Sunday Reads: GOP’s Final Solution 

 

The GOP anti-healthcare bill, is truly the “Final Solution.”

At least it will be for folks like my mom.

If you are very sick…say with stage three ovarian cancer, and on Medicare…when this death bill passes, if you don’t get thrown off Medicare at first, the lifetime caps will get you anyway. Yeah, so as my mom is going through this hell, if she survives her surgery, she still must continue with the chemotherapy. That treatment (which will more than likely reach the lifetime cap) can be cut off by the states in mid-treatment.

Republicans’ Senate Health-Care Bill Would Devastate Those With Preexisting Conditions – The Atlantic

…the Senate bill will open the door to states forcing people with pre-existing conditions into segregated markets that will lead them to pay far, far higher costs than everyone else. People with pre-existing conditions could run into new annual or lifetime limits on how much insurance coverage they can get. That means those with the most serious chronic health conditions (and their families) will be at increased risk of financial devastation and even bankruptcy. The bottom line is that the backdoor discrimination the Senate plan allows against those with pre-existing conditions is as cruel as the discrimination in the House bill which the Senate claimed to fix.

These are exactly the reasons why the American Cancer Society urged concern about waiving these critical protections: “If a state decides that prescription drugs are no longer an essential health benefit, a plan could cap the amount it covers for cancer drugs—or decide to not cover cancer drugs at all—leaving patients to pay the entire bill.” And it is why they urged the Senate to “return to the drawing board” when they saw the bill’s text.

For more on this specific language in the bill: How the MacArthur Amendment Impacts Cancer Patient Protections | American Cancer Society Cancer Action Network

On April 25, 2017, the text of an amendment to the American Health Care Act (AHCA) to be offered by Representative MacArthur (R-NJ) was released.  The amendment could undo several key protections that are critical for cancer patients and survivors – including the prohibition on pre-existing condition exclusions.

The MacArthur Amendment Could Make Pre-Existing Condition Exclusion Prohibition Meaningless for Some Cancer Patients

The amendment would enable states to apply for a waiver that would allow insurers to rate individuals based on their health status in some instances.  States that have established a high-risk pool, use state stability funds (provided in the AHCA) or have adopted a state reinsurance program could allow insurers to impose health status underwriting for individuals who have a gap in coverage of at least 63 days.

While health insurers would be required to sell a plan to an individual with pre-existing condition like cancer, the premium charged could be so high that it would be unaffordable.  Compounding this is the fact that the tax credits offered under the AHCA would be significantly lower than those provided under current law and the AHCA would allow plans to increase premiums for older Americans.

Higher Age Ratios Could Also Price Older Cancer Patients Out of the Market

Current law allows an age rating of 3:1 and the AHCA proposes to expand this to 5:1 – this means older Americans could be charged five times as much as younger Americans in premiums.  The MacArthur amendment would allow a state to specify an even higher age ratio in a waiver.

No Guarantee of Consistent Coverage

Current law requires insurance plans to offer ten categories of essential health benefits – including hospitalizations, physician care, prescription drug coverage, and other services.  Under the MacArthur amendment, beginning on or after January 1, 2020, states could apply for a waiver to create their own state version of essential health benefits.  This could mean that a state could choose not to cover specific kinds of benefits, including certain cancer drugs.  A state could also decide that an insurance plan no longer has to cover preventive services, leaving patients in one state with access, but patients in a different (even neighboring) state without access to prevention.

Another serious problem is the potential loss of key patient protections.  The cap on out-of-pocket costs, and the prohibition on lifetime and annual limits – are applied only to essential health benefits.  That means if a state decides that prescription drugs are no longer an essential health benefit, a plan could cap the amount it covers for cancer drugs – or decide to not cover cancer drugs at all – leaving patients to pay the entire bill.  Finally, depending on the state law, a plan may not have to cover services that a cancer patient may need, which is another way to discourage individuals who need those services from enrolling in the plan.

