This article is from the source 'guardian' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.
You can find the current article at its original source at https://www.theguardian.com/us-news/2016/nov/29/obamacare-trump-administration-tom-price-hhs
The article has changed 5 times. There is an RSS feed of changes available.
| Version 0 | Version 1 |
|---|---|
| What an Obamacare replacement could look like under Tom Price | What an Obamacare replacement could look like under Tom Price |
| (about 1 hour later) | |
| Donald Trump’s choice of Georgia congressman Tom Price as health and human services secretary suggests his campaign rhetoric attacking Obamacare was more than mere bluster. | Donald Trump’s choice of Georgia congressman Tom Price as health and human services secretary suggests his campaign rhetoric attacking Obamacare was more than mere bluster. |
| In Price’s 12 years in Congress, he has been a fierce critic of Barack Obama’s signature healthcare legislation while championing conservative proposals, such as selling insurance across state lines, replacing Medicare with a system of vouchers and transforming Medicaid into a block grant. A close ally of the House speaker, Paul Ryan, he has voted to repeal Obamacare dozens of times. | |
| Should he be confirmed by the Senate, Price would bring his conservative mentality – anti-abortion, anti-LGBT, anti-Obamacare – to the $1.1tn budget of the Department of Health and Human Services. | Should he be confirmed by the Senate, Price would bring his conservative mentality – anti-abortion, anti-LGBT, anti-Obamacare – to the $1.1tn budget of the Department of Health and Human Services. |
| However, even if Price is able to re-envision health policy, some experts believe he risks undermining benefits to some of the president-elect’s most ardent supporters. | However, even if Price is able to re-envision health policy, some experts believe he risks undermining benefits to some of the president-elect’s most ardent supporters. |
| Current estimates show that 20 million Americans gained health insurance as a result of Obamacare, either through individual exchanges, Medicaid or by allowing older children to stay on their parents’ plans. | Current estimates show that 20 million Americans gained health insurance as a result of Obamacare, either through individual exchanges, Medicaid or by allowing older children to stay on their parents’ plans. |
| That means Republicans are “between a rock and a hard place”, according to Professor Michael Sparer, chair of health policy at Columbia University’s Mailman School of Public Health. “How could we simultaneously keep our promise to repeal and replace the [Affordable Care Act] without leading to millions of newly uninsured folks, without facing a political backlash because of those newly uninsured folks, and without spending a whole lot of money?” said Sparer, outlining what he felt was the GOP position. “I think that’s not easy to do.” | |
| Some experts believe policies championed by Price could actually worsen health coverage for the poor and infirm, while benefiting the healthy and wealthy. | |
| During his time in Congress, Price made several proposals to replace Obamacare. His plans have included replacing the ACA’s “individual mandate” with tax credits and punitive “continuous coverage” requirements, allowing companies to sell insurance across state lines, and making Medicaid – which was expanded by the Affordable Care Act – a block grant program, which would give states more discretion in determining who and what to cover. | During his time in Congress, Price made several proposals to replace Obamacare. His plans have included replacing the ACA’s “individual mandate” with tax credits and punitive “continuous coverage” requirements, allowing companies to sell insurance across state lines, and making Medicaid – which was expanded by the Affordable Care Act – a block grant program, which would give states more discretion in determining who and what to cover. |
| Jonathan Oberlander, a professor at the University of North Carolina who studies health policy, said Price’s plan to repeal the “individual mandate” – the ACA requirement that people buy health insurance or suffer a tax penalty – was more severe than the current system; in a 2015 proposal, for example, Price suggested that if people do not maintain “continuous coverage” they be denied health insurance coverage for a pre-existing condition for up to 18 months after purchasing insurance, according to NPR. | Jonathan Oberlander, a professor at the University of North Carolina who studies health policy, said Price’s plan to repeal the “individual mandate” – the ACA requirement that people buy health insurance or suffer a tax penalty – was more severe than the current system; in a 2015 proposal, for example, Price suggested that if people do not maintain “continuous coverage” they be denied health insurance coverage for a pre-existing condition for up to 18 months after purchasing insurance, according to NPR. |
