Updated: RyanCare Pulled … Is This the Backup Plan?
For those of you worried about the American Health Care Act/RyanCare, let me give you pause for a moment.
First, I agree that the bill is as bad — if not worse than the Affordable Care Act — for many reasons. I also don’t trust the Congress — regardless of which party controls it — to follow through on the other two steps in the supposed “three step process.”
Personally, I would like to see an up or down vote on repeal, with an end date of Sept. 30, 2017, the end of the federal fiscal year, and then, many different proposals voted on individually.
Some of those things include:
- Healthcare Savings Accounts need to expand from the annual federal limits while Flexible Spending Accounts need to have the annual expiration date removed so that the money can roll over into the next year. This is one of the reasons I don’t have an FSA — you lose the money at the end of the year. That’s just stupid. If you already have a decent plan, you don’t need an HSA. But you do if you don’t have one or have a high deductible or high co-insurance plan.
- True preexisting conditions (no, pregnancy is not a preexisting condition but families have to buy family plans to pay for healthcare for children) should not keep people from gaining access to care or insurance. As we have seen with the creation of various plans before and after the ACA, as well as the insurance industry’s penalization of smokers, this is an easy fix on its own.
- The elimination of non-compete state line provisions created to protect the corporate profit model. A no brainer — competition is the only way to reduce prices.
- Coverage of children in family plans while they are college. Another no brainer, easily approved as a separate provision.
- Tort reform proposals (even if I don’t agree with lawsuit regulation personally).
- The creation of national, inexpensive, catastrophic care plans that are portable so that people who choose not to purchase regular insurance but pay cash for basic services have a backup plan if they get cancer or something serious, regardless of employment status. Combined with the HSAs/FSAs, this would lower costs for everyone while also giving people the freedom to live outside of the system if they choose.
The “it’s time to end negotiations and have a vote” talking line by the president and his aides is typical Trump — sometimes, you have to walk away from deals if they aren’t good enough or you give away too much, as he has previously written about and acted upon in his business life.
This makes me wonder if the backup plan is to not to worry about RyanCare passing or failing. Why? Well, there is precedence to “fix” the Affordable Care Act via executive order and memorandum and in the wake of the GOP Congress failure, he can do that. Trump already has – by signing a memorandum on the individual mandate. This might be the backup plan.
He can’t do that, you say? Oh, yes, he can, because the previous president was allowed to make more than 70 changes to the Affordable Care Act after passage, away from Congress, via executive order and memorandum.
I bet this is the backup plan …
Update 1
I don’t know if this is “fake news” or not — “Trump the Dealmaker Projects Bravado, but Behind the Scenes, Faces Rare Self-Doubt” — according to the New York Times … but, yes, Mr. President, you fell for the same trap Pelosi pulled on Obama – going all-in with Congress’ special interest health care mess instead of dealing with the economy first and foremost. The economy is the most important thing; it affects many more people than health care; everything you want to do — and promised to do — is reliant on getting the GDP up, getting people back to work, getting everyone saving again, paying down the debt, etc. As president, you can do more than walk and chew gum at the same time. But the speaker’s RyanCare bill is as bad as the ACA and feels, frankly, like a trap. Your “self doubt,” if true, is spot-on.
Update 2
Speaker Ryan couldn’t muster the votes and has pulled the bill. Trump is hinting he’ll wait to let the ACA collapse and then, bring Democrats into the fold with Republicans to fix the health care system. That will be interesting …
Photo courtesy of Google.