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Del. Ken Plum: Virginians Will Lose Under New Health Care Proposal

by Del. Ken Plum — March 23, 2017 at 10:15 am 74 Comments

Del. Ken Plum/File photoThis is a commentary from Del. Ken Plum (D-Fairfax), who represents Reston in Virginia’s House of Delegates. It does not reflect the opinion of Reston Now.

Explanation of the recently announced American Health Care Act usually starts with an expressed need to clean up the mess that the Affordable Care Act (ACA) — or Obamacare — had made.

Most all agreed that the massive transformation the program of health care had brought about could use some tweaking and refinement, but clearly a seven-year campaign against the Affordable Care Act left a blurred view of what the program did for consumers. If the ACA had created a mess, the recently proposed replacement of it will certainly create an even messier and unfair situation.

Virginians in particular will suffer a double hit on health care, especially for those most in need. The General Assembly would not approve an expansion of Medicaid that would have brought health care to as many as 400,000 uninsured most in need in the Commonwealth and would have expanded the health care network with the $4 billion that would have flowed into the state. While the new program would eliminate Medicaid expansion in 2020, persons would have been able to get health care in the interim rather than to go without or have to seek help at free clinics or one-time-a-year Remote Area Medical (RAM) clinics. States that have expanded Medicaid would continue to get full coverage for persons already enrolled but would get a lesser amount for new enrollees beginning in 2020. That provision alone would add to the $4 billion loss already incurred in Virginia.

There are 327,000 Virginians who gained coverage under the ACA as it expanded access to affordable health care. The proposed replacement to the ACA would do away with federal health insurance subsidies that helped people afford their monthly premiums and lowered out-of-pocket expenses. Subsidies would be replaced with tax credits. Currently insurers can charge older customers up to three times what they charge younger customers; under the new plan that would increase to five times.

Although some would never acknowledge it, there are features of the despised Obamacare program that were maintained. Insurers would still be banned from denying coverage based on preexisting conditions. Dependents would still be able to stay on parents’ insurance plans through age 26. Caps on annual or lifetime coverage would still be banned.

Clearly fewer people will have access to affordable care under the AHCA. Virtually every developed country in the world with the exception of the USA has decided that access to health care is a basic human right. What is the biggest objection to the program enacted under President Obama? It included targeted taxes on investment income and wages for the very high income individuals and couples. The new AHCA eliminates many of the taxes. The wealthiest 400 households including the billionaires in the new administration would get an average tax cut of $7 million per year while taxes for many low-income working families would increase. Eliminating the two taxes on very high-income households would cost the federal government $275 billion over 10 years.

Most Virginians will lose under the replacement proposed for the ACA. Only the very rich will gain. Maybe that is what the debate is really about!

  • 30yearsinreston

    Even the dogs on the street know that Ryancare has nothing to.do with healthcare
    It’s a cover for tax breaks

  • Guest

    Ryancare, Trumpcare, GOPcare? Whichever, Virginia isn’t even the worst hit state.

    My favorite anecdote so far, when Trump was presented with estimates that the biggest losers would be his own rural base, he quipped, “Oh, I know.”

    http://i.imgur.com/urtMFPO.png

    • Mike M

      So, he should pander to certain constituencies and change his ideals?
      Has it occurred to you that Virginia was a borderline state for Hilary? Has it occurred to you that certain constituencies in states such as Georgia and Alabama and Detroit were anti-Trump because of their DNC-inspired racism and these particular constituencies received all kinds of pay-outs, yet Trump won their state? Has it occurred to you that a large number of people in the so-clalled red states do not get handouts AND don’t want them? Has it occurred to you that we are borrowing to make payouts? Do you recall the Dems saying their was no hand-out on Obamacare? Now you admit it.

      • I’d Rather Post As A Guest

        “DNC inspired racism”? As if “birtherism” was not? Please explain.

        • The Constitutionalist

          Don’t get your issues confused now. I would absolutely love to hear your argument comparing the two and how they’ve both had equal impact on society.

        • Mike M

          Birtherism had to do with where someone was born. We know the man was of mixed race. Different issue. Plenty of white citizens were born in other countries. Place of birth and race are two different things. For example, Arnold Schwarzenegger was born in Austria and so, in accordance with the Constitution he cannot be President. Place of birth matters. But then, you knew that and you are a Libby just playing Libby games.

