Trump Tweets Hint Healthcare Battle Far From Done

When the Republican push to repeal the Affordable Care Act (ACA), aka Obamacare, came to an abrupt halt Friday, Senate Majority Leader Mitch McConnell said “it’s time to move on.” But it appears that President Donald Trump didn’t get the message. Or, perhaps, he doesn’t care.

In a tweet storm that began during the weekend and continued Monday, Trump made several statements implying that the battle over healthcare is far from done. In addition to demanding a return to the table to attempt to kill Obamacare, President Trump appears to have made threats against Congress and their staff, and insurance companies.

For Congress, Trump threatened to take away the health insurance coverage they and their staff are fortunate to have. As FoxNews noted, Congress benefits from part of their Obamacare premium costs to be covered by taxpayers through a government subsidy. If you’ve been following the conversation at Medicare World’s Facebook page, you’d see Trump’s threat is something our users may get behind.

As for the insurance companies, Trump has threated to turn off their cost-sharing reduction payments. Under the current law of the land, the government pays insurers directly to help them reduce out-of-pocket expenses for deductibles and co-pays by customers who have trouble affording health insurance. Should Trump follow through with this threat against insurance carriers, the companies will lose billions and yet still be required to make payments to meet thresholds. The result could be the insurance companies raising premiums on their current plan holders. Will he follow through? One of Trump’s senior advisors, Kellyanne Conway, told “Fox News Sunday” that the President “would decide this week whether to end the cost sharing reduction (CSR) payments.”

Although not a threat, Trump has also urged a reforming of the current voting system in Congress, primarily to drop the number of votes needed to pass legislation down from 60 to 51 (some refer to it as the “nuclear option”). If the GOP-led Senate appears hesitant to do so, it’s because the plan could backfire in 2018 if the Democrats retake the majority.

So will action be taken this week? The House of Representatives has already gone on their summer break and aren’t expected to return until after Labor Day. So it’s up to the Senate. McConnell has already delayed the start of the upcoming August recess until August 11. However, they have other priorities to address, including a defense bill, the debt ceiling, and various measures to ensure government funding continues without a crisis. So only time will tell.

This news breaks shortly after a Reuters/Iposos poll shows that the majority of Americans want Congress to move on from healthcare reform. According to the Pittsburgh Post-Gazette, nearly 66% of Americans want to keep the 2010 health care law, either “entirely as is” or after reforming “problem areas.”

While this can easily be construed as traditional (now almost daily) partisan saber-rattling, it is important for Medicare beneficiaries to remain alert. There is no news, yet, on any healthcare bill aimed to replace Obamacare. Recent history has shown that there will be no repeal of the ACA without a replacement plan that’s approved by the majority of the Senate. Still, it’s good to know what MIGHT change in Medicare if Obamacare is repealed.

How ACA repeal could affect Medicare

If the ACA is repealed, what may a replacement plan mean for Medicare beneficiaries? Two of the more popular items that would be changed are complimentary preventive services and the closing of the “donut hole” in Medicare Part D prescription drug coverage. The first version of the Better Care Reconciliation Act repealed the .8% mark on investment income by those who make more than $200,000 per year, the Medicare Health Insurance Tax (a 0.9% payroll tax on high-income individuals), and a tax on compensation for health insurance executives. But the legislation met high resistance, which led to dropping these repeals in the second version of BCRA. But, that was the replacement bill. So that doesn’t mean those taxes will continue to remain in place.

Other parts of Medicare that would be affected, according to analysis by the Kaiser Family Foundation, are Medicare Part A and Medicare Part B. The analysis notes that out-of-pocket costs could soar for Medicare beneficiaries if the ACA is repealed because the costs are influenced by payments the government makes to healthcare providers. Obamacare legislation reined in the rate at which hospital payments were increasing. If repealed, the government would increase spending which correlates with an increase in out-of-pocket costs for beneficiaries.

If you’re part of a Medicare Advantage (MA) plan, however, repealing the ACA may not be as bad. Obamacare limited the payments to MA plans from the government and added an annual tax on the private insurers involved with MA plans. In theory, if the ACA was repealed, insurers could pass on to patients the savings gained from no longer receiving reduced payments from the government as well as no longer paying the annual tax. But that’s in theory.

Unfortunately, this is just one of many thorns in the side for Medicare beneficiaries. Earlier this month, the House Budget Committee proposed a budget that would slash Medicare spending by $487 billion over the next 10 years. Like the plan to repeal Obamacare, the budget is not set in stone just yet. If you have concerns about the budget or the plan to replace Obamacare, learn how to contact your local representative before he or she takes their summer recess.

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