 

 

 

 

For some real life outlooks on how this death bill will effect real people, take a look at the following thread:

 

 

 

Or…take a look at this:

It is all too upsetting, every day I send letters to my representatives in Congress. I realize many feel this bill will not pass, but I do not see the failure of this monstrosity in so clear a light. Nothing as horrible as this bill seems possible now.

 

But hey…what the hell, at least we have this:

That does it, I am too disgusted to go on…

This is an open thread.


21 Comments on “Sunday Reads: GOP’s Final Solution ”

  1. dakinikat says:

  2. NW Luna says:

  3. NW Luna says:

    And they say Dems don’t talk about economics.

  4. dakinikat says:

    • NW Luna says:

      This can’t get much more obvious than this. Might as well tweet “Vlad is my biggest friend.”

    • quixote says:

      Maybe I need to start wearing my tinfoil hat, but my first thought was Putin is getting Kislyak out before the investigation gets any closer.

      Which, if that’s not just wildeyed, would mean the investigation is close enough to make Putin think a bit.

      (Well, I can dream, can’t I?)

  5. jane says:

    You know what @SenateMajLdr made sure was covered in the hateful Healthcare Bill? Erectile dysfunction. You know what else they made sure was covered? Their own health care expenses, paid for by those low income people who can’t afford to pay for their own health care.

  6. quixote says:

    So they can cut costs by taking away a patient’s cancer therapy in the middle of treatment and killing him or her.

    But they can’t cap the prices Pharma can charge for drugs?

    Interesting.

  7. dakinikat says:

  8. Sara says:

    The impact of mucking around with Medicaid is the financial disaster on families dealing with dementia and Alzheimer’s in addition that is also going to cause state & federal financial crisis in the near future. [See PBS program: Alzheimer’s: Every second counts].

  9. Sweet Sue says:

    I had a tooth extraction on Friday and had to beg the dentist for a ten pill prescription for Hydrocodone-Acetaminophen. They got me through the weekend but this morning, I woke up with considerable pain at the wound and injection sites.
    I called the dentist and asked for one more, ten pill Rx. The assistant checked with the doctor and called me back to say no because pharmacies are cracking down on such scrips and suggested I take Advil. Advil?
    I said, “thanks for nothing, ” and hung up. I’m just grateful I controlled myself and didn’t say “Fuck you.”
    I’ve never felt so condescended to in my life. I’m sixty six years old and know my mouth and what level of pain I can tolerate and what I can’t. What did they think I would do with ten pills-get hooked; become a drug king pin??
    Every response to every problem is ass backward now. So, there’s a fentanyl problem in Ohio? So I can’t get adequate pain relief? Can you imagine how many people are going to suffer because of the big crackdown at CVS?
    Meanwhile, there’s nothing in Trumpcare to address the opioid problem and certainly nothing for rehab and drug development.
    As my sister says people don’t become addicted to pain relief, they become addicted to pain free lives.

    • Enheduanna says:

      Sue – I’m sorry for your pain! I will have to undergo periodontal surgery later this year.

      It should be the doctor’s decision. I’m surprised they didn’t call it in and at least see if the pharmacist interfered.

      I suspect if you were a man they’d have done it.

      • Sweet Sue says:

        Yes, quite possibly. But you know hysterical women can’t be trusted to make their own decisions.
        Good luck with your procedure, Enheduanna.

  10. Sweet Sue says:

    Sweet Sue was not so sweet this morning but the assistant’s relentless cheery, up with people. Christianist attitude gets under my skin. Plus I’m in pain.

    • NW Luna says:

      No wonder! Hard to be sweet when in pain. And … studies have shown that women’s complaints of pain are taken less seriously than men’s. Pisses me off.

      I don’t like your dentist’s excuse. And it was just a damn excuse, IMO. Since when does a prescriber blame it on the pharmacies before even writing a prescription? That’s a cop out. And when your patient needs a med, you fight to get them that med. At least that’s what I do. In a situation with acute pain from yanking a tooth out, there’s a reason why the patient needs pain relief, and it’s going to be short-term. I don’t understand these providers who lack compassion.