TrumpCare focuses on access not insurance. What to watch for

President Donald Trump made some huge promises about healthcare while he was campaigning, and he’s now realized that getting a bill passed in Washington D.C. isn’t so easy. Not to mention the fact that overhauling something that will affect every single person in America isn’t such an easy task either.

Between the two factions, he should also realize that this was the wrong thing to focus on as his first major piece of legislation. That’s if you don’t count the failed immigration ban bill that’s on version 2 already.

The Republicans screamed at how Obamacare was killing America and voted over 60 times to repeal it. It’s always easy to blast something when you don’t have to worry about fixing it, but now the party has found the chickens have come home to roost, and it’s obvious that Paul Ryan‘s slip is beginning to show. He’s running around saying how great it is and all Americans will be given ‘access’ to better insurance.

The funny thing about that word ‘access’ is that it’s a meaningless one. All of us have access to buy a beautiful mega mansion, but it doesn’t mean we can all afford it. Such is the same with TrumpCare. The Republicans (who have chosen not to work so closely with Democrats on this) are promising plenty of access, but when pressed on the fact about how many people will lose their current insurance, they begin a very fast political word dance.

Personally, I am angered that they know this will hurt many Americans who actually like their insurance. The Republicans pushing this bill so hard know what the outcome will be, but they are so worried about just passing this bill, actually passing any bill, that the long-term effects just don’t matter to them.

It makes me wish there was a way for elected officials to be responsible for these actions because many voters forget or don’t realize that they know they are selling them something that isn’t good. My in-laws believe that Donald Trump is the savior to the people and that the new TrumpCare will be better for them. Sadly, they live in North Carolina and fall into the elderly category that will be badly hurt if this bill passes as it is. Such is the case for the 40 percent of people who still find Donald Trump’s actions amusing or exactly what they were hoping for.

These people got the Donald Trump they voted for, and sadly, they just don’t realize how dangerous he has become to them. It will take a long time for them to realize this and then it will be too late. They’ll be the ones to either blame the Democrats, Barack Obama, the news media, the crooked government or just look for that next savior. This is why Trump and his Administration keep denouncing all the things that can call him out on his lies and dangerous actions.

On that note, here are five major things for people to look out for with TrumpCare when the Congressional Budget Office (CBO) comes out. You’ll understand more why they are trying to rush this through before the CBO releases the harsh truth. White House press secretary and a few Republicans have already start discrediting the office which should be a telling sign they know the outcome is not good.

What will the long-term cost be?

Republicans are passing their health reform package through a special budget process called reconciliation. For the bill to qualify, the C.B.O. will need to say that the bill would save the federal budget at least $2 billion over 10 years. That is a relatively small amount in federal budget terms, but most of our panelists thought there was at least a chance the plan would fall short. If it does, Republicans will need to make changes before the bill can proceed.

More broadly, finding some savings in the bill may be important to sell it politically. Republicans have long railed against Obamacare as expensive and unsustainable. But Democrats balanced out the Affordable Care Act’s new spending with new taxes and cuts to Medicare. The Republican plan would spend less on providing health insurance to the poor, but it also eliminates all the Obamacare taxes, reducing the revenue coming into the federal government.

How many people will lose their health insurance?

President Trump has promised that his plan will “cover everybody.” This legislation won’t do that. Forecasts from our experts ranged widely, but all of them thought that the bill would result in more Americans becoming uninsured. House Speaker Paul Ryan has also acknowledged that the Republican bill would cover fewer Americans than Obamacare. But the size of the coverage losses is what matters: Some senators who would be comfortable voting on a bill that causes five million people to lose their insurance might be less comfortable endorsing it if it would lead to losses of 20 million.

An earlier Republican plan, which would have simply repealed Obamacare’s major coverage provisions, was expected to cause 32 million people to lose health insurance by the end of the decade. If the numbers for this bill start looking close to those numbers, some conservatives who prefer the simpler repeal bill may be less enthusiastic about this one.

How much will premiums change?

Premium cost is a major complaint among Republicans, who have argued that Obamacare made insurance too unaffordable to be attractive to many Americans. But several of our experts think the result of the reform bill will be to raise, not lower, insurance premiums. The Republican plan doesn’t change many of the regulations that critics say made Obamacare plans expensive, like its requirements that insurers charge the same prices to healthy and sick people or its rule that every health plan cover a set of minimum benefits.

Many economists believe that the law’s tax credits will not be generous enough to bring as many poor, healthy people into the market as the Obamacare tax credits did. And it does away with the individual mandate, a provision of the law some experts think encourages healthy customers to sign up. The result could be a smaller pool of people who are sicker and more expensive to insure. The plan does make some changes that would tend to lower insurance prices, which is why some of our experts think prices could be a little lower under the new plan.