      • Willie Reston

        TIL that Detroit is a state. Hey, if a Trumpster says it then it must be true, regardless of the universally accepted reality. We’ve been looking at fake maps all these years! Thanks for setting the record straight, Mike.

      • Guest

        None of your rhetorical questions are factual. You’re so upset you’re starting to make spelling errors. But good try, and thank you for the nostalgia-inducing Gish Gallop.

        • The Constitutionalist

          Well….

          We are borrowing money to make our payouts. That much is true.

          • Guest

            We’re selling bonds to pay for our military. That much is true.

          • The Constitutionalist

            And what is, at root, an issuance of bond notes?

          • Guest

            So you agree that the vast majority of our spending is for our military? And that, in fact, any savings from Trumpcare will be more than ruined by Trump’s proposed increase in Defense spending?

          • The Constitutionalist

            Again, you did what you excel at, forcing your own point of view into my mouth.

            Try going back and reading what I said while removing your emotional BS agenda and evaluating it word for word.

            We spent almost 600 billion on our military in 2015. We spent 1.2 trillion on our social services and almost 1 trillion on medicare and health expenses.

            So no, I do not believe that the vast majority of our spending is for our military.

          • Guest

            Oh good! Would you like to corroborate any of Mike’s other claims?

          • The Constitutionalist

            Is it possible for you to have an educated debate with someone based on the substance of their message, or just what you read between the lines?

          • Mike M

            Can you refute? No.

            Former Representative Tom Davis has a presentation that breaks the electoral results in the counties of the key states. It shows plainly that the Democrats do well in largely black areas and major metro areas and not so well elsewhere. It is stark. That is also well-known. It is exactly the result of the DNCs long-running strategy. I am wondering now if they are not so addicted to it that they can even win with anyone but a black male since one of their core constituencies will not vote female, and many not for a white male.

          • Mike M

            Virginia was a borderline state for Hilary. Fact.

            Certain constituencies in states such as Georgia and Alabama and Detroit were anti-Trump because of their DNC-inspired racism and these particular constituencies received all kinds of pay-outs, yet Trump won their state. Facts.

            A large number of people in the so-called red states do not get handouts AND don’t want them. Fact.

            We are borrowing to make payouts. Fact. Scary one. Our largesse is coming from our grandkids future! Hamburger today?

            Dems said there was no hand-out in Obamacare. Now you admit it.

          • Guest

            So sad that you stick to this messaging and need to keep trying to fight election battles in the face of what’s actually happening, now, in our current administration.

          • Mike M

            Sad that I addressed your comment directly?

          • Guest

            And if you actually cared about your kid and grandkids, you’d be fighting tooth and nail to preserve EPA and other regulation-setting agencies. Unless I’ve completely misjudged you, of course, and you’ve responded in kind during this very busy time to the same attacks on efforts to maintain access to clean air, and water, and medicine that is safe to use.

          • Mike M

            “Guest,” I care about my descendants at least as much as you do. You are presumptuous and characteristically demonizing of you to imply otherwise. But I also know that the EPA got way too big for its britches in recent decades and could use a good whack! The return on their investment has been negative in many areas. As for the future, when your country is indebted and broke, no one cares about the environment, and they would not have the means to do anything about it if they wanted to do so. Choose your future.

          • Guest

            Wow, okay, since I mentioned it go ahead and attack EPA. That demonic agency, which deserves a spanking for how much it has improved our air and water.

            Mike, go remind yourself how things were before the Clean Air Act. Imagine, if you will, how what we’re doing now will look after a similar few decades. Then keep righteously frothing at the mouth about how arrogant and expensive it is to regulate improvements. How evil, those expensive “scientific” studies that tell us what should be worked on next. How terrible, those crippling regulations that might have culled your favorite cash cow from the herd.

          • Mike M

            Wrong! Entitlements and interest payments are the long pole in our expenditures.

        • Mike M

          Got substance?

  • Guest

    “People don’t even want health care.” — A Trumpcare Fan

    • The Constitutionalist

      Who are you quoting? I didn’t say that. I’m not a fan of any government forced healthcare.

      In fact, as you should know by now, we’ve been arguing for a long time, I’m against just about anything that anyone forces me to buy.

      • Guest

        You said they choose not to have health insurance, so they must not want it.

        I completely understand, because young and healthy people never need health care.

        • The Constitutionalist

          There’s a difference between choosing and not wanting, and wanting and not being able to afford.

