“Nobody knew health care could be so complicated.”
– President Donald Trump, February 27, 2017
Outside the military and veterans, our congressmen and senators and recipients of Medicare, all other Americans fall into one of three classes where health insurance is concerned:
Those who receive employer-sponsored plans, the freelancers who need to buy their own and the poor who cannot afford it.
Under Obamacare, each of these groups saw significant changes.
Depending on whether the changes were predominantly positive or negative depended on factors like political affiliation, profession, socio-economic class and age.
Those under the employer-sponsored plans saw plans that added on things like pediatric dental and vision care, mental-health care and inclusion of children up to age 26.
For the freelancers, the exchanges suddenly allowed the purchasing of affordable plans plus the benefit of getting coverage for pre-exiting conditions.
The biggest boon was felt by the fraction that was too poor to afford insurance yet ineligible for Medicaid. This was done through expansion of Medicaid. The poster child of that is Kentucky.
In 2013, about 13 % of the non-Medicare population had no form of health insurance. By 2015, that fraction had fallen to less than 7%. The estimate is about 300,000 to 500,000 have benefitted from Medicaid expansion in the state.
As with everything, the devil is in the details and in this case, that devil is twofold – money and politics.
Paying for the Medicaid expansion is a bone of contention between the states and the federal government.
Also, there were significant tax increases on those who make more than $250,000 a year to pay for subsidies for those who couldn’t afford to buy insurance on the exchanges.
Then is the fact that companies with 50 or more full-time employees are compelled under the law to insure all employees, a condition that deterred a lot of companies from hiring.
Politically, the desire to annihilate all things Obama is also driving the desire to repeal and replace.
Trumpcare might lead to less tax increases, be less onerous on employers and remove the Medicaid burden BUT will it maintain the same level of insured Americans?
From what is out there, I doubt it but since it is just a framework, the devil will be in play again – in the details.