Friday, 24 March 2017

Trump's new healthcare bill

I don't have much of an opinion on Trump either way - I figure we wait and see how he does, it's a bit early to judge so far. That said, I saw this story on the BBC and the graph at the bottom is very misleading:

The scale on the left jumps from 0 to 10 so a quick glance will appear as if the fall under the ACA was significantly greater than it was. Looking at the numbers, it seems to have fallen from a high of 18% to 10% (a drop of 44%) but looking at the positions on the graph it appears more like a drop of 80%.

The prediction under the new republican plan appears to be heading back to where it was before the ACA, but I do note the little uptick they've added at the end (suggesting it will be worse?).

Anyway, let's have a look at what they're doing (and I've cross checked with PolitiFact - no idea if they're any good, but they come across as relatively unbiased)

Key elements of the new bill:
Cuts the Medicaid programme for low earners
This is one of the key things in America, from what I can gather. The Democrats want more support for the poor and the Republicans want less (or at least don't want to have to pay for it). There are a couple of parts of the new act that this could refer to, but probably the biggest one is that the the rollback of the provision under ACA that allowed states to expand their Medicaid provision to those earning up to 138% of the official poverty level (with the federal government paying 90% of the cost), whereas previously it had been limited to 100%. This option has only been taken up by 31 states, so it seems like another one of those odd cases where you get different levels of federal support depending on which state you live in.
Provides tax credits to help people pay medical bills, but reduced compared to Obamacare
Still higher than before the ACA, from the sounds of it, but I can see why some people are unhappy about it being lower.
Ends penalties on those who do not buy health coverage
Definitely a good move - I'm against forcing anyone to buy anything - although there is a risk that young healthy people won't buy healthcare and that will mean the insurance companies can't afford to provide cover for the less healthy.
Allows insurers to raise premiums for older people
This looks fairly big. I do think it's misleading for the BBC not to mention that this is already the case under the ACA, but the limit is going from 3x to 5x the premiums expected from a younger person. In addition, the new act will reduce the subsidies available (for everyone, but this has a bigger impact on the older people).
Blocks federal payments to women's healthcare provider Planned Parenthood for a year
That's a policy thing. The Republicans don't agree with abortion, so they're banning payments to a group that carry them out.

Looks to me like people will still be better off than they were before the ACA. To be entirely honest, the healthcare system in America is a bit worrying - they should look to somewhere like Singapore for a good example of how it can be done.

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