www.middletowntranscript.com/news/20170309/aarp-video-gop-trumpcare-dramatically-increases-medical-costs-for-americans-50-64

Edited to change the link to AARP position.

 

[Ronstar]

The moderator team finds that this thread is becoming too political in that a few partisan jabs have been launched.

A few posts have been edited in an attempt to steer the thread back on course. We realize the importance of the topic to the membership, and hope that we can restrain from blaming either administration for shortcomings. Please refrain from partisan political comments in future posts.

 

[Fedup]

Those ways are not in the current repeal plan. The Brookings article was from December, 2016, before the current GOP repeal plan was released. If the funding that extended the Medicare Trust fund by four years is removed and not replaced, then I believe it is basic math, not speculation, that the Medicare trust fund will run out 4 years sooner (some articles quote a 3 year figure). As before, please let me know if you have any sources stating otherwise.

More info here:
"Repealing the Medicare tax would also speed up the depletion of the Medicare trust fund. It would run out of money in 2025 instead of 2028, as is currently projected, said Senator Ron Wyden of Oregon, the top Democrat on the Senate Finance Committee."
Source:
Trump's Republican Obamacare repeal plan a $US600 billion tax cut for the wealthy - Donald Trump's America - ABC News (Australian Broadcasting Corporation)

Like I wrote you need to reread your link. The increase in Medicare rate was what save Medicare for 4 years. It's hard to role back entitlement. I don't know how else to say it without getting too political. It's not because of the ACA plan is better than the AHA. Of course if that's how you want to save any program. But what about economics growth from AHA that might help shore up Medicare plan.

 

[Fedup]

AARP raises alarm about premium increases for seniors:

55-year-old first-time voter who chose Trump protests large increase in health costs - ABC News

I'm not surprised about this from AARP, they advocate for ACA.

 

[Meadbh]

No domestic wines in Canada right, all imported?

Not quite. Canada's wine industry currently contributes $9 Billion CAD per year to the economy. I live in one of the major wine producing regions.

Canadian wine industry contributes $9 Billion in economic impact to Canadian economy

 

[daylatedollarshort]

The increase in Medicare rate was what save Medicare for 4 years.

I agree. That was the point of my prior posts.

 

[MRG]

Not quite. Canada's wine industry currently contributes $9 Billion CAD per year to the economy. I live in one of the major wine producing regions.

Canadian wine industry contributes $9 Billion in economic impact to Canadian economy

I thought there was good Canadian wine. I spent a lot of growing up years in upper NY and lower Ontario, I thought there were great grapes in both areas. The NY area is now big wine country, I haven't been back to Ontario.

 

[Meadbh]

I thought there was good Canadian wine. I spent a lot of growing up years in upper NY and lower Ontario, I thought there were great grapes in both areas. The NY area is now big wine country, I haven't been back to Ontario.

Maybe you should come and visit BC.

USA Today Readers Choose Okanagan Valley as Top Wine Region

 

[Meadbh]

The costs of healthcare in Canada are subsidized by higher prices on other goods. For example, some snowbird friends of ours from Canada pay $40.00 for a cheapo bottle of wine that sells less than $10.00 here.

Three things.

1. Whatever about one bottle of wine, I would dispute the generalization that the cost of goods sold in Canada is four times that in the US.

Canada Among Most Expensive Countries, But It's No Australia

2. There are many reasons why the cost of goods and services may be higher in Canada, and universal healthcare is only one of them. Consider, for example, the cost of transportation to remote areas.

3. The actual per capita cost of healthcare in Canada is considerably less than in the US.

https://en.m.wikipedia.org/wiki/Comparison_of_the_healthcare_systems_in_Canada_and_the_United_States

 

[MRG]

Maybe you should come and visit BC.

USA Today Readers Choose Okanagan Valley as Top Wine Region

We have one time. Stayed in Vancouver and Vancouver Island, loved it. We toured a few small Gulf Islands and they were awesome. I went salmon fishing and caught an incredible view of a Bald Eagle.

Obviously we saw half of one percent.

 

[explanade]

I'm not surprised about this from AARP, they advocate for ACA.

But is their analysis wrong?

