Today, The Hill published an article that covered five important issues to ponder when reviewing the Graham-Cassidy GOP plan to “repeal and replace” Obamacare, which in essence is Obamacare Lite 2.0.
These five issues have divided Republicans in the past because of the controversial nature of the policies per The Hill.
So far, some senators have refrained from taking a position on this bill because “they have yet to fully digest the bill and how it would work.”
Translation: we haven’t read it but are waiting for our staff to complete their analysis and tell us what is in it.
These are the five issues The Hill uncovered with the proposed bill. Being that The Hill leans left, these issues are a problem for the publication.
“It could lead to insurer rules being waived in some states.”
The Graham-Cassidy GOP plan contains “controversial waivers” that allow some states to “opt out of certain Obamacare regulations,” with the approval of the federal government.
So, some Obamacare regulations could be rendered moot if the federal government approves the States to opt out of the regulation.
This is not a repeal of Obamacare regulations, but allowing States to receive a waiver of participation.
If the federal government is going to allow States to receive a waiver, then why not go ahead and repeal the regulation?
The Hill reported:
For instance, insurers in some states could charge sick people more money and opt out of covering a list of 10 categories of services, such as maternity and mental health care.
In early May, Cassidy said any legislation the Senate passes must meet what he dubbed the “Jimmy Kimmel test” — a reference to an impassioned speech the talk show host gave urging Congress to ensure those with pre-existing conditions had affordable health insurance.
On Monday, Kimmel suggested the legislation failed Cassidy’s own test.
But Cassidy told reporters Friday that he believes the bill protects those with pre-existing conditions because states would have to show they are providing “affordable and adequate” coverage before a waiver could be granted.
Does a single male really need to pay for maternity coverage? Does a couple without children need to pay for pediatric coverage?
This is the problem many have had with insurance companies.
The companies throw together a plan that provides comprehensive coverage then charges a premium based on single or family coverage.
Why are insurance companies not providing a true cafeteria plan of coverage where individuals choose the coverage he or she needs and the premium reflect the chosen coverage?
Simple – the insurance companies would not make as much money otherwise.
The “scam” of insurance coverage is these companies bank on individuals never utilizing all the services covered.
So, the single male paying for pediatric and maternity coverage in the premium actually provides the insurance company with additional funds to invest.
Moreover, when the single male marries, adding a spouse, the insurance coverage doesn’t change; but, the premium increases dramatically because it is now “family” coverage.
If the concern is truly for insurance companies to cover pre-existing conditions, the incentive for the insurance companies has to be attractive enough to warrant the expenditure.
Normally, this would be in premium increases passed along to the healthy groups covered.
Of course, Cassidy himself issued the operative words – “affordable and adequate.”
Who determines what is “affordable” and what is “adequate?”
These are vague terms and subject to interpretation.
In other words, there is plenty of opportunity for the federal government to tell States “no” or “yes” on waivers based on the vague terms of “affordable and adequate.”
More than likely, the federal government will never say “yes” to a State requesting a waiver, meaning these Obamacare regulations remain in place, not repealed.
Moreover, it could be seen as a way to safeguard health care insurance companies.
“It would change Medicaid funding dramatically,” indicates The Hill.
A provision of the Graham-Cassidy bills proposes to eliminate the funding for the Obamacare Medicaid expansion replacing it with a block grant to the States “based on a formula meant to redistribute money from high spending States to low-spending States.”
The Hill continued:
The block grant would be capped per beneficiary, regardless of how much a state spends. The grant would not adjust based on changes in states’ funding needs, and it could be spent for virtually any health-care purpose.
The bill’s sponsors have said the formula is based on fairness. They say states that took the Medicaid expansion like Massachusetts, California and New York shouldn’t get more federal money than states like Texas or Alabama that rejected the expansion.
Sen. Rand Paul (R-Ky.), who said he opposes the plan, said it isn’t about fairness at all.
“This is a game of Republicans sticking it to Democrats,” Paul said. “The formula is taken arbitrarily out of space mostly to take money from four Democratic states and redistribute it to Republican states.”
From someone who worked for about ten years in the State of Georgia’s Medicaid division, I can affirm politics, fraud, abuse and waste riddles the Medicaid program.
And, no individual in charge or the legislature has any inclination to change it.
Moreover, because of the reimbursement rates to providers under Medicaid, many providers of medical services have ceased serving Medicaid beneficiaries.
Many individuals do not know that the majority of funding for State Medicaid programs comes from the federal government.
It is only after a certain period of time, claims for services two years old or greater, that funds to pay those services are taken from State funds.
The idea of block grants to the States to assist with providing health care insurance coverage to individuals, through Medicaid or another program, is not the answer.
And, Sen. Rand Paul (R-KY) is correct when stating it isn’t about fairness.
The proposed plan eliminates the funding for Medicaid expansion under Obamacare, supposedly.
Does anyone actually believe that States who expanded Medicaid would be able to keep that expansion in place without that funding?
Is this block grant to the States based on a per beneficiary amount to cover only individuals who qualify for Medicaid or all State residents for the purpose of attaining health care insurance coverage?
The Medicaid program needs a total rework since “reform” is never a measure to correct problems with any fraud, abuse, waste or politicization.
In fact, it would be better to end the Medicaid program all together.
If States choose to provide some type of medical health care insurance coverage for eligible individuals, it should come through a ballot vote by the people; however, no individual should want any government, local, state or federal, having anything to do with their health care or health care insurance.