          No one is arguing with you that health care is too expensive. I don’t know why you’re arguing with with me the possibility of people existing who did not WANT healthcare, for whatever reason.

          • Evidently

            Everyone wants healthcare. It’s just they want someone else to pay for it. Voluntary insurance plans provide what is needed.

  • drb

    OK Ken,you are right that the GOP plan is bad and Obama Care is worse. So what?

    You keep harping on getting Fed money that has to borrowed from future generations to pay today’s freebies. Be an honest Liberal for once and say you want to tax the Hell out of Virginians to pay for all your government control of peoples lives. Just put up a bill so all can see what you want done in writing. If your scared to do it say your scared to do it.

    You intellectual dishonesty of what the ACA has done to the people of the whole nation is disgraceful. Forcing people to buy insurance and then not able to access health care unless they choose between eating or paying for the health care is the lowest.
    BTW it is not insurance if you have a preexisting condition. Try and buy auto insurance after you have an accident or life insurance after you die.

    • Guest

      Trumpcare is going to be far worse than Obamacare ever was. It will, in fact, make the majority of affected Americans worse off than they were before Obamacare was signed into law.

      If Trumpcare is signed into law, an estimated 23 million fewer American citizens will have health insurance after ten years. And not by choice.

      And this may be a foreign concept to you, but health care should be for people with pre-existing conditions as well. Since you like car analogies: insurance companies pay for regular oil changes so your crankshaft doesn’t fire a piston out sideways, making taxpayers pay for a whole new engine.

      • drb

        First things first. We have know idea how it will shake out and Ken and you are only making claims based on what the press says it will be.

        To be fair it will be bad if it is just a GOP version (as reported by the press) of Liberal health insurance. But, not as bad as Obama Care is now. It will not be as good as before Obama Care because health insurance is standing on it’s head in the States because of the ACA. So yes it will be really bad if it is as advertised.

        To your other point of less insured. By choice is the answer. Not a forced purchase of something that can’t be used by average people. Which means it costs you and you have no use for it.

        Lastly, you are in dream land if you think auto insurance companies pay for your oil changes.

        • Guest

          The funny part about all of this is that my goofy car analogy still makes more sense than your claim that people knowingly choose to not get insurance instead of can’t afford it, and your implication that the ACA did more damage than good.

          You want intellectual dishonesty? Here’s some great reading.

          • drb

            They knowingly choose to not buy because of a variety of reasons.
            1. They are young and are willing to take the risk and want to spend their money on stuff they want.
            2. It is too expensive. Not realizing they can buy (before ACA) catastrophic insurance that isn’t to expensive and would be available under GOP advertised plan.
            3. Would rather not have insurance for ideological reasons. (go figure)
            I am sure there are more but just don’t want to go through the whole list of possibilities.

            You and your ilk seem to not get why Trump won. If you are really interested I can explain as I had to in the last topic of “…gun running State…” Here is a hint it isn’t what you think. So before you ask try and think it through without your preconceived notions.

          • Guest

            It’s not even a matter of choice. AHCA is going to drive more people back to having two options: aspirin and suck it up, or go to an emergency room and cost taxpayers far more than they would with preventative medicine.

            Here’s a brain-expander: voters of moderate income who voted because Trump promised them better health care suddenly discover they are actually going to lose affordable care. Most of the funding they previously enjoyed will instead be applied to tax breaks for people who take in $500K or more annually.

            But here’s the bigly best thing: in their failure to defeat Obamacare, Republican lawmakers have called everything even slightly socialized flat out Evil for most of a decade. So not only does AHCA in its current proposed form leave his base worse off, he can’t guide creation of a plan that would actually be better without that plan being called evil. And he’s even losing votes for AHCA because it doesn’t screw his base hard enough. Some reps want maternity care removed to get their vote! Seriously, how evil do you have to be?

          • drb

            First, your diagnosis of AHCA is flat out wrong. ( if what is reported by the press is even close to accurate) It will not cost more but be less.

            Second let us not call any of this health care. It is insurance care and free give away to those that have preexisting issues.

            Third, no there was no affordable insurance for anyone unless you are rich. The ACA cost more for all concerned and you could not afford to use it if you got sick.

            Forth the tax breaks for the rich is irrelevant.Who cares what someone else gets? It is what you get that counts. Stop being envious of equal treatment.

            Fifth, socialized anything is evil and is against it by conservatives because market based things work. Trump (but really the GOP establishment) is trying to be better managers of socialism than the Dems. It doesn’t work for them any more than it works for flailing Dems.

