We keep coming back to Andy Slavitt for analysis, both because of his expertise and his ability to post his analysis in straight-forward, clear sentences. (If you’re not following him, you should be.) Here is his evening thread (Thursday night), after further examination of the Senate Trumpcare bill and various conversations he had had throughout the day.
EVENING SUMMARY ON SENATE BILL:
People have been pouring through details. So what comes is based on some convos & mostly done analysis.
In the main, the Senate bill is the House bill, but people pay more & get less. Medicaid as we know it ends.
The 5 points I made this morning still apply. Review here: https://twitter.com/aslavitt/status/877902867457331201 … Here’s what more we’ve learned. (Or see earlier story on ForwardKY.)
- POINT 6: The Senate bill is not fixable or amendable.
- Better health & more access will not come from this bill. Only from its defeat.
- The entire next week will be about amendments 2 make the bill “better.” Better than this? Than the House bill? We need better for America.
- As of now, I’ve read statements from over half of the R Senators. Conservatives like Cruz are aiming to throw out the Bird Rule.
- Senators from many states are in a tough spot. This bill is bad for their states– NV, AK, WV, OH, LA– & many will get amendments.
- POINT 7: Some things that have turned up.
- Age tax doubled down. Income caps added to 5:1 ratio makes it much more expensive if over 50.
- The new waiver process allow states to waive essential benefits for Medicaid & exchanges. And even waive access to Medicaid.
- Protections against pre-ex discrimination end because services would no longer need 2 be offered. Cover the patient, but not the treatment.
- POINT 8: I have read over 50 statements from care providers, patient groups, faith Lars, educators & public health experts. Talked 2 more.
- There is uniform condemnation for a bill that causes so much human misery. I will publish samples of these later.
- The math in this bill drives up premiums as a prominent R staffer says:
Guaranteed issue, 58% AV and no coverage requirement is pretty much the definition of a death spiral. The only takers are users. pic.twitter.com/VFrpjC9I1s
— Rodney Whitlock (@RodneyMLS) June 22, 2017
- And, the math also drives up deductibles.
So – more premiums, higher deductibles, and fewer benefits.
And Medicaid ends as we know it.