“It defunds Planned Parenthood,” according to The Hill.
This is actually a good thing.
Planned Parenthood is a private organization receiving federal funds.
This organization is mainly known for its murder of innocent babies in the womb.
In fact, the murder of innocent unborn babies is its main cash cow.
No federal funds should be provided for any private organization much less one that deals in murder.
The pertinent section of the proposed legislation that covers the supposed defunding of Planned Parenthood is “Section 118: Federal Payment to States.”
This section is reproduced with sections emphasized that will show Planned Parenthood is in no danger of being defunded, unfortunately.
Section 118: Federal Payments to States
- Prohibits federal funds made available to a state through direct spending from being provided to a prohibited entity (as defined), either directly or through a managed care organization, for a one-year period beginning upon enactment of the draft bill.
- The provision specifies that this prohibition would be implemented notwithstanding certain programmatic rules (e.g., the Medicaid freedom of choice of provider requirement that requires enrollees to be able to receive services from any willing Medicaid participating provider, and states cannot exclude providers solely on the basis of the range of services they provide).
- The section defines a “prohibited entity,” as an entity that meets the following criteria at enactment:
(1) it is designated as a not-for-profit by the IRS;
(2) it is described as an essential community provider that is primarily engaged in family planning services, reproductive health, and related medical care;
(3) it is an abortion provider that provides abortion in cases that do not meet the Hyde amendment exception for federal payment; and
(4) it received more than $350 million in Medicaid expenditures (both federal and state) in FY2014.
To qualify, the “prohibited entity” has to meet all the criteria.
If the entity cannot meet one or more of the qualifying criteria, the entity is not considered a “prohibited entity.”
The first criteria is “not-for-profit as designated by the IRS.”
There is a difference between “nonprofit” and “not-for-profit.” This can be explained here, here, here, and here.
The crux is “which is Planned Parenthood since nonprofit is not the same as not-for-profit.?”
Planned Parenthood describes itself as a “nonprofit” 501 (c) (4) organization aka a social welfare association.
That’s one qualifying criteria down.
Since not-for-profit is specifically used, it would not include Planned Parenthood if the IRS has not designated it as “not-for-profit.”
Planned Parenthood is formed under the designation as a social welfare association.
Is Planned Parenthood “described as an essential community provider that is primarily engaged in family planning services, reproductive health, and related medical care?”
And, is that criteria based on the IRS designation or the entities self description?
That’s possibly another criteria down.
How can anyone prove or disprove that Planned Parenthood performs murder of babies in the womb meeting the Hyde Amendment exception for federal payment?
Is that another criteria down?
Has Planned Parenthood received more than $350 million in Medicaid expenditures in 2014?
By being able to skirt just one of these criteria would continue funding of Planned Parenthood.
Let’s cover the Medicaid “freedom of choice” regarding providers.
Under the “Medicaid Freedom of Choice” provider requirements, the State of Georgia ended up paying a non-Medicaid provider for providing services to a Medicaid beneficiary under a “violation of the freedom of choice” of the individual to choose the provider.
Despite the State providing an extensive list of enrolled Medicaid providers from which the individual could choose to receive the same services, the individual did not want to use any of those providers, instead choosing to use one that was not enrolled in Medicaid.
The court upheld the individual’s right to choose providers despite having the choice of multiple enrolled providers available that could provide the service and receive reimbursement.
So, Planned Parenthood essentially could potentially still receive funding based on “freedom of choice.”
If the federal government truly wanted to defund Planned Parenthood, would not a better way to say it be, “no funding will be provided for Planned Parenthood?”
The Hill says, “It does not contain funding to fight the opioid crisis.”
This has been covered previously in the article at Freedom Outpost, “Trump to Declare State of Emergency Due to Opioid Overdose, Addictions, and Death.”
The crux of the issue is addiction is being inaccurately used and applied to tolerance and/or dependence.
It is recommended one read the article in its entirety to understand the problems with government interfering where it has no constitutional authority to interfere.
Ask yourself this, “how has the government’s ‘war on poverty’ worked to decrease poverty?” When you answer this question, on the many different levels, you will understand where this “fight on the opioid crisis” will go as well as predict the many pitfalls of it.
Therefore, the federal government should not fund this red herring, mainly because it is unconstitutional.
“It would set up a huge fiscal cliff,” states The Hill.
When has anything by the federal government not set up a huge fiscal cliff?
Obamacare did it.
All previous versions of the GOP’s “replacement” plans have done it.
Why should this one be any different?
And, when have liberal left progressive socialist/communist/Marxist cared about a fiscal cliff?
All government health care insurance plan scams create a fiscal cliff.
The problem at The Hill is this is a Republican plan for destruction, not a Democrat one.
The bottom line in all of this is the Graham-Cassidy plan is another health care insurance replacement scam intended to fail, just like Obamacare. Its intent is the same as Democrats – usher in government sanctioned, government controlled, government paid socialized medicine designed to place government in the position of determining whose life has value in order to be able to receive health care services.
While many may like to spout that not every has access to health care, it is simply not true. Everyone has access to health care, even when the individual cannot pay for it.
What everyone does not have access to is health care insurance.
The terms are not interchangeable.
Congress needs to be reminded that the constitution does not authorize it to control health care insurance or health care of the citizens.
The sooner Americans can realize the facts instead of the hype, the sooner America can avoid legalized genocide by government under the socialized medicine ruse umbrella.
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