      • The Constitutionalist

        Here’s something we can take away from this as fact. Guest doesn’t understand ICE engines.

        • drb

          The E in ICE is redundant.

          • The Constitutionalist

            You’re right, my mistake.

          • Guest
          • The Constitutionalist

            That’s a crankshaft in picture. There is no way that a piston game out of that hole. Part of a connecting rod, maybe, piston, no way.

          • Guest

            Ah, the death of illustrative hyperbole.

          • drb

            I’m trying to figure out why “Guest” doesn’t have a real handle.
            I am also wondering if “Guest” is an old school anti-American and hate America like a Senator Leahy or is in or recently graduated college person that thinks they have all the answers or is just a typical person that thinks it is a great idea that the government should control our lives. All of which fails to understand the Constitution or the consequences of such political ideas when they come to reality.

          • Guest

            I’m trying to figure out why “Guest” doesn’t have a real handle.

            Most likely his “real” disqus handle got banned for offending oh-so-delicate liberal sensibilities.

          • drb

            Sorry for you in that.

          • Guest

            By “reality” do you mean your reality, where Nazis are leftist?

          • drb

            They are. Yes.

          • Guest

            Not in the reality most people share. As we already explored, dictionary and encyclopedia definitions often stand contrary to your beliefs.

          • The Constitutionalist

            The political sphere isn’t just made up of lefts and rights.

          • Guest

            I agree! And moreso, because there’s no single measure for politics or government.

            drb and similar commenters try to break everything into a single scale of left and right, even to the point of classifying anarchists when they roam the entire field (collectivists to libertarians). Another classic is equating left and “liberal”, which I guess means they don’t believe in Keynes, with a strong government to protect the social elite.

            This is why party politics is failing AHCA: without a strong executive to hammer people into line it’s too centrist to various members of the majority. And now that the heist is crumbling nobody wants to be stuck holding the bag.

          • drb

            My reply seems to be flagged. Hopefully they will be released soon.

          • Guest

            It’s okay, we just love keeping the mods busy.

  • Jeannie

    I must comment to say how very delighted I am to learn that there are other Restonians who not only grasp but openly state how great of a failure Obamacare has been for our country.

    • Greg

      Your assessment of it is far too kind! It’s a disaster.

  • RestonResident

    So what happens to people who think that they should not be forced to buy insurance if they they get sick? Do Republicans think that we should let them die when they run out of money? Probably not, so what happens — taxpayers foot the bill. So maybe no one should buy insurance and then taxpayers can pay for everyone. Or is that a single payer system?

    • drb

      What is single payer is the answer for $1000 Alex.
      Why should someone be forced to buy anything? Why are people not held responsible for their personal decisions? You want to take a chance then pay the price. It is that simple.
      Those that are in true need can be helped. But, as in socialized England when and if you get on your feet you pay back.

      • 30yearsinreston

        Because Sherlock, the uninsured go the emergency and we all pay
        Look up.the meaning of society

        • drb

          Do you want to take it one step at a time to the obvious answer because it is “elementary my dear Watson”.

    • The Constitutionalist

      The issue with this whole thing is not so much the government is forcing you to buy insurance. It’s that the government is forcing you to buy insurance from a private company that makes a profit and pays dividends to its shareholders.

      And because we love our car analogies around here, it’s the same as if the government forced us to buy a car, and when we say no, I’d rather bike to work for these reasons, they slam you with a car payment anyway. It’s for the public good.

  • Angry Angler

    Stick to things you can solve at the state level, maybe you could come up with a plan to keep our local schools safe from 18 year old men from other countries enrolling into 9th grade…

    • The Constitutionalist

      Most people here probably wouldn’t have read that story. Didn’t make very many headlines in the liberal media.

  • Bernie Supporter

    Ken, when you run again you have my vote. Not even the GOP wants the health plan that Trump is issuing an ultimatum for them to sign.

    Recent revisions to the Republican health care bill means it would cost more, and still leave 24 million fewer people insured by 2026. That’s not my opinion. That’s the conclusion or the Congressional Budget Office. Why are Republicans so quick to cut off our nose to spite our face. When people aren’t insured they wait longer to seek medical help, and they go to our Emergency Rooms… and we pick up the tab. Somebody needs to get our Elephant a new pair of glasses and see this as the political posturing that it is, rather than a well thought out, workable repeal & replace Obamacare simultaneously that has REAL benefits for everybody.