How many people will lose Medicaid coverage?

The Republican bill makes two major changes to Medicaid, both of which are likely to depress enrollment in the program. That’s why all of our experts estimate substantial reductions in the number of Americans in the program.

Obamacare allowed states to expand Medicaid to cover more poor adults without children. The bill lets that expansion stand but would cut the funding the federal government would give states to provide care to that population. The law also reduces the long-term funding the federal government will give states to cover all Medicaid beneficiaries, even those who were in the program before Obamacare. The C.B.O.’s calculations on the effects may depend more on political predictions than the budget analysis since it will have to estimate how states will respond to these changes.

How will employer-based insurance change?

Far more Americans get their insurance from work than buy it directly, and many people with work-based insurance are happy with what they have. That means that any prediction that the policy will lead people to lose their work-based coverage could be unwelcome news for Republicans.

The Republican bill eliminates an Obamacare provision that fines employers that don’t cover their workers. It also offers more generous tax credits to higher earners, who currently tend to get insurance through work. Employers of middle-class workers who would be reluctant to drop coverage and leave workers empty-handed might feel differently under this system. That mix of policies could lead more employers to drop coverage than they would under the current law.

But our experts aren’t sure about what the C.B.O. will say on employer coverage. Economists have tended to feel that the fine on employers hasn’t had much effect, and predictions that Obamacare would lead employers to drop workers’ coverage turned out to be inaccurate.

When you see these facts, you begin to realize why Donald Trump has suddenly chosen not to add his name to this insurance. This goes against all of his normal actions of taking credit and slapping his name onto every accomplishment (earned or not). He’s not a modest person so the average person should wonder why he’s afraid of sticking his name onto this.

Below if a thorough breakdown of how TrumpCare is all about access without the promise Donald Trump made.

Forget about insurance coverage. The new Republican buzzwords in Washington are health care access.

When Republicans released their long-awaited health care replacement plan, much of their sales pitch featured words like “choices,” ”options” and “access.”

“What matters is that we’re lowering the cost of health care and giving people access to affordable health care plans,” said House Speaker Paul Ryan, R-Wis., when asked whether the GOP plan would cover fewer people.

“Insurance is not really the end goal here,” said Office of Budget and Management director Mick Mulvaney, in an interview with NBC. “We’re choosing instead to look at what we think is more important to ordinary people: can they afford to go to the doctor.”

House Oversight Committee Chairman Jason Chaffetz cast the proposal in even starker terms: “Americans have choices and they’ve got to make a choice and so maybe rather than getting that new iPhone that they just love and they want to go spend hundreds of dollars on that, maybe they should invest it in their own health care,” the Utah Republican said, in an interview with CNN. “They’ve got to make those decisions themselves.”

The GOP rhetoric underscores a striking difference in how the two parties approach the potent politics of health care, long one of the country’s thorniest policy problems.

The Affordable Care Act, the signature domestic achievement of former President Barack Obama, aimed to use government funds to cover as many people as possible with health insurance.

Income-based subsidies helped millions pay for premiums and an infusion of federal funds expanded state Medicaid rolls. Those who went without insurance were subjected to tax penalties – an unpopular provision that quickly became a political liability for Democrats.

But Republicans don’t believe the government should provide billions of dollars in subsidies for people to buy insurance as they seek to scale back the role of government in health care.

Now that they control Congress and the White House, they’ve set a goal of “universal access.” That means everyone would get a chance to buy some form of insurance – but they wouldn’t necessarily get it.

Their plan would provide age-based and income-based tax credits that could be used to buy any state-licensed health plan. There would be no tax penalties for the uninsured, though insurance premiums could increase by 30 percent for those who let their policies lapse.

The credits, which range from $2,000 to $4,000 would not cover as much of the cost of premiums as the current subsidies for many people, particularly older Americans.

The GOP rhetoric makes sense politically, says Robert Blendon, a Harvard University expert on public attitudes about health care.

“They’re offering the idea that you’ll be able to acquire an insurance plan that’s more affordable and more flexible than what you have. But it’s not going to come with a subsidy,” he said. “Otherwise, it would look like they’re just trying to get rid of a plan that covers millions of people.”

Critics say what’s being lost is actual coverage and benefits.

Since the law passed, about 22 million people have gained coverage through Medicaid and by buying private health insurance on government-sponsored markets that offer plans with subsidized premiums. The national uninsured rate is below 9 percent, a historic low.

Republicans are moving forward with their plan without any official estimates from the Congressional Budget office of how many people would gain or lose insurance. They hope to pass the legislation before lawmakers leave for the congressional recess in early April.

But a preliminary analysis released on Tuesday from ratings agency Standard & Poor’s found that about 6 to 10 million people will lose health insurance if the bill passes.