| Price’s proposed subsidies for individual insurance plans are also less generous. Currently the average subsidy is $3,480 a year, according to the Centers for Medicare and Medicaid, the federal body that administers the programs. The most generous tax credit in Price’s plan is $3,000 a year. | Price’s proposed subsidies for individual insurance plans are also less generous. Currently the average subsidy is $3,480 a year, according to the Centers for Medicare and Medicaid, the federal body that administers the programs. The most generous tax credit in Price’s plan is $3,000 a year. |
| Other proposals, such as selling insurance across state lines, could also disproportionately benefit the healthy, experts said. Purchasing across state lines could allow young people to purchase inexpensive, less comprehensive health plans, and leave a sicker population in highly regulated states. Proponents of selling insurance across state lines argue it increases competition. | Other proposals, such as selling insurance across state lines, could also disproportionately benefit the healthy, experts said. Purchasing across state lines could allow young people to purchase inexpensive, less comprehensive health plans, and leave a sicker population in highly regulated states. Proponents of selling insurance across state lines argue it increases competition. |
| “If you repeal the ACA and put one of those replacement plans into law, we’re going to go backwards,” said Oberlander. “We’re going to go back to that world where millions of Americans certainly couldn’t afford [insurance].” | “If you repeal the ACA and put one of those replacement plans into law, we’re going to go backwards,” said Oberlander. “We’re going to go back to that world where millions of Americans certainly couldn’t afford [insurance].” |
| Public programs, such as Medicaid (for the poor) and Medicare (for the disabled and elderly) cover about one-third of Americans. As a congressman, Price’s proposals have consistently looked to rein in the federal government’s spending on these programs. Together they make up 86% of HHS’s budget. | Public programs, such as Medicaid (for the poor) and Medicare (for the disabled and elderly) cover about one-third of Americans. As a congressman, Price’s proposals have consistently looked to rein in the federal government’s spending on these programs. Together they make up 86% of HHS’s budget. |
| For example, one of Price’s 2015 proposals would have transformed Medicaid into a state block grant, similar to what happened to welfare through the Temporary Assistance for Needy Families program in the 1990s. | For example, one of Price’s 2015 proposals would have transformed Medicaid into a state block grant, similar to what happened to welfare through the Temporary Assistance for Needy Families program in the 1990s. |
| How much money states got from welfare reform was determined by what they spent in 1994, according to the Center on Budget and Policy Priorities, a progressive thinktank. But in the case of Medicaid, that model would create winners and losers. | How much money states got from welfare reform was determined by what they spent in 1994, according to the Center on Budget and Policy Priorities, a progressive thinktank. But in the case of Medicaid, that model would create winners and losers. |
| The 19 states that refused to expand Medicaid spend less money, meaning they would get less federal cash in that block grant calculation. But if legislators use pre-Obamacare Medicaid spending to determine block grants, that proposal would anger the 32 states that did expand Medicaid. | The 19 states that refused to expand Medicaid spend less money, meaning they would get less federal cash in that block grant calculation. But if legislators use pre-Obamacare Medicaid spending to determine block grants, that proposal would anger the 32 states that did expand Medicaid. |
| Some regions that heavily supported Trump are especially dependent on these programs, such as in West Virginia, where 68% of voters cast ballots for Trump and nearly half the population receives healthcare through a public program. | Some regions that heavily supported Trump are especially dependent on these programs, such as in West Virginia, where 68% of voters cast ballots for Trump and nearly half the population receives healthcare through a public program. |
| Just 40% of West Virginians are insured through employers, the third-lowest rate in the nation. Meanwhile, 29% of state residents are on Medicaid and 19% Medicare, the most in the country. Medicaid enrollment in West Virginia grew by 62% after Obamacare went into force, covering an additional 230,000 people, according to Kaiser Family Foundation, a non-profit focused on health issues. | Just 40% of West Virginians are insured through employers, the third-lowest rate in the nation. Meanwhile, 29% of state residents are on Medicaid and 19% Medicare, the most in the country. Medicaid enrollment in West Virginia grew by 62% after Obamacare went into force, covering an additional 230,000 people, according to Kaiser Family Foundation, a non-profit focused on health issues. |