    • The Constitutionalist

      My fellow socialist, there is NO POSSIBLE WAY to come up with a program where EVERYONE pays LESS and gets MORE INSURANCE and sees a doctor SOONER.

      If there was, we’d do it.

      Take an economics class and throw out your Keynesian textbooks.

      • Bernie Supporter

        I agree with you. No possible way. While I am certain I can benefit from an economic class or two, the people who needed them are those who voted for a certain guy, making broad sweeping promises that are impossible to keep, and later said, “Who knew health care could be so complicated.” (Um… we all did?) And the idea to meet some artificial deadline — the anniversary of Obamacare — was inane, political thinking. One of the finest examples I’ve ever seen of “Fire. Ready. Aim.”

        • The Constitutionalist

          You can’t possibly be suggesting that people who pride themselves as personal free market economists should’ve voted for Hillary.

          I do encourage you to take an economics class, it is good fun and quite fascinating. You’ll generally find two spectrums of economic theory that disagree at almost every turn, but good information nonetheless. Being able to see how things play together factually, without rhetoric, is a nice tool to put in the toolbox.

          However, I think the people who need economics classes most are the people we elect on a daily basis.

          • Bernie Supporter

            LOL. Giving my Avatar, you’re not suggesting that would have supported Hillary economics over Bernie economics. So clearly I do NOT believe in Smith’s “invisible hand” of free markets being all we need to set the ship straight. Nor do I believe in any theories based on Hayek, Menger and others (whose names I can’t remember) that tell me that the free market can solve most of our problems, and the more we reduce government or eliminate government the better off we will all be.

            Nope. I think I stick with my Bernie theory of economics, and my belief that what works best for society is a healthy combination of responsible capitalism, and socialism that straddles the line between “conservative” socialism and “liberal” conservatism. While I’m certain that I can still benefit from an economic class or two, I believe that — more than ever — that is true of everyone, perhaps even yourself. To my mind, one can’t separate the economy from social justice, and basic decency.

          • The Constitutionalist

            I understand where you’re coming from and what your views are and I accept them.

          • Bernie Supporter

            I concede your superior knowledge of the subject based on your degree. In fact, I plead “no contest.” (And even I never believed that Bernie could pay for everything he promised.) 🙂

          • drb

            Ok, I see you guys discussing your preferred economies and justice. My question is how does the Lefty side of this political spectrum square it with the Constitution?

    • Greg

      And it’s all just paid for with pixie dust, isn’t it?

      • The Constitutionalist

        No Greg, that would be stupid.

        We’re instead paying for it with something that also doesn’t exist. The money we are counting on making tomorrow.

        • drb

          The money people not yet born might earn if there is an economy to support them. (if allowed by Democrats to be born)

  • Guest

    This right here is the perfect example of equating left and liberal. In an attempt to step from “authoritarian racists led by a narcissist demagogue” to “left”, the positive elements of leftism (“if we do not hang together we will hang separately”) have been wrapped up with nationalism (“America first!”).

    The autocrats and oligarchs you seek are very visible in Russia. There’s a reason we don’t want them in our house messing with our stuff.

  • Bernie Supporter

    Well, since its probably apparent to people by now that I love to argue, I want another shot of the apple here. 🙂

    For those of you who are against Obamacare for whatever reason you have (like I can respect Constitutionalist, he has a economics degree and truly believes he shouldn’t have to pay for anyone else) …. please explain to me the MORONS who supported Trump because they hated Obamacare and wanted to do away with it … because they felt they already had wonderful insurance under the Affordable Care Act.

    Obamacare isn’t perfect. It was created to be under a one-payer system, and one that could negotiate with other countries to get our pharmaceutical costs under control. (And before anyone says that would be un-American, please know that that’s what the Veterans Admin already does. And I don’t know anyone more American than the men and woman who served.)

    Please also know that Obamacare covered you now no matter how much you hated it — and had other, better insurance on your own — because it did away with pre-existing conditions and caps, and all the other tricks of the insurance trade that collected your premiums but didn’t want to pay out if you ran into SERIOUS medical conditions.

    the GOP could have gotten democratic support if they had tried to FIX what is wrong with Obamacare. Instead they were FORCED to try to repeal and replace it because that’s what they’ve been running on for seven years. Seven years. And they still didn’t have a clue. Or as my new president famously said, “Who knew health insurance could be so complicated?”

    Um… like everybody.

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