This plan would allow insurers to charge higher premiums to older people than is currently the case.

 

[explanade]

Maybe you should come and visit BC.

USA Today Readers Choose Okanagan Valley as Top Wine Region

Maybe it's a relatively recent development, with climate change?

I thought you needed some amount of sun for winemaking regions.

Australian wine can be cheap but New Zealand wine is price, though they get great reviews.

 

[TreeHugger]

But is their analysis wrong?

This plan would allow insurers to charge higher premiums to older people than is currently the case.

Perhaps that can be somewhat regulated by a state laws.

Anyways Tax Credits under the Affordable Care Act vs. the American Health Care Act: An Interactive Map | The Henry J. Kaiser Family Foundation tells us that nearly all people in New York, Massachusetts or Washington will benefit and states like Arizona/Nebraska will take it in a chin.

 

[Meadbh]

Maybe it's a relatively recent development, with climate change?

I thought you needed some amount of sun for winemaking regions.

Australian wine can be cheap but New Zealand wine is price, though they get great reviews.

Summers are quite hot and sunny here. It has been a fruit growing region for decades. Market forces have transformed the local economy. Too detailed to go into here.

There are clearly many misconceptions about Canada.

Now back to regularly scheduled programming on the subject of this thread.

 

[audreyh1]

Maybe it's a relatively recent development, with climate change?

I thought you needed some amount of sun for winemaking regions.

Australian wine can be cheap but New Zealand wine is price, though they get great reviews.

There is a huge wine growing area just south of Canada in the US. The Columbia River Valley - very hot sunny summers.

 

[rodi]

I watched the tutorial that Paul Ryan presented today. My ears perked up when he started talking about state risk pools - something discussed here.

It sounds like you can get "regular" insurance as long as you're not sick. But if you get cancer, you'll be moved to the state risk pool insurance. He gave an example of a small company with a pool of 40 people. 36 are healthy and 4 have cancer... the four are moved to the state run risk pool in order to keep the costs down for the remaining 36.

Still digesting what this means... Sounds great (lower costs) for the healthy - but heaven forbid you actually need the insurance because you get heart disease or cancer...

 

[samclem]

This plan would allow insurers to charge higher premiums to older people than is currently the case.

Let's be precise and accurate, because this is a complicated subject that deserves it. The new plan changes the allowable difference in premiums between what young people pay and what older people pay. It was a 1:3 ratio, it will now be 1:5. Nobody knows if the actual premiums, in dollars, paid by old people will be higher.
The later stages of the transition have elements to reduce all premiums. Those elements can't in this legislation because the intent is to pass this present bill using the "reconcilliation" process, and only legislation that primarily affects the government budget can be passed under "reconciliation."

 

[explanade]

Let's be precise and accurate, because this is a complicated subject that deserves it. The new plan changes the allowable difference in premiums between what young people pay and what older people pay. It was a 1:3 ratio, it will mow be 1:5. Nobody knows if the actual premiums, in dollars, paid by old people will be higher
The later stages of the transition have elements to reduce all premium.

Well I have no doubt that insurers will charge older enrollees more than younger ones.

You're suggesting they can charge more but won't?

Now maybe they will offer much more bare-bones plans than the ACA. Maybe we'll get catastrophic plans by another name with a lot of exclusions. That's how they can lower the premiums, because they will cover fewer diseases or conditions and thus pay out less.

But there's no doubt that they will aim for a differential between young and old.

 

[Johanson]

When obamacare was being debated and before it became law, I said that forcing more people to buy medical insurance will do nothing to stop the rise in healthcare costs. If anything, it will increase it because the health care industry now has more customers.

Having said that, I still see nothing about getting healthcare costs under control with the new plan and it's still has nothing to do with healthcare. It has everything to do with healthcare insurance. I would make H-1B visas unlimited for healthcare workers with no minimum wage other than the FMW along with an expedited path to citizenship. I would raise the HSA limit by at least 3 times. I would totally eliminate the insurance mandate. I would also change FDA regs and have tort reform for medical malpractice.

 

[Fermion]

How does raising the HSA limit help poor people though? If your family income is $30,000 a year, does it matter if you can contribute $6,000 or $18,000 